Posted by Dr. Hardesty
This is probably the most difficult to research on a individual basis.
Most Bd. Cert. Plastic Surgeons perform both reconstructive (insurance) and
Aesthetic/cosmetic (non insurance/self pay). Only 2% or less focus/restrict their surgeries only on Aesthetic/Cosmetic procedures.
Those that belong to American Society for Aesthetic Surgery (ASAPS), have demonstrated by being accepted into membership (based on on criteria and historical case load)that they have a additional focus and experience in Aesthetic/cosmetic Plastic Surgery.
Do not hesitate to ask how many total procedures a year does your prospective Plastic Surgeon perform. Specifically ask how many of these procedures did he/she perform last year?
Ask to speak with several patients who have had the procedure,
Ask to see several pre and post operative photos that are not on his/her website.
Ask if residents or students will be assisting or help performing your surgery (most common at teaching medical schools or University based practices)
There are several companies that rate Physicians based on patients votes. I suggest you “google” your Plastic Surgeon by name ie, “patient ratings Dr. X” and see what you find. In particular RealSelf.com focuses on Bd. Cert. Plastic Surgeon ratings and is additionally a good place to post questions that will be answered by them
Physician and particularly Operating Room Nurses recommendations are usually accurate and based on the local Plastic Surgeons reputation.
Testimonials on a particular Plastic Surgeons web site are usually true but cannot easily be verified.
Personal friends and relatives who have a had positive experience with a similar procedures is also validating.
Over time, Plastic Surgeons often Plastic Surgeons will often be recognized for their contributions, commitment and service.
Some of the most appreciated awards are bestowed from the Plastic Surgeons own peers, colleagues and patients. Unlike some awards (physician registration, printing fee or purchase fees are required) the following are independent organizations, the award cannot be self appointed, bought (no physician fees required or asked for) or solicited for (unfortunately some are). Please go to websites listed under the reference section to see how the awardees are chosen. I would also recommend you search all awards mentioned on the Plastic Surgeons web site for its validly and how he/she chosen.
National Organizations: (no required fees to be payed to register or obtain award)
1) “Top Doctors of America”, top 3 % of all Plastic Surgeons. Source:Castle/Connolly (peered selected/voted)
2) “Top Doctor Ratings: top 3 % of all Plastic Surgeons. Source: The Center for the study of Service (peer selected/voted)
3) “Best Doctor”, top % of all Plastic Surgeons. source: Best Doctors, Inc. (peer voted)
4) “Compassionate Doctor Award”, top 3% of all Physicians. Source: Vitals Physician Rating (patient voted)
Local Magazines/newspapers, etc:
If your potential Plastic Surgeon claims a certain award ask him/her to validate it and how she/he obtained it. Was there a required fee to pay (registration, printing, etc) obtain the award.
– State licensure Board
Query the state licensure Board for any disciplanary actions, license restrictions, and complaints. In California medical licenses can be searched under the Dept. Of Consumer affairs.
If your Bd. Cert. Plastic Surgeon has multiple state licenses or has not been in one state his/her entire career see: Federation of State Medical Boards link under reference section and you will be abel to search his/her past experience in any state
– Legal actions
Malpractice lawsuits are not uncommon in medicine in general and have a higher incidence in a Plastic Surgery practice.
Just because a Plastic Surgeon has been sued doesn’t mean he or she did anything wrong. In 96% of those cases that go to trial the Physcian is found innocent.
And if found guilty the case will be reviewed by the State Medical Board and recorded in the National Physician data Bank
The “patient experience” is how you felt from the first phone call you made, how the receptionist treated you, your consult and are reflective of how you uniquely make choices.
It is a combination of both a intellectual process but also a visceral (gut) level feeling of who YOU will allow to help you reach your surgical goals.
In addition I have tried to include additional information that you as the patient should be aware of or ask.
There should be a clearly stated (in writing) and understood financial disclosure regarding your responsibility for all fees you will incur. Ask what the “total” fee will be for the procedure you are considering. This should include:
1) Plastic Surgeons fee, 2) Facility Fee (where the operation will take place), 3) Anesthesia fee (M.D. Anesthesiologist or Cert. Registered Nurse Anesthetist).
Are there any additional fees I that I will be responsible for (garmets, medications, non-narcotic pain pumps, etc)Ask to speak with several patients who
have had the procedure, Ask to see several pre and post operative photos that are not on his/her website.
Should a complication occur am I responsible for additional Plastic Surgeons, facility and anesthesia fees? Does the Plastic Surgeon have supplementary insurance for the patient if there is a unexpected need for a E.R. evaluation or hospitalization? There are companies (Cosmetasure and others) that (the Plastic Surgeon purchases preoperatively) will help off set additional expenses ( if your insurance company will not pay for or if you don’t have medical insurance).
Revisions or “touch ups” will on occasion need to be done despite the best efforts and expertise of your Plastic Surgeon. Ask specifically what the Plastic Surgeons “revisional policy” is and make sure you obtain a copy in writing. Most Plastic Surgeons will waive their fees and patient is responsible for the facility and anesthesia fees for a period of 1 year after surgery should a revision be necessary and agreed upon.
Please use this as a check list and only as a starting point. The following should not be considered inclusive by any means. Through this
question-and-answer period, consider impressions of the support staff, technical adjuncts (lasers, radiofrequency, etc), experience levels, and overall feelings of the office.
- Where did you complete your Plastic Surgery Residency?*
- Did you take a fellowship? * If so what in?*
- Are you certified by the American Bd. of Plastic a Surgery*
- Do you belong to the American Society of Plastic Surgeons? If not why?*
- Do you belong to the American Society for Aesthetic Surgery? If not why?*
- Do you operate only at accredited Out Patient Surgicenters?
- Should I need to be admitted after my outpatient surgery, do you have admitting privileges to the accepting transfer Hospital
- Do you have Hospital privileges to perform the surgery I am requesting? Which Hospital(s)?
- How many total surgeries a year do you perform?
- How many of the type of procedures I am considering have you performed in the last year?
- Do you have pre and postoperative photographs of the procedure I am considering?
- Do you have several patients that have had the procedure (that I am considering) that I may talk with?
- Have you ever been denied surgical privileges?
- Has your medical license ever been restricted or investigated?*
- How many medical malpractice cases have you settled or found guilty of.*
- If a have a problem or question during non business hours how do I get in contact with you.
- Do you provide a clear and written total cost for the procedure? This should include but not limited to: Plastic Surgeon fees, facility fees (operating room fees), Anesthetist fees, garments, pain pumps, medications, laboratory fees, pathology fees, etc.
- What is your overall revisional rate?
- What is your revisional policy? Specifically do you (Plastic Surgeon) charge additional fees? Who pays for facilities and anesthesia?
- Do you carry supplemental insurance for your patients? Example: Cosmetassure.
- What financing options do you provide?
- What is your deposit policy? Is it refundable?
- How do prophylactically protect against deep vein thrombosis (DVT) before,during and after surgery?
- Do you require a preoperative clearance by a physician?
- What, if any, preoperative lab work do you require?
- Do you perform the entire surgery yourself (from incision to the last stitch)?
- Do you have students, residents in training, or assistants in attendance that help perform my surgery?
- What happens if I unexpectedly need to be admitted to the Hospital after surgery?
- Is your out patient surgical facility accredited? By whom? Infection rate?
- Does your outpatient surgical facility have a “transfer agreement ” to a nearby hospital if I need to be admitted unexpectedly? Which Hospital?
- Do you use Bd. Cert. Anesthesiologist or Certified Nurse Anesthestists? Why?
- What is involved in my procedure?
- How long will I be under general anesthesia?
- How long will I be in the outpatient surgical facility recovery room?
- How long is my recovery time (days) after surgery?
- When can I expect to return to my daily activities, exercise program, work, etc.?
- What our the SPECFIC risks ( other bleeding, infection, and anesthesia)?
- What are the warning signs to be aware of possible postoperative complications?
- Where SPECFICALLY our the incisions placed?
- Do you have a postoperative scar reduction/protocol program? Silicone gel tape, Embrace, steroid injection/tape, lasers, etc
- Will I have drainage tubes? How long will they be in?
- The awards you have posted on your website… Are they peer voted/selected or patient voted. Did you pay to be included in any of them
- Will I need any preoperative laboratory evaluation and a clearance from my primary care physician?
- Have you ever been disciplined by a board or the state?
- On average, how many revisions do you perform on your own work?
- What is your success rate with this procedure?
- Would you be willing to perform this procedure on a family member?
- Is there any reason I would not be a good candidate for this surgery?
- Do you believe my expectations are realistic?
- What are my options regarding anesthesia?
- Are there newer techniques available to accomplish the same thing?
- How much pain should I expect? Do you offer non narcotic pain pumps? Do you inject long acting local anesthesia medication at the time of surgery?
- How much time should I plan to allow for healing?
- When should I expect to look “normal” again?
- Have you performed this procedure before?
- How long have you been performing this procedure?
- Can I see some before and after photos of patients who have had this procedure done by you?
- May I speak to some of your patients who have actually had this procedure done by you?
- Will the procedure be done in your office, or an outpatient center or a hospital?
- Do you have hospital privileges if I choose to have the procedure done in a hospital?
- Is the out patient surgical facility certified and licensed?
- Who will perform the actual surgery and outpatient care?
- Does your office offer financing?
- What will you do if I have a complication?
- If I’m not happy with the results, what if your policy for revisions? Would you put that in writing?
- If I need to talk with someone after hours, nights or weekends who will answer my questions.
I am often asked by friends, patients and those interested on how one becomes a Board Certified Plastic Surgeon. How to choose The Best/Top Plastic Surgeon and what questions to ask during a consultation. Thus, I have created a 3 part document addressing each of these areas. This is part 3. Part 1 is entitilted “What does it take to become a Board Certified Plastic Surgeon” And part 2 is entitled “How does a Plastic Surgeon become credentialed to perform plastic surgery”.
Those that belong to American Society for Aesthetic Surgery ( ASAPS), have demonstrated by being accepted into membership (based on on criteria and historical case load)that they have a additional focus and experience in Aesthetic/cosmetic Plastic Surgery.
There are several companies that rate Physicians based on patients votes. I suggest you “google” your Plastic Surgeon by name ie, “patient ratings Dr. X” and see what you find. In particular RealSelf.com focuses on Board Certified Plastic Surgeon ratings and is additionally a good place to post questions that will be answered by them.
The bottom line is:
- Do your research.
- Don’t be afraid to ask any question.
- Be specific about your needs, wants and desires.
I hope you find this information helpful. If I can improve upon, bring greater clarity or make absolutely anything more understandable, please email me at [email protected].
My best wishes and may you choose wisely.
Robert A. Hardesty M.D., F.A.C.S
Certified and Diplomate of the American Board of Plastic Surgery
ABOUT THE AUTHOR
1) 9 years of post graduate M.D. Degree residency/fellowship training
-General Surgery (obtained Bd. Cert) full residency
-Plastic Surgery (Bd. Certified) full residency
-Crainofacial Fellowship Training
2) As a Plastic Surgery Residency Training Program Director/ Division Chief (having help train over 30 Board Certified Plastic Surgeons/fellows).
3) 17 years in full time academic medicine at Loma Linda University resulting in attaining the rank of Professor.
4) 12+ years in private practice to the present (focusing on Aesthestic/Cosmetic Plastic Surgery)
5) Leadership positions:
a) Past president of the Medical Staff at Loma Linda University.
b) Positions within organized Plastic Surgery:
-Past President of the Ca. Soc. of Plastic Surgeons (CSPS)
-Past Bd. Member of the Am. Society of Plastic Surgeons (ASPS)
-Officer (Historian) of the Am. Ass. of Plastic Surgeons (AAPS)
-Chairman of Plastic Surgery Research Council (PSRC)
6) -Clinician of the year 2003
-Physician of the year 2015
7) National (Peer voted/selected) Awards and patient voted Awards:
-Top Doctors Award: peer voted/selected (Castle/Connolly, Inc.)
-Best Doctors Award: peer voted/selected ( Best Doctors, Inc.)
-Top Doctors Rating Award: peer voted/selected (The Center for Study and Service)
-Compassionate Physician Award: patient voted/selected (Vitals Rating)
– Real Self Top 100 Award
– State licensure Board
Query the state licensure Board for any disciplanary actions, license restrictions, and complaints. In California medical licenses can be searched under the Deptartment of Consumer Affairs.
If your Board Certified Plastic Surgeon has multiple state licenses or has not been in one state his/her entire career see: Federation of State Medical Boards link under reference section and you will be abel to search his/her past experience in any state
Accreditation Association for Ambulatory Health Care (http://aaahc)
American Association of Plastic Surgeons http://www.aaps1921.org/
American Association for Accreditation of Ambulatory Surgical Facilities (http://aaaasf
American Association Medical Colleges(http://www.aamc.org)
American Board of Medical Specialists(http://abms.org)
American Board of Plastic Surgery, Inc. (https://www.abplsurg.org/ModDefault.aspx
American Council of Graduate Medical Education(http://www.acgme.org)
American Medical Association (www.ama-assn.org)
American Society for Aesthetic Plastic Surgery (http://surgery.org)
American Society of Plastic Surgeons (http://www.plasticsurgery.org)
BBB Better Business Bureau (www.bbb.com)
Best Doctors, Inc (http//wwwbestdoctorsinc.com)
California Department of Consumer Affairs (www.dca.ca.gov)
Centers for Medicare/Medicaid Services (http://cme.gov)
Federation of State Medical Boards(http://www.fsmb.org)
Top Doctors, Castle and Connolly (http://wwwcastleconnolly.com)
Top Doctor Ratings:The Center for the study of Service (http://www.checkbook.org)
The Staff of Imagine Plastic Surgery serving many of the communities of the greater Inland Empire including but limited to Riverside, CA and Inland Empire, Redlands, Rancho Cucamonga, Ontario, Corona, Upland, and Chino Hills.
One Goal, Many Options
The most important factor to consider for your procedure or treatment is seeking the opinion and services of a skilled, experienced and Board Certified Plastic Surgeon who are experts in techniques. The Imagine Plastic Surgery team uniquely provides the full array of both non surgical and surgical alternatives thus filling our motto of “One Goal, Many Options.” For over 30 years Dr. Hardesty, an award winning, Board Certified Plastic Surgeon, has proudly been serving Riverside and San Bernardino counties of the Inland Empire and the communities of Rancho Cucamonga, Ontario, Upland, Corona, Chino Hills and Redlands. For over 30 years Dr. Hardesty and the Staff of Imagine Plastic Surgery have provided comprehensive Cosmetic Plastic Surgery services and procedures to Riverside and San Bernardino counties of the Inland Empire and the communities of Rancho Cucamonga, Ontario, Upland, Corona, Chino Hills and Redlands.
What is the cost?
At Imagine Plastic Surgery, we offer a variety a different procedures that all vary in prices. We strive in being transparent to all potential patients and being up front with how much our services may cost. For more information regarding the costs and prices, visit our plastic surgery prices page!COST OF PLASTIC SURGERY