The Aesthetic Medicine Consult

All too often the “bean counters” are telling us how you are falling short. They come up with some scheme to get us to see more patients than we can reasonably see or how to “create” more procedures than are requested. This is bottom-line or practice-centered medicine and in my opinion is underhand and immoral. It is also outside of what we are called to do and is unnecessary and counter to a healthy practice. What I believe builds a healthy practice and is simply at the heart of accomplishing what is right for patients, is the patient-centered consult. This type of consult is designed to get to the main of the patient’s issues and do all one can do to help them achieve their health and aesthetic goals.

In this age of population-based medicine discomfort been told to do the minimum, but that doesn’t change the fact that our patients are concerned with optimal health and results. Olympic athletes do not win their competitions by training to the minimum nor will our patients be served by providing the minimum. Let’s look at an example of how population-based medicine is sneaking into the quiz room in a manner that is not fully understood by medical professionals and yet has great affect the individual (many similar examples can be seen in medicine today):

The drug companies tell us that Plavix is about 30% better than aspirin. What they don’t tell us is that it is relatively 30% better. In absolute terms it is about 1% better. What does this mean? Well, in one study on CVA the relative risk reduction was estimated as 25% but the absolute reduction was 0. 9 for ASA versus 1. 2 for Plavix or about 0. 3% (1). Now Plavix costs $5. 00 per pill and ASA is about $0. 05 to the individual on a fixed income is the absolute difference of 0 美容医療に関する疑問や不安の解消はこちら. 3% worth $4. 97 per day? Maybe, maybe not depending on many factors. Certainly it may be worth it to society but society is not paying the bill… the individual on a fixed income is. This is the confusion between population based and individual medicine. Some have even strongly suggested difficult or eliminating Aesthetic procedures to reduce all around health costs in the usa. This may help some number accompanied by economists but is it serving the individual who is interested in a specific goal?

So what is the patient-centered consult? Medicine is complex and in particular, Aesthetic Medicine is complex, yet it has been reduced to sound bites on TV. Tv ads ask the question “Is it better than Botox? inch or “Is it better than a Medical Peel from the lemon? inch yet they don’t give the answer or any real helpful information. Patients have, in general, no realistic idea of so what can and cannot be done for them. The patient-centered consult is an educational experience for the patient that helps them know very well what is realistic and what is not.

It starts with gaining reveal understanding of what the patient’s concerns are, not what treatments they are interested in. Most aesthetic patients come in thinking they know what they want. As an example many think they need an second motorcycle blepharoplasty but what they really need is a brow lift. Other come in asking about filler injections but really need Botox or vice versa. The understanding of what they are concerned about is available not by asking what they are interested in but instead, what their concerns are. We begin in a audio manner. Most often the patient begins by saying similar to “I think I need Botox right here. inch My answer is generally similar to, “Well, that may be something we can do, but the facts that makes you want Botox? inch The next several questions are inclined to helping the person target the real issues behind the concerns such as texture, tone, rigidity, facial lines, poor size, volume etc.

I take advantage of a consult tool I call the $10, 000 mirror. We have a simple hand mirror that has no magnification on one side and 3 to 5 times magnification on the other. I hand it to the patient with the amplified side facing them. The interesting thing is that most people when given the mirror begins looking very intently at themselves and even start picking and scrubbing at things on their face. When i have a checklist of items I ask them about. We feel the checklist item by item and discuss its affect the overall appearance of the face. Once this is completed, I make a plan of all which can be done for them, that will include things I can do but also things others may be able to do. As an example, I really do not do face comes, in case your result they are after is best served by a face-lift, I put that on the plan. It is rare that we don’t do most of what they will benefit from.