Author Topic: Earl's guide to consults  (Read 2293 times)

earl25

  • Sr. Member
  • ****
  • Posts: 409
  • Karma: 52
Earl's guide to consults
« on: October 02, 2013, 09:05:07 AM »
Hi all. I just wanted to share my experience/advice  on consulting with out of state (also applies to in state also) doctors. This especially applies to specialty procedures that few doctors do. This advice IMO is very helpful because Dr. consults for surgery are very expensive. They can range from $100 -500. Especially maxfax and cranio docs. Also if you have to travel then you have to take on even more cost for flight/cab/hotel /using a vacation day from work etc.  One of the worst feelings is going through all this trouble and expense only to hear the doc say "im sorry I don?t do the procedure or its not for you". I will be writing my Earl"s warning signs. These are not concrete just a  possible heads up.

First I recommend everyone get a conebeam/ or ct scan,  AND facial x-ray (all angles)  done at a local place near you.if you can get insurance to cover it great , if you cant you can try to find a local place that just recently opened up they might be willing to give you a deal. You can check with your state/city  dept  that issues business or medical facility licenses  to find recently opened places.  You can also contact radiology/ ct scan schools to see if they can do it for cheaper .
Then get 2 sets of photos done.  1 set professional (with a realistic lighting as possible, if you can find a medical photographer that?s even better), the second set candid (taken by a friend or whoever with your own camera). Then buy a bunch of blank cd?s and cd cases (or ask if they can somehow condense the ct scan to be sent via e-mail if its possible.

Next search the web for docs who do or might do the surgery you want. Check medical journals like pubmed etc.

Next either e-mail or call the doctors office to ask if they do that specific procedure. Don't go into to much details. More details will come later. WARNING SIGN: If you ask the secretary if the dr.  does the procedure and you get a pause and she has to ask that's a warning sign he doesn't do it often. It not the be all and end all, but from my experience if the secretary or office manager has to pause and ask if they do it it?s not a good sign. Let?s be realistic if you call any cosmetic surgeon and ask does the dr. do rhinoplasty's your not getting a "um let me check". Theyre saying of course and maybe they will throw in some BS like "he's the best". When I was consulting for orbital rims I got the pause a lot, and I was foolish enough to go down there and waste my time and money.When I called dr. y for oris there was no pause.

If the secretary says yes , ask if you can send the doctor your ct scan, x-ray and photos for a fast pre-review. Present it as your trying not to waste the doctors time because you know hes busy . If they still say no, ask if the doctor does phone consults for a fee WARNING SIGN:  if they say no to both, you might want to go somewhere else. Yes doctors are very busy, but  even top ones,( this is 2013 the digital age)  I will make a random  uneducated guess that 70-80% atleast  do phone consults and most ive seen will review you pics and scan for free. If they say no you run the risk of them just wanting your consult fee. While the bread and butter for these practices are surgeries, but every little bit helps.

If after they say no and you still feel he?s worth a consult ask the office manager  to see  that if the doctor says no to surgery  if you can get a reduced consult fee since your traveling far  without a pre-review.  If they say yes that?s a decent sign, if they say no I wouldn?t do it, odds are you will be screwed.

If the doctor says yes. Either e-mail or mail the stuff and include a semi detailed note of EXACTLY what procedure (you might want to include a diagram if you have one) and your medical history. If the doctor gives the green light schedule your consult.

Don?t be afraid to fly in and out in one day (business man do it daily). I do it very often for consults if Im only seeing one doctor. I only get like 3 weeks vacation from my job. So I need to use as little as possible for consults so I have enough for the actual surgery. I normally take the first f?light of the day in and last flight of the day back. I am fom NY and Have gone to CA and back In  1 day (Take advent age of any time differences) .  Yes it?s a hassle and tiring  but saving future vacation  days is a priority. I always view this as a battle. In war you have to be ready for inconveniences for victory.

These tips are good for also docs close by.  Consults ad up very fast to a lot of money.If you can mitigate the risk its better. Also from  my experience all these guys lie. It might not necessarily be the dr. ,or even malicious or intentional but they life. When I was researching porex removal. A lot of doctors told people "yes I can remove them via e-mail" Then when the guy got down there they got the "o they don't look so bad, medpor removal Isnt easy to do ,you will have post operative issues ". The doctor probably felt he didn't technically lie. he would argue he didn't because on a technical/literal  level he can remove porex ,but its not easy and he will not do it.  ( technically he can also remove your  legs....but he aint doing it).
« Last Edit: October 02, 2013, 09:31:39 AM by earl25 »

Lazlo

  • Private
  • Hero Member
  • *****
  • Posts: 3004
  • Karma: 175
Re: Earl's guide to consults
« Reply #1 on: October 02, 2013, 09:26:28 AM »
all very wise advice from a real pro.

earl25

  • Sr. Member
  • ****
  • Posts: 409
  • Karma: 52
Re: Earl's guide to consults
« Reply #2 on: October 02, 2013, 09:34:29 AM »
sorry for all the typos and question marks instead of  parenthesis. I wrote it on a word processing software which somehow got weird.

Lazlo

  • Private
  • Hero Member
  • *****
  • Posts: 3004
  • Karma: 175
Re: Earl's guide to consults
« Reply #3 on: January 07, 2015, 09:17:33 PM »

From what I've now ascertained Zarrinibal doesn't do a real malar osteotomy, he just does a zygomatic sandwich. Has anyone had this procedure and seen the results of it? I recall someone saying his results were fantastic, but do we have any objective proof of this?

terry947

  • Sr. Member
  • ****
  • Posts: 456
  • Karma: 15
Re: Earl's guide to consults
« Reply #4 on: January 07, 2015, 09:37:42 PM »
Hey Earl thanks for this!

I'll most likely get surgery locally, but is it worth paying A/G or other top maxfacs for their surgical opinion on what cuts/movements need to be made? Or will they not take you seriously because you won't be getting surgery with them?

Lazlo

  • Private
  • Hero Member
  • *****
  • Posts: 3004
  • Karma: 175
Re: Earl's guide to consults
« Reply #5 on: January 08, 2015, 12:07:11 AM »
Hey Earl thanks for this!

I'll most likely get surgery locally, but is it worth paying A/G or other top maxfacs for their surgical opinion on what cuts/movements need to be made? Or will they not take you seriously because you won't be getting surgery with them?

I definitely went to A/G for a consult to calm my mind. I think it was worth it. They have a VERY strong emphasis on the importance of "counter-clockwise" rotation, and I think they're right.

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: Earl's guide to consults
« Reply #6 on: January 08, 2015, 12:08:43 AM »
Earl, if I could give you infinite karma, I would.  BTW, what kind of lens do you use for the photos?  IMO, it can make a big difference.  My face is like a ball in ortho's photos, and a horse face in selfies.

The phone call thing is good, but what if the surgeon is German or Swiss?  From what I've read here, their secretaries often have poor English.

BTW, did you ask Sinn's secretary if he'd done LFIIIs ?