"Public law and policy do not necessarily protect us from unreasonable and untrue claims," says Dr. Bayati. "A physician needs to be licensed in medicine -- which means earning a recognized medical degree -- and can hang out a shingle in any specialty he chooses; the state does not control what area of medicine he practices or which type of specialist he says he is unless there are complaints and he is brought before the Office of Professional Medical Conduct. Often, however, by then is too late."
What can we look for before placing ourselves under a physician's care to ascertain the qualities and qualifications of that physician? There are four basic areas that must be investigated to determine the qualifications and fitness of physicians. These are:A physician's training; a physician's certification; a physician's associations; and a physician's attitude toward his or her patients and the medical community at large. All board certified plastic surgeons are listed on plasticsurgery.org
"A physician should have and be willing to provide evidence that he or she has trained in the area of their expertise," says Dr. Bayati. "For example, patients want to locate a plastic surgeon who trained in plastic surgery, which means a post-surgical residency fellowship in the sub-specialty. Each residency or fellowship program gives a certificate certifying the dates of service as well as the hospital and department in which the physician trained." Physicians are usually quite proud of their achievements and keep these and many other framed diplomas in their offices. If they are not available, then at least a curriculum vitae or a brochure describing a doctor's training should be available and should be carefully examined by the patient him or herself. "If a physician is either unable or unwilling to disclose this information, it becomes a clear issue of 'medical consumer beware,' says Dr. Bayati.
After training in their chosen field, each medical or surgical sub-specialty has a certifying board that is approved by the American Board of Medical Specialists (ABMS). After spending the requisite number of years training, a physician has to take an examination in order to be certified. After being certified, a surgeon often applies to the American College of Surgeons for a fellowship. These credentials can be checked online and hospital libraries, where there is a Directory of American Medical Specialists that lists all physicians and the various specialties as well as a number of local physician directories which provide the same information.
"Unfortunately, the AMA and other state and local medical societies often allow a physician to self-designate a specialty and this can be misleading," says Dr. Bayati. "If a patient has questions misunderstandings and clarify the issue." A patient must be careful and wary of the self-designated specialist, however. "For example, The American Board of Cosmetic Surgery is not approved by the American Board of Medical Specialists and neither are a host of other so-called 'boards,'" advises Dr. Bayati, who is board-certified with the American Board of Plastic Surgeons which is the only plastic surgery board recognized by the ABMS. A gynecologist, ENT or general surgeon may be an exquisitely trained physician--but if they did cosmetic surgery, where did they learn to do it? Was it on-the-job training, or a correspondence course? How often do they go for a refresher course? Are they affiliated with a certified hospital in case of emergency? "
Dr. Bayati advises the would-be medical consumer "not to be impressed by a P.C. after the physician's name--it only means that they are incorporated. Jane Doe, M.D., F.A.C.S.', on the other hand, actually tells one something about the qualifications of the physician."
If patients are still confused, Dr. Bayati advises them "check a third area: a physician's associations and affiliations. If a physician is on the staff at a well-respected local teaching hospital in the department that is appropriate to their qualifications, then patients at least know that his or her qualifications have been appropriately researched by the hospital's committees and should therefore be valid and current. "Today, however, because of skyrocketing hospital costs, the trend is toward more out-patient surgery and care," says Dr. Bayati. "Because of this physicians have moved further away from the hospital. This may be good for the patient from a cost standpoint, but a well qualified surgeon should maintain a relationship with a hospital just in case there is a problem with a patient that requires hospitalization." Dr. Bayati further advises patients to remember that "when a physician is outside of an institutional setting, there is no quality control or peer review other than what the physician sets for himself."
Fourth, and finally, how does the physician approach and deal with you? "You don't have to like your surgeon as a friend, but do you think he/she has you, the patient at heart as his first consideration?" asks Dr. Bayati." For example, did your plastic surgeon explain all that was involved to the patient directly or leave it up to someone else? "It is important that the physician spend time with a patient and explain the goals of his or her care -- the alternatives, risks and possible complications. Usually, there is a lot of ground to be covered; a good measure is always to ask yourself whether you were given an opportunity to ask questions and have them answered to your satisfaction, or were you just rushed out of the office?"
Patients must feel comfortable with their physicians -- that is the bottom line. If not, and there is a problem post-operatively, it may not be easy to communicate." If a surgeon spends little or no time with a patient before surgery, he or she will probably spend less time afterwards. "Patients should ask themselves if this is really what they want," says Dr. Bayati. Another important question is whether or not the physician is available after hours for emergencies or questions. Sometimes an assistant takes care of all calls and sometimes the phone is answered by a machine that directs you to call back in the morning or go to the local emergency room. Wouldn't you prefer to have the ability to talk to your doctor if there is a problem?"
Patients must look into many areas of a physician's training, especially certification, association, and personality prior to allowing a medical professional to manage their health care. "If you do your homework well," says Dr. Bayati, "you should end up with a compassionate well-trained competent physician with whom you feel totally at ease and in whom you have the utmost confidence."
About Semira Bayati, MD, FACS
Dr. Bayati is a Newport Beach, Orange County Cosmetic Surgeon. She graduated with honors from Boston University’s School of Medicine and completed her integrated post doctoral training program in General Surgery and Plastic and Reconstructive Surgery at Southern Illinois University School of Medicine. She completed a fellowship program with the Loma Linda University Medical Center in Loma Linda, CA and is licensed to practice medicine in California.
Dr. Bayati is a member of the American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgery, American Society for Surgery of the Hand and a Fellow of The American College of Surgeons.
Dr. Bayati is also a diplomate of the American Board of Plastic Surgery, The National Board of Medical Examiners. She has earned a Certificate of Added Qualifications In Surgery of the Hand and has been a Qualified Medical Examiner. Her hospital affiliations include Hoag Memorial Hospital Presbyterian and Orange Coast Memorial Medical Center. Surgical Affiliations include Hoag Newport Surgicenter at Fashion Island, James Irvine Surgical Center and Laguna Hills Surgery Center. For more information about Dr. Bayati, please visit www.drbayati.com.
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