In Hans Christian Andersen’s classic fairy tale, “The Emperor’s New Clothes,” two wily tailors convince the not-so-shrewd emperor that his new suit is invisible to those who are unfit for their positions, stupid, or incompetent.
When the emperor confidently parades before his subjects in his new “clothes,” no one dares to say that they don’t see his suit until a child cries, “He isn’t wearing anything at all!”
Now, if only it were that easy to get your new or returning patients to feel comfortable in the buff during a consult.
From drawing the blinds to keeping the exam room warm, here are some tips from plastic surgeons on how to reduce patient anxiety during these sometimes awkward interactions.
“Many of our clients are excited to have surgery and are anxious to go through the process, and so are not embarrassed or afraid. For those more timid and modest, we suggest that they consult with [female plastic surgeon] Dr Michelle Spring, who is also board certified, on staff, and is brilliant. Having another woman do the exam is often the most sensible way to overcome any fear.”
Grant Stevens, MD, FACS
Marina Plastic Surgery
Marina del Rey, Calif
“I keep them in a robe [and] keep the ambient room temperature on the warm side. Being a female surgeon and validating their concerns, and telling them something to the tune of, ‘We’re all women here and understand how you feel,’ helps more than anything.”
Jennifer L. Walden, MD, PLLC
“My office is located on the 12th floor of a high-rise building in the Metro Detroit suburbs. The consultation room is a corner room with floor-to-ceiling windows. Even though we’re on the 12th floor without any tall buildings facing us, I always close the blinds before performing an exam. Although it’s extremely uncommon, I once had a window washer scare the patient as he scaled down the window like Spiderman before her exam! As a male doctor with mostly female patients, I always have another woman (or the patient’s male companion) in the room with us whenever we perform an examination, and get it done as efficiently and quickly as possible. I also make sure the room isn’t freezing.”
Anthony Youn, MD, FACS
Youn Plastic Surgery PLLC
“There’s no question that this creates the most anxiety for the entire visit. We use black satin gowns with slits down the sides for exams so that patients always feel fully covered. I can lift up the back to look at the back or buttocks, and patients still feel covered. Alternatively, if I’m looking at the front of the body, I can lift up the front to look at the abdomen or unbutton the top to look at the breasts while still keeping the strap around the abdomen so it is fully covered.
“Obviously, we don’t do this for everyone. Many patients are comfortable disrobing, and that really helps for a full examination, but if I have an inkling that someone is very modest about being unclothed, I go through the special effort to make sure that no one body part is uncovered at any time. It’s interesting to see that in most cases during the postoperative visit, patients that were previously very nervous about being ‘naked and afraid’ lose that completely and are quite comfortable showing off their new breasts during exams or their new tummy, liposuctioned waist, etc.”
Mark Mofid, MD, FACS
Mofid Plastic & Reconstructive Surgery
La Jolla, Calif
“The doctor-patient relationship, and the exam room in general, represent interactions in which the patient can feel an acute vulnerability and huge uncertainty. We don’t know each other yet, and although most patients have thoroughly ‘vetted’ their potential future physician prior to even scheduling an appointment with us, it’s paramount to immediately put the new patient at ease by providing a quiet, plush exam room and a nice silk robe to wear while we begin our conversation.
“My nurse will usually take the patient to the exam room first and gather the health history while the patient is still dressed. Then the patient is asked to undress to the appropriate degree, and they are given a nice silk robe to wear until I enter. The actual exam and eventual photos simply must follow a warm entry and handshake from me, and an initial conversation about their goals.
“When patients can warm to their stories in their own words and be acknowledged as partners in the treatment plan, they always quickly begin to feel that we are friends in this very personal adventure, and are immediately put at ease. If an individual patient is visibly too nervous to be asked to undress when initially placed in the exam room by my nurse or new patient coordinator, then it is sometimes wise for us to meet in a private consultation room to gather the history, for me to introduce myself, and then to proceed to the exam room.
“We also give patients an opportunity to decline the offer of photographs (which we emphasize are taken to accurately record the exam findings only, remain digital until surgery is scheduled, and can assist in answering any questions which may come up later prior to scheduling a procedure) if they are merely in the office to gather initial information. We always end in a place where the patients feel thoroughly respected and understood, and most times, they comment that they needn’t have worried.”
Julene Samuels, MD, FACS