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    In this economy, it's wise for even prestigious institutions to at least consider the price point

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    Dr. Wood-Smith
    Discount might have been a dirty word in cosmetic surgery in the past, but in this economy, even the anchored, prestigious institutions are considering fee cuts. Case in point, the 50 plastic surgeons on staff at New York Eye and Ear Infirmary can opt in or out of a hospital-wide effort to increase cosmetic surgery business. The eye; ear, nose and throat; and plastic surgery departments have all joined with the hospital to offer discounted cosmetic surgery.

    "We will be giving patients a global fee, which will be significantly less than the combined regular fees of the surgeons," says Donald Wood-Smith, M.D., chairman of the Department of Plastic Surgery, New York Eye and Ear Infirmary and professor of clinical plastic surgery at Columbia Presbyterian Hospital.

    Consumers who come to the New York Eye and Ear Infirmary will have a choice between two surgeons (chosen by staff on a rotational basis). The surgeons and hospital have agreed to lower their fees to what the staff has agreed will be more acceptable to people in this economic climate.

    "In my instance, the discount from my regular fees would be 50 percent. We came to a figure that would make the majority of patients happy," Dr. Wood-Smith says. "I think about 50 percent of the staff will end up participating. The hospital is discounting about 30 percent of the normal hospital charges."

    What's happening in New York seems to be happening everywhere. While some cosmetic surgeons are reporting flat business cycles, many more have noticed that patients are less likely to book surgery because of plummeting discretionary spending.

    QUALITY AND VALUE Ran Y. Rubinstein, M.D., a facial plastic surgeon in Hudson Valley and an assistant clinical professor at Columbia New York Presbyterian Hospital, NY, says he's experiencing what many of his colleagues are: decreased demand for big-ticket cosmetic surgeries. "At the same time, I've seen an increase in patients coming in for the injectable treatments," Dr. Rubinstein says, but adds that even his established injectable patients are also opting for less.

    "Typically, someone will come in for a few sites of Botox; a few syringes of fillers. Now...my injectable patients will come in for one site of Botox and, often skip the fillers. So, my patient volume has gone up when it comes to the nonsurgical services but they're spending less."

    To turn things around, Dr. Rubinstein is focused on providing not only quality, but also value by giving them incentive to opt for more of what they need to achieve quality outcomes.

    "I'll offer them specials. ...for example...if they get two syringes of one filler, they get one free. Now I am able to give them a phenomenal result—I believe in volumizing, not just filling lines—and they feel like they're getting tremendous value because I'm throwing in a syringe that could be worth $600, $700, and it doesn't cost me anything," he says. "When the economy turns around, they're going to remember me and the beautiful results and will not go to the person next door who was offering $100 off a filler [syringe]."

    Dr. Rubinstein has also teamed up with filler companies, which are also offering price incentives.

    "I purchase my fillers in bulk and what [the companies] do is frequently throw in a tremendous amount of free syringes," he says.

    Dr. Rubinstein says that he won't discount surgery, but patient response to his filler and Botox offers has been tremendous and is helping to offset surgical losses.

    DEEPER CUTS Trained as a general surgeon, Paul Fondacaro, M.D., transitioned to a cosmetic practice about five years ago because of diminishing reimbursements and rising malpractice premiums associated with general surgery.

    The surgeon, who today practices in Brick, NJ, says he has stepped up marketing efforts and discounting because two patients who were recently booked for laser liposuction cancelled, citing the economy's uncertainty as the reason.

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    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.

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