Category Archives: plastic surgery

More criminal malpractice, and patient deaths: in my own backyard…

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Phoenix, Arizona –

In a case of criminal malpractice that sickens and horrifies health care personnel like myself – ‘self-proclaimed’ plastic surgeon, Peter Normann was able to delay sentencing after being found guilty earlier this summer in the deaths of three of his patients  – in three separate incidents.

The details of each of the cases are quite frightening, and highlight reasons why trained observers like myself are critical for objective and unbiased evaluations for potential patients.  In one case, another ‘homeopathic’ doctor working with Mr. Normann (not a licensed plastic surgeon) participated in a liposuction case that resulted in the death of a patient.  In two cases – patients died because Mr. Normann failed to intubate the patients correctly (and tore the esophagus of one of the patients.)

In all cases,  there was no intra-operative monitoring during cases – and Mr. Normann’s only assistant was a massage therapist (not an anesthesiologist, not a surgical nurse or trained surgical team.)  Horrifying – completely criminal, and unforgivable and unacceptable.

Additional Links on this case:

Homeopathy in Arizona covered for doctors’ mistakes

‘Homeopathic’ doctor kills patient performing liposuction.

The Times: Surgical Roulette

Another fraudulent surgery clinic

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this time in Los Angeles, where several individuals were posing as licensed physicians.  A sting operation was conducted after several patient complaints – and injuries.  The story in the Manila paper is here. The LA Times initially broke the story.

Notably, the clinic operators had posted fake degrees and credentials on the walls.  (This is why it’s important to independently verify credentials with state licensure boards).  Anyone with a scanner, and basic computer literacy can print up and fake any document they want..

I’ll keep posting these stories as a reminder for people to use credible sources for information about their doctors (such as well researched books like mine) or licensure boards.

(While most of the stories appear to originate in the United States I think this is probably just a result of our media interests – and what makes national and international headlines.  There are frauds everywhere, who just want people’s money – they don’t care if people get hurt or die in the process.

Unfortunately, many of these people operate for years before they get caught, if ever.

In international news, the need for investigation and medical scrutiny of medical tourism is becoming more and more apparent.  (I told you that Cartagena Surgery was a trendsetter.)  Now, if only we could translate that into book sales.

Another sad story

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of a preventable/ unnecessary plastic surgery death in a young woman in Massachusetts.  In this instance – yet again – the ‘surgeon’ performing the breast augmentation wasn’t a surgeon at all – he was a “family practitioner”.

He may be a doctor – but specialty specific training is an absolute must – along with board certification.  Medical doctors (in medicine specialties) as opposed to surgeons spend only a very limited time in the operating room during medical school, primarily as observers.  This is not adequate preparation!

Board certified specialty trained surgeons on the other hand, spend years training in the operating room – performing surgeries under the direct supervision of more experienced surgeons before completing their surgical residencies.

Please do your homework – as we’ve discussed in several previous posts; research your physician and evaluate all health claims.  Your life, health and well-being are a stake.

 

 

 

World Health Information & Patient Safety

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As Bogotá Surgery readers know, we were just talking about the  relevance of hospital rankings, and scorecard criteria for patient safety and optimal patient outcomes.  In particular, we were talking about the use of this criteria  (along with Core Measures) as just one of the ways surgeons, hospitals and surgical programs are evaluated for Bogotá! a hidden gem guide to surgical tourism.

Now several news outlets have picked up the story under the headline, “Hospitals riskier than airplanes.”

Liposuction in a Myrtle Beach apartment

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Another case of sketchy plastic surgery reported – this time in Myrtle Beach, South Carolina.   Yet again, I would like to caution readers about seeking ‘cheap’ plastic surgery on the internet.  (I’m not saying don’t look – please do!  But look smartly.)  This doesn’t only apply to plastic surgeons, but to all surgeons, physicians, and healthcare professionals.

‘The internet’ is not all the same – the grade of information can vary widely from scientific journals (highly reputable/ reliable) to fiery but heavily opinionated blogs (unreliable/ unscientific) to frankly fraudulent such as in this instance (in the story above).  People need to use caution, due diligence and common sense when researching anything, but particularly medical information on the internet.  You need to do your homework.

There are a few things to consider when researching medical information/ providers on the internet.

1.  Is the information independently verifiable?  (and by what sources?) 

As a medical writer – this is a huge portion of my job – verifying the information obtained during interviews, etc.  But when you are looking to purchase goods or services – you need to do a little investigative work yourself.  Luckily, once again – the internet makes this simple.

The first thing you should investigate is – the person making the claims/ and what their focus is.  Use this website for an example, if you like.  So take the following information (below) – that is easily available on the site..

(If this information isn’t readily available on the site – that should make you suspicious.  “Anonymous” blogs or hidden author websites are NOT reputable.  People with valid, truthful information have nothing to hide, and are not ashamed to stand by their work/ writings.)

so you’ve gathered the following information  from the site:

Author – XXXX   credentials claimed/ authority source:  Physician (MD/ DO etc.)

Product or service advertised on the site:  surgical procedure XX

Use this information to answer the following questions:

1. Who is this person?

2. How do they know this/ what special knowledge do they possess?  (for example – a hairdresser shouldn’t be giving medication advice)

3.  Can I verify this?

– Medical personnel can be verified thru state licensing boards. 

Some states make this easier than others, but ALL states have this information available to consumers.  So go to the website of the licensing board (medical board for doctors, nursing board for nurses) and look the person up.

In this example, I am currently licensed in several states – so pick one, and do an internet search for the board of nursing for that state.  (Tennessee is particularly easy since they post educational information, license violations etc. on-line).  If this licensing information isn’t easy to find on the website, call the board.**

If the website (ie. plastic surgery clinic) lists an address – use that state for your search.

In another example – as seen below – we’ve looked up a surgeon at the Colorado Medical Board.

Looking up a medical license

Looking up a medical license

– All physicians should be licensed in the state of practice (where their clinic is.)  If they aren’t licensed in that state – STOP and find another provider.  Even if the doctor claims to be from another country, he or she is STILL required to have an active license in the state they are working in.**

Here is an example of physicians sanctioned by the Texas medical board (all of this information is freely available on the internet for your safety.)


Here is another example of a surgeon with multiple medical board actions against her.

licence details

license details

Many of the state medical boards will let you read the complaints, actions and disciplinary measures against physicians licensed in that state.  However, some states allow physicians under investigation to ‘surrender’ or inactive their license to avoid having disciplinary measures recorded.

– All surgeons, or specialty doctors should also be listed with specialty boards – such as the American College of Surgeons, or the American Society of Plastic Surgery.  (While membership is not mandatory, the vast majority of specialty trained surgeons maintain memberships in their specialty organizations.)  Other things to consider while investigating credentials:

Do the credentials match the procedure?  (Is this the right kind of doctor for this procedure?)

These credentials should match the procedure or treatment you are looking for: such as Plastic surgeons advertising breast augmentation.

This may sound obvious but it isn’t always the case.  (for example:  dermatologists shouldn’t be doing eyelid lifts or plastic surgery, primary care physicians shouldn’t be giving Botox injections, general surgeons shouldn’t be performing lung surgery etc.)
If you aren’t sure what procedures the doctor should be performing, look at the specialty surgery board – it should list the procedure.  i.e plastic surgery and liposuction.

4.  After verifying this information, it is time to do a basic internet search on the individual.  To do this – perform both a Yahoo! and Google search.   This should give you at minimum, 10 to 15 results.

These results should include several non-circular results.  “Circular results” are results that return you to the original website, or affiliated websites.   For example: Using the information from above – both Google and Yahoo! return several results that link directly to this website.  These results also return links for the sister sites.  All these of these are circular results – that return you to the starting point without providing any additional outside information.

However, if you scroll down the results:  outside links should appear.  These should include articles/ publications or scholarly work.  Other search results may include more personal information, social networking sites and other newsworthy articles.  This gives you a more comprehensive picture of the provider.

One of the things we should mention, is patient testimonials.  While many providers include extensive patient testimonials, I disregard these for several reasons:

– There is usually not enough information to verify the authenticity of these patient claims.  “I love my doctor. He’s a great surgeon.” – Gina S.  doesn’t really tell you anything.  In particular, there is no way to verify if there really is a Gina S. or if she is a fictitious creation of the website author.  (There have been several cases where people working for the doctors have created ficticious accounts including before and after photos talking about procedures that they never had).  Don’t be lulled into a false sense of security with patient testimonials.

– Some people use blogs, or message boards for the same purpose, and the same caveats apply.

– Another reason that patient testimonials are not useful in my opinion, is that patients (and their families) are only able to provide subjective information.  Several of the cases in the news recently (of fraudulent individuals posing as doctors) had several “happy patients’ to recommend them.  Patients, for the most part – aren’t awake and able to judge whether the surgery proceeded in a safe, appropriate fashion.  The testimonials are merely a comment on the physician’s charisma, which may give future patients a false sense of security.

I’ve finished my search – Now what?

   Use commonsense:

– Surgical treatments should be performed in an appropriate, sterile environment like a hospital or freestanding clinic.  A reputable surgeon does not operate in the back of a motor home, a motel room or an apartment.  (All of these have been reported in the media.)  If the setting doesn’t seem right – leave.  You can also investigate the clinic.

– Bring a friend.  In fact, most surgeons will require this, if you are having liposuction or another large procedure.  Doctors don’t usually drive their patients around (as was done in several recent cases.)  The exception to this rule is medical tourism packages.  These packages often include limousine transportation services but these services are provided by a professional driver (not the doctor, or ‘his cousin’).  Your friend/ companion is not just your driver – they are also there to help feel out the situation.  If something seems amiss – do not proceed.

– if the price is too cheap – be suspicious.  If every other provider in the same location charges a thousand dollars – why is this doctor only charging a hundred dollars? Chances are, it’s not a sale – and he/ she is not a doctor.

– Use reputable sources to find providers – Craigslist is not an appropriate referral source.

– Are the claims over-the-top?  Is the provider claiming better outcomes, faster healing or an ‘easier fix’ than the competition? (We will talk more about this in a future post on  “miracle cures’ and how to evaluate these claims.

I hope these hints provide you with a good start to your search for a qualified, safe, legitimate provider.  The majority of health care providers are excellent, however the internet has given criminals and frauds with an easy avenue to lure/ and trap unsuspecting consumers.

** The majority of cases that have been recently reported have taken place in the United States (Nevada, New Jersey, Florida and South Carolina.)  Many of the people perpetrating these crimes have posed as Latin American surgeons to capitalize on the international reputation of plastic surgeons from South America.  They also used these claims to try and explain away the lack of credentials.  A legitimate doctor from Brazil,  Argentina, Colombia, Costa Rica or another country, who is practicing in the United States WILL HAVE an American license.

Additional references/ stories on fraudulent surgeons.

(Hopefully this section will not continue to grow)

More on the Myrtle Beach story

Myrtle Beach – a nice article explaining why people should see specialty surgeons

Basement surgery

Article on unlicensed clinics in Asia (medical tourists beware!)

A truly bizarre story about unlicensed dentistry in Oregon

Additional references:

American College of Surgeons – lists doctors distinguished/ recognized as “fellows” in the academic organization, and provides a brief summary of specialties.

Plastic Surgery: Breast Augmentation news

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For all of my devoted readers, who have been wondering what I have been doing since I returned from my latest trip to Bogota:

Still traveling around, still interviewing surgeons whenever I get the opportunity.  Today, I spent the day in the operating room in Fresno, California watching a very large cardiac surgery case (Aortic valve replacement/ Mitral valve replacement/ Tricuspid Repair (annuloplasty) with multi-vessel bypass) with Dr. Richard Gregory, MD, a native Fresno resident and cardiothoracic surgeon at St. Agnes Medical Center, in a Stanford affiliated surgery program.  Today’s case seems to tie in (unplanned) with our previous discussions on valve surgery last week.  It was a great – but complex case.

The facility is a private boutique specialty hospital; elegantly appointed with large, well-lit operating rooms.  The surgeon was experienced and talented.  Most importantly, the patient did beautifully.

All international/ national protocols followed with pre-operative time-out (which consists of several criteria to meet the National Surgical Quality Improvement Project (NSQIP) requirement.  (More about this and the surgical apgar scoring system is detailed in Bogota! a hidden gem guide to surgical tourism).  Sterility was maintained throughout the case – and the patient’s hemodynamic needs were promptly and properly addressed.  Continuous Anesthesia / Perfusion monitoring through out the case.

Surgical Apgar scores not applied (not appropriate for this type of case.)

In other surgery news – this time, plastics and aesthetics – the Food and Drug Administration released a new statement today cautioning consumers on the use of Silicone breast implants.  Previously, the FDA had attempted to limit the use of silicone-filled breast prostheses but had been met with significant resistance from groups of consumers who preferred silicone implants over saline filled implants.

In the article (re-posted below) the FDA states that while previous concerns regarding health complications related to the use of silicone implants such as silicone toxicity/ silicone poisoning have not been validated – the FDA cautions that over 20% of women will need to have their breast implants removed within ten years of implantation.  This data confirms information provided during previous interviews with plastic surgeons, who stressed that breast implants are NOT a lifetime device, and several surgeons who stated, “Most patients will need the implants changed within ten years.”  [notably, during these physician inteviews – the plastic surgeons were not specifically talking about silicone breast implants.]

Article Re-post: Medscape

Long-term complications likely with silicone breast implants 

Mark Crane

June 22, 2011 — Silicone gel–filled breast implants are safe and effective when used according to their labeling, but the longer a woman has the implants, the more likely she is to experience complications, the US Food and Drug Administration (FDA) said in a new report released today.

“Breast implants are not lifetime devices,” Jeffrey Shuren, MD, JD, director of the FDA’s Center for Devices and Radiological Health, said during a telephone news conference. “One in 5 patients who received implants for breast augmentation will need them removed within 10 years of implantation. For patients who received implants for breast reconstruction, as many as half will require removal 10 years after implantation.”

Women with silicone breast implants will need to monitor their breasts for the rest of their lives. To screen for silent ruptures, women should undergo magnetic resonance imaging 3 years after implantation, and then every 2 years thereafter, Dr. Shuren said. Women with saline implants do not need regular imaging.

When the FDA allowed silicone breast implants back on the market in November 2006, it required manufacturers to conduct follow-up studies to learn more about the long-term performance and safety of the devices. The FDA’s report is based on preliminary safety data from these studies, as well as other safety information from recent scientific publications and adverse events reported to the agency.

The most frequently observed complications and adverse outcomes are tightening of the area around the implant (capsular contracture), additional surgeries, and implant removal. Other complications include a tear or hole in the outer shell (implant rupture), wrinkling, uneven appearance (asymmetry), scarring, pain, and infection.

Studies to date do not indicate that silicone breast implants cause breast cancer, reproductive problems, or connective tissue disease, such as rheumatoid arthritis, the FDA said. However, no study has been large enough or lasted long enough to completely rule out these and other rare complications.

“Most women report high levels of satisfaction” with their implants, Dr. Shuren said.

The FDA is working with the 2 manufacturers who make silicone breast implants, Allergan and Mentor, to address the challenges in collecting follow-up data on the women who have received these implants.

Approximately 5 to 10 million women worldwide have breast implants. In the United States, 296,203 breast augmentation procedures and 93,083 breast reconstruction procedures were performed last year, according to the American Society of Plastic Surgeons. About half the procedures used saline implants, and half used silicone implants.

Patients with either saline or silicone implants may have a very small risk for a rare cancer called anaplastic large-cell lymphoma (ALCL) adjacent to the implant. However, the risk is “profoundly small,” said Dr. Shuren. “Since 1997, there are only 34 cases in the published literature, and at most 60 cases out of the 5 to 10 million women with implants worldwide,” he said. “We don’t yet know if there is a causal link.”

When the FDA first released information about the risk in January, William Maisel, MD, MPH, chief scientist and deputy director for science in the FDA’s Center for Devices and Radiologic Health, said the evidence suggests that the kind of ALCL found in conjunction with breast implants is less aggressive and is sometimes treatable by simply removing the implant, the capsule, and the collected fluid.

“The FDA will continue to monitor and collect safety and performance information on silicone gel–filled breast implants, but it is important that women with breast implants see their healthcare providers if they experience any symptoms,” Dr. Shuren said. “Women who have enrolled in studies should continue to participate so that we may better understand the long-term performance of these implants and identify any potential problems.”

The FDA is holding an expert advisory panel in the next few months to discuss how postapproval studies on breast implants can be more effective.

The FDA will issue an update at a future date on saline implants, Dr. Maisel said.

All serious adverse effects should be reported to the breast implant manufacturer and Medwatch, the FDA’s safety information and adverse event reporting program, by telephone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm, or by mail to MedWatch, FDA, 5600 Fishers Lane, Rockville, Maryland 20852-9787.

Interview with Dr. Catalina Morales, Plastic & Hand Surgeon

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Met with the very nice Dr. Catalina Morales yesterday evening to talk about Plastic, Aesthetic and Reconstructive Surgery.. Oh – and did I mention hand and maxillofacial surgery..

She’s very enjoyable to interview because she’s one of those people who really finds pleasure in what she does..  She likes to help people with reconstructive surgery, and she enjoys the satisfaction her aesthetic practice gives her patients..

Planning to go to the OR with her today – so we will re-visit the smiling, talented Dr. Morales later this afternoon..

Update:  In the operating room with Dr. Catalina Morales, at Clinica de Marly  7 May 2011

Dr. Catalina Morales at Clinica de Marly

Dr. Morales at Clinica de Marly during hand surgery

I also interviewed Dr. Casallas Gomez over at Santa Fe de Bogota, read about it in another post..

Dr. Celso Bohorquez, plastic surgeon

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When we first met Dr. Celso Bohorquez, he was donating his time and surgical skills for the repair of congenital facial malformations in Chia, Colombia as part of Operacion Sonrisa.

I went back, yesterday, to Clinica Shaio, to learn more about the man, and the surgeon that so generously contributes to improving the lives of the less fortunate.

Dr. Celso Bohorquez, plastic surgeon

We spent the day in the operating room, watching Dr. Bohorquez perform several techniques including a case with facial endoscopy as part of a face-lift. The results of the cases were striking.


 

In other news, we are discussing pre-operative and intraoperative risk reduction for peri-operative/ post operative MI (along with the high incidence of missed diagnosis) over at our sister site.

Dr. Ernesto Andrade, plastic surgeon

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Dr. Ernesto Andrade is another one of Bogota’s celebrity plastic surgeons, of “Cambrio Extremo” fame.  (A latin television version of ‘Extreme Makeover’ that was popular here several years ago.)  Unfortunately, he was delayed today so I was unable to meet with him, but I did speak with a young doctor in his office, Dr. Eliana Garces.  She filled in a bit of Dr. Andrade’s biography.

I’m hoping to meet with Dr. Andrade himself  tomorrow after I get out of the operating room with Dr. Celso Bohorquez.  If you remember, I met Dr. Bohorquez out in Chia while he was volunteering his surgical skills as part of Operacion Sonrisa (Operation Smile.)

In the OR with Dr. Hakim

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Had an interesting day with Dr. Fernando Hakim, Neurosurgeon, over at Santa Fe de Bogota, for a tumor resection.  A lot of the stereotypes are true; neurosurgery is a  precision-based specialty (not that the other specialties aren’t – but at least in most cases, there is a margin to work with**.) but some of them aren’t.. In this case, with a tumor pressing against the spinal cord – there is no margin to work with, no border area around the tumor, so to speak.. but then again this petty much describes a lot of neurosurgery.. requiring careful, painstaking process..something I would find inherently, and incredibly stressful – but Dr. Hakim and his team didn’t; they were focused, precise, but relaxed and well-coordinated with each other.. Definitely not the uptight, high stress stereotype.. (You’d think I would have known better – I’ve seen plenty of surgery, and some spine cases# before – but nothing of this magnitude, and as I’ve said before; neurosurgery is a bit of a final frontier)

(not to give you the wrong impression – surgery is always serious, this just wasn’t the melodrama that stereotypes/ stories sometimes suggest)

Dr. Fernando Hakim Daccach (left), neurosurgery

** ‘margin of tissue’ or area surrounding the tumor, not ‘margin of error’

# cartagena neuro cases were ‘back cases’ or spinal cases for chronic back problems..

Dr. Hakim, neurosurgeon using the OR microscope for precision work

To switch gears a bit, I met with Dr. Fabio Andres Mejia, a plastic surgeon specializing in rhinoplasty and breast procedures (augmentation/ reduction).  He’s a former fellow (and current member of the) Dr. Ralph Millard (Society) and has been in practice since 1998.
He’s no longer working three jobs or taking emergency plastic surgery calls all over the city – and is now focused solely on private practice (and having a livable schedule)

Thoracic surgery, Operation Smile, and a new perspective in Chia

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Spent the morning in Chia with Dr. Osorio (thoracic surgeon) at Clinica Universitario Teleton.  Cases went smoothly, beautifully and quickly. Then we rounded on patients in another facility..


While I was in Chia, I had an opportunity to meet several members of Fundacion Operacion Sonrisa (Operation Smile to all my stateside readers).  I spoke with Pilar, one of the nurses on the surgical team, and Dr. Celso Bohorquez Escobar, plastic surgeon, who said they have sixteen cases planned for this weekend.  They come to Chia several times a year, and operate in multiple locations throughout Colombia.  For any of you unfamiliar with this organization (consisting of volunteer doctors, nurses and other medical staff), Operation Smile performs cosmetic repairs of facial deformities such as cleft palate for indigent patients and their families.

I also had a chance to (briefly) meet two urologists from Medellin that traveled to Chia to perform a urinary continence restoring surgery. I particularly like to see this sort of thing, (bringing care to patients in rural areas, or those who would otherwise go without) – because while neither of these procedures is arguably lifesaving, both procedures are dramatically life-altering, and contribute greatly to the enhancement of quality of life.

But, back to Dr. Osorio – I especially enjoyed talking to Dr. Osorio because as the Dean of Medicine for a medical school, he has different perspectives on the future of medicine, and Colombian medicine in general. He also shows a lot of insight, and open-mindedness to outside perspectives and opinions. Part of this comes from dealing with students and residents everyday, another part may be from his partnership with another physician in Chile (Dr. Claudia Suarez) and some of it undoubtably comes from experience.

I found it interesting and illuminating that Dr. Osorio is probably the first person to ask about my observations, and perspectives on surgery and medicine in Bogota, after being here three months, meeting numerous surgeons, and visiting multiple facilities.. And he seemed to actually be interested in the answers.. I think that any doctor who takes the time to consider the insights of foreign nurse, and asks for criticisms, is someone, who takes the time to look at the world differently, (and medicine needs that.)

New article at Colombia Reports.com

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Bogota’s Hottest Young Surgeons is my latest article on Colombia Reports – talking about some of the great young surgeons here in the capital;

1. Dr. Juan Pablo Umana (cardiac surgeon)

2/3. Dr. Ivan Santos and Dr. Freddy Sanabria, (plastic surgeons)

4. Dr. Costanza Moreno (orthopedics)

5.  Dr. Juan Carlos Garzon (thoracic surgeon) and

6. Dr. Jose Felix Castro (general surgeon)

and some of the things they are doing (which all of my loyal readers already know all about!)

It was a different style of writing than I am used to – but I enjoyed it, and hope to do another article in the future.

Update: After getting a few requests – I’ve re-posted the article here.  (But, I’d appreciate it if you went to Colombia Reports anyway, so the editors can know how many people are reading the articles – and hope that they will publish more in the future!)

From Colombia Reports.com

Bogota’s Hottest Young Surgeons
Don’t let their youth fool you. These young Bogota surgeons are well versed in the latest technologies and the newest surgical techniques, and are changing the face of, and bringing new sophistication to the capital’s medical community.

Colombia news - docDr. Juan Pablo Umana, 46, Cardiac surgeon

A Bogota native, Dr. Juan Pablo Umana, with his Stanford education, quintessential rugged good looks and a refreshing outlook, brings a California flavor to Fundacion Cardioinfantil, where he has been the Chief of Adult Cardiac Surgery since 2004.  He, along with Dr. Nestor Sandoval have ushered in a new era of Cardiac Surgery in Bogota with a expanding and state-of-the-art cardiac surgery service line.  Notably, in 1997, Dr. Umana along with Dr. Memhet Oz invented the first mitral clip for percutaneous valve repair. During surgery, he is focused, meticulous and unflappable.  Despite being the most senior of the surgeons listed here, he is just hitting his stride.

Colombia news - doc

Dr. Ivan Adolfo Santos, 41, Plastic Surgeon

Dr. Ivan Santos operates at Clinica Shaio, and is one of a trio of celebrity plastic surgeons here in Bogota. Genetically blessed, he looks ten years younger than his 41 years. In spite of his boyish good looks and shy nature, Dr. Santos is a confident and talented surgeon; more importantly, he gets results. Watching Dr. Santos operate is similar to watching a symphony conductor orchestrate classic music composures with 160 musicians. He never misses a beat, and he is simultaneously aware of everything around him. With his precision in the operating room and aggressive post-operative therapies, patients recover faster, with less pain, and leave his office looking and feeling their best.

Colombia news - doc

Dra. Constanza Moreno Serrano, 40, Orthopedic Surgeon

Dra. Constanza Moreno is orthopedic surgeon specializing in hand and microsurgery such as digital reattachment after traumatic injury, reconstructive surgery and correction of congenital deformities. After training with the famed Dr. Harold Kleinert and Dr. Breidenbach III in Louisville, Kentucky, she returned to Bogota in 2005.  She is currently developing a hand transplant program for victims of landmines. Next week, she is presenting her proposal at the International Hand and Composite Tissue Allotransplantation Society in Atlanta, Georgia.

Colombia news - doc

Dr. Juan Carlos Garzon, 39, Thoracic Surgeon

Dr. Juan Carlos Garzon is a man of action; operating at several facilities across Bogota. Trained in Hong Kong, Dr. Garzon excels at the more difficult thoracic cases. As one of just a few board-certified thoracic surgeons in Colombia, he is using video-assisted thoracoscopy to able to treat complex disease with minimal incisions.  He is also teaching this technique to surgeons across Colombia. During cases, he is relaxed, controlled and ready for anything.

Colombia news - doc

Dr. Freddy Sanabria S., 38, Plastic Surgeon

Dr. Freddy Sanabria, a young Richard Gere look-a-like, makes his own pretty women as one-half of the Sanabria plastic surgery practice. Trained at the University of Pennsylvania and Stanford University, he brings skill, dedication and the latest cosmetic innovations to a well-established surgical clinic. While operating, he is confident, focused and detail oriented, and his surgical team anticipates his every need.

Colombia news - doc

Dr. Jose Felix Castro, 37, General Surgeon

Dr. Jose Felix Castro is a staff surgeon at Clinica del Country. This magna cum laude academic scholar is one of a few of the talented young general surgeons in Bogota who have embraced single port laparoscopy, which means abdominal surgery without a scar. While Dr. Castro is the youngest of our line up, he brings a wealth of experience to the operating room.

// //

Back in the OR with Ivan Santos

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Back in the operating room today with Dr. Ivan Santos at Clinica Shaio.  Dr. Santos was in perfect form, as always..  (I swear, watching him in the operating room is like watching a conductor with a 160 member orchestra..He sees and notices everything.)

Between cases with Dr. Ivan Santos, plastic surgeon

He was assisted by Dr. Julie Alfonso today.

with Dr. Julie Alfonso, plastic surgeon

If you want to see & learn more about Dr. Ivan Santos – he has his own YouTube channel.. (It’s in Spanish.)

In the OR with Dr. Freddy Sanabria, plastic surgeon

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Dr. Sanabria

with Dr. Freddy Sanabria, plastic surgeon

Spent the morning with Dr. Sanabria, at his clinic in North Bogotá (Usaquen) which was a treat. (I have lots of great things to say – but for more in-depth information, you’ll have to buy the book. 😉  I will say that surgical conditions were excellent, technique and skills were impeccable.

Working on my next possible article, which just may feature the good doctor.. Guess you’ll all have to wait and find out. (If the editor passes – I’ll post here.)

Update:  3/2012:  Readers know that I put little stock in ‘testimonials’ but I’ll include them (by readers multiple requests) when I find them.. or otherwise stumble across them – since this isn’t an ad agency..

Dr. Freddy Sanabria

Dr. Rudolfo Reyes, plastic surgeon

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Dr. Reyes, on the Right

Spent the afternoon with Dr. Reyes in the operating room.. Happy to report that I remembered I had a camera in my back pocket this time.. (you may recognize Dr. Reyes from Dr. Santo’s OR, but with the masks, maybe not.) Dr. Alvaro Pedraza, ENT assisted.

In the OR with Drs. Roa

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Went to the OR today with the doctors Roa (father and son) for combination plastic surgery procedures..

Interviewed Dr. Cure – a neurosurgeon – hope to follow him to the OR soon.. Off to surgery with Dr. Rudolfo Reyes tomorrow..  More information to follow when I get some time!

Dr. Sergio Abello and Dr. Felipe Roa

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Met with Dr. Sergio Abello, an orthopedic surgeon specializing in foot and ankle surgery and Dr. Felipe Roa, plastic surgeon.. Dr. Roa is the son of Dr. Tito Roa, and they share a practice..

Planning to follow both of them to the OR tomorrow and next week..

Dr. Santos, almost Dr. Hoyos and Dr. Castro

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Full day today – met with Dr. Hernando Santos at Clinica Shaio – and I’ll be heading to the OR with him on Monday..

 Dr. Hoyos – he was in surgery when I arrived for our appointment, so I’ll try again soon..

Spent the evening with Dr. (Jose) Felix Castro, a very nice general surgeon, on staff at Clinica del Country.. Followed him to the OR for a case –

Dr. Ivan Santos, plastic surgery

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Dr. Ivan Santos

Dr. Ivan Santos, (right)

Spent time in the operating room at Shaio watching Dr. Ivan Santos operate this morning.  Operating rooms are large, clean, well-lit and all equipment is modern and fully functional.

Dr. Santos operates with a second surgeon assisting, Dr. Rudolfo Reyes.  Today’s case which was a combination of body and facial procedures was performed under a combination of local and conscious sedation.  Patient appeared comfortable during the procedure and all standardized intra-operative protocols were followed.  Sterility was maintained throughout the case.  (No intra-operative photos taken with patient in view – for privacy concerns.)

The particular case was more complex that average – patient was undergoing a revision after previous surgery several years ago (with another surgeon).  Dr. Santos was meticulous in attention to detail, calm and pleasant in demeanor, and aggressive in surgical management.  He has a good rapport with his OR team, who were able to anticipate his needs.

Going back on Monday for another case.

Note: Be careful when searching the internet for doctor information – there is a lot of disinformation out there (which is why I am writing a book).  Currently there is a doctor impersonating Dr. Ivan Santos – if you do a search for Dr. Santos – this doctor comes up, claiming to be in practice with him.  Please be careful everyone!)

More about Dr. Ivan Santos:

Back in the OR with Ivan Santos

Bogota’s celebrity surgeons

Bogota’s Hottest Surgeons

Dr. Ivan Santos and Clinica Shaio

A delightful surprise

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Caught up with Dr. Ivan Santos, plastic surgeon today.  What a delightful surprise!  After all I had read and seen, I had expected an arrogant self-important surgeon – but that certainly wasn’t the reality.  (To all you naysayers who think that surgeons being interviewed by a relatively obscure nurse are always on their best behavior – well – that’s just not the case.)

I will tell you answers to the rumors floating around Bogota (which are):

1.  Dr. Santos is so busy, he often sleeps in his car between cases..  TRUE.. He loves to work – used to operate seven days a week, but now down to six..

2.  He isn’t related to Dr. Hernando Santos Calderon (heart surgeon at Shaio) and President Juan Manual Santos (President of Colombia.)  Okay, only an NP in cardiothoracic surgery would rank it that way – but there you have it.

Don’t let his youthful good looks fool you, at 41, Dr. Santos is a seasoned, experienced surgeon.  I’ll tell you more when I get back from the operating room on Saturday.

And as you know, if you want the real stats, you have to wait for the book..

Interview with Dr. Freddy Sanabria

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Here’s some of the highlights from one of today’s interviews – with Dr. Freddy Sanabria, a charming young plastic surgeon operating here in Bogota – across the street from Santa Fe de Bogota, as a matter of fact.

He does a wide range of procedures including plastic / aesthetic surgery of face and body as well as offering a variety of injectables, laser procedures, and other treatments.

He has a full OR set up contained within two floors of the Centro Medico de La Sabana building.  The equipment was refreshing modern, along with the facility itself, with good lighting and nice sized ORs.

His English is excellent, and polished, courtesy of several training stints in the US as a medical student, and later, as a resident.  He has a series of infomercials on YouTube in Spanish with English subtitles..

I won’t be able to tell you much more until I take a trip to the OR. (and I’m saving the best details for the book!)

Bogota notes

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Re-post from sister site.

January 27th, 2011 – Surgical Tourism in Bogota, Colombia

Fundacion Cardioinfantil

Currently working on my latest project – here in Bogota, Colombia.  So far everyone I’ve contacted has been wonderfully gracious – even with very little notice! 

Chief of (adult) Cardiac Surgery, Dr. Juan Pablo Umana and Chief of Pediatric Cardiac Surgery, Dr. Nestor Sandoval; Fundacion Cardioinfantil
January 31, 2011
Spending some more time over at Cardioinfantil this afternoon. I have been contacting surgeons all over the city, and my schedule is quickly filling up. 
Talked with Dr. Renato Bresciano, a very nice (talented) pediatric cardiovascular surgeon, and visited one of his patients in the NICU this afternoon – a little baby girl just out of the operating room.  Spoke with the nursing staff – it’s great how nurses from everywhere  – we all connect, and all care and worry about the same things.
 
I’ll be over at the Shaio Clinic later this week.
10 February 2011 –
It’s been a busy week – at Clinica Shaio, Cardioinfantil, Clinica del Country (San Sebastian) and tomorrow SaludCoop.. In between all of that – I’ve been hitting the pavement to check out some private clinics..
12 February 2011
Not enough hours in the day – racing around Bogota, all day, everyday, meeting new people, taking notes, photos..  talking to patients in hospitals, shaking hands – trying to get a glimpse inside at the everyday workings..  Then back to the apartment at night, typing, typing, typing.. Researching, emailing, requesting more interviews..
My main expense these days is the cab fare..  Already booked up with meetings for the next two weeks, but I’ll try to squeeze as many as possible in – without crowding.. Still going to the ORs – since that’s the real reality for our patients.. Spending as much time as I can at each site, going back for second, third, fourth, even fifth visits  – until I almost feel like staff sometimes..
Next week – Bariatric week..
with Dr. Urazon, Plastic Surgeon

 

15 February 2011 – wow – what a different an hour makes..
when you are in the company of Dr. Chaux, Bariatric surgeon.. I spent much of the day with Dr. Chaux and his group – in the operating room, observing.. All procedures in under an hour.. (Roux N Y gastric bypass, sleeve ect..) Don’t worry – he certainly wasn’t rushed about it – just efficient, meticulous..

24 February 2011
Been too busy meeting physicians, spending time in the OR and writing to keep up.. Spent time with a talented young Thoracic surgeon today, Dr. Juan Carlos Garzon. Sorry, no pictures this time – too busy to stop and take any! (which frequently happens).

Met quite a few terrific surgeons, spending a lot of time on my feet, peeking over their shoulders so I can tell my readers everything they need to know. A couple more surgeries tomorrow and a full weekend too..