What you need to know

Hair Transplant
21

“Serious side effects will not occur if you sit on your butt all day working under 25 power magnification, making every incision yourself and being accountable for each and every follicle yourself.”

I wasn’t aware that sitting on one’s butt and working hard on a patient could prevent keloids or LPP. Fascinating. Every dermatologist I know would be eager to learn more.

From your website…

woodstechnique.com.au/hair-transplantation/

“No Legal Disclaimer Required To our knowledge we are the only Hair Transplantation Clinic in the world where legal disclaimers and waivers are not required. This is your guarantee of our ethical approach, confidence in our procedure and commitment that we are providing the safest and most perfect Hair Transplantation method possible.”

By this logic, does it mean that the clinic I visited in Turkey is also providing the safest and most perfect hair transplant method possible? They also had zero legal disclaimers and didn’t even really care if I had identification. They also didn’t want to show me how they perform the procedure and they didn’t really want to talk about it much either. I don’t recall if they guaranteed that the procedure was perfect but since not needing legal disclaimers is in fact (according to you) a guarantee of perfection I’m sure I would have been fine.

You can see what I mean in the video I made where I went undercover to a Turkish mill clinic last year. The link will have to be copied and pasted.

I think “WHAT PEOPLE NEED TO KNOW” is whether or not you discuss possible complications arising from surgery and what size punches you use. They are two simple questions that should have simple answers. For instance, you could say “yes” or you could say “no” and then you could say “.9mm to 1.2mm”. I know the punch size for most every other recognizable clinic out there as it is information they freely share. Patients make decisions regarding their surgical prospects based on this kind of information. Do you think patients should not be informed of possible complications and punch sizes?

22

+1 to Joe if what you said is true about different regulations in N.America vs Australia allowing Dr. Woods an unfair advantage to self promote.

23

Follicle size and shape matters…and it is determined during surgery.

Australian regulations are stricter than what they get away with in LA, Florida or New York

I am paid to protect the patient…you are paid by doctors and industry

Big disconnect

In order to protect the patient, I place myself at physical and financial risk each and every time

What do you risk joe? Your pay masters bounce the cheque.

You gotta ramp up the anti woods thing cause I’m saying too much.

Keep at it son, you will attract more clinics crawling out needing your special talents to talk em up
And of course get rid of dissenting voices

Dr Woods

24

“I have since moved on from Hasson & Wong and am currently an independent patient advocate.”

Hair transplant mentor & industry insider - YES; Independent patient advocate - NO

25

Dr. Woods,

This is not an “anti-woods” issue. You’re making a claim and I think your claim is misguided so I’m asking you to substantiate your claims. If anything, call it part of the scientific process. No one across the pond is trying to figure out how to beat you down because, unfortunately, you are no longer relevant in the field. In fact, you are literally being written out of hair transplant history. Dr. Sam Lam, in his most recent book, Hair Transplantation 360, does not even mention you in the history of FUE. I saw recently where Dr. Rassman stated on Realself that he invented FUE. It’s madness, really, and I’ve been actively reminding people of your place in history and made sure you had a proper place in my own write up about the history of FUE. We all have you to thank but that is not what this is about so please stop the pity party and playing the victim. It is beneath you.

If you do not have the patient sign informed consent forms how do you ensure that they are informed of possible complications that can arise from any surgery?

Before you perform surgery on your patients do you inform them of possible side effects or complications that can arise from surgery? These complications can include pit scarring, ridging, cobble stoning or discoloration of the tissue.

Do you inform your patients that there is a chance the grafts will not grow?

Do you inform your patients before surgery that in rare instances patients can develop keloid scarring or LPP as a result of surgery?

Do you inform your patients by telling them that in rare instances patients can have a reaction to adrenaline that may lead to cardiac complications?

I’m not trying to dig up a dirt file (or whatever it was that you said). I’m asking you questions based on the point of this thread, that you started, and have been preaching about for two decades.

"No Legal Disclaimer Required To our knowledge we are the only Hair Transplantation Clinic in the world where legal disclaimers and waivers are not required. This is your guarantee of our ethical approach, confidence in our procedure and commitment that we are providing the safest and most perfect Hair Transplantation method possible."

Hair Transplantation, Hair Transplant Surgery

You said you do not have legal forms to sign and you said this guarantees a perfect procedure (from your website). On this forum, “WHAT YOU NEED TO KNOW” is the theme so do you tell your patients everything they need to know before they commit to having surgery? Do they have all the facts before they allow you to break their skin? You have talked about what other clinics do for years. What is it exactly that you do?

What size punches do you use for your surgery? Because hair follicle size will vary what is the smallest punch you use and what is the largest punch you use? I can ask this question of any other clinic in the world and they will tell me. What size punches do YOU use?

26

My doctor used different sized punches on me with my repair.

.8mm punch for a single beard graft and .9mm for a double beard graft
makes sense really, although most automated devices are unable to do this,
one hat fits all approach.

I would like to talk about the disclaimers, general releases that are used afterwards when a procedure has gone wrong and a client is left with nowere to go other than request a refund, this is much more interesting to me

27

Fortunately I was mistaken regarding the history of FUE in Dr. Lam’s book. You are in fact mentioned but it was hardly befitting, really. You are somewhat of a footnote which is unfortunate.

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The overall issue of requiring informed consent is difficult to confirm online. I could swear I located a reference to minor procedures not needing such consent in NSW Australia but I can no longer find it. I’ll add this to my questions.

What is the legal requirement regarding informed consent in NSW?

What size punch do you use for your FUE procedure? To adapt to the follicles you are working with, what is the range of punch sizes you have at your disposal and regularly use?

Do you inform your patients of possible complications or risks from having FUE surgery? This can include various forms of scarring such as pitting/ridging/cobble stoning, etc. There can also be post-operative issues that develop as a result of surgery such as keloid formation as well as LPP.

Do you mention potential cardiac complications as a result from adrenaline injections? Do you point out potential side effects from local anesthesia? These can include dizziness, headaches, blurred vision, twitching muscles and even continued numbness or “pins and needles”.

28

When referring to the United States, from Clinical Review of Surgery

informed-consent.jpg1225×347 80 KB

"The legal requirement is not the same from state to state but it is the generally accepted rule as laid out in the above image. The legal standards are further met by obtaining this consent with a discussion of the pertinent information, establishing WRITTEN CONSENT stating the patient's agreement to the procedure offered, and again this consent in a manner free from coercion."

From HealthCareFindLaw.com

"When medical care or treatment is provided, medical practitioners are required in many situations to obtain a patient’s “informed consent.” But what does this term mean? What can happen if proper informed consent is not given?

A Definition

Although the specific definition of informed consent may vary from state to state, it basically means that a physician (or other medical provider) must tell a patient all of the potential benefits, risks, and alternatives involved in any surgical procedure, medical procedure, or other course of treatment, and must obtain the patient’s written consent to proceed. The concept is based on the principle that a physician has a duty to disclose information to the patient so he or she can make a reasonable decision regarding treatment."

This should settle the issue of acknowledged informed consent and the law in the United States.

29

From my most recent research it appears that written informed consent has not been a requirement, at least on the federal level, in Australia. In NSW, the state where Dr. Woods is established, it is also not a requirement.

April 20, 2011 NSW Policy Directive PDF File

“Consent
Patients must give consent before receiving treatment.
In most cases this will be verbal consent. It is NSW Health
policy that written consent is given for some procedures,
such as surgery.”

Also interesting. I believe this would be language that would allow FUE to be considered a minor procedure…

NSW Policies PDF File

“Signed consent forms are not required for minor procedures performed under local anesthesia, eg insertion of IV cannulae, urethral catheterisation, or suture of minor lacerations. However, the criteria for obtaining a valid consent must still be met, the procedure must still be explained to the patient and it is advisable for a written note to be made in the patient’s medical records to this effect.”

We have a situation where Dr. Woods has been extolling his virtuous decision to not require “legal forms” aka “informed consent forms” while in North America this has not even been an option. I suspect it is the same situation in the EU but I’d rather not spend more time researching this today.

Further, in the US (and Canada) just because one has signed an informed consent form does not mean that they are out of luck if the procedure does not turn out as expected. I found several references to “written consent” not being enough to protect a doctor. Keep that in mind, guys.

Regardless, it appears that as of October 1, 2016, Dr. Woods will have no choice but to obtain informed consent for even minor surgery as new laws go into effect thereby rendering his unfair ( not to mention undisclosed) so called advantage null and void.

“Patients will benefit particularly from the improved informed consent provisions. Cosmetic medicine and surgery are almost always self-referred, and there is a greater need for the stronger informed consent guidelines announced today by the Medical Board of Australia,” said Dr. Ron Bezic, college president."

While signed informed consent is not required in NSW it is strongly encouraged and is considered part of the basic medical ethic.

30

Joe
Do you really want to go down this road? The doctors you represent
are the most legally protected that I have come across in 25 years

Do you want me to disclose more about the releases they use to silence
clients ? Its all here at a cut and a paste

31

Go for it ejj

And rassman took credit for work legitamitely done by Dr Bob Limmer

I have one question…where the hell is our reality tv show …NBC, CNN, ABC…anyone ?..

This affects 50 % of the population and needs air…joe and I can play good cop bad cop in turns

Move over kardasians…new show in town

Dr Woods

32

EJJ,

How well one is protected or not is irrelevant. Dr. Woods claimed that every other clinic has pre-surgical gag orders. I refuted it. He then admitted that this is not the case. He’s been saying this however for at least eight years and people have been believing it.

He then said pre-surgical consent forms are in essence acting as gag orders. This is incorrect. Now his own state will require informed consent in a matter of a few months and at that time the Turkish clinics can say THEY are the only ones that don’t require consent forms.

Don’t confuse “affiliated” with “represent”. I represent no one. I work for no one. Therefore, I’m not concerned with what you copy and paste because it doesn’t affect me one way or the other. You are obviously chomping at the bit to post something since this is the second taunt you’ve thrown so have at it. The question is, if your copy/paste is so damning why haven’t you posted it before now?

33

“No Legal Disclaimer Required To our knowledge we are the only Hair Transplantation Clinic in the world where legal disclaimers and waivers are not required. This is your guarantee of our ethical approach, confidence in our procedure and commitment that we are providing the safest and most perfect Hair Transplantation method possible.”

Hair Transplantation, Hair Transplant Surgery

How does not being required to collect legal disclaimers by your medical authorities correlate to having the most perfect hair transplant possible?

What is the range of punch sized you use to score follicular units for your patients?

Do you discuss possible complications of FUE surgery with each patient before you begin surgery?

34

Yeah joe…for someone not representing someone you sure as hell seem to be representing someone

Ejj, send it to me. I will take the heat

Now, there must be at least, I dunno, 5 people watching this thread, so in the tradition of the Donald, let’s make an apprentice type thing

Contestants, your job is to get a meeting with the head of all syndicated reality tv shows

Gerry zuckerfistinbutenberger…his friends call him ger…but don’t do that

It may be a stretch and there may be pain…but if you fail…YOUR FIRED…I’m not sure from what, haven’t thought that through

but , if you succeed, you get to be assistant assistant director with all the ham sandwiches and vodka you need to get through the day…I know, it sounds too good to be true

Ok guys, your time starts …NOW

Dr Woods

35

[quote][postedby]Originally Posted by JoeTillman[/postedby]

Don’t confuse “affiliated” with “represent”. I represent no one. I work for no one. [/quote]

http://aphadvocates.org/resources/articles/berthoudjuly5.pdf

“Unlike professionals who are termed as patient advocates on staff at a hospital or insurance company, an independent and
private patient advocate is not affiliated with or paid by a potential conflict of interest organization. A private patient advocate is typically paid directly by the individual or the family to help find and decide on the best options to prevent a crisis and/or manage a care situation with their client’s interest as the priority.”

You can say you’re selective with your affiliate partners but saying you represent no one is just bullpoo - they pay you :wink:

Remove the words “independent patient advocate” from your website or alternatively take your fee directly from the patient and you’re golden; I don’t why you can’t take any constructive criticism.

36

There is no getting through to jotronic…waste of time,

There may not be a specific gag order, but if you talk, they sue…so, you don’t talk, hence…gag

Jotronic refuses to accept the blatant legal reality which has shielded the worst butchers for decades like a protected species

Keep it up jotronic and I am writing you out of the reality tv show and replacing you with a hot chick…I will call her jilltronic…and no, don’t ask how I thought of the name

And regarding the tv show…how is it coming along ??

Do I need to call the Donald to get things happening ???

Dr Woods

37

OiSD,

Independent does not mean unbiased. The link you referenced talks about “private” advocates. I’ll never take money from patients for what I do. I’m not pushing hair-growth schemes. I’m independent in that I am not beholden to any single doctor and if I disagree with any of the doctors that want to be a part of what I do (it’s happened a few times already) the ability to provide for my family is not put in jeopardy if/when I decide to walk (and I have walked). I don’t have to deal with childish temper tantrums, over bearing egos or any of the other things that go on when one is strapped to a desk at one clinic. I get to choose whom I want to work with based on a set of parameters that allow me to sleep at night.

Dr. Woods,

“There is no getting through to jotronic…waste of time”

You can get through to me by speaking to me like an adult. All I’m doing is pointing out some facts and asking you some point blank questions of which the answers should be quite easy to provide. Everything up to now has been evasion and distraction, which are things which you accuse clinics of doing with their videos and photos. Was Dr Pethebridge right? Ironic.

Here is why doctors cannot sue patients for speaking about their procedures.

  1. It is a patient’s right to say they had a surgery with their doctor, no different than is their right to say they went shopping at Macy’s. It is also a patient’s right to state their degree of satisfaction, or lack thereof, about their treatment or their final outcome. If someone signs a piece of paper acknowledging they have been informed that one of several problems may occur before they have surgery, stating online that such a problem did in fact occur does not warrant or justify legal action by a doctor. The patient is simply stating as fact that they had a procedure and they are not happy about the outcome that they were told may happen. Without embellishing the issue, a patient has no legal boundaries when discussing their own personal experience. It is the embellishments and assumptions stated as fact that can get people into trouble. It is also stating something as being their opinion when it is an opinion about something which they have no reasonable expectations of knowing enough about to form an opinion. One example would be if a patient said “It is my opinion that my doctor did not use hypothermosol as a holding solution.” There is no way for the patient to know one way or the other unless they have factual proof. This does not qualify as an opinion.

  2. You may be referring to bullying litigation as a way to intimidate a patient. There is this idea that suits can be filed by the rich and powerful doctor just to keep the poor patient tied up with paperwork and legal bills even when they know they don’t really have a case. This can’t happen in North America, and I think in the EU as well, due to anti-SLAPP legislation. A “SLAPP” suit (strategic lawsuit against public participation) is a suit designed for intimidation and for silence. In most jurisdictions if one feels they are being unnecessarily targeted by a SLAPP suit they need not worry about long drawn out and expensive court battles. Anti-SLAPP motions usually bypass the normal court system and go straight to a judge that looks at all the evidence and makes a decision. If the evidence shows that the suit is frivolous and intended to intimidate only, the judge will not only throw out the suit they will also award attorney fees and potential damages to the patient that the doctor will have to pay. I have experience with SLAPP issues and while the details I’ve presented here may not be exact (depending on jurisdiction) it is, in general, factually accurate.

A doctor can sue a patient if that patient speaks about the procedure in a manner that knowingly uses false information or states assumed information as being factual when it is not. This is defamation and it would be a valid basis for a suit if the patient went online and said, “My doctor screwed up and I’m unhappy with my results. He is not board certified and his diploma is a fake.” It would be up to the doctor to present proof that he is board certified and he does have a real diploma and then he would be free to sue his patient for defamation.

In summary, a doctor CANNOT sue his patient for going online and saying he’s unhappy just because the patient signed a required informed consent form before surgery. CAN’T. HAPPEN. PERIOD. No way, no how.

I just got off the phone with the Australian Health Practitioner Regulation Agency. Nice people. I was asking them about informed consent and they did confirm that it is an absolute across the board in your country. You must obtain informed consent from your patients. This would require you to inform them of the possible complications that can arise from your surgery such as the various forms of scarring that can occur. These include pitting, cobble stoning and ridging. Patients can also experience poor to no growth. Having surgery of any kind can result in the formation of keloid scarring not to mention the activation of previously undiagnosed lichen planopilaris. Anesthesia used for pain reduction can lead to “pins and needles” sensations and even long term numbness. The use of adrenaline injections can have cardiac related side effects.

These are not side effects unique to YOUR surgery. These are side effects that can occur with any FUE surgery. Are you informing your patients about this?

What size punch(es) are you using? Any other clinic in the world would be happy to disclose this but you don’t. Why do you knot disclose this? I know that in August of 2007 you made a modification to the “mechanized portion” of your FUE procedure (that’s what the report says). Do you still employ a mechanized device for your FUE procedure or have you switched back to full manual, if you ever used full manual to begin with?

I’m only asking these questions because you claim transparency and you’ve been making false statements about the use of legal forms for years. Instead of answering my initial questions you decide to insult me and play games so now I want to get to the bottom of this. I’m waiting for more in depth information from the Australian Health Practitioner Regulation Agency regarding informed consent. I’m also waiting to hear back about practice scope and specialities, among other things.

By the way, your license is set to expire in September, 2016 so don’t forget to renew.

38

Done correctly , serious or significant scarring will not, and has never occurred in 25 years.

When the nasty scarring and side effects occur, there is a good reason for it .

Can be avoided, but way too much work , its too skillful and too costly…how can the clinics operate without unskilled cheap labour…

Trust me, if I were doing what they were all doing, patients would be signing a telephone book of disclaimers as well…but I am not, never have, and never will subject a patient to that kind of "äcceptable risk " you are so passionately defending.

If I were to knowingly expose a patient to a significant risk, I would be covering my butt. But I am not.

And every doctor in Australia has to renew registration every few years. They send out the paper work several months in advance.

As far as the other stuff your trying to dig for, I am planning it for season 2 of Hair Wars"…

Dr Ray Woods

39

, “My doctor screwed up and I’m unhappy with my results. He is not board certified and his diploma is a fake.” It would be up to the doctor to present proof that he is board certified and he does have a real diploma and then he would be free to sue his patient for defamation.

So according to Joe, its perfectly OK for a doctor to seriously screw you up, as long as he is board certified and has a real diploma…a license to maim, and get away absolutely free, and sue the victim for complaining…is there something I am missing here??..

Dr Woods

40

"Done correctly , serious or significant scarring will not, and has never occurred in 25 years.

When the nasty scarring and side effects occur, there is a good reason for it."

I’m not asking if it has happened. I’m asking if you inform your patients that scarring, as well as other side effects, CAN happen. There is a big difference between the two and you are required by the laws of your own country and state to inform your patients of these potential side effects.

“Can be avoided, but way too much work , its too skillful and too costly…how can the clinics operate without unskilled cheap labour…”

You’re not the only doctor in the world doing the procedure yourself but regardless, your point is moot and has no bearing on the issue.

"Trust me, if I were doing what they were all doing, patients would be signing a telephone book of disclaimers as well…but I am not, never have, and never will subject a patient to that kind of “äcceptable risk " you are so passionately defending.”

I am not defending anything. I am dismantling your claim that “every” doctor that is not you requires “legal forms” before surgery so they can sue their patients if they talk about being unhappy. I am dismantling the notion that your refusal to require legal forms before surgery is an indicator of quality. The reason why you don’t require legal forms before surgery is because NSW does not see FUE as surgery thus you are not required by your regulatory body to obtain signed informed consent. Most doctors in North America and the EU do. This is a fact but you are using it to your marketing advantage as if it is a qualifier of the ethical differences between you and the rest of the world.

Dr. Woods, come October 1 of this year you will have no choice but to have “waivers” or disclaimers" as you call it. Your country calls it verified informed consent and very soon it will be a requirement to document informed consent with a signature.

“If I were to knowingly expose a patient to a significant risk, I would be covering my butt. But I am not.”

By using local anaesthesia you are exposing your patients to potential side effects. By piercing the skin up to 600 times a day to a depth of 3mm to 6mm you are exposing them to potential side effects. By transplanting follicular units from the donor zone to the recipient zone you are exposing your patients to potential side effects. Many side effects are beyond your control so I hope for your sake you are setting your ego aside and informing them of this.