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May/June 2016 Facial Plastic Times 1
MUSIC CITY HOSTS THE 2016 AAFPRS FALL MEETING
May/June 2016Vol. 37, No. 4
This year’s co-chairshave radically rede-signed the program bycreating topic-focused
tracks such as rhinoplasty,facelift, eyelid surgery, theaging face, non-surgical aes-thetics, and more. Phillip R.Langsdon, MD; Rami K. Batniji,MD; and Sam M. Lam, MD,collaborated to give you whatyou asked for—new speakers,new presentations, and a newformat.
Instructional courses havebeen eliminated and the entirethree-day program is organizedaccording to themes. Redun-dant talks were reduced, whilecreating focused lecturescontaining facts, new technol-ogy, and emerging trends.
“We have worked tirelesslyto structure a beneficial pro-gram that is all-inclusive andmaximizes the use of time,” saysDr. Lam. “Whether or not you’veattended an AAFPRS FallMeeting before, this year will setthe new standard for meetings,”Dr. Lam adds.
To be held at the Music CityCenter in Nashville, this meet-ing promises to be an unforget-table educational experience.
The preliminary program isincluded in this issue of FacialPlastic Times. Register early toget the early-bird rate and bookyour hotel accommodations atthe beautiful Omni NashvilleHotel—which is adjacent to theMusic City Center—beforerooms run out. M
2 Facial Plastic Times May/June 2016
Articles signed by their authors express theviews of those authors only and do notnecessarily express official policy of theAcademy. The Academy does not necessarilyendorse the products, programs, andservices that appear in paid, non-AAFPRSadvertisements.
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Executive Editor: Stephen C. DuffyMedical Editor: Steven H. Dayan, MDManaging Editor: Rita Chua MagnessFreelance Writer: Lynnette SimpsonFacial Plastic Times is published by theAmerican Academy of Facial Plastic andReconstructive Surgery (AAFPRS)310 S. Henry St., Alexandria, VA 22314;Phone: (703) 299-9291; Fax: (703) 299-8898E-mail: [email protected]; www.aafprs.org.
May/June 2016Vol. 37, No. 4
BOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORSBOARD OF DIRECTORS
Edwin F. Williams, III, MD, MD*President
Stephen S. Park, MD*Immediate Past President
Fred G. Fedok, MD*President-elect
Minas Constantinides, MD*Secretary
William H. Truswell, MD*Treasurer
Richard E. Davis, MD+Group VP for Education
Theda C. Kontis, MD*Group VP for Membership & Society Relations
Wm. Russell Ries, MD*Group VP for Public & Regulatory Affairs
Sam P. Most, MD+Group VP for Research, Development, and
Humanitarian Programs
Harrison C. "Chris" Putman, III, MD+Treasurer-elect
Paul J. Carniol, MD+Group VP for Membership and
Society Relations-elect
Andres Gantous, MDCanadian Regional Director
Patrick J. Byrne, MDEastern Regional Director
John S. Rhee, MDMidwestern Regional Director
Phillip R. Langsdon, MDSouthern Regional Director
David W. Kim, MDWestern Regional Director
Anthony P. Sclafani, MDDirector-at-Large
Lisa M. Ishii, MDYoung Physician Representative
Theresa A. Hadlock, MDEastern Regional Director-elect
Travis T. Tollefson, MDWestern Regional Director-elect
Stephen C. Duffy+Executive Vice President
*Member of the Executive Committee+ Ex-officio member of the Executive Committee
PRESIDENT’S MESSAGE:
I realize this message is politically charged. However, for those of you who know me well, I'm not one to mince words. The Affordable Care Act (ACA) asit stands is unsustainable and needs to bereplaced or radically altered. To under-stand how we ended up with the ACA, Iencourage you to read Steve Brill's book,America's Bitter Pill. Brill is a terrificwriter and journalist who has written forthe New York Times, New York Magazine,and the American Lawyers to name a few.
In the book, he sheds light on the historical perspective of health insur-ance, which I found informative, before reporting on the "blow by blow"accounts of what actually occurred leading up to the signing of theAffordable Care Act, in March of 2010, by President Obama.
Unfortunately, physician representation was not at the table; neitherwas organized medicine nor the American Medical Association involvedin the background negotiations. As the saying goes, "If you're not at thetable, you get eaten for lunch." Where did we—as physicians and pa-tient-advocates—fail at this process? I guess it begins when we firstallowed the healthcare system to start referring to us as "health careproviders" in the late 1990s. Really, where did the patient-doctor rela-tionship go?
Brill does a great job at keeping the book very objective and apoliti-cal. His "fly on the wall" approach is not only entertaining, but alsomakes it very difficult to put the book down. Clearly, the health caresystem was ripe for change with 30 million Americans not covered byhealth insurance, and anecdotal stories of Americans who thought theyhad adequate health insurance only to be devastated when a familymember had a catastrophic illness. Additionally, by the 1990s to 2000s,the cost of health care had continued to rise between 15 to 20 percentannually and by all accounts was not financially sustainable. However,while there was much made to do about the 30 million Americans whowere "not covered." I must say in all of my years of practice, I'm unawareof a patient who presented to the emergency room who was turned awaybecause of their inability to pay. Furthermore, in all my years of beinginvolved in trauma and our fellows' involvement at Albany MedicalCollege, patients were given tertiary level care regardless of their healthinsurance status. When we became aware that a patient did not haveinsurance or was unable to pay, we wrote off the balance. That's justhow we did things. Additionally, for the working middle class who didhave health insurance, the system clearly worked with reasonablecopays and coinsurances. Despite the naysayers, the United States stillis considered to have some of the best health care in the world. I havefriends and colleagues who travel here from Europe to receive theirexecutive physicals or any other health care that they may need.
In retrospect, what occurred with the passage of the ACA is essen-tially a one trillion dollar expansion of health care over the subsequent10 years, once the ACA was to be implemented. The potential winnersand players at the table were pharma, health insurance companies,large hospital health systems, and naturally the U.S. government thatwould be the recipient and distributing agent for the multitude of hiddentaxes and fees for the 9,625-page document governing the ACA. Whilethe intention of the ACA was to hold everyone getting paid accountablefor their actions in delivering health care, at the eleventh hour, a hugeconcession was made to get the legislation passed, which includedscrapping tort reform. Senator Harry Reid was adamantly opposed and
May/June 2016 Facial Plastic Times 3
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WHERE DO WE GO FROM HERE WITH THE ACA?
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2016 AAFPRS ClinicalInvestigation Award Deadline
The deadline to apply for theAAFPRS Clinical InvestigationAward is June 1, 2016. Thisaward is intended to providefunding to AAFPRS memberswho don't normally participatein research projects but demon-strate an interest in furtheringthe profession. These grants aremeant to foster career develop-ment and provide mentorship tomembers. The purpose of theseawards is to encourage youngsurgeons to pursue valid ideasby providing grants to offsetexpenses. To learn more, or toapply go to www.aafprs.org/research/.
given his influence, it was clearthe Affordable Care Act would notbe passed if malpractice and tortreform were included. A neces-sary concession to scrap thispiece occurred in apparently atenuous discussion betweenRahm Emanuel and Harry Reid.
In the months and yearsfollowing the passage of the ACA,stock prices of health care com-panies continue to rise with thepromise of more Americans notonly covered, but also unlikeMedicare payment and negotia-tions for medications, a conces-sion was made that the newsystem would allow payment foreveryone at "list" rates versusnegotiated rates currently inexistence for CMS with drugs.
Health insurance and hospi-tal executives were giddy over thethought that everyone would becovered with health insurance asa result of the original mandate.And while the aggressive consoli-dation occurred within the indus-try, stock prices for health insur-ance rose and many healthinsurance executives profitedhandsomely on speculation theinsurance industry stood tocollect their share of this onetrillion dollar expansion. Healthinsurance executives cashed inon their stock options and manyof them walked away extremelywealthy despite consolidation andloss of their jobs. While manyhealth insurance executivescontinued to complain about theregulations, restrictions, andconsolidation, many of thesesame executives were thrilledabout the promise of more con-trol, revenue, and salaries un-foreseen in the previous "brokensystem."
Fast forward to January 2016,the system is clearly more brokennow than ever and the patient-doctor relationship continues tobe strained even more. What do Imean by this? As a small busi-ness person who provided excel-lent health care benefits to our50+ staff, I can no longer afford
the 30 to 50 percent proposedincreases in providing the samehealth insurance my outstandingstaff is accustomed to receiving.Because we've had to cap theincreases at 15 percent, my hard-working, middle-class staff eitherpay the additional increases orconsider opting for the NYS publicoption that is a bit more afford-able. Those who have chosen theincreases frequently have consid-erably higher deductibles. Thishas resulted in a feeling of re-sentment; my staff often hasdifficulty paying for their deduct-ible for a needed service only tosee a patient who has a system-sponsored version of Medicare orMedicaid with very little or nocopays. Who has won here?
As head of a household and aperson who pays their own healthinsurance, I've seen triple-digitincreases in my high deductibleplan over the past three years.Currently, we pay approximately$15,000 annually for a family ofsix with a $10,000 deductible. Attimes, I honestly feel like I can'tkeep up with the doctor billsgiven this high deductible planthat costs me a small fortune.While I personally can afford thedoctor bills, many middle andupper middle class familiessimply cannot.
There was a recent editorialin the Wall Street Journal writtenby a gentleman who expressedhis feelings. He makes $110,000annually at his job and pays for a$10,000 deductible policy. He nowhas a policy where he can barelyafford the premiums and cer-tainly cannot afford the deduct-ible should he be required to usehis insurance for a minor familyillness or hospitalization. Whowon here? Clearly, not the middleclass.
As a shareholder in a surgerycenter that has been marginallyprofitable over the past 15 yearsand saved the health insuranceindustry a small fortune ascompared to performing surgeryin a hospital, the center lost
money last year. What we areobserving is the middle classchoosing to defer on electivesurgery at a record rate becauseof the high deductibles and theirinability to afford outpatientprocedures. Meanwhile, insur-ance co-sponsored Medicaidpatients who have no copay aremuch more likely to sign up forelective surgery that is financiallycrippling the surgery center. Thesurgery center, which representsa considerable amount of costsavings to the system, is nowfaced with either dropping insur-ance altogether and focusing ononly "cosmetic" cases or contin-ued insolvency. Who won in thisdeal?
The health insurance compa-nies are now wondering whathappened to them. Because theywere lured by the huge pot ofadditional revenue associatedwith covering 30 million addi-tional Americans in the indi-vidual mandate, things have notworked out favorably for them atall. As a result of the high cost ofcompliance associated with theAffordable Care Act, and the low See Patient-Doctor, page 12
4 Facial Plastic Times May/June 2016
The latest infographic from theAmerican Academy of FacialPlastic and ReconstructiveSurgery (AAFPRS) can, and
should, help kickstart your marketingand media engagement efforts. Releasedin early April 2016, the new infographicbreaks down the top trends spotted inour annual member survey. And whilethe graphic itself is eye candy, it con-tains a lot of meat that can be ex-pounded upon, shared, andrepurposed.
Here are six ways to use the info-graphic to help promote your practice,talents, and our specialty.
Spin it on social mediaInfographics are great social mediafodder. Post it. Tweet it. Feed yourfollowers. Infographics tend to be amongthe most shared type of content acrossall social platforms. Thank followers forsharing or commenting, as we knowthat engagement is social media gold.
Dissect it for spare partsEach “factoid” in the new infographic issubstance for your blog. Consider apost on new fixes for tired looking eyesor share your take on the desire for that“undone” look when it comes to nosejobs. Video blogs (vlogs) cater to pro-spective patients who would ratherwatch than read; and downloadablepodcasts also resonate well.
Share it with your media contactsEveryone loves a pretty infographic—especially beauty bloggers and report-ers. Send ours along. Let your contactsknow you are available for interviews onany and all of the trends highlighted inthe new infographic. This may beespecially appealing for local medialooking to put a down-home spin onnational news and trends. For example,64 percent of AAFPRS members saw anincrease in cosmetic surgery or inject-able treatments in patients under 30due to social media and selfies. Doesthis mirror what you are seeing inpractice? If so (or even if not), that'syour way in.
Learn from itLook at what the infographic is tellingyou about patients, and use the trend
data to better plan in-office events andtarget your marketing efforts. Morethan 70 percent of AAFPRS report thatcombining surgical and non-surgicalprocedures are in high demand.
Should this be something you offer(if you don't) and promote more vigor-ously (if you do offer)? Lips are also ontrend, according to the AAFPRS mem-ber survey. Consider an in-office eventdiscussing all the ways that you canadd volume and contour to the lips in2016.
Update your Web siteYour practice Web site says a lot aboutyou and the procedures that you offer.It is likely a prospective patients’ firstforay into your sphere. Yes, they willlook to credentials and education, butthey will also want to know that youperform the very procedures theywant. More than 50 percent of facialplastic surgeons report an uptick inpatients asking to get their cheek-bones back. Do you have the latestinformation on cheek enhancement onyour site? If not, it may be time toupdate this section.
Blast it out to your mailing listIf a picture is worth a thousand words,an infographic is worth at least10,000. Include ours in your newslet-ter to break up the text with a brightand colorful image. We know thatdifferent patients consume informationin different ways. Some like to read,some like to see it, and others like tohear it.
Enjoy the process and reap thebenefits. M
Remember to like us on Facebook(AAFPRS) and to follow us on Twitterand Instagram (@AAFPRS).
KELZ PR is eager to hear about yourdynamic patient cases that they canshare with the media. If you have astory to share, please e-mail Pattydirectly at [email protected].
Editor’s note: This column wasprepared by the Academy’s publicrelations firm, KELZ PR.
PR TIPS: WAYS TO USE THIS INFOGRAPHIC
May/June 2016 Facial Plastic Times 5
6 Facial Plastic Times May/June 2016
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By Steven H. Dayan,MD, Medical Editor,Facial Plastic Times
An Austra- lian comp- any has developed
a smartphone app that remotelyrecords cardiac rhythms. It cancapture atrial fibrillation, a widecomplex QRS, and maybe even anearly MI.1 A smartphone saving alife isn’t the only medical app thatis paving the way for the future ofmedicine. The monitoring andtreating of diabetes, hyperten-sion, and PTSD is also nowavailable. According to industryestimates, 50 percent of the morethan 3.4 billion smartphone andtablet users will have a mobilehealth app by 2018.2 Growing at20 percent a year, both consum-ers and physicians recognize thevalue of consumer medical appsfor improving health and increas-ing compliance.3 However, to everyyin there must be a yang.
My yang came about a monthback, when I was in the Guate-mala rainforest getting in touchwith my explorer side and Irealized I lost my phone. Has thatever happened to you? I panicked.What was I going to do? Howwould I get back? How would Itake pictures? But mostly, Ifeared private information, accessto my bank accounts, and pass-words being compromised. It ishard to believe that for 30 yearsof my life, I travelled and survivedwithout a cellular phone but nowit felt like I had lost my wallet orworse. Fortunately, about anhour later a taxi returned withmy phone. “Muchas gracias,” Isaid in my poor accented Span-ish. I was thankful, but it mademe stop and think: How has thesmartphone changed my life andthe world?
As a third-year resident, I gotmy first mobile phone. It made mylife a lot easier; now if paged, I
MESSAGE FROM THE MEDICAL EDITOR: “HYDROCODON-
PHONE,” A 21ST CENTURY DRUG
could immediately call back andnot have to stop at a phone booth.(Millennials: Note, phone boothswere the glass-enclosed closetslocated on street corners. Wewould put quarters into a payphone and make a call to alandline. See Superman video.4)But I was embarrassed to talk inpublic on a cell phone; it seemedrude. So, I would politely stepoutside, even if it was belowfreezing, to take a call. To thisday, I still feel uneasy talking onthe phone publically. I wouldcontrast this to the loud smack-ing power broker sitting next tome on the plane who has noconcerns letting the whole air-craft know about his indigestionfrom the French onion soup hehad for lunch.
Over the last decade, thephone has morphed from a devicedesigned for remote verbal com-munication to a self-containedentertainment, information, andpleasure toy. Early phones hadprimitive messaging, but theinsemination of the phone by theInternet has birthed thesmartphone. I would venture toguess it is probably the singlemost identifiable device respon-sible for changing the world themost over the past 50 years. Iremember 15 years ago, travellingthrough the rural country side ofan Eastern Bloc country after thefall of communism, and localvillage people curiously gatheredaround me to see what I wasdoing on a hand-held Blackberry.Fast forward to the present, andregardless of age, culture, reli-gion, color, or creed, the smart-phone has become a stapleappendage even in the mostremote corners of the earth. Itconnects all, highlighting thesimilarities between all humans.When 23rd century historianslook back, how will they catego-rize the impact the smartphonehas had on society and theprofession of medicine?
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There has been enormousstrides made in humanity, safety,information gathering, dissemina-tion, and education, all becauseof the smartphone; however,could the smartphone also be thestrongest mood altering sub-stance since opium? I am going tosuggest the “hydrocodon-phone”is a 21st century drug, withdangerously addictive properties.Look no further than the 1.6million car accidents per yearand nearly 4,000 deaths per yearattributed to those who“DUIphone,” (drive while texting).5
And, if you think that mature,reasonable adults are capriciouswith their phones...try pulling oneout of the hands of a teenager. Allstruggle with discipline andmoderation when it comes toprimitive urges; but, it can beespecially wrenching for tweenswho lack maturity of temperance.
The hydrocodo-phone has allthe elements of an addictive drug:mood altering, increasing toler-ance, and withdrawal symptoms.The hydrocodone phone offers theperfect escape for an uncomfort-able or socially awkward moment.And nowhere is this more appar-ent than when getting into anelevator. Today, not only is it rareto get an acknowledgment or a“hello,” but a troubling invisibilityis approaching. Politely engagingin conversation about theweather or staring blankly upinto space is no longer necessary;now, we can take a hit from afour-inch screen satisfying anurge to feel immediately at ease.And for those who need a quickerhigh, a screen can be wristmounted for quicker delivery ofsoma.
Like any drug that has me-dicinal value, if abused, it canlead to destruction. And theisolated cocoon weaved to protectan awkward back side, maydiffuse into an uncontrollableself-indulgence that can destroySee Effective Communication, page 11
May/June 2016 Facial Plastic Times 7
8 Facial Plastic Times May/June 2016
SUMMER FPST: IMPROVE FORM AND FUNCTION
Do you have a strategy forinforming your currentand potential patientson the latest techniques,
technologies, and surgeries thatyou offer? How often do youupdate your Web site with fresh,engaging content? The Academyprovides its members with FacialPlastic Surgery Today (FPST), anewsletter for consumers. If youare not a subscriber, now is yourchance to order your digital copyof the upcoming summer issue.You can print the newsletter withyour practice information for yourwaiting room or e-mail it to yourpatients. Additionally, you canpost the articles on your Web site.
The summer issue will cap-ture readers' attention with the
cover article, "News Flash: Menare Having Facial Plastic Sur-gery." The month of June is men'shealth awareness month; formany men, this will include avisit with a facial plastic surgeon.This article will review the moti-vation behind cosmetic improve-ment and what procedures aretrending among men.
Inside the issue, "Reconstruc-tive Surgeries to Improve Formand Function," will explore thevarious types of reconstructivesurgery: cancer reconstruction,nasal airway reconstruction, cleftlip repair, cleft palate repair, facetransplants, facial paralysis,facial trauma reconstruction,microtia repair, and scarrevision.
"Ask the expert"will tackle carboxy-therapy and how itcan be used to treatdark, under eye circles. Did you knowthat there is a linkbetween the levelsof air pollution andthe formation ofdark spots on theskin (lentigines)?The "What's new?"section will high-light a largescalestudy that con-cluded that forwomen older than50, exposure tonitrogen dioxide wassignificantly associ-ated with morelentigines on thecheeks. Patients will bereminded to seekadvice before com-mitting to the latesttrend in the "HealthTip." New products,procedures, andtechniques arepopularized in themedia every day. Itis important—espe-cially for products
that are not approved by the Foodand Drug Administration—thatthey seek your expertise beforeforging ahead.
Exciting research in theProceedings of the National Acad-emy of Sciences is exploring theaging process. "The Speed ofAging," on the back page, willhighlight this study of nearly1,000 participants, who werefollowed from age 26 to 38, across18 measures to show how quicklythey were aging. Factors typicallylinked to aging were includedsuch as, blood pressure, lungfunction, cholesterol, body massindex, inflammation, and theintegrity of their DNA. Theyrepeated the testing at 32 and 38years of age and then calculatedthe pace at which each personwas aging. This is an excellentway to track whether anti-agingtreatments work or not.
Start your annual subscrip-tion with the summer issue.Order your copy today. Refer tothe enclosed form in this issue ofFacial Plastic Times. M
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YOU CAN STILL RECEIVE THE SPRINGISSUE OF FPST (AS SEEN ABOVE). AND YOUCAN GET IT AT NO-CHARGE, IF YOU STARTYOUR ANNUAL SUBSCRIPTION ON ORBEFORE JULY 15, 2016. SEE ENCLOSEDSUBSCRIPTION FORM.
G
May/June 2016 Facial Plastic Times 9
By Wayne F. Larrabbee, Jr., MD
Our friend and colleagueTony Bull, MD, met anuntimely death lastmonth; we are all still
absorbing this great personal andprofessional loss. Tony worked,taught, and entertained us fromhis iconic office at 107 HarleyStreet seemingly forever. Forthose who didn’t know himpersonally, it is impossible tosummarize his charisma, humor,and wisdom—but there was noone like him. He was a giant inour specialty and along withClaus D. Walter, MD, the “glue”that bonded the North Americanand European facial plasticsurgery communities.
Tony was a consultant sur-geon at the Royal Throat Noseand Ear Hospital, The KingEdward VIIs Hospital for Officers,the Charing Cross Hospital, anda senior lecturer at the Instituteof Laryngology and Otology RoyalFree Hospital. His surgical skillswere legendary as seen in thelong queues of internationalpatients traveling to have himperform their rhinoplasties at theLondon Clinic. Rhinoplasty washis single largest passion; butunknown to many, he was alsoan equally talented stapedectomysurgeon and seemed to switcheffortlessly between the two skillsets. It is of note that Bill Wright,MD, one of the great rhinoplastysurgeons in the United States,also continued to do otology.These two pioneers chose opera-tions that required great preci-sion and craft.
Most of us first met Tony as ateacher. His lectures on rhino-plasty and “bat ears” were im-mensely entertaining; but be-neath the wit and irreverence,there was a deep understandingof the art and craft of our spe-cialty. His gravelly voice wasunique and immediately recogniz-able to all. His sayings such as“spot on” and “first rate” still echoin my mind. I remember when he
MR. TONY BULL...SURGEON, TEACHER, VISIONARY, FRIEND
and Jill joined us at a meeting inMorelia, Mexico, and he told mehe had developed a unilateralvocal cord paralysis. That neverleft him but only added to thecharacter of his voice and presen-tations.
Tony was one of the foundersof the European Academy ofFacial Plastic Surgery. This grewfrom the Joseph Society that heDr. Walter, had organized. Heserved as secretary from 1977-1988 and president from 1989-1994. He helped me organize theInternational Federation of FacialPlastic Surgery Societies andserved as president in 1998.
I have a special fondness forhis role, along with M. EugeneTardy, Jr., MD, in founding theFacial Plastic Surgery Monographs.I served on his editorial board for
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many years and this journal wasessentially the first credibleinternational publication in facialplastic surgery. J. Regan Thomas,MD, and I launched the Clinics inFacial Plastic Surgery later, basedto a large degree on this founda-tion. Our peer reviewed Archivesof Facial Plastic Surgery (nowJAMA Facial Plastic Surgery) alsowas possible because of hispioneering work and the demon-strated audience.
The most important legacy ofTony Bull is his kind and gener-ous support to all of us for whomhe was a mentor. When I wasstudying eye plastic surgery atthe Moorfield’s Eye Hospitalduring the 80s with Mr. RichardCollin, I would go on Fridays towatch Tony operate. He didn’tjust allow me to observe, butbecame a good friend. We wouldgo to his favorite pub afterwardsto continue the conversation.When I decided to start a practicein London, Tony welcomed mewarmly. He offered to allow me tosee my consultations in hispersonal rooms at 107 HarleyStreet and then wouldn’t considerany payment in return. He was agreat man, a great friend, and Iwill miss him very much. M
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Plan now to attend
Advances inRhinoplasty 2017
The course promisesto be an exciting,interactive learningexperience for stu-dents of rhinoplastyat all levels.
The faculty representsthe best rhinoplastysurgeons in the world,coming from multiplecontinents to provideup-to-date informationon rhinoplasty.
10 Facial Plastic Times May/June 2016
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FACE TO FACE UPDATE: VIETNAM AFTER 40 YEARS
I was 17 years old when myfamily left Vietnam and settledin Lansing, Mich. I earned amedical degree from the
University of Tennessee, Mem-phis. I met John M. Hodges, MD,during a clinical rotation in theENT program and we developed aclose relationship. I was veryimpressed with Dr. Hodges'personal character and profes-sionalism; and based on hisrecommendation, I pursued theENT program.
In October of 1998, I wasscheduled to give lectures duringthe FACE TO FACE trip to Viet-nam, but was unable to attenddue to my father's illness. Hepassed away in December of thatyear. I moved my family to At-lanta, and started my practice inENT and facial plastic surgery,with the focus on Asian blepharo-plasty and rhinoplasty. I re-mained in contact with Dr.Hodges, and on occasion, soughthis advice. Dr. Hodges continuedto give lectures at several hospi-tals in Vietnam after 1998. Heinvited me to travel with himthroughout the years; unfortu-nately, due to family and workobligations, I was unable to attend.
In October of 2015, I wasinducted into the Legacy SocietyClub at the University of Tennes-see and was reunited with Dr.Hodges. Again, Dr. Hodges ex-tended the invitation to go withhim to Vietnam in December as ateacher. I was very happy that mycircumstances allowed me toaccept his invitation this time. Aninvitation immediately followedfrom Tran Phan Chung Thuy,MD, the director of the ENTHospital in Ho Chi Minh, to givelectures at a plastic and recon-struct surgery workshop, Decem-ber 3-4, 2015. I gladly accepted.
PreparationAlong with the help of my wife,Linh, we started to prepare forthe long journey. I was a bitanxious regarding presenting thelectures in Vietnamese. Even
though I can speak the languagefluently, all of my medical train-ing has been in English. TheEnglish-Vietnamese dictionarybecame my best friend! In someinstances, I combined bothlanguages and hoped that theVietnamese physicians couldunderstand.
The courseAfter five days of touring thecountry, I returned to Ho ChiMinh City. As I entered the gatesof the ENT hospital, I became veryemotional. There were numerouspatients waiting outside, hopingto be seen. The hospital is old,but in much better conditionthan I had expected. Dr. TranThuy welcomed me and asked meto give an opening speech for theworkshop. I was humbled by theprivilege to teach at a hospital inmy birth country after 40 years. Iwas glad that I could still commu-nicate with the Vietnamesephysicians in the same language.
I gave a lecture on Asianblepharoplasty and Dr. Hodgeslectured on rhinoplasty after hisarrival the first morning. Heperformed two surgeries later thatafternoon, a rhinoplasty recon-struction for a cleft lip patientand a lower lip scar repair/reconstruction for another. Wethen attended a welcome dinnerat the Majestic Hotel attended bythe director and staff fromthe hospital. We enjoyedscrumptious food accompa-nied with live Vietnamesemusic and traditionaldance. The next morningwas especially thrilling forme because I performedand taught a live surgeryof Asian double eyelid withlocal anesthesia. Then Iwas requested to performan impromptu live upperand lower eyelid surgery ona doctor who was attendingthe class. Dr. Hodgesperformed and taught alive facelift and anothercleft lip rhinoplasty in the
other surgery room. The after-noon of the second day wasdedicated to lectures. I spoke onAsian augmentation rhinoplastyand complication, and Dr. Hodgeslectured on reconstruction offacial defects. We attended aprivate dinner that evening withthe chair of the Plastic andReconstructive Surgery Depart-ment of Cho Ray Hospital.
We were invited to visit thebeaches at Vung Tau the follow-ing day, but Linh and I decided tospend our last two days in Ho ChiMinh City. We spent them visitingwith relatives and friends andalso visited the hospital to followup with the patients. Both of mypatients had gone home, and Dr.Hodges' patients were fine andready to be discharged from thehospital. We had a wonderfulfarewell dinner on our last nightat Quan Dong Restaurant.
We left Vietnam and arrivedsafely back in the United States.The experience and the memoriesof this trip have left a giganticimprint on our lives, and we arealready looking forward to ournext return to Vietnam in thenear future.
Editor's Note: This article waswritten by Khuong Van Nguyen,MD (seen here with his wife), acolleague of Dr. Hodges (right) anda friend of the Academy.
May/June 2016 Facial Plastic Times 11
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From Medical Editor, page 6relationships. As we are trans-ported to a virtual world instantlyconnected to all others minute-by-minute, we become occupiedbut not present in the moment.The phone today is an amazingadvancement in long-distanceconnections, allowing instantsharing of a story with hundredsif not thousands of people aroundthe world and maintaining tieswith family and friends overseas.The irony is that nothing stealsan intimate moment from the oneclosest to you than a phone. Howhurtful or insulting when a phoneis placed face up at the dinnertable? Your meaningful story canbe swiped out and dismissed by aconfidant more interested in thenext Facebook alert. According toresearchers at Baylor University,nearly 50 percent of respondentshave felt insulted by “phubbing,”a new word meaning beingsnubbed by a loved one becauseof phone interruption. At least 23percent felt it had a negativeimpact on the relationship, evenleading to feelings of depressionin over one-third.6
How we communicate haschanged more in the last fiveyears than in the 2,000-year leapit took to go from hieroglyphics toalphabet letters. We have anemerging generation that commu-nicates better in 140 characters,emoji’s, and acronyms than inspoken words. Although I am surethe early 1900s had comparativedilemmas when the telephoneencroached on the written word,there is something so uniquelyone dimensional about communi-cating via the smartphone that itcannot be overlooked. Texting andsocial media allow communica-tion within a time frame that bestfits one’s schedule, as opposed toa phone conversation that forcesengagement in the moment. It isimpossible to have a one-wayphone conversation. I have toadmit, I am a fan of the “commu-nicate when you wish” aspect oftexting, a great tool for multi-
taskers. It allows a say when wefeel like it… and if we want to fireoff a quick note and selfishly notwait for a response, we can dothat too. For the ADD and thosealways needing to get in the lastword, what could be better? Itseems that human culture hasfinally caught up with them.Nevertheless, what will be theimpact on human interaction andsocialization when the influenceof the smartphone is fully real-ized?
Will the disuse atrophy ofinterpersonal communicationskills and an inability to be alonewith our thoughts slowly erodeour evolutionary advantage toreason, actively ponder, reflect,and imagine? From Einstein toFreud to Jobs, many of the great-est advancements in humanculture stem from those wholearned to experiment withdetailed thoughts in their mindsto create, manipulate, and extendthe boundaries of science.
Closer to the here and now,how does and will the smart-phone impact aesthetic medicine?For many, it is already providingan important added measure ofcomfort allowing an ability to seepostoperative concerns in realtime. Soon it may be an accept-able standard for performingimaging and virtual consults fromanywhere in the world. And justas orthopedic surgeons arereporting a burgeoning businessof carpal tunnel phone syndrome,there is some thought that aes-thetic physicians will be seeingmore patients with NWPS (neckwrinkle phone syndrome), sec-ondary to looking down to view aphone.7 Perhaps the phone will beable to determine where skindamage lies, measure laxity, andhelp to virtually schedule a laseror chemical peel. Perhaps aphone will allow patients tocapture and create an idealized3-D image of a nose that can beprinted and delivered to officesonly needing to be inserted underthe nasal skin in a quick
procedure. A smart-phone doingsurgery is fortunately hard toconceptualize; thankfully so, as ifit could, we might be out of a job.Yet crazier things have happened.The future of how the phone willaffect our field is fascinating toconsider.
While we continue to praisethe phone and its aid in medicalconvenience, diagnostics, andmonitoring, we have to be cau-tious. In aesthetics as in life, themost important contributor towell-being and patient satisfac-tion distills down to effective andmeaningful communication.
Embracing the emergingvalue of the smartphone to theadvancement of our field isprudent. However, equally criticalis not to overlook the need tomaster the art of empathetic face-to-face communication. Maybe itis time to occasionally put downthe phone and better engage withthose in front of us. How weinteract, treat, and advise thosewho rely on us may be the key-stone not only to securing thefuture of our profession, but alsoto maintaining a sense of serenityas well. M
References1Alivecor™ www.alivecor.com2www.fda.gov/MedicalDevices/DigitalHealth/MobileMedicalApplications/default.htm3www.modernhealthcare.com/article/20151128/MAGAZINE/311289981.4www.youtube.com/watch?v=p0B1ufyXOds)5www.textinganddrivingsafety.com/texting-and-driving-stats6www.huffingtonpost.com/entry/cell-phone-hurts-relationships-phone-snub_us_560c0cdee4b0dd85030a1c4e7www.aafprs.org/media/press-release/20150324.html
MAINTAIN EFFECTIVE AND MEANINGFUL COMMUNICATION
12 Facial Plastic Times May/June 2016
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From President’s Message, page 3enrollment by individuals seeking"private" or non-state sponsoredprograms, most health insurancecompanies are losing money atrecord rates and are now on anunsustainable path. Aetna,historically one of the largestproviders of health insurance,recently announced they areconsidering an exit of healthinsurance altogether in 2017. Inthe Wall Street Journal at the timeof this writing, May 5, 2016,health insurance giant UnitedHealthcare is also entertaining awithdrawal from all but a handfulof states where private healthinsurance is sold. Who winshere?
As a physician/surgeon, I'vealways taken pride in the factthat while we could afford to dropcare for insured patients, to thechagrin of our consultants, we'vealways participated with essen-tially every health insurancecompany including Medicaid.Over the years, I've just felt as amember of the community that itwas my obligation to do so. As ofMay 2016, I will no longer partici-pate with any health insurancegiven the associated hassle,compliance cost, declining reim-bursement, and frustration. Whowon here?
For all physicians, change isin the air and unfortunately, it isnot favorable. The underpaidprimary care physicians werepromised increased compensationwith the implementation of theAffordable Care Act. That has nothappened thus far. Additionally,they have been rewarded withadditional compliance costs,further regulations, and theassociated frustration. This alsoholds true for surgical sub-specialties. Many surgical prac-tices have been absorbed by thehospital system with the lure of astable salary and protection. Theresult again has been moreregulation and loss of autonomy.While compensation has beenreasonable, most experts agree
surgical sub-specialists canexpect to see compensationdecreases between 20 to 30percent over the next five years.
Given the sacrifices associ-ated with medical school andsurgical training, the AffordableCare Act quite honestly is a toughsell and I'm not sure it makesgood financial sense. If I am inneed of a neurosurgeon at somepoint in my life, I want the bestand brightest to be attracted toneurosurgery and not to WallStreet. Who is winning here?
Being the eternal optimist, Ihope you understand this mes-sage is not intended to be adowner but to cause a call foraction by all of us. We are nowexperiencing a record number ofphysicians pursuing an MBA overthe last five years and I'm specifi-cally calling to action each andevery one of us—but specificallyour newly minted MD/MBAs.Given the current financiallyunsustainable mess we arefacing, I am challenging thosephysicians to use their influenceand resolve to put the patient-doctor relationship front andcenter in each and every discus-sion related to health care reform.
Medicine is truly a nobleprofession. There's definitelysome type of psychological trans-formation that occurs as you gothrough a residency trainingprogram. One slowly becomesacutely aware of the responsibil-ity bestowed upon you and thetrust a total stranger will place inyou simply because you are theirdoctor. It is a trust I committed tonever take advantage of; I believemost good physicians feel thesame way. This is why we cannotsimply rely on others with a deep-rooted agenda to rectify theshortcomings of the ACA or howwe practice our profession.
In the interest of not spoilingthe book, in America's Bitter Pill,Stephen Brill comes to many ofmy same conclusions. I continueto remain hopeful for our youngresidents, medical students, and
aspiring physicians as I lookthem in the eye and assure themthat caring for someone as aphysician or surgeon will givethem the fulfillment not achiev-able by any other profession.
To the next generation ofphysicians, given what is atstake, we need your lifelongcommitment more than ever tobecome involved and stay in-vested.
Edwin F. WIlliams, III, MD
PATIENT-DOCTOR RELATIONSHIP IS FIRST AND FOREMOST
CLASSIFIED ADPractice Opportunity SanFrancisco Bay Area40-year-old, accredited office-based surgery facility, facialplastic surgery practice includ-ing hair transplantation,available for fellowship trainedFPS or equivalent. Immediateassociation available and earlypractice acquisition/transfer/sale. Contact Sheldon S.Kabaker, MD, for further detailsand information regardingpractice and timeline. Thepractice is located in the SanFrancisco Bay Area communityof Oakland, California, only 20minutes from downtown SanFrancisco. E-mail requests to:[email protected].
ACADEMY AWARDSThe AAFPRS is still acceptingnominees for the followingAcademy awards: ResidencyTravel, William Wright, MarkRafaty, John Dickinson, andCommunity Service awards forpresentation at the 2016 FallMeeting in Nashville, Tenn.
For more information,contact Glenda Shugars at theAcademy office at (703) 299-9291, ext. 234, or visit theAAFPRS Web site, AAFPRSFoundation, the ResearchCenter: www.aafprs.org/research/awards/.
May/June 2016 Facial Plastic Times 13
14 Facial Plastic Times May/June 2016
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LEVELING THE PLAYING FIELD BETWEEN OUT OF NETWORK
By definition, a "levelplaying field" is a conceptabout fairness where allplayers play by the same
set of rules. The underlyingassumption is transparency andconsistency of the rules, theirdefinition, and their interpreta-tion. In other words, a playbookthat all players have access toand understand. Unfortunately,in today's reimbursement worldfor out of network providers(OON), the field is sorely offbalance leading to potentiallyhundreds of thousands of dollarsunclaimed and uncollected.
The playersInsurance companies: For themost part, insurers are corporategiants with deep pockets thathave mastered the art of creatingprocesses on top of processes. A
Web of red tape at every turncauses members and providersalike to feel stuck and out ofcontrol. This is the image oftoday's insurers. An exaggera-tion? You be the judge.
Out of network providers:Long gone are the days of privatepractice physicians seeing pa-tients with little concern aboutinsurance reimbursements.Today, being in private practice,and one who is an out of networkprovider, carries with it hugerisks and daily unknowns. Profes-sionals, who were trained to treatpatients, but not necessarily runa business, are forced to face-offdaily with their large-scale coun-terparts on matters directlyaffecting the bottom line. Theresult? Physicians must managethe rising costs of business in amedical climate they have very
little control over.The claims audit-ing and appealsprocess itself getsoverburdening, andwithout knowingthe specific planoutlined in apatient's SummaryPlan Description(SPD), providersare unable to takeaction againstclaims offers thatare unfair andsometimes evendownright insult-ing. Even a largepractice rarely hasthe internal abilityand resources toeffectively managethis process.
The playbookSummary PlanDescription: Forevery health insur-ance plan that iswritten, there is aSummary PlanDescription (SPD)that goes alongwith it and is given
to the member when he or sheenrolls. In most cases, it is solelythe insurer who interprets andexecutes the terms in the SPD,and controls the claims processevery step of the way. Therefore, itis ultimately up to them to deter-mine the level of difficulty, clarity,and consistency of each claimhandled.
The language in an SPD istypically ambiguous, unclear, andwide open to interpretation.Terms such as "usual and cus-tomary," and "allowable amount,"are examples of ways insurerskeep control of specific claims.The ambiguity allows for interpre-tation, and usually this interpre-tation is done solely on theinsurer side. For example, what isusual and customary, and whodetermines that? Further, whodetermines the allowable amountand when can it change?
Why does this keep the claimnegotiations one-sided? Becausethe member rarely keeps or readsthe SPD and the provider onlyhas access to it if the membergives him the right. If the providerdoes not see the SPD, they areunable to determine if what theinsurer is offering is outside thescope of what is fair for eachclaim.
The answer?With knowledge, comes power.ERISA-Most insurance policiesare governed under ERISA (Em-ployee Retirement Income Secu-rity Act), and therefore have strictregulations regarding disclosureof terms and administration ofpolicies. Specifically, ERISAguarantees each member a fulland fair review of plan documentsand all evidence, methodology,and fee schedules relied upon todetermine the reimbursementamount. The key to OON provid-ers receiving more, if not all, ofthe reimbursement in accordancewith each member's policy, is totake a systematic approach andwork with the law under ERISAfor each claim.
May/June 2016 Facial Plastic Times 15
PROVIDERS AND INSURANCE COMPANIES
Leveling the fieldEnsure all patients sign a DAR(Designated Authorized Represen-tative) form on initial visit. Acritical starting point as thisallows the providers to "step intothe shoes" of the patient. Withouta DAR, providers have no rights,as health insurance is a contrac-tual agreement between themember and the insurancecompany. Once signed, however,the provider has all the rightsand protections afforded underthe patient's policy and the law.By exercising the member's rightsunder ERISA, providers are ableto appeal, negotiate directly,clarify terms, and ultimately holdthe insurance companies to thefairest interpretation of the SPDpossible under the law.
Exhaust the written appealsprocess. This process includes allthe administrative remediesrequired before a claim can moveon to litigation. It is a tediousprocess complete with red tape,denials, and delays, and can takesix months or longer. Manyproviders and members give upand accept whatever they areoffered at this point—usually wellbelow what they are entitled to.
Request an SPD. Legalintervention begins with a re-quest for a Summary Plan De-scription. Providing the SPD isrequired under ERISA, and arefusal or a delay in doing so hassevere fines.
Take legal intervention andaction. Once the member's SPD isreceived, a careful analysis canidentify language to be challengedand proven inconsistent. It isthese inconsistencies, ambigu-ities, or buried promises that canlead to a clarification of theterms, a re-evaluation of thecurrent payment, and ultimatelya favorable result. Many times,claims can be settled prior tolitigation with demand letters.However, as a last resort, insur-ers will be taken to court, manytimes resulting in a settlement inthe early stages of litigation.
No pain, no gainObviously, this sounds simple butcan be difficult and sometimesimpossible for busy medicalpractices to implement. Histori-cally, insurers have realized thistoo and brought in outside help.In many cases, it is beneficial forproviders to consider doing thesame. A designated resource thatworks specifically on the claimsauditing and appeals process andinsurer negotiations can keep theprocess moving to a favorableoutcome—ultimately leavingmuch less money on the table.These resources can work on oneor several parts of the process, oncurrent claims, or provide acomplete analysis of historicalclaims with potential benefits.
The only constant in today'smedical climate is that thingscontinue to change. Keeping upwith the changes, and staying ontop of claims processes arecritical to maintaining a success-ful practice. It might be a difficultand sometimes painful part ofbusiness, but one that is notgoing away. The positive impacton the bottom line can be aconstant reminder that it is along-term investment in a difficultbusiness. M
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Editor's Note:The Law Offices of Cohen &Howard grants permission to theAmerican Academy of FacialPlastic and ReconstructiveSurgery (AAFPRS) to print thisarticle in the May/June 2016issue of Facial Plastic Times.The writer, Leslie Howard, Esq.,will speak on this topic at theupcoming Fall Meeting in Nash-ville during the Practice Manage-ment Session. Leslie is a found-ing member of The Law Offices ofCohen & Howard, a New Jerseybased firm that works with non-participating medical groups (outof network providers) to helpdrive up reimbursements frominsurance companies by focusingon an underutilized area of thelaw (ERISA).
CLASSIFIED ADCosmetic clinical assistant inNew York City needed.Responsible for managementof facial plastic surgery de-partment by focusing onmedical and surgical patientcare and development of thecosmetic practice. Dutiesinclude assisting physician inperforming examinations andprocedures, educating pa-tients on procedures andoptions, maintaining cosmeticinventory, and assisting incosmetic marketing andevents. Candidate should beable to initiate and convertpatients from general ENT tofacial plastic surgery.
The applicant must haveknowledge of infection control,medical/cosmetic procedures,OSHA and HIPAA regulations,medical safety protocols,software systems includingExcel, Word, Epic, Greenway,and Televantage systems orability to learn.
Please send your resumeto [email protected].
CLASSIFIED ADVECTRA H1 3D imaging andconsultation system for sale.We are selling a new Vectra 3Dimaging system. Improve yourconsult to surgery conversionrates with visual communica-tions. The VECTRA H1handheld imaging systembrings clinical quality 3Dimaging to any practice. Itdelivers precision optics forhigh-resolution 3D images inan intuitive, lightweight, andeasy to handle image capturesystem. Ideal for facialaesthetics, clinical documen-tation, and more; it’scompletely self-contained withintegrated flash and ranginglights. The VECTRA H1 isready to go with minimalstaff training. ContactRyan Menachof [email protected],(303) 792-3242.
16 Facial Plastic Times May/June 2016
For four days, top facialplastic surgeons, plasticsurgeons, dermatologists,and oculoplastic surgeons
convened at the Beverly Wilshireto present and learn about thehottest techniques throughdynamic panels, workshops, andfirst-ever dueling live surgerysessions for the Facial Rejuvena-tion: Master the Techniques event.For those of you who do not know,this meeting is a reboot of themeeting formerly known asRejuvenation of the Aging Face.The faculty, the program, thehotel, and the host city were all ofthe reasons why this meeting wasvery well attended; attendeescame from all over the world,including Brazil, England,France, Lebanon, Saudi Arabia,and Kuwait.
One meeting feature was afull-day injection course demon-strating innovative off-labeltechniques. Another highlight tothe program was "dueling" livesurgeries: two surgeons demon-strating different approaches andtechniques to address the sameissue. For instance, Stephen W.Perkins, MD, and Andrew J.Jacono, MD, each performedtheir facelift/necklift surgicalprocedures at the same timeand these surgeries were broad-cast live to the Beverly Wilshireballroom where a moderator,panelists, and attendees dis-cussed the differing techniques.
Celebrity speakers includedPaul S. Nassif, MD, and MichaelWestmore, both giving interest-ing anecdotes about theirexperiences in Hollywood.
Thirty-six companies jam-packed the exhibit hall, wherethe lunches, breaks, andcocktail receptions were held.Exhibitors were pleased withthe traffic of nearly 300surgeons daily.
Members of the media tookadvantage of the insightfulpresentations. The AAFPRSissued passes to 15 credentialedjournalists. Many attended the
opening reception and enjoyedmingling with the AAFPRS leader-ship and presenters.
Media coverage was earned invarious outlets, such as a toptelevision segment with Associ-ated Press TV, which will airsoon. In addition, press clippingsinclude beauty and celebrityblogs and trade journals likePRIME and Modern Aesthetics. Theevent was pre-promoted viavarious calendar listings espe-cially in the trade magazines andWeb sites like Plastic SurgeryPractice and Modern Aesthetics.Finally, a wrap-up press releasetitled, "What's Trending in 2016,AAFPRS members reveal 'TheNext Big Thing,'" was distributedto media contacts after the event.
Beverly Hills is an ideallocation for a facial rejuvenationmeeting. Interestingly, thismeeting is the first major plasticsurgery society meeting held inthe iconic Beverly Wilshire Hotel.Attendees had a full immersionexperience in Beverly Hills, withRodeo Drive across the streetfrom the hotel. M
THE CO-CHAIRS (FROM LEFT), DRS. BATNIJI,PERKINS, AND KONTIS, ON THE RED CARPETIN FRONT OF THE STEP-AND-REPEAT, WHEREATTENDEES GATHERED FOR SELFIES.
A RECAP OF A HOLLYWOOD SUCCESS○
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Check out the updates to the left hand navigation tabs on LEARN, the Academy’s educational
portal. The following changeshave been made to allow viewersan easier browsing experience.O We have added a Practice/JobOpportunities tab. This tab will beactivated in the coming months.O The John Dickinson LibraryVideos tab has been renamed toSurgical Videos to be consistentwith the Academy's Web site.O The Core Lectures tab has beenrenamed Keynote Speakers.These are videos from past FallMeetings.O The Member Only JohnDickinson Library Videos tab hasbeen revised to Free SurgicalVideos for Members.O The Research tab is nowAAFPRS Grants and Awards.O There is a sub-section to theFellowship tab, providing easieraccess to Free InstructionalVideos for fellows.O The Journal tab is renamedJAMA Facial Plastic Surgery.O The capability to go directlyfrom the LEARN home page to theAAFPRS Web site is added.
Finally, we are working on theconcept of a Virtual Exhibit Hall.Check future issues of FacialPlastic Times for updates.If you have any questions regard-ing how to navigate the LEARNsite, contact Karen Sloat,[email protected]. M
NAVIGATION TABS
MADE CLEAR
May/June 2016 Facial Plastic Times 17
18 Facial Plastic Times May/June 2016
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By Rachel Hardy, OFPSA President
We are looking forwardto connecting withnew members andfamiliar faces at the
upcoming Fall Meeting in Nash-ville, October 6-8, 2016. We hopethat you have made arrange-ments to join us; the programthis year is going to be outstand-ing.
In preparation for the FallMeeting, we would like to intro-duce Chelsea Berendsen, anOFPSA officer who serves as oursponsorship coordinator. Herenergy, creativity, joyful spirit,along with her diligence and hardwork, has made her an incredibleasset to the OFPSA. Chelseaworks as lead administrator andsurgical services coordinator atCascade Facial Surgery andAesthetics in beautiful MountVernon, Wash. She was kindenough to share some insightinto her practice life in thefollowing interview.
Q: How long have you beenwith your practice and how didyou start in facial plastics?
A: I started working withJonathan Grant, MD, when heopened the doors of his privatepractice in January 2014. Withhis educated background, profes-sional mannerism, and passionfor wanting to help people lookand feel their best, I knew he wasgenuine. Before I met Dr. Grant, Iworked for one of the communityhospitals at a dialysis center. Mypassion for medical care isgreatest when I see real changes.I stopped working there knowingthat I wanted to work as a part ofthe patient experience before,during, and after treatments thatproduce changes you can see.Nothing compares to being ableto see the results-driven outcomeyou work so hard to achieve.
Q: What is your practice like?A: When you walk into our
reception area, you first seeflowers sitting on the counterabove our fountain, which is
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MEET YOUR SPONSORSHIP COORDINATOR
located right at our front deskwhere patients check in. Behindthe front desk, we strive to havea smiling staff member alwayspresent to greet and assist ourpatients as they walk throughour doors. At Cascade FacialSurgery and Aesthetics, we prideourselves on providing world-class service in every aspect ofour practice. From cutting-edgetechniques and high standardsfor surgical safety and efficiencyto concierge service and indi-vidual, personalized care, ouraesthetic and medical specialistshave the advanced skills tosupport our nonsurgical as wellas surgical patients, both facialplastic and reconstructive. Dr.Grant is double-board certifiedand specializes in cosmeticsurgery, reconstruction surgeries(including skin cancer recon-struction), and nonsurgicalprocedures that can improveboth appearance and functionand reduce the signs of aging.Our clinical aesthetic nurse andmaster certified aestheticianwork as the ideal extension ofhim and offer services thatcomplement our surgeon's proce-dures. The entire team works welltogether to help our patients lookand feel their best. We use theCanfield Mirror imaging softwarewhenever possible to simulateanticipated changes with sur-
gery. This helps our patients feelmore confident about their choiceof procedure.
Q: What is your role in thepractice?
A: I have evolved into the leadadministrator and surgicalservices coordinator. I play alarge part in helping run the day-to-day operations, as well ascoordinate surgical services. Myexperience working with oursurgeon provides me with thegreatest understanding of thequality care he gives to hispatients, both in and out of theoperating room. We have highlyqualified professionals workingon our team who are passionateabout providing exceptionalpatient outcomes. Working withthis highly talented group ofindividuals makes my job easierand all the more gratifying.
Q: What is your favorite partof your job?
A: Being with our patientswhen they see their result for thefirst time is my favorite part ofwhat I do. When I hear a womancomplaining of her protrudingears—she had never been able towear hats and wouldn't go swim-ming with her family because herwet hair accentuated her ears—and then I am part of the processto get her the outcome shedesires, it is easy to see why Iwork in this field! Patients often
Cascad
e Facial S
urg
ery and
Aesth
eticsR
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May/June 2016 Facial Plastic Times 19
2016MAY 7AAFPRS FUNDRAISER ON THEHUDSONNew York, NYChair: Edwin F. Williams, III, MD
MAY 11-148TH WORLD CONGRESS OFFACIAL PLASTIC SURGERYRio de Janeiro, BrazilSponsored by the IFFPSS
MAY 18ESSENTIALS IN FACIAL PLASTICSURGERYChicago, ILDirector: Stephen S. Park, MD
MAY 18-22COMBINED OTOLARYNGOLOGYSPRING MEETINGS (COSM)Chicago, ILCo-chairs: Robert M. Kellman, MD, andLisa E. Ishii, MD
MAY 21*HEMANGIOMAS AND VASCULARANOMALIESCharleston, SCDirector: Marcelo Hochman, MD
FACIAL PLASTIC TIMES
MAY/JUNE 2016
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JUNE 23-25*AESTHETICA SUPER SYMPOSIUMWashington, DC
JUNE 25-26ABFPRS EXAMINATIONWashington, DC
JULY 29-31*2016 PORTLAND RHINOPLASTYCOURSEPortland, ORDirector: Tom D. Wang, MD
OCTOBER 5AAFPRS COMMITTEE MEETINGSNashville, TN
OCTOBER 6-8FALL MEETINGNashville, TNProgram Director: Phillip R. Langsdon, MDCo-chairs: Samuel M. Lam, MD, andRami Batniji, MD
2017MAY 4-7ADVANCES IN RHINOPLASTYChicago, ILCo-chairs: Peter A. Adamson, MD;Sam P. Most, MD; and Oren Friedman,MD
Enclosed in this May/June issue of Facial Plastic Times are theFall Meeting Preliminary Program and FPST Subscription Form.
*ENDORSED BY THE AAFPRS
look in the mirror and smile, orshed happy tears, and say,"Wow!" Our procedures are lifechanging for people. When a manwalks into our clinic that has losthis entire nose from skin cancer,you get to be part of the teamthat gives him a nose again.When his wife says, "Wow! Thatlooks better than the nose youhad before!" That is why I dowhat I do. Anyone who works inthis industry is very blessed to bepart of something so special.
Q: What is the most stressfulpart of your job?
A: The most stressful part ofmy job has been helping toestablish a team fit for a growingpractice. There are many detailsto growing a business. When youare in the business of taking careof people, every aspect of what wedo is vital to giving the patientthe best experience and the bestcare. Establishing a team withinour clinic that pays attention tothose small, but important,details as we have grown hasbeen the key to our success.Every patient outcome showsthis. Needless to say, the stresshas been worth it.
Q: Any other fun facts aboutyou that you would like to share?
A: Being a young female thatwore cowgirl boots growing upand that has always been a fanof hunting and fishing, I neversaw myself working in the field ofplastic surgery. I would say myperception was definitely wrongabout the field. The surgeon Iwork for has a natural aestheticand treats his patients as hewould treat his own family. Weare changing lives, helping ourpatients feel better about the waythey look, and I find that verygratifying. I also enjoy getting toknow my colleagues that work inthis specialty. Networking inother areas of the country is apiece of my job that is very
special to me. I am always look-ing for ways to increase efficiencyin the personalized care that weprovide. I am honored to be onthe OFPSA Board for the sisterorganization of the AAFPRS.
Thank you to Ms. Berendsenfor sharing about herself and herpractice. We hope to highlightanother OFPSA officer soon. And,we would like to hear your story
too. Please feel free to send me ane-mail anytime [email protected].
Don't forget to ensure thateveryone in your office is amember of OFPSA; the cost is$175 and covers the whole officefor an entire calendar year. Tosign up, visit the OFPSA Web site:www.aafprs.org/ofpsa/become-member. M
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20 Facial Plastic Times May/June 2016
