Tuesday, August 13, 2013

Teaching Other Surgeons Rhinoplasty

I have been blessed with the ability to help patients.  I am thankful that one by one I can make a difference in their lives.  However, more than the one by one approach, I am thankful for my ability to teach other surgeons how to think their way through difficult operations, create solutions, and help their patients achieve what they are looking to achieve.  On this note, I am thankful to be a teacher of the art of plastic surgery and, specifically, primary and secondary rhinoplasty.

I am a faculty member at the University of Southern California and I have the plastic surgery residents rotate with me on a regular basis.  Though I still do all of the operating, they do get to observe some of the most difficult problems in nasal surgery being solved.  I also have visiting residents from around the world and visiting attending surgeons from around the world.  There is nothing I like to do more than perform a great operation and have not only the patient benefit, but also other surgeons who will affect other patients with their increased knowledge.

Rather than spending my money on fancy banner ads on google and yahoo, I have chosen to spend my money flying to the far reaches of our planet to perform surgery at congresses and lecture to my international colleagues.  However, I think my patients have benefitted the most by my exposure to so many different ideas.

There is more to come, so stay tuned...next trip - IMCAS - Shanghai!


Friday, May 31, 2013


As a physician who deals with the internet bringing misinformation to my patients on a constant basis, I am pleased to see my project, http://mdinsider.com taking the form of the ultimate transparent source of medical information on the internet.  MDIndsider.com is a big data site that is focused on getting patients objective information that can bring them to the right doctor for them.  We have assembled an amazing team with loads and loads of experience.  We are very excited to launch the site in the fall and clearly there is much to do to get there.  But there is so much more to it!  If we can characterize the data on the internet in such a way that every contribution is searchable and ranked, we are in good position to change the way medicine is practiced  around the world.

Our team:



More to come...

Friday, March 15, 2013

Online reviews are affecting your health care

My friend said to me, "I have to order this test...if I don't, this patient will get angry and I will get yet another bad yelp review."  My friend is a doctor.  The test he ordered is unnecessary and carries with it some risk of complications that could essentially kill the patient. The test costs money that clearly does not need to be spent.  So lets look at this carefully:

1.  The implication is that the patient will NOT be happy with their care if they do not get the test.
2.  The doctor is more concerned about his online reputation because that is a major driver of his practice.  Poor reviews = hurtful financial situation i.e. less money to pay the bills.
3.  The fact that the test is unnecessary is irrelevant to both doctor and patient - patient wants it therefore he gets it because the doctor does not want to have another black mark against his name.

This situation has now become common place.  The problem is no one is brave enough to stand up for what is right.  Look at his words, - specifically the part about another bad yelp review.  He did not say, "I want to order this test to get a good review."  That's because happy patients don't write reviews - unless you ask them a ton of times.  Because it is not what patients do.  However, 75% of patients coming to the office today will read online reviews about the doctor they are going to see.  Thus, online patient reviews are truly useless UNLESS they are verified.  Of the 30 major review sites out there, none use a verification system.

So what are we to do when our health care dollars are being spent this way and our physicians are more worried about their online reputations to carry their paychecks then they are about the actual quality of care?  Send me your comments info@drcalvert.com or go to http://drcalvert.com.  There is much more coming...

Friday, January 18, 2013

Nasal fractures and Rhinoplasty - tough combination

I have been performing about 200 rhinoplasty operations a year for the last 5 years or so.  Many people come in for a rhinoplasty and respond to the question of nasal trauma with a "No."  However, I have learned to be a bit more observant and investigative in the last few years because nasal fractures make rhinoplasty more difficult.  If I can figure it out before hand, it allows me more time to plan for the potential problems that come with this type of operation.

The reason it makes rhinoplasty more difficult is because of the fracture lines.  When a person gets a broken nose, it does not break in an aesthetically pleasing manner.  They mostly break according to the direction and magnitude of force doing the breaking.  And then they heal into that broken position making the osteotomies (bone cuts) of rhinoplasty more difficult to control.

There is also the question of the airway after a nasal fracture.  If the airway is good before surgery, it can be maintained with proper operative technique.  However, if the airway is bad before rhinoplasty, it most likely will be the same or worse after surgery.  This makes it essential to diagnoses airway problems before surgery so that they can be corrected or at least improved rather than making them worse.

Here is a video about one of my patients who broker her nose and wanted to get things back into shape:

Nasal Fracture Patient

Feel free to call the office with any questions about nasal trauma and rhinoplasty.  We are reachable at 310.777.8800 or at info@drcalvert.com.