Choosing a physician is one of the most important decisions you will make regarding your health. Physicians vary widely regarding their credentials, experience, range of services provided, specialties, costs, and personalities. As such, it is important to be an informed consumer. This article focuses on the subjective and objective criteria one may use to make the best possible choice.

Please realize that patients are not protected by state or federal laws that mandate training and credentials for doctors to call themselves plastic or cosmetic surgeons. No such laws exist. Anyone who has graduated from medical school and obtains a state medical license can practice any specialty. A medical graduate also may advertise for clients in any specialty. In fact, physicians may advertise as board certified but neglect to mention that their board certification is from an official-sounding board that actually has no national recognition as a specialty medical board. Elective cosmetic surgery can be a very lucrative field; therefore, it attracts some of the more unscrupulous physicians who lack the appropriate background, training, and experience. Although this is alarming, there are certain safeguards one can take to be protected from physicians who practice a particular specialty without the proper training, experience, and credentials.

By using these guidelines, one may narrow their search to 1 or more physicians. At that point, it is important to visit each physician for a private consultation, a subject explored in greater depth in the article  What Should I Expect From the Consultation?. It may take several consultations to choose the right surgeon for you.

Word of Mouth

Perhaps the best indicator of a physician's success is the number of individuals walking around raving about what a wonderful person he or she is.

A friend or family member may have been treated for a similar problem and might recommend their physician. Please realize that everyone is different and two people having the same procedure performed by the same surgeon may have vastly different results. However, a positive recommendation by one or more friends may establish a baseline level of comfort with a particular physician.

Family doctors may also be able to provide you with recommendations based on their own perception of who in the community or region is accomplished and well respected in the area you wish to inquire about. However, doctors are not always knowledgeable about different fields and the importance of certain credentials in other fields. Is this referral merely a golfing buddy or neighbor of your family doctor or has your doctor referred patients to this surgeon before and seen consistently good results and satisfied patients? What feedback has been received from other referrals to this physician? Would your family doctor refer his or her own family members to this physician for the same type of procedure?

Other physicians who may be knowledgeable regarding elective cosmetic surgery include dermatologists and obstetricians and gynecologists. Pose the same questions to these physicians to get their opinions.

Operating room nurses are also a good source of information if you are acquainted with one in your area. Nurses work closely with multiple doctors in the operating room setting. An experienced operating room nurse will be well informed about a physician's temperament, demeanor, ability, results, and respect among other health professionals.

If you have a preferred hospital, call their medical staff office and ask for the names of physicians with privileges to perform the procedure you are interested in. Hospitals conduct extensive background checks of education, training, certification, and licensure prior to granting hospital privileges. Even if you know the surgeon performs most if not all of his operations in his office, the fact that a physician has privileges to perform the procedure you are interested in at the hospital provides a measure of assurance that the physician should be able to perform the procedure and should have the necessary background and experience.

Beauty salon personnel often know the scoop on local surgeons as well. Being in a business centered on appearance, conversations often turn to other methods of appearance enhancement, including elective cosmetic surgery. Also, since these people deal with multiple individuals at very close range, they are able to observe the outcomes and the scars from multiple surgeons.

Advertising

Unfortunately, advertising is probably the least helpful source in selecting a physician. Advertising arenas, such as the yellow pages, are often nothing more than marketing wars. You are being solicited by a physician who feels it is important to spend a great deal of money practicing self-promotion. Realize that any physician with a license can advertise as a specialist in any specialty. Usually, there is little factual research or credential checking done by the medium in which the advertisement appears; therefore, factual statements should not be automatically accepted as true.

The usefulness of advertisements probably ends after you have noted the physician's practice address and phone number. Any models pictured in advertisements are often not real patients and frequently are individuals who would never be candidates for elective cosmetic surgery. Many supposed patient photographs placed in ads are actually stock photos maintained by the advertising company with the words ”actual patient” superimposed. Yes, these individuals are probably “actual patients” of some physician in some city, but usually not the physician placing the ad.

The Internet

There are innumerable web sites devoted to cosmetic surgery, but these generally fall into one of two categories. The first category is little different from other forms of advertising previously described. Personal web pages are paid for and designed by the physician. There is very little regulation and virtually no verification of credentials in this area. However, personal web pages can be more helpful than print ads in several ways.

Web pages tend to reveal more about the personality and background of a physician because they are cheaper to produce and can be more voluminous. There may be extensive background on the surgeon including education, training, experience, specialties, board certification, and professional society membership.

Also, these sites often detail the types of procedures offered by a physician. There may also be pre- and postoperative patient photographs on display. Of course, physicians are going to show their very best results, so one must take care not to interpret the results presented on the web page as a guarantee or warranty of the results that anyone can and will achieve following the same operation.

Web sites may also detail any additional services available at the physician's office, such as skin care or laser treatment. Financial options may be detailed as well. There may also be a way to e-mail the physician to ask general questions about a problem or a procedure. This can serve to establish an initial rapport and prepare you for the consultation.

The Internet is a great source of information, but information available on a personal web site should not be accepted as fact without verification. Throughout this article there are contacts and methods of verification to enable you to confirm any and all facts and information you obtain regarding a physician. You are strongly encouraged to confirm all facts, credentials, certification, licensure, and hospital privileges prior to making your selection.

The second type of web site is one maintained by official organizations (eg, nationally recognized medical specialty societies, medical specialty boards). These sites and organizations are an excellent source of unbiased factual information and will be discussed in further detail in the following section.

Professional Societies and Board Certification

Professional societies and certifying boards are another good source of information in helping you find a qualified surgeon in your area. The societies have strict membership requirements, usually including board certification. Board certification is granted only after rigorous qualifications are met. For further information on the importance of board certification, see the article chapter Why is Board Certification Important? There is only one nationally recognized board that certifies physicians in plastic surgery of the entire body, The American Board of Plastic Surgery. The national organization representing plastic surgeons is the American Society of Plastic Surgeons.

• The American Board of Plastic Surgery  (ABPS)
  Seven Penn Center, Suite 400, 1635 Market Street
  Philadelphia, PA 19103-2204
  (215) 587-9322
  www.abplsurg.org

• The American Society of Plastic Surgeons (ASPS)
  444 East Algonquin Road
  Arlington Heights, IL 60005
  1-888-4-PLASTIC
  www.plasticsurgery.org

Other official sources of information include the Board of Medicine in your state as well as local medical societies.

Local and State Institutions

Your local library should have several good sources of information. These include The American Medical Directory, The Directory of Medical Specialists, and The Compendium of Certified Medical Specialists.

The Phone Call

Once you have done the appropriate research, it is time to choose 2 or 3 physicians to visit for a formal consultation. It may become obvious to you during the course of your research if several physicians keep appearing on your lists. The next step is to call the office.

A tremendous amount of information may be gained by a simple phone call to the office. In many instances this will enable you to determine whether or not you would like to visit the physician for a consultation.

Are you greeted professionally and courteously? Is the receptionist friendly, attentive, and helpful? Are you put on hold or transferred to voicemail? Is the receptionist distracted, or is there a great deal of background noise?

The receptionist may answer your questions directly or, more often, will transfer you to another member of the office staff who regularly answers patient questions. Only rarely will physicians be available to take a call. A physician being able to take a call may indicate that his or her practice is not very busy.

Questions you will want to ask include the following:

· Does the surgeon perform the surgery you are interested in?

· How often does the surgeon perform this surgery?

· Where is the surgery performed?

· Is the surgery is performed in the office?

· Who is the anesthesia provider?

· If the procedure is performed in the surgeon’s office, does the physician also hold privileges to perform the same surgery in a hospital? (No to this question is a very important warning sign).

· At which hospital(s) does the physician have privileges to perform the same procedure?

· Does the physician lecture or participate in any teaching or research activities?

· Does the practice have a web site with capability to ask questions via e-mail?

· Where is the office located?

· How far in advance is the surgeon's schedule booked?

· How much will the procedure cost?

· Is this a global fee or just the surgeon's fee?

· Is an overnight stay anticipated or required?

· If an overnight stay is anticipated, will this be in the office if the surgery is performed in the office?

· If so, who will attend the patient during the night?

· Is there a fee for the initial consultation?

· Is the physician board certified, and, if so, by what board?

· Is the physician a member of any professional organizations and, if so, which ones?

· Are pre- and postoperative photos available for viewing?

· Are other patients who have had the same procedure performed available to talk with you?

· Does the physician carry malpractice insurance? (Some states, including Florida, do not require malpractice insurance.)

Once you have asked these important questions, you will have a very good idea if you would like to schedule an appointment or look elsewhere.

Conclusion

Choosing the proper physician is a critical decision in your choice to have surgery. Ways of obtaining the names of physicians who perform the surgery you are interested in and how to check up on their background are presented in this article.

Once you have done the necessary background research, phone the office. The way in which they treat you and their answers to your questions will help you decide whether or not to seek a formal consultation.

Any and all information gained from biased sources (eg, print ads, personal web sites, office phone call) should be confirmed with the appropriate organization, agency, board, society, or hospital.

Once you have narrowed your list, go see several physicians. Seek a second opinion. No physician should be insulted if you decide to seek a second opinion before making your decision. Never let yourself feel pressured to accept the first physician you visit. A physician who places this type of pressure on you or makes you feel guilty for wanting a second opinion will probably not satisfy your needs in the long run. Each physician should have the patient's best interest, health, and safety as their top priorities.

More specific information regarding the consultation is presented in the chapter entitled What Should I Expect From the Consultation? For further information, please contact our office at (954) 630-2009 or you may email Dr. Revis.

E-mail: DrRevis@SouthFloridaPlasticSurgery.com