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Reflections of Dr. Rassman
When I first entered the field, a local competitor came by and welcomed me into the field. He said: This is a great business and there is plenty of room for newcomers like you. My advice to you is take your market share and don't change too much of what is going around. We don't need controversy as there is already too much of it. Obviously, I never followed this advice. I started off by reducing prices and offering smaller grafts in larger numbers, something different and far more natural that the larger grafts that were being offered by the "old guard." I was a popular doctor amongst my patients because I was not just offering them something different, but better. Every hair transplant patient walking down the street advertised that he had a procedure and everyone looking at him, knew it and felt sorry for him. As my initial results started to come in, I found that the results even exceeded by wildest expectations. That drove me further into smaller and smaller grafts with increasingly larger sessions. I was fortunate that I worked my way up from smaller sessions to larger ones. The incremental improvements allowed the procedure to continually be successful.
As early as 2 years into my practice, I started to bring patients to medical meetings to show doctors that these results were possible. I was not well received at some of the earlier meetings. On two of my patients who had transplants, the disbelieving doctors accused me of bringing normal patients who never had balding to the meeting. With that type of criticism, I was even more motivated to buck the trends and started publishing the results and the techniques. First the 'establishment' attacked my radicalism, others moved me to the forefront of medical meeting which felt like I was being set-up to be attacked and discredited. But my practice grew as my results were undeniable better. I eventually got the upper hand and started a trend that others, like you, added to very significantly.
Unfortunately, what I have learned is that the hair industry had become like any other business. And too many doctors acted like mercenaries rather than medical professionals. Too many doctors employed a sales force, hired staffs for doing the surgery and disassociated from the actual surgery such that the "business" was somehow apart from the people who had the actual procedures. Maybe because the results were not great by modern standards, "sales" was a major part of consultation. But my background was one of being a surgeon, commanding the surgery and being accountable for what I did. That drove me to ask my patients about their satisfaction, their disappointment, and their criticisms. I listened to what I was told, reacted to what I heard, molded my practice and altered the actual surgery to meet the goals of my patients.
I enlisted patients to become my advocates at open houses and seminars and to allow prospective patients to actually see the procedure that they were considering, so that they would have true informed consent. We now have built a practice that is driven by predominantly physician and existing patient referrals.
Once particular event stands out in my mind. It was not a bad experience, but a sad one. A famous hair transplant 'plugger' from New York was moderator at a medical meeting with about 300 doctors in the audience. He asked the following question to the audience: "Can someone in the audience tell me how to get the patients back for the touch-up surgery they need. I am talking about the patients who already have 6-8 surgeries but need just a few more to complete their work. I have tried everything, but somehow I can't get them to come back after 8 surgeries. It does seem like between 6-8 surgeries is the limit." The audience was full of commentary and suggestions. Some people had nurses calling the patients while others had routine call back campaigns. I listened to this dialogue and could not believe my ears. I raised my hand but the chairman refused to recognize me. Constantly ignored, I stood up and took the microphone in the audience and said:
"I believe you've all missed the point." I said. "Your patients are telling you they do not want to be your annuity; they don't want to keep coming back for more and more surgeries. What they are telling you is that they want to see results in less time and for less cost and that is why they don't want to come back." There was a silence as the audience waited to hear the retort from the chair.
"No Doctor Rassman, you missed the point," he responded. "These patients are not as happy as they could be if they had a few more surgeries to fine tune their results."
This is a sad commentary because the doctor forgot what being a doctor was about. He was no better than the used car salesman, specializing in selling lemons and then wanting to profit on their repairs. But "lemon" surgery is an inexcusable tragedy for the patient, one that everyone in our profession should work hard to prevent.
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