Episode 37: Sunday March 21

Drs. Sam Jejurikar @samjejurikar, Salvatore Pacella @sandiegoplasticsurgeon, and Sam Rhee @bergencosmetic in a fascinating Part 2 tackle a growing influence in plastic surgery - social media and apps such as Instagram, Snapchat and Tiktok. Whether it is marketing a plastic surgery practice, educating potential patients, or simply entertaining viewers, what are the benefits and potential issues associated with the growth of social media within plastic surgery?

Full Transcript (download PDF here)
2021.03.21 S02E08 SOCIAL MEDIA Show 38 TRANSCRIPT
Dr. Sam Rhee: [00:23:24] Let me highlight yeah. Of this plastic surgeon and his name is Dr. Daniel Barrett and he's a. In Beverly Hills and I think he's a pretty well-known tick-tock guy.
That are still.
This is my recital, I think is very vital to
what is
Hey doc, how many flips do you think I can do in here? You're not flipping my arm. I'm not doing what if you're going to do. I'm not doing what you better not.
who's not flipping. What? No. I'm taking a knack to
work here.
What's a syringe 
Dr. Sam Jejurikar: [00:23:57] habit you picked up from work. 
Dr. Sam Rhee: [00:24:00] So I have this thing about breast implant.
Burst.
So what'd you guys think of that video of Dr. Barrett 
Dr. Salvatore Pacella: [00:24:08] Entertaining, and the first thing I think about is when you're jumping up on your or table with your shoes and there's a clean sheet there I hope he changes the sheets afterwards, for the next patient, because although all that staff on the ground will right.
Go right up on the Read up on the or table. So beat, I gotta say the operating room is like my church, my dojo, right? Like I, it's approached with some level of reserve, some level of respect. It's like an altar, and I just don't, I have trouble with.
Just doing whatever in the operating room, a, it's a place of sterility. It's a place of concentration. It just, it's not me, but it works for a lot of people, so yeah, go ahead. 
Dr. Sam Jejurikar: [00:24:56] I was going to say, I don't think I could be as entertaining as Dr. Barrett, so I'll give him that.
He's definitely got a, got an outgoing personality that I'm sure Pete people are really attracted to at the end of the day, why are we on Instagram? Why are we on Tik TOK? Why are we in Snapchat? It's a form of marketing, right? Ultimately plastics are in the, wouldn't be doing this, that weren't trying to get more patients.
So I make the conscientious effort to try to attract people that, that are going to view me as an authority figure, and that are going to treat surgery with some level of gravitas. We're going to ultimately. Make this decision to have an elective procedure to make themselves look better, but ultimately recognize that it's still a little surgery and there's consequences that go around that are around it.
So for me, personally, if I were dealing with Dr. Barrett was doing, I don't think I'd be able to convey that message. I think ultimately It wouldn't look like it's something that's more than just going to the nail salon or getting your hair cut. So it wouldn't work for me and my practice and what I'm going for.
Obviously it works for him. He's gotten a fair amount of notoriety, but it's not something I would ever do. Yeah. 
Dr. Sam Rhee: [00:25:58] It's funny because I bet you that 20 years ago, our mentors would say, you know what? Social media is fine. But it's not something that I would ever engage in. My work speaks for itself and I really want to get my patients through word of mouth.
And, if you want to post stuff on social media and whatever, that's something I just wouldn't do. And now we are our mentors and we're Dr. Barrett is going to be is where the future lies because it's, it was a joke where he had the three glasses of water and he poured some into the. Study hard, poured some into the amazing results.
And then he like overfilled the, the tick talk beaker. And to me it was clever. Yeah. There's a grain of truth in that, in the sense that I think as a young surgeon being trying to market yourself this is where they're going to go. This is what they see as the future.
And should we, or as a society like our society, our professional societies, should we start trying to establish guidelines about what is appropriate or what isn't appropriate? We already have some guidelines about advertising, about what we can and cannot say, should we have better guidelines that cover social media as well?
Dr. Salvatore Pacella: [00:27:13] The thing is, what the attorneys will say is, you can't. You can't legislate or you can't regulate taste, so as long as patient safety is respected, as long as patients are consented for being on social media, there's really little that I think the professional societies can do.
But the one thing I wanted to just clarify her is I think we have to understand what's happening in the local and regional environments of where these surgeons are posting, Dr. Barrett is in an exceptionally competitive market. Arguably the most competitive market. You walk down Robertson or Westwood and you throw a stone and you can hit five plastic surgeons just bouncing off their heads, sitting at lunch.
Okay. And so it's exceptionally competitive and I've been down there. I've I did a fellowship in Los Angeles. I scrubbed in with some of these docs and, they take pride and going. Out of their operating room in their scrubs, wearing their white coats, wearing their hats, just walking down the street.
It's a lot of visibility. And to some extent, if you're not in that game, you're just going to be marginalized. Whereas in other venues, San Diego, Chicago, the Midwest, it's not. You don't have to engage completely in social media to be competitive. And so th there's some extent of, what's happening in your regional community as well.
Dr. Sam Jejurikar: [00:28:38] Yeah. And yeah. And looking at, going back to your question to Dr. Rhee about, should our professional societies be be involved. Dr. Baird's videos are goofy and they're meant to be funny and entertaining. They're not violating patient confidentiality. They're not showing. They're not degrading people there.
I was interested in the breast implants in that hyper volt and the, they were a gun. I was hoping it's actually be an assessment of the two guns because I have both. And I'm trying to figure out like, yeah, which I like better, but ultimately he's not hurting anyone by it, so it's just it's entertainment and he's not violating any professional standards.
It's just silly and goofy and he's entertaining. And that's what he's trying to be. 
Dr. Sam Rhee: [00:29:19] I think that's what, more and more of our plastic surgery colleagues are going to be doing. Yeah. It's funny that you mentioned location because the wired article that I want to talk about with about this particular influencer doctor, the real doctor, six or six, I'm not sure how you would say that is in Toronto, which you wouldn't necessarily think is the hotbed for cosmetic surgery, he.
Dr. Salvatore Pacella: [00:29:41] Very competitive market, very competitive 
Dr. Sam Rhee: [00:29:43] market and very competitive. Ask 
Dr. Salvatore Pacella: [00:29:46] as Dr. Kusan. Okay. Can you see him on social media? He would be just entertaining. He'd be accepted. 
Dr. Sam Rhee: [00:29:53] I think he'd do great. I think he'd do really well. His persona translates really well to social media. So basically this article was written by Catherine Laidlaw and it was published out in January.
And it was your body, your self, your surgeon, his Instagram. And basically the title was social media, gave the real doctor six a stage in which to show off liposuctions and breast lift. But when cosmetic surgery becomes entertainment, who owns the story? Now I think this a surgeon is under multiple Charges for which she's currently on in the legal process of dealing with.
But I just wanted to pull out a couple quotes and have you guys think about, or. Comment on this. His name is Dr. . And it basically follows a story of a particular patient named Laura who saw his post on Instagram. This Dr. Martin, you Ginsburg, who's a clinic Toronto cosmetic surgery Institute.
Had a ton of satisfied customers on online reviews. Had a sizable following on Instagram and Snapchat and Basically underwent breast augmentation with he said he, during her consultation, he asked if he could stream her surgery on Instagram live. And the article says she remembers the moment the tenor changed, how it first felt like a medical appointment and then like a sales pitch quote.
Everyone does this. Don't worry about it. She didn't want to say yes, but she felt there was no room to say no. And so whether it was the nerves of impending surgery or some desire to please the man who'd be wielding the scalpel on her body, she acquiesced.
What do you think of that?
Dr. Sam Jejurikar: [00:31:33] Obviously, no, one's going to feel good about coercing.
You can go ahead. Go fine. Okay, go ahead. 
Dr. Salvatore Pacella: [00:31:39] Go ahead. Go ahead, please. Go ahead. 
Dr. Sam Jejurikar: [00:31:41] Okay. Yeah, so the way the article is written, Sam. The PA the patient basically says that he feels coerced into having her video film live for Instagram. And the article also goes on to say later on that the doctor pulled pictures off of her social media feed and put it on his, which she asked him to take down.
And he wouldn't. Also, and so there's a lot of. Not even questionable ethics and volunteer, you can't coerce patients into doing things they don't want to do. And you do yield a huge amount of power as a surgeon to potentially coerce people into doing things because you're going to be operating on them.
They don't want to displease you. So it's hard to, obviously you have to feel terrible for this patient and feel if the story is true as it's written feel like there's significant unethical behavior going on.
Dr. Salvatore Pacella: [00:32:22] Yeah, I think I know several Canadian surgeons in the Toronto world and the laws in Canada, particularly Ontario are much more stringent than they are in the United States. For example you are not allowed to show before and after photos. On a public Instagram account or online for that matter, you have to S you have to be invited.
So they, they won't allow you to show before and afters. But if you have an Instagram account where a patient signs up for it, a requested account that is acceptable. So the laws are really pretty stringent here. So if you're looking at the regional environment here, if our if our benchmark is here, Ontario's is over here.
So the fact that the patient felt even more coerced that, that can be a challenge, it's it's unfortunate that that's so this social media topic has gotten that far. I never want to put a patient in a situation where they feel uncomfortable with me in the exam room.
That's just. That's just unheard of. I think, 
Dr. Sam Rhee: [00:33:25] I think that this is a cautionary tale for all plastic surgeons, because you're right. We wield an incredible amount of power over our patients. And there are some patients that are more than happy to have every part of their plastic surgery journey highlighted or featured. And I've had cer certain patients who, who actually asked to do and then obviously there are many who don't feel that way at all. And, and they basically say that they say many clients are happy to play a role in Dr.  reality show, but others say they felt pressured to participate.
So I think as plastic surgeons we need. To take steps to ensure that if we do ask a patient to participate in whatever marketing that we want to have them in, that they don't feel pressured. And I'm not sure exactly the steps that we can take to do. I'm sure we could obviously the, our approach to it and how we discuss it with patients is super important.
Also there's probably some legal documentation that would be super helpful for us to make sure is completed. So that patients know exactly what they're getting into, but I'm not, I wouldn't be surprised if there are a number of patients with many plastic surgeons who might feel that way, especially if that plastic surgeon is heavy into marketing.
Broadcast surgery live frequently, does that sort of celebrity media influencing, so would it be okay for you to have this type of entertainment that this value that this plastic surgeon had, for example, he Had the rapper two Chainz in his operating room during a surgical procedure, making comments about the surgery and the results about the patient.
Is that totally fine? Is there's no, is there any sort of, do you see any issue with that? 
Dr. Sam Jejurikar: [00:35:18] I thought that was Dr. Miami that actually happened. 
Dr. Sam Rhee: [00:35:22] That's right.
Dr. Sam Jejurikar: [00:35:23] That was Dr. Rhee. Again this is a leading question, Dr. Rhee. Obviously none of us would feel comfortable with having.
People not relevant to the procedure in the operating room, but no, we've all I think made the conscientious effort to to use social media, to educate as a form of advertising as well, but tasteful and one that actually shows the gravitas that we also shared with surgery. But but there is, as Dr.
Pacella already alluded to, there are people that because of their markets, their age and the demographics of their patients, Choose to use it more for strictly entertainment purposes and blur that line between professionalism. There is going to be a catastrophic event that happens at some point to a patient, which is really going to lead to I think, a reckoning for those sorts of practices.
But I think we're all going to be on a light line of conservatism. We're not we're not doing, but it'll be tragic when something bad happens, but unfortunately at some point invariably, something is going to happen.
What do you think about the fact that this seems to be a growing trend with plastic surgeons? Doctor union Berg was actually a group of 15 surgeons called the Dr. Miami squat. This is from the wired article. There was Dr.  from long Island who had 215,000 followers. Dr. Real, the real Dr. Feelgood and fall river, Massachusetts 521,000 followers.
The real Dr. B Moore from Baltimore 36,000 followers. They pay for an affiliation, $15,000 for the initial branding and social media training with the real Dr. Miami, then 2.5, two and a half thousand dollars a month for social media promotion on the Dr. Miami platforms. So this is actually almost being franchised and becoming 
Dr. Salvatore Pacella: [00:37:04] Yeah, it's very entertaining.
He he nights his followers on live. I Knight you Dr. Sammy, Jay of Dallas, Texas, it's just an opportunity to extend the brand, it's. Some to some extent we can argue that we do the same thing with our professional societies, we apply to the aesthetic society or HSPs by nature of being accepted into that community.
We're listed on their website, we're listed as being legitimate. The same argument can be made for board certification. It's not going to stop you from practicing, but you get that kind of extra little bit of Of a certification. So you know, all the power to these guys. I th I think my judgment comes in when it affects patient safety and it affects patient patient outcomes.