Diversity Committee Course Addresses Cultural Concerns
The Diversity Committee’s ongoing endeavors to promote cultural competence and improve patient care across the spectrum of cultures and ethnic backgrounds has been furthered by the release of a recent Patient Management Perspectives in Otolaryngology (PMP) issue. The Volume 42 issue addresses the “Adult for Rhinoplasty Consultation: The Mixed Non-Caucasian Rhinoplasty.” This is the first education activity developed by the Diversity Committee, and it is in the subspecialty of facial plastic surgery. The case is a non-Caucasian woman seeking rhinoplasty, whose aesthetic characteristics show a mix of ethnic backgrounds. She is aware of her ethnic background, and she and her family share pride in this background. These feelings cause her to express specific preferences to the consulting surgeon about the desired result. The preferences expressed may likely result in some confusion on the part of the surgeon, as they may seem to restrict the surgeon from planning a rhinoplasty that he or she might understandably feel would yield an overall pleasing result. This tension is woven into the case that plays out as the case study is read and followed. This course has a number of goals. As a basis, the case guides the participant in the approach to the aesthetic rhinoplasty patient, demonstrating an orderly progression from thoroughly listening to the patient, to formulating and carrying out a surgical plan, and through the postoperative care of the patient. Further, the case challenges the surgeon to listen, accept, and act upon a patient’s desires, even when these desires confuse or even thwart the surgeon in his or her efforts to achieve a result that he or she feels would be reasonably favorable. The case also demonstrates the concept that some patients of mixed ethnic heritage may be knowledgeable and sensitive about the specifics of that heritage, and may wish to preserve some, but not all, of the aesthetic characteristics of some components of that mixture. The influence the patient’s family may have on the aesthetic surgery patient’s feelings about his or her appearance is introduced. Even though it is axiomatic that the patient should be the primary beneficiary of surgical results, the surgeon who ignores the influence of significant surrounding persons on the patient’s self image and acceptance of surgical change does so at his or her peril, particularly when appearance characteristics are clearly ethnic in nature. The management of selected postoperative complications is explored. The concept of deciding against offering an operation to a patient who is clearly desirous of this operation is included, and an ethical manner that might be used to carry out this somewhat unusual decision is suggested. Finally, the course serves as a review of the characteristic rhinologic appearance of a specific non-Caucasian ethnic mix, the Mestizo nose. This review of the approach to, and management of, the Mestizo nose seems itself to be important, because with the increase of Hispanic populations and the increasing mobility of populations in general, the chances of any rhinoplastic surgeon, in any location, encountering a patient with Mestizo characteristics, is growing. Also, because of the specific ethnic mix that comprises the Mestizo nose, it lends itself well to the discussion of the patient with atypical, unexpected, or confusing aesthetic desires, some or all of which may originate in the patient’s ethnic self-image. This exercise also shines a light on the emergence of differing aesthetic ideals other than the generally accepted, Euro-centric, Caucasian/Western ideal of beauty that has long been the norm in aesthetic endeavors. These differing ideals may well grow to take a place beside long-accepted Western ideals, coexisting with them rather than replacing them. So, this course may be seen to address cultivation of the competencies of Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, and of course, Practice-Based Learning, in addition to stimulating the development of cultural competence. The interactive nature of the study promises to make it more interesting, and, we hope, more effective than simply presenting didactic material. Participants are invited to visualize themselves in their consulting rooms, actually discussing the patient’s desires and possible management options. The Diversity Committee hopes this PMP issue serves not only to educate participants in the specific aspects of this type of challenge in Facial Plastic Surgery, but also to increase awareness of the ever-broadening scope of patient self-perception, especially as it pertains to the non-Caucasian patient. PMP is an interactive online or print series that simulates real-life clinical decision-making. Each volume consists of eight issues that provides up to 64 AMA PRA Category 1 creditTM . To subscribe, visit www.entnet.org/PMP.
The Diversity Committee’s ongoing endeavors to promote cultural competence and improve patient care across the spectrum of cultures and ethnic backgrounds has been furthered by the release of a recent Patient Management Perspectives in Otolaryngology (PMP) issue. The Volume 42 issue addresses the “Adult for Rhinoplasty Consultation: The Mixed Non-Caucasian Rhinoplasty.” This is the first education activity developed by the Diversity Committee, and it is in the subspecialty of facial plastic surgery.
The case is a non-Caucasian woman seeking rhinoplasty, whose aesthetic characteristics show a mix of ethnic backgrounds. She is aware of her ethnic background, and she and her family share pride in this background. These feelings cause her to express specific preferences to the consulting surgeon about the desired result. The preferences expressed may likely result in some confusion on the part of the surgeon, as they may seem to restrict the surgeon from planning a rhinoplasty that he or she might understandably feel would yield an overall pleasing result. This tension is woven into the case that plays out as the case study is read and followed.
This course has a number of goals. As a basis, the case guides the participant in the approach to the aesthetic rhinoplasty patient, demonstrating an orderly progression from thoroughly listening to the patient, to formulating and carrying out a surgical plan, and through the postoperative care of the patient. Further, the case challenges the surgeon to listen, accept, and act upon a patient’s desires, even when these desires confuse or even thwart the surgeon in his or her efforts to achieve a result that he or she feels would be reasonably favorable.
The case also demonstrates the concept that some patients of mixed ethnic heritage may be knowledgeable and sensitive about the specifics of that heritage, and may wish to preserve some, but not all, of the aesthetic characteristics of some components of that mixture. The influence the patient’s family may have on the aesthetic surgery patient’s feelings about his or her appearance is introduced. Even though it is axiomatic that the patient should be the primary beneficiary of surgical results, the surgeon who ignores the influence of significant surrounding persons on the patient’s self image and acceptance of surgical change does so at his or her peril, particularly when appearance characteristics are clearly ethnic in nature.
The management of selected postoperative complications is explored. The concept of deciding against offering an operation to a patient who is clearly desirous of this operation is included, and an ethical manner that might be used to carry out this somewhat unusual decision is suggested. Finally, the course serves as a review of the characteristic rhinologic appearance of a specific non-Caucasian ethnic mix, the Mestizo nose.
This review of the approach to, and management of, the Mestizo nose seems itself to be important, because with the increase of Hispanic populations and the increasing mobility of populations in general, the chances of any rhinoplastic surgeon, in any location, encountering a patient with Mestizo characteristics, is growing. Also, because of the specific ethnic mix that comprises the Mestizo nose, it lends itself well to the discussion of the patient with atypical, unexpected, or confusing aesthetic desires, some or all of which may originate in the patient’s ethnic self-image.
This exercise also shines a light on the emergence of differing aesthetic ideals other than the generally accepted, Euro-centric, Caucasian/Western ideal of beauty that has long been the norm in aesthetic endeavors. These differing ideals may well grow to take a place beside long-accepted Western ideals, coexisting with them rather than replacing them.
So, this course may be seen to address cultivation of the competencies of Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, and of course, Practice-Based Learning, in addition to stimulating the development of cultural competence. The interactive nature of the study promises to make it more interesting, and, we hope, more effective than simply presenting didactic material. Participants are invited to visualize themselves in their consulting rooms, actually discussing the patient’s desires and possible management options.
The Diversity Committee hopes this PMP issue serves not only to educate participants in the specific aspects of this type of challenge in Facial Plastic Surgery, but also to increase awareness of the ever-broadening scope of patient self-perception, especially as it pertains to the non-Caucasian patient.
PMP is an interactive online or print series that simulates real-life clinical decision-making. Each volume consists of eight issues that provides up to 64 AMA PRA Category 1 creditTM .
To subscribe, visit www.entnet.org/PMP.