The Art of Altruism
by Rich Smith, Plastic Surgery Products Magazine
Selfless acts not only create a solid reputation among patients, they make life-altering differences for those unable to afford corrective surgery
It costs more than $40,000 each time Larry S. Nichter, MD, MS, FACS, flies to a third world country to devote as much as 3 weeks to teaching physicians abroad how to perform various plastic and reconstructive procedures. However, that money only covers the tangible expenses, like transportation and equipment. Not included is the potential income Nichter forfeits by being away from is southern California-based practice, the Pacific Center for Plastic Surgery. For Nichter, altruism is what drives him to participate in these medical missions, which to date, has been more than 30 times in his career.
“Most of us who go into medicine do so with a desire to accomplish wonderful things by helping people in need,” says Nichter, who is board certified by the American Board of Plastic Surgery, the American Board of Surgery, and has certification of added qualifications in hand surgery.
“But somewhere along the line, a lot of us become disillusioned by the harsh realities of running a practice. By making altruism a formal part of my practice, I have been able to avoid disillusionment and burnout. For example, when I return from an overseas mission, I have a greater appreciation of my family, staff, and patients because I realize how fortunate we are that we don’t live in grinding poverty where access to even the most basic medical care is often unavailable.”
Nichter’s deeds are not confined to foreign shores, however. He is a firm believer that charity begins at home. “ A short time ago, I spent half a day in surgery with a neurosurgeon to work on a child suffering from a very unusually shaped head,” he says. “ No bills were sent afterward. I did this purely as a labor of love.”
Nichter’s practice partner, Jed Horowitz, MD, FACS, board certified by the American Board of Plastic Surgery, explains that taking care of indigent patients is something the two have always opted to do. “Providing life-changing care to those who cannot afford it is a great source of satisfaction for us,” Horowitz says.
In some instances, it turns out to be less of a financial strain on the practice to provide free treatment than it would be to charge for services. “We are very dedicated to collecting financial data so that we have a clear picture of its fiscal health,” says Nichter. “ We discovered that with our state’s Medic-aid patients, we were losing significant sums of money because of the expense involved in documenting, submitting, tracking, and, if necessary, appealing claims. We looked at what it cost to provide treatment divorced from the cost of jumping through all of the insurance hoops and found that we were better off giving away our services to those patients.”
Altruism is also beneficial by the goodwill it engenders among the public. According to Horowitz, prospective patients tend to feel more certain about using the services of practitioners with a solid reputation for selfless acts.
“Thanks in part to our reputation in the community, we have been able to build a large – albeit informal – referral network that supplies us with a reasonably steady stream of new patients in need of complex reconstructive services, “ says Horowitz.
“There are fewer and fewer plastic surgeons willing to take on the challenges of complex reconstructive patients these days, so our referral sources are understandably appreciative that they have us to see their patients.
Even with this network, the practice has observed a shifting emphasis from reconstructive work to cosmetic procedures. “It is a natural evolution that most practices experience as time progresses,” says Horowitz. “Today, cosmetic proc