Medesthetics

NOV-DEC 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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16 NOVEMBER/DECEMBER 2018 | MedEsthetics © GETTY IMAGES Patient satisfaction following plastic surgery is most affected by surgeon-related factors, such as taking the time to answer questions and including patients in the decision-making process, according to the results of a patient survey published in the September issue of Plastic and Reconstructive Surgery. By comparison, practice-related issues, such as wait time and interactions with offi ce staff, have a much weaker ef- fect on patient satisfaction scores. In 2016, Neil Tanna, MD, MBA, and colleagues at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York distributed a 24-item Press Ganey survey to patients of 686 plastic surgeons nationwide. After analyzing 36,836 responses the researchers found that offi ce hours or scheduling appointments, waiting times, in- teractions with nurses or staff other than the surgeon, and attention to patient privacy or safety had weak correlations to a patient's likelihood to recommend the surgeon or practice. In contrast, the items with the strongest correlation included patient's level of confi dence in the surgeon and the surgeon's concern for the patient's questions and wor- ries. Other important factors included the surgeon's explanations of the problem or condition and efforts to include the patient in decisions. Physician Interaction Best Predictor of Patient Satisfaction Best Densities for Laser-Assisted Topical Anesthetic Delivery Fractional laser treatment delivered with 15 percent density prior to application of a topical anesthetic offers more effective pain reduction than 5 percent density, and there is no signifi cant difference between use of a CO 2 versus Er:YAG laser. Researchers Arne A. Meesters, MD, et al, of the Netherlands, treated four 10mm x 10mm test regions on the backs of 15 healthy subjects with CO 2 laser at 5 percent density, CO 2 laser at 15 percent density, Er:YAG laser at 5 percent density or Er:YAG laser at 15 percent density (70–75µm ablation depth). Following laser treatment, the inves- tigators applied articaine hydrochloride 40mg/ml + epinephrine 10µg/ml solution under occlusion to all four test regions. After 15 minutes, they performed one pass with the CO 2 laser (1,500µm ablation depth) to each test region as well as one unanesthetized region as a pain stimulus. The median visual analog scores (VAS) were 1.50 (CO 2 5%), 0.50 (CO 2 15%), 1.50 (Er:YAG 5%), 0.43 (Er:YAG 15%) and 4.50 (unanesthetized reference). While the investigators found no signifi cant difference in VAS scores between the CO 2 and the Er:YAG laser pretreated regions, sub- jects did report that pretreatment with the CO 2 laser was slightly more painful than pretreatment with Er:YAG laser. The study was published in Lasers in Surgery and Medicine (October 2018). BEST PR ACTICES When asked whether it was better for a leader to be loved or feared, Machiavelli famously posited that it was better to be both. But if you must choose, be feared. New research from Binghamton University contradicts this notion. Chou-Yu Tsai, assistant professor of management at Binghamton University's School of Management and colleagues surveyed nearly 1,000 members of the Taiwanese military and 200 adults working full time in the United States. They looked at employee per- formance under three different leadership styles: • Authoritarianism-dominant leadership Leaders who assert absolute authority and control, focused mostly on completing tasks at all costs with little consideration of the well-being of subordinates • Benevolence-dominant leadership Leaders whose primary concern is the personal or familial well-being of subordinates. • Classical paternalistic leadership A leadership style that combines authoritarianism and benevolence, with a strong focus on both task comple- tion and the well-being of subordinates. The researchers found that authoritarianism-dominant leadership almost always had negative results on job per- formance, while benevolence-dominant leadership almost always had a positive impact on job performance. Classical paternalistic leadership, which combines both benevolence and authoritarianism, had just as strong an effect on subordi- nate performance as benevolent-dominant leadership. Tsai said his main takeaway for managers is to put just as much—or even more—emphasis on the well-being of your employees as you do on hitting targets and goals. The study was published in Leadership Quarterly (August 2018). KINDNESS IS THE MOST POWERFUL MOTIVATOR

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