Introduction: With increasing sub-specialization of medicine, an increasing number of clinicians may not practice the full breath of Plastic Surgery. Furthermore, as we move into the 21st century, other specialties may further enter the clinical arena of practicing Plastic Surgeons. These two factors can confuse the Primary Care Physician about the scope of practice of Plastic Surgeons and other specialties. These internists, pediatricians, and family practitioners can serve as important source of information to their patients. As such, the authors investigate the perceptions of primary care physicians towards the practice of different areas of Plastic & Reconstructive Surgery.
Methods: A short, anonymous, web-based survey was administered to residents of Internal Medicine, Pediatrics, and Family Practice training programs in the United States and Canada. Respondents were asked to choose the specialty they perceived to be an expert for 6 specific clinical areas. These included eyelid surgery, cleft lip & palate surgery, facial fractures, hand surgery, rhinoplasty, and skin cancer of the face. Answer choices for each area included Dermatologist (D), General Surgeon (GS), Ophthalmologist (O), Oral Maxillofacial Surgeon (OMF), Orthopedic Surgeon (OS), Otolaryngolgist (ENT) and Plastic Surgeon (PS). More than one specialist could be chosen. The respondent’s specialty, gender, year of training, and geographic location were also elicited to help further categorize responses.
Results: A total of 640 survey responses were collected with equal distribution among post-graduate year of training and geographic location. Respondents believed the following specialties were experts for eyelid surgery (70% PS, 61% O, 5% D, 5% ENT); cleft lip & palate surgery (75% OMF, 58% PS, 37% ENT); facial fractures (88% OMF, 39% PS, 30% ENT, 10% OS, 4% GS, 3% O); hand surgery (76% OS, 51% PS, 7% GS); rhinoplasty (79% PS, 45% ENT, 18% OMF); and skin cancer of the face (90% D, PS 37%, OMF 11%, 9% ENT).
Conclusion: Primary care physicians believe that in addition to Plastic Surgeons, other specialties may be experts in eyelid surgery, cleft lip & palate surgery, facial fractures, hand surgery, rhinoplasty, and skin cancer of the face. As sub-specialization within Plastic Surgery and other areas of medicine occur, it will be increasingly important to educate trainees in Internal Medicine, Pediatrics, and Family Practice. These physicians can serve as an important source of referrals and their knowledge about the wide breadth of practice of Plastic & Reconstructive Surgery is indispensible.