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Careful screening may help to identify, avoid difficult patients

Article-Careful screening may help to identify, avoid difficult patients

Palo Alto, Calif. — A physician here says that when it comes to avoiding the potential wrath of a disgruntled plastic-surgery patient, the best defense is a good offense, reports Medical News Today.

In “The Unhappy Patient Following Facial Plastic Surgery: What To Do?”, an article that appears in the May issue of the online journal Facial Plastic Surgery Clinics of North America, Richard Goode, M.D., writes that the key to avoiding the patient with unrealistic expectations or those obsessed with imagined physical defects is to use the initial interview as an effective screening process — and not to operate on patients who “fail” the screening.

In his article, Dr. Goode details certain patient types to interview carefully before making the final decision on whether to operate:

  • Perfectionists: Those seeking a flawless face cannot accept minor asymmetries or slight imperfections after surgery. Their hair is perfectly coifed, their attire and jewelry just right, nails and makeup flawless. They have the potential to be unrealistic patients.
  • Dissatisfied patients: Some of these were dissatisfied with previous facial plastic surgery by another surgeon. She or he wants the doctor to “fix” it. Goode writes, “Do they really need correction? Are customers always right as long as they can pay for it? I don’t think so.”
  • Patients whom the doctor or staff persons don’t like, for some reason. First instincts may be correct.
  • VIPs: Someone highly visible to the public, such as actors, TV personalities and politicians, have bigger stakes. An unhappy VIP after surgery is definitely worse than an unhappy non-VIP.

Dr. Goode, professor of otolaryngology at the Stanford University School of Medicine and chief of otolaryngology at the Veterans Affairs Palo Alto Health Care System, writes that research shows a small percentage of plastic surgery patients are at risk of experiencing psychological problems after undergoing elective plastic surgery. For some, it leads to depression. Some of these patients sue, harass and even threaten to kill the doctor who performed their surgery.

Medical News Today quotes Dr. Goode as saying, “We teach facial plastic surgeons in great detail how to evaluate a nose, the eyes and other facial features, but we need to provide more training on how to predict who will not be a ‘good’ postoperative patient.”

Dr. Goode recommends the use of electronic computer imaging during the interview process to help judge the prospective patient’s expectations. Also, he writes, it’s important for every surgeon to have a policy about who pays for revisions when necessary and to make sure the policy’s provisions are clear before surgery.

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