The change toward patient-centric care and patient empowerment has been mostly positive for patients- although in some ways it could be argued that these changes in the doctor-patient relationship have had a few unintended consequences.
I prefer to approach interactions with my patients from a perspective of equality and mutual respect, and believe this natural, not contrived or paternal approach has been very effective in giving my patients the sense of comfort and confidence they desire, knowing that they are being given the tools and information necessary to decide for themselves what is in their best interests.
Occasionally though, I meet someone who is confused about their role in the modern doctor-patient relationship... who either wants me to tell them what to do, or who mistakenly believes that decisions about plastic surgery are similar to ordering dinner at a restaurant- where it is their job to decide where to eat and what to order from the menu, and it is the job of the restaurant to provide them exactly what they asked for. Or worse, someone who thinks that surgery is a "drive-through" experience in which they choose what they want, the surgeon then provides it, and they drive away to choose how their postoperative management should go. It seems these particular patients have mistakenly concluded that being an educated, empowered patient means having an absolute distrust of all physicians...
To some extent therefore, I think that the patient empowerment movement has endangered the patients it meant to protect by eroding trust in physicians beyond what is healthy or appropriate. To be clear, I realize better than most that some of my colleagues have done more to erode trust in doctors than any other group or movement. Not all doctors are worthy of our trust.
But being too distrustful of your health care providers (once you've entered into the relationship) because you think that is the best way to be your own advocate is probably not going to be helpful if your goal is truly to be safe and happy- the relationship you develop with your surgeon will be very important to your safety and happiness, and you (and your surgeon) should approach it with the respect and goodwill you would any other important relationship in your life.
So here is my best, most sincere effort to clarify how you can best approach your relationship with your chosen, Board Certified Plastic Surgeon in order to maximize your safety, enjoy the most pleasant experience, and also maximize your chances of achieving your aesthetic goals.
It should be noted that I will not be discussing how to choose a plastic surgeon, as this has been covered in other posts on this blog. I will also not be reviewing the types of doctors to avoid, as this has also been covered in many of our Monthly Safety Reports. Generally, you should not have liposuction performed by an eye doctor.
So what does it mean to be a truly empowered patient? How can you be sure you're making decisions that are truly in your best interests and not those that are in the best interests of the surgeon? What behaviors might compromise your care or your relationship with your surgeon?
Being an empowered patient, in the simplest terms, means being a well-educated and compliant patient.
Being well educated is the easy part, right? In this day and age, it truly is the rare exception when I meet a patient who doesn't know everything about my education, training, experience and approach- indeed most have even been in contact with a few former patients- all thanks to the internet.
But it should always be kept in mind that the internet is a largely unregulated environment, and unless information is being dispensed by a reputable, authoritative body (for example, The American Society of Plastic Surgeons or The American Board of Plastic Surgery), it should be subject to verification- at the very least. Board Certified Plastic Surgeons are held to a very strict code of ethics, but some among us do go astray from time to time in our advertising. In other words, take what you read with a grain of salt... especially if you only read it in one place.
Furthermore, the internet is a great place to gather general information about physicians, procedures, what most patients experience during recovery,.. But you should never allow yourself to think that you can use the internet to make all of your treatment decisions before meeting with a qualified surgeon.
I've said it to a great many of my friends on the web- choose a great surgeon first, then worry about the what and the how. Learning about your options is great- making firm decisions and then shopping for someone willing to do what you've decided you want is not. Why? Because you cannot be expected to understand the nuances of your own anatomy, the details of how different options might alter your appearance, and other important aspects of the decision making process without the guidance of a well qualified, Board Certified Plastic Surgeon.
Entering the consultation process- or worse, the postoperative period- without an open mind and without a spirit of mutual good faith is disrespectful of your surgeon and truly will compromise your own ability to be safe and happy. We can all agree that treating your doctors like gods is not necessary or appropriate- but it should be equally obvious that (as long as you know the doctor is appropriately trained in the specialty) their many years of education and training do make them worthy of your respect and open-minded communication. Don't be rude and think that hours spent on the internet will make you as knowledgeable as your surgeon.
So learn as much as you can- but keep your mind open. And always spend more time and energy finding a great human being and qualified surgeon to entrust with your safety and happiness FIRST.
Okay, so what does it mean to be compliant?
Does it mean you should be soft and pliable, abandoning what is important to you to the recommendations of the surgeon? No, it doesn't.
But it does mean that once you and your surgeon have identified (together) the best course of action to follow- one that maximizes your safety (taking unnecessary chances in cosmetic surgery doesn't make any sense) and likelihood of being happy, that you need to trust them to "do their thing", and once surgery is performed, follow all of their instructions and restrictions in every detail.
The postoperative period is not the time to start second guessing your surgeon's advice- or worse yet, asking your friends what their surgeons told them to do when they had the same procedure.
Only your surgeon understands the details of your procedure and the implications these details will have on your recovery, restrictions, and needs. Complicating your doctor-patient relationship by introducing information from well-meaning friends and doctors unfamiliar with your procedure and care can only harm you- and almost ensure you will not achieve the best outcome you could have.
The plastic surgery experience is supposed to be about being as happy as you can be- achieving maximum self-esteem, right? If this can be agreed on, then it should be easy to understand that doing anything that makes it more likely your experience is negative (even if you look great) or compromises your safety or outcome should be avoided at all costs.
So, following the KISS principle and keeping it simple:
- Do your homework and find the very best surgeon you can
- Investigate not only the surgeon, but also the facility and the anesthesia provider
- Learn about your options but keep an open mind
- Be as educated as you can, but remember your Board Certified Plastic Surgeon will still know more about your options and the details- listen carefully
- The relationship between you and your surgeon will be very important to your safety, experience, and outcome- approach it with the care and respect you would any other very important relationship. Once you've decided who's hands you will trust with your safety and appearance- do trust them- follow their instructions carefully and completely.
- If you do develop doubts, discuss them openly and respectfully with your surgeon.
I hope every patient achieves their very best sense of self this year- and that you are all smart and lucky enough to only have plastic surgery performed by surgeons certified by The American Board of Plastic Surgery.
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