TobinA message from Howard A Tobin M.D.  As patient and physician, ours is more than a relationship; it’s a partnership. A partnership is based on mutual trust and confidence. I want to ensure that you get the best possible care and the best possible result from your surgery. To give you the best, most thorough care possible, I need some things from you:

1. Communication – If you don’t understand what I’m saying to you, tell me.  If I explain again and it’s still not clear, say so.  With a complex topic, sometimes it takes two or three explanations to clarify all of the details.  I’m willing to explain as many times as needed.  I simply need you to ask.

2. Clarification – Tell me what you need to know about your condition. If you wish suggestions about what I would recommend in the way of treatment, ask.  If you know what you are seeking, and don’t want additional suggestions, let me know.  If you are unsure about your post op care, even after reading the instructions, let me know so a staff member or I can review it with you.

3. Satisfaction – Be sure you’re comfortable with what I’ve recommended, and if you’re not, tell me.  I can discuss alternatives, or, if there are no other options, I’ll try to do a better job of making you feel more at ease by explaining the choices you have.

4. Understanding – Understand that cosmetic surgery is less a science than an art.  We don’t usually have an absolute answer to all of your needs or desires.  I’ll use my knowledge of surgery and medicine to evaluate your condition.  I can do a better job of treating you if you will keep me informed, ask me questions, and give me honest, complete information about your medical history and current problems.  If your problem is outside my area of expertise, I will try to help you find the proper assistance.

5. Information – Tell me or one of my staff when something is troubling you, whether its that my front door is difficult to open, that one of us was short-tempered with you, or that the medication I prescribed had unpleasant side effects. If I know when you’re unhappy or not fully satisfied, I can do something about it.  If you keep it to yourself, I’ll never know—and sometimes the information you keep to yourself may affect the course of your treatment or recovery.

6. Pain – There is always pain involved in surgery.  Patients often ask how much an operation will hurt.  Unfortunately, there is no simple answer.  Everyone’s pain threshold is different. Pain also relates to a patient’s attitude toward surgery. Surgeons have long recognized that a healthy positive attitude is usually a cue that there will be less pain after the operation.  We will do everything we can to help you with any pain that you have.  However, you must understand that pain cannot be entirely eliminated.  If the medication you are taking does not seem to work, tell us and we will try to adjust the dosage or type of medication you are taking.  A sudden increase in pain may be an indication of problems, and you should inform us if that happens.

7. Complications – No one expects problems after their operation, even though we all know they can happen.  If they do occur, I will try my best to get you through the problem as quickly as possible.  Unfortunately, complications always involve increased recovery time and increased anxiety on both our parts.  They may also involve increased expense.  As much as possible, I will try to tell you the risks of surgery, but no one can anticipate every possible problem.  You can help to avoid problems by following instructions, alerting us to problems as soon as possible and taking good care of your general health.  Smokers should especially be aware of the harmful effects of smoking on wound healing.  If you are a smoker, you must stop for at least two weeks before and two weeks after surgery.

8. Pre Operative Evaluation – Routine preoperative requirements include an EKG for patients age 40 and above. Most breast surgery patients will require a preoperative mammogram. Other tests are individualized. In cases where we feel that underlying medical problems are significant, we may require a clearance for surgery from your primary care physician or other specialist who is treating you. In return for your involvement and communication, I promise I’ll communicate with you. I believe the result will be better care and a stronger partnership.