A local veteran surgical nurse shared the following observations and insight with me:
"Dr. A's fees are high and for the wrong reason. His results are not above average, there's no justification there. He does not take on the toughest cases. His practice gives Chevrolet not Cadillac service; acceptable, average, but not great. His fees are high because he is very slow in the operating room. It takes him two hours to do a routine cosmetic nasal surgery that would take you 45 minutes. But in his mind, he is billing like a lawyer: hourly. So his fee is inappropriately high because the patient is overpaying for his inexperience and lack of expertise."
What you just read is very telling. And a very special bit of "insider information" that is important to share with you. Actually, I never thought of fee setting in the light that our veteran nurse just described. The very best surgeons I have seen are rarely "slow." They are not fast for speed's sake; it's that they are very efficient and waste no time. They do not spend five minutes walking around the table and looking at the nose and trying to decide what to do. The "A" surgeons already have a plan. They know what to do even before they walk into the operating room. They deliberate in advance. Then they operate without hesitation or uncertainty.
Efficiency is critical because after a certain amount of time elapses, the local anesthetic wears off, bleeding increases, and swelling becomes burdensome. The hapless, inadequate surgeon is now "drowning in the case" and has very little chance of coming up for air. It is very disturbing to see these amateurs struggling against odds that only worsen minute-by-minute.
There may be a good reason for you to pay a surgeon a fee that is 10 to 25 percent above average. But, double or triple? Okay, I guess, if you can't think of another way to spend money.-DJ
Every time our nurses talk about assisting in a four-hour nose job, or a five-hour eyelid surgery, or a ten-hour face lift, I shudder. I know they were teamed up with an inexperienced, inefficient, amateur surgeon who probably should not be doing these cosmetic procedures. Because the patient will be at least disappointed and, possibly, even endangered.
Now that you understand the financial basics, you will want to know how to compare professional fees. Let's take a common scenario experienced by patients while comparison-shopping: A prospective patient consults with Dr. A, who recommends a facelift and whose office provides a fee quotation of X dollars as an all-inclusive fee. At the next consultation, Dr. B tells the same patient he needs a facelift but Dr. B's facelift is 50 percent higher than Dr. A's. The patient is rightfully confused. How to reconcile the difference in charges!
Comparing professional fees is not easy; never "apples to apples." Cosmetic surgery is an art form, each surgeon an artist. No two cosmetic surgeons do the same operation identically. Regardless of the artistic variations, procedure-specific, technical variables will effect the fee.
An example:
Dr. A's "facelift" may differ greatly from Dr. B's. Not all facelifts are identical. One doctor's procedure may include an aggressive neck sculpture technique while another's focuses on the forehead and brows with less attention to the
jaw and neckline. There may be major qualitative differences in similarly titled procedures. Does the facelift include neck surgery? Are eyelids upper and/or lower, included? Reminder: Know the components of the procedure the surgeon is quoting.
There can be quantitative differences as well. Dr. A's preferred "neck sculpting" or "neck lifting," to improve a sagging or "double chin," may involve only superficial liposuction through a tiny incision or incisions. Dr. B's neck work may include, in addition to the superficial liposuction, removal of the deeper layer of fat as well as tightening of the lax platysma neck muscle that causes those vertical bands running from the chin to the mid or lower neck.
This platysmaplasty, an additional step creating an internal "corset," further defines the neck and jaw line. But this more ambitious neck surgery requires a longer (but still hidden) incision, and many more maneuvers. So while both Dr. A and Dr. B name their procedures identically, Dr. B's method adds additional time and complexity compared to the lesser procedure.
I spent all this money tailoring my clothes. There is no reason why I couldn't do the same for my face.-Elinor, designer California
But, Dr. B's result will probably be superior and apt to last longer. Expect, therefore, B's fee to be higher. Reminder: Understand the objective of the procedures the doctor recommends. Be sure you understand how the doctor intends to accomplish the mission. If you are unclear, request more information including drawings that you can understand. And take notes! Be studious!
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01222010
1. Pamper Your Skin and It Pampers You
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