It is Hard to Say No to a Patient


I am by nature an optimist.  I believe in the goodness of people, and my first instinct is to help. This has gotten me in to trouble several times in my life, but I would rather be taken advantage of than refuse to assist someone in true need.

As a Plastic Surgeon, there are patients who come in looking to make trouble.  They have been to other doctors and have been, in their words, “butchered”, and need someone to fix the mistakes.  I am willing to listen, but most of the time, the doctor has done a reasonably good job, but the patient is expecting more than is humanly possible.  If you then do a nice improvement, you may become the next in a line of “butchers”, with the patient threatening to ruin your reputation if you do not refund them or “pay them off.”

Some patients are very nice, but have health concerns or weight issues that make elective surgery riskier than usual.  While I have supreme confidence in my ability to perform the procedure to the highest standards, I cannot predict how the patient will heal or if they may develop issues unrelated to the surgery.  It is hard to say no to them if you can technically perform the surgery well, even if their doctor clears them for the operation.  I have learned I must.

Some patients have psych issues that make them unsuitable.  No matter how delicately you phrase it, patients do not like to be told they are unfit for elective cosmetic surgery.  You cannot argue with crazy.  You do not want them in your practice.

After 18 years at Yager Esthetics, I like to think I am still an optimist.  I just have become a more savvy optimist.