The General Medical Council and the Royal College of Surgeons of England have produced booklets entitled ‘Good Medical Practice’ and’ Good Surgical Practice’. These are the basis for consultants’ annual appraisal and are based on five areas, 1) good clinical care which includes providing evidence of the number and type of operations you perform and their outcomes, 2) maintaining and improving good surgical practice which includes continuing professional development and learning, 3) teaching, training and supervising particularly of surgical trainees and in advanced practice of other surgeons ,4) relationships with patients and, 5) working with colleagues. Probity in professional practice and personal health are also included. The Independent Health Care Association has also produced a booklet on good medical practice in cosmetic surgery which is based on the same areas. Your surgeon should be able to provide evidence of the quality of their practice in all these areas.
In the modern world it is often possible to find evidence to support a surgeon’s commitment to these areas. Your surgeon, particularly if they have a significant teaching commitment, will look to present their work at national and international meetings and will have published book chapters and scientific papers. Evidence of these activities is often to be found from reliable 3rd parties on the internet such as publishers, universities and specialist surgical societies and teaching course organisers. Often invitations to national and international meetings to teach and publications in the scientific literature and in books is evidence of recognition by peers in the field. I have performed surgery on teaching courses in the UK and abroad and there is no greater audit of one’s practice than being watched closely by one’s peers when invited to demonstrate surgical techniques in front of them and a large audience. I have blogged about the value of teaching and training previously not only with regard to helping others learn surgery but also because I believe teaching is a strong motivating force driving one to reflect with discipline on one’s own practice and improve.
Surgeons should be able to show you examples of their previous work, in particular that are relevant to you and should have a body of work rather than just occasional cases. Asking about revision rates for rhinoplasty surgery does provide some useful information but again as I have blogged before figures alone do not give the whole picture and a surgeon with higher revisions rates may have more complex cases to operate on and may have patients who request refinement procedures more than others.
Personal patient and colleague testimonials can be very helpful and ideally your surgeon should also be able to put you in touch with previous patients who can talk to you and help you if you wish. These patients are not anonymous and are happy to be accountable. You are able to personally judge them and the truth and value of their opinions and advice. Their full personal story will give you context. This in my opinion is much more valuable than using internet forums where posts are anonymous and when it is difficult to judge the writer and their motivation for writing. The General Medical Council states that if a surgeon advertises any information it must be factual and verifiable. These same standards cannot be applied to anonymous posts on the internet .
In light of the PIP breast implant problems a call has been made for cosmetic surgery marketing to be more about helping patients make informed decisions not selling http://tiny.cc/g4xgt.
I completely agree and empowering patients so that they have the confidence to make their own decision about what is right for them has always been an absolute and fundamental aim of our practice. You should be thinking about all the above factors and the professional goals of your surgeon and his team when reading their literature, when preparing for your consultation and during your consultation to make it truly valuable.