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Clients vs. Patients

By: Marc Ronert, MD, PhD
Posted: January 29, 2010, from the January 2010 issue of

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Competition is also tight as a result of the rising trend in cosmetic surgeries and the influx of new surgeons available to perform them. Turning customers away is a decision that could greatly cost a plastic surgeon and, in some markets, provoke a negative reputation. So the question remains, when should a doctor step in and refuse to perform a procedure? At what point should the doctor turn away a client? Who is the judge if someone does or doesn’t need surgery?

The answer is that a good physician needs to be the judge, making sound judgment calls based on medical experiences and ethical understanding. The physician also needs to weigh potential health risks for the patient or client, and if the procedure’s risk outweighs the benefit, it must not be performed under any circumstances.

Enough is enough?

Without a clear set of standards for determining the limitations that should be placed on customers seeking procedures, the decision remains with the physician, and the code of ethics will have to be the guide. Therefore, every physician has the responsibility to view everyone as a patient first, whose best interests are of chief concern. This facilitates the need to sometimes decline procedural requests.

However, declining procedures can be easier said than done. Many patients of plastic surgeons are considered clients because they are repeat customers. These physicians can often see the same person again and again for different procedures, and because the client primarily pays for cosmetic and elective surgeries, when and how often they get a procedure is done entirely at their discretion. For someone with endless means who abuses cosmetic surgery, the only system of checks and balances may be the physician.

Maintaining your reputation

To maintain a quality reputation and good standing in the medical community, the goal is to achieve positive and profitable relationships with patients, giving appropriate attention to the cost of doing business and ethical concerns in different amounts. Patient first, client second. Ethics and the medical background of each case must come before profits are considered. And while reserve must be shown in deciding who deserves a procedure, it is imperative the question be asked for every procedure and patient.