In the last 25 years, few specialties have experienced such dramatic changes to their public perception as plastic surgery, which was once seen mainly as a specialty that repaired damaged exteriors so that patients could lead normal lives. Today, the surgeons of Plastic Surgeons of Lexington (PSOL) practice both reconstructive and enhancement procedures with a mission for compassion and forthright advising that ensures their patients feel understood and fully informed about their aesthetic procedures.
The PSOL team of Andrew Moore, II, MD, Mike Moore, MD, Sherwood Moore, MD, and Joe Hill, MD, combine for over 100 years of experience in the field of plastic surgery – and share a legacy they are all proud to live up to. The three Moore brothers followed in their father’s footsteps: Andrew Moore Sr., MD, began the practice in the 1950s and was Lexington’s first plastic surgeon. Dr. Hill completes the “family” practice as Dr. Andy Moore’s son-in-law.
Dr. Moore Sr. practiced a broad spectrum of plastic surgery, but Dr. Mike explains that his main focus was the honorable goal of “trying to put people back together again.” How he approached his calling was even more honorable: “Taking care of people without concern for their ability to pay and doing it the best way you can” was his philosophy, says Dr. Andy. This air of compassion informs the practice today. He goes on, “When we make important decisions in this office, we try to remember the past we came from.”
Compassionate Care in the Office
PSOL offers a common suite of procedures, about 40% of which are enhancement and 60% reconstructive, but its doctors are committed to certain practices that distinguish them from other Lexington plastic surgeons. While many practices employ patient educators, the doctors at PSOL serve that role directly. “I prefer to spend as much time with the patient as possible,” says Dr. Andy. Dr. Mike concurs, “I like my patient interaction. I take the time to use books and diagrams to explain what I am going to do.” This commitment to patient contact is consistent with their attitude of full disclosure about procedure appropriateness. Dr. Mike says they are committed to thorough patient communication. “You have to do it honestly and ethically so that you are giving the patient what they need, not just what they want. Because what they want may not be attainable – and it may in fact, be detrimental.” He continues, “When I go over the risks and benefits, some patients decide the risks outweigh the benefits and forego a procedure.”
Seeing every patient as a whole person – and their features as a part of a whole body – are anchors in the practice. While elective enhancement procedures are an important revenue stream in the practice, Dr. Mike refuses to refer to his patients as customers or consumers. “When you use the term ‘patient,’ you are taking on their psychological, physiological, sociological, and pharmacological well-being,” he says. The doctors at PSOL also take the time to educate their patients about the big picture of their prospective procedures, be they reconstructive or aesthetic. Using nasal reconstruction as an example, Dr. Mike says, “You have to know the nose’s relationship to the lip, to the chin, to the forehead, to the head, and even to the body. If you are not considering all those body parts together, when you start to enhance or reconstruct one particular area, you are not truly considering the well-being of the patient.”
The practice also has two policy elements that put patients at ease. Referrals are handled the same day if requested (something that four doctors in the office allows) and an in-office surgical room for minor procedures has been set up and may avoid more costly ER or hospital visits. Despite this service turning out to be revenue neutral, PSOL remains committed to it because of the comfort it allows patients.
Translating Compassionate Care to the Community
The Drs. Moore and Hill readily extend their philosophies beyond the office, strengthening their professional and personal communities. They have been integral in maintaining the 20-member “Journal Club,” which is open to all Lexington plastic surgeons. This informal professional organization allows it members to collaboratively review developments in the field and maintain open lines of communication between practices. “The resulting collegiality of the plastic surgery community in the Bluegrass has been noted by a number of visiting surgeons,” says Dr. Andy.
PSOL surgeons are also active in The Commission for Children with Special Healthcare Needs (which Dr. Andy Moore Sr. founded), Shriners’ Hospital for Children, and Baby Health. Dr. Sherwood Moore currently spends time at the VA Hospital, serving veterans’ needs.
Most notably, Dr. Andy’s Surgery on Sunday (SOS) program (profiled in these pages in February, 2009) continues to gain national recognition and inspire similar programs elsewhere. SOS’s plastic surgeons, along with 400 other healthcare providers, volunteer weekly to provide reconstructive services to the working poor, have helped over 5500 people in the eight years they have been using donated space.
Surgeons from the region’s biggest hospitals have long been involved, and now some of those hospitals – Saint Joseph Main, Kentucky One in Louisville, and most recently Baptist Health – are offering their own versions. Dallas, Texas and Omaha, Nebraska hospitals have begun their own Surgery on Sunday programs. A group from Rome, Georgia came to observe as they begin theirs. In reference to his motivation to create Surgery on Sunday, Dr. Andy likes to quote his father, who said, “If you want to help the poor, you don’t have to go overseas. There are plenty of poor people here in Kentucky.” With his inspired guidance, Dr. Andy is certainly doing his father’s legacy justice.
A Rapidly Evolving Field
PSOL’s “patient not consumer” attitude contrasts with how the field of plastic surgery is currently trending. The rapidly evolving field is consumer-driven in many of its innovations. “Case studies and testimonials about enhancements are marketed directly to the patient,” says Dr. Andy. As a result, people have access to marginally accurate information. He continues, “There are a lot more celebrity testimonials about the efficacy of some new procedures than there are scientific studies.”
Some of the latest surgical and non-surgical developments include fat grafting, in which a patient’s own tissue is used for filler; silicone gel implants with increased gel cross-linking allowing for anatomic shape; skin removal after massive weight loss; non-invasive body contouring using freezing techniques; and skin care products. The durability of these is unknowable, as Dr. Andy says, “It’s difficult to know which will emerge as the most successful treatments.”
While they agree that many of the innovations are exciting, the doctors at PSOL take a cautious approach to the changes in the field. Dr. Mike cites their father who was fond of saying, “Don’t be the first on the ship; don’t be the last off the ship.” This is consistent with their deliberate approach to giving patients a clear picture of what they can realistically expect amidst the media and advertising barrage about the possibilities of aesthetic procedures. Dr. Mike continues, “It’s imperative that we avoid over the top claims about what we might achieve.”
Redefining “Family” Practice
While the legacy of Dr. Moore Sr. is palpable in the philosophy of PSOL, the daily practice is strengthened by a more immediate familial element: the bonds of brotherhood. Simply put by Dr. Mike, the Moore boys “know they have each other’s backs.”
Forged on years of sharing the same bedroom and attending the same boarding school, Dr. Andy, Dr. Mike, and Dr. Woody are beyond many of the prideful insecurities they have observed in other partnerships. This glues the practice together. “When you practice with family members, you have a lot more to lose if the partnership falls apart,” states Dr. Andy. And there is nothing to hide here: the Moore boys have seen each other fail and succeed for a lifetime. Besides, Dr. Andy quips, “If someone feels unjustly treated, we can always call Mom, and she will straighten it out.”
There is healthy competitiveness between Dr. Andy and Dr. Mike; they know they counterbalance each other in style and experience. “We don’t always agree,” says Dr. Mike, “but we are willing to help each other even in those disagreements.” This commitment manifests itself in an ethos of collaboration and forgiveness in the facility. As Dr. Mike say, “Compared to many partnerships, there are probably a lot more apologies that go on here.” And Dr. Hill, the relative outsider, agrees, “They are special people.”
Besides the patients of PSOL, Dr. Hill can be seen as the main beneficiary of the Moore brothers’ enduing collaboration. The first of his generation in the practice, he is in the luxurious position of being in the midst of three physicians who care for him as family and have a combined 75 years in those hallways (Dr. Andy joined in 1983, Dr. Mike in 1986, and Dr. Woody in 1995). “I really appreciate the opportunity to have this mentor-mentee relationship on a daily basis,” he says. He knows with another family it might have been different, but he cites the Moore brother’s “character and what they are about” as the key. They in turn value him greatly, as Dr. Hill holds up the spirit of the practice and brings an interest in cutting-edge practices. Dr. Andy says, “Joe has the compassion and surgical skills – and a lot of new ideas. Around here, everybody calls him ‘Dr. Future.’”
And the future of the practice is fast approaching. Facility and technological advances are constant and personnel changes imminent. In addition to creating the in-practice surgery, PSOL has a satellite office in Richmond. They have begun using fillers and Botox. Previewing new technologies is a regular part of their schedule; recently they looked at laser hair removal and non-invasive fat removal equipment.
Dr. Andy plans only to practice at PSOL for a few more years. He is considering new challenges that involve less of the red tape that modern medical practices entail. Everyone in the practice expects Dr. Mike’s son, Evan, who is just starting residency, to eventually join up. PSOL is on the lookout for more new talent – that is talent that wants to practice in the spirit of compassionate and deliberate care that has become their hallmark. With a third generation of Moore family doctors who have direct access to that tradition, it’s safe to assume the PSOL of the future will embrace it.
While the legacy of Dr. Moore Sr. is palpable in the philosophy of Plastic Surgeons of Lexington, the daily practice is strengthened by a more immediate familial element: the bonds of brotherhood.