The commoditization of the hair transplant industry began in its inception. As soon as the first TV ad was aired and the no-obligation free consultation was born, a tone was set that turned this incredibly nuanced and life altering discipline of cosmetic surgery into a one size fits all product that had less to do with medicine and more to do with sales. IAHRS Founding Member Alan J. Bauman. M.D. speaks with Spencer Kobren about the reality of free surgical consultations and the real price patients pay when lead generation takes precedence over medicine.

Alan Bauman, MD: Think about this for a moment. What's the ROI of shutting down the practice for a week with all of our key people and bringing them out to a conference? It's not the ROI of that. It's the VOI. It's the value on investment.

Spencer Kobren: Absolutely.

Alan Bauman, MD: And so the value that we come home with is worth all of that time that we're not operating, that we're not seeing patients, that we're not doing consultations. It's a huge amount of value that we can bring back to Boca Raton, Florida, for the patients that come in to see us every single day, whether they're coming in from across town, across the state, or across the ocean.

Spencer Kobren: Look, I've been preaching VOI for a long time. Docs look at me like I have two heads. They don't understand what that is. VOI is invaluable. It is sometimes intangible. You may not be able to put it on a spreadsheet, but the reality is ... I mean, you explained it well right now. You are bringing back a tremendous wealth of information and insight to help your patients, and-

Alan Bauman, MD: Yep, but you also have to come to the conference and go to the conference, and unfortunately, I see a lot of my colleagues, "Well, where are they in the lecture hall? Gosh. I saw them for the welcome reception, and then where did they go after the opening bell?" They're MIA, missing-in-action.

Spencer Kobren: Yeah

Alan Bauman, MD: My staff knows-

Spencer Kobren: You can see them straggling along. Sometimes they're a little loaded in the hallways. I mean, a lot of these guys, it's their vacation. They get a chance to get away from their wives.

Alan Bauman, MD: Yeah. I don't know. [inaudible 00:01:33] for me and for our team is not a vacation. We are here to absorb as much as possible. And you can absorb things that are not necessarily in the lecture or in the presentations. I mean, we collaborate with our colleagues and a lot of our informal chatter and discussion could happen over a coffee table and so forth.

Spencer Kobren: Sure.

Alan Bauman, MD: But what we bring back, it's that value on investment. It's that time, effort, and energy. And so I just met with a plastic surgeon a couple of days ago who does hair transplant surgery. He's a part-time guy, and he has a lot of fun doing it, but he doesn't come to conferences that are specifically for hair. He doesn't get the journals that are specifically for hair restoration. So he doesn't have his finger on the pulse of anything that's going on in the industry and also what's coming next. That's why I'm here. We want to figure out, "Well, what can we do better this next year? What can we implement in the next 60 to 90 days that's going to change our outcomes for the better and improve our patients lives?"

Alan Bauman, MD: So that's the VOI, the value on investment, that again, my bookkeeper will tell me, "Oh my God. You were out of the office for X number of days and so forth," but that's what goes in behind, the costs that you don't see on that $3 a graft or free consultation-

Spencer Kobren: Absolutely.

Alan Bauman, MD: ... or discount on the AdWords and such that's popping up in your browser or in the last YouTube video, Instagram feed, or Facebook feed. Someone who's giving those discounts away, they're cutting corners somewhere, and that's just-

Spencer Kobren: Well, I made a point. I actually posted on our industry Facebook group about what's going on in the field and people cutting corners and the type of ads that I'm seeing. And really, I think a lot of physicians out there, even some well-known guys, are diminishing their value and the value of this incredible discipline by putting out really cheesy cut-rate specials, not charge ... I believe, you guys, anyone who's not charging for a consultation is insane. You guys are doctors, for crying out loud. If I go to get my blood pressure taken, I'm going to get charged. This is a consultation for surgery. If I was going to have a consultation for orthopedic surgery or anything, even if I had to have a hangnail removed, I would have to pay for that.

Alan Bauman, MD: Yeah. Go try talking to your attorney without paying a consultation fee for a serious issue.

Spencer Kobren: I'm getting paid right now, and you didn't even see it. I wouldn't be behind this mic if I wasn't getting paid. My time is valuable.

Alan Bauman, MD: Sure.

Spencer Kobren: It really shows when people ... It makes me sad. It makes me sad when people aren't valuing or understand their worth.

Alan Bauman, MD: Their expertise. Their expertise. So all of those things are what backs into the costs of a consultation, and yeah, one of the best things I ever did in the practice is charge for consultations because I'll tell you, our consultations got better because of it.

Spencer Kobren: Well, you were able to spend more time.

Alan Bauman, MD: Absolutely. We were able to do more things, whether it be a hair check analysis, a microscopic analysis. I mean, now we do scalp health evaluations with pH level, moisture level, all that stuff. So we can really see what's going on at the level of the scalp, if there's inflammation and such. And look, it is credited towards a procedure, so it is what it is. But that consultation fee, it sets up that time that I can focus on that patient and give them undivided attention, whether it be through Skype or FaceTime or physically in the office.

Spencer Kobren: Well, I tell every patient, every prospective patient or consumer who contacts me that, "If you're saving for this procedure, if you're budgeting for this procedure, set aside a minimum of $1,000 for consultations."

Alan Bauman, MD: Sure.

Spencer Kobren: You will, if you choose to have a procedure, get a percentage of that back, depending on who you decide to go to. But it is part of the process that you need to put aside.

Alan Bauman, MD: Absolutely.

Spencer Kobren: I often tell doctors, "If you are getting your leads through third-party online consultations, and you're spending time with the tire kickers, for every dollar you're spending on sites that provide these types of leads, you're losing $10 out the back door. You don't even realize that you're losing that money. All you're seeing is things coming in. Maybe you're delegating it to some people, but you're going to have to pay these people to handle all this stuff.

Alan Bauman, MD: Yeah, someone has to handle, like you say, maybe the tire kickers. So we know that the serious people who are interested in hair transplant surgery and interested in the quality that we provide, they're going to come through the door. They're going to do the consultation fee. They're going to have the full evaluation, and we're going to figure out together what needs to be done.