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PLASTIC SURGERY AND GERIATRICS
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Factors Influencing Patient Interest in Plastic Surgery and the Process of Selecting a Surgeon Charles Galanis, MD; Ivan S. Sanchez, BS; Jason Roostaeian, MD; and Christopher Crisera, MD Abstract Background: Understanding patient interest in cosmetic surgery is an important tool in delineating the current market for aesthetic surgeons. Similarly, defining those factors that most influence surgeon selection is vital for optimizing marketing strategies. Objective: The authors evaluate a general population sample’s interest in cosmetic surgery and investigate which factors patients value when selecting their surgeon. Methods: An anonymous questionnaire was distributed to 96 individuals in waiting rooms in nonsurgical clinics. Respondents were questioned on their ability to differentiate between a “plastic” surgeon and a “cosmetic” surgeon, their interest in having plastic surgery, and factors affecting surgeon and practice selection. Univariate and multivariate analyses were conducted to define any significant correlative relationships. Results: Respondents consisted of 15 men and 81 women. Median age was 34.5 (range, 18-67) years. Overall, 20% were currently considering plastic surgery and 78% stated they would consider it in the future. The most common area of interest was a procedure for the face. The most important factors in selecting a surgeon were surgeon reputation and board certification. The least important were quality of advertising and surgeon age. The most cited factor preventing individuals from pursuing plastic surgery was fear of a poor result. Most (60%) patients would choose a private surgicenter-based practice. Conclusions: The level of importance for each studied attribute can help plastic surgeons understand the market for cosmetic surgery as well as what patients look for when selecting their surgeon. This study helps to define those attributes in a sample population. Keywords patient interest, surgeon selection, influence, plastic surgery, aesthetic surgery Accepted for publication August 21, 2012. From the Division of Plastic and Reconstructive Surgery at UCLA– Ronald Regan Medical Center, Los Angeles, California. Corresponding Author: by guest on 20 May 2021 586 Aesthetic Surgery Journal 33(4) nearly impossible to estimate the number of providers available to patients. The field of cosmetic surgery continues to be a predominantly patient-driven market. This is complicated by the public’s general lack of understanding of what it means to be a “plastic” or “cosmetic” surgeon.4-6 Patients seeking plastic surgery now have more options in terms of potential providers and procedures than ever before. In contrast to most medical fields, the elective nature of cosmetic procedures suggests that the surgeon must seek out patients as much as patients seek out their surgeons.7 To that end, physicians engaged in the practice of cosmetic surgery commonly employ public relations experts and engage in widespread advertising in marketing-related endeavors.8,9 Although there has been some investigation into factors influencing procedure and surgeon selection,10,11 there is a relative paucity of published research on the topic. (In this context, the competition continues to grow as more physicians—plastic and non–plastic surgeons alike—introduce themselves as cosmetic providers.) Given the continued growth of this field, even in the face of economic hardship, and the patient-driven nature of the field, it is increasingly important to understand the patient’s mind-set. Defining the factors that influence a patient’s interest in plastic surgery and delineating what drives a patient to select a particular surgeon are invaluable for the cosmetic practitioner.12 This study examines subjects who were not affiliated with a surgeon’s practice at the time of participation. It therefore provides a glimpse into the thought process of the general population. From these subjects, this study intends to investigate those factors that influence a patient’s interest or lack of interest in cosmetic surgery. In addition, this study evaluates those criteria most important to patients when selecting their surgeon. Methods Participants Subjects were recruited over a 3-month period at 4 primary care clinics in the greater Los Angeles area. SERVICE: Plastic Surgery / Head and Soft tissue Surgery – BRRH, PGY 2 General description: The FAU surgical residents will rotate with assigned Program teaching faculty during their 2nd clinical year. The duration of this rotation is 4 weeks. The FAU resident will be a fully integrated member of the Plastic Surgery team, under the supervision of the attending. This rotation is designed to complement the exposure to Plastic Surgery that each resident receives throughout his/her training at the FAU Program in General Surgery integrated hospitals, by providing a focused rotation across inpatient and outpatient settings in an apprenticeship setting. This rotation will expose the surgical resident to the field of plastic and reconstructive surgery for adult patients across a wide spectrum of disease. During the rotation, the residents will participate in the following educational activities: Surgery Core Curriculum - once a week Surgery Morbidity and Mortality Conference – once a week General Surgery Grand Rounds – once a month Assigned reading: TBD SERVICE: Plastic Surgery / Head and Neck Surgery - JHH, PGY 3 Competencies: Goals and Objectives: Patient Care: Goals: During this rotation the resident should learn and practice to: § Demonstrate caring and respectful behaviors when interacting with patients and their families; demonstrate sensitivity to gender, age, ethnic, religious, value systems and other potential differences of patients and their families; practice according to the clinical standards of The Johns Hopkins Hospital § Gather patient and case specific essential, comprehensive multi-source and accurate information about their patients for initial or peri-operative work-up and patient follow-up in the inpatient and outpatient setting § Using all available resources, under the guidance of the Plastic Surgery fellow and attending, make informed decisions about diagnostic and therapeutic interventions based on patient information, up-to-date scientific evidence, and clinical judgment; evaluate and implement priorities in patient care and incorporate preventive measures § Under the guidance of the Plastic Surgery fellow, attending and other designated Plastic Surgery related expert personnel, develop and carry out patient management plans § Under the guidance of the Plastic Surgery fellow, attending and other designated Plastic Surgery related expert personnel, monitor closely the patients clinical progress; review and react to variances in patient progress or response to therapeutic interventions; communicate the details and changes of patient care, progress and complications to the Plastic Surgery fellow and/or attending in a timely manner § Under close supervision of the Plastic Surgery fellow, attending and other designated Plastic Surgery related expert personnel, counsel and educate patients and their families on the state of the patient’s disease, necessary diagnostic tests, operative procedures and medical management § Use information technology (hospital computer system) to support patient care decisions and patient education (electronic patient record, electronic radiology studies, online educational resources, including literature research) § Work closely with other healthcare professionals, including those from other disciplines (ENT, Neurosurgery, General and Trauma Surgery, Pediatric Surgery, midlevel providers, nurses, Plastic Surgery office staff, etc.), to provide patient-focused and optimum outcome driven care § Ensure that the needs of the patient and team supersede individual preferences when managing patient care; incorporate evidence based medicine into patient care whenever possible; comply with changes in clinical practice and standards given by Plastic Surgery fellow and/or attending Objectives: During the rotation, the resident should: § Outline the components of a comprehensive focused history and physical examination pertinent to the evaluation and correction of congenital or acquired defects under the realm of plastic and reconstructive surgery. § Outline the components of a comprehensive examination of the face, neck, naso-, oro-, and hyo-pharynx. § Initiate and follow-up work-up for problems related to trauma, neoplastic and other disease § Under one-on-one supervision of the Plastic Surgery attending, perform competently and/or assist in procedures considered essential for the area of practice including: a. Primary repair of simple and complex lacerations
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