Here’s how we ensure your safety, every time, and why it matters so much to us.
Blog by Dr. Robert Shenker
As a plastic surgeon who operates in a certified out-of-hospital facility, patient safety remains the number one goal for me and my team at The Cosmetic Surgery Clinic. Our mantra is “safety first, forever and always.”
We use many obvious safety measures that our patients can observe for themselves.
They see all of our top-of-the-line, modern surgical and anesthesia equipment. They read about our credentials and experience in the “About Us” section of our website, and they can see that we have always passed all of our official inspections from the Ontario Ministry of Health and the College of Physicians and Surgeons of Ontario.
However, there’s another way that we keep all of our patients safe that is not immediately apparent at first glance.
Every single one of our surgical patients gets a complete preoperative medical and anesthesia consultation before their surgery. They just don’t know it because it happens behind the scenes.
The process starts with taking a complete medical history and doing a physical examination at the time of the first consultation.
We are often told by our patients that we ask a lot more questions and spend a lot more time getting to know our patients than other plastic surgeons. I have no way of knowing if that’s true, as I’ve never had a formal consultation with a plastic surgeon myself, but if my patients say it’s true, then it’s true! Our extra-long consultation visits don’t happen just because we like to chat. We are probing the entire medical history of our patients so we can get a full and complete picture of their fitness for surgery.
Sometimes a patient tells us that they have, in the past, had some sort of previous medical concern. Maybe they saw a cardiologist for chest pain, or a hematologist for a blood clot, or any other medical specialist. When we hear that, we will routinely ask our patients to sign a release of information form so that we can get the most up-to-date information from that specialist to review it.
The next step in our behind-the-scenes pre-operative assessment process is a thorough chart review by the operating room manager, Ange.
Ange has extensive experience both within and outside the operating room. She’s been a registered nurse for well over 20 years and there’s not much she hasn’t seen or heard. Ange will sort through a patient’s medication list, previous blood work, and reports from other medical or surgical specialists and arrange it all into a nice tidy concise report.
After this step is completed, Ange and I sit down with Dr. Paul Nicholas, our chief of anesthesia, to review each patient’s complete medical history, including any specific concerns they raised at the time of their consultation.
Dr. Nicholas is not only our chief of anesthesia, but for the last 15 years he’s been just about our only anesthesiologist at The Cosmetic Surgery Clinic. That level of consistency in our medical staff can’t be overemphasized, and it plays a major part in maximizing patient safety.
What makes Dr Nicholas so special is that he has over 30 years of anesthesia experience, and that he began his career as a family physician working in small towns across the east coast, both in Canada and in the United States. That gives him a perspective on the health of our patients that goes well beyond simply putting them to sleep and waking them up after their cosmetic surgery. Dr. Nicholas looks into the medical history of our patients with the eye of a small town family doctor who wants to take care of the patient from top to bottom, and from A to Z.
Most of the time, after we sift through all of the medical information, there are some minor adjustments to be made:
- Sometimes we ask a patient to get a sleep study and make sure they bring their CPAP machine with them on the day of surgery.
- Sometimes we make sure a diabetic patient brings their own insulin or blood glucose monitoring equipment from home so that we can make sure we’re getting consistent readings compared to what they get at home.
- Sometimes the tweak is as simple as asking a patient to use an iron supplement for a few weeks before surgery.
- We make sure patients understand what medications they should take before surgery, and which ones they should skip.
- We speak to any of the patient’s medical consultants who might have a perspective on the safety and appropriateness of the operation we’re planning.
All of this work takes weeks and sometimes months to sort out, but we do it with pleasure because we know that on the day of surgery, our patients are going to be safe, the surgery is going to proceed without complication, and the recovery is going to be smooth.
We do all of it to give you the best experience possible and to keep you safe.
So, when you come to visit us, don’t be frustrated when four different people ask you if you have any allergies or if you’ve taken your blood pressure medications. Don’t think we’re just being nosy when we ask the name and contact number of your family physician. We’re doing it because we love our unblemished safety record, and we’re doing everything we can to keep you as safe as possible when you work with us at the Cosmetic Surgery Clinic.