The Arizona Medical Board has a very good standard for choosing a Plastic Surgeon which I firmly believe all clients should read and be prepared. This checklist is produced by the Arizona Medical Board.

How to Choose a Physician for a Cosmetic Procedure or Plastic Surgery                        

The demand for cosmetic procedures and plastic surgery is rapidly growing. A large
industry of professionals has also grown to meet this increased demand. The practice can
be very lucrative as many of the procedures are paid for in cash rather than by insurance.
Because most of these procedures are not covered by insurance, patients are on their own
in finding the right physician to perform the desired procedure. When trying to decide
which physician should perform the procedure, patients are motivated by cost,
convenience of location and how soon the procedure can be scheduled. While these are
legitimate and important considerations, they should not override the importance of
choosing the right physician.

In Arizona, any licensed allopathic physician may perform any procedure that he or she is
competent to perform. The law does not prohibit physicians from performing procedures
that were not part of their formal training. There are very good reasons for this, but it
does require patients to carefully research how a particular physician received training in
a particular procedure. The Arizona Medical Board requires all physicians to have the
knowledge and skill to perform procedures within the community standard of care,
whether the physician learned the procedure as part of the formal education or through
informal education.

This leaves the patient with many options in choosing a physician to perform a
procedure. Making the right choice can be challenging. To help in choosing the right
physician, the Arizona Medical Board is offering this guidance document and attached
checklist to assist patients in choosing the right physician to perform a particular
procedure.

Getting started: Most patients begin their search for the right physician by asking friends,
co-workers and family for suggestions. This may be a great way to identify potential
physicians and obtain an actual account from a trusted source. However, the physician
that was right for a friend or family member may not be the right physician for you. Each
patient is unique. Differences in age, gender, build, weight and skin color can make a
difference in choosing a physician. In addition, patients may ask their primary care
physician or other healthcare providers for referrals.

Research: Once you have developed a list of potential physicians, you need to research
the physicians. One of the best places to start this process is at the Arizona Medical
Board’s website, www.azmd.gov. The Arizona Medical Board maintains an on-line
profile of every licensed allopathic physician. This profile will identify the status of the
physician’s license, list where the physician received formal training, identifies the field
of medicine in which the physician received formal training, i.e. surgery, radiology,
family practice, pediatrics, etc. The physician’s profile also identifies if the physician is
Board Certified in a particular specialty by a Board that is recognized by the American

Arizona Medical Board

Board of Medical Specialties (ABMS). If such a Board does not certify the physician,
the physician may list an area of practice in which the physician focuses. The web
profile also shows whether the physician has been disciplined, paid on a malpractice
claim or judgment or received a criminal conviction.

Training: You should carefully consider the potential physicians’ training. There are
several ways a physician can learn to perform a particular procedure. First, physicians
can learn a procedure as part of the formal training during a residency or a fellowship.
Second, physicians can learn a procedure informally after completing formal training
from organizations that specialize in training physicians to perform particular procedures.
Third, physicians can learn new procedures by being mentored or trained by other
physicians. Regardless of the training method, physicians can become highly proficient
and competent in performing a particular procedure.

Board Certified: If a physician is Board Certified by a Board recognized by the ABMS,
this indicates that the physician has completed a residency or fellowship in a particular
specialty and has passed examination at a level higher than that required for licensure.
Additionally, some physician must re-qualify for Board Certification every few years to
demonstrate continuing competency in the specialty. Not all Boards that certify
physicians are recognized by the ABMS, and these Boards may not require the higher
standards of training and examination, however, some non-ABMS Boards have high
standards for certification. Therefore, if the physician is not Board certified by an ABMS
Board, you need to research the Board to determine if it is a legitimate organization.

A number of physicians licensed to practice medicine in Arizona do cosmetic procedures
successfully. Some of these physicians may not be Board Certified, but they have had
adequate training and possess sufficient skills to perform procedures safely. Therefore,
Board Certification alone does not demonstrate whether the physician is competent to
perform a particular procedure, but it is one factor to consider.

Assessing the Physician: After selecting a potential physician, it is important that you
assess the physician and the physician’s staff during your first visit. When assessing the
physician’s office and staff, you should look for such things as cleanliness, politeness of
staff, courtesy, privacy, etc. In general, you should feel comfortable with the practice
upon walking in the door and being greeted by staff. When assessing the physician, you
should consider if the physician answered all your questions and spent the time necessary
to make you feel comfortable. You should ask general questions about the procedure: for
instance, how many times has the physician performed the procedure, how did the
physician learn to perform the procedure, will anyone other than the physician perform
part of the procedure, what other similar procedures does the physician perform, does the
physician have picture of the results of the same procedure on other patients.

Arizona Medical Board

Learning the Procedure: Once you are comfortable with the physician, you need to
discuss the actual procedure. The physician should explain, in detail, what is involved
with the procedure. The physician should explain the actual mechanics of the procedure,
how long the procedure should take, how long recovery should take before discharge and
how long recovery should take post-discharge. The physician should also explain what to
expect with regard to wound recovery and how much pain to expect and how to treat the
pain and other post-procedure requirements. The physician should also explain what
warning signs or concerns to watch for that might need immediate attention, such as
bleeding, infection or excessive pain.

Very often, the sedation used during the procedure has more associated risks than the
risks associated with the procedure. Therefore, it is very important that the physician
explain if sedation will be used, and if so what type of sedative agent will be used. The
physician should explain what level of consciousness will be maintained. Sedation can
range from complete unconsciousness to alertness with a mild sedative affect. If the
physician plans on using general anesthesia, then the procedure must be performed in a
facility licensed by the Arizona Department of Health Service such as an outpatient
surgical center or hospital. The physician should explain who would administer and
monitor the sedation and their training, skills, knowledge, qualifications and licenses.
The physician must also inform you of any other persons involved in the procedure,
along with their purpose, training and skills.

Informed Consent: Physicians must have your informed consent prior to performing any
procedure. Physicians must not only have consent for the procedure, but they must also
obtain consent for every person who will be involved in the procedure and where the
procedure will be performed. In order to obtain informed consent, the physician must
provide you with sufficient information for you to make an informed decision. Ensuring
that the you receive sufficient information requires good communication between you
and the physician. While the physician knows the risks and benefits of the procedure,
knows the individuals who will help perform the procedures, and knows the location
where the procedure will be performed, the physician cannot know every issue that may
be of importance to you. So you must ask all questions necessary to ensure your comfort with having a particular procedure performed by a particular physician using particular staff at a particular location. You must also express any limitations or conditions you
want to place on your consent.

Only after you feel completely comfortable with the procedure, the physician, the staff
and the location, should you consent to proceeding with the procedure. While cosmetic
procedures and some plastic surgeries may seem routine and very safe, these procedures
do come with some level of risks. The skills of the physician and the physician’s staff
bear directly upon the risks of a particular procedure. So, it is critically important for
your health and safety that you choose the right physician to perform the procedure, even
if it means paying more for the procedure at a less convenient location and at a later date.