Do You Agree Doctors - That a PATIENT is the ONE Who Decides - It is HER RIGHT - to Say a Resident Will Not Touch Her Face?

The aforementioned question begs to be answered and not one doctor brought this up. I know two people who had facelifts and wrote NO RESIDENT in operating room on their consent form and it was honored. You can all tell me about teaching hospitals, but when it's all said and done, A RESIDENT BEING PRESENT, was LEFT OUT of the conversation with my surgeon- HOW CONVENIENTLY.....It is a MAJOR ISSUE - and I would have REFUSED...I'm paying for THIS surgeon's expertise and I need to fix the ptosis.

Doctor Answers 9

Residents in the OR

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You have a right to demand that only the primary surgeon perform the surgery. This is why one seeks out an experienced plastic surgeon. There is nothing wrong with residents helping in surgery (someone has to help) but I would honor your request. Generally if the resident is performing the surgery, the surgery would take place in a resident's clinic at a lower cost. 

Who is in the OR with your surgeon?

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Patients certainly have the right to choose who is present and who is helping if they are paying for the costs themselves.  All consents have a paragraph about education and residents... did you not have a consent such as that?  You simply line out that paragraph.  If that was not in your consent and you failed to bring the issue up, then residents are allowed in the OR.

However it sounds like you had a complication/poor result (ptosis) and you should address this with your surgeon.  Most surgeons want the best results for their patients since their patients in turn refer more patients to that doctor.  If you concerns are minimal, that's another story.  But if obvious, your surgeon should easily appreciate it and help you through the process to get it fixed.  Thankfully, almost everything can be fixed.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Your rights.

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Yep.  No question about that one.   But, it may be to your benefit to have a resident assist the surgeon.  Often surgeons are assisted by physician assistants.  A resident may be a bette option.  

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon

Teaching/University Hospitals

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As a surgeon that works both in a private practice and at an academic university medical center, I can appreciate the difference in the cultures of the two settings. If a patient asks me for a resident not to be involved, I would tell them that they should see me at my private practice, as my role at the University is to treat patients while training the next generation of surgeons. Let me explain:

First and foremost, it is absolutely you right to REQUEST that either a resident/fellow not perform the surgery, or even be present in the room. At a teaching hospital, it is also the right of the surgeon to agree or not agree to your request. If your surgeon feels that your procedure requires the help of an assistant, then it is in your best interest for a resident to be present. Furthermore, it is a University Surgeons responsibility to train the next generation of surgeons, and as such, it is important for them to involve a resident, whether as an observer or an active participant. As mentioned by others here, the attending surgeon  would likely perform the key portions of the procedure.

In a University setting it is understood that medical students/residents/fellows will be present/involved so it is often not explicitly stated by the surgeon. Also the consents will almost always have that language in writing.

So you are correct. It is absolutely your right to make such a request, but a surgeon has the right to refuse, and then it would be up to you to find another surgeon to do your surgery. Your surgeon was not trying to trick you. It is just a normal operating procedure in a University.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Residents In the OR

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Thank you for your question. It is definitely your right to request that residents not participate in your procedure. Having said that, if this is important for you to be comfortable then you should consider having your procedure with a surgeon who does not participate in a teaching program  Residents are an integral part of teaching programs and it is impractical to ask your surgeon to forgo a skilled assistant who benefits from participating in surgery.  Many patients get excellent care with residents completely out of the picture, observing and actively participating.  Discuss your concern about your result with your doctor.  I am certain that he/she is committed to your satisfaction.  Resident participation is most likely not the central issue to your dissatisfaction.  I wish you the best in your recovery.

Residents and Operative Procedures

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It is fairly customary for the patient to have the ultimate decision on who is allowed in the operating room.  In the setting of a private pay cosmetic surgical patient, seeking the expertise of an Attending Surgeon in an academic medical center, it is also fairly customary for that Attending to perform the key points of the procedure.  For patients seeking reduced fee cosmetic surgical procedures in academic center resident/ fellow clinics, it is customary for residents or fellows to perform such procedures with the Attending Surgeon's guidance.  When patients are seen at academic medical centers, there is usually language in the consent forms which states that residents, fellows, and medical students may be present for and/or assist in the procedures. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Who Decides if a Resident is Present During Surgery?

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Ultimately, it is the patient's choice as to who provides their care and the surgeon should follow the patient's wishes. However, in many cases, it is not practical to define every member of the surgery team and many cases can be done better with an assistant (student, resident, fellow, nurse, physicians assistant, etc).

There are no laws stating that it must be mentioned if a resident is present or not, so you should not think that your surgeon "conveniently" left it out of the conversation. The presence of a resident does NOT mean that you are not getting the full attention and experience of the surgeon. More likely, your surgeon is highly regarded and has been selected as someone who can teach the next generation of surgeons.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Residents in the Operating Room

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You are absolutely correct that the patient should have the last word on whether a resident participates in an elective cosmetic procedure. The patient should take this into consideration when one consults with a Plastic Surgeon. There are many Plastic Surgeons who participate in the training of residents and find it very difficult to change their "systems" and not use residents as assistants. These issues should be discussed open and honestly during the consultation. I would not ask a surgeon to change his routine regarding assistants as many surgeons are a slave to routine and depend on their routines for optimal results.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

Do You Agree Doctors - That a PATIENT is the ONE Who Decides - It is HER RIGHT - to Say a Resident Will Not Touch Her Face?

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          If a patient is the private patient of the attending and not a resident clinic patient (usually receiving a reduced fee), then the patient has the expectation that the surgeon seen is  the individual who is performing the surgery. 


Kenneth Hughes, MD Los Angeles, CA

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.