A question on ethics

[topccat29]

I had a patient in my home last night. Good guy only 25 and in my opinion not really a suitable candidate for a hair transplant €¦ €¦..too early and maybe not quite ready for the decision. The doctor seemed to entice him with a 50% discount on the robotic procedure but he would need to make a decision quickly as the offer would not last. He then proceeded to hand him a bottle of Xanax to take for a couple of weeks to help ease his decision.

Personally I think this is a bit unethical and my jaw dropped when I heard it. I was wondering what those that work in the industry thought about this type of tactic being used.

For those that are considering a procedure €¦ €¦ €¦if you are having a tremendous amount of anxiety maybe it €™s your brain telling you that you are just not ready. The mind and body sometimes work in ways to protect itself and we are not even aware so maybe just wait it out €¦ €¦ €¦ €¦..continue to research and wait until it passes.

Now that this same patient is not taking that medication he is regretting his decision. From what I viewed I don €™t believe he was harmed to the point of no return but I still question the ethics.


Personally what I have found is that if you can get to the point where you can visualize something in your mind..............there is a better chance that you will have all the necessary information to move forward..............the only drawback is sometimes it makes for a slower process when making those decisions so one does need to have patience.

 

[JoeTillman]

I had a patient in my home last night. Good guy only 25 and in my opinion not really a suitable candidate for a hair transplant €¦ €¦..too early and maybe not quite ready for the decision. The doctor seemed to entice him with a 50% discount on the robotic procedure but he would need to make a decision quickly as the offer would not last. He then proceeded to hand him a bottle of Xanax to take for a couple of weeks to help ease his decision.

I'm having a hard time believing this. It is such an unusual and odd post. The "offer won't last long" but he's got a few weeks to think it over while taking a controlled substance to help him with his decision? I call BS.

This is not questionable ethics, it is illegal and just weird. Benzodiazapines are presciption medications that cannot just be stopped if taken over the course of a few weeks as there are potential dependency and withdrawal issues to contend with. No legitimate doctor would do this, not to mention, doctors don't just keep bottles of Xanax laying around to hand off to patients for the sake of decision making. They have to go to a pharmacy with a script in hand.

One of three things are happening here:
1. You're making this up.
2. The 25 year old is making this up and you believe him.
3. It is true and the doctor should be reported immediately to the Illinois state boards.

You're in Illinois and I doubt someone would fly in to see you in your home for advice which is why I assume the doctor is in Illinois. Considering this doctor is using the ARTAS that means it is one of four doctors in Chicago that have the only ARTAS robots in the state and I HIGHLY doubt that any one of them would offer a 50% discount.

My gut tells me it is option #1 as it's a way to discredit doctors that use ARTAS. That is honestly the only thing that makes sense about this post. You have the motive because you are a vocal critic of ARTAS and there is no reason to mention ARTAS to begin with. ARTAS has nothing to do with the supposed behavior of a doctor allegedly giving a controlled substance to a 25 year old kid to help him decide over the course of a few weeks if he will take a 50% discounted offer that won't last long. You are therefore trying to discredit doctors that use ARTAS through association of this scenario. That is the thing that makes sense.

If it's true, send me an email with the doctor's name. You won't be breaking any confidentiality "rules" in doing so and I'll personally investigate this myself.

 

[janna]

topccat29 wrote:

I was wondering what those that work in the industry thought about this type of tactic being used.

Since you asked.....

I'm inclined to side with Joe - the whole scenario you describe is bit too incredulous to believe. It's not totally unbelievable a 50% discount offer - maybe the doctor is new to this field and is also new to using the Artas so he's hard up for patients. However, the Artas comes with a hefty price tag plus an added cost of per graft surcharge so most clinics are not going to offer such a steep discount if any.

The part about Supplying Xanax to help him in his decision making is the hard part to believe. I can tell you in my 19+ years in working with Shapiro Medical doctors (Dr. Keene, Dr. Rose, Dr. Charles, Dr. Paul Shapiro, Dr. Ron Shapiro, Dr. Josephitis), none have ever prescribed Xanax or similar drugs to any of our patients let alone a "potential" patient that I know of. Writing that type of prescription is not in their realm of specialization. And it's not to say they haven't come across patients with anxiety. What they would do is refer them to a specialist depending on their level of anxiety.

 

[JoeTillman]

"A question of ethics" is a fitting title for this thread.
I just called all four clinics in the state of Illinois that uses ARTAS. One offers Xanax to patients during surgery but they are not, and have not, had a 50% off deal, or any deal for that matter. Ever.


There is one clinic out of the four that has a discount available but they do not have Xanax in their office as a relaxant available for patients during surgery, much less for decision making purposes. The "deal" they have is not for a limited time either. It lasts for the rest of the year. They have two other medications that sound nothing like Xanax so this 25 year old could not have confused one medication for another due to similar sounding names. This doesn't address the additional unlikely situation of a hair transplant doctor prescribing a benzo so a kid can decide to take a limited time offer that isn't so limited that he can't take a few weeks to think it over.


I think this eliminates the probability of #3 as a likely option. Either you are making this up for the reasons I stated or the 25 year old is making it up. If the latter, then it shows how the way you learn about the industry, from others that have had their experiences, isn't such a reliable way of learning much less can it be considered reliable enough to put into a book.

 

[topccat29]

I swear on the life of my family that this is an asolutely true story related to me last night. Actually this patient didn €™t think anything of it but I was absolutely shocked. My exact words to him were that is completely illegal in my mind and I €™m not telling you to sue anyone but that is a lawsuit. I kept saying that is "so wrong" and repeated it several times..................I just couldn't get over what I was hearing.


He is only 25 so not being aware that this is completely unethical I guess is maybe normal.

Sorry Joe I am not going to e-mail you this doctor €™s name and I specifically asked this person if I could mention this incident because I don €™t like to discuss private conversations online. He told me it would be okay and yes he does read the forums and I think after he reads the responses it might very well start to click in for him that it €™s a much bigger deal than he realizes. It's up to him to figure out what he should do if he does anything.


I don €™t make things up and post them to the forums and I take that as a complete insult but I can also understand the reaction. Is it possible that the patient made it up €¦ €¦ €¦ €¦.I guess but very unlikely as we were just having a casual conversation and it wasn €™t really focused on just his procedure. I also remember him saying it once before but didn't pay attention close enough.

 

[topccat29]

Let me also add that the reason I posted is I started to think is it just me or is this not a big deal and judging by the responses it is in fact a big deal. And Joe this patient could very well be from Wisconsin, Iowa, Indiana, etc or maybe he was visiting from out of town to see relatives after our phone conversation €¦ €¦ €¦ €¦ €¦.sorry but I don €™t get into specifics.

I also need to add that this patient is hardly a person anyone would consider vindictive and in fact he a happy just to be past the whole thing having learned a lesson. He is completely mild mannered and very low key. If he pursues legal action that is completely up to him but at this point he does not even realize there is an issue and doesn €™t seem to care much. The best option for him is if he has a change of heart then just consult a lawyer where he can be given proper legal advice.

 

[janna]

Topcat,

That's fine that you totally believe him. It's just that what he says doesn't seem to add up. But it maybe in the way you wrote it out? For instance, you say he's "very mild manner and very low key" yet he was given Xanax to calm his anxiety.

Also, if the young man said you can discuss your conversation, why can't you say the doctor's name?

 

[topccat29]

Janna sorry I wasn €™t clear and I really need to work on that €¦ €¦..just writing too fast. What I meant to say was that he is not an aggressive person. He doesn €™t seem to get angry about anything and usually when someone wants to sue it can sometimes be generated by anger or at least that is my opinion.

What he said was that he was really unsure about the whole ht thing but after taking the medication that feeling of being unsure simply went away. Is it possible he is making it up................sure..............but I'm telling you in my opinion when someone is lying I can pick up on it and it would make absolutely no sense because he didn't think much of it.............

And I know I can be just the opposite. I can be aggressive as a result of my own experiences with hair transplantation and just in general having to deal with aggressive people in the industry in which I worked. Sometimes one cannot simply be mild mannered with aggressive people or people trying to harm you. When I encounter nice people who have good intentions I am equally as kind. My own personal mistake with ht in the past was that although I could easily pick up on aggressive people with bad intentions at an early age I never picked up on those cues from people that were being overly nice to me like some of the ht doctors. I actually thought that they were good people it was just not something I had experience with............... you know nice people with not really good intentions............or let's say they had selfish intentions.

I had one doctor that used the janitor to place my grafts. Another doctor had one of his patients shoot himself in the chest because he was so distraught by what had happened. I never felt those type of feelings but what if I had €¦ €¦ €¦ €¦ €¦.then what €¦ €¦ €¦ €¦ €¦it is something I think about that someone could care so less about me or another human being and what he might do because that person simply wanted to make a buck. These are not made up stories in fact I still have those news articles along with many more. Nothing really needs to be made up for this industry as there is plenty to pick and choose from.


The patient is not really damaged he can walk away from it all which he is actually thankful for but the Xanax thing really did shock me so I just wanted to get some thoughts.

 

[Bigmac]

Why does the patient regret having the procedure. Is the result not good, bad extractions, poor placement, age related and level of hair loss. Maybe he could post some pictures showing the work.
As for a doctor supplying meds to help with a decision, it seems hard to believe but if it is true then the patient should take it further.

 

[topccat29]

BM the kid is 25 and he now realizes the ht was a bad idea for him personally because he is now locked into all of this including taking hair loss medications. The work doesn €™t look bad €¦ €¦ €¦ €¦not perfect and he could have some issues down the line with it all matching up but the work is not something I would consider terrible. He is definitely locked into all of this at this point and at some time in the future he will have another decision to make.

BM this person has also read the thread and it kind of freaked him out €¦ €¦ €¦ €¦..some of the responses. He doesn €™t want to get involved in all of this which I can understand. In fact it all kind of scares him he just wants to move on with his life and is certainly not interested in suing anyone or reporting anyone to medical boards. Once again he is only 25 €¦ €¦ €¦ €¦.. what is important to him is different than what is important to me like how this industry often operates.

I can tell you one thing he now understands this all a little better. I am certainly not anti hair transplant but I don €™t like much of what I see that goes on behind the scenes by those that have no other way to compete.


I try to post thoughts that I think are important for others towards making a decision and nothing more. I also try to be as open as possible about what I €™m doing because it €™s important to me but also because the way this industry operates anyone can say anything about me or anyone else behind closed doors which might actually might not be true. Most in the industry seem to be as much in the dark as the patient as the truth becomes perverted in many ways. I don €™t believe in being your buddy while behind your back I €™m looking to steal something from you €¦ €¦ €¦ €¦not my style. Many don €™t seem to understand this about me. I €™m doing my best to put as much out there about myself as possible and will certainly do more in the future and from what I have seen some of the friendliest guys in this business are the ones that need to be watched the most.

This is not about money for me €¦ €¦ €¦ €¦ €¦.it €™s about principle and there is a big difference. This story I related in this post is absolutely true and if some believe it great if not than that €™s okay too. It €™s only information and it all becomes a choice.

I told this same patient that I would not let this escalate so I will keep my word.

 

[topccat29]

BM I am not trying to disrupt your forum just trying to sometimes give an opposing view as that is just as important when making a decision as the cheerleading. I €™m going to just let this thread go because the kid is now afraid and of course I don €™t want to add more stress to his life.

This is all important to me and most especially with the very young guys that visit these forums because they simply don €™t know as much as they think they do. The older guys of course should know better but that is not always the case either. Just want to give them a balanced view and sometimes that does involve mentioning some of the bad and I didn €™t really think the response would be so strong. Even my own mother-in-law who was 75 at the time was very casually handed Lexapro for a problem she did not have so even though I thought that was also wrong €¦ €¦ €¦..I also thought legally maybe the medical community does not think it €™s a big deal. I posted about that too probably 5-6 years ago.

Just by coincidence I wrote a letter to a 17 year old last night at the request of his mother who is a long time friend going way back to 8[sup]th[/sup] grade. Her son wants to join the Air Force which is not necessarily a bad thing but his mother thinks he has much more potential and I would agree plus being a mother she is very worried. I think any 25 year old here would agree that a 17 year old doesn €™t know much €¦ €¦ €¦ €¦ €¦.sometimes what they fail to realize is that very often neither does a 25 year old.

Here is that letter and it can equally apply to hair transplantation so it €™s worth posting here.
Hi *****,
Hope your workout is going well. I heard you are interested in joining the military which is something I can understand. Have a little independence, travel, college tuition etc.

My advice to you would to be careful and maybe take at least 1 year to think about it. What you want to do is read and research opposing views. You don't necessarily have to believe them but what you want to do is take in all the information and then form your own opinion and this applies to making a decision or establishing a view on any subject or issue. Unfortunately this all takes time.

What I can tell you is that I am very, very well read on marketing along with other subjects but marketing in particular because not being aware of it at a very young age created a tremendous amount of distress for me in my life..............even today I can't easily speak about it.

Military recruiters are in the game of marketing and young men such as yourself are very easy targets for them. They know you better then you know yourself. They know exactly which buttons to push and before you know it you have that gleam in your eye and they know that they got you.
Research first for at least a year....................once you have all the information then you can make an informed decision either way. Take in the opposing views first.

Kind of like the bodybuilding supplements...............the marketers know which buttons to push with young men and the young men eat it up.

BTW I added beet juice to my diet for the extra nitric oxide and I highly recommend it. The nitrates in the juice turn into nitric oxide in the body with the help of saliva.

I would also suggest trying to get a job at a college and go to school for free. I know at least 3 people who have done exactly that and one currently works for North Western University.


Here is an interesting article.

 

[Coopman]

Someone may well correct me on this, but I seem to recall reading somewhere about non recognised/less known HT Clinics (possibly Trichologists) using Artas in the US. I can not totally recall the details but if this rings a bell it is very alarming.

In respect to Artas. If a 1.0mm punch size is still being used by the majority of Clinics, try explaining that to guys whom have had SMP to cover up their FUE scarring from 1.0mm punches. These guys were sporting a buzzed head due to advanced hairloss and a fue HT.

Artas is a viable option, but under no such circumstances should it ever be marketed as an equal to manual FUE. The day will come however when it is superior but that is not now.

TC
Its these guys in their early/mid 20s as you well know are more likely to not undertakes such research. It does not help sometimes when you see a 25yo undergo a 2-2.5 thousand fue procedure to boost his hairline and fill in his temples. You see a bunch of people from a particular forum congratulating the Surgeon who has done the work, yes it is good work. But you can see if his hairloss progresses which is inevitable, he has a big problem.

Whilst nobody can doubt the reputation of reputable Clinics. Can you always make that assertion towards the Patient/sales Reps of a Clinic. Granted 95% are probably good guys, but that 5% could do anything to generate a sale. Some of the bullsh@t I have been told by Reps over the years from non reputable Clinics was quite frankly unbelievable.

We have bad guys in every industry unfortunately.

 

[FutureFue]

TC if you have been told a clinic is doing this, is there anything you are going to do to report it, or could you email Joe so other guys don't fall for the same thing. I think it is a question of ethics that if you have information of wrongdoing that you act on it, otherwise who is to say it won't happen again?

 

[Bigmac]

Tc, maybe this young guy could reach out to Joe as it's something that needs to be looked into, if a doctor is using these tactics the ethical thing to do is make other people aware of it as Future fue suggests.It could save others from making the same mistake.

 

[topccat29]

It €™s not up to me it €™s up to this person and as I stated he does read the forums €¦ €¦ €¦ €¦.it €™s his choice.

 

[topccat29]

My last post on this thread and my advice to this patient is that it is very easy to feel foolish and blame yourself at your age. It's normal I did it when I was 23 and most young guys that are given bad advice do it. Even today I blame myself for my mistake at 23.

I would suggest absolutely not discussing this any further with anyone tied to the HT industry in any way. You mentioned your parents know that you had the procedure. Discuss this with your dad and ask him what he thinks you should do. He is your dad so you know that you can trust him................don't trust anyone else as the industry is just too corrupted. Yes there are some good people doing good things but too many are simply tied to one another in some way and it €™s not necessarily for the patient €™s benefit.

Sorry but that is just the way it is and now you understand.

If someone wants to assume this topic is all make believe than that is your choice. It €™s only information so you have not been harmed.

 

[JoeTillman]

TC,

Ok, now I'm confused. At no point before Bigmac chimed in did you say this kid actually had surgery. You said he didn't look like a candidate and a bottle of Xanax was given to him to help him make a decision about a limited time offer.

Now that this same patient is not taking that medication he is regretting his decision. From what I viewed I don €™t believe he was harmed to the point of no return but I still question the ethics.

The statement above is the closest thing you said that indicated surgery was performed but even if we were to to take this as confirmation that he did it still doesn't make sense. What would Xanax AFTER surgery have to do with him regretting his decision BEFORE surgery, unless he was indeed given Xanax before surgery for the decision making process.




Which is it?


1. The kid has not had surgery and he was given prescription medications to help him make a surgical decision.


2. The kid HAS had surgery and he was given Xanax AFTER so he would relax during the initial recovery period.


There is a huge difference between the two scenarios. If #1 then the doctor would potentially lose his license and face criminal charges if reported. If #2 then it is not nearly such an issue and this has all been a waste of everyone's time, because you could not be clear with your post. Most clinics will give prescription medications for post-op recovery including pain killers and either sleeping meds or muscle relaxers. Xanax is an unusual choice of medication to give but I would not go so far as to call it an "unethical" action. A "bottle" can have just a few tablets in it and doesn't necessarily have to be full. Regardless, it would have nothing to do with the decision making process before surgery if it were given AFTER surgery.


Please clarify this incredible story. The good thing is that regardles of which scenario is true, you are still the center of attention.

 

[JoeTillman]

This is still a weird thread. Why are you telling this 25 year old patient to ignore anyone that has a connection to the industry, publicly no less? Can't you just tell him privately through email or phone? You have his contact information, obviously, else you would not be able to coordinate for him to come into your home, right? Was the public notice to him just for a public display to pretend he exists? Why have you not used a public forum to communicate with him until this final post? Why use the forum to communicate with him at all?
To the 25 year old. If you do exist, and you would like to have some help real help, write to me at admin AT hairtransplantmentor.com. At the very least, please clarify what happened, if you were illegally drugged before surgery to make the decision or if you were simply given medication after surgery to help with the recovery. The time frame of these "events" makes all the difference in the world with regards to the ethics of your doctor.

 

[janna]

Topcat,

It was a surprise to me too that this 25 yr old had surgery from your first initial post.

I get that you are trying to help young patients from going through the same things you did and you aren't trying to be confusing intentionally. You've said several times that you reply too quickly sometimes so that's why I didn't understand what you really meant to say. You've been on the forums for many, many years and know that each post that you write will basically stay forever on the internet. I can't speak for others but I know that I myself get confused & sometimes frustrated trying to decipher what you're trying to say. It may just be your writing style and I'm never going to comprehend it the first time. Perhaps you can take your time with each and every post to write what your mean and mean what your write. Thanks.

 

[Sparky]

Not going to comment on the actual stories true or false being told here, but can confirm that on my first surgery I was having seconds thoughts about and and was given 'something' to calm me down, which made me feel very chilled out, but also made me go through with the awful surgery that came after, this was in 1998.