PRSonally Speaking

Monday, August 26, 2013

Innovation and Wellness: The Value Proposition of Plastic Surgery
By Henry C. Hsia, MD, FACS
Does our society need plastic surgeons?  In the August 2013 issue of PRS, Wang, Kotsis, and Chung write about applying business concepts of innovation strategies to plastic surgery.  The specialty has a long tradition of past surgical innovations including facial reconstruction and microsurgery, but the authors make the case that the continued ability to innovate will be necessary if plastic surgery as a specialty is to maintain its edge in the future.  To directly quote from their article, “Innovation makes plastic surgery different and distinctive, and will be key to the survival of the specialty.”
The article touches on an important existential question for plastic surgeons: What is so special about plastic surgery now as a surgical specialty in an age when its past technical innovations have gone mainstream and can be readily performed by other technically skilled surgeons? 
You can approach this question by considering what gives other specialties their value.  The easiest way to do this is to play this quick exercise in free association: Think of a medical specialty, and what’s the first word that pops into your head?  It’s likely you’ll quickly come up with a single word that captures its essence as well as its value, thereby justifying its existence: cardiology = heart, orthopedics = bone, pediatrics = kids. 
As a specialty that does not limit itself to any one particular anatomic area, physiologic process, or demographic group, plastic surgery defies this trend, thereby making it more difficult to define its value.  The general public tends to think of plastic surgery as the “cosmetic” specialty, but as any plastic surgeon knows, this definition is woefully incomplete, and unfortunately leads many people to trivialize the importance of plastic surgery to society.  This inability to easily define plastic surgery’s “portfolio” makes it understandable if our society wants to ask the existential business question: What is the value proposition of plastic surgery?
Wang, Kotsis, and Chung take the right approach in saying that plastic surgery as a specialty could do a better job at associating itself in the public’s mind with the concept of “Innovation” (with a capital ‘I’).  I would add that plastic surgery could further distinguish itself as a specialty by better emphasizing the unique perspective of its practitioners in being able to serve patients in the context of their respective medical and social circumstances to maximize their quality of life and sense of “Wellness” (with a capital ‘W’ of course!). 
This perspective is derived from a combination in breadth and style of training that is rare (if not unique) among medical specialties.  In addition to ranging over the spectra of anatomical areas and demographic groups, the training process in plastic surgery imbues a thoughtful openness to new and different approaches that make plastic surgeons well positioned not only to lead surgical innovation, but also to develop sophisticated treatment plans tailored to the diverse circumstances of individual patients. 
In an age when health care is increasingly emphasizing personalized and holistic care and medical students are being taught to view patients as more than the sum of their parts and organs, plastic surgeons should be seen as the embodiment and leading proponents of this philosophy.  Just as plastic surgeons had been pushing the envelope and innovating long before “Innovation” became a buzzword in business, plastic surgeons have also been improving the quality of patients’ lives and helping patients achieve a sense of well being long before “Wellness” became a buzzword in healthcare.  When viewed from this perspective, the value proposition to our society of plastic surgery as the specialty that promotes innovation and wellness to improve quality of life for patients becomes clear.  Hopefully those will become the first words that automatically and universally pop into people’s minds as the answer whenever someone asks: Why do we need the specialty of “plastic surgery”?