How to choose a plastic surgeon

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Picking A Plastic Surgeon (or any doctor) - a guide to online resources

Dr. Nachbar discussed some strategies for making one of the most important decisions you may ever make -- who should be your surgeon or your doctor.

Although there are laws, licenses, and boards that regulate physicians and other health care providers, most people are surprised to learn that the boards don't really evaluate how good a doctor is, and that once a doctor has a license to practice medicine, there is no law or regulation requiring them to have any surgical training to perform surgery.  Indeed, there are doctors out there performing surgery without any surgical training whatsoever, and even more doctors performing procedures for which they have had no specific residency training at all.

Like the Department of Motor Vehicles, any state's medical board is only responsible for administering the law.  Once you have met the basic legally-prescribed requirements, you will get a driver's license.  Even if you are not a very good driver, you probably won't get a ticket unless you break a specific law, like speeding or running a red light.  A state medical board is the same -- unless you break a specific law, they are not permitted to issue a citation.

Fortunately, the Internet has made it much easier to check out a doctor before they treat you.  Dr. Nachbar has put the information you need, and the links to appropriate websites, on the "Picking A Plastic Surgeon" page on his website, at www.plastic.org/picking.html .

The first place to check is your state's medical board website.  Most states, including Arizona, have a feature of the medical board's website that allows you to look up any doctor licensed in the state.  You can verify their license, as well as check for any disciplinary actions and malpractice settlements.  Be aware that the information is automatically purged, often after five years.  In Arizona, the medical board website also lists a doctor's claimed specialization, but the board does not check whether the doctor is actually board certified.

Board certification is the next thing to check.  However, at least as important as whether a doctor is board certified is WHICH board the doctor has applied for certification from.  The American Board of Plastic Surgery ( www.abplsurg.org ) is one of the 24 boards which is itself a member of the American Board of Medical Specialties ( www.abms.org ,  www.certificationmatters.org ).  However, once the American Board of Plastic Surgery was established, other boards with confusingly similar names were created, which will give certification to physicians who would not qualify for certification by the American Board of Plastic Surgery.  Just because the board has "Plastic" in the name does not make it the American Board of Plastic Surgery.

Dr. Nachbar recommends that you check whether your doctor is certified by the American Board of Plastic Surgery, using the link on his website.  If the doctor says that he is certified by a different board, Dr. Nachbar recommends that you check the website of the American Board of Medical Specialties to see if that board is one of its member boards.  You can do this for any doctor, not just a plastic surgeon -- some other member boards include The American Board of Family Medicine and the American Board of Dermatology.

The next thing to check is what specialty societies the doctor belongs to, and how active they are.  This is important for several reasons.  First, it indicates that the doctor is serious about his specialty.  More important, depending on the society, it may indicate that the doctor has voluntarily agreed to abide by that society's Code of Ethics.  For example, both the American Society of Plastic Surgeons ( www.plasticsurgery.org ) and the American Society for Aesthetic Plastic Surgery ( www.surgery.org ) each has a strict Code of Ethics.  Without a Code of Ethics, there is nothing that a doctor can do if they become aware of unethical activities by another doctor, because of anti-trust laws.  Also, "unethical" can mean different things to different people - the Codes of Ethics make those rules clear.  For example, both the ASPS and ASAPS Codes prohibit a doctor from claiming to be "the best" or other similar claims unless a prospective patient could independently and objectively validate those claims.  (If you see a doctor making vague, unverifiable claims like that, that should be a red flag, anyway).

Next, ask the doctor's office at which hospitals the doctor has surgical privileges.  Even if the surgery would be performed outside of a hospital, surgical privileges generally require at least a minimum amount of training in that procedure, and also mean that the doctor can take you to a hospital if there are problems.  Then, unless the surgery will be performed in the hospital (which, of course, proves that they have privileges), call the Medical