CDHC = Consumer Driven Health Care or the ability to choose doctors
and hospitals based on their track record and their price.  This would
put the incentive on the health care system to keep you healthy rather
than to keep you sick as it exists today.
------------------------------------------
Web attack on surgeon starts battle
Published 12:00 am PST Thursday, February 8, 2007

Georgette Gilbert was at a low point in her life. At 33 and having
recently broken up with a long-time boyfriend, she was feeling
insecure about being single and looking older.

At least that's how the Sacramento-area woman describes her motives
for undergoing facial plastic surgery on her Web site,
www.mysurgerynightmare.com.

Dr. Jonathan Sykes, the UC Davis surgeon who performed the operation,
believes that Gilbert's tale, as revealed online -- complete with
before-and-after photographs -- is riddled with false and misleading
statements and is defamatory. He filed a lawsuit to squelch Gilbert's
online commentary.

Four years, several court filings and a medical malpractice lawsuit
later, Gilbert's Web site is still up and running. Sykes, an author
and frequent television commentator on cosmetic surgery, remains
unhappy. And the self-expression revolution that is the Internet is
emerging as a potential public relations threat to similarly
high-profile professionals.

Late last month, a state appeals court sided with Gilbert on the
defamation suit Sykes filed in an effort to shut down her Web site.
The court said the Web site is protected free speech and that Sykes
was fair game for public criticism because "he had placed himself in
the spotlight on a topic of public interest."

Sykes told The Bee that he has written more than 100 articles and book
chapters on plastic surgery and annually gives more than 200 lectures
on the topic around the United States and the world.

The decision by the Sacramento-based 3rd District Court of Appeal may
have ramifications for other kinds of professionals, some legal
experts said.

"The opinion is good protection for consumers who want to express
opinions about services they receive, but professionals who promote
themselves may have this burden if they think they have been defamed,"
said First Amendment attorney Charity Kenyon.

Sykes' lawyer, Daniel L. Baxter, contends that doctors and other
health care professionals will be left powerless to defend themselves,
since they are bound by federal patient privacy laws.

Gilbert's attorney, William L. Brelsford, would not allow Gilbert to
speak to The Bee because of her malpractice lawsuit.

On her Web site, Gilbert said she hadn't considered having plastic
surgery until about three weeks before her appointment.

"I really liked how I looked, but I started to notice small changes
that probably no one else noticed," she writes. "I never wanted to
change my looks (sic) I just wanted to maintain what I had longer."

After consulting with Sykes, she said, she agreed to an operation in
which the surgeon would lift her eyebrows (endoscopic brow lift),
tighten the skin around her eyes (blepharoplasty), lift her cheeks and
inject fat into her face to tighten skin and decrease wrinkles.

According to court documents, Gilbert "was extremely unhappy with the
results, asserting that she could not fully close her eyes, her
eyebrows were higher than she expected, one eyebrow was higher than
the other and she had a permanently 'surprised' look on her face."

On her Web site, Gilbert posts before and after photographs of her
face, the later one taken five months after the surgery.

"I was told by my doctor that this was a good result -- that I looked
better after his surgery -- what do you think?" she asks Web site
visitors.

Baxter contends that several statements and representations Gilbert
made on the site were untrue or misleading, including her comment
about the photographs.

Gilbert calls her decision to undergo facial plastic surgery "the
biggest regret of my life," stating that she "didn't need five
procedures and I had no idea what I was really getting myself into."

Baxter disputed the notion that Gilbert was an unwitting patient. In
fact, he said, she "directed him to be very aggressive in carrying out
the procedures."

Sykes, who spoke to The Bee by telephone from his UC Davis office,
would not comment specifically about Gilbert's case except to say that
her Web site has tainted some patients' opinions of him.

Speaking more generally, he said he never tells a patient what types
of procedures to undergo, since cosmetic surgery is not a medical
necessity.

He added that he commonly talks patients out of surgery, particularly
those he deems to be impossible to satisfy or those who are
emotionally unstable.

"They come to us with the complexity of issues, and our job is to
ferret them out, to make sense of them and try to decide if we can
please that patient," he said. "That is at least as challenging as the
surgery itself."

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