Medicine is losing its touch. The personal touch.
One of the studies I was reading talked about nonplastic surgeons doing plastic surgery. In the article it talked about the depersonalization of medicine. In English, they were referring to how many people get their plastic surgery care at the “Cosmetic Institute of blah___ (insert name of your town/area/state here).”
Who is their doctor? Do they see the same doctor each time? Do they even see a doctor? In the article they talk about how you used to KNOW who was your doctor. The doctor’s name was on the door. You knew who was going to treat you, answer your questions, hold your hand through it all, and most importantly, who to call if you had any problems.
I am not a good business woman. I get why these institutes are popping up. A single doctor can only do so much in a day. If only you could clone yourself. (Yes, we moms would benefit from that as well.) So since cloning is not around yet, you get a nurse and “patient coordinator” to help you see patients. They may do the initial consultation, screen, and educate on what the surgery entails. The nurse may see you for your follow ups, take out your drains, check your wounds. The doctor may poke their head in for the quick 2 minute chat and viewing. They may not.
When you are deciding to do a major surgery, I think it is imperative to be a team with your doctor. Particularly for cosmetic elective surgery, we are trying to make you happier. I should know you and understand your goals. This for me is my favorite part. I love my patients. I like getting to know them. The definition of a successful surgery is not an objective thing. There is no perfect breast or eyelid or tummy. And if I made a breast which fit the “ideal breast shape and coordinates” but you were bigger than you wanted to be, you would be unhappy, despite having a “perfect” breast. A successful surgery is when you, the patient, are happy.
I had a patient who went to a local dermatologist recently for laser to expedite the lightening of her scars. She got some hyperpigmentation and redness of the scar. She called me to see her. I asked her, “What did the doctor say?” “I haven’t seen the doctor.” “I have only seen the nurse. She promised me this would make the scars go away quickly for sure!” 1. I can’t advise her. I do not do lasers to hasten the lightening of scars. I do not know what it should look like. She should see the doctor. She called me because she knows I will see her, treat her, and advise her honestly. 2. I can’t believe anyone would guarantee anything to do with scars. When I hear that, I think the staff is more about selling, and less about truth. 3. She had gone for 3 or 4 visits, including her initial consultation, and had never seen the doctor.
I guess it is the way of the world a little bit… Depersonalization….Everyone went from seeing each other, to talking to each other on the phone, to email, and now to two second sound bites on twitter and facebook. Celebritydom… If I have one office, I am not a big name. But if I have an institute, or a chain of institutes, and have lots of staff working for me then I will be big. Maybe I’ll get a TV show.
What I hear from these and see in these is a loss of personal connection. During our medical school we are taught this is the doctor patient therapeutic bond.
So. I am not an institute. I won’t make as much money. I have no nurses. No patient coordinators. No one is going to film me for a reality Dr. 94304 show. But I love the connection with my patients. I try to do my best and be honest. And I see my patients- all of them, at every visit.