Question: Dear Dr. DeLorenzi: I don’t feel comfortable talking to my surgeon. She never really answers my questions, and she often changes the subject and seems annoyed when I ask her a direct question. A lot of what she says seems like it is out of a legal document rather than just two people talking. Her prices are very good though, and I think I am going to go ahead with the surgery she proposed. What do you think?
-JBT

Answer: Dear JBT: It sounds like you have serious issues with your surgeon! That’s breaking one of the cardinal rules of the doctor patient relationship. If you don’t feel comfortable communicating with your surgeon before the actual surgery, how do you predict that will change after the surgery? Remember that you are creating a life long relationship here, and you should choose your surgeon with just as much diligence as you choose a mate. Surgery is never just a one time deal (which is why I can never understand medical tourism, where patients travel outside the country for surgery they could get at home). Any surgery will have a risk of complications or unforeseen events. If you have trouble with your relationship before surgery, how will it be different if you have a problem that needs attention after surgery? You should have a bond of trust with your doctor, since you are entrusting them with your very life! If that trust is NOT there, then you should get out of that relationship as soon as possible and never look back. You have to find someone that is right for you. This goes both ways too. I do not operate on every patient that sees me.

There are three cardinal rules that I live by in my practice:

• I have to like and trust the patient
• The patient has to like and trust me
• The patient has to have a problem I feel confident I can fix.

If any one of these rules is absent, I won’t operate on them, period.
We all have likes and dislikes, and sometimes the chemistry just is not there.

Some operations, particularly breast augmentation, is never a one-shot deal. Every breast augmentation patient will eventually need further surgery (because breast implants will never last as long as you will live). If you do not like your surgeon, that is going to create even more stress for both of you in the future, so choose someone else! You should take as much time as necessary to build a trusting relationship.