PEER-REVIEW | LIPOSUCTION | In addition to questions about the
Table 1 List of survey questions
1. How pleased were you with the personal attention you received?
2. How pleased were you with your surgical results?
3. How would you rate the value of your services relative to cost?
4. How likely would you be to use our services again?
5. How likely would you be to refer others to our clinic?
6. How well did we meet your expectations?
7. How would you rate your pre-surgery experience?
8. How would you rate your surgery experience?
9. How would you rate your post-surgery experience?
10. Did you experience any complications?
11. Did Sono Bello treat your complications?
12. How would you rate the complication treatment?
13. How would you rate our reception staff?
14. How would you rate our PCC?
15. How would you rate our medical support staff?
16. How would you rate our surgeon?
17. How would you rate our facility?
18. How would you rate our marketing materials?
19. How would you rate our radio advertising?
20. How would you rate our TV advertising?
21. How would you rate our website?
patient’s surgery, the survey also asked a series of questions, not necessarily related to the procedure, in order to improve our own practice’s system and office procedures. These questions, answered on a scale of 1 to 5, are listed in Table 1. The actual evaluation of patients’ satisfaction, however, was just one of the questions (Question 6), buried within the 21-question survey: ‘How well did we meet your expectations?’
Results After the data was collected, patients were divided into two categories: high (30) and low (<30) BMI; the categories contained 740 and 1,086 observations respectively. The average satisfaction scores, numbers of patients within each BMI category, and percentage of total are shown in Table 2, this data is plotted in Figure 1. A univariate Ordinary Least Squares (OLS)
regression was used to compare the impact of patient BMI on satisfaction. Ordinary Least Squares regression is a commonly used statistical technique in research, featuring predominantly in biostatistics, engineering, finance, and economic applications. It allows researchers to account for the variation in a dependent variable (in this case satisfaction on a 5 point scale) given one or more independent variables, such as a binary variable for high or low BMI. In this case, satisfaction values were regressed on a dummy variable, ‘Low’.
The
resulting estimation is: Satisfaction = 3.72 - .053 *Low
This indicates that the average satisfaction for
a ‘high’ BMI patient is 3.72, and the average satisfaction for a ‘low’ BMI patient is actually lower: 3.667. This regression holds very low predictive power, predicting only 0.047% of the variation in satisfaction between patients, indicating that virtually all of the variation (the other 99.953%) not predicted by the model is explained by other factors, such as a surgeon’s technical ability or bedside manner. In testing whether Low is not distinct from zero, the null and alternative hypotheses are:
This comparison proved
that there was no statistical difference in satisfaction among all BMIs.
36
H0: 1 = 0 Ha: 1 0
The null of a two sided t-test is
rejected at the 5% level if the absolute value of the t statistic is greater than 1.96.
The t statistic of 1 is -.92;
consequently the null hypothesis cannot be rejected. The difference in satisfaction between patients cannot be shown to be statistically distinct from zero with a reasonable degree of certainty.
January/February 2016 |
prime-journal.com
Discussion Comments concerning liposuction satisfaction were first made by Carson Lewis, MD, in 19841
. Dr. Lewis emphasized that the ultimate goal was
patient satisfaction, which could be achieved by selecting patients with realistic expectations and positive attitudes, who were highly likely to be satisfied regardless of the outcome. He suggested that the optimal patient should: Be self-motivated and not motivated by an outside party
Have had the concern for a long time and should not treat it lightly
Have a higher level of deformity than anxiety Not be looking for a complete makeover Not be severely depressed or psychotic. Frank Herhahn, MD, also offered guidelines for
choosing the ideal patient: ‘usually less than 35 years old and falls within the ideal weight for his or her height and body type,’ although the source listed no method, such as BMI, for determining the ‘ideal weight’ for height and body type3
. The patient should also have good skin
turgor, no cellulite, firm adiposity, little sagging, and no striae. The so-called ‘average’ patient at that time was 30 to 45 years old, and 5 to 10 pounds above the ideal weight ‘for his or her height and body build.’ At that time, the ‘less-than-ideal patient’ was over 35 years old and 10 to 20 pounds overweight. Those comments were recorded in 1984 when liposuction began in the United States. In today’s world, those ideal patients only represent a tiny minority of patients upon whom plastic surgeons actually perform liposuction.
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