Send a Message
to TooMuchInternetBS

Comments

4

Joined

Sep 19, 2010

TooMuchInternetBS Profile

Forums Owned

Recent Posts

Chattanooga, TN

Plastic Surgeon

@Impacted, I have no knowledge of Dr. Pancake or any of his history. So I cannot comment one way or the other. It sounds to me from your post and your screen name that you or a family member was impacted as a result of interaction with either this surgeon or another. I'm guessing it was not a good impact and if this is the case, I am sorry. I've still got to disagree with you however, that the ABMS issue is the safest bet going. At when it pertains to cosmetic surgery, you're going to have to show me some statistics that back up this assertion. I don't believe you'll find any but if you do I'll gladly retract. You may find data that's exactly the opposite. I'll see if I can dig it up but I ran across a paper awhile back that showed that the highest incidence of complications and malpractice litigation in cosmetic procedures was amongst ABMS board certified plastic and reconstructive surgeons. The marketing of the ABMS and its members as the only bastion of patient safety when it comes to the practice of cosmetic surgery is a concept that is promoted primarily by plastic surgeons. And they promote it widely and heavily. You believe it as do many others because it has been sold very effectively. A portion of every plastic surgeon's dues in their professional organizations is ear-marked for the political arm of plastic surgery which also includes marketing. If you'll notice carefully, it's not the ABMS itself that is self-promoting. It is the plastic and reconstructive surgeons who are touting their ABMS board certification as if it somehow confers the ability for them to be the only ones that do not have complications and deaths. This doesn't mean that I think that all plastic surgeons are poor cosmetic surgeons. On the contrary, many are gifted exceptional men and women. But ABMS plastic surgery board certification is not what makes for an exceptional surgeon and I find the efforts of organized plastic surgery along this vein to be at best misguided. By the same token, there are many exceptional and gifted surgeons who perform cosmetic surgery who have ABMS board certification in another primary specialty and who have acquired their cosmetic surgery training after their residency. And yes, I think if the surgeon in question does not have ABMS certification in a surgical specialty or certification by the ABOMS (American Board of Oral and Maxillofacial Surgery)which certifies dental surgeons, then with few exceptions they should not be doing invasive surgical procedures. Here's my take FWIW. Good and bad people will always exist and they will be found in all walks of life. It is not appropriate although it is exceedingly common to paint all members of an organization with the same brush. People must be judged on an individual basis - it is the only way to prevent or minimize punishing the good along with the bad. In cosmetic surgery as well as others, the complication rate and death rate will likely never be brought completely to zero. Human beings will always be fallible and will always err. Bad things will happen to good doctors as well as to bad doctors. And some doctors, either unwilling to face this stark reality of what they do for a living or for purely financial reasons will attempt to take the moral high ground by claiming that their training, board certification, etc. is the best and hang their hat there. Others who have lived a little more fully and gained a little more wisdom and perhaps seen a little further into the looking glass will educate and equip themselves to the best of their knowledge and ability, treat their patients with the utmost respect and refrain from judging others lest they be so judged.  (Sep 21, 2010 | post #17)

Chattanooga, TN

Plastic Surgeon

Hospital privileges for the procedures is fraught with politics as shown above. There are very good plastic/cosmetic surgeons that have dropped their hospital privileges. Why ? They have busy cosmetic surgery practices. They want to do their face- lifts and go home. Hospital privileges usually means the doctor has to be on call from time to time. They don't want to be called to the Emergency Room at 3 am to sew up some drunk who got in a bar fight when they've got a full slate of surgery in the office the next day. They want to be able to give those patients their best and not be bleary-eyed from the night before. So they withdraw from being on staff. These surgeons should have arrangements with the hospital and other medical colleagues to admit their patients in the event of complications that can't be treated in the office. Talk with other patients, try to get a feel for the doctor's local reputation with patients. Check out the office. Ask questions. Take your time. Look at pictures of the procedure you are considering. Like buying a house or a car, this is a decision process that should be given it's due diligence. Its not those papers hanging on the wall that are operating on you. It's the human being whose name is printed on them. You should have a good rapport with the doctor and staff and feel comfortable. All your questions should have been answered to your satisfaction without attempts to side-step them or stand only on credentials. Finally, my above-stated points are not meant to diminish or demean the necessity for ABMS boards in attempting to provide a consistent and high level of training and then testing the graduates and conferring "board certification ". It is imperative that we should continue to strive for high standards and that an organization such as ABMS should be in existence to allow for some set of uniform standards to be held up for the protection of the public. If you read the ABMS literature regarding "board certification " you will find no assurances to the competency of surgeons. And this is as it should be. We are human beings. We will strive for perfection and always falls short. Medical errors have, do and will continue. The risk of surgery can NEVER be 0%, no matter the surgeon's credentials or hospital privileges. My problem is with ill-informed people such as @Impacted seeing things in only black and white, having little real knowledge of the particulars of a situation other that what they have read in the paper or on the internet (because as we all know, reporters are infallible, have no agenda, never either willfully or unknowingly perpetuate someone else's agenda and are the fountains of knowledge about all things that matter) and then holding themselves out as an authority on the subject and having the audacity to advise others. You sir or madam are as guilty of "quackery " on these boards as the doctors you accuse.  (Sep 19, 2010 | post #10)

Chattanooga, TN

Plastic Surgeon

Request for privileges denied because your training was inadequate because you are not a plastic surgeon and we don't recognize any training you have done. If you want to do breast surgery go back and do a plastic and reconstructive surgery residency (even though you may perform less breast surgery than your log currently show) and we'll happily give you carte blanche "full scope" privileges. So now you begin to see the origins of the Boards other than ABMS. They are attempts to document a practitioner's training in procedures traditionally considered to be outside of the scope of his or her practice and to then test the practitioner's competence in these areas by the administration of an examination patterned after the (you guessed it) ABMS board examinations. But these exams are fought against by the ABMS tooth and nail as to their validity. They can't chance losing their position as the preeminent authority. (Holy cow, it's about power and money too ?) Here's an interesting tidbit. Ever wonder just exactly what's on the ABMS test? It's a written exam and then and oral exam. No testing of your operating skills whatsoever. You have to have performed a number of surgical cases considered representative of your specialty. So while the technically marginal surgeons are supposed to be weeded out in residency training, I can assure you that some do not. And after taking and passing tests their whole life practically, any doctor who cannot pass a board exam is questionable IMHO. Here's another interesting problem. Impacted refers to Dr. Pancake as "nothing more" than an ABMS certified general otolaryngologist. This is indicative of the level of ignorance and brain-washing seen in zealots of all manner. Check out youtube under radical neck dissection or glossectomy or hemi-mandibulectom y with pectoralis major reconstruction and see what "nothing more " than a general otolaryngologist can do. Now tell me that a surgeon that is trained to do these these major dismantling and reassembly procedures cannot learn to do a simple face-lift or breast augmentation. Seriously ? Don't misconstrue my take on this to suggest that I am defending Dr. Pancake or others. There are good and bad doctors within the ranks of all the specialties noted here. None has a lock on virtue and ethical behavior. However, I would hope that one could see by now that the the politics behind this situation would also carry over to the media handling of the deaths and other untoward events. In the same way that Impacted has been indoctrinated, so has the media. The facts that ABMS board certified plastic surgeons have patient deaths and complication rates similar to if not higher than these other specialists performing cosmetic surgery is either swept under the rug by their plastic surgeon run malpractice insurer(that's right they run the malpractice company that insures the majority of their ranks so what are the odds that they settle quickly with large sums and contracts that forbid the injured parties to speak to anyone about the settlement) or somehow made "acceptable " because he was ABMS board-certified and so couldn't possibly have been at fault. Just business as usual. Folks, the secret is this, cosmetic procedures are the least technically difficult surgeries (with the possible exception of rhinoplasty) of all the procedures these doctors train to do. That's why it's easy for any of these guys to transition to cosmetic surgery and that's why so much B.S, about competency and ongoing attempts to convince you that Board certified plastic surgeons are the only good safe practitioners of this craft. So how is the poor unsuspecting public to pick the good surgeons from the bad ? It's tough. Board certification in their primary specialty shows that they have completed a program that had standards for training and that they were smart enough to pass a written and oral examination. (cont)  (Sep 19, 2010 | post #9)

Chattanooga, TN

Plastic Surgeon

Wow. Where to start? @Impacted you sound like a shill for the ABMS plastic surgeons. Do you work in a PS office in Chattanooga. Are you a plastic surgeon ? If not, the only other reasonable assumption is that you have been sold a story filled with half-truths and now proceed to spew it forth in the interest of "patient safety." The best comment you've made above is that there is no ABMS board certification in cosmetic surgery. Then you immediately default to the standard position of plastic surgeons. "Make sure your cosmetic surgeon is ABMS board certified" Because that assures the public of what exactly ??? You do mention to check for hospital privileges and that is a viable method of evaluating a surgeon. However, it implies that all surgeons with hospital privileges are competent and patients can be assured of a safe outcome of their procedure whilst a surgeon without hospital privileges will surely only harm patients. This is also a naive and misinformed assertion that is widely disseminated by the political arm of organized plastic surgery. Here's why folks. Hospitals use ABMS standards to assure patients of a certain level of clinician competency. They do this by helping to determine the basic standards for training in each of the specialty areas that @Impacted mentioned and then testing the graduates of such programs in order to proclaim them "board certified". Each specialty then has a proscribed set of procedures which are deemed to be within its "scope" of practice. Currently, plastic and reconstructive surgery contains all body cosmetic procedures within its scope. Otolaryngology (ENT) contains a significant amount of facial plastic surgery within its scope. Oculoplastic surgery - a subspecialty of Ophthalmology also considers facial cosmetic procedures within the scope of its practitioners. Oral and Maxillofacial surgery while not an ABMS specialty is an approved American Dental specialty with standards for training equally as high as its ABMS colleagues who work in the same area. It considers facial cosmetic procedures to be within its scope of practice. So what's the deal with hospital privileges? The problem boils down to big time politics and has to do with training for procedures that are considered "out of the scope" of the practitioner's original training. Since plastic and reconstructive surgeons scope of practice is basically "everything from the top of your head to the tip of your toes" they get to be the ones in the hospital setting that determine whether a doctor from another field like ENT is qualified to do breast augmentation. (It's interesting to note that the reason plastic and reconstructive surgeons have such a wide scope of practice is mainly because they were the first historically to claim those privileges. The main focus of a plastic and reconstructive surgery residency is reconstructive surgery. Burns, hand injuries, free flap reconstructions etc. And yet as part of their "scope of practice" many plastic surgeons with minimal amounts of cosmetic surgery training are given hospital privileges to perform all cosmetic procedures.) So now say an ENT surgeon wishes to perform breast augmentation surgery. Ideally, he/she attends courses to familiarize himself/herself with the anatomy of the surgery as well as the potential complications and then performs surgery as an assistant with an experienced mentor until the mentor deems him/her competent. The surgeon then presents their log of cases performed with the mentor as well as their course work to the Section Chief of the department of plastic surgery and requests hospital privileges to perform breast surgery. What do you think the answer will be folks ? That's right now you're catching on.  (Sep 19, 2010 | post #8)