Why do doctors go beyond their area of expertise?  In Be Careful of What You Want! Part 1, I described the importance of the training of a doctor to know whether or not that doctor is qualified to treat a specific problem. In cosmetic surgery, it’s even more difficult to know how to choose a cosmetic doctor because of so much DECEPTION.

Why is there so much DECEPTION?  Cosmetic doctors don’t want you to know that a lot of them are going beyond what they are trained to do.  So, the essential question is what makes a COSMETIC DOCTOR exceptional or, at least, good at what he or she offers.  The problem is that the terminology that we use, ‘COSMETIC SURGERY’ or ‘COSMETIC SURGEON’ or ‘COSMETIC DOCTOR’, is not useful at all.  The idea of an ALL ENCOMPASSING cosmetic doctor is actually silly if you really want to know.  Just think about any other big industry like cosmetic products or shoe manufacturers or the food industry.  If you want a pair of fine, expensive Italian dress shoes, you are not going to a Nike store.  If you want sushi, you are not going to a steak house!  We understand such examples because we have a lot of experience with buying and wearing shoes and eating different types of food.

Think about buying a car.  Where do you go?  To a dealer?  What kind of dealer?  How do you feel about used car dealerships?   Think about car maintenance.  Where do you go?  To a dealer?  To a small auto shop near you?  If you have a Mercedes, are you going to a Toyota dealer for service or vice-versa?  Do you feel a little concerned that you will be taken for a ride?

You should have as much concern in seeing any doctor.  I don’t care how amazing their reputation is as a doctor or as a person.  Is the doctor staying in his or her lane of expertise?  It’s easier for me to know who is staying true to his or her specialty.  Here is an example: My wife loves to scuba dive. However, she is unable to equalize the pressure in her ears beyond a few meters.  She’s had sinus problems for years, and she underwent sinus surgery, hoping that that would solve her problem. Her breathing got better, but it didn’t help her equalize her ears under water.  Now she’s being told that it could be a problem with her eustachian tube.  She researched on line (as most people do these days) and found a doctor, who is known for treating eustachian tube problems.  I went to this doctor’s website.  While he features a ‘revolutionary’ treatment for eustachian tube problems, he also advertises himself as a cosmetic doctor.  I told my wife that, if she goes and sees this doctor, he will most likely sell her on the idea of the treatment and probably Botox as well.  That’s in the DNA I saw on his website.  He’s going to go beyond his lane of expertise. That is a red flag for me.  Then, my wife got a recommendation of an otologist from her ENT doctor, who performed her sinus surgery.  I went to this recommended doctor’s website. She’s all about her expertise as a neuro-otologist.  She was staying in her lane of expertise.  There was nothing about Botox and fillers.   Do I know that she’s good at what she does?  No, not yet.  But I have two reasons to feel that my wife will get an honest opinion: a recommendation by an ENT doctor, who stays in his lane of expertise, of another ENT doctor, who is staying in her lane of expertise.

The credibility issue is hard to decipher in medicine.  We want to believe that doctors always have our concerns as patients in mind.  One of the most important oaths that we take as doctors is the Hippocratic oath: DO NO HARM!  I would add this to the oath: ON PURPOSE!  The skill and judgment of a doctor comes from PROPER TRAINING and PROPER EXPERIENCE.  However, proper training and experience alone does not make a doctor fabulous.  I think people consider EXPERIENCE too naively.  Experience alone does not make a doctor an excellent doctor. Just because a doctor has been in practice a long time does not mean that he or she is all that good.  A lot of doctors NEVER LEARN how to be exceptional or are not capable of being exceptional.  Every profession has a bell curve in terms of quality: a few exceptional talented ones, most are competent, and some are down right awful.  This is true in Plastic Surgery as well as in any other medical specialty.

What’s most important in choosing a doctor: training, experience and judgment, and a doctor who stays within his or her expertise.  This should be corroborated by honesty and a thorough explanation of benefits AND risks for the treatment you are seeking.  So, how do you choose an exceptional doctor?  Here are some basic things to think about and hope for the best:

  1. Am I spending most of the time with the doctor or is it with someone else?
  2. Do you feel that the doctor is being honest and thorough?
  3. Or is the doctor too busy to spend all the time you need?
  4. Do you feel like your doctor is educating you and giving you a professional understanding of the problem?
  5. Do you feel like you are being pressured to undergo a treatment?
  6. Or do you feel that you got the proper information and you feel free to think about your options?

Exceptional doctors do not compromise on quality of care.  Why?  Because we take a lot of pride in the work that we do.