It’s a jungle out there. Bad surgeons are almost impossible to spot. But if you believe the 80/20 rule, you need to at least try to figure out if your prospective surgeon is among the small minority which are simply lousy at their jobs, or creeps, or both. Don’t trust your state medical board sanction poor performers — they rarely sanction doctors, and in some states, they almost never do.¹ (See my blog post about how state-run medical boards often fall down on the job.) What this means is that, even in hospitals, 13.5% of patients experience adverse events, about half of which are preventable.² Are adverse events more common in ambulatory surgery centers (ASCs)? Interestingly, 17 states don’t even require ASCs to report such events.³

Seeking recommendations from people you trust is often the best route to finding a good physician, as publicly available quality rating schemes are iffy at best. After this? Of course, a Google search may turn up some helpful nuggets. Even if we don’t want to admit it, many of us next turn to Yelp, a review site that embraces trust and safety. But are Yelp reviews really representative of a doctor’s skills? Yelp admits that can remove reviews that violate its content guidelines. Practitioners with lots of poor Yelp reviews can hire clever lawyers to petition Yelp to remove many of them, arguing they violated such guidelines.

In the cosmetic surgery world, getting trustworthy data is even more challenging. Unlike Yelp, sites such as RealSelf earn their revenue through surgeon advertisements, do not report how frequently patient posts are taken down, and ask reviewers to “avoid personal attacks.”

If you’re having elective surgery, another way to gain insights into your prospective surgeon’s character is to scrutinize their website and social media posts (many surgeons that perform elective surgery maintain their own sites). Are their pages and feeds professional, respectful and informative…or full of boastful media profiles (which are easy to obtain from any number of trade magazines)? If this person has a large number of social media followers, pull up some of their profiles to assess if they are real people, or if this practitioner might be paying for fake followers.

Once you’ve whittled down your list of prospective surgeons, it’s time to do some additional research and schedule in-person consultations with them.

First, call into the offices of your short-listed surgeons and find out if they:

• Have malpractice insurance for the procedures they perform? If not, are they self-insured?
• Are board-certified? Lack of certification may mean that a doctor did not complete the training requirements of the board overseeing their field of practice, or failed their final examination.
• And if your procedure is taking place in a same-day (ambulatory) surgery center, determine if the surgeons on your shortlist have admitting privileges at a nearby hospital. Having privileges to admit patients and perform surgery at a reputable hospital means your surgeon has satisfied the hospital’s credentialing committee and board of trustees that they are well qualified. Also find out how far away this hospital is from the facility proposed for your surgery.

During your in-person visits, your paramount objective is to ascertain how experienced the physician in question is with the kind of surgery you are planning to undergo.

Here are some other things to pay attention to during your consultation:

• Skills and experience. Willingness to share how many of this kind of surgery the doctor has done in the past year and over the course of their careers — and how this volume compares to the threshold that’s associated with good outcomes in the field. Ability to compare their surgical success and complication rates with averages in the field. If your doctor is unable or unwilling to answer these questions, consider looking elsewhere.
• Training. Comfort with answering questions about their post-doc education, mentors, fellowships, research interests.
• Listening skills. Eye contact, patience, note-taking, acknowledging your concerns.
• Verbal communication abilities. Ability to explain treatment options and the pros and cons of each. Precise answers stated in layperson’s terms, free flowing give-and-take.
• Character. Seeming authentic and caring, acting relaxed and affable, willingness to discuss risks and recovery challenges without hedging or whitewashing them.
• Personal chemistry. Sensing that this physician sees, respects, and hears you, and that the two of you are able to partner together to achieve the best possible outcome.

After you exit the consult room…don’t leave the building just yet! Now it’s time to sniff out how this doctor treats their staff. If their behavior is respectful, upright and honorable, this will give you confidence about their character and trustworthiness. In this step, your challenge is to get chatty with the medical and administrative personnel. You will learn a lot by interacting with staff and asking plenty of questions about the inner workings of the practice. For instance, ask staff members what it’s like when the doctor is having a bad day, if they enjoy working for this person, what this doctor’s pet peeves are, and whether there are other practitioners you might also consider.

After assessing your prospective surgeon’s character, below are a few ways you can try to determine which side of the 80/20 rule this practitioner falls (also check out my blog post about doctors that still use paper-based records…a possible red flag to consider). If you’re willing to dive into the resources below, just be aware that, if you discover any formal complaints or allegations that were not officially adjudicated, you ought not assume the worst — that is, unless you spot a pattern of alleged bad behavior, which you can then judge for yourself.

State medical boards. Every state has a different way to request disciplinary history for licensed physicians. ProPublica published a handy compendium of each states’ request procedures here. The Patient Safety Action Network offers an in-depth review of information resources here. You can also try to look up doctors on the Federation of State Medical Boards website, but not all states report, and the data does not go very far back in time. You can also try searching your state’s Department of Consumer Affairs website for disciplinary actions (in California, you can find such a site here).

Grassroots patient safety organizations. Often cobbled together by individuals with little funding, these organizations can be difficult to track down. Here in California, the Patient Safety League runs a searchable database that collects disciplinary information on California doctors that goes back many years.

Court case records. According to one law firm, an average of 20,000 medical malpractice lawsuits are filed each year in the U.S.⁴ Among elective surgical specialties, plastic surgery has by far the highest paid claim rate, coming in almost four times higher than the average for all surgeons.⁵ Many patient lawsuits go nowhere, and defendants are presumed innocent unless proven guilty in a court of law. Still, it’s a good idea to look up your prospective surgeon in an online court records database such as UniCourt, or in a government-run online court records portal in your state. Unless a lawsuit was sealed by a judge after an out-of-court settlement, these databases will give you a picture of how frequently your prospective surgeon has been sued by patients, and what the verdicts were.

Drug Enforcement Agency (DEA). The DEA maintains a public list of actions taken against prescribers and pharmacies, but this list is not user friendly or easily searchable. Although this is a lengthy process, you can also submit a Freedom of Information Act request for DEA sanctioning actions taken against any doctor using this website.

It goes without saying that physicians don’t enjoy being reviewed by their patients. As a result, patients confront enormous roadblocks in obtaining reliable data about a physician’s skills, experience, and track records. I hope this blog post helps you to make the right choice.

Nothing in this article should be relied on for medical or legal advice.

Footnotes

¹ No author (2021, 31 March). New Public Citizen Analysis Finds Major Differences Among States in Rates of Serious Physician Disciplinary Actions. (link)

² Wolfe, Sidney M.D. and Oshel, Robert E. Ph.D (2021, 31 March). Ranking of the rate of state medical boards’ serious disciplinary actions, 2017-2019. Public Citizen’s Health Research Group. (link)

³ No author (2019). Q&A with Bill Prentice, CEO Ambulatory Surgery Center Association. (link)

⁴ Whitt, Jeff (2022, 31 January). Shocking Medical Malpractice Statistics for 2021. Raynes & Lawn. (link)

⁵ Schaffer AC, Jena AB, Seabury SA, Singh H, Chalasani V, Kachalia A. Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014. JAMA Intern Med. 2017;177(5):710–718. doi:10.1001/jamainternmed.2017.0311 (link)

Copyright © 2025 by Monica Berlin