BMM The Social Media Issue

The Social Media Madness Issue!

MEDICINE MAGAZINE™ The Magazine for Big Thinkers

LOOK INSIDE! Here’s To Your Health Dealing With The Body Dysmorphic

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Letter From The Editor Welcome to BIG Medicine Magazine™. Generally I can’t wait to write my introductory letter detailing the exciting articles we have for you in each issue. This time, however, rather than do a letter from me, I decided to use this valuable piece of magazine real estate to focus on a letter we received from one of our doctor subscribers. If I or any member of our team had any doubts about our mission with BIG Medicine Magazine™ this letter puts it all in perspective. Creating, writing, editing, publishing and distributing a magazine is not easy. This letter makes all the hard work and long nights worth it!

Angela O’Mara Editor-In-Chief Founder

Review by

Christopher Lyon, M.D., Ph.D., M.Sc. Ocular Facial Surgeon

Kudos to Angela O’Mara, Giles Raine, Enna Ruiz and all the team for having the guts, initiative and foresight to bring forth the “BIG Medicine Magazine™”. True to form, as befits “The Professional Image, Inc.” this production is classy, professional, well laid out, pleasing to the eye and an easy read. Let me tell you why I subscribed. BIG Medicine Magazine’s upbeat tone is more than welcome in this era of gloom and doom in medicine.

Its authors bubble over with enthusiasm, insights, optimism and resourceful pearls for those who still believe that private practice provides the best quality care for our patients. All critiques rest upon one’s reference points garnered through life. Please allow me to share mine.

An upbringing under Britain’s socialist National Health Service provides my perspective, lacking in those for whom US medicine was the norm. This, coupled with the onerous NHS stamp taxes imposed on small businessmen such as my father, was a forerunner of the Supreme Court mandated tax that hovers US businesses under Pelosi’s Obamacare. Notwithstanding a lifetime of taxes, when my father’s adenocarcinoma of the lung was finally diagnosed late in its course, he was dumped unwittingly and unknowingly into the “Liverpool Pathway” for terminal “care”. His visiting nurse deprived him of his ‘costly and too addictive’ pain killers. So he ended his days relieving his misery by sucking on a bottle of Johnnie Walker.

My volunteer work in faraway places such as Burma, Cambodia, Laos, the Philippines and Thailand under the auspices of The Blindness Foundation provides me with yet additional references. Participation in a multitude of differing and constantly evolving health care systems, with politics ranging from military dictatorships to nominal democratic monarchies, yields insights unknown to our leaders in Washington. Over the past 20 years I have watched these political systems evolve, alongside their native healthcare systems. The Blindness Foundation has helped cure cataract blindness in over 50,000 people, working hand in hand with local Doctors. This work itself evolved into oculofacial repairs for landmine victims in Cambodia, and of course cosmetic repairs to enable local Doctors to be self-sustaining in their very own practices. One common denominator across all these countries, also including the UK and the USA is that evinced by even that arch-conservative Churchill himself, who planned to buy votes in 1944, by underpaying Doctors’ labors. And so it goes on, as Thailand bought the popular vote by giving the peasants’ health care for one dollar a visit.

The counterbalance and hope that exudes from the pages of BIG Medicine Magazine™, for the endurance and prospering of independent private practice, encouraged me to sign up for my subscription. Tuning out and turning off the baleful news media sure helps, but BIG Medicine Magazine™ writers go one step further to achieve balance: their faith in the survival of our private practices, fulfilling our patients’ needs, validates our own belief in our chosen profession. Lifting us up out of the slough of despond, BIG Medicine Magazine’s messages help us recognize the wisdom of some of our fellow colleagues who have foresworn all insurances, with their coercive strictures mandating intrusive electronic records of our very own intellectual property, and all the potential loss of privacy that entails. These brave souls have reverted to the days of yore with cash and carry payments only. Yet, at the end of the day it is not just the size of your portfolio that makes life wonderful, but the opportunity, the privilege, on an hour-by-hour basis of doing one of the most fulfilling and satisfying lifestyles that life can offer: genuinely helping others in a way that no-one but a real Doctor can. Nothing else comes close. BIG Medicine Magazine™ is a pathfinder, lighting the way to enriching and achieving that goal. Thank you Angela!

MEDICINE MAGAZINE™ The Magazine for Big Thinkers

www.bigmedicinemagazine.com

T able of Contents

MEDICINE MAGAZINE™ The Magazine for Big Thinkers

Editor-In-Chief Angela O’Mara Copy Editor Brandon Murphy Barnes

6

Here’s To Your Health

7

Doctor Salaries

8 - 11

Virtual Consultations

12

Plastic Surgery Statistics

14 - 15

Thinking Rich

16

Grow Your Practice With Video

18

An Entrepreneur’s Guide

20 - 23

Social Media Madness

24

Facebook In 60 Minutes

26 - 32

Industry Transformers

33

Beauty & Grooming

34 - 35

Yoga At Your Desk

36

The Body Dysmorphic

37

Contributors

38

Yelp! Help!

Beauty & Grooming Editor Enna Ruiz Contributing Editor Michael O’Mara Graphic Design Joe Felipe Publisher Giles Raine Tel: 949 768-1051 www.bigmedicinemagazine.com info@bigmedicinemagazine.com

Advertising Sales 949 768-1051 All content in this magazine is protected and may not be copied, reprinted or republished without written permission of Publisher.

All rights reserved. BIG Medicine Magazine™ is a Registered Trademark.

social

madness!

Social Media Madness In all of our recent surveys, our doctor readers have requested help understanding Social Media and its importance to a medical practice. This issue covers many aspects including the good and the bad...

... begins on page 20

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Here’s To Your Health Did you know that the Centers for Disease Control stated that four out of five U.S. adults do not meet the basic guidelines for healthy physical activity? While this may not come as a surprise to any of us in the health care industry, let’s face it many of us have seen the movie “Supersize Me”, but what may come as a surprise to you is how this statistic can be of benefit to your practice.

Research by the Center for Medicare and Medicaid Services shows national health care expenditures are nearing $3 trillion dollars per year. And it seems that doctors, engineers and entrepreneurs in the health, telehealth and wearable device industries are embracing new technology that can literally put more new patients at your fingertips daily!

Everything from digital heart attack detector implants, on-line personal training, mobile app physical exam scanners, virtual doctor visits, wearable biosensor “tattoo” stickers that measure vital signs and secure medical social networks, to name a few, are available to you and your patients on your laptop and on your phone.

Just imagine the possibilities of practice growth available to you.

The sky’s the limit. Or, as singer/songwriter Paul Simon might say, “one man’s ceiling is another man’s floor.”

Get Smart!

According to a survey by American HER Partners of 696 physicians, 150 allied health professionals totaling approximately 1500 responses, doctors in a clinical work setting say they use their Smartphones to: 1. Send and receive emails (65 percent) 2. Use apps (51 percent) 3. Instant message (50 percent) 4. Researching information about medications (35 percent) 5. Communicating with other physicians (32 percent) However, when they switched “smartphones” to “tablets” well, judge the findings for yourself.

1. Send and receive e-mails (52.4 percent) 2. Access electronic health records (50.6 percent) 3. Access diagnostic information (41.7 percent) 4. Research information about medication (33.3 percent) 5. Staying up to date with medical journals and papers (29.8 percent) Embracing new technology is nothing new to a physician. Using that new technology in a meaningful and more useful way is. Using what’s convenient – the Smartphone, versus using what’s easier to read – the Tablet – especially for EHRs on a wider screen. Next time you’re asked what you would like to receive as a gift, hopefully this tidbit of information will help you Get Smart about your decision.

Who’s Really Making The Moola?

Forbes Magazine released the results of a survey they conducted on the Highest Paid Jobs for Doctors in the USA. Ever questioned your medical specialty of choice? Here’s a look at where the money is when it comes to doctor salaries last year.

1: Orthopedic Surgery - $563,074

6: Urology - $420,516

2: Invasive Cardiology - $532,000

7: Ophthalmology - $384,000

3: Gastroenterology - $521,216

8: General Surgery - $367,885

4: Dermatology - $471,555

9: Emergency Medicine - $306,682

5: Hematology/Oncology - $427,000

10: Obstetrics/Gynecology - $301,737

Did you notice not a squeak about the salaries of aesthetic surgeons which leaves us to summize that you are either a bunch of wonderfully philanthropic gift givers or you’re not fessing up. Either way, it will be interesting to compare these salaries in years to come as health care cuts and budgets continue to affect medicine in general.

HELP! I’m Going On Skype Meetings on Skype, Google Hangouts and other Internet video communication centers should be taken as seriously (or even more so) than regular in-person meetings. When you conduct a meeting where someone is looking directly AT YOU from their computer screen you might as well be under a microscope.

Not only can they see every flaw about you, but everything that surrounds you, on your desk and is over your shoulder. If you are considering becoming a member of any website that offers patient concierge services or are being interviewed on-line by a national news organization, Here are the TOP THINGS TO CONSIDER WITH ON-LINE INTERVIEWS 1. Dress professionally. Either in a business suit, lab coat or even scrubs 2. Make sure your name is obvious. Embroider it on your lab coat or scrubs, display it on your desk, or even along the sides of your glasses if you wear them 3. Hair and make-up is very important. Keep it clean, keep it fresh. Brush your teeth, making sure to not have any trapped food, especially in your front teeth 4. Position yourself so that you are seated at a good height in front of the camera and are not continually leaning forward and peering into the computer screen. Try and hold still and appear relaxed. The bandwidth of the Internet connection rarely moves as fast as you do and you will appear both jumpy, pixelated and delayed to the viewer 5. Set up a pre-call with yourself so that you can view what a patient or caller will see and hear when they connect with you 6. Make sure the space around you that is in the lens of the camera is tidy. Do not have any patient charts on your desk or any clutter surrounding you 7. Be seated in a position where nobody will be walking behind you at any time during the conversation. You should be the ONLY person on the camera, unless it has already been arranged for more than one person to be on the video call 8. Do not sit against a window with a view to the street or a view where there is any activity going on behind you 9. Be sensitive to how what you are wearing looks to the viewer. Male docs – keep the hairy chest covered. Female docs – no cleavage.

10. Most of all be prepared, be relaxed, be on time and be present

Developing Patient Connections In A Changing World Is There A Missing Link? Not Anymore

Dr. James Newman demonstrates AestheticLink at his office in Palo Alto, CA.

W

Wrong! It is true.

“AestheticLink has made a very positive impact on my practice,” stated Dr. Newman in a recent telephone interview. “As a doctor, I constantly strive to deliver the best care and quality of service to patients and take all measures of privacy very seriously. When patients first began sending me pre- and post-operative pictures on their smart phones I was worried. Now with AestheticLink I can simply accept those pictures within the security of AestheticLink, make an immediate evaluation and either act upon it, or store that photo or comment directly into a patient’s file, digital or paper, in my office. It’s really quite phenomenal.”

because the patient is too busy. In aesthetic surgery post-operative photo documentation is crucial to helping a doctor keep a careful eye on healing, as well as to document recovery. In other cases, a patient might have something that is troubling them and they either take up a lot of time with appointments that are unnecessary, or worse, patients self-diagnose things that they really should be showing to their surgeon and are quite possibly compromising their own health and healing. As we all know, time is of the essence in aesthetic surgery, following a patient’s healing process is critical to a good result.

According to James Newman, M.D., F.A.C.S., a board certified facial plastic surgeon and Founder of Premier Plastic Surgery which has three office locations in the San Francisco Bay Area, the addition of AestheticLink, a web based in-office communication tool to his practice has been very effective.

AestheticLink is changing how patients and aesthetic surgeons interact pre- and post-surgery.

It is also helping doctors create better, longer lasting relationships with their patients. Often times, doctors say that they cannot get patients to come back in for post-operative pictures

Dr. Sanjay Grover, a plastic surgeon in Newport Beach, California says, “AestheticLink provides for me an even better opportunity to maintain a professional means of communication with my patients long term in an efficient manner that works for my staff and I, as well as the patient.

hile the Internet has been around for a while, for many doctors it still feels like a new frontier when it comes to patient communications with HIPAA laws, personal privacy and the need for on-line reputation management. So when a new company comes along and says that it can increase your visibility on line, and offer a means of communication with existing and new patients that is not only compliant with HIPAA laws but has been endorsed by leading malpractice insurance carriers and is also able to increase staff efficiency and patient safety, well it seems like it’s too good to be true, right?

3 Steps To Providing Online Consultations Step 1

Step 2

Step 3

Set up your Aesthetic Link practice profile

Receive patient consultation requests

Review and provide online consultation

All forms of cosmetic and plastic surgery treatments have reached levels of global interest and many patients are willing to travel from other states for surgery, and even from other countries.

With the safe application of on-line consulting via AestheticLink doctors are now able to consult from the luxury of their office with a patient at a distance. This not only saves time but helps the doctor and patient to get acquainted before they ever meet in person.

Dr. Juris Bunkis who practices in both Southern and Northern California, says, “I practice in Orange County and the San Francisco Bay area so AestheticLink makes it easier for me to stay in touch with my patients, and consult with new ones. It’s a fabulous software especially when it comes to online consults.”

The brainchild of Victor Gane, PhD an ubersmart computer entrepreneur and genuinely nice guy, AestheticLink is following in the successful footsteps of DermLink, another online patient/physician communications platform developed by Mr. Gane who is Founder and CEO of the company. DermLink has become the leading online dermatology provider in the US with a network of doctors extending to over 25 states. Its technology has been used to detect multiple skin cancer patients and many patients use the DermLink iPhone app to get fast and convenient access to board-certified dermatologists. AestheticLink’s network of physicians is rapidly growing and it is becoming used as a search tool and communicator by patients seeking aesthetic surgeons and providers here in the USA. “Our early work with DermLink has paved the way for our release into the aesthetic marketplace,” said Victor Gane. “The need for privacy for both doctors and patients is being threatened daily.

Existing communication methods via email, SMS, Skype or the physicians’ websites cannot offer the kind of screening, privacy, and efficiency that is provided by AestheticLink.”

Further proving Gane’s point, AestheticLink is HIPAA compliant and has been approved and endorsed by The Doctor’s Company, a leading malpractice insurance company.

“I am happy to say that I can use AestheticLink to consult with patients worry free, the graphic capabilities are amazing – no fuzzy pictures at all, so I can more accurately assess a patient’s need as well as their level of healing,” continued Dr. Newman. “There is also no need for extra work by my staff. In fact it cuts down staff time and reduces stress from an overload of waiting room patients. Plus the follow up capabilities are great, it’s clear and it’s easy.”

Dr. Newman went on to further explain one of his favorite uses for AestheticLink is on postlaser skin resurfacing patients. He says it works especially well for procedures with a longer healing time, including laser resurfacing patients whose progress he likes to watch frequently as identification of potential problems can improve recovery time and patient satisfaction.

“In the past with laser resurfacing patients especially, I would never provide a consultation over the phone as I couldn’t see for myself what the patient was talking about,” said Dr. Newman.

“I also don’t like to short cut patients but with this system I can see every detail of healing every day and we can determine whether or not it’s necessary for the patient to come into the office for additional care.”

Dr. Newman states that his office policy is a 24 hour response to a patient request, and in the case of an emergency that they call 911.

AestheticLink does not replace that policy but says it is a great means of communication, allows him to be more portable and cutting edge, and it memorializes patient communication both digitally and with photos. Keeping it safe on all levels is the key to success.

“The need for privacy for both doctors and patients is being threatened daily. Existing communication methods via email, SMS, Skype or the physicians’ websites cannot offer the kind of screening, privacy, and efficiency that is provided by AestheticLink.”- Victor Gane.

Get started with AestheticLink

1.

Open a provider account at www.aestheticlink.com/md

2.

Receive automated notifications when patients submit online follow ups

3.

Log in to your account to provide online follow up consultations. Easily intergrate consultation notes with existing EMRs

What physicians are saying James Newman, MD, FACS Premier Plastic Surgery Palo Alto, CA Implementing AestheticLink has improved the high quality of care we strive to offer our patients. Direct, secure and meaningful clinical data from my patients with text, photos and video improves the efficiency of managing a complex aesthetic surgery practice.

Sanjay Grover, MD, FACS Newport Beach, CA Beverly Hills, CA AestheticLink provides plastic surgeons the opportunity to maintain a professional means of communication with patients long term in an efficient manner.

Juris Bunkis, MD, FACS Orange County Plastic Surgery Newport Beach, CA AestheticLink is a fabulous software that allows us to do online consults. This is particularly useful for our out-of-town patients. Our practice is in Orange County and in the San Francisco Bay area - with AestheticLink we can always stay in touch with our patients!

Face Time Do You Have Your Patient Library Card?

As online searches for physicians are increasing, so is the number of companies offering doctor to patient online communication opportunities. But there is now a new service for validation, ClinicalNotebook. This online media company, in partnership with organized medical communities, now provides a distinct patient engagement service to physicians nationwide. Utilizing advanced software features, invited doctors and selected specialists have been actively submitting video commentaries to this dedicated medical library which is now proving a new and effective platform to communicate with new and existing patients.

ClinicalNotebook is an online medical media platform dedicated to helping physicians and specialists better inform the public through quick video commentaries, cross-platform marketing and advanced patient engagement services. It is one of the largest on-line medical video libraries available, and recently opened its physician membership to doctors and practitioners in the aesthetic medical community as a way to further help aesthetic surgeons increase their online profile to new patients in this easy to use format.

The site features new patient engagement tools for physicians and specialist members to be used as an educational tool for widespread public relations and to give doctors the ability to control their online presence. This service ClinicalNotebook profile of Beverly Hills plastic surgeon Dr. Frederick H. Corbin. provides physicians and medical leaders additional resources to online presence and makes it easier for increase efficiency, retain patients patients and the general public at large to find and position their practices in an ever-changing an individual member’s office. As our doctors economic landscape. and specialists become more familiar with this Bill Bergstrom, Co-Founder of ClinicalNotebook, basic video technology that will only increase believes this service will help physicians their rate of new patient consults.” and health specialists become more Physician members and other specialists can competitive too. “We have seen that having a ClinicalNotebook Profile increases a physician’s be more accessible to their patients and

colleagues on a constant basis through video messages and links to concierge virtual visits. “CN Dashboards” are personalized for each physician creating an atmosphere for medical leaders to directly produce video content from their own office, home computers or smart phones and share the information across websites and social medial platforms.

The best part about ClinicalNotebook is that membership only costs $19 per month after approved participation by the CN Advisory Board. ClinicalNotebook provides a marketing instrument and an effective service to improve patient care.

“My patients as well as visitors to ClinicalNotebook have the opportunity to learn quickly and with more enjoyment because the doctors get quick commentaries and can authenticate the material through video. It’s a great retention tool as the next time my patients visit me, they are better informed,” said former Los Angeles County Medical Association President and Co-Founder Dr. Marcy Zwelling-Aamot.

In an interview with Bill Bergstrom of ClinicalNotebook, he gave BIG Medicine Magazine™ writers a birds-eye view as to how this system can benefit our readers.

Frequently Asked Questions Q. What Is ClinicalNotebook?

A. ClinicalNotebook.com is a non-profit online medical video library founded by Santa Monica, California based CN Health Solutions to provide a vetted on-line media platform for the public to view educational medical information. It was launched with the help of national physician organizations that expressed a need for their members to share quick video commentaries with their patients and colleagues on an easily manageable website that is safe and secure.

Q. How Do You Help Physicians and Medical Groups?

A. We keep our participating members affordably ahead of the curve by connecting them with their patient community with cutting-edge, easy to use media technology.

Whether it’s an individual physician or a physician participating within a larger group, our membership provides the online tools to easily record and share videos, connect with patients, and ultimately control their online presence while simultaneously performing a public service. The video content is displayed Video Library

Affiliate Libraries

within a Vetted Customized Media Library™ that is presented on ClinicalNotebook.com as well as the website of the participating member. This media library improves patient engagement and naturally encourages patient retention and supports reputation management. It also helps with new patient acquisition as the site is available globally. Also, through our video technology partners, physician members can participate in the CN Concierge Virtual Visit Service™ which provides a secure live appointment option for private consults, group meetings, and webinars if and when doctors may need them.

Q. Do Physicians Need ClinicalNotebook?

A. Over 80% of all health related research is conducted online and more importantly 3 out of 5 patients use Google or Bing searches to make decisions regarding their providers, our platform provides a valuable service for physicians looking to share information. With the massive changes in healthcare, on-line searching is estimated to increase even further.

Video is fast becoming the primary source of CN Physicians

CN Specialists

GET STARTED

education and authentication for medical providers and our format enables the member to share this content while never re-directing patients to another website or subjecting them to advertising. Visitors have responded well to this authenticated format as they spend nearly ten minutes per visit to our website.

Q. Can Anyone Be A Member?

A. Our membership is exclusive to individual physicians, medical practices, medical organizations, medical Groups, and medical centers. We have a non-medical healthcare section for appropriate candidates in health, nutrition and fitness. Our membership is based on those looking for an affordable and safe media platform to present reliable, ethical and responsible educational content to the general public at large.

And if you left your library card at home, don’t worry, the team at ClinicalNotebook will easily help your retrieve access to your switchboard.

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Welcome to ClinicalNotebook

Current medical specialty categories offered on ClinicalNotebook.com.

Plastic Surgery Statistics Report Quick Facts

Cosmetic Plastic Surgery Demographic Trends

Age 13-19 year olds 2012 vs. 2011

Gender Female 2012 vs. 2011

Make up the least number of cosmetic procedures – only 2% of the total. Some of the most common procedures for teens were: nose reshaping, male breast reduction, ear surgery, laser hair removal and laser skin resurfacing.

91% of all cosmetic procedures

236,000 total cosmetic procedures 76,000 surgical 160,000 minimally-invasive

Male 2012 vs. 2011 X 1% 4% X 4%

30-39 year olds 2012 vs. 2011 2.5 million total cosmetic procedures 350,000 surgical 2.2 million minimally-invasive

X 5% 2% X 6%

X 2% 1% X 4%

20-29 year olds 2012 vs. 2011 804,000 total cosmetic procedures 244,000 surgical 560,000 minimally-invasive

12.8 million total cosmetic procedures • 1.3 million surgical • 11.4 million minimally-invasive

9% of all cosmetic procedures 1.3 million total cosmetic procedures • 204,000 surgical • 1 million minimally-invasive

X 5% no change X 6%

X 2% 4% X 3%

40-54 year olds 2012 vs. 2011

Ethnic 2012 vs. 2011

Make up the majority of cosmetic procedures – 48% of the total.

6.8 million total cosmetic procedures X 6% 518,000 surgical 1% 6.3 million minimally-invasive X 7%

Caucasians (10.2 million) Hispanics (1.6 million) African Americans (1.2 million) Asian Americans (980,000)

X

X X

7% 1% 6% 21%

55 and over 2012 vs. 2011 3.6 million total cosmetic procedures 364,000 surgical 3.3 million minimally-invasive

X 6% X 1% X 7%

Did you know…

• Business from repeat patients increased 7% • $11 billion was spent on cosmetic procedures in the U.S., up 5.5% • Office-based cosmetic procedures are up 10% • Region with the most cosmetic procedures performed in the U.S. is Mountain/Pacific – 4.2 million procedures

Courtesy of American Society of Plastic Surgeons. ASPS procedural statistics represent procedures performed by ASPS Member Surgeons certified by The American Board of Plastic Surgery® as well as other physicians certified by American Board of Medical Specialties-recognized boards. ©ASPS, 2013

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Is Thinking RICH Thinking Right?

Author Steve Siebold spent nearly three decades interviewing people around the world to compare the thoughts, habits and philosophies of the middle class to the world class when it comes to wealth.

He wanted to find out what separates millionaires from everyone else. “It had little to do with money itself. It’s about their mentality,” he says. “These people gave me unprecedented access to their lifestyle and playgrounds; from Palm Beach to Aspen.” His results, he says, are that the middle class tells people to be happy with what they have and, on the whole, most people are steeped in fear when it comes to money. Here are some excerpts from his best-selling book “How Rich People Think” which can be found on Amazon.com. There are over 100 chapters to the book, but here are our Top 21 picks on what separates the Average Joe from the Gazillionaire.

Class think MONEY is the root of 1 Middle all evil. World Class believe POVERTY is the root of all evil.

“The average person has been brainwashed to believe rich people are lucky or dishonest,” Siebold writes. That’s why there’s a certain shame that comes along with “getting rich” in lowerincome communities. “The world class knows that while having money doesn’t guarantee happiness, it does make your life easier and more enjoyable.”

Class think selfishness is a vice.

2 Middle World Class think selfishness is a virtue.

“The rich go out there and try to make themselves happy. They don’t try to pretend to save the world. The problem is that middle class people see that as a negative––and it’s keeping them poor. If you’re not taking care of you, you’re not in a position to help anyone else. You can’t give what you don’t have.”

Class have a lottery mentality.

3 Middle World Class have an action mentality.

Class earn money doing things they 7 Middle don’t love. World Class follow their passion.

“While the masses are waiting to pick the right numbers and praying for prosperity, the great ones are solving problems. “The hero [middle class people] are waiting for God, government, their boss or their spouse. It’s the average person’s level of thinking that breeds this approach to life and living while the clock keeps ticking away.”

“To the average person, it looks like the rich are working all the time. But one of the smartest strategies of the world class is doing what they love and finding a way to get paid for it. On the other hand, middle class take jobs they don’t enjoy “because they need the money and they’ve been trained in school and conditioned by society to live in a linear thinking world that equates earning money with physical or mental effort.”

Class think the road to riches is 4 Middle paved with formal education. World Class believe in acquiring specific knowledge.

“Many world-class performers have little formal education, and have amassed their wealth through the acquisition and subsequent sale of specific knowledge. Meanwhile, the masses are convinced that master’s degrees and doctorates are the way to wealth, mostly because they are trapped in the linear line of thought that holds them back from higher levels of consciousness. The wealthy aren’t interested in the means, only the end.”

5

Middle Class long for the good old days.

World Class dream of the future.

“Self-made millionaires get rich because they’re willing to bet on themselves and project their dreams, goals and ideas into an unknown future.

People who believe their best days are behind them rarely get rich, and often struggle with unhappiness and depression.”

Class see money through the 6 Middle eyes of emotion. World Class think about money logically.

“An ordinarily smart, well-educated and otherwise successful person can be instantly transformed into a fear-based, scarcity driven thinker whose greatest financial aspiration is to retire comfortably. The world class sees money for what it is and what it’s not, through the eyes of logic. The great ones know money is a critical tool that presents options and opportunities.”

Class set low expectations so 8 Middle they’re never disappointed. World Class are up for the challenge.

“Psychologists and other mental health experts often advise people to set low expectations for their life to ensure they are not disappointed. No one would ever strike it rich and live their dreams without huge expectations.”

Class believe you have to DO 9 Middle something to get rich. World Class believe you have to BE something to get rich.

“That’s why people like Donald Trump go from millionaire to nine billion dollars in debt, and come back richer than ever. While the masses are fixated on the doing and the immediate results of their actions, the great ones are learning and growing from every experience, whether it’s a success or a failure, knowing their true reward is becoming a human success machine that eventually produces outstanding results.”

Class believe you need money 10 Middle to make money. World Class use other people’s money.

Linear thought might tell people to make money in order to earn more, but Siebold says the rich aren’t afraid to fund their future from other people’s pockets. “Rich people know not being solvent enough to personally afford something is not relevant. The real question is, ‘Is this worth buying, investing in, or pursuing?”

YOU Be

The Judge

Class believe the markets are 11 Middle driven by logic and strategy. World Class

Class would rather be 15 Middle entertained than educated.

know they’re driven by emotion and greed.

Investing successfully in the stock market isn’t just about a fancy math formula. “The rich know that the primary emotions that drive financial markets are fear and greed, and they factor this into all trades and trends they observe. This knowledge of human nature and its overlapping impact on trading give them strategic advantage in building greater wealth through leverage.”

World Class would rather be educated than entertained.

“While the rich don’t put much stock in furthering wealth through formal education, they appreciate the power of learning long after college is over. Walk into a wealthy person’s home and one of the first things you’ll see is an extensive library of books they’ve used to educate themselves on how to become more successful. The middle class reads novels, tabloids and entertainment magazines.”

Class live beyond their means.

12 Middle World Class live below theirs.

“Here’s how to live below your means and tap into the secret wealthy people have used for centuries: Get rich so you can afford to. The rich live below their means, not because they’re so savvy, but because they make so much money that they can afford to live like royalty while still having a king’s ransom socked away for the future.”

Class teach their children how to 13 Middle survive. World Class teach their kids to get rich.

“Rich parents teach their kids from an early age about the world of “haves” and “have-nots and even he admits many people have argued that he’s supporting the idea of elitism. He disagrees.

People say parents are teaching their kids to look down on the masses because they’re poor. This isn’t true. What they’re teaching their kids is how to see the world through the eyes of objective reality––the way society really is. If children understand wealth early on, they’ll be more likely to strive for it later in life.”

Class let money stress them out.

14 Middle World Class finds peace of mind in wealth.

“The reason wealthy people earn more wealth is that they’re not afraid to admit that money can solve most problems. The middle class sees money as a never-ending necessary evil that must be endured as part of life. The world class sees money as the great liberator, and with enough of it, they are able to purchase financial peace of mind.”

Class think rich people are snobs.

16 Middle World Class want to surround themselves with like-minded people.

“The negative money mentality poisoning the middle class is what keeps the rich hanging out with the rich, Rich people can’t afford the messages of doom and gloom.

This is often misinterpreted by the masses as snobbery. Labeling the world class as snobs is another way the middle class finds to feel better about themselves and their chosen path of mediocrity.”

Class focus on saving. World 17 Middle Class focus on earning.

Siebold theorizes that the wealthy focus on what they’ll gain by taking risks, rather than how to save what they have. “The masses are so focused on clipping coupons and living frugally they miss major opportunities,” he writes. Even in the midst of a cash flow crisis, the rich reject the nickle and dime thinking of the masses. They are the masters of focusing their mental energy where it belongs: on the big money.”

18

Middle Class play it safe with money.

World Class know when to take risks.

“Leverage is the watchword of the rich. Every investor loses money on occasion, but the world class knows no matter what happens, they will always be able to earn more.”

* Class love to be comfortable.

19 Middle World Class finds comfort in uncertainty.

“For the most part, it takes guts to take the risks necessary to make it as a millionaire––a challenge most middle class thinkers aren’t comfortable living with. Physical, psychological, and emotional comfort is the primary goal of the middle class mindset. World class thinkers learn early on that becoming a millionaire isn’t easy and the need for comfort can be devastating.

They learn to be comfortable while operating in a state of ongoing uncertainty.”

Class never make the connection 20 Middle between money and health. World Class know money can save your life.

“While the middle class squabbles over the virtues of Obamacare and their company’s health plan, the super wealthy are enrolled in a super elite “boutique medical care” association.

They pay a substantial yearly membership fee that guarantees them 24-hour access to a private physician who only serves a small group of members. Some wealthy neighborhoods have implemented this strategy and even require the physician to live in the neighborhood.”

Class believe they must choose 21 Middle between a great family and being rich.

World Class know you can have it all.

“The idea the wealth must come at the expense of family time is nothing but a “cop-out. The masses have been brainwashed to believe it’s an either/or equation.The rich know you can have anything you want if you approach the challenge with a mindset rooted in love and abundance.” * This book can be purchased at www.amazon.com

The Power Of Video Most doctors’ busy daily schedules make it nearly impossible to give each patient the time they want and deserve. Often those valuable minutes are spent explaining basic information about their condition. In the end, limited face time with a patient can lead to misunderstandings, mistakes, and even malpractice suits. When the crux of your business is the doctor-patient relationship, how do you make those critical short minutes with a patient truly valuable for everyone? BIG Medicine Magazine™ spoke with Jim Sanders of Reel Ideas about this issue.

Earning a patient’s trust is vital to their recovery and to your practice.

New trends in technology from iPhones to social media are helping some doctors establish and maintain patient engagement, allowing them the opportunity to respond quickly to patient concerns or bounce ideas off other doctors. This is very helpful to the patient, but not all physicians can be available 24 hours a day nor does each one want to be. More and more, one of the easiest and most effective solutions to providing accurate medical information to patients and gaining their trust is one we are all familiar with - the power of video.

Video’s inherent capability to grab a viewer’s attention and deliver memorable content can help establish a stronger doctorpatient relationship in a shorter amount of time. A high quality video educating patients on what to expect from their visit can quickly ease anxiety and worry. This frees you up to dig deeper into a patient’s case during their actual office visit.

Ahead of an appointment, your staff can direct patients to your website for in-depth video answers to some of their basic questions (FAQs or more) before they ever step foot in your office. Later, face to face, you can tackle the trickier questions that require more discussion. This method of sharing information could even replace the cumbersome practice of mailing pages of information to a patient before a procedure or test.

Encouraging your patients to watch videos on your website or on a YouTube channel shouldn’t be hard when you work with a professional to create them. Not only will your patients understand their medical concerns easier, you will be positioning your practice competitively and effectively for the future.

“Utilizing video on any website is now expected for information-hungry web users. For doctors, using professional quality video to introduce yourself and your staff and practice to potential patients in a welcoming, personal way is simply good business practice,” says Jim Sanders of Reel Ideas Production Company in Pasadena. “Beyond the basics, what’s exciting is using video in multiple new ways and across new media. There are so many options now. And since video engages the viewer visually and with sound, it’s a very effective way to impart lots of information and answer complex questions. That’s why video is such a great teaching and learning tool.”

Sanders also suggests: “When considering marketing with video, it is important to realize that with just one day’s worth of professional footage you can have enough material to brand and re-brand your practice on your website and across the internet by creating various podcasts, blogs, YouTube tutorials and more. You can then carry these videos over into social media such as LinkedIn, Facebook and Twitter. The possibilities are virtually endless.”

Instead of leaving your valued patients to wander Wikipedia and the internet in search of specific medical information from unreliable sources, you can provide it to them in caring, professionally produced videos that feature you, your staff and your own office or facility. Establishing a first level of trust is invaluable to the patient. Making their visits more effective and informative means you are giving them your best and building a better practice.

Questions for our Video Expert? You can contact Jim at jimtv@reelideas.com.

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Michele Garber, the NipTuck Coach, is a leading expert in the plastic surgery and beauty industry, and is nationally recognized as the “go to” person when considering plastic or cosmetic surgery.

Why Hire a Cosmetic Surgery Coach • Michele ONLY refers to the BEST qualified Board Certified Plastic Surgeons who hold the safest track records • She saves you Hundreds of Dollars in Time and Consultation fees • Michele works independently. She is not paid by doctors, medical organizations or manufacturers

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The Year of The Entrepreneur 2014 will be a year of many big ideas, because it will be the year of the entrepreneur. This year has seen the growing trend of entrepreneurship being embraced as a positive way to create the jobs of the present and the future. From being a dirty word in the past, now entrepreneurship is increasingly being celebrated and encouraged - as it should be.

There has been a surge in the excitement surrounding start-ups, from Silicon Valley to Silicon Roundabout and beyond. Many internet start-ups came to fruition, and big businesses went public, creating enormous wealth for their founders. That generation are now setting up new businesses, helping to create more jobs and stimulate more innovation. Jack Dorsey from Twitter didn’t rest on his laurels after launching Twitter, he is now taking Square from strength to strength and I expect to see more entrepreneurial ideas from Jack and his peers in the coming year.

I believe 2014 will be the year of the entrepreneur more than just in California. When visiting Africa, Australia, Europe, South America and the US this year, there was a real appetite for entrepreneurship wherever we went. We launched Virgin StartUp in the UK, and are receiving lots of applications from new businesses hungry to succeed. In South Africa and the Caribbean the Branson Centres of Entrepreneurship are overflowing with talented individuals eager to unleash their ideas onto the world.

With the right support (financial and otherwise) they can and will.

The entrepreneurs who will succeed in 2014 will need to focus upon having a purpose beyond profit for their business. A great example of this in the British Virgin Islands is an entrepreneur named Gumption, who we gave a

loan to start a glass-bottom boat company. He has paid back his entrepreneurial loan in full, and is now focusing upon his company becoming a force for good, helping protect turtles as well as entertain tourists.

Technology is helping every business, large and small to move forwards, which will only increase in the coming year. Now, entrepreneurs can build companies at a fraction of the cost in the past. All of the little things that used to add up to big headaches for new businesses, from accounting to website development, are now available to small businesses, giving them the same capabilities as large enterprises at a cost they can afford. Because of this, new entrepreneurs have more time to think about the bigger picture and work out how to grow their

business, rather than fretting about every detail.

Don’t get me wrong, there are still a thousand and one things for every entrepreneur to focus upon, and you need a great team of people around you and good delegation skills to utilise them. But now new businesses have more of a fighting chance.

So, what is your big idea for 2014? Why not decide to set up the business you have always wanted? Screw it, just do it!

This article is part of a series in which LinkedIn Influencers picked one big idea that will shape 2014. Other contributors were: Jim Kim President at The World Bank Trish Regan Anchor and Editor-at-Large at Bloomberg Television Tom Gardner, Co-Founder at The Motley Fool Michael Andrew Global Chairman and CEO at KPMG Steve Tappin CEO Xinfu, Host of BBC CEO Guru & Founder, WorldOfCEOs.com Bill McComb Chief Executive Officer at Fifth & Pacific Companies, Inc. Walt Bettinger President & CEO at Charles Schwab to name a few.

To read more go to www.linkedin.com.

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Social Media Madness!

Simplifying Social Media

by Angela O’Mara

Social Networking has become a powerful method of expanding your communication with new and future patients and customers. While other social networking sites have come and gone, Facebook appears to have held ground and expanded beyond anybody’s imagination. Social Networking is a great way to build business connections, promote products and events and find new patients. Facebook facilitates the possibility of making an association with prospective and future patients. Once a network of “friends” is developed, users can communicate using private messages just like email or by ‘writing on their wall’, which is a message that can be seen by everyone else who is connected to the user. Facebook brings together millions of people globally and has also become a platform for online marketing. If you wish to generate new leads you cannot afford to ignore Facebook in your social media strategy or as a part of your overall PR and Marketing plan. The latest statistics have revealed that the average Facebook user spends about an hour each day on Facebook and has 130 friends. More than half of its 1 billion users log onto Facebook on a daily basis.

social

madness!

Simplifying Social Media

by Angela O’Mara

HOW TO CREATE A WINNING PROFILE

BUILDING YOUR NETWORK BY ADDING FRIENDS

HOW TO BUILD PROFITABLE RELATIONSHIPS

The Home page of your website is your store front “window to the world”. Your Facebook page is an opportunity for the viewer to have a personal appointment with you. Having an interesting, attractive and effective profile is extremely important if you are going to use Facebook as a marketing tool, which of course you are. A profile is information that you write in the “About Me” box to introduce yourself to your audience. While this profile should not be too lengthy, it should be descriptive, accurate and engaging.

Whether you want to connect with you referral sources, new patients, existing patients, business associates, old college friends or complete strangers who might become patients, you need to first add them to your friends list on Facebook

What is the point in having hundreds of friends on Facebook if you are not able to convert them into paying customers? In social media as in other Internet media, customers, or patients, are acquired by building relationships with people in your target audience. In order to be a successful online marketer, you must get inside the head of your prospects and understand their needs, motivations and behavior.

Here are several other ways you can connect to people on Facebook to grow your network:

Your profile will be read by potential patients, existing patients, your target audience, other business associates, as well as your friends, colleagues and competitors.

Your profile should create a positive first impression of who you are and what you do, and especially how you can be of benefit to others.

All forms of Social Media, including Facebook, are opportunities for branding.

Your Facebook page should reflect the same branding as your website, collateral materials, etc. Using your name and/ or the name of your practice is important. Do not use a nick name or a pseudonym because you think you should be anonymous. Anonymity is not going to get you new patients. Use your practice name or actual name for your Facebook profile.

Internet Entrepreneurs will attest that trust and credibility rely on personal brands based on the names of the individual, especially on line. There are two types of pages on Facebook, a personal page and a business page.

Personal pages are easier to grow and it is easier to connect with old friends and new friends on a personal page.

A business page is harder to grow because you have to get people to “LIKE” your page. This is a longer term process and may take a small amount of internet marketing or advertising to ultimately grow this page. However, you should consider having both a personal and a business page.

a. Search for people from other social networking sites you are a member of and invite them to be your friend on Facebook b. If you have an email list, you can design a personalized newsletter with an invitation to become your friend or to LIKE you on Facebook c. Search for groups on Facebook related to the niche you are in, become a member and send friend requests to all the group’s members. You could also search for general Internet groups and send friend requests to their members d. You can also use your mobile telephone.

Facebook can find a friend through their phone numbers e. Send a friend request to the friends of your friends. Since you have the friend in common, you have a better chance of getting them to accept your friend request f. Add a Facebook icon on your website or blog which invites visitors to request you as a friend

Remember that people DO NOT browse the Internet to search for products and then buy them. Instead people browse the Internet to search for information that would help to solve their problems. If you have a product or a service that solves a problem, you must supply useful information online which will attract people to you and not just advertise your product. The core principle of Attraction Marketing is not to sell but to attract your prospects.

This is done primarily by positioning yourself as an expert, an authority or a specialist in your niche.

If you understand the above point, no one can stop you from becoming a star Internet marketer.

The next question is how to position YOU as an expert? You become an expert in the eyes of others by sharing useful information with them. For instance, if you share factual information about your industry or help someone to understand the concepts of your subject or share the latest news and updates in your niche, you will soon be able to develop a perception of being an expert in your field. You will start attracting people to your site or blog on a regular basis. Many of them may choose to subscribe to your mailing list, if you have one. All these people are potential customers. If, and when, you offer a product, you can be sure to get a good response from them because you have already developed trust and credibility.

While the position of expertise is an excellent way to attract customers to your website or blog, the same strategy cannot be solely applied directly on Facebook.

As mentioned earlier, your website is your “window to the world”. Your Facebook page is where you begin to actually have a conversation with the person who has stepped into your practice.

Generally speaking, Facebook is a platform for building friendships and not for soliciting business. However, most people are using Facebook for two reasons – to be social and to grow their business. With Facebook the goal is to get as many people looking at your page and using it to update them on the services that you offer. You don’t have to over sell or promote your business directly, rather you will carefully craft your messages so that your viewer has a very clear idea of what it is you offer. The idea being that if you develop good friendships with people on Facebook, they will look at your profile and then go to your website, and then either ask questions or schedule a consultation to see you.

Making friends on Facebook is just the same as making friends in the real world. I compare Facebook to a networking event or a cocktail party. At any of these events or parties you only have a limited amount of time to: a. b. c. d.

Make a first impression Strike up a conversation Explain what it is you do Understand how you can benefit the person you just met e. Determine if you can do business together f. Exchange contact information g. Cultivate a lasting relationship Here are several ways you can expand and keep your new friends on Facebook: a. b. c. d. e.

Send a personalized friend request Write a brief message on their wall Create interactions Develop the relationship Comment on their wall post if you find it interesting f. Write something that will get you noticed g. If you comment frequently on your page, other people will definitely notice you h. Tag people you know in notes, videos and pictures

HOW TO MARKET USING FACEBOOK Advertising While Facebook is tremendously powerful for building relationships, it also offers very effective applications for advertising - over 1 billion users is a market place that you cannot ignore. One of the most valuable things about Facebook is that

SOCIAL MADNESS

COMMENT, SHARE, LIKE you can target your advertising and marketing to a specific group of people based on age, location and other demographic criteria that is important to you. Advertisers can also track the performance of their ads in real time and make relevant optimization. You can also choose how you pay for your ad. You can use a pay per click (CPC) method or pay per 1000 impressions (CPM). I would recommend starting with a CPC method. That way you are only paying if someone actually shows interest and clicks on your ad.

Facebook Groups Groups on Facebook have a great potential.

They help you to find and attract fans for your pages or simply to find friends. Search for groups related to your niche or area of expertise and become a member, then contribute

USEFUL TIPS: Plan your Facebook and Social Media Campaign and Marketing Strategy before you begin any activities.

Give Facebook and Social Media Marketing minimum of four months to gauge whether or not you are seeing a noticeable number of friends/fans for your Page.

Remember that it takes time to position yourself as an expert in your niche.

Take things step by step and add/set up the appropriate tabs (Events, Discussions, Videos, Groups, etc.) over a course of time so as to keep your content fresh.

quality information to the group and develop relationships with other members. It is especially useful if you can develop a relationship with the group administrator as they are in control of the whole group. Send a personal note to the administrator and ask if there are any areas of specific content they would like you to contribute. Once you develop a rapport with this person, you can also ask if they would like to post a link about their group to your Page, and vice versa; ask if you can post your page link on their group wall. Once you develop a relationship here, you can also ask if you can post your future events to their group.

Starting Your Own Facebook Group You could even start your own Facebook group.

It is a simple process. Click on groups in the navigation panel. On the next page, click on Create a New Group. Fill in the details and voila, you have created your own group.

The difficult part is to get members for your group. If you choose to create a group with a well defined focus you will increase your chances of getting people interested in joining.

It is best to invite your friends and fans or people from your email list to join your group. One of the most important things to remember with any form of Social Media Marketing is that you must be active. Blogs or Facebook pages that are not updated on a regular basis make it look as though you are not in the game. The same holds true of your group page. Keep it active.

Publish information which is useful to the group members on a regular basis. Get the group members to participate by raising issues or asking questions.

One of the downsides of Facebook or other Social Media Networks is that you and your staff can easily become distracted. While you do have to conduct a fair amount of time on adding friends and fans, and browsing other people’s walls to learn more about them, you must limit your activity. Otherwise, you will find that you have just lost two or three hours of time.

However, if you are not disciplined in your Social Media Marketing efforts you will not see any results. Being disciplined means having a long term view of what Facebook can do for your practice, and not expecting quick results.

NOTE: With Facebook, YOU MUST ADHERE TO THE SAME PRINCIPALS AND PATIENT CONFIDENTIALITY RULES THAT YOU DO IN YOUR DAY TO DAY MEDICAL PRACTICE.

Growing Your Facebook Presence

In Just 60 Minutes A Day!

Plan your Facebook and Social Media Campaign and Marketing Strategy before you begin any activities. Give Facebook and Social Media Marketing a minimum of four months to gauge whether or not you are seeing a noticeable number of friends/fans for your page. Remember that it takes time to position yourself as an expert in your niche. Take things step by step and add/set up the appropriate tabs (Events, Discussions, Videos, Groups, etc.)

Over a course of time so as to keep your content fresh.

FACEBOOK IN 60 MINUTES A DAY MARKETING STRATGEY 0 – 2 Minutes: Login to Facebook and briefly look through the recent wall posts and get a feel for what people are discussing and sharing.

2 – 7 Minutes: Manage Friend Requests. Check whether you have any friend requests. Accept those requests that you want to, and write a brief personal note to each one Remember that developing personal relationships is the way to succeed on social media.

7 – 14 Minutes: Write personal comments on walls of 10 to 15 people in your network. Click the LIKE button or comment on posts that you are drawn to, as this form of relationship building is a continuous and crucial activity.

14 - 18 Minutes: Update your Status Update your status on the wall. The more visible you are, the more increase you will see in terms of practice, patients and branding.

Write something interesting, inspirational or informative on your wall.

18 – 24 Minutes: Add more Friends and Fans to your Network. Increasing your network is as important as building relationships. Send out 50 new friend requests.

Try to have a simple algorithm for sending out friend requests. You could send 20 requests to friends of friends, 10 requests to members of the groups you have joined and 20 requests using the friend adder software.

- Growing Your Facebook Presence In Just 60 Minutes A Day!

Add a video which you have previously uploaded to your Page.

Upload an article in the Facebook Notes. Remember to put in your signature (website or blog link) at the end of the note.

Update photos from an event.

Browse through the threads on your Discussion Tab and answer questions and share your opinions and expert commentary.

Monitor the performance of your Social Advertisements (if you have placed one) and optimize them as necessary.

38 – 54 Minutes: Develop Relationships with Groups and Joint Ventures such as: Contribute content on the groups you are a member of.

Communicate with your joint venture partners and group administrators.

Share a link or a video you want others to see.

Simplifying Social Media

24 – 38 Minutes: Contribute Valuable Content such as:

Search for new groups or joint venture partners to associate with.

54 – 60 Minutes: Check On What Your Competitors are Doing: Do some research on what your competitors are up to.

Browse through the Pages and review content on their wall to see what they are talking about and what interaction they are getting.

As you can see, by simply spending 60 minutes each day on Facebook, you can easily build a page and attract new friends and fans. Like other forms of marketing, Facebook and Social Media requires diligence, but once you start the process you will begin to build a momentum and the results might just surprise you!

Clever Thoughts!

Angela O’Mara, President The Professional Image, Inc.

Available at www.theprofessionalimage.com

Involve as many people as you can in your social media outreach!

If you have the opportunity to tag or mention someone in your status update, DO IT! The tagging feature allows your photo or post to be featured on other profiles making it accessible to other people who have not LIKED your page.

THE CALIFORNIA SOCIETY OF

FACIAL PLASTIC SURGERY

10th Annual Lake Tahoe Meeting

March 6-9, 2014 Please join us at the beautiful Ritz Carlton Hotel in northern Lake Tahoe, California for an educational update on the latest advances in Facial Plastic and Aesthetic Surgery.

A multidisciplinary faculty of Plastic Surgeons, Facial Plastic Surgeons and Dermatologists come together once again to bring you the most advanced and interesting winter meeting.

• Watch live demonstrations of Ulthera, Zeltique, Liposonix • See new products and debates on energy based applications in Aesthetic Medicine • Take a live injection workshop on all fillers including Voluma • Great educational programs for your nurses, patient coordinators and assistants • Interactive panel discussions on topics including Fat Transfer, Fillers,

Neuromodulators, Platelet Rich Plasma, Stem Cells, Energy Based Systems for Rejuvenation and Lipolysis, Rhinoplasty, Facelifting and Oculoplastic Surgery • Live patient injection workshop with advanced applications and techniques on Saturday March 8th, 2014

19 Hours of CME Credits Co-Chairs: - James Newman, MD and Corey Maas, MD

Register and make hotel accommodations at The Ritz Carlton Northstar. Ask for the California Facial Plastic Surgery special rates. Please make reservations early as the hotel sells out consistently by mid February. The Ritz Carlton offers Ski In and Out, Ice Skating, Dog Sledding, Full Spa, Free Gondola To Northstar Village.

Register Now www.CSFPS.org

Special Thanks To Our Corporate Sponsors Allergan, Medicis Zeltique Merz Lumenis Cynosure Ulthera Implantech Hansen Medical Serene Medical My Body Lasering Usa Syneron The Professional Image (TPI) Cooperative American Physicians (Cap).

To Register Go To www.CSFPS.org

Industry Transformer

Is It Nature or Nurture?

What Makes A Great Surgeon?

by Enna Ruiz

An Interview With

H. George Brennan, M.D. Newport Beach, CA

H. George Brennan, M.D. in his office in Newport Beach, CA

Surrounded by sculptures and paintings from a bygone era of classical luxury it was easy to relax in the big comfy leather couch as I listened to “I Could Have Danced All Night” a song from the famous movie and Broadway musical “My Fair Lady” which was delicately playing in the background. The song itself was apt for the occasion. I was waiting on an appointment with world-renowned cosmetic surgeon and former President of the American Academy of Facial Plastic and Reconstructive Surgery, H. George Brennan, M.D and the American Association of Cosmetic Surgery.

President of AAFPRS, and another 80 to become President of ASPS. It takes a special person to not only strive to the height of becoming President of an organization they feel passionate about, but also one that holds a great deal of personal accomplishment, practice success and the belief that they can make a difference. A belief that is shared by other members of those societies otherwise they would not have been voted President.

So the question remains. Is it nature or nurture that makes a great surgeon? Or perhaps it’s a combination of both.

During his career Dr. Brennan has been known to turn ordinary faces into works of art with subtle changes to the nose, the eyes, the chin or whatever minor flaw was holding that face back from achieving full natural looking beauty. While Professor Henry Higgins wanted to change the accent and sophistication of poor young flower girl Eliza Doolitle, thereby making her more presentable into posh London society, Dr. Brennan uses his surgical talent to help patients feel better about themselves so that they can live more comfortably in a world of their choice.

Dr. Brennan decided to become a plastic surgeon when he was in medical school rotation. His older brother Lou was a plastic surgery senior resident while George was doing his rotations. Lou showed him before pictures of a young girl who had a rhinoplasty procedure that he performed. She was a cute girl other than the bump on her nose. And here was a doctor, a man, who was able to improve what nature had bestowed upon her. George wondered if maybe he was as gifted as Lou was. It was obvious from what he had witnessed during rotations that Lou had performed something on that girl that many of the other senior residents could not.

In the USA there are approximately 2800 board certified facial plastic surgeons, and around 5000 board certified plastic surgeons.

The AAFPRS was founded in 1964. The ASPS was founded approximately in the 1940’s.

Statistically speaking that means that only 50 doctors have had the privilege of becoming

Then as they went into the exam room, as they were taking bandages off the patient, George could not help but be amazed at the transformation that cosmetic surgery had made to the girl.

“At that moment, it became perfectly obvious to me what surgical path I should take,” said H. George Brennan, M.D. “I thought, ‘who wouldn’t rather practice aesthetic/cosmetic surgery that overall made people happy rather than medicine that would most likely deliver bad news… like neurosurgery.”

To be clear, Dr. George Brennan knew immediately it was cosmetic and not reconstructive surgery where he would excel.

“Reconstructive will never be perfect as it is an attempt at correcting a deformity,” continued Dr. Brennan. “Whereas cosmetic surgery is working on something that is already fine but can be improved and made better, even perfect, with surgery.”

After medical school and residency, like many other young surgeons that had survived the cold weather states, Dr. Brennan packed his bags and headed west.

“It was pretty easy to settle in Newport Beach,“ said Dr. Brennan. “I followed Nat King Cole’s directions and took “Route 66” and ended up originally in Santa Monica.”

Both Louis Brennan, M.D. and H. George Brennan, M.D. continued to practice in California ever since that fateful day when George followed his brother. To this day, they agree that some things just can’t be taught in medical school. Performing any form of cosmetic/aesthetic surgery has to first come

Industry Transformer

“Most of all to be successful as a cosmetic surgeon a doctor must have an artistic eye, a good sense of judgment and impeccable training. This field is not a paint-by-numbers job.”

- H. George Brennan, M.D., F.A.C.S.

from a natural born talent that is combined with the highest level of surgical academic training available.

2.

Sharing his knowledge. He believes that the cardinal rule of medicine is to share information that will benefit a patient

Over the past 30 years, Dr. Brennan has seen, and contributed to, many surgical changes and the development of many techniques.

3.

Artistry that goes hand-in- hand with technical skills that are improved with continuous education and personal self-growth.

“When I first started out the only type of implants that were available were for the chin,” laughed Dr. Brennan. “Now we have implants for the cheeks, nose, forehead, breast, arms, legs and even the buttocks.”

Dr. Brennan himself developed the anatomic cheek implant and right now he is using an intra-nasal suction device for rhinoplasty that leaves a patient with zero pain, and packing is not necessary after nose surgery. With this device patients can breathe through their own nose during recovery. I watched a video showing an actual patient the day after surgery stating that they had minimal pain and hardly needed even over-the-counter pain relief medication. It’s a great boon for the patient as it means they can have optimal healing and still be active, eat a regular diet and sleep which are all necessary to a great recovery post nose surgery.

He also elaborated that today’s surgeons are so lucky that they can learn from the past.

“Just look at liposuction now. Besides growing to be a procedure of choice worldwide, the technology we have now to perform this technique could not have been dreamed of 30 years ago,” he exclaimed.

“Young doctors need to understand all the benefits they are receiving from knowledge of people who have created these new

I asked Dr. Brennan what were three things that contributed to his tenure as a cosmetic surgeon: 1.

Confidence and self- esteem. This comes with each successful surgery and the knowledge that he makes people happy from his work

Aesthetic Facial Surgery authored by Dr. Brennan

techniques and tools for aesthetic surgery. It is a tremendous advantage to them.”

For Dr. Brennan his passion for cosmetic surgery comes from it being an innate knowledge to him. It is the epitome of art and science. He believes that surgeons are now better equipped on non-surgical things such as Practice Management, an area still not taught in medical school, but now most society meetings hold lectures on specific topics of practice management and marketing. In the past marketing was considered a stigma and unethical.

With the sun setting on the Pacific Ocean and the last few notes of “My Fair Lady” playing overhead, I asked Dr. Brennan what he recommends a doctor do to insure his future success.

1.

Training programs. Get into the best training program possible

2.

Don’t stop at one fellowship. In cosmetic surgery it is a must to do as many as possible.

3.

Always stay on the cutting edge.

While you must have what is new, you have to be smart. Don’t fall for the hocus pocus that the medical device companies want to sell to you.

“Most of all to be successful as a cosmetic surgeon a doctor must have an artistic eye, a good sense of judgment and impeccable training,” he continued.

Industry Transformer

A Lifetime of Smiles Laurence Rifkin, DDS Beverly Hills, CA For more than three decades, Dr. Laurence Rifkin has been bringing smiles to the people of Beverly Hills and beyond. What is the secret to this man’s never ending optimism and vibrancy? Is it expertise?

Passion? A love of art? Or maybe it’s all three.

by Angela O’Mara Dr. Laurence Rifkin in his office in Beverly Hills, CA

When Laurence Rifkin, DDS says “we strive to deliver perfection in every smile and pleasure in every visit”, he’s not kidding. Dr. Laurence Rifkin has been practicing dentistry in Beverly Hills for close to four decades and continues to rank, if not lead, as one of the top cosmetic dentists in the world.

From the moment you walk into his posh office on tony Bedford Drive in Beverly Hills where you are always greeted by a bouquet of the most exquisite and exotic flowers which stand poised in front of a sweeping panoramic view of Beverly Hills, Sunset Boulevard and the gorgeous Santa Monica mountain range, you know you have found a small slice of Nirvana. If you are lucky, Dr. Rifkn will give you a tour of Suite 1200, his private celebrity patient space on the other side of the building with views as opposite and diverse – vistas of the Hollywood sign and all the way to the sky scraper towers of Downtown Los Angeles – as his treatment center.

Known through Hollywood circles and the Jet Set Who’s Who as one of dentistry’s most creative and private individuals, Dr. Rifkin is often seen on the sets of Hollywood movies creating special effects in movies such as The Hangover, and you might bump into an A List actor, European Princess or a genuine Rock Star on any given day at his office.

But it’s not his social grace or easy charm that makes him so successful, although granted it helps a lot! It is his constant pursuit of perfection

in all aspects of his life and his work that makes him the crème de la crème. As a dental industry leader and advocate of true facial harmony, Laurence Rifkin, DDS has paved the way for aesthetic surgeons and aesthetic dentists to bring together the perfect balance of form and function ever before dreamed possible in the human face.

“When I first reached out to the cosmetic surgery world I was welcomed because of my approach to patient care and cosmetic dentistry but was not immediately included as an integral part of a patient’s aesthetic health and well-being,” recalls Dr. Rifkin. “It took me lecturing on “form and function” at many aesthetic congresses worldwide, and arranging my own educational courses to help other doctors understand the importance of dentistry when it comes to facial support during facelifts and other forms of facial aesthetic surgery.”

As such, many patients now visit Dr. Rifkin before visiting a plastic surgeon to make sure that their dental work is complete and ready to lay the framework for a facelift.

69,121 and counting… that’s the actual number of individual patients who have received care from Dr. Rifkin and, given his lust for life and natural high energy that number will continue to grow. Although trained as a dentist Dr. Rifkin’s complete understanding of the function of the head and neck goes far

beyond teeth and gums. He fully “gets” how the teeth and jaw support the soft tissue of the face, as well as how misaligned teeth can cause stress and tension on the face and neck that not only contribute to problems such as TMJ or TMD, but can also be responsible for premature aging of the face. The ability to achieve a natural-looking smile is considered the holy grail of aesthetic dentistry because it takes knowledge of the underlying skeletal form, the natural draping of soft tissue and the proportions of other facial features such as the nose, the eyes, the lips and the ears.

It also takes a complete understanding of appearance and aesthetics to achieve superior results.

Dr. Rifkin has surrounded himself with a team of skilled artists, professionals and the latest in technology and dental innovation to deftly capture the elusive beauty of nature which can be seen in the smile of every one of his patients.

At the pinnacle of his career Dr. Rifkin is excited to share with others the secret to success.

“Many people ask what the secret to my success is. To me, it’s no secret, I simply love what I do,” said Dr. Rifkin. “Every day I wake up excited to go to the office and see my patients. Every sunrise is a new opportunity for me to better someone’s life whether it’s by improving their dental health, or by improving their self-esteem.”

Success to Dr. Rifkin isn’t just about the end result for the patient, the entire journey is just as important and in his quest for perfection, he attends to every detail personally.

“I start by involving my patients. I take the time to hear them. My initial consultation consists of asking questions, gathering details, taking lots of photographs and having conversations about what their needs are,” continued Dr. Rifkin. “I then create a computer presentation that identifies their conditions, confirms their personal goals and outlines my recommendations. There is a personalized design DNA in every patient’s smile and I use that to create the ultimate blueprint for each individual smile.”

Doing a personal Power Point presentation for each and every patient can take a good deal of time, but it can also pay dividends in patient satisfaction. As we always say, an educated patient is a happy patient. You can see the same detail in other aspects of his practice. Each treatment room has a large HD screen TV and it’s not for watching cartoons. It’s so patients can see in detail any problems associated with their teeth.

The TV’s are hooked up to the state-of-theart microscope Dr. Rifkin employs during his most intricate and precise procedures. Not only can he see a problem area through

the microscope, but he can magnify it to such a degree that there is little or no room for error. He can better diagnose decay, cracks and other pathologies that may escape detection without this form of magnification, and it also allows him to be gentle to the teeth and gum tissues, as well as providing an accurate restoration.

In addition, Dr. Rifkin has his own lab and technicians that make dental restorations such as crowns and veneers on site, which is just another way to ensure that the patient receives the ultimate in care and service. Dr. Rifkin knows that patients come to see him because they consider him a master architect who is executing their vision. Surrounding himself with an expert team makes him unrivaled.

Aside from being a master dentist, Dr. Rifkin is also an author, lecturer, educator and a professional sculptor with many of his pieces in private collections world-wide.

This accomplished man has distinguished himself in one of the most competitive markets in the world – Beverly Hills, and all without the aid of advertising. By integrating his artistic background to create beautiful, natural smiles and his humble and modest personal nature of good will and good care, Dr. Rifkin brings to his patients and his practice an all-encompassing philosophy of absolute and on-going perfection.

A Warm Welcome Reception Area

A Room With A View Treatment Room

An Eye For Detail Microscopic Dentistry

Art Imitates Life Laurence Rifkin, DDS Sculpting

Dr. Rifkin showing a patient a brand new smile.

69,121 and counting… that’s the actual number of individual patients who have received care from Dr. Rifkin.

It’s the attention to detail that keeps his patients coming back.

A Finished Masterpiece “Serenity”

Industry Transformer

What’s The Next BIG Thing In Cosmetic Treatments That’s Affordable?

Let “The Doctors” TV Show Tell Us! As science merges with aesthetic applications the battle to stay beautiful and youthful continues to advance. In today’s highly competitive marketplace appearances on TV shows such as The Doctors is always good for both the patient and the doctor as it helps raise awareness of new available treatments. Dr. Sandra Lee, a board certified dermatologist who practices in Upland, CA was recently interviewed on The Doctors where she discussed the new Eclipse MicroPen™ which is rapidly becoming one of the hottest aesthetic procedures to sweep the U.S.

The Eclipse MicroPen™ is a new micro-needling device which is utilized to apply a clinical concept known as Collagen Induction Therapy (CIT). Dr. Lee demonstrated how the pen itself has 12 tiny needles that are applied across the surface of the skin to create thousands of micro channels or micro wounds to stimulate collagen and elastin formation.

It’s no big secret either that this technique is a new “must have” among Hollywood celebrities and no surprise that the Eclipse MicroPen itself has been sold to thousands of medical practices nationwide since its recent introduction to the US aesthetic market.

“Finding ways to maintain or recapture lost collagen is considered part of the front line in the battle against aging,” said Tom O’Brien, Founder and CEO of Eclipse Aesthetics, LLC. “The Eclipse MicroPen delivers a means to improve the skin’s appearance in a more effective way that creates an improved youthful appearance.”

Although the idea of micro needling of the skin sounds somewhat unnerving, it is actually quite tolerable. So what exactly is Micro-Needling?

Automated Micro-Needling (also known as Collagen Induction Therapy or CIT) is a new treatment that reduces fine lines, acne scars and improves the skin’s overall appearance. During this procedure, tiny needles are used to create controlled micro-injuries to the skin in order to produce collagen and elastin. The skin’s repair process results in a thicker dermis with the appearance

of softer wrinkles. The MicroPen also creates superficial micro-channels which allow topical gels, creams and serums to be absorbed more effectively into the skin.

This treatment can also create a positive effect on hyper-pigmentation as well as on hypopigmentation, acne scars, traumatic scars and stretch marks and other parts of the body including the face, neck, décolleté, arms, hands, legs, abdomen and back.

It works by attaching a sterile needle-tip containing 12 tiny micro-needles to the Eclipse Micropen. A thin layer of topical gel is applied to the skin and the technician selects the appropriate treatment depth based on the individual needs of the patient. Next, in a single motion, the pen is gently pressed against the skin while simultaneously gliding in one direction until the entire treatment area has been covered. While it feels similar to light sandpaper being gently moved across the skin,

some areas are more sensitive than others but by applying a hydrating gel the process can be made more comfortable. The procedure takes approximately 15 – 30 minutes and the patient will notice a bright redness to the skin which may last for 2 – 4 days, although some patients heal within 24 hours. Visible changes to the skin develop over the course of several days and weeks and results continue to improve up to 6 months after treatment as collagen production continues.

“Showcasing this treatment on The Doctors TV Show was a great way to educate the public,” said Tom O’Brien “As this is a treatment that is suitable for almost all patients, everyone can benefit in some way from the MicroPen.” The Eclipse MicroPen is now selling the device worldwide. For more information about the Eclipse MicroPen go to: www.eclipseaesthetics or www.eclipsemicropen.com.

Editor’s Note: TV shows such as The Doctors, Dr. Oz and even The View, The Talk and many others offer viewers the chance to see firsthand what new health and beauty treatments are available at the doctor’s office. At BIG Medicine Magazine we are firm believers in patient education and are always excited to see national news shows demonstrate new techniques and technology.

The Eclipse Micropen was demonstrated on The Doctors TV Show.

A Night To Remember!

It was a hot and sultry night as we celebrated A Night of Beauty and the launch of Dana Elise Solutions exclusive Vocal Facial and Luxury Membership Program at the world famous hip and trendy House of Blues on Sunset Boulevard. Surrounded by rock stars, musicians, entertainers, actors and the behind-the-scenes beauty makers connected to Dana Elise, this was a night to remember!

Dana Elise Solutions, a premier full-service skincare spa and leader in progressive skincare options and BIG Medicine Magazine™ assembled the best of the best in beauty to pamper guests as they mingled among recording artists, celebrities and media. In addition to enjoying shoulder massage, hand microdermabrasion and beauty makeovers, guests received complimentary gift bags and were registered to win raffle prizes as they nibbled on delicious hors d’oeuvres and sipped decadent cocktails! Dana Elise and her team are thrilled to settle into their new offices located at 11500 West Olympic Blvd, #315, Los Angeles, CA 90064.

A GREAT BIG THANK YOU TO: Beauty Bumps CND Solar Oil Nail Treatments Carmella Cardina, Chaos Films Luscious Lip Gloss by Dana Elise Solutions Elevation Fitness Frank Barron Hair Design iS Clinical Skincare Youth Eye Complex Jus De ‘amour By Mercedes Eau De Parfum K Chocolatier by Diane Kron Kelly Taylor Metropolitan West Ken Siporin, M.D. Laura Bradley Music Nelson J. Salon Nelson J. Argon Oil Hair Care Neova Squalene Osea Skincare Oxygenetix Concealing Makeup Prtty Peaushun Body Lotion Solar Tizo Sun Protection Tan Towel Wipes Wiliiam Dorfrman, DDS

Clients, friends, family and the famous having a night of fun at the world famous House of Blues on Sunset Strip in Hollywood celebrating Dana Elise Solutions. You can learn more about Dana Elise Solutions at www.danaelisesolutions.com, or by calling 310-550-5566.

Industry Transformer

RIDING THE WAVE Advancements In Skin Tightening The use of radiofrequency in medicine has been around for over 70 years, but Florida based facial plastic surgeon Steven F. Weiner, M.D. is among the first doctors in the US to use the new INFINI Micro-Needling RF device for skin tightening. Dr. Weiner told BIG Medicine Magazine™ that he is usually not an early adopter of new technology but in the case of INFINI, the science just made sense.

Over the last decade or more, there has been an array of aesthetic RF devices introduced to the aesthetic market. While much of the technology seems similar in nature, the results to the patient are not. Some yield good results, while others cannot stand behind their marketing claims. According to Dr. Weiner, when he was first introduced to the Lutronic INFINI, his decision to adopt it into his practice was immediate.

“I just had to jump on this one,” he exclaimed.

“The science was what convinced me, as well as the potential of this being a piece of technology that had a broader use base among my patients.”

Research has shown that heating the dermis to a certain temperature will cause collagen stimulation and can result in skin contraction.

Damaging the skin with heat triggers the natural healing process to generate new collagen.

Heating the skin to temperatures high enough to melt or coagulate collagen first produces a contraction and then a rebuilding as new collagen replaces the old. The problem, however, lies in the control of the temperature keeping it safe enough for the skin surface. While we all know that more energy equates to more visible results, the price to the patient of this uncertainty was just too much for Dr. Weiner.

Also, as Dr. Weiner states, the devices rely on the tissues to carry the energy to the right level and with differences in skin thickness, levels of skin hydration and the composition of the collagen and fat that approach can lead to

a placement of energy at unknown or variable depths. If the energy is placed too deep you can get fat necrosis. Likewise if the device doesn’t reach the critical temperatures, there is no collagen stimulation.

“With the Lutronic INFINI RF microneedles the superficial layer of skin can be bypassed and the tissue can be penetrated to the level that you want to heat,” said Dr. Weiner. “With this technique the deeper tissue can be heated at a much higher level leading to greater collagen remodeling, collagen contraction and stimulation.

According to Dr. Weiner, going deeper into the skin tissue allows for some treatment opportunities which haven’t been effective in the past with RF devices: Acne treatment (attacking the sebaceous glands, acne or other scarring (particularly darker skin types), sweating (attacking the sweat glands) and stretch marks1.

He also uses it for fine lines and wrinkles and due to the RF’s ability to bypass melanocytes, he can safely offer this treatment to patients of color without being overly concerned about hyperpigmentation or increased melasma.

With the evolution of RF energy delivery from external electrodes to interstitial needle electrodes heat delivery has been further refined by the use of insulated microneedles which have only the very tip of the needles as the active part of the electrodes. In addition, the insulated needles do not all punch into the tissue at the same time, but are inserted serially

Before and After Photos Courtesy of Steven F. Weiner, M.D.

in rows known as ComfortFlow Technology™. This minimizes pain, aids a more gentle insertion of the needles and helps to eliminate the bounce effect in thinner skin over bony areas of the face.

With each RF pulse of INFINI, the array of needles is first quickly inserted into the skin in a 100ms mechanical pulse. After insertion the RF energy at the designated pulse duration is delivered followed by quick retraction of the needles.

Because of the very fast and slight offset from row to row of the very fine needles, the needle penetration itself is virtually painless and minor pin-point bleeding. Because the shaft of the needles is insulated, there is no electrothermal damage at the epidermis, so skin cooling is not required: there is of course some micro-damage from the mechanical needling effect, but that has actually been shown to be beneficial.

Dr. Weiner says that this technology certainly fills a void in his practice and that with every day use he is able to treat a wider array of patient concerns. His typical patient age is 40 – 65 for skin tightening, fine lines and wrinkles and with INFINI patients can return to work almost immediately with less downtime. In 35 – 40 minutes he can perform a full face and neck procedure. Like other RF treatments, collagen stimulation takes place over weeks and months and results will only continue to improve. His patients are seeing a visible result in 3 – 4 weeks and Dr. Weiner shows them their before photos so they can see the results for themself. To say the least, Dr. Weiner has a very happy patient base.

Beauty & Grooming While we have so much to say about outer beauty and grooming, we thought we would put to the test some inner beauty remedies.

Juicing Our Way To Gorgeous!

Two years ago our Editor-in-Chief Angela O’Mara started a daily juicing regimen and to date her favorite is what she calls “Beet That”. She’s tried a variety of juicers and feels the Hurom Slow Juicer works best for her family. As she states, “what have I learned over the course of many juices? Not all taste as delicious as that first one, and sometimes it is trial and error. But, I have learned a lot about the health benefits of the fruits and vegetables that I juice. I now custom make juices for my family that I believe are able to fight everything from stress and hormonal changes to fatigue and inflammation. I can honestly say that we’ve never been healthier.”

Hurom Slow Squeeze Juicer

Here’s the recipe and the added benefits.

“Beet That” is comprised of beetroot, cucumber, celery, ginger, apple, orange, lime and parsley.

Cucumber: a good quantity of vitamin A a fatsoluble vitamin and antioxidant that plays an important role in helping with eyesight, bone growth, reproduction and cell division. Sufficient amounts of vitamin A can also help promote healthy and intact surface lining in the eyes, respiratory tract, urinary tract and gastrointestinal tract. It’s also good for skin clarity.

Celery: packed with an assortment of the essential minerals and vitamins that our bodies need to function properly. Celery also contains plant hormones and a variety of oils that can be calming and help maintain the nervous system.

Ginger: according to the UCLA Biomedical Library, ginger juice can treat osteoarthritis and rheumatoid arthritis due to its high content of gingerol an anti-inflammatory compound. Ginger juice will also help relieve morning stiffness and inflammation, and it boosts the immune system.

Beetroot: rich in antioxidants, protects cells against the destructive effects of the free radicals believed to play a role in heart disease, cancer and other adverse health conditions. It is high in folic acid, vitamins A, B-1, B-2 and C, and essential minerals including iron, calcium and potassium.

Juice made from beets, carrots and cucumbers is said to have a cleansing and detoxifying effect on the kidneys and gall bladder.

Apple: adds sweetness to the juice and the vitamin A found in apples is essential for healthy teeth, skin and tissue. Also vitamin A can improve your vision and promote reproductive health, although the majority of vitamin A is in the apple peel that is usually extracted during juicing.

Apples also supply vitamin C that is instrumental in the growth and repair of body tissues. Its presence is required for collagen production, which aids in skin, scar, ligament and blood vessel creation. Vitamin C also prevents various

health conditions such as heart disease and inflammatory conditions that can deplete your overall quality of life.

Orange: has many, many health benefits and vitamins the most common being Vitamin C, an essential vitamin that cannot be produced by the human body. Vitamin C is an important antioxidant that protects the body against the harmful effects of free radicals, the molecules that may cause tissue damage and early aging.

Other vitamin C benefits are listed above.

Lime: as well as adding a little “zing” to your juice, limes contain unique active compounds called flavonol glycosides, which not only offer anticancer and antioxidant benefits, but also have antibiotic properties. They are also believed to hold potent anti-carcinogenic properties and are great for detoxing the body.

Parlsey: a great source of natural beta-carotene, chlorophyll, essential fatty acids, folic acid, iron, vitamin B12, vitamin K and vitamin C. It is said to be beneficial to the kidneys, immune system and aids in anemia. It can also freshen breath.

Source: Many of the health and nutritional benefits stated above about the fruits and vegetables I juice are obtained from a variety of sources including www.livestrong.com and www.webmd.com.

Disclaimer: Please be careful when juicing. Thoroughly wash all fruits and vegetables, cutting boards and knives with clean water.

Use certified organic produce if possible so as to avoid pesticides.

Also, consult your physician before beginning a regular juicing program or undergoing any type of juice fast or cleanse. Certain juices may be too high in sugars for those that suffer diabetes or other illnesses.

GliSODin Skin Nutrients Continuing on our quest of “beauty from the inside out”, our team was so excited to come across GliSODin Skin Nutrients, a professional medical line of nutricosmetics that promotes enhanced, longer-lasting results from aesthetic procedures. The products contain powerful antioxidants and bioactive nutraceuticals and it is considered to be a nutritional skin care program that protects the skin from the effects of oxidative stress. Imagine that! And, the Advanced Anti-Aging Formula hydrates the skin, improves skin elasticity and reduces the appearance of fine lines and wrinkles. We give this product a thumbs up! You can learn more at www.glisodinskin.com.

How To Be A Healthy Doctor

Minutes to

Less Stress

It’s five o’clock and you still have a waiting room full of patients to see before the office doors close for the day. As a practicing doctor, you know the demands of running an efficient, modern medical practice really means you are a long distance runner, moving from one task or patient to the next in a seemingly never ending race.

That nagging feeling of always being behind in your schedule can lead to dangerous stress levels that jeopardize your work and threaten your own physical and mental wellbeing. The list of physical complaints from time-stressed doctors seems to grow longer by the year: anxiety, depression, high blood pressure, body aches and sleepless nights. Add in irritability and low energy levels and you have a perfect storm of symptoms that will take their toll on you if not addressed daily.

For doctors, the real challenge is finding quick and easy ways to relieve stress, because unless you are packing it in for the islands, it is going to be with you. So when every minute counts, how do you find enough time in the day to stop and heal yourself?

The answer is simpler and more enjoyable than you think: Yoga-like poses – on the go.

Elyse Briggs, Nationally Certified in Therapeutic Massage and Bodywork and owner of Yoga at the Village in Glendale, California, created her latest Stretch in Time® DVD series (The Basics and Balance: Build Strength – Gain Confidence) on the idea that the simplest of exercises are often the ones that do the most good.

“My motto is to keep exercise simple so you are more likely to continue it. And it works.” says Briggs, herself a bundle of yoga-induced energy.

“If your work schedule doesn’t allow for a trip to the gym, just grab a chair from your waiting room and do these easy exercises in between patients. You’ll be refreshed and invigorated within minutes.”

Although it does not appear that doctors’ harried schedules will change for the better any time soon, it is possible to limit the negative effects of high stress levels through incorporating these easy yoga-like exercises into your day. Working just one exercise an hour into your schedule means one less minute of stress, and many more of good health.

At BIG Medicine Magazine™ we love yoga. These fun and practical DVD’s are available at www.stretchintime.com

Briggs developed the following five exercises and stretches to relieve the physical and mental stress doctors experience on the job. You can feel better in as little as five minutes - and all without rolling out your yoga mat.

1 2 3 4 5

Downward Facing Dog with chair – Relieves tight shoulders, hamstrings and lower back pain.

Position a stationary chair against a wall. Stand and hold onto front edges of seat. Inhale, and on an exhale step back, knees bent and hips lifted. Chest presses toward thighs, spine lengthens as you try to straighten your legs. Breathe for 30-60 seconds.

Backbend with chair – A reverse spine stretch for lower back fatigue.

Sit near the edge of the chair with hands on the side edges. Walk your feet forward, lifting your hips and coming into reverse plank.

Shoulders are over wrists, arms and legs are straight. On an inhale with feet planted, lift your hips toward the ceiling. On an exhale arch your back. Breathe. Hold for 30-60 seconds.

Twist – Relieves back pain, lower back tension and aids digestion.

Sit in the chair with shoulders and hips aligned. Inhale, and then on an exhale, leading with your navel, slowly turn to the right, placing your hands onto the arms or back of the chair. Inhale and move back to the center for a few breaths. Inhale again and repeat to the left side. Hold each side 30-60 seconds.

Forward Fold – Releases neck tension, lower back and spine tension and pain.

Sit near the edge of the chair, feet more than shoulder-width apart. Inhale and raise arms overhead, palms facing each other.

On an exhale and with a long spine, hinge at the hips and slowly lower your body and let hands reach the floor. Breathe. Hold for 30-60 seconds. For more of a stretch, grab the two front legs of the chair and with feet planted, straighten your arms, lengthen your spine and lift up. Hold for 30-60 seconds. Breathe. Then relax back into the forward fold. Come up carefully, hands on knees, pushing back up to your original seated position.

Relax with legs up the wall – A restorative pose for aching legs and lower back pain.

Lie with your back on the floor, bottom and hips as close to the wall as possible. Straighten legs up the wall. Lie with arms outstretched and palms facing up. Breathe and relax for five minutes or longer.

Turning A Negative Into A Positive

DEALING WITH BODY DYSMORPHIC DISORDER There have been a lot of stories in the news recently about plastic surgery and patients with Body Dysmorphic Disorder. As the media reports that this is a disturbing and growing trend, BIG Medicine Magazine™ talked with Beverly Hills celebrity therapist Carla Lundblade to ask her how you can spot a patient with this disease before you perform surgery.

All of us have some kind of relationship with our bodies. Some of us love our body, others do not. Psychologically speaking we have either a normal or abnormal relationship with our body. While we say “to each his own”, there are signs you can look for to determine whether the patient standing in front of you is going to be a future problem due to their personal image of themselves.

Most patients coming to you for surgery are generally complaining about some aspect of their face or body that they do not like. However, a patient suffering BDD absolutely hates that body part. There is a difference between “don’t like” and “hate”. These patients try to not to look at that body part, or attempt to hide it from others. When they glance at their reflection in your lobby mirror and make a face at what they see, this is an obvious sign of deeper troubles.

How do you know what is normal and what can be harmful, and how do you get the truth from your patients so you may best help them?

We can all experience embarrassment or frustration about our bodies, but what if these thoughts are all consuming, create significant fears, anxiety and panic, and stop your patients from living normal lives? What if you have a patient that is even considering suicide as a result? How would you help?

Such problems are real for many men, women and children who experience body dysmorphic disorder. New findings have been uncovered and effective treatments have been developed for BDD and its emotional and neurological causes. Brain activity patterns appear to be different in people with BDD than in people without the disorder. It was reported that the dissimilarity showed up in areas of the brain involved in visual processing. The severity of symptoms seem to coincide with measurable brain activity of similar magnitude. BDD seems to possess a mixture of genetic, emotional and neurobiological factors, which can also show up in other family members. So evidence supports that this disorder may have real causes and may not be “just imagined” or a sign of a lack of will power or low self esteem.

The good news is that management of symptoms is possible and found to help a large percentage of those who suffer, as long as their issues are uncovered and they can withstand their personal awkwardness around them long enough to follow through with your referral to a therapist.

Trust me, you will need a therapist to assist you in this multi-pronged approach.

The most effective treatment regime seems to be cognitive behavioral therapy, CBT, partnered with serotonin-enhancing drugs. In cognitive therapy, patients become skilled at improving their thinking, showing publicly their “defect” to others and seeing themselves as more whole emotional people rather than just focusing on their “defective” emotionless parts. And prepare yourselves, relief and positive change may take longer than 3 months to show up but it will show up to the tune of ½ to ¾ of patients experiencing improvement.

What fails miserably to treat BDD is plastic surgery and other beauty enhancing procedures. Even if the surgery or procedure changes the identified defective body part, the individual’s brain and patterns of thinking are still likely to search out and find another perceived defect and so on, and so on, and so on. None of this leads to a better life and more happiness. But you can help this patient.

As a doctor, it is important to identify this problem within your patients and not to give up on them, so they may experience the joy of effective treatment that significantly improves the quality of their lives, their families’ lives and may even be life saving!

Questions for doctors to ask patients:

• How do feel about your body?

• When you look in the mirror, what do you see?

• Have you had or are considering having surgery or procedures to correct a perceived defect? How did that go?

• Are there things you avoid doing because of your concerns?

• Do you ask others their opinions about it and what do they say?

The reality in this day and age is for surgeons to realize that they cannot and should not attempt to psychologically screen patients and it’s even worse to leave the job to a staff member or a questionnaire. With growing concerns about the extent to which cosmetic surgery affects patients’ relationships, self-esteem and quality of life in the long-term, it makes more sense to add both pre- and post-surgical patient assessments as a primarily fail-safe and excellent standard of care. This will ensure 1) no harm is done, 2) improvement is achieved and 3) each patient feels well cared for, happy and will tell the world about their procedure, which in turn affects how your referral business and your professional reputation grows. As a side note, the pre- and post-screening are considered “therapy” and are generally covered by most insurance companies, unlike most cosmetic procedures.

Of course all aesthetic surgery patients are coming to you because they are not happy with a particular aspect of their body. However, there is a difference between a healthy dislike and an unhealthy one. Key phrases like “I hate the way I look” vs. “I feel that my nose is too large for my face” are obvious sign of the psychological health of the patient. Also, patients that “hate” multiple aspects of their body, or want to look like another completely different looking person like a celebrity are other warning signs that you should pay close attention to. With great and genuine care from you, a patient suffering body dysmorphic disorder, can ultimately go on to have a successful procedure and a happy future, given that you know what you are dealing with in advance of performing surgery.

Contributors

American Society of Plastic Surgeons www.asps.con

James Newman, M.D. www.premierplasticsurgery.com

Bill Bergstrom, ClinicalNotebook www.clinicalnotebook.com

Jim Sanders www.reelideas.com

Carla Lundblade www.carlalundblade.com

Juris Bunkis, M.D. www.ocps.com

Centers for Disease Control www.cdc.gov

Kris Sanders www.stretchintime.com, www.reelideas.com

Centers for Medicare and Medicaid Services www.cmc.gov

Laurence Rifkin, D.D.S. www.drlaurencerifkin.com

Christopher Lyon, M.D. www.lyoneyecosmetic.com

Lutronic www.lutronic.com

Dana Elise Solutions www.danaelisesolutions.com

Marcy Zwelling-Aarnot, M.D. www.z-doc.com

Eclipse Aesthetics www.eclipseaesthetics.com

Michele Garber www.niptuckcoach.com

Elyse Briggs www.stretchintime.com

Oxygenetix www.oxygenetix.com

Facebook www.facebook.com

Richard Branson www.virgin.com

Forbes Magazine www.forbes.com

Sandra Lee, M.D. www.skinps.com

Frederick Corbin, M.D. www.drcorbin.com

Sanjay Grover www.drgrover.com

Giles Raine www.theprofessionalimage.com

Skype www.skype.com

GliSoDin Skin Nutrients www.glisodinskin.com

Steve Siebold www.speakerstevesiebold.com

H. George Brennan, M.D. www.drgeorgebrennan.com

Stricell Stretch Mark Cream www.vitamedtech.com

Hurom Juicers www.hurom.com

TPI www.theprofessionalimage.com

Implantech www.implantech.com

Victor Gane, AestheticLink www.aestheticlink.com

If you want to become a contributor to BIG Medicine Magazine™, or if there is a medical topic you would like to see covered in this magazine, send your ideas to: storyideas@bigmedicinemagazine.com.

A Final Word

By Giles Raine

Help! Yelp!

Lies, More Lies and Social Media Recently I received an unexpected e-mail from a Crown Prince in Africa who informed me that my trustworthy character was needed to help guard many millions of dollars which he wanted me to stash in my bank account. I would, of course, need to share my bank account number, social security number and some other personal data with him in order for him to transfer the funds into my safekeeping!

The reality is that anybody can say anything and pretend to be anyone in our digital world and, more importantly, compared to the non-digital default world they can say anything and act with very little fear of being sued, prosecuted or in the case of the ‘Crown Prince’ arrested. In other words this is a First Amendment petri dish that can’t be controlled.

The internet is full of social media review sites for everything from restaurants to doctors. Some social media sites are famous reputable branded companies while others are, quite frankly, opportunistic bottom feeders. However, in general with social media anybody can make any comment about you regardless of accuracy, or even make deliberately false and malicious comments about you that virtually no social media site will fact check or even delete.

All businesses including medical practices, individual doctors or staff members can have damaging vicious and false commentary posted about them on multiple social media sites without even knowing about it. This has the potential to impact your professional career and even the success of your practice. Social media is very much a double-edged sword that can be empowering, but can also leave you vulnerable and unable to defend yourself.

So how do you control the social media that surrounds you?

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Any comment on any e-mail or social media site made by anybody has the potential to remain in the digital world forever.

On a regular basis you should conduct a google search of your name and practice to see what comments are being made.

Be aware that some social media comments and reviews (both positive and negative) made by alleged patients may be fake.

The same goes for restaurant and other product reviews! On the Internet seeing is not always believing.

Be extremely careful to who you give the authority to manage your social media pages and who is able to write commentary on your behalf. Many doctors have found that due to them not monitoring their social media pages, incorrect commentary has been made on their behalf, emails coming from them are rife with spelling errors and conversations are being had that they know nothing about.

If you have somebody else besides you managing your social media, frequently monitor it.

It is inevitable that negative or even hostile and malicious statements about you and or your practice will be made at some point. NEVER reply, comment, respond or most importantly directly acknowledge any negative comments.

6 7 8 9 10

Document all comments that you feel are deliberately false and malicious that individually attack you, your professional reputation and your practice. This will be helpful to your attorney or the police if you identify the attacker and decide to prosecute.

It is certainly worth trying to contact a social media site to see if their policy allows correction of false or malicious information, although be warned there are some websites that actually encourage your participation with negative content about you in order to drive traffic who will view their advertising. Either have your attorney represent you on these matters, or at best try to speak with a human being on the telephone.

The best method of making any negative social media disappear is to bury it with multiple positive genuine reviews. Initiate a campaign to engage you patients, friends and colleagues and ask them to post positive truthful comments about you and your practice on their favorite social media sites.

It is never necessary to create fake patients with fake comments; website visitors are smart and will know when you post fake comments which will question your credibility.

Without of course violating patient privacy, you can create genuine positive comments about the patients who brought flowers or cookies for the staff after a great surgical result or other positive general practice information such as new babies, weddings, staff promotions or even just talking about the beauty that surrounds you or something inspiring you saw on a website.

As a professional publicist I have worked with and helped many doctors who have been maliciously attacked on the Internet. Rather than focus on the negative, I prefer to focus on the positive and to help rebuild your reputation with the truth. Every practice and every doctor has something interesting and special to say and share with their current and prospective patient community. Bedside manner is just as important Online as it is Offline. Giles Raine can be reached at 949.768.1522 or giles@theprofessionalimage.com.

The Professional Image, Inc.

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