Spokane Journal of Business

Plastic surgeons campaign to promote certification

Group member contends he's seen jobs botched by other specialists here

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An organization set up by 10 Inland Northwest-based plastic surgeons is funding an advertising campaign here intended to advise those who may be considering going under the knife to do their homework beforehand.

Those surgeons have formed a group called the Inland Northwest Plastic Surgeons Cooperative, which consists of all of the board-certified plastic surgeons practicing in the Spokane-Coeur d'Alene area.

The cooperative is sponsoring TV and print ads, and a website to educate people on the potential risks of having a cosmetic procedure done by an unqualified or under-qualified medical professional, says member surgeon Dr. Alfonso Oliva.

Oliva practices at Plastic Surgery Northwest, a clinic at 530 S. Cowley that he shares with three other plastic surgeons.

A current concern in the field of plastic surgery, Oliva asserts, is that as medical insurance reimbursements have diminished through the recession, more doctors nationwide have found it more lucrative to expand their practices to include cosmetic procedures. Most such surgeries require payment up front and usually aren't covered by medical insurance plans, he says.

While the large majority of the physicians who've recently entered into plastic surgery are trained medical professionals, Oliva contends that many haven't gone through the required training in that specialty. Furthermore, he says some of them advertise to be board certified, but don't disclose to patients in what medical subspecialty they're certified.

Oliva says an example of that scenario could be an orthopedic surgeon doing breast augmentation surgeries. While he or she might be board certified in orthopedic surgery and have a formal medical education, they might not have gone through the training specifically required of plastic surgeons who are board certified.

"From a consumer perspective, it's a nightmare getting people to understand what's going on, and this isn't just unique to Spokane," Oliva says. "We came together here as a group to say, 'Let's try and educate patients on what it means to be board certified. I try and tell patients, if your doctor says he's board certified to just ask, 'In what?'"

Oliva says only four states in the U.S.—Texas, Florida, California, and Louisiana—require doctors to specify in what areas of medicine they're board certified.

Oliva claims he's seen firsthand the results of some botched procedures performed by surgeons here who aren't board certified in plastic surgery.

"We have had several patients who have had laser liposuction done who had deep rivets in their legs and tummy area," he says. "Those types of mistakes are very difficult to treat. A lot of them are uncorrectable deformities and patients have been very upset."

Oliva says liposuction tops the list of improperly administered cosmetic procedures for which patients seek a second opinion or a correction. Others include breast augmentation, abdominal procedures, and injectables, such as Botox.

He says all of the Inland Northwest cooperative's members are board certified through the American Board of Plastic Surgery, which is the national accrediting board for surgeons who specialize in that area of medicine. That board is overseen by the nonprofit American Board of Medical Specialties (ABMS), which oversees a total of 24 medical subspecialty accrediting boards, he adds.

To become board certified in plastic surgery by that organization, Oliva says, a doctor must meet extensive training and residency requirements, as well as pass written and oral examinations.

The same is the case for physicians who specialize in other specialties and subspecialties.

To complicate the situation further, Oliva contends that there are a number of bogus accrediting boards that mimic the names of boards overseen by the ABMS. For example, Oliva says, there's a group in Las Vegas marketing itself as the American Board of Cosmetic and Plastic Surgery and that only asks for a $500 membership fee but no proof of education or other qualifications.

"Patients can be duped because they see these certificates that mimic the actual certifying bodies," he says.

Oliva says he applied through that supposed accrediting group under his high-school-aged daughter's name for a membership and received a notice of approval.

The phone number listed on the literature Oliva says he received from that group since has been disconnected and its website also is no longer live.

"The problem is that there are no state regulations to protect patients," he says. "The reason for that is because up to this point, it hasn't been necessary. You don't see nephrologists going around masquerading as cardiologists, or gynecologists masquerading as orthopedic surgeons."

In addition to prospective plastic surgery patients ensuring their surgeons are board certified in that specialty, Oliva says they should ask if their physicians have hospital operating privileges. He says hospitals are meticulous in ensuring that a physician has the proper training and credentials before extending operating privileges.

Another key question Oliva suggests that people ask before agreeing to a cosmetic surgery is whether or not the physician's clinic or surgery suite is credentialed by Medicare or the American Association for Accreditation of Ambulatory Surgical Facilities. Both entities ensure that such clinics are adequately equipped and safe for patients receiving minimally-invasive outpatient procedures there.

Oliva says it's important to ask those two questions because if a doctor isn't able to perform a procedure in a hospital, there's nothing to stop him or her from doing it in their own facility, where there'd be no oversight as in a hospital setting.

"Non-plastic surgeons say it's just a turf war, and that plastic surgeons are just trying to encroach on their practice, but that's not the case," Oliva asserts. "Plastic surgeons are seeing serious complications with patients who've had surgeries by non-board certified surgeons."

The Inland Northwest Plastic Surgeons Cooperative's marketing campaign was organized by Spokane Valley-based Brand It Advertising.

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