On Dr. McKee’s Facebook page, we recently posted a link to an article about the dangers of choosing an underqualified surgeon for cosmetic surgery. So it got me thinking: what do patients know about their surgeons’ qualifications before having surgery?
Who is looking out for you?
Who is looking out for your health and safety as a patient? Unfortunately, that answer may include fewer organizations than you think.
In my personal background, I used to work for an insurance company before coming to work for Dr. McKee. I worked in the Credentialing department, which means that I had to investigate each physician’s education and training before we would allow the doctor to participate in our network. If a doctor had insufficient training, he would not be approved and wouldn’t receive patient referrals from our insurance network.
So does that mean that if you have health insurance, any doctor you see in your network has been verified to have the right training?
Different insurance companies have different standards, so just because my former employer had fairly rigorous standards, that doesn’t mean that they all do.
And what about elective cosmetic surgery? Since your insurance company won’t be involved in helping choose the doctor, you may be starting your search from scratch.
When a doctor is licensed to practice medicine in the U.S., they’re not limited as to what procedures they can perform in their own office. If a doctor claims to be able to give you amazing results with a liposuction procedure in his office, the fact that he has a nice office, a medical license, and fancy equipment doesn’t necessarily mean he’s had adequate training in that procedure.
What does that mean for you? It means that, as a patient (or a potential patient), you need to do a little bit of homework on your doctor before agreeing to go under the knife.
Hospital Privileges: a tool patients can use
One reason some doctors may choose to perform cosmetic surgery in their offices is because they may not have the qualifications to obtain hospital privileges for those operations. What are hospital privileges? Like insurance companies, hospitals verify a doctor’s training and education to determine what procedures they will allow the doctor to perform in their hospital. However, according to Dr. McKee, “many non-American Board of Plastic Surgery cosmetic surgeons are doing procedures in their offices that they could not get privileges to do in the hospital because they are not qualified and wouldn’t be granted hospital privileges.”
In other words, if a surgeon is performing a certain procedure in his or her office, you may not know whether that surgeon would be qualified to perform that same procedure in the hospital operating room. If you’d like to know what operations your surgeon has privileges for, you can start by asking them directly. But bear in mind that while there are ways of confirming whether or not your doctor has hospital privileges (by calling the hospital or going to their website, for instance), none of them can verify the specific surgeries a doctor has privileges for.
However, hospital privileges are just one method of testing your doctors qualifications. You also need to examine the fine print when it comes to board certification.
Board Certification: all boards are not created equal
Is your doctor board-certified? By what board? The American Board of Medical Specialties (or ABMS) is the gold standard of physician training. In order to be certified by the ABMS, a doctor must undergo a specific amount of training (different for each specialty) by an accredited school, pass rigorous testing, and maintain a certain number of continuing education credits each year.
Under the ABMS are 24 “member boards”- these are the boards that represent a range of different medical specialties that the ABMS has determined meet their exacting standards. When it comes to cosmetic surgery specifically, the Palo Alto Medical Foundation puts it this way, “None of the 24 ABMS approved boards includes ‘cosmetic surgery’ in their name… While some of the 24 ABMS approved boards may cover a very limited number of cosmetic surgery procedures, only the American Board of Plastic Surgery covers all cosmetic surgery procedures.”
There are dozens (if not more) organizations that are collections of doctors all practicing the same specialty that are trying to be recognized by the ABMS, but simply don’t meet their standards. Some of these organizations accept any doctor who pays their dues, without doing much in the way of verifying their training. These organizations might have a name that sounds prestigious, but be careful: the only way to really be sure a plastic surgeon has top-tier training is to choose one certified by the American Board of Plastic Surgery.
How do I know if my doctor is board certified?
Depending on your doctor’s office, you may not get much time to examine all the certificates on the wall. Luckily, the ABMS allows you to search their website for board-certified surgeons in your area.
When it comes to plastic surgeons, you can also check for membership in the American Society of Plastic Surgeons (ASPS). All of their members are certified by either the ABMS or the Royal College of Physicians and Surgeons (for doctors in Canada).
From the ASPS:
Choosing an ASPS Member Surgeon ensures that you have selected a physician who:
- Has completed at least five years of surgical training with a minimum of two years in plastic surgery.
- Is trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction.
- Operates only in accredited medical facilities.
- Adheres to a strict code of ethics.
- Fulfills continuing medical education requirements, including standards and innovations in patient safety.
- Is board certified by The American Board of Plastic Surgery or in Canada by the Royal College of Physicians and Surgeons of Canada®.
Your best results
Even in these enlightened times, there are still an unfortunate number of snake oil salesmen out there. Certainly, not everyone you come across is trying to take advantage of you, but for your safety, it is vital that you remain an advocate for your own health. The good news? Finding your surgeon’s qualifications can be done with just a couple of clicks.