The Bald Truth
Americans turn to weaves, rugs, plugs, and drugs to alleviate hair loss, creating a $1.5 billion industry
Surge of surgeons. In most medical fields, physicians would warn their patients, or even refuse to perform a transplant, if they thought there might be problematic long-term consequences. Plastic surgeons know that any patient will eventually look old; their task is simply to delay the appearance of aging. But in the booming world of hair-transplant surgery--in which any M.D. is allowed to try his hand at the procedure, regardless of whether he has even witnessed the operation--some physicians are too inexperienced to know what the long-term ramifications of the surgery they perform might be.
The creeping advance of managed care has pushed doctors of all backgrounds into the hair-transplant market. Plastic surgeons and dermatologists, who have traditionally performed such operations, have been joined in recent years by a stream of pediatricians, urologists, emergency-room physicians, and others--all looking to make extra money while avoiding the headaches of reimbursement forms and insurance companies. Dr. W. Gregory Chernoff has witnessed this growth firsthand. For each of the past few years, he has spent 3 out of every 4 weekends away from his Indianapolis home teaching as many as 200 fellow physicians at a time how to do hair transplants.
The influx of new hair-transplant doctors has helped push prices down--from as much as $30 per graft two years ago to as little as $4 per graft today--but it is not necessarily good news for patients. "I probably did several hundred procedures before I knew what the hell I was doing," confesses one physician who has been in the business for over two decades. Indeed, many experienced hair specialists say that at least half of their patients come in looking for someone to repair the damage caused by a previous transplant.
Plugging away. The growth, and profit potential, of the transplant business may also be fueling a level of competition between hair surgeons that is not necessarily healthy for patients. With the largest transplant centers spending millions of dollars a year on advertising, for example, some doctors fear that there is an extra incentive for these offices to pay more attention to their revenue stream than to the interests of their patients. The Bosley Medical Group is the nation's largest transplant operation, performing as many as 10,000 procedures a year. The center's headquarters is located in the penthouse of a Beverly Hills office building. Founder and Director L. Lee Bosley, one of the nation's most experienced transplant physicians, has performed over 35,000 procedures over the past 34 years. It is his name that the company sells. Copies of Dr. Bosley's diplomas and certificates and a photograph of the doctor with country music star Kenny Rogers--a former patient--are featured not just in Bosley's wood-paneled office but in each of the half-dozen or so consultation offices where prospective clients receive their assessments.
These consultations also are a source of controversy. One physician who performs hair transplants himself paid an anonymous visit to Bosley several years ago. Although this doctor clearly did not need transplants, a Bosley medical counselor--who critics say is nothing more than a salesman in a lab coat--recommended not one but three surgeries. The doctor who breezed in toward the end of the consultation quickly agreed with the diagnosis. An investigative report earlier this year by the NBC program Dateline also concluded that the role of Bosley counselors is to sell as many procedures as possible. Bosley President John Ohanesian dismisses the matter as a difference of opinion. "For one physician to say that a diagnosis is right or wrong is merely an assessment of a judgment," he says. Ohanesian also says that Bosley sends anonymous visitors into each of its 37 offices several times a year to prevent such problems and has in the past dismissed employees who made faulty diagnoses.
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