535602 research-article2014
AESXXX10.1177/1090820X14535602Aesthetic Surgery JournalGellis
Letter to the Editor
Imagine Yourself Lying on the Table Michael Gellis, MD
So much of our surgery is local only or local with mild sedation, it behooves all of us to place ourselves in the patient’s position. Imagine yourself lying on the table, feeling cold, body exposed to strangers, unable to understand the lingo used by the staff, fearful of the procedure and pain, and having a fairly large procedure under local anesthesia that will take a couple of hours. Your doctor tells the nurse to turn the radio to a station that plays music that you detest and would not listen to even if you were paid to do so. Then without warning, the doctor sticks a needle into you. The surgery has begun. The doctor then talks to the nurse about the Super Bowl game but mostly says nothing to you for 2 hours. You feel like you have been betrayed by the doctor, who should be caring and interested in your welfare but apparently is not. Physicians have picked a field that demands responsibility for the patient’s needs and being kind to the patient. To be successful means that physicians and surgeons must engage the patient and establish a rapport not only to gain the trust of the patient but also to allow him or her to accept the difficult times that surgery can bring, some pain, soreness, and occasional complications. Having a caring physician can make difficult times tolerable and potentially reduce lawsuits. So, what are the little things that we can do to improve the patient’s experience? First, create an upbeat mood. Meet and great with a positive attitude. That also goes for patients who are not yours as well. While in surgery, remember that the patient should make the call as to which radio station is to be played. Engage the patient during the procedure to show the patient that he or she is not just another body you are operating on. If something you are doing causes pain, you can say, “Sorry, I will move away from that area,” or “Maybe you need a little more anesthesia,” or “Let’s let the medicine work a little longer.” To say nothing is noncaring, and that rings out loud and clear. There should be no side conversation or inappropriate
Aesthetic Surgery Journal 2014, Vol. 34(7) NP74 © 2014 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: http://www.sagepub.com/ journalsPermissions.nav DOI: 10.1177/1090820X14535602 www.aestheticsurgeryjournal.com
comments. Conversations during surgery should be patient directed as much as possible.1,2 Try to make a connection to build rapport (where does the patient live, any children, hobbies, sports, work). Unless there is a definite emergency call, phone calls that interrupt are not to occur. Any call that is answered should be ended quickly. By the way, humor does go a long way. The patient is very aware. Other negative events that make the patient very uncomfortable—do not leave the room to see a preoperative patient, and always be respectful of the patients being exposed not only for loss of heat concerns but also for modesty.3 Make every attempt to talk with the patient’s companion without telling details about the actual operation. The companion’s positive experience with you can be very helpful. Reversing roles can be a learning experience that all of us need occasionally.
Disclosures Dr Gellis is Chief Medical Officer of Sono Bello Body Contour Centers (Scottsdale, Arizona).
References 1. Gellis M. Patients are listening during surgery. Surge Magazine. Summer 2013:20-21. 2. Albert W. Conversation during surgery. South Med J. 1990;83(5):602. 3. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108(1):71-77.
Dr Gellis is a plastic surgeon in private practice and is Chief Medical Officer of Sono Bello Body Contour Centers, headquartered in Scottsdale, Arizona.
AESXXX10.1177/1090820X14535602Aesthetic Surgery JournalGellis
Letter to the Editor
Imagine Yourself Lying on the Table Michael Gellis, MD
So much of our surgery is local only or local with mild sedation, it behooves all of us to place ourselves in the patient’s position. Imagine yourself lying on the table, feeling cold, body exposed to strangers, unable to understand the lingo used by the staff, fearful of the procedure and pain, and having a fairly large procedure under local anesthesia that will take a couple of hours. Your doctor tells the nurse to turn the radio to a station that plays music that you detest and would not listen to even if you were paid to do so. Then without warning, the doctor sticks a needle into you. The surgery has begun. The doctor then talks to the nurse about the Super Bowl game but mostly says nothing to you for 2 hours. You feel like you have been betrayed by the doctor, who should be caring and interested in your welfare but apparently is not. Physicians have picked a field that demands responsibility for the patient’s needs and being kind to the patient. To be successful means that physicians and surgeons must engage the patient and establish a rapport not only to gain the trust of the patient but also to allow him or her to accept the difficult times that surgery can bring, some pain, soreness, and occasional complications. Having a caring physician can make difficult times tolerable and potentially reduce lawsuits. So, what are the little things that we can do to improve the patient’s experience? First, create an upbeat mood. Meet and great with a positive attitude. That also goes for patients who are not yours as well. While in surgery, remember that the patient should make the call as to which radio station is to be played. Engage the patient during the procedure to show the patient that he or she is not just another body you are operating on. If something you are doing causes pain, you can say, “Sorry, I will move away from that area,” or “Maybe you need a little more anesthesia,” or “Let’s let the medicine work a little longer.” To say nothing is noncaring, and that rings out loud and clear. There should be no side conversation or inappropriate
Aesthetic Surgery Journal 2014, Vol. 34(7) NP74 © 2014 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: http://www.sagepub.com/ journalsPermissions.nav DOI: 10.1177/1090820X14535602 www.aestheticsurgeryjournal.com
comments. Conversations during surgery should be patient directed as much as possible.1,2 Try to make a connection to build rapport (where does the patient live, any children, hobbies, sports, work). Unless there is a definite emergency call, phone calls that interrupt are not to occur. Any call that is answered should be ended quickly. By the way, humor does go a long way. The patient is very aware. Other negative events that make the patient very uncomfortable—do not leave the room to see a preoperative patient, and always be respectful of the patients being exposed not only for loss of heat concerns but also for modesty.3 Make every attempt to talk with the patient’s companion without telling details about the actual operation. The companion’s positive experience with you can be very helpful. Reversing roles can be a learning experience that all of us need occasionally.
Disclosures Dr Gellis is Chief Medical Officer of Sono Bello Body Contour Centers (Scottsdale, Arizona).
References 1. Gellis M. Patients are listening during surgery. Surge Magazine. Summer 2013:20-21. 2. Albert W. Conversation during surgery. South Med J. 1990;83(5):602. 3. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108(1):71-77.
Dr Gellis is a plastic surgeon in private practice and is Chief Medical Officer of Sono Bello Body Contour Centers, headquartered in Scottsdale, Arizona.
