ISSUE 143: Special Section

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Skill, Service, and Selection

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LOUISVILLE The basic principles of success in an independent medical practice are elementary, says plastic surgeon T. Gerald O’Daniel, MD, FACS. “Our basic philosophy can be distilled down very simply to any type of plan that you use for a business or service industry, which is a quality type of product with excellent customer service,” says O’Daniel. High quality work is essential in a field where outcomes are visible and insurance coverage is limited. Customer service is an equally important component, contends O’Daniel, because service sustains the business. He cites an obsessive-compulsive attention to detail and surrounding himself with people who do the same as keys to his success.

In a slow economic climate, internet merchants such as Groupon and Living Social have thrived, selling discounts on everything from hang-gliding to Medispa services. But O’Daniel says he has never advertised his services, relying instead on referrals and word-of-mouth. While discounted services are a blanketed approach to increasing volume, O’Daniel’s goal is to focus on a specific population that he can serve extremely well. “We can’t treat everybody, but when you come to our practice, you’re going to get high-end quality outcomes with unsurpassed customer service,” he says. O’Daniel estimates his patient population is 60% local and 40% out of town or out of state.

With an office staff of seven employees, two of whom have been with him 20 years, O’Daniel does approximately 400 facial procedures a year, including 150 to 200 face lifts. He performs surgeries at nearby Louisville Surgery Center, a nationally accredited and state-licensed multi-specialty surgery center in which he is a partner. While the surgery center covers services from ophthalmology to pain management, its largest volume of patients are plastic surgeries. The center, which has about 20 employees and accommodates 4,000 cases a year, is 100% physician owned, although non-owners also operate at the facility.

A benefit of maintaining a successful practice for 20 years is that you get to be selective about the services you offer. O’Daniel, who has been practicing in Louisville since 1993, trained in ear, nose, and throat surgery and facial nerve surgery. He continued his facial surgery training with a plastic surgery residency and then completed pediatric plastic surgery and craniofacial surgery fellowships. He is board certified in otolaryngology/head and neck surgery and plastic surgery. “After nine years of surgery training, two board certifications, and two fellowships, I’ve kind of whittled my practice down to doing a handful of operations,” says O’Daniel. He used to do acute trauma and breast reconstruction, but the downside of a very successful practice was that he could not be readily available for acute cases and maintain a timely and accessible practice for his scheduled patients.

Focusing on facial procedures, O’Daniel’s cosmetic procedures include facial rejuvenation, rhinoplasty, and ear pinning in young children. Non-cosmetic procedures include cleft lip repair on children, cleft lip revisions on young adults and adults, nose revision on children with cleft lips, reconstruction after cancer removal, and post-traumatic reconstruction.

O’Daniel is also selective about his patients. Because his referrals are word-of-mouth, he feels his patient base is preselected and carries an inherent trust, but that trust must go both ways. “If I don’t feel like I can develop a relationship with the person that’s going to be amicable and understanding and that’s going to be reasonable, then I don’t partake in the surgery,” says O’Daniel. He also relies heavily on his office staff to look for red flags that might signal a patient that is impossible to please.

The doctor-patient relationship is critical in aligning the patient’s expectations with what is surgically possible. “Really, I look at myself as being an educator,” says O’Daniel. If expectations are misunderstood or unrealistic, clients walk away unhappy. For the patient who wants to look more youthful, matching expectations with outcomes includes comparing photographs of them at 20 or 30 years old with current ones and discussing concerns, why things look the way they do, and what can be done to restore it. Patients also see pictures of what other patients looked like an hour after surgery, a week after, a year, and ten years after to get an idea of their own recovery.

“We can make people feel really good about themselves, but if a person comes in for the wrong motivation, you’re going to end up a failure every time,” says O’Daniel.

The doctor-patient relationship is critical in aligning the patient’s expectations with what is surgically possible. “Really, I look at myself as being an educator,” says O’Daniel. If expectations are misunderstood or unrealistic, clients walk away unhappy.