20 Questions: Anthony S. Youn, MD, FACS
Created November 2, 2011 by Juliet Farmer
Anthony Youn, owner of Youn Plastic Surgery, PLLC, in Troy, Michigan, earned his MD from Michigan State University College of Human Medicine in 1998 before participating in a general surgery residency program at Grand Rapids Medical Education and Research Center for three years. From there, Dr. Youn focused on plastics, serving a two-year plastic surgery residency with Grand Rapids Medical Education and Research Center (MERC, formerly GRAMEC), followed by a one-year Aesthetic Plastic Surgery Fellowship at the Ellenbogen Plastic Surgery Institute with Dr. Richard Ellenbogen in Los Angeles.
In 2002, Dr. Youn was recognized with a Clinical Research Award, Michigan Academy of Plastic Surgeons. He has appeared on The Rachael Ray Show, The CBS Early Show, The Montel Williams Show, Youth Knows No Pain (HBO Documentary), E! Celebrity Plastic Surgery, CNN, The Fox News Channel, eTalk (Canadian entertainment show), TV Made Me Do It, and Dr. 90210. He has been published in numerous medical journals, as well as in US Weekly, In Touch Magazine, Life and Style Weekly, Globe, Consumers Digest, Women’s Running, Radar Magazine, JANE Magazine, OK! Magazine, National Enquirer, Pink Magazine, HOUR Detroit, Detroit News, Detroit Free Press, Cosmeticsurgery.com, MarketingShift.com, and MSNBC.com. His recent book, In Stitches, a humorous memoir about medical school, was published in April 2011. Dr. Youn was born in Detroit and currently resides in Birmingham, Michigan, with his wife, Amy Youn, M.D., and their two children.
In your book, you note that your father wanted you to be a doctor practically the day you were born. If you had it to do all over again, would you still become a physician? (Why or why not? What would you have done instead?)
Yes, I would definitely choose this career path again. I can’t think of a career that is more rewarding or would allow me the privilege of changing people’s lives, making a nice living, being my own boss, and receiving the gratitude of my patients. There were many times during my education and training where I questioned my reasoning behind being a doctor. Now that I’m in practice, those questions have long-since disappeared. I am proud to call myself a doctor.
What do you like most and least about being a physician and interacting with patients?
No question, the thing I like least about being a physician is dealing with the stress of malpractice. When I was in medical school an attorney told me, “It’s not IF you will be sued, but WHEN.” Unfortunately, with today’s legal climate, even if you are a hard-working, moral, expertly-trained, and sincere doctor, you can still be sued for everything you are worth and then some. It’s a cloud that hangs above the heads of all doctors. I am so thankful that I’ve never been sued but dread when that day comes. I know it will, no matter how conscientious a physician I am.
The best thing about interacting with patients is seeing how their lives are changed after surgery. As a plastic surgeon, my results aren’t measured in lab values or resolving symptoms. I’m blessed to be able to see the results of my treatment, often immediately. I get a warm feeling when a patient returns to my office in a postoperative visit with a big smile on his or her face. I wouldn’t trade those smiles for anything.
What did you like and dislike about using a prosected cadaver?
My medical school, Michigan State, utilized prosected cadavers. Most other medical schools assign a specific cadaver to a small group of students, who usually give the cadaver a name (such as Joe, Sally, or Chachi) and proceed to dissect the cadaver over the course of a semester or two. We had our cadavers dissected for us, with little green cards with arrows pointing to the body structures. It saved me a heck of a lot of time otherwise spent trying to dissect the lingual nerve from the inferior alveolar nerve. Instead, I used this freed-up time to study, exercise, catch a nap, and even try to find a date.
The negative is that we often lost a little of the three-dimensional appreciation for the body. The body is composed of many layers, which a student who dissects their own cadaver may appreciate better than one who learns from prosected cadavers.
Looking back now on the circumstances of Mrs. Zingerman’s death (referenced in your book), do you agree with your intern that, if it had to happen, it was good to experience that situation on your first day rather than later? Why or why not?
Mrs. Zingerman – as I called her in my book, not her real name – was my first patient in medical school. Ten seconds after introducing myself she literally dropped dead right in front of my eyes. My initial thoughts were: “I have killed my first patient. This can’t be good. It may be some sort of record, but I know it can’t be good. Will I be marked down for this?”
In all seriousness, all doctors experience patient death. It’s a fact of medicine that I believe is important to witness as early as possible.
Obviously, there is no upside for the patient in educational experiences of this nature, but the reality of the hospital is that it’s a place of new life, healing, and death. I strongly believe that it’s only with the knowledge and experience of medical failures that we can truly appreciate the successes in medicine.
You used a very personal story to connect with a difficult patient with great success. How did that experience shape future interactions with your patients?
This first life I “saved” as a medical student really had nothing to do with medical knowledge at all. Frank was a junk dealer who was diagnosed with critical coronary artery disease. If he didn’t consent to open-heart surgery he was going to die, and die soon. He smelled like old cheese, had the personality of a pissed-off gorilla, and distrusted the medical system so much he refused to sign the consent. He was estranged from his family, so they weren’t available to help.
My intern assigned me to talk with him about the surgery, in hopes of saving his life. After being cursed at and told to leave him alone, I tried one last thing. I sat with him and told him about how my mother’s life was saved with the same surgery that could save his. He consented to the surgery and even reconciled with his family because of it. This taught me the lesson, as described in the next question.
Explain why you agree that “It is more important to know what sort of person has a disease than to know what sort of disease a person has” (Hippocrates).
Experiences like the one with Frank have taught me that medicine is more than just pharmacology and physiology. While I don’t believe that laughter is necessarily the best medicine (my patients would forcefully object if I wrote a script for ‘laughter’ instead of Vicodin), personal interactions involving humor, levity, and sincere interest are extremely important for our patients’ well-being. The time we spend with our patients may be just as important as the medications we prescribe.
How did Dr. Pyle’s confidence in you during the first spinal tap you performed affect you/your career?
Most medical students have a mixture of excitement and dread for the first time they perform an invasive medical procedure. It’s funny to look at it now, but I was SOOOO nervous for my first fake and real patient interview, my first IV placement, and definitely my first spinal tap. During the preparation for the spinal tap, with the parents watching me intently, I felt like a minor league batter called up to pinch hit in the World Series. It’s a mixture of nerves, excitement, pride, gratification, enthusiasm- but mostly NERVES. Luckily I hit a clean tap on my first try. This was really the first time I performed a medical procedure perfectly, and even today I strive to do this with every surgery I complete.
The case of the baby vs. raccoon was a point in your career path. How much did that case play into your specialty decision? Looking back on it, how much did your own reconstruction procedure play into your decision?
I underwent major reconstructive surgery to my jaw in the summer between high school and college. Prior to this surgery, my mandible was so large it was twice the size of Jay Leno’s and dubbed “Jawzilla.” At the time, I hoped that this surgery would transform me, a skinny Asian American nerd with no nerve, no game, and no clue, into an Adonis. A ladies’ man. Unfortunately, this surgery started a four-year dating drought, and didn’t really teach me that changing your appearance could change your life until much, much later.
My real introduction to plastic surgery came in the form of an eight-month-old boy who was mauled by a raccoon. His face was literally eaten off. The moment I saw the plastic surgeon make plans to reconstruct this poor child’s face, I was hooked.
Has your specialty met your expectations?
No question. I, like many medical students, struggled with which field of medicine to choose. At one time or another, I considered many different specialties, including orthopedic surgery (these jocks of medicine wouldn’t be interested in a skinny nerd like me), general and trauma surgery (I nixed this one the moment I saw a sixty-year-old attending stumble out of a call room at 2 a.m. for a trauma), psychiatry (my fear of falling asleep on a depressed patient mid-session cancelled this one out), and family practice.
Plastic surgery is the only specialty that really inspired me. It allows me to operate, which I love, and use some of my artistic skills and aesthetic eye. I strongly believe plastic surgery has one foot firmly planted in art and the other in medicine. The variety of surgeries is also fascinating and enjoyable. Tomorrow, I’m performing three surgeries: a breast enhancement on a 30-something woman with breasts that shrank after having children; a breast reduction on a young woman with severe back, neck, and shoulder pain; and reconstruction of an older man’s nose after having Moh’s surgery to remove a large skin cancer.
Describe a typical day at work.
I see patients all day Mondays and Wednesdays, and operate Tuesdays, Thursdays, and Friday mornings. Here is my typical Thursday:
6:30 a.m. – Alarm goes off, I fumble for the snooze button and accidentally knock my clock onto the hard wood floor.
6:32 a.m. – My daughter wakes up and begins yelling, “Daddy!”
6:35 a.m. – Stumble out of bed, change daughter’s diaper and bring her into my bed. Take a shower, change, then make breakfast.
7:30 a.m. – Drive to hospital, flipping between Sirius Hits 1 and NPR
8:30 a.m. – Begin first surgery of the day. Usually operate until about 2:30 to 3 p.m. In between surgeries, I see the next patient and check my email. If the OR turnover takes too long, jump on Facebook or bribe OR staff with Starbucks to decrease turnover time.
Approximately noon – Stuff a sandwich down my throat, wash it down with water or Pepsi, inhale stale hospital cookie, then rush back to OR.
3:30 p.m. – Return to office to see a couple postoperative patients and perform some minor procedures (Botox injections, mole or skin cancer removals, touchup surgeries).
5 p.m. – Paperwork, dictations, emails back to patients and media.
6 p.m. – Drive home, feel guilty for emails not returned.
6:30 p.m. – Dinner with wife, kiddies, and poorly trained begging dog (Shih Tzu).
8 p.m. – GTL (just kidding!) Help put kids to bed, then stretch out on couch and read newspaper, watch “Modern Family,” or surf the internet on iPad. If surgeries were overly difficult, then it’s Miller Time.
9 p.m. – Work on latest project (book, book promotion, TV segment, or original article) or exercise in basement workout room while watching UFC or “Survivor.”
11:30 p.m. – Go to bed, tell myself and my wife that tomorrow I’ll go to bed much earlier (never happens).
3 a.m. – Wake up to dog snoring.
What mix of clinical/research/teaching work do you do? How much power do you have to change that mix?
In an ideal world, I’d perform both research and teaching. Unfortunately, as a solo practitioner who is not affiliated with a university, there is very little time to perform research and no residents to teach. Early in my career, I worked on a couple of clinical research projects and submitted the abstracts to the national meetings but was rejected for each one. I think it’s a frustrating fact in the field of plastic surgery that if you don’t have a “big academic name” to promote your abstract, there is very little chance you will be able to present it at a meeting. Now, with my children and In Stitches to take up my time, research has taken a back seat. It’s actually in the trunk.
Are you satisfied with your income?
Yes. I would never complain about what I am making, although Uncle Sam takes a large percentage of it!
You took out educational loans–is/was paying them back a financial strain?
My wife and I made the conscious decision to live like residents until we had our loans completely paid off. So, for the first two years of practice we drove our beater cars, rented a small apartment, and were pretty frugal. We lived off her income as a part-time pediatrician and put everything I made into paying back my practice and our student loans.
The day after I sent in the last check to the government I bought a huge, old-school video game console complete with 4000 games. I played Ms. Pac Man and Golden Tee for the next three days until I had blisters on my fingers.
On average: How many hours a week do you work? How many hours do you sleep each night? How many weeks of vacation do you take?
I work approximately 50 to 55 hours per week, but take all my weekends off. I sleep 6 to 7 hours each night and take 3 to 4 weeks of vacation per year. I also take at least 5 to 10 days off each year to travel for media like the “Rachael Ray Show” and “The Doctors.”
In your position now, knowing what you do – what would you say to yourself on your first day of medical school?
Don’t neglect your family and friends. You need, and can still have, a life outside of medical school. Balance is important. As a medical student, I was so absorbed in my med school world of tests, classes, and stress, that I really neglected my family and friends. I didn’t return calls or emails, spent too many weekends studying, and even lost touch with several people I shouldn’t have. Simply said, I should have called and visited my family more.
What information/advice do you wish you had known when you were an undergraduate? (What mistakes or experiences have you encountered that you wished you had known about ahead of time so you could have avoided?)
As an undergrad, I did really well academically, but my social life was a big zero. Literally zero. I had zero girlfriends in all my four years of college. This all changed once I went to medical school and was mentored by my medical school colleagues on how to date successfully. They taught me three rules: (1) All single guys should read Cosmo religiously; (2) Never talk about your mother on a date or at the bar; (3) Buy a lighter!
From your perspective, what is the biggest problem in health care today?
I believe that the biggest problem in health care today is that the combination of a growing population and increasingly expensive technology is causing health care costs to skyrocket. Doctors and hospitals are being paid less and less, yet the costs continue to go up. There really isn’t an easy solution. Should we ration care to those who need it most? Should we refuse expensive tests and treatments on those with little chance of survival? The real solution probably includes a combination of EMR, care dictated by evidence-based-medicine, malpractice liability reform, some form of rationing, and others. I wish I had the answer.
From your perspective, what is the biggest problem in your specialty?
As a board-certified plastic surgeon, I’ve completed four years of medical school, five years of general/plastic surgery residency, and one year of aesthetic plastic surgery fellowship. I’ve passed my written and oral specialty board exams and am held up to the highest ethical standards by the American Society of Plastic Surgeons. Yet, there are thousands of doctors who work under a cosmetic doctor for a few months or even just take a weekend course, and proclaim that they are real plastic surgeons. Ob Gyns, ER docs, and even some dentists are performing plastic surgery. As a whole, my specialty has not done a good job of informing the public of our qualifications as real plastic surgeons.
What other types of providers and/or technicians do you work with in your day-to-day practice?
I often interact with dermatologists for skin cancer treatments, family docs and internists for preoperative clearances, and general surgeons to aid in hernia repairs. I’ll occasionally curbside one of my best friends, a psychiatrist, for “difficult” patients or patients with BDD (Body Dysmorphic Disorder). My employees include a nurse who performs cosmetic injections like Botox, an M.A. who helps take care of my postoperative patients, and two medical aestheticians who perform laser treatments, chemical peels, and skin care consultations.
What do you like to do for relaxation or stress relief? Can you share any advice on finding a balance between work and family/life?
I think it’s always a challenge for physicians to find balance, whether we are in practice or in training. As a medical student, I had very little balance, especially during my brutal second year and before Step 1 of the Boards. For me, medical school was about pure survival, so balance was pretty much thrown out the window. Once I entered residency, however, I started a Jimmy Buffet cover band and spent a good portion of my limited free time playing gigs. It was quite a rush to play to packed bars filled with dancing and singing friends and patrons. Now, I spend a lot of my time dancing and singing with my kids. When the kids are asleep I work on projects like In Stitches and segments for TV.
I think the best advice I can give is this: When you are done with work, do things you enjoy. As physicians, we are accustomed to delayed gratification. I think the turtle in Kung Fu Panda said it best, “Today is the present, and that’s why it’s a gift.” Find moments of happiness in medical school. And once you finish med school, there is no excuse to delay. Enjoy yourself, because the worst is over.