Dress to Impress: Public Perception of Plastic Surgeon Attire.

BACKGROUND: Physician attire has been shown to impact patients' perceptions of their provider with regards to professionalism, competency, and trustworthiness in various surgical subspecialties, except in plastic and reconstructive surgery. OBJECTIVES: The authors sought to address this knowledge gap and obtain objective information regarding patients' preferences. METHODS: A survey was distributed to adult, English-speaking participants in the United States using the Amazon MTurk platform from February 2020 to December 2020. Participants were asked to evaluate with a 5-point Likert scale 6 attires (scrubs, scrubs with white coat, formal attire, formal attire with white coat, casual, casual with white coat) in terms of professionalism, competency, and trustworthiness for male and female plastic surgeons during their first encounter in clinic. RESULTS: A total of 316 responses were obtained from 43.4% men and 56.6% women. The mean age of participants was 53.2 years. The highest scores across all metrics of professionalism, competency, trustworthiness, willingness to share information, confidence in the provider, and confidence in surgical outcomes were given to the formal attire with white coat group, with average scores of 4.85, 4.71, 4.69, 4.73, 4.79, and 4.72, respectively. The lowest scores across all metrics belonged to the casual attire group with scores of 3.36, 3.29, 3.31, 3.39, 3.29, and 3.20, respectively. Patients preferred formal attire for young plastic surgeons (P = 0.039). CONCLUSIONS: This study suggests that physician attire impacts patients' perception of plastic surgeons regarding their professionalism, competency, and trustworthiness. White coats continue to remain a powerful entity in clinical settings given that attires with white coats were consistently ranked higher.

Patient and surgeon experiences with video visits in plastic surgery-toward a data-informed scheduling triage tool.

BACKGROUND: Coronavirus disease 2019 provided the impetus for unprecedented adoption of telemedicine. This study aimed to understand video visit adoption by plastic surgery providers; and patient and surgeon perceptions about its efficacy, value, accessibility, and long-term viability. A secondary aim was to develop the proposed 'Triage Tool for Video Visits in Plastic Surgery' to help determine visit video eligibility. METHODS: This mixed-methods evaluation assessed provider-level scheduling data from the Division of Plastic and Reconstructive Surgery at Stanford Health Care to quantify telemedicine adoption and semi-structured phone interviews with patients (n = 20) and surgeons (n = 10) to explore stakeholder perspectives on video visits. RESULTS: During the 13-week period after the local stay-at-home orders due to coronavirus disease 2019, 21.4% of preoperative visits and 45.5% of postoperative visits were performed via video. Video visits were considered acceptable by patients and surgeons in plastic surgery in terms of quality of care but were limited by the inability to perform a physical examination. Interviewed clinicians reported that long-term viability needs to be centered around technology (eg, connection, video quality, etc) and physical examinations. Our findings informed a proposed triage tool to determine the appropriateness of video visits for individual patients that incorporates visit type, anesthesia, case, surgeon's role, and patient characteristics. CONCLUSION: Video technology has the potential to facilitate and improve preoperative and postoperative patient care in plastic surgery but the following components are needed: patient education on taking high-quality photos; standardized clinical guidelines for conducting video visits; and an algorithm-assisted triage tool to support scheduling.

Phase resetting behavior in human gait is influenced by treadmill walking speed.

Gait is often modeled as a limit cycle oscillator. When perturbed, this type of system will reset its output in a stereotypical manner, which may be shifted in time with respect to its original trajectory. In contrast to other biological oscillators, relatively little is known regarding the phase resetting properties for human gait. Because humans must often reset their gait in response to perturbation, an improved understanding of this behavior may have implications for reducing the risk of fall. The purpose of this study was to further evaluate phase resetting behaviors in human gait with particular emphasis on (1) variance of the phase resetting response among healthy individuals and (2) the sensitivity of this response to walking speed. Seventeen healthy subjects walked on a treadmill at 2.0mph, 2.5mph, and 3.0mph while their right limb was perturbed randomly every 12-20 strides. Discrete, mechanical perturbations were applied by a rope that was attached to each subject's ankle and actuated by a motorized arm. Perturbations were applied once during a select stride, always at a different point in the swing phase, and the amount of phase shift that occurred on the subsequent stride was recorded. A subset of 8 subjects also walked at their preferred walking speed for 3 additional trials on a separate day in order to provide an estimate of within-subjects variability. The results suggested that phase resetting behavior is relatively consistent among subjects, but that minor variations in phase resetting behavior are attributable to walking at different treadmill speeds.