List date(s) this work was published or aired.
Sept. 14 and 15, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
This two-day series was the most comprehensive national report ever on the growing safety lapses in cosmetic surgery. Part 1 chronicled the increase in doctors from other medical specialties branching into cosmetic surgery as their insurance reimbursements decline. Part 2 took a hard look at the board-certified plastic surgeons working at high-volume cosmetic surgery clinics where safety can take a back seat to profits. The eight-month project showed how a public increasingly fixated on being trim and youthful leaves no shortage of patients for doctors with questionable credentials. The discount-mania that permeated purchases of everything from food to fashion during the recession hit cosmetic procedures with a potentially deadly force. Cosmetic surgeons working out of their own offices, often after only a few days of training, could undercut board-certified plastic surgeons by reducing the overhead of pricey hospitals or accredited outpatient facilities or offices. Once doctors get their medicial licenses, they are free to practice whatever kind of medicine a patient wants done. Key findings: • Up to 100,000 doctors who aren’t plastic surgeons are practicing cosmetic surgery, according to a trade group representing many of them. The number is sure to grow until and unless states act to tighten restrictions on what doctors can do and where they can do it. • Most hospitals require doctors to only perform procedures in the fields that are board certified in, but these non plastic surgeons can and do use their typically unaccredited offices. They say it saves patients money, but it’s usually their only choice.. • The heavily-promoted Lifestyle Lift procedure is performed in offices that are not accredited. • The death rate at Strax, the South Florida clinic that says it does more breast implants than any other facility in the country, is almost twice the accepted level in cosmetic surgery, not half the rate that’s considered acceptable, as the company maintained. Strax often says it has a “safety record that’s second to none.” O’Donnell interviewed the husband of a woman who died on the family’s living room couch on Valentine’s Day after having liposuction. Along with her husband, who said he loved her the way she was, Kellee Lee-Howard left six children behind. In the course of O’Donnell’s reporting, another patient of the doctor who treated Lee-Howard died. After that death, the Florida Departent of Health restricted Dr. Alberto Sant Antonio’s license, prohibiting him from performing surgery in his office. O’Donnell was first to report that at least 20 other doctors who weren’t plastic surgeons were touting their training by Sant Antonio’s company online. She interviewed two OB/GYNs who learned how to do liposuction during three-day courses at Sant Antonio’s office near Miami. Another liposuction victim, Elsie Soto, felt lucky to be alive even though her complication-related medical bills topped her annual salary and she was plagued by often crippling pain nearly two years after the procedure. Strax, where Soto had her surgery, and Lifestyle Lift say they have made cosmetic surgery available to the masses. But because health insurance typically doesn’t cover complications from these elective procedures, lower-income patients are particularly hard hit by the commoditization of cosmetic surgery. USA TODAY published the articles despite warnings of possible legal action by two of the companies.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I requested and got copies of complaints to the Florida attorney general about the company Lifestyle Lift. Our lawyers wanted me to use allegations contained in public records whenever possible so this helped in that regard. I also obtained the settlement agreement between this company and the New York attorney general through a FOI request. The agreement’s details were very different than what Lifestyle Lift was saying the facts were about whether their employees had posed online as satisfied customers. I also used numerous lawsuits, depositions, autopsy reports, and affadavits in my reporting,
Explain types of human sources used.
I intervewed scores of victims, plaintiff lawyers, defense lawyers, state legislators, plastic surgeons (and the heads of their industry groups), doctors from other specialities who now do cosmetic surgery (and the heads of their industry groups) and the doctor who heads the American Board of Medical Specialties,
Results:
The American Board of Medical Specialities, the Federation of State Boards of Medicine and the American Society of Plastic Surgeons all put links to the stories on their websites as a way to educate the public. Florida State Sen. Eleanor Sobel, a Democrat who is vice chair of the health regulations committee, said the series “absolutely” played a role in the committee’s unanimous approval of her bill to tighten restricions on so-called med-spas that perform liposuction. She put a giant blowup of the first day’s story on a board outside of her office and distributed the article to all the committee members before the vote. The Florida Attorney’s General office is reportedly nearing the end of its investigation into Lifestyle Lift’s marketing claims.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
I have done two articles since the series ran on the ways state laws are lacking in this area and on legislation in some states that would address the issues, particularly by requiring accredtation or licensure of offices where surgery is performed. I plan to continue to cover related issues more incrementally throughout 2012 and beyond. Two dermatologists I talked to during my reporting wrote a letter to the editor criticizing Part 1 because it didn’t include their findings, which they say showed plastic surgeons have more deaths than those practicing cosmetic surgery without any board certification. They did their analsysis to lobby against office-based surgery regulation. Their data from Florida and Alabama does not include the number of procedures overall that are performed so it’s impossible to conclude that plastic surgeons have a bigger problem. (which i pointed out in a later article, where i did say what they found.) The American Academny of Cosmetic Surgery posted a letter on their website that was never received by USA TODAY calling on the newspaper to “correct the false and misleading statements” in the series. Then it misrepresented several things in the article. When O’Donnell discussed the article with the head of the American Board of Cosmetic Surgery after it was published, he did not ask for a correction but focused on the fact he wished he had known how he was going to be portrayed in the article and accompanying video.
Advice to other journalists planning a similar story or project.
Try to get every allegation in a legal document as the reporting progresses to save time at the end. Work with other reporters; this was a very big project to tackle alone, especially for a reporter who did not have a background in medical reporting. Don’t let legal threats scare you off.