There's an old expression that says, "The best way to judge a man is to meet his dog." If the individual in question happens to be a physician to whom you're entrusting your body, then this axiom would apply to his staff, his patients, his family, and anyone else who reflects his personality. If the people around him are unhappy or unhealthy, if they appear to be untrustworthy, cold, or rude, then this should give you a good indication of what the doctor is like.
A Checklist to Use During Your Consultation
Is the surgeon a true cosmetic surgery specialist (his whole practice is "beautification" surgery), or does he do reconstructive, cancer, hands, or other kinds of surgery?
Does he claim to "operate from head to toe"? You are better off with a left-finger specialist if you need surgery on a left finger.
What boards, if any, has your doctor passed?
Cosmetic, plastic, dermatology, and facial plastic offer board certification, but you need to look much closer, whatever the answer is. The American Board of Cosmetic Surgery (ABCS) is the only one that specifically certifies for all types of beautification surgery. Other boards are established to certify a surgeon for a more general range of tasks, and their emphasis on purely cosmetic procedures may be limited. You may call the ABCS at (708) 474-7200 to see if your surgeon has passed the cosmetic surgery boards, or is a member of another less specialized board.
Has the doctor performed at least several hundred cases of the type of surgery you are considering?
International experts have performed many thousands of surgeries for which they are considered top-flight. Experience is much more critical than any credential or training. Medical journal studies have shown that many fancy residency programs contain very little cosmetic surgery training experience.
Is your doctor spending his time in hospitals doing all kinds of other work or does he do his work out of an outpatient surgery facility?
Most modern cosmetic surgeon sub-specialists work almost strictly outpatient. Hospital privileges show the hospital has checked the doctor's general credentials, but never purport to certify great expertise. And if your doctor is on the staff of many hospitals, he is more likely a generalist than a cosmetic surgery specialist. Hospitals usually remove inactive doctors from their staffs, so this doctor is certainly working actively at the hospitals. All this said, however, some very competent surgeons perform cosmetic surgery in hospitals or hospital-affiliated outpatient surgical centers.
Is your doctor involved with fellowships?
If so, beware: surgeons in training may be doing part or even most of the work.
What is your impression of the office and the staff ?
If you have a bad impression, get out. The office and the staff reflect directly on the doctor.
How do you feel about the doctor?
If you don't like him, leave. He should be able to make a good impression. You are marrying him in a metaphorical way when you have your surgery, and you must be willing to put up with him if you have a complication.
Is the surgical center certified by a national organization which you can find on the Internet?
There should be a diploma somewhere in the center that you can ask to look at.
What kind of anesthesia is recommended, and are you comfortable with the choice?
This is a complex question, and Dr. Yoho's preference is for monitored anesthesia care - a step down from general anesthesia, for the reasons cited above and on DrYoho.com: safety and comfort. And who's watching you while you are asleep?
Speak with patients in the waiting room. What do they say?
Previous patients who are referred to you by the staff won't ever say anything bad. Every doctor, no matter who he is, has at least a few fans.
What do the before-and-after photos look like?
If there are only a few, run. This surgeon has little experience. Be sure and ask if the photos are of the doctor's own work, and watch his response carefully. Ask the staff the same question. Believe it or not, there are sources from professional organizations that supply these photos for beginning doctors to use for "marketing." We think this is (to put the most charitable spin on it) consumer deception. In California, the law is that the doctor must tell you where the photos came from.
Is there any part of the consultation that feels like a pressured sales job?
If so, forget it. In particular, if the doctor is trying to sell something that sounds like a one-time total makeover, run. It might be risky. Are you hassled by repeated calls from the office staff trying to get you to schedule? This is a sign of a sales and marketing organization rather than a real surgeon's office.
Look at the doctor's biography and professional history information (CV).
Ask questions about anything you don't understand. If this isn't available, go elsewhere.
Has the doctor published any articles in journals?
This generally lends some credibility, although there are physicians who spend more time writing and speaking than operating. While not always true, the saying goes, "Those who can, do. Those who can't, teach." And these days, the surgeon who doesn't have a lot of his work on a website for all to see may be inexperienced.
Does the doctor or his website bad-mouth other specialties?
Remember: many specialties have contributed to cosmetic surgery techniques. Any group claiming to be the "one and only" has an aggressive marketing campaign going.
What is the policy about touch-ups?
If the doctor has his own (certified) operating suite, touchups often can be done very reasonably, sometimes at no charge. However, if you have to go back to an expensive hospital or outpatient surgical center, the charge may be thousands of dollars even if the doctor takes no fee.
Ask the doctor and the office staff what percentage of the patients are referred by other patients. Watch the response carefully.
You can tell when someone is telling the truth. If the doctor has been in business for years and years, and has not been able to generate a primarily referral practice, there's something wrong. Some possibilities include: the service isn't great, the surgeon isn't skilled, there's pain during the surgery, the recoveries are painful or too long, the office staff is rude, or the follow-up might be careless. A primarily advertising based practice isn't standing out above the crowd enough to become a referral-based practice.
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