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Choosing A Hair Transplant Physician - Part I

This article is an excerpt from the chapter in Dr. Verret's Book Hair Loss & Hair Restoration on choosing a hair transplant surgeon.

When choosing a physician for hair loss, there are two aspects to consider - diagnosis and treatment. Physicians who treat hair loss will often be able to diagnose hair loss but sometimes may opt to defer treatment for medical causes to more qualified individuals. Often primary care physicians, such as family physicians, internal medicine physicians, or gynecologists, can diagnose straight forward hair loss. Dermatologists are specially trained in diagnosing and treating diseases of the skin including hair loss and referral to a dermatologist may be necessary in more difficult cases. For hair loss treatment by surgical hair restoration procedures, it is important to choose an experienced and trained physician to get the best results possible.

There is a huge market for hair loss treatments which has spawned many hair related businesses which claim to treat hair loss. Surgical treatment too has several large multinational organizations which provide treatment, sometimes at the cost of personalized care and individual results.

There is no set method to choosing a physician. First and foremost, you must be comfortable with the person to whom you are trusting your face. The rest of the suggestions provided should be taken together as a whole to make your decision. No one factor is more important than another in determining a competent hair restoration physician. Taken as a whole, they provide a good starting point to get the best results possible.

Board Certification

Board Certification refers to accreditation a physician receives by completing some form of testing to demonstrate competence in a specific field. In the United States, the standards for board certification are administered by the American Board of Medical Specialties (ABMS), a not-for-profit organization. The ABMS is composed of 24 approved medical specialty boards.

Each board has its own set of criteria to become board certified. Generally these criteria include completion of an MD or DO degree program in the United States or equivalency testing for foreign medical graduates; completion of a board approved training program (often referred to as residency); completion of a written and oral examination; and for some surgical specialties, demonstration of skill competency through a certain period of time in practice or submission of case logs. Each board as well may have specialty areas which provide additional certification through associated boards. Before 2000, board certification was performed once in a physician’s career. As of 2006, board certification must be renewed every 10 years though certain physicians have been grandfathered into the lifetime certificates.

Currently, there is no ABMS member board which certifies hair transplant surgeons. Therefore, consideration is made to a broader category of cosmetic and reconstructive procedure certification. The three boards generally acknowledged to train physicians in cosmetic and reconstructive skin procedures are: The American Board of Dermatology, the American Board of Otolaryngology, and the American Board of Plastic Surgery.
There is no national law which sets forth criteria for what organization can call themselves a board or provide physicians with board certification. Some ‘board certification’ involves simply paying a fee and receiving a certificate, similar to belonging to a medical society. Should you question the qualifications for a board certification, be sure to visit the board’s web site. Reputable national boards will provide the qualifications for certification and identify qualified physicians. At minimum, the certification should include a written examination, verbal examination, and some form of continuing maintenance of certification.

Remember that appropriate board certification ensures that a physician has the minimum competency in his/her field. This does not guarantee results or that a physician has had appropriate training in newer procedures introduced since residency.

Special mention should be made of the American Board of Hair Restoration Surgery (ABHRS). The ABHRS is not a member board of the ABMS but does certify surgeons in hair restoration surgery through experience, written testing, and oral testing. Due to the lack of ABMS membership, lack of oversight by any nationally recognized governing board, and no official medical residency in hair restoration, most states do not recognize ‘board certification’ from the ABHRS and limit advertising this credential. Because of these limitations, many well qualified physicians do not undertake the added expense of credentialing with the American Board of Hair Restoration Surgery.

Training for a Hair Transplant Doctor

Ensure that a hair transplant physician is trained to do what they are doing. If a physician is board certified and the certifying board condones cosmetic and reconstructive procedures, this will ensure a basic training has been undertaken. If a physician is board certified by a board which does not specifically deal with cosmetic and reconstructive concerns, ensure that the physician has gone through additional extensive training in hair restoration surgery. For some this may include additional observation of physicians or extensive training courses. Beware though of physicians who have a certification from a weekend course or some other process to do something which is completely outside of their initial medical training.

Though board certification will ensure the basic training to participate in a particular field of medicine, just completing a residency does not ensure that a physician is trained in the procedures they are performing. Simply asking how many of a procedure a physician has performed also is not completely informative. Adding 2+2 and getting 5 several hundred times does not make it happen. Similarly, just because someone has performed 500 hair transplant procedures, doesn’t mean that they perform them well or can adequately address the desires you have for your procedure. Training and experience must be taken together with all of the other criteria before choosing a physician.

Faculty Appointments

Physicians do not have to be employed by a university to have an appointment to the faculty of the university. Often, private practice hair transplant surgeons will volunteer time to teach at medical schools and residency programs. For their time, they may receive an appointment as a clinical faculty to the medical school. These appointments usually do not have any monetary reimbursement associated with them but reflect the surgeon's commitment to continuing education.

Articles and Presentations

Though the demands of a busy practice can be great, hair transplant doctors will often publish peer reviewed articles in scientific journals and speak at national and international physician society meetings. There is generally no financial reward for these presentations and journal articles. By writing and presenting, a hair transplant surgeon shows commitment to continuing education, illustrates that they have techniques which other physicians are interested in learning, and demonstrates that they have enough patient flow to report results in the medical literature. Peer review indicates that the articles or presentations are reviewed by other physicians in the same field before publishing. In contrast to columns published in mainstream media, a peer reviewed publication requires approval of other physicians before publishing helping to ensure that topical and factual presentations are presented.

Hospital Privileges

Unfortunately all medical procedures have some risks, even hair transplant procedures. Though significant complications with hair restoration procedures are rare, they do occur and hence the need for informed consent. For a physician to practice medicine, hospital privileges are not required. Unfortunately, some complications from hair restoration procedures do require hospitalization and as such, having a hair transplant doctor who can admit you to the hospital can be life saving. If your physician does not have hospital privileges, you may be entrusted to the care of someone who is not familiar with the procedure that you underwent or you may have to be sent to a facility with a higher level of care a distance from your initial physician. Be sure to ask your physician where they have hospital privileges.

To read the remainder of Dr. Verret's suggestions, click here for part two of Choosing A Hair Transplant Surgeon.

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Dr. Verret

Dr. D.J. Verret is board certified by the American Board of Otolaryngology, Head & Neck Surgery, is a member of the prestigious International Society of Hair Restoration Surgeons and the American Academy of Facial Plastic & Reconstructive Surgery, and a clinical assistant professor at the University of Texas Southwestern Medical Center. His hair restoration center focusses on natural and long lasting results for people suffering from hair loss. For hair restoration, hair transplants, Dallas hair loss treatments, eyebrow restoration, eyebrow transplants, treatment for male pattern baldness, and treatment for female pattern baldness, consider Dr. Verret. Common misspellings of Dr. Verret's name include Verrett, Verrette, Varret, Verette, Veret, Varratte, Verette, Verrett, and Ferret. Click here for our disclaimer and terms of use.