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Furthermore, an increasing number of providers from plastic surgery backgrounds and non–plastic surgery backgrounds alike are offering services to cosmetic patients. Understanding the general public’s interests as well as the factors they consider when selecting both procedure and surgeon are vital to the success of any cosmetic practitioner. This study attempted to investigate not only the general public’s interest in cosmetic surgery but also the criteria considered by members of the public when moving forward with procedure and provider selection. Our study findings are consistent with the continued demand for aesthetic surgery. Nearly 90% of respondents reported that they would consider plastic surgery in the future. Furthermore, our survey results suggest that cosmetic surgery is becoming increasingly socially acceptable, since not a single respondent cited concern over what others might think of them as a reason not to proceed with surgery. This seems to indicate that the negative stigma that may have been previously present for plastic surgery has been reduced. An interesting finding in our survey relates to the public perception of the “cosmetic surgeon.” Hamilton et al6 previously investigated this issue and found that the general public considered a cosmetic surgeon different from a plastic surgeon, with the former being thought of as a more temporary, less trained provider. Nearly 70% of respondents in our study also drew a distinction between a plastic surgeon and a cosmetic surgeon. However, only 8 of the 96 respondents correctly pointed to the fact that any physician with a medical degree was legally qualified to perform cosmetic surgery. The remainder of respondents felt that the cosmetic surgeon population was composed of either trained surgeons only or some arbitrary combination of surgical and nonsurgical practitioners (dermatologists, dentists, etc). This is made even more remarkable by the Figure 3. Responses to the question, “How important would each of the following be when considering your plastic surgeon?” Respondents rated each category on a 0 to 10 scale, with 10 representing the most important factor. (B) Responses to the question, “Where you would prefer to have plastic surgery done?” Figure 2. (A) Responses to the question, “On which part of the body would you be MOST interested in having plastic surgery?” (B) Responses to the question, “Which of the following is the principal reason you would NOT have plastic surgery?” Downloaded from https://academic.oup.com/asj/article/33/4/585/204723 by guest on 20 May 2021 Galanis et al 589 finding that 1 of the primary considerations for respondents in selecting a plastic surgeon was board certification. These findings seem dichotomous. If respondents felt that board certification was important, that would seem to highlight the recognition that not all cosmetic surgeons were boardcertified, which should in turn indicate a distinction between a cosmetic surgeon and a plastic surgeon. These results suggest a major deficit in public understanding of what it means to be a board-certified plastic surgeon and what it means to be a cosmetic surgeon, which is consistent with previous findings by Kim et al4 and Dunkin et al,5 who also demonstrated the public’s general lack of understanding about which procedures a plastic surgeon is qualified to perform. As suggested by previous studies on public perception, it is imperative that the plastic surgery community educates the general public on this distinction, thereby ensuring that only properly trained practitioners are treating this growing population. The most important factor for patients in selecting their plastic surgeon was surgeon reputation. The factors creating and constituting “reputation” are, of course, subject to some interpretation. 85%) conferences, M&M conferences, Grand Rounds/other educational activities of the division of Plastic Surgery during the rotation § Take a post-rotation self-assessment test with at least 75% correct answers Practice-based Learning and Improvement: Goals and Objectives: Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices. Residents are expected to: § Self-assessment: Analyze practice experience during the rotation and own performance based on interaction with Plastic Surgery fellow, attending(s) and other key Plastic Surgery staff; accept and use constructive criticism to improve performance in the six core competencies § Medical knowledge: Self-directed and under mentorship of Plastic Surgery fellow and attending staff, locate, appraise and assimilate evidence from scientific studies related to their patient’s health problems; use evidence based medicine approach to patient care whenever possible; apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness; use information technology to manage information, access online medical information and support their own education; facilitate the learning of students and other healthcare professionals on the Plastic Surgery service by sharing preexisting and newly acquired knowledge (general and case-based) on rounds and during formal educational activities. Residents are encouraged to ask/question the Plastic Surgery fellow, attending staff and/or other Plastic Surgery related expert providers for clarification of unclear concepts/practices at any time. Participate in the perioperative management of Plastic Surgery patients as outlined in patient care competency. During the rotation the resident should become familiar/proficient with: a. Comprehensive, focused history and physical examination for Plastic Surgery/Head and Neck surgery patients b. Evaluation of wound healing/flap and/or graft viability c. Various methods of conservative wound management d. Management of postoperative complications including wound infection, dehiscence, bleeding, flap ischemia, systemic complications, etc. § Perform/participate in Plastic Surgery service related operations as outlined in patient care competency; during the rotation the resident should become familiar/proficient with: a. Harvest and application of skin and composite grafts b. Repair of complex wounds including debridement Interpersonal and Communication Skills: Goals and Objectives: Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients families and professional associates. Residents are expected to: § Develop interpersonal skills necessary to communicate effectively with patients, patient families, nursing staff, mid-level healthcare providers, ancillary staff, medical students, fellow residents and attending staff in the complex multi-specialty environment that constitutes Plastic Surgery § Contribute to creating an atmosphere of collegiality and mutual respect with all providers involved in the care of patients § Develop effective listening, questioning and documentation skills § Demonstrate ability to work effectively as a member of a team § Demonstrate ethically sound behavior (see also Professionalism) § Share own knowledge with other members of the team to foster an environment of learning Professionalism: Goals and Objectives: Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population. Residents are expected to: § Demonstrate adherence to institutional and departmental standards and policies § Demonstrate respect, compassion, integrity and ethical behavior that are consistent with the values of the department, institution and The Johns Hopkins University School of Medicine; develop and sustain sensitivity towards differences of age, gender, culture, religion, ethnicity or other diversities in both co-workers and patients. § Demonstrate ability to appropriately take on, share and delegate responsibilities with regard to patient care; balance own rights and privileges appropriately with responsibilities and accountability resulting from being a member of a team dedicated to patient care § Demonstrate commitment to excellence and ongoing professional development § Under attending and other Plastic Surgery staff guidance, develop skill to resolve potential problems and conflicts in a complex corporate environment using the appropriate channels and methods of communication and maximize patient care and surgical service performance § Evaluate and formulate a response to ethical questions Systems-based Practice: Goals and Objectives: Residents must demonstrate an awareness of and responsiveness to the larger context and system of healthcare and the ability to effectively call on system resources to provide care that is of optimal value. Residents are expected to: § Understand how choices in patient care and other professional practices affect other healthcare professionals, the healthcare organization and the larger society and how these elements of the system affect their own
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