December’s Surgery Spotlight features ASPS President, David Song, MD

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Our December Surgery Spotlight is particularly meaningful for us at PSEN, as it showcases a VUG flap surgery by our new ASPS president, David Song, MD.

In this video, Dr. Song demonstrates the use of a VUG (Vertical Upper Gracilis) flap for breast reconstruction. The patient is a 37-year-old female, with previous attempted alloplastic breast reconstruction on the left side after a bilateral mastectomy. She has undergone radiation and lost the implant due to infection. The use of the VUG flap is the secondary option in this case, as the patient did not have enough abdominal nor buttock donor site tissue available. This video demonstrates the use of the penrose drain, used to identify both the proximal and distal portion of the gracilis muscle and to confirm that the skin and fat are centered over the muscle. The complexity of this procedure stems from the irradiated tissue, and multiple prior episodes of infection and scarring, making the anastomosis more challenging than usual.

Past Surgery Spotlight programs remain freely available to view on PSEN. Hard copies of these programs can also be purchased from the PSEN DVD Library
Filmed and produced by the Plastic Surgery Education Network (PSEN), Surgery Spotlights feature peer-reviewed, high-definition surgical video. It offers an excellent opportunity to study each step and technique as performed by the top names in the specialty.

Plastic Surgeons Need A Makeover

Plastic Surgeons Need A Makeover
By Daniel R. Solin

Plastic surgeons are acutely aware that they are in a competitive business. To increase sales in such a crowded marketplace, many have engaged marketing consultants, revamped their websites, posted video on YouTube and actively participate in discussions on realself.com and related sites.

The stakes are high. By some estimates, more than $12 billion was spent on cosmetic procedures in 2014.

What’s more, plastic surgeons are not only competing for new patients with each other, but also against dermatologists, otolaryngologists, oculoplastic surgeons and others who perform cosmetic procedures. I recently saw a billboard by a dentist advertising Botox injections!

The typical prospective patient will likely do research online and schedule a consultation with several different specialists or practices before making a final decision. That was the procedure I followed recently. My experience, however, was informed by the fact that I recently published a book on sales. I also coach professionals on how to convert more prospects into clients.

My personal experience interviewing three plastic surgeons and one oculoplastic surgeon convinced me that many need a makeover in their approach to attracting patients. Here’s why:

First impressions are instant

How long do you think it takes others to form an impression of you? It could be as short as a tenth of a second. That’s the conclusion of a recent study published in Psychological Science by Janine Willis and Alexander Todorov. Undergraduate students from Princeton University were shown pictures of male and female actors. They were then asked to give an opinion about various traits of the person portrayed. Exposure times as brief as one-tenth of a second were enough for participants to form an opinion.

First impressions are lasting

Numerous studies have established that, once we make up our mind about a person, that impression is very difficult to change. One of the problems with making determinations predicated on very little information is that, once the judgment is made, our brain scans for information that confirms our initial impression and ignores contrary data.

If you want to convert more consultations into patients, you need to focus on insuring your first impression is a positive one.

My first impressions

In my own search for a plastic surgeon, my first impressions were generally negative. My visits started well. I was greeted professionally in three of the offices I visited, and those offices were well-appointed. This was not my first experience when I met with a plastic surgeon at a major medical center. The reception area was crowded and the furniture looked like it had been rescued from the Salvation Army. The receptionists were obviously overwhelmed and dressed poorly.

The real problems, however, began when I met the surgeons. How would you like to be perceived? Competent, professional and caring or cool, good-looking and hip?

Two of the male plastic surgeons I met with had two-day stubble and were wearing conspicuously expensive designer clothes. If I was casting for cool, hip actors, their appearance would have scored points. In the context of my visit, it was a turn-off.

One of these two surgeons was wearing green scrubs. I had a more positive impression of him, but the scrubs looked like he had slept in them. Perhaps he had just come from a surgery, but it sure didn’t look professional to me.

Lack of interest

Given my training, and if the substance of my visits had gone better, I might have been the exception to the rule that first impressions are lasting. I use a very simple litmus test. When I am asked what I do, I reply that I am an author, which is true. You would think most people would then ask at least a few perfunctory follow-up questions, like “What kind of books do you write?”

The three plastic surgeons failed my test miserably. They showed no interest in me as a person. They asked me no questions, including why I was interested in the procedure we were discussing. Instead, they launched into an account of who they were, explained why they were eminently well-qualified to perform the procedure I sought and described what was involved with undergoing it. The surgeons then dismissed me and sent me to their coordinator, who focused on cost and scheduling.

Perhaps taking a cue from the surgeon, the coordinator also asked no questions. None made even this simple inquiry: How did your visit go?

Non-verbal recommendations

Plastic surgeons should be aware of these three factors which determine first impressions:

  • Facial expression
  • Clothes
  • Gestures

Facial expressions

Studies indicate people who are perceived as open, expressive and somewhat animated make a more positive first impression than people who come across as “difficult to read.” Keep this in mind when you walk into the examining room and greet your patient.

Clothes

There are a number of studies on how the clothes worn by physicians affect the way they are perceived by patients. I concur with the ones indicating most patients prefer doctors who dress professionally and wear a crisp, clean white coat. I want my surgeon to look like one, not a runway model. If you don’t want to wear a white coat, I recommend a “business casual” look, which makes you more relatable and less threatening.

Gestures

A classic TED talk by Amy Cuddy, an associate professor at Harvard Business School, vividly demonstrates the importance of gestures. The bottom line is that broad, open gestures with your hands extended and palms facing your patient convey both trustworthiness and transparency.

Verbal recommendations

Here’s a tip that will likely increase your conversion rate. It’s easy to state but difficult to implement. I need to constantly reinforce it with my own clients.

At the initial visit, don’t utter a single sentence ending in a period. Just ask questions. There will come a time when the patient will have questions for you. When this occurs, answer the question as briefly as possible, and then ask: Have I answered your question or do you want more information? If you have answered the question, continue to ask more questions.

There is evidence that following this process increases the production of oxytocin, which makes us feel good and more likely to trust others.

Because surgeons have asymmetric information, many believe patients want to (or must) be “educated.” My experience indicates this is almost never true. Most people want to be heard and understood. They want to feel you understand them and took the time to listen to them.

If a prospective patient has a question, they will ask it. Just to be sure, ask this question at the end of the visit: Have I addressed all your concerns?

Dan Solin (danielsolin.com) is the author of The Smartest Sales Book You’ll Ever Read and the New York Times bestselling author of the Smartest series of investing books.

October is Breast Cancer Awareness Month

In our efforts of acknowledging breast cancer awareness, PSEN invites you to revisit one of our past Surgery Spotlights, a Nipple-Sparing Mastectomy procedure.  Arthur Salibian, MD teams with oncologic breast surgeon Jay Harness, MD, to demonstrate a nipple-sparing mastectomy (NSM) performed through an inframammary approach.

Dr. Arthur Salibian is a plastic and reconstructive surgeon with more than 35 years of experience in Orange, Calif. Dr. Jay Harness is a breast cancer surgeon specializing in oncoplastic reconstruction and nipple-sparing mastectomy. He has a private practice in Orange, Calif. that focuses on complete breast health.

Purchase the online course to earn CME credit or watch the surgery video for free on PSEN.

The Surgery Spotlight DVD Library is available to purchase on PSEN. Surgery Spotlight is a video-based product line produced by the Plastic Surgery Education Network (PSEN).

Are you prepared for ICD-10?

On October 1, the United States will transition to the ICD-10-CM diagnostic coding system – the biggest change to medical coding in the last 20 years. The American Society of Plastic Surgeons has created an online interactive learning module designed to provide broad familiarity with the ICD-10-CM codebook and the steps necessary to accurately report new codes for plastic surgery. This in-depth course begins with the basic structure and concepts of the new system and progresses into the specifics of coding the diseases, locations and causes that frequently arise within the specialty. By using “Now You Code It” interactive exercises, downloadable coding challenges and a CME exam, this single module will quickly help coders make a smooth transition to ICD-10-CM.

Be ahead of the curve and access the ICD-10-CM Introductory Course on PSEN, today.

ASPS designates this online course for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This Month’s Patient Safety Discussion Sounds Off on VTE Prevention

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The latest Patient Safety Discussion on PSEN sparks conversation on the topic of Venous Thromboembolism prevention and screening.

ASPS Patient Safety Committee member, Gary Culbertson, MD, will be guiding the forum discussion hot topic, highlighting preoperative screening, significant risk factors, family history, postoperative planning and cost.

Patient Safety Discussion is a newly created forum in the PSEN Community that will be host of month long, open discussions on hot topics regarding patient safety.  The format allows and encourages completely open and honest conversation that will be community driven and committee guided.

Any and all members are encouraged to participate, so feel free to log on and chime in.  All questions, comments, concerns and answers are welcome here.

To join in on the discussion, head over to the PSEN Community Section.