How Bad Is It to Be a Plastic Surgeon in Los Angeles?
Worse than you could ever imagine. Every day patients call in for consultations either through email or Skype, and many ask why there is a $100 email consultation fee or a $250 Skype consultation fee. Lawyers charge $300 to over $1000 an hour and have only 3 years after college. The minimum time to achieve the level of plastic surgeon is 10 years after college with much more intensive and rigorous training against much more competitive and intelligent colleagues. It is not uncommon to spend an hour with a patient on Skype followed by sometimes dozens of questions. $250 for several hours of time is a losing proposition for any plastic surgeon. The overhead alone in a plastic surgery office is at least $50,000 a month with payroll for all employees and independent contractors, rent, utilities, web and advertising fees, supplies and operating room fees etc. not to mention patient cancellations, fraud, and other issues. So $100 for an email consultation is a truly laughable amount. However, if consultations were free, Dr. Kenneth Hughes would be evaluating 50 people or more per day. There is also the argument that a person who spent 15 years after high school to develop expertise probably deserves to be compensated a tiny fraction for his or her time.
Dr. Kenneth Hughes probably receives 300 to 400 inquiries about plastic surgery each month. The office staff then follows up with all of those individuals to determine interest. Most of the patients when called or emailed never respond yet, just hours before, they expressed great interest in the procedure. What happened in the intervening period that they now are no longer reachable by any means?
This disappearing act would probably frustrate anyone and it frustrates Dr. Kenneth Hughes and his office staff to no end. Should you actually get a person by phone or email they will usually start with several questions before even considering paying the small consultation fee. They want to extract as much information as possible without any respect for anyone else’s time. On top of the endless questions, the office staff usually encounters quite a few unreasonable people who yell at them about why there is a consultation fee. Some will argue about why they know what must be done despite never having received a consultation with Dr. Kenneth Hughes.
Another common issue is arguing with the office staff about in person consultations during the coronavirus pandemic, when this done for their own protection. It is simply not worth it for the doctor, his office staff, and other patients to create a breeding ground for the coronavirus. Perhaps as the number of vaccinated patients approach the majority and the coronavirus number of cases goes down, in-person consultations will be appropriate. Dr. Kenneth Hughes believes that even one patient hospitalization or serious illness or death would be a really sad indictment on in person consultations for the masses during the coronavirus pandemic. Nonetheless there’s always complaining about in-person consultations. There are complaints about not being able to see the doctor multiple times prior to surgery. There are complaints about almost anything you could possibly imagine despite the fact that Dr. Hughes and his staff do everything they can to both take care of patients and keep patients out of trouble.
The virtual consultation typically begin with the patient sending a request for what they want done. Dr. Kenneth Hughes will usually respond by asking for to see pictures of those various areas so that he can evaluate. After that Dr. Hughes will usually get his office staff to provide an estimate. There will usually be questions about realistic expectations, goals and goal pictures, the procedure itself, time for the procedure, relative risks, and procedure downtime along with best ways to recover from procedure and advice during the recovery.
Remember that no one at Hughes Plastic Surgery is actively recruiting anyone and we never send emails or call patients to ask about those procedures. These patients are sending inquiries through the website or calling the office directly. So it is sometimes hard to fathom why a patient could somehow get upset that we are responding to them or asking them if they’re interested in moving forward with a procedure or something of that nature. However, this happens all the time.
If a patient is not interested in a procedure, he or she can just simply tell us that. This certainly saves Dr. Hughes‘s office staff a lot of time with all of the misspent time on emails and phone calls that fall on deaf ears. Certainly, the goal is not to deal with people who do not want to have a procedure. There are plenty of people who do want to have a procedure. The doctor wants to focus on those patients. And, actually, all of these other patients who are asking unending questions who will never have the surgery only serve to disenfranchise the office staff and take away from the office’s ability to help those patients who truly need the attention.
Nonetheless, there will be patients who will claim to call in and schedule a procedure only to find out later that they have not scheduled. They will say that they will schedule in the future only so that you can read their MRIs or write to their insurance companies or give doctors’ excuses for work, or give doctor’s excuses for travel, get help with visas to enter the United States. These are just examples and do not even scratch the surface. The number of disingenuous people is truly astonishing.
Dr. Hughes could probably list several thousand different ways patients try to manipulate doctor and staff in the plastic surgery realm. Once the patient schedules for surgery then all of the labs have to be done as well as medical clearance. This is where you get further stratification of patients. Some of the patients, after scheduling the surgery, will want to back out of the surgery, because they have buyers remorse or want to spend the money for something else. So, at this point, they become impossible to reach by phone or email, despite calling the office dozens of times in the previous few weeks and asking Dr. Hughes hundreds of questions. In this manner, they can they think that they can avoid paying the fees for surgery for which they are obligated as these types of cancellations within the month of surgery lead to huge losses to any business.
Another method that is frequently employed is to find some type of illness. This has become particularly prevalent during the time of COVID as everyone just says they have COVID even though they supply no documentation of any positive test. Some have used the excuse that it is not safe to get surgery during COVID, as though they possess the knowledge necessary to make that determination.
Another very common excuse that people will cite is some type of family emergency. The number of family emergencies goes up exponentially anytime a surgery is scheduled for a patient who does not want to fulfill his or her financial obligations. An additional maneuver employed occurs when a patient says that he or she could not get the labs or that he or she does not have the lab results. The same thing is done for medical clearance. You can see how just getting a patient to surgery can be a very frustrating and time-consuming exercise for a lot of patients.
Assuming that a patient finally gets to have the surgical procedure, Dr. Kenneth Hughes routinely performs surgery at levels approaching perfection. Even in a perfectly executed surgery, at least 5% of the patients will have some kind of complaint following surgery. Despite 100% of the patients looking markedly better, this type of scrutiny will continue for months or years afterwards. There will be patients who will try to extort money by threatening to write reviews that are totally ludicrous and dishonest. There are patients who threaten to get a lawyer. There are patients who demand a copy of their records. All of these things are largely ignored by Dr. Hughes unless the patient is particularly nasty or malicious. Dr. Hughes has won many lawsuits, legal fees, and compensation due to defamation or malicious prosecution or legal misconduct. These amounts can be substantial amounts far exceeding what the patient or lawyer originally tried to extort. This approach serves to teach these really horrific individuals the dangers of trying to extort people as they have done throughout their lives.
If you are a reasonable person and do not talk in an insulting or condescending manner to Dr. Hughes, Dr. Kenneth Hughes will go above and beyond to try to help you. Dr. Hughes can help where someone else would not help or have the ability to help. He is willing to work with you and he will do it.
