From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medical Center; the Division of Plastic and Reconstructive Surgery, Wright State University, Boonshoft School of Medicine; the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School; and the Division of Plastic and Reconstructive Surgery, Albany Medical Center.
Plast Reconstr Surg. 2021 Jan 1;147(1):231-238. doi: 10.1097/PRS.0000000000007493.
Non-board-certified plastic surgeons performing cosmetic procedures and advertising as plastic surgeons may have an adverse effect on a patient's understanding of their practitioner's medical training and patient safety. The authors aim to assess (1) the impact of city size and locations and (2) the impact of health care transparency acts on the ratio of board-certified and non-American Board of Plastic Surgeons physicians.
The authors performed a systematic Google search for the term "plastic surgeon [city name]" to simulate a patient search of online providers. Comparisons of board certification status between the top hits for each city were made. Data gathered included city population, regional location, practice setting, and states with the passage of truth-in-advertising laws.
One thousand six hundred seventy-seven unique practitioners were extracted. Of these, 1289 practitioners (76.9 percent) were American Board of Plastic Surgery-certified plastic surgeons. When comparing states with truth-in-advertising laws and states without such laws, the authors found no significant differences in board-certification rates among "plastic surgery" practitioners (88.9 percent versus 92.0 percent; p = 0.170). There was a significant difference between board-certified "plastic surgeons" versus out-of-scope practitioners on Google search between large, medium, and small cities (100 percent versus 92.9 percent versus 86.5; p < 0.001).
Non-board-certified providers tend to localize to smaller cities. Truth-in-advertising laws have not yet had an impact on the way a number of non-American Board of Plastic Surgery-certified practitioners market themselves. There may be room to expand the scope of truth-in-advertising laws to the online world and to smaller cities.
非认证整形医生进行美容手术并自称为整形医生，可能会对患者对医生医学培训和患者安全的理解产生不利影响。作者旨在评估（1）城市规模和位置的影响，以及（2）医疗透明度法案对认证和非美国整形外科学会医师比例的影响。
作者进行了一项系统的谷歌搜索，搜索词为“plastic surgeon [城市名称]”，以模拟患者对在线医生的搜索。对每个城市的热门搜索结果进行了认证状态的比较。收集的数据包括城市人口、地区位置、执业地点以及通过广告真实性法案的州。
共提取出 1677 名独特的从业者。其中，1289 名从业者（76.9%）为美国整形外科学会认证的整形医生。在比较有和没有广告真实性法案的州时，作者发现“整形手术”从业者的认证率没有显著差异（88.9%对 92.0%；p=0.170）。在谷歌搜索中，认证的“整形医生”与超范围从业者之间在大城市、中城市和小城市之间存在显著差异（100%对 92.9%对 86.5%；p<0.001）。
非认证医生倾向于本地化到较小的城市。广告真实性法案尚未对许多非美国整形外科学会认证从业者的自我营销方式产生影响。可能需要将广告真实性法案的范围扩大到网络世界和较小的城市。
