When I first heard this phrase, it totally changed my practice.  As a Cosmetic Plastic Surgeon, all of my patients are choosing to have surgery- it is all elective.  Being exceedingly well trained and Board Certified, my thoughts opening my practice were that if I did everything right in the operating room, the patient’s personality or demeanor were secondary.  Who could be unhappy with a good result? I then learned that the patient’s personality and demeanor were the MOST important part of my job.  It doesn’t matter how well you do the surgery, it matters how the patient PERCEIVES the result.

After more than 18 years in private practice Plastic Surgery, I can tell you that the key to happiness in my profession is happy patients.  I can also tell you that superb results do not always result in happy patients.  The key is to identify them before surgery is performed and tell them no.

If you can look at a before and after picture side by side that shows a great result, and the patient says she sees no difference, something else is going on.  Either it didn’t fix a relationship issue, they did not get the feedback they wanted, someone in their life said mean things to them, or they are crazy.

If someone’s expectations were not met, you can reason with them and explain what is possible.  Usually they realize that things went well, and ideally are happy.  If they are unable to see reality, explanations or conversations are meaningless.

I try to not operate on crazy people, but I some occasionally slip through the cracks. Afterwards, they become my difficult people. If you are crazy, please do not come to my office. I love what I do, but there are some patients I can not help.