Why Should We Foster Core Specialty Collaboration in Cosmetic Medicine?

Abstract

Every day in my cosmetic practice, I am faced with the challenge of maximizing patient outcomes through my knowledge of available and emerging energy-based technologies, soft-tissue injectables, and medical skin care products. Keeping up-to-date in these areas is an extremely time-consuming process. To better understand the scope of current research and clinical evidence, it is necessary to familiarize myself with the work coming from 4 distinct specialty groups: plastic surgery, dermatology, facial plastic surgery, and oculoplastic surgery. Although I am encouraged that each of these 4 core specialties in the field of cosmetic medicine has embraced the concept of evidence-based medicine (EBM) at national meetings and in society-endorsed peer-reviewed journals,1,2 I remain frustrated by the lack of widespread collaboration among the specialties to achieve standardized outcome measures that are both safety and patient-centric driven. As Dr Carl Hartrampf's fellow in 1988, I was exposed to the value of EBM. Under his direction, we meticulously evaluated clinical outcomes using prospectively collected data. I was introduced to the concepts of inclusion criteria and, more important, exclusion criteria so that best practices in autologous breast reconstruction could be developed. In 1996, Sackett et al3 wrote, “Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” As American Board of Plastic Surgery-certified doctors, we are charged with developing our own “best practices” through a variety of avenues. First, we must engage in vigorous and ongoing evaluation of our clinical results. We accomplish this through careful observation, meticulous recording and analysis of all relevant data, and meaningful measurement of patient satisfaction. In addition, we draw from the experiences of other qualified practitioners by attending educational meetings and reading peer-reviewed journals. But how many meetings must we attend, and how …