Dr Jan’s Blog Novel-Correcting the Record

In a comment C.S. wrote “…most important…what do you want people to do as a result of reading?…”  The answer: Nothing! There is not anything I want people to “do” after reading this manuscript. My goal, however, is that after reading it they will come to believe as I believe: That life need not be a struggle but a process, a process of self-definition (not self-discovery), of Growth (not learning) and of Being (not doing).

Therefore, please understand that my purpose is not to villify any of the players (neither Scoggins, Levin, the Medical Board of California, or the lawyers).  There are no villains in God’s world. As we begin, I am simply stating the facts.

This is a book about reclaiming oneself. This is about seeing with clarity the ultimate truth: that what you do to others you do to yourself; and that what you fail to do for others, you fail to do for yourself.

Back to our story:

In order to sit for board certification, you are required to fulfill a minimum of three years of general surgery and two years of plastic surgery training. As in all cases of “regulation” it is the minimum standard that is emphasized.These minimum standards gradually tend to become the maximum also. If the minimum qualifications are set for surgery, there is little to be gained from producing those surgeons who are above-average. Gradually, even an attempt to maintain minimum standards erodes.

I, on the other hand, had done much more during my training, and for that I am immensely proud. I completed five, not three, years of general surgery training at Lenox Hill Hospital, the Cornell University affiliate at the time. In my fifth year I served as administrative chief resident.

 Lenox Hill Hospital’s training program in general surgery is a pyramid program. That means, it is competitive all along the way. It begins with 12 interns but ends with only two chief residents; people are excluded from the program each year based on performance. Only two people get to complete the residency program. I was one.

From Lenox Hill Hospital, I went on to plastic surgery training at the University of Michigan. There I completed two years of plastic surgery training at one of the best programs in the country. I also served as administrative chief resident at that program in my senior year.

I could have been done at that point, but chose to do more. I wasn’t satisfied with the minimum. I knew I wanted to do aesthetic or cosmetic surgery, and Dr. Timothy Miller, a professor at UCLA School of Medicine, was starting a fellowship in aesthetic plastic surgery.

There are four areas of plastic surgery: 1) craniofacial surgery which involves moving bones around in the face, and pertains to anatomic defects in children and accident victims; 2) hand surgery, which is self-explanatory; 3) reconstructive surgery, which has to do with moving flaps around to cover holes or loss of tissue; and 4) aesthetic or cosmetic surgery.

Cosmetic surgery is actually a small part of what most plastic surgeons do, but as a result of its relationship to Hollywood and movie stars, gets the majority of the press. In fact, in the plastic surgery community, programs are deemed better if they virtually ignore vanity (cosmetic) surgery and concentrate on the more advanced techniques in reconstructive surgery including bone growth and microsurgical techniques. As a result, residents don’t get a lot of cosmetic surgery training, and that’s another reason why I chose to extend my training to include a fellowship in aesthetic surgery.

This is a fact that a lot of plastic surgeons don’t want you to know. They don’t want you to know that you can be board certified and have never done a face lift, a tummy tuck, or a breast augmentation on your own. It is simply a cheap advertising tool that suggests an air of expertise but guarantees nothing. It does not eliminate potentially dishonest or substandard plastic surgeons, but merely make their activities harder to detect and easier to whitewash.

 I am particularly sensitive to this group dynamics. I reject guild socialism and it frankly serves as both an asset and a liability. When I started my fellowship in aesthetic surgery at UCLA, it was precisely that group of board certified casual faculty who began to dismantle the aesthetic fellowship the first day. And you want to know why?  Because they make most of their money doing cosmetic surgery, and the last thing they needed was to produce a lot of Dr. Adamses. The last thing they needed was to produce cosmetic surgeons with more training than they have. That would raise the requirements for “standard of care” and that created fear for them all.

They weren’t about to let better trained aesthetic surgeons enter the market. And so Harvey Levin missed the real story. He failed to see that they hate and resent surgeons like me because I am better trained and refuse to join their club. Mr. Levin helped them continue to fool and mislead the public, in addition to denying Donda West justice.  

          Dr. West knew this. She was an extremely smart and educated woman who interviewed a number of physicians (according to the coroner’s report) before deciding on Dr. Adams. In fact, all my patients know this. As lead dog, Harvey missed it and then led the pack, including the real news reporters, down the wrong path. The real story here is not board certification. The real story is why this program is no longer offered at UCLA even though the other three areas of plastic surgery offer fellowships. The real question is why would surgeons kill a program that raised the standard of care?

 Now board certification is important-it’s just not the only way- and I would advise any resident to pursue it (The fact is that many, many more types of surgeons are more than qualified to perform cosmetic procedures than plastic surgeons). It’s not that it means that much if you have it, but if you don’t, they will surely one day find a way to use it against you. I knew that day would come for me and I wanted it. I wanted people to talk about training and expertise, not advertising. I wanted people to justify killing a program, like the one at UCLA, simply because it raised the “standard of care”.


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