With the popularity of the internet and its accessibility and anonymity, comes great responsibility. For any consumer or client seeking a product or service, “word of mouth” is important.
If you want to find a good Chinese restaurant or a good car wash or a good sun screen, it’s nice to hear feedback from others who have personally experienced these services or products. Negative reviews are usually more powerful than positive reviews. For example, when I research purchasing a new digital camera, I care less about all the positive reviews on the particular camera and look more for the negative reviews to hear what are the issues or problems that people potentially face with this camera. Similarly, if you simply ask one or two people about their experience with Range Rovers, you may hear positive feedback. But once you ask a larger group, one sees that Range Rovers do indeed have huge issues with reliability due to the trend of reviews and feedback.
So how does a potential patient seeking cosmetic surgery go about learning the truth about a procedure or a surgeon? Trusting another human with your wellbeing is tough. Cosmetic Surgery patients are usually healthy and seek elective surgery. They “desire” surgery but do not “need” surgery. Researching the plastic surgeon involves researching his or her training, education, specialization, area of practice focus (if any), seeing before and after pictures of his or her work, as well as talking to previous patients &/or reading reviews online.
The fact is that like anything else in life, happy people move on while unhappy people linger and try to “get even.” Most people don’t take the time to write a splendid online review of a good meal they ate or a good daycare center or a good painter. But many people will gladly take the time to “tell the world” about their negative experience with a restaurant or a certain retail store. It’s just human nature. But there are also those rare few that will take on a life mission to destroy the restaurant or painter or store which they feel has somehow wronged them making. It’s also a fact of human nature that “you cannot please all the people all the time.” Add into the mix the thousands of ways and opportunities people can say whatever they want online these days in an anonymous fashion on the internet and you just created a potential for disaster.
For example, a plastic surgeon who did a breast lift and a breast implants on a woman with very asymmetric breasts may have greatly improved the look of her breasts but in her eyes or her husband’s or friends’ eyes, the results may be “botched.” Or how about a patient who had a very bulbous nose tip with a large hump who underwent a rhinoplasty with vast improvement but whose nasal tip could have been made a bit smaller or her bridge hump slightly grew back due to the nature of bone healing. These patients can go online and say whatever they want in a unilateral and uncontested fashion with usually no repercussions. On some of the more popular chat rooms, such a patient will find the attention and support and encouragement of lots of other angry, hurt and disappointed patients from around the world, who have also been the victim of botched plastic surgery or the victim of “perceived” botched plastic surgery – creating a good old fashion “lynching mob!”
Many of the online review sites are easily set up using simple template software and can be designed and managed by a 16 year old boy out of his parent’s basement. Some are more sophisticated. All desire internet traffic, discussion and dialogue. Nothing gets more traffic and dialogue going than a lynching mob mentality or heated online negative review of a plastic surgeon. Lifestyle lift is probably one of the most controversial topics in most of the internet chat rooms.
I personally see hundreds of patients who have been the victims of botched plastic surgery by negligent plastic surgeons. It breaks my heart to see a plastic surgeon take a patient’s money and self esteem and damage his or her well being and health by providing clearly bad plastic surgery. But I also see hundreds of patients who have had very decent plastic surgery but they perceive the results as botched. Some have gone as far as organizing hate groups, under the pretense of support groups, against some very good plastic surgeons. This variability or reasonability of human perception makes it impossible to tell the truth about a certain plastic surgeon’s work. My colleagues and I see several Plastic Surgeons right here in Washington DC get rated as “Washingtonian Magazine’s Top Plastic Surgeons” year after year when we all clearly know that none of us would trust our relatives to any of these “top” surgeons and we spend a great deal of time correcting their botched cosmetic surgery results. I remember I used to get offended when someone used the term “botched plastic surgery” or called a surgeon a “butcher” but after seeing some of the horrific results from very bad nose jobs that come in for Revision Rhinoplasty, I have gained a new appreciation for these terms. But then again, I see patients with very good noses who come in claiming another surgeon botched their nose job. Unlike some plastic surgeons who are eager to take these patients’ money and naivety and perform unnecessary cosmetic surgery on them, I spend hours each week trying to talk patient out of unnecessary plastic surgery by explaining the facts about healing and expected surgical results, etc.
But then again, no one can please all the people all the time. I am just thankful to my parents, who are two caring and compassionate and skillful surgeons themselves, for instilling in me the values and ethics to be a compassionate physician and always place my patients’ well being before any financial gains. I am grateful for choosing a very exclusive specialization and area of focus that enables me to have mastery over my field rather than being a “jack of all trades.” I have no problems referring patients seeking endoscopic brow lifts or sub-periosteal mid face lifts or sliding genioplasties to other plastic surgeons because if I never want to offer a procedure to my patients based on the desire for financial gains or a bloated ego. There is comfort and satisfaction in being focused and specialized.
So after many years of a free for all online where the mean spirited folks can say whatever they want without any repercussions, the pendulum has swung and doctors are fighting back. There have been several cases of plastic surgeons suing these online reviewers or ex-patients. Many of these reviewers are the same patient posing as multiple patients with multiple “names” or email addresses. But with legal action, the identity of the anonymous reviewers can be uncovered.
Other doctors have taken a more direct approach. When a patient starts divulging their own private medical records, they basically have thrown their legal HIPAA rights out the door and there have been cases of plastic surgeons actually making video responses to allegations. Even if the allegations are true, there is always two sides to each story and until now, only one side has been heard loud over and over and over. But that seems to be changing now. Restaurants can now review their patrons on opentable.com. Times are changing with the internet. The internet is still in its infancy in relative terms and the issues of privacy and freedom of speech and other legal matters are going to be clarified over the years to come. But for now, we all have to take anything we see or read with a grain of salt and realize that we do not know the mental state or the intentions of the “anonymous reviewers.”
