Interesting points Falc, but let's face it, this is not your average office job. It's artistic, creative work. I understand how you feel, just as others understand how the good doctor feels. Let's just say, it's nice to have choices when choosing a doctor. They are not all clones of each other. They each offer something special and unique.

And besides, how would you ever prove something so subjective? Let's just take it for what it is - another option, another approach.

Gorp

Thanks Folica.

Gorpy,

Agreed...

Options are good...I have no problem with that.

My only concern about it is...could this be creating more trauma to the donor area? Since one side of the donor is already going to be traumatized, could this create more trauma when taking out the other half, especially as the doctor gets closer to the half already taken out? I assume there won't be any overlapping since the one side is already stitched up. How close will the doctor get to the existing scar? Will the scar connect? If not, the patient would lose some grafts.

Anyway...these are just some thoughts and obviously it depends on HOW this is done.

Falc

Good question, but is there really more trauma than taking out the strip in a one day session? After all, the strip is taken out in sections, is it not? When you traumatize the area by taking out one section, do you not go in next to it to cut out the next section? Same thing, just different day.

I think what you are getting at is that somehow there would be more shockloss or healing would be somehow impaired.

I suppose Dr. Keene would know more about that from looking at her own results.

I don't agree with the 2 day surgery but I do like the doctors hands on aproach.

Can I prove it is a superior approach?
Well, Like said in my last post, Gorpys hairline is one of the most natural I have seen.

One might argue that Gorpy's own characteristics are the reason for his natural hairline.

I'm not so sure he would have the same results with a different doctor, I guess we will never know...

My strip was taken in 1 piece.

Like you said Gorpy, All of these doctors have thier own style.

As long as they get excellent results consistently, thats what counts.

If that is done, there is no Right or Wrong guys, just different approaches.

Interesting Folica,
You are right, doctors have different ways of producing excellent results.

I think that "in general" the strip is taken out is smaller sections. So it is very common to take out say a 10cm strip, close it up, then come back and take out another, directly next to it, creating what appears to be one long strip scar.

Everyone,

I guess I don't know exactly where I stand on the topic of the 2 day session and 2 strips.

I agree with the idea of the hands on approach and how that in my opinion it is better for the patient. Also I agree that great results can still be achieved without issue. I guess Falc does provide a good arguement as to why it might not be, but so intangible I guess. Something we could discuss back and forth with no real outcome.

What is tangible however, is the fact that as a patient it potentially means 1 more day off work and one more day in a hotel out of town. That can add up significantly depending on the situation.

Moreover, it is very inefficient for the office itself. It is one less client that they could schedule. This could be significant since fees are per Fu not per day. Example-- if they are open for business 250 days per year and charge $12000 for 3000 fu and they did 2 day sessions with all patients. We are now talking about $1.5 million in revenue versus potentially $3 million. Simplistic example but you get my drift.

Now I understand that this site is about the patient but my business mind races seeing something like that. It would be idiotic not to hire more staff to do the procedures in 1 day wouldn't it?? I know that Feller would be shaking his head.

Has anyone considered the fact that in regards to this particular patient there may be some reasons as to why a 2 day approach was considered? Possibly due to his age maybe he has some heart concerns and the doc thought that it would be better on him? Just a thought.

NN

NN,

You have good points from a business perspective. I checked her website (per Gorpy) and she offers and explains it clearly.

I would think she might abandon the technique if it caused excessive trauma or transection. Maybe she is a bit of a micro-manager and likes to do everything herself. I know the type and they are ussually perfectionists which probably makes her outstanding as a surgeon and not as concerned about maximizing her revenues.

I would have no problem going to her myself - not for a 2-dayer though!

It is much less money. Isn't that interesting? Someone who feels so strongly about something that it takes precedence over money. What's this country coming to?

Dr. Keene has many trained staff. She had 6 or 7 there during my first. They could be used to place the grafts. So instead of doing 3000 in a day, she could be doing some 5000 sessions in a day.

Dr. Limmer, on the other hand, allows the techs to both make the incisions and place the grafts. So I think the ultra-small session size is for a completely different reason.

Gorpy/Nobuzz,

Yes you definitely have to give her credit for putting the potential money on the back burner. She obviously demonstrates where her priorities are. Good for her. She should be commended for it. One heck of a talent also.

I guess however, there is the aspect of the fact that she may not get some individuals as clients if she elects a 2 dayer versus a 1 day. I have to admit that it would be a factor for my decision making process. Kind of sucks that some might want her as their surgeon but can't or won't do the 2 days.

I guess I got off topic as we are talking about Limmer. Yes it is interesting as to why he would choose the 2 days for a smaller session. Must be a reason.

NN

quote:

Yes you definitely have to give her credit for putting the potential money on the back burner.

Not to start a fight, but let us not forget that Dr. Keene wants FULL payment up front 2 weeks before surgery.

That point is neither here nor there, but I don't want people getting the idea that it isn't still just about the money as it is the quality of service. I have to mention that I am NOT stating that the quality of her work suffers as a result...only to point out that may we not get the impression that she is a "saint".

It appears that Dr. Keene and Dr. Limmer may have two different reasons to do a 2 day session.

My opinion remains...it is a waste of time for the patient, regardless of the reasoning. People can agree to disagree with me...that's fine by me .

Falc

Falc,

I agree with you. I personally liked getting it over with in one day for a number of reasons. Less time away from home & less time in the chair are a couple of them.

I guess everybody has to make the decision of what they are willing to accept vs. the end result.

Falc,
I just don't really see the connection there. Of course we all have to get paid. I'm sure your doctor "demands" to get paid also and if you didn't pay a conniption fit would soon follow.

Falc,

I by no means was trying to imply that she is a saint, but maybe she needs the money upfront because there is not as much revenue generated as the others due to her practices. Just a thought.

I just thought it was somewhat refreshing given the many hairmills and others out there that are trying to do as many surgeries as possible.

Personally, I too would rather get everything over with in 1 day as opposed to 2.

NN

I think you guys are taking some things out of context regarding Dr. Keene.
Only her mega sessions are done in two days.
Not all.

I don't think she ask for payment up front because she needs the money.

I am waiting for several checks right now for services I rendered. Now I am ready to adopt Dr. Keenes policy!

Really, I have no alligiance to Dr. Keene but I do feel she is being unfairly portrait here.

Peolple are speaking without knowing the all facts.

I know Dr. Keene is a dedicated surgeon who is always striving for the BEST.

I have not had a HT by Dr. Keene & I don't work for her...

Gorpy,

Unless I'm incorrect on my interpretation of your one post, you brought up price as some sort of defense to prove that her principles take precedence over money.

I do not believe the picture painted here is accurate.

I think a "slap" back to reality was relevant at that time, since she demands payment for services before the patient even walks in the door.

This is NOT typical, and personally I don't like it as I've said previously either in this or another thread (can't remember).

However, I didn't bring this point up to debate whether it's good or bad. One can either either agree or disagree with her policy...there is no right or wrong necessarily here.

I want to make clear that I have NO problem with doctors being paid...in fact, I believe strongly that they should be paid well for their work. There is no question/debate here at all.

But since we got off topic about surgery and price was brought up in a way (even though not intentional) to paint a noble picture of her, a slap back to reality was necessary IMO.

Falc

I understand your point of view Falc. I just don't think a policy of requiring payment 2 weeks prior has much relevance to the other point that NN made. You seem to think it's a big deal, but as Ailene pointed out, it is a standard and an accepted practice and has very little to do with the fact that the doctor could be making much more money by lowering her own personal standard. See what I mean? You don't make more or less money by getting paid two weeks before or two weeks after. So the comparison is invalid.

You pay for services rendered.

The doctor or clinic holds a deposit in order to secure the date.

Until services are rendered, payment should not be rendered.

This is my opinion.

Would you pay a contractor for work before it is completed? No.

Would you give them a deposit of 1/3 or 1/2 before in order to "secure" the contract?

Yes.

Now, I really do not care what Dr. Keene does as far as payment or pre-payment goes.
It is irrelevant to the results.

I would never pay in full for services before I received said services.

I am simply voicing my opinion toward this practice that I personally do not care for.


I also believe that 2 day surgeries are an excuse NOT to pay staff over-time or have the Dr. work late.

In fact, other than extenuating circumstances brought forward by NN, I think it is a terrible practice.

This is especially true for sessions under 5000 grafts, which can be completed in 10-14 hours, vs 18 total hours in the chair over 2 days.

However, in all fairness, spreading massive sessions out over 2 days would seem to be acceptable--- I remember LondonLads session being 18hours, so a case can be made to break up 5000+ sessions over 2 days if the doc and staff are unprepared for such a day. I think your trading a bit of time/discomfort for a more methodical approach.

Let me be frank, I am not a fan of the 2 day session, simply from an increased risk of an infection and an overall comfort/approach standpoint.

I think both of these issues fall back to the informed patient to decide.

Hopefully all of us who have weighed in can help potential patients decide what is best for them.

Take Care,
J

We all have our opinions don't we. I would never go to a doctor who has paid consultants that meet with you instead of the doctor him/herself. That's just an excuse so that the doctor can be doing more patients and bringing in more money. Kind of like an assembly line...

or to a doctor that left the room and let the techs place all the grafts. Not acceptable to me. But that's just my opinion.

Two day sessions aside for a moment, how many surgeries can one fit into the couple of hours in the afternoon that are necessary for consultations? I'm half kidding since I don't think anyone actually believes this. My main question is; why is "paid" always inserted in front of "consultant"? I don't get it. Is that supposed to be a bad thing? Is there anyone where the term "volunteer consultant" or "indentured servitude consultant" applies? I love what I do, but I don't work ten hour days for free, for NO body.

Anyway, carry on.