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Plastic surgeon develops online consult tool

Article-Plastic surgeon develops online consult tool

Dr. Gary BreslowGary D. Breslow, M.D., was so bothered by inefficiencies of the patient consultation process that he began calling it the consultation conundrum.

The Paramus, N.J., plastic surgeon says he spent precious in-person time with people who were not candidates for procedures, who wanted something they couldn’t afford or who were simply doctor shopping.

“The consultation conundrum… describes the apparently universal yet seemingly unresolvable problem, where, as a cosmetic doctor, I have to waste a significant amount of time going through consultations with unqualified patients or consultations that go nowhere,” Dr. Breslow says. “It’s really just a description of the process, itself. The patients aren’t coming in to waste my time. The patients are coming in because they need information.”

In this Article

The Online Consult

Using Zwivel

But Is It Worth It?


The Online Consult

Today, Dr. Breslow is cofounder and CEO of Zwivel Online Cosmetic Consultations, a consultation tool, which, he says, solves the conundrum.

“This is a prequalification tool for both the doctors and the patients,” Dr. Breslow says.

The online tool Dr. Breslow helped to develop has two consultation-type options. The first is Zwivel Direct. With this options, doctors put the “start your consultation now” widget on their websites. Potential and current patients click on it and anonymously (using a user name) go through the consultation process. It’s much like what happens in the office, according to Dr. Breslow. Patients elect whether to answer questions about their medical histories, areas of cosmetic concern, treatment of choice, budget and more. If they want, they can upload photos — even videos.

“It’s all private and secure. It’s all HIPAA compliant and encrypted software,” Dr. Breslow says. “[It’s] mobile-compatible. You can do it from the iPhone or from the iPad.”

A patient then clicks send, which results in the doctor being notified that he or she has a new request.

“The doctor can reply with his or her recommendations and opinions and estimated fee. Or they can say, ‘I don’t think you’re a candidate at all for this procedure,” Dr. Breslow says.

Doctors can respond with their own procedure videos or before and after photos. The patients then gets a notification email that the doctor has replied to the request.

The result? The preliminary work — determining if what the patient wants and what the doctor is willing to do are a match — is completed before the patient sets foot in the office. 

The second consultation option is’s Zwivel Search, where potential patients search for doctors, based on a few parameters, such as location and board certification, then go through the consultation process with up to five doctors they choose.

Using Zwivel


Using Zwivel

There is no cost for using Zwivel Direct Basic on individual practice websites, according to Dr. Breslow. The company is getting ready to unveil Zwivel Premium, which will incur a cost. With the basic tool, the patient can send the doctor a request. The doctor can reply, but that’s it. The premium version offers the option of more back and forth communication. Other perks with the premium version include the ability to save replies for future use, creating a library of consultation videos and responses, and allowing doctors to incorporate staff members, such as nurse injectors, into their replies, according to Dr. Breslow. hasn’t started charging doctors for listings for the search function. Right now, company administrators are populating the site with doctors who do cosmetic surgery. These doctors may or may not be signed up on Zwivel. If patients go on to and search, the doctors they choose may not be signed up. But when that patient selects that doctor, the doctor gets a notification about the request and the option to activate a Zwivel account. Without activating the account, doctors can’t consult with potential patients.

“Ultimately, there will be a subscription fee for doctors. The doctors will be listed on Zwivel Search and will be able to see the request that comes in, but they won’t be able to reply to the request unless they’re Zwivel Search subscribed members,” Dr. Breslow says.

But Is It Worth It?


But Is It Worth It?

But the big question is, is it worth it?

Dr. Breslow says doctor feedback has been positive. When he does consults using Zwivel, Dr. Breslow says it takes him about four minutes, versus the 45- to 60-minute in-person consultation.

Not My Thing

Dr. Jonathan BermanJonathan R. Berman, M.D., a plastic surgeon in Boca Raton, Fla., didn’t know about Zwivel and agreed to check it out for Cosmetic Surgery Times. He signed up for a Zwivel account and says he’s unconvinced that the portal can effectively prescreen patients.

“Truly, there are different ways that different people get info about what they want, what surgery they are interested in...  There is a plethora of information on the web. Sure, it would be nice to have a platform that is the… authoritative voice for information. That is not a reasonable expectation. All in all, this platform is another type of ‘capture portal.’ It is entirely dependent on how active the practice website is,” Dr. Berman says.

For physicians to make it work, it’s important to respond to requests in a timely way, Dr. Berman says.

“I personally prefer in-office consultations. Quality plastic surgery is not a commodity. Every person is unique, as is their cosmetic desires,” Dr. Berman says.

Works for Me

Fort Myers, Fla., plastic surgeon Robert Brueck, M.D., uses Zwivel Direct and says the tool saves him time.

“It allows me to give a preliminary consult to a prospective patient pretty much anytime. Patients can send me some preliminary info along with photos, as well as what their needs and desires are. I can look at the info and see if it is reasonable and can at the same time give them a price range,” Dr. Brueck says. “They may soon realize the price is way out of their budget, hence they do not come in [and] spend 30 minutes in a consultation, which will waste their time and mine.”

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