Whoops B spot! hard to read over forums sometimes .

Sorry my replies to this thread are a little late. Nonetheless I'd like to respond with my opinion........

There have been many fine points addressed in this thread. From my prospective, a hair transplant is a "package deal". Does Dr. Rassman's quality of work qualify him for coalition membership, in my opinion, Yes.

However, my question to Pat and many other loyal posters on this forum is this. What does the Coalition of Surgeons represent? The best of the best............correct? To me, it is NOT merely about the quality of work but the "package" that is offered. Personally, I could not recommend someone go to a surgeon who charges $10 per graft when someone else can provide the SAME service for less than half.

This site's purpose is to aid hair loss sufferers with solutions (surgical and non-surgical) and support, correct? Let me ask any of you this question.............when a poor balding sole frequents this board for the first time how many of you would recommend Dr. Rassman before H&W, Shapiro, Cooley (the list goes on)? A question of ETHICS comes to mind here! Ethically, how can you offer up a surgeon whose quality of work is no better than any other Coalition member but cost more than twice as much?? I definitely could not.

I hope most of you who post here often know me well enough to know that it doesn't get personal with me. I'm sure Dr. Rassman is a very fine, high quality surgeon who does excellent work. However, no way could I ever recommend someone go to him for a hair transplant due to his pricing..........it's as simple as that.

I equate it to the industry in which I serve (Commercial Banking)...............if I were to offer my clients (existing and prospective) pricing that was twice that of my competitors at the very least I would be laughed off........more likely I'd hear some four-letter words and a few carnal verbs!

I care about the site, what it offers to those coming here for advice and support and believe maintaining its integrity to be number 1. I have the highest respect for Pat and the other frequent posters here and have learned much (and continue to) about hair trasplants and alternatives to stopping hair loss.

I really do believe it is in the best interest of this site not to add Dr. Rassman to the Coalition. We all have our opinions............this is mine.

Hairbank,

Well said and I agree.

Falc

I vote no to Dr. Rassman. If the difference between Coalition doctors is the difference between excellent and excellent, as said before by Pat, then there is no justification for Dr. Rassman charging more than twice the going rate. And it is easy to see where including him in the coalition will lead. All of a sudden because he charges the most, he must be the "best". And other Coalition doctors will feel compelled to up their prices so that they also appear the "best". Before you know it, prices are beyond the reach of most of those who rely on this sight to find top quality HT doctors. For better or worse, many people believe that the highest priced physicians are the best. Thats why MHR and Bosley are so expensive (I am guessing), because they hold themselves out as better than everybody else and so are entitled to charge more. Its a question of perception not truth and perception becomes truth. So Pat, its obvious you have already made up your mind but mark my words that other coalition doctors will shortly be dramatically raising their rates also, not necessarily because they are as greedy as Dr. Rassman, but because they will feel it necessary to do so to compete.

Let me also say, if Dr. Rassman is reading this, that although HTs are an elective procedure, you should be happy earning a very good living doing what you do. There is no justification for gouging somebody, charging them. say thirty or forty thousand dollars for a six hour surgical procedure. At that rate you are charging far more than most surgeons get for far more necessary and improtant work that actually saves peoples lives and that is far more stressful then what it is you do. Yes this is a capitalistic society but that doesn't mean anybody should have respect for pure greed, imho.

I would have to agree, I do not feel Rassman should be added to the Coalition. If you ever look at his blog he uses it as an advertisement to gather more clients at his inflated prices. I would say he is a better than average surgeon, but there are much better surgeons on the coalition that charge reasonable prices, some of them are down right cheap in my opinion. If you check his patient portfolio you will notice he rarely does megasessions, but prefers to break it up into smaller procedures. I for one would not go to him for a transplant.

I have been reading with interest the thread about Pat’s visit to my office. It is great to see so much discussion. I found the discussion of my fees was lively, but I think it is understood by most, that fees are a reflection of a ‘supply/demand’ economy. I have patients who fly in from around the world to see me and I have done surgery on heads of state, movie stars, prominent business leaders, royalty, as well as ‘common’ folk like the rest of us.

Value is something I discuss in great detail in my writings and fees are only one element of the value formulae, and that is often missed when everything is simplified to asking “How many dollars per graft am I going to pay?” The meaning of value was extensively covered by me at http://www.baldingblog.com/2006/10/12/how-do-i-know-im-...f-grafts-i-paid-for/ and I would advise those reading this entry in HTN to look carefully at that referenced page.

I don’t think most of you realize that I have trained some of the better hair transplant surgeons around, and they include: Drs. Robert Bernstein, Paul Rose and Ron Shapiro as well as others who may not meet the standards of this network. Many of the doctors I trained participated in training other doctors, so the techniques that I developed have had iteration upon iteration of evolution and enhancements made by each of them. This group has shared information on techniques over the years so whatever advancements were made, benefited all. I am especially excited about Dr. Jae Pak, NHI’s present Associate Medical Director in California, who has worked silently behind the scene with me for 9 years. He was responsible for many of the innovations and the technologies that were developed, patented and published by NHI (e.g. he started the FUE technology with me in 1998 and has helped develop and fine tune many hair transplant instruments since). Some of these instruments will eventually find their way into every hair transplant surgeon’s practice.

I have followed the HTN site and comments by Pat over the years, and although we have had our differences in style, the site appears to play a significant influence in helping people sort through the overwhelming amount of information needed to make informed decisions on the choices for selecting hair transplant services. The site also offers value to those doctors who do not have the marketing expertise or computer skills to be able to drive their message to the buying audience, so Pat services doctors as well as prospective patients. I hope that the association between HTN and the New Hair Institute is long and fruitful.

Hi Dr. Rassman, and welcome.

I am truly glad that you have been included in the Coalition because you have been at the forefront of change and while doing so, trained some of the finest HT surgeons in the world.

I also respect the fact that you can address this issue with an open mind and without negative discourse.

I can certainly understand your supply/demand economic base. Why would you feel the need to adjust your fee structure when patients are flying in all over the world willing to pay you for your services? In addition, it is somewhat of a false dichotomy for anyone to attempt to determine a "man's worth" for anyone other than themselves.

However, I think what you will find, at least here on the Hair Transplant Network,is that many of us feel an obligation or responsibility to "give back" to the community that has fostered so many successful hairtransplant experiences. In doing so, we feel it is neccesary to take a wider perspective and that includes the entire hair transplant experience, start to finish. That includes cost vs results.

In saying this, I would be remiss if everytime a prospective patient asked about you and your results, I did not mention the costs associated with your practice. This does not have to be done in a negative way, but it will arise EVERY time, unfortunately. Please do not be offended or incensed when a veteran poster offers Dr. Shapiro, Dr. Rose, or Hasson and Wong as alternative to yourself or NHI because of cost.

I hope your involvement here will be one of education and unbiased debate, as we need more physician interaction on subjective topics.


Again, I want to say thanks for being a pioneer.

Thanks for becoming a Coalition Doctor, and a special thanks for training with the guy I think is one of the best in the world, Ron Shapiro!!!!!!!!



J

Dr. Rassman, thank you for your input. I have to say, after reading your blog and contemplating "your" description of value, I'm not seeing it. You are insinuating that many doctors break down grafts into sub follicular units and you are somehow giving more value because you are giving a true number of grafts. Well, first of all, only a handful of the coalition surgeons do that, and their prices are very low comparatively. It is not a matter of trying to inflate the graft count. It is a matter of philosophy of technique. In the end, for what you get, your prices are still higher.

Having said that, I do believe that it is a supply and demand economy. If you can get away with charging that much based on having trained others and pioneered certain techniques and instruments, I won't hold it against you. I personally would not use your services because the other coalition members offer the same quality for less (supply and demand works both ways).

I think as long as prospective patients understand that Dr. Rassman is performing state of the art hair transplantation equal to but not better than other coalition members, he should be invited to join the coalition, regardless of his pricing structure.

As I mentioned in my earlier post, my issue with Dr. Rassman being a Coalition member has nothing to do with the quality of work provided.

Dr. Rassman - Thank you for posting. I do understand that you have been a pioneer in the industry on many fronts and, additionally, that you have trained some of the finest surgeons around. This benefits any and all who are experiencing hair loss and choose a surgical alternative to restoration. I did read the referenced link but, to me, it only explained that some surgeons treat grafts in a different fashion with respect to the division of grafts. What it didn't do is help me to understand why I would opt to choose you as my HT surgeon versus someone who will deliver equal results for less than 1/2 the price?

Pat and other forum members - Though Ethics is not mentioned (though it is implied) in the Coalition Membership criteria as a requirement it is mentioned in the opening paragraph I quote here:

"With hair loss treatments often being marketed without regulation or accountability, hair loss sufferers need credible information about legitimate treatments and the ETHICAL physicians who provide them."

Again, I have no question in my mind that Dr. Rassman is a quality surgeon, however, to me, quality includes a fair price for services rendered. If supply/demand is the determining factor in driving up the fees and Dr. Rassman can charge $10 per graft and have an overload of patients, maybe I'm off base here. In my search for an HT surgeon, market competitive pricing showed $4.00 to $4.50 per graft with a discount to $2.00 per graft for anything more than 2000 grafts. Of the prospective HT patients I've interacted with on the board, in my opinion, even those who were able to pay for their procedure in cash would opt for the less expensive surgeon if quality is the same.......I believe this is a reasonable assumption.

Pat........this is your call to make. I wholeheartedly appreciate what you do, and what you continue to do with the information you provide for those experiencing hairloss. So please take my comments in the fashion which they are intended......constructively. ETHICALLY, in no way will I recommend anyone seeking advice here to see Dr. Rassman. Opting to pay a premium for a better product/service is one thing..........paying more than double for that IDENTICAL product/service with the same result is wasteful and foolish. Again, we're here to provide guidence and direction for those suffering from hair loss. What kind of guidence are we providing if one of our recommended surgeons costs more than twice the others but, while excellent, is no better than the other excellent coalition surgeons??

Ethically, I respectfully disagree with the addition of Dr. Rassman to membership in the Coalition of Surgeons. Although, apparently Dr. Rassman is now a member of the Coalition as I saw him listed among the other members upon accessing the link so I suppose this is a moot point.

Bank, Gorpy.........

And I thought I was the one accused of stirring up trouble??

Seriously though, thanks for posting your take on the situation.

Bank, you and I disagree so rarely that I am shocked that I do in this instance!!!!

Anyway, I am inclined to agree with Gorpy, with regards to Dr. Rassmans inclusion into the Coalition. I honestly do not think the fee structure is unethical, per se, if people are willing to pay AND they are satisfied with the results
(Nothing I have heard about Dr. Rassman leads me to believe otherwise)
I can certainly understand that in California things can be inflated, and I think a little of that may have crept in to Dr. Rassmans pricing.

Consider that when we look at Rose, Shapiro, Berstein, we see Dr's focused on what is BEST for each individual patient, and not necessarily what is in vogue at the time. Maybe Dr. Rassman instilled a bit of this during his time with them.

I think we have to ask ourselves a question:
Is the Coalition better or worse with Dr. Rassman?

Regardless of our feelings about fee's, I think it is better.

Just my opinion, as always
J

Dr. Rassman,

This message is primarily directed to Dr. Rassman, however, I invite any and all respected members of the community to read and continue to share their thoughts. I want to make clear that I do NOT intend this maliciously or to pick a fight, though I do make strong statements and ask bold questions. Whether or not Dr. Rassman wants to indulge me is his choice of course...but I stand firm in my opinion on this.

Thank you for contributing your thoughts into the discussion and defending your position. I have high respect for you as a seemingly outstanding and accomplished skilled surgeon and am glad to see you here.

That being said, allow me to give you some constructive criticism...since you have taken it well so far...perhaps you will get the message. I have to stand firm with hairbank and other members who are strongly against your high prices. I want to make clear that the quality of your work, I believe, is all agreed upon by all members...you do world class work.

The bottom line the way I see it is this: Patients today can go to ANY surgeon in the world, many of which can yield the same quality product as you can for half the price. The fact that you trained other top surgeons does put a notch in your belt as one of the founders of modern day hair transplantation and you have obviously helped pioneer things the way they are today. However, I strongly question why you charge MUCH more money when other founding fathers and pioneer doctors with equal skill charge half the price. Other big names like Hasson and Wong charge $4.50 a graft up to 2000 grafts and $2.50 per additional graft. Considering you charge more than double that, my 3701 graft transplant with Dr. Hasson that cost slightly over $13000 would have been over $26000 with you. Most people can hardly afford $13000 let alone $26000. I'm on the fence whether I'd pin this as a matter of ethics...but from your post:

quote:

"I don’t think most of you realize that I have trained some of the better hair transplant surgeons around..."

And

quote:

"I have patients who fly in from around the world to see me and I have done surgery on heads of state, movie stars, prominent business leaders, royalty, as well as ‘common’ folk like the rest of us"

Since your post was designed to defend your pricing, I think it's pretty safe to assume that these comments were related. So one must look at the underlying statements in your words to make a determination of ethics. Your underlying statement from my first quote seems to be "Look at all the outstanding work that I did...therefore I deserve more money". Your second underlying statement seems to be "I can get away with charging more because people still come to see me..." with a twist of "I'm famous because I've had famous people in my chair". There is truth in these underlying beliefs. You HAVE accomplished much and have done oustanding work. And yes, you do have people coming to you apparently, no matter how much you charge. These are true. These underlying beliefs, however, definately make a strong case that your ethics are an issue here. Please note, I'm not trying to pick a fight, but I think further clarification needs to be made why you charge twice as much as other well respected top docs. Do you think you are better than they are? This is not meant to be a malicious question...it's an honest question. Why should a patient choose you and not another coalition doctor?

Furthermore, all of what you said about yourself can also be said about Hasson and Wong, Shaprio, etc. Though I have no proof that movie stars went to any or all of them...but all of the rest can be said.

Follicular Unit Grafts vs Sub Follicular Unit grafts has been a debate on and off on this forum as to what the best method is...but I'm still under the belief that it's 6 in one half, a dozen in the other. I know it's not exactly that simple...but what I look for as a patient is the end result. Dr. Hasson has been said to do some sub follicular grafting, however, out of the results that have been posted by hundred of patients over the years, the majority have been outstanding. I would say the same thing about some other top doctors like Ron Shapiro who supposedly does straight follicular unit grafting with some double unit grafting thrown in there in a few patients. Two different philosophies, but both producing great end results. In other words...the end product in both philosophies can definately yield positive results. The proof is in the pudding!!!

That being said...you are the only doctor (that I know of) that's charging as much as you do. I stand firm with Hairbank that as long as I'm here, I would not recommend people go to you when they can go to other equally efficient doctors and get the same results at a significantly lower price.

Heh...so any chance we've convinced you to lower your prices? I think most likely, when all is said and done, we can all agree to disagree...and I'm sure your business will not suffer either way, whether or not people like me don't recommend you because of your pricing. But to me it does appear morally questionable, especially if you don't disclaim to new naive patients that walk in your door that other doctors charge significantly less AND many of them are equally skilled.

I think it's important to look at this from the perspective of a consumer regarding all types of products. If you were in the market for a car...would you buy the same exact car, assuming they are both new with no defects, etc from the dealer that is charging $18000 or the one that is charging $36000? This probably sounds ridiculous because it would be unheard of to find this type of price difference in a new car. Likewise, it is just as ridiculous for the same quality product of hair transplantation to charge twice as much for it as other top quality doctors in the industry.

Falc

B-spot,

The one problem with the below statement that I see is that it is very possible that some patients coming into his office will not be aware that there are other doctors that are just as high quality that charge half the price. To me, whether purposeful or not, this is a type of deceit...just as bad as other marketing companies marketing minoxodil in other forms and charging 4 times the price (though it's obvious in THAT case, the decieit is purposeful). Unless there is some disclaimer (not just on this website) but in his office, in the paperwork or verbal consults, it can be argued as deceit. I'm not saying that there should be no responsibility on the patient to do proper research...but you know as well as I do that people make emotional decisions and may not take the proper time. I believe doctor's who are supposed to be the ethical professionals should take the time to explain to patients, ALL the facts before they move forward, including that their fees are well above normal.

Regarding inclusion into the coalition, I'm on the fence. If I had a say in the matter, I'd say no, because to me, there is a question about ethics regarding such high pricing...almost like gouging simply because he can get away with it, simply because he still gets patients. Kind of like gas prices! :P (attempt at humor). However, if he is admitted into the coalition, I will not attest to it...I will just simply make sure perspective patients of his on this forum are aware that even though he is a top rate physician, his prices are well overpriced and there are other equally skilled physicians with strong reputations that can do their HT. That way, it's up to the completely INFORMED patient to make their own decision.

I am not anti-Rassman. I'm only Pro-Information!!!!!!!

quote:

Anyway, I am inclined to agree with Gorpy, with regards to Dr. Rassmans inclusion into the Coalition. I honestly do not think the fee structure is unethical, per se, if people are willing to pay AND they are satisfied with the results

Hey Falc!!!!! Man, those are some GREAT posts, my friend..........!

My point during all of this is that anytime someone mentions going to Dr. Rassman, one of us, or other vets will be there to drive home the point of pricing. Dr. Rassman is not going to wake up tomorrow innundated with patients from here, either. For those that think I am attaching an unfair stigma on Dr. Rassmans fee's, DON'T!
I castigated Dr. Konier for charging a FLAT 5.00 per graft, regardless of session size and everytime his name is mentioned, I say what a great Doc he is, but understand that you can go elsewhere to some of the best in the world for a much lower price.
That is the corollary I am using when these two physicians are discussed.

COMPLETELY understand everyone's positions here.
Still think the Coalition is stronger with Dr. Rassmans inclusion.
Know for a fact that one of us will inform others and allow them to make the right decision for them.
After we give a prospective patient the information and they chose to see Dr. Rassman, then that is their right.
We feel the same about the 22 year old who goes to Armani, right?

Keep spreading the hair love boys!

Hey B-Spot!

Thanks for replying my friend. We both seem to agree that price is an issue, however, I think where we disagree (and that's ok ) is whether or not there is an issue of ethics at hand here. I am leaning toward a "yes" in the issue of ethics UNLESS there is some kind of broadcast on this forum AND by Dr. Rassman himself to every patient that he deals with, stating that he charges much more than most equally qualified doctors.

quote:

We feel the same about the 22 year old who goes to Armani, right?

Ah...fine point my friend....but Dr. Armani is not part of the coalition for his lack of ethics now is he?

Oh and...HAPPY THANKSGIVING TO ALL!!!!

Falc

I would agree with you, perhaps as a gesture of good faith, for the added benefit of being included in the coalition and the subsequent increase in prospective clients, perhaps Dr. Rassman could extend the courtesy of a discount to more reasonable levels to those that were led to him through this forum. I would be interested in hearing a response from Dr. Rassman on this.