So many articles about plastic surgery tell you, “Make certain your doctor is board certified.” Sometimes they say that the “board” must be one of the 24 boards monitored by the ABMS (American Board of Medical Specialists). That concept is inadequate and can give you a false sense of security.
All board certification means is that, at some point in time, the doctor satisfactorily completed a residency in a training program approved and accredited by the board, and the director of the program signed documents to the effect that the doctor was trained and he/she practiced in a safe way. Several exams and case presentations must be completed before official board certification is granted. Once doctors have completed the board certification process, the board has no way of knowing the quality of their ongoing work. Boards also maintain records of continuing medical education and set minimum standards. The boards do get involved in disciplinary actions but only when a complaint is filled with them.
A few years ago, I took care of a woman from a major eastern city. She had checked that her doctor was properly certified and proceeded with breast surgery. The surgery didn’t go well and her doctor talked her into two subsequent revisions. During the second revision, police came into the recovery room and removed the doctor for practicing on a suspended license. He had a long history of substance abuse and multiple prior suspensions.
How could this have been avoided?
1. Realize that knowing the proper board certification is only part of the research you need to do.
2. Check with the state and hospital regarding any documented doctor’s sanctions and suspensions.
3. Check that the doctor is credentialed to do your procedure in a hospital.
4. If not a hospital, check on the facility for certification and any other doctors involved, especially Anesthesia. (A young woman in Florida checked on her surgeon who was board certified but the anesthesiologist had just been released from prison for substance abuse. The case went wrong and she’s now in a permanent vegetative state).
5. Know the procedure you’re contemplating. You can research the procedure on the internet, but consult only the main societies; ASPS, ASAPS, ISAPS or University sites. Realize that the bulk of the internet is marketing not education.
6. When you go for your consultation, take a friend and never a child which can be too distracting. Tune up your intuition and observe everything. Discuss it with your friend later. If it “feels” wrong, don’t do it, get another opinion. Most of the people I see for repair work had the “feeling” that something was not right, but it was too much trouble to do it all over again. Now with an injury or bad result, they’re facing additional time and expense and wish they had taken the time for a second opinion. If you go to a doctor’s office where all the staff have mega-mammaries and sausage lips and your goal is conservative, this may not be your best choice.
7. Be aware of the “wall candy”; plaques attesting to the “best doctor” are sometimes real but many, if not most, can be purchased. Pictures of your doctor shaking hands with a celebrity has no meaning. These things can skew your judgement and affect your decision.
8. There are well studied psychological reasons (cognitive dissonance) why even the recommendation of your best friend does not relieve you of the need to do your own research and has to be considered very carefully.
9. Ask the staff and the doctor how often the doctor performs the procedure. It is well documented that more frequency gives better results.