Emerging perceptions of facial plastic surgery among medical students

Primary care doctor's perception about the scope of plastic surgeons: A national survey

BACKGROUND

Plastic surgery is characterized by a broad spectrum of aesthetic and reconstructive surgical expertise that is not defined by an anatomic area. The authors sought to identify primary care doctors' perceptions of different fields of plastic surgery.

METHODS

A short, anonymous, web-based survey was administered to primary care doctors in Portugal. Respondents were asked to choose the specialist they perceived to be an expert for 29 specific clinical areas, including 20 that are the core of plastic surgery practice. Specialists for selection included the following choices: dermatologist, general surgeon, maxillofacial surgeon, vascular surgeon, neurosurgeon, orthopedic surgeon, otolaryngologist, and plastic surgeon.

RESULTS

A total of 430 complete answers to the survey were collected. Out of the 20 clinical cases related to plastic surgery, only nine were attributed to plastic surgery in the majority of the answers: thumb reimplantation (64,2%), abdominoplasty (93%), breast reduction (94%), otoplasty (62,3%), skin graft for a burn (97,7%), breast reconstruction (94,9%), complex open wound (57,2%), facial reanimation (36,7%) and first web space contracture of the hand (78,6%).

CONCLUSIONS

There is a clear underestimation of the role of plastic surgery in a wide range of conditions, which may lead to the downsizing of plastic surgery departments in the national health system. It is of utmost importance to educate primary care doctors so that patients are referred correctly and in a timely manner.

Public and Physicians Perception of Oculoplastic Surgery Subspecialty in Saudi Arabia

Objective

Oculoplastic surgery is a highly specialized subspecialty that studies pathologies of the orbit, lacrimal system, and eyelids. Although it is an independent ophthalmological subspecialty, many procedures fall within the shared scope and anatomical area of oculoplastic surgery, otorhinolaryngology, and plastic and reconstructive surgery, which tend to confuse physicians and patients seeking medical advice. In this study, our goal is to evaluate the perception of oculoplastic surgery among the public and physicians.

Methodology

A cross-sectional study in which data were collected from an online questionnaire formulated by the authors. The questionnaire included 18 questions divided into two categories: demographics and targeted questions that serve the objective of the study. Each answer option to targeted questions was encoded with either one or zero points, and each participant's response was scored accordingly, with the maximum score being 22 points, reflecting the highest perception rate according to the questionnaire.

Results

Data were collected from 1029 questionnaire responses, with 202 of the respondents belonging to physicians. The highest number of responses was from females which consisted 82% of our sample. Perception scores were higher among physicians with a mean of 12.3 ± 2.9 points compared to a mean score of 11.2 ± 2.9 among the public. Age played a statistically significant factor in both physicians and the public as younger participants' scores were higher.

Conclusion

Insufficient knowledge of oculoplastic surgery subspecialty was observed among the public and physicians. Moreover, core aspects of oculoplastic field such as lacrimal system pathology and orbit pathology were less recognized by participants of our study, which highlights the importance of raising awareness of oculoplastic surgery and the diversity of the field, to enhance referral patterns among physicians and improve medical advice seeking among the public resulting in better health care.

Reconstructive and restorative cues improve public perception on the value of plastic and reconstructive surgeries

BACKGROUND

Persistent public misconceptions of plastic and reconstructive surgery (PRS), ambiguity between cosmetic versus reconstructive surgical procedures, and subjective interpretation of aesthetics can result in undervaluing of the field. Our study analyzes how patient context (cosmetic or reconstructive/restorative cues) affect public perception of outcomes and value of surgery.

METHODS

We distributed Qualtrics™ surveys to laypersons via Amazon Mechanical Turk. Demographics were self-reported. The survey presented a series of pre- and post-operative photographs of PRS surgeries alongside either a cosmetic or reconstructive/restorative cue, followed by questions on values of procedure. Survey responses were analyzed using two-tailed Student's t tests and chi square analyses, univariate and multivariate analysis, and linear regression.

RESULTS

Of the 459 respondents, the mean age was 38.5 ± 12.1 years, and was 50.5% (232) male. The majority of respondents classified breast reconstruction as a cosmetic surgery (243, 66.8%), and was rated more attractive (p < 0.0005), higher impact on self-esteem (p < 0.001), and to be covered by health insurance (p < 0.0001) compared to breast augmentation. Reconstructive cued breast and facial procedures were viewed more favorably; the exception was gynecomastia reduction. Reconstructive classification had significant positive correlation with support for insurance coverage (R² = 0.8268) and willingness to pursue (R² = 0.5328).

CONCLUSIONS

This study revealed more public support for reconstructive/restorative cued PRS cases over cosmetic cued PRS cases, and persistent misconceptions of breast reconstruction as a cosmetic procedure. Reconstructive or restorative cues can be used to educate the public and address skewed perceptions on the roles and value of PRS.

Medical Student Selection of Otolaryngology-Head and Neck Surgery as a Specialty: Influences and Attitudes

OBJECTIVES: 1) To determine factors students perceive as influential in decision to pursue otolaryngology; 2) to determine perception of importance of factors used for resident selection and individual student commitment to the match; and 3) to identify exposure to various subspecialties within otolaryngology.

DESIGN: Population survey.

METHODS: A survey was administered to students applying for otolaryngology between 2000 and 2003 at a single institution.

RESULTS: Ninety-six students were interviewed. Seventy-eight percent believed that the main factor influencing their decision to pursue otolaryngology was their exposure to the residents. Board scores and one-on-one interviews were important factors in selection of interviewees and ranking process. Interestingly, over 20% of students believed that the match should not be early because they wanted more time to commit to ENT.

CONCLUSIONS: These data underscore the importance that residents have in directing future students to our specialty. Results of the match survey may indicate an attrition rate within residency programs that may be avoided if ENT were part of the “regular” match.

EBM RATING: C

Preliminary evaluation of junior medical students' exposure and comfort with performing the basic head and neck examination

OBJECTIVE

To assess junior medical students' comfort levels in performing the head and neck physical examination (H&NPE) and perception of the importance of otolaryngology--head and neck surgery (OTO-HNS) in medical training before and after undergoing a department-led teaching session.

DESIGN

Anonymous cross-sectional survey study, before and after educational intervention.

METHODS

One hundred one second-year medical students participated in an H&NPE teaching session as part of their preclinical curriculum. Students first watched a 25-minute H&NPE instructional video. Students then participated in lectures (90 minutes) on OTO-HNS subspecialties and faculty- and resident-led group H&NPE instruction (five to six students each, 90 minutes) with practice on student partners. Students rated their comfort levels (0-5 point Likert scale) in performing the H&NPE and the importance of OTO-HNS rotations throughout medical training before and after the session.

RESULTS

Ninety-five and 77 medical students completed presurveys and postsurveys, respectively. Before the teaching session, students reported an average comfort level of 2.1 in performing the complete H&NPE, which increased to 3.4 (P < .0001) after the session. Similar changes were observed for the individual ear, nose, mouth, and neck exams.

CONCLUSIONS

A specialized teaching session significantly improved medical students' comfort levels in performing the H&NPE and increased their awareness of the importance of OTO-HNS in medical training immediately after the session.

Professional perceptions of plastic and reconstructive surgery: what primary care physicians think

BACKGROUND

The great breadth of the specialty of plastic surgery is often misunderstood by practitioners in other specialties and by the public at large. The authors investigate the perceptions of primary care physicians in training toward the practice of different areas of plastic and reconstructive surgery.

METHODS

A short, anonymous, Web-based survey was administered to residents of internal medicine, family medicine, and pediatrics training programs in the United States. Respondents were asked to choose the specialist they perceived to be an expert for six specific clinical areas, including eyelid surgery, cleft lip and palate surgery, facial fractures, hand surgery, rhinoplasty, and skin cancer of the face. Specialists for selection included the following choices: dermatologist, general surgeon, ophthalmologist, oral and maxillofacial surgeon, orthopedic surgeon, otolaryngologist, and plastic surgeon.

RESULTS

A total of 1020 usable survey responses were collected. Respondents believed the following specialists were experts for eyelid surgery (plastic surgeon, 70 percent; ophthalmologist, 59 percent; oral and maxillofacial surgeon, 15 percent; dermatologist, 5 percent; and otolaryngologist, 5 percent); cleft lip and palate surgery (oral and maxillofacial surgeon, 78 percent; plastic surgeon, 57 percent; and otolaryngologist, 36 percent); facial fractures (oral and maxillofacial surgeon, 88 percent; plastic surgeon, 36 percent; otolaryngologist, 30 percent; orthopedic surgeon, 11 percent; general surgeon, 3 percent; and ophthalmologist, 2 percent); hand surgery (orthopedic surgeon, 76 percent; plastic surgeon, 52 percent; and general surgeon, 7 percent); rhinoplasty (plastic surgeon, 76 percent; otolaryngologist, 45 percent; and oral and maxillofacial surgeon, 18 percent); and skin cancer of the face (dermatologist, 89 percent; plastic surgeon, 35 percent; oral and maxillofacial surgeon, 9 percent; otolaryngologist, 8 percent; and general surgeon, 7 percent).

CONCLUSION

As the field of plastic surgery and other areas of medicine continue to evolve, additional education of internal medicine, pediatrics, and family practice physicians and trainees in the scope of plastic surgery practice will be critical.

Otorhinolaryngologists' interest in facial plastic surgery: a survey in the United Kingdom and Ireland

Introduction:

Within the field of otorhinolaryngology, interest in facial plastic surgery has grown significantly in recent years. There is a lack of evidence in the literature documenting this interest in the British Isles.

Materials and methods:

572 questionnaires were mailed to all members of the British Association of Otolaryngologists, Head and Neck Surgeons and to members of the Irish Otolaryngological Society.

Results:

Our response rate was 68 per cent. One-third of respondents were performing facial plastic procedures regularly, most commonly otoplasty (80 per cent), rhinoplasty (74 per cent) and facial flaps (28 per cent). Two-thirds of respondents had attended supplementary courses in facial plastic surgery, and 65 per cent would like facial plastic surgery to compose one-third of their daily practice.

Discussion:

Facial plastic surgery has become a significant part of the otorhinolaryngologists' practice. They are now offering a wider variety of procedures in the area. This is the first paper to document this interest in the United Kingdom and Ireland.

Perception and reality-a study of public and professional perceptions of plastic surgery

A questionnaire survey of the perception of plastic surgery amongst 1567 members of the public, general practitioners and medical students is presented. Closed-ended format questions were designed to assess understanding of the range of conditions managed by plastic surgeons. Respondents were asked to match nine surgical specialists with 40 conditions or procedures. To investigate understanding of the multidisciplinary nature of some surgery, respondents were asked which type of surgeon might have a supplementary role. Completed questionnaires from 1004 members of the public, 335 general practitioners, and 228 medical students are presented (responses rate>65%). Significant differences were identified between public respondents and other groups. Plastic surgery was associated with reconstruction for trauma and cancer and procedures with a strong aesthetic element by all three groups. The public were poorly informed about some core plastic surgery including burns, melanoma and hand surgery. General practitioner and student respondents had a better understanding of the diversity of the specialty. However, both groups considered orthopaedic surgeons and not plastic surgeons to be hand surgeons. The strengths and weaknesses of this study are discussed together with potential areas for education and promotion.