Plastic Surgery Patients Report Shorter Wait Times Than Others

Plastic surgeons had some of the shortest wait times seen among 139 types of specialists, according to Vitals seventh annual wait time report.

Plastic surgery patients report waiting 13 min, 13 sec to see their doctor, the report showed. In general, most patients are waiting 19 minutes, 19 seconds. This is down nearly 10 percent from the average 21 minutes and 18 seconds patients once spent in the waiting room.

Other specialists with short waits include radiation oncologists (12 minutes, 29 seconds) and sports medicine doctors (13 minutes, 4 seconds). Spine surgeons had the longest wait times, averaging 29 minutes, 34 seconds.

Vitals studied more than six million reviews left by patients for doctors to see how wait times correlate to star ratings and found that doctors with five-stars, the highest doctor rating on Vitals, had a 13-minute wait on average. In contrast, doctors with a1-star rating, the lowest rating, averaged a 33-minute wait. The findings also indicate an important correlation between wait time and patient satisfaction. In fact, positive reviews start to skew negative after patients are left waiting more than 20 minutes. For instance, 49 percent of patients who had a 15-minute wait rated their doctor positively. Yet, only 27 percent of patients who waited for 45 minutes ultimately left a positive physician review.

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Alex Thiersch, JD, founder of the American MedSpa Association (AmSpa), recently spoke to Steve Dayan, MD about the regulatory challenges of aesthetic medicine. Watch the video for advice on keeping up with regulations and avoiding trouble. He touches on issues like scope of practice for physicians, nurse practitioners, and physician assistants. He talks about staying compliant, and how to manage staff.

“The fact of the matter is there are so many regulations in aesthetic medicine. You've got different practice groups—you've got nurses, you've got nurse practitioners, you've got PAs, you've got estheticians, you've got doctors, you've got different levels of doctors with different types of certification, you've got zoning issues, and you've got FDA and DEA issues coming in from different levels of drugs and things…”

By contrast, patients mentioning wait times in positive ratings were likely to “highly recommend” the doctor. The doctors were often labeled “friendly,” “kind,” and “caring.” Patients said an extended wait was “worth it” for a doctor who was “thorough” and “took time to listen” and “didn't rush” during appointments.

Vitals' annual Physician Wait Time Report, now in its seventh year, was compiled from patient-reported wait times in 2015.

YouTube: A Training Tool?

More than 60 percent of facial plastic surgeons watch online streaming media, such as YouTube, to learn a new technique. And most use these techniques in practice, according to a study in JAMA Facial Plastic Surgery.

Leading facial plastic surgeons are quick to point out the merits of video learning and the place that this knowledge can, and should, have in the operating room—along with potential pitfalls of the practice.

Anita Sethna, MD, of the Emory University School of Medicine, Atlanta, and coauthors surveyed American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) members and received 202 responses, about eight percent of the AAFPRS membership.

The most popular ways to stay current with technical and nontechnical findings still includes meetings, journals, and discussions with colleagues, but 64.1 percent of respondents have used online media at least once to learn a new technique, especially for rhinoplasty and injectable procedures, and 83.1 percent had used those techniques in practice. Less experienced surgeons were more likely to have used online streaming media than more experienced surgeons, the study found.

“Using videos as the sole source of a surgeon's training is not acceptable, but in combination with years (>10) of didactic and hands-on surgical training, through accredited residencies and fellowships, and continuing one's education with through meetings and discussion and visiting with colleagues, videos can then be an important component to remain current and improve one's technique and skill set,” says Timothy R. Miller, MD, a facial plastic surgeon in Aliso Viejo, CA.

“As a supplement to hands on experience, reading, consulting with colleagues and even at times use of simulation device video can be an incredibly adjunctive tool to improving technique, shortening learning curves and demonstrating current updates,” says Modern Aesthetics® co-chief medical editor Steven Dayan, MD, FACS, a Chicago facial plastic surgeon.

“The key is that we look at videos as an adjunctive educational tool not a primary or a solo tool for learning new techniques or augmenting current ones. And the more we can develop and have available peer reviewed videos the better,” he says. “Physicians have to be very judicious to trust the source that they are learning from whether it be journal article, podium presentation or a video.“

AAFPRS President Edwin Williams, MD, of Williams Center Plastic Surgery Specialists in Latham, NY, says that videos can help even the most seasoned facial plastic surgeons refine or validate a surgical technique. “We can learn little tricks like how a master holds the scissors. Sometimes when we are watching a video, it validates our own approaches to a procedure.”

The main caveat is the quality of the videos, which can be hard to control on the Internet. In addition, these videos can be helpful for the experienced and skilled. They should not be used by unskilled practitioners to perform surgeries outside of their area of expertise.

This is the future of medical education, says Sam Rizk, MD, a facial plastic surgeon in New York City. “YouTube is just the beginning. One example is a new innovative platform is that is a connector for physicians to observe live cases all over the world,” he says. “We are also seeing more digital opportunities for physicians to learn from each other with videos placed on Facebook, Instagram, as well as Periscope.”

MU Exemption Deadline Now July 1

Physicians now have until July 1 to apply for a hardship exemption from the electronic health record (EHR) meaningful use financial penalties for the 2015 program year. Those who don't apply could face up to a three percent cut in Medicare payments in 2017. All physicians—even those who believe they met the requirements of the meaningful use program in 2015—are encouraged to apply for the exemption because there is no downside to doing so. The Centers for Medicare & Medicaid Services (CMS) has explained that submitting an application for a hardship exemption will not prevent those who qualify from receiving an incentive payment. n

AMA Advances Initiative to Create the Medical School of the Future

Since announcing the expansion of its Accelerating Change in Medical Education Consortium last fall, the American Medical Association (AMA) is kicking off the next phase of its work to ensure that future physicians are prepared to care for patients in the rapidly changing 21st century healthcare environment. The AMA, along with Penn State College of Medicine, convened the now 32 medical school Consortium in Hershey, PA, this week to further the innovative efforts underway to reshape medical education across the country.

Only a year and a half after launching its new Systems Navigation Curriculum in August 2014 thanks in part to a $1 million grant from the AMA, Penn State's new curriculum has sparked interest from several medical schools that plan to adopt similar programs, including Case Western Reserve University School of Medicine and Sophie Davis Biomedical Education/CUNY. Both of these schools are among the 21 schools recently selected to receive AMA funding and join the newly expanded Consortium, based on their proposed projects that will build upon Penn State's new program aimed at aligning medical education with the health system and immersing students in the local health care system from day one of medical school.

Penn State College of Medicine collaborated with its health system leaders to design a new curriculum to meet the needs of the health system. The new program, which embeds first-year medical students working as patient navigators in clinical sites throughout central Pennsylvania, was created to ensure students learn not only the basic and clinical sciences, but also health systems science. This is an important innovation given that the majority of medical students still receive their training in hospital settings despite the fact that the majority of patients are now being cared for in out-patient settings.