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An analysis of leading, lagging, and coincident economic indicators in the United States and its relationship to the volume of plastic surgery procedures performed: an update for 2012. Can minimally invasive cosmetic procedures maintain and build a practice during periods of poor economic times?
Ian C. Hoppe, MD, Craig Pastor, MD, Angie Paik.
New Jersey Medical School - UMDNJ, Newark, NJ, USA.

BACKGROUND: As physician compensation and reimbursement tightens throughout the United States it is important for physicians to be aware of the influence that the economic environment has on the unique medical field of plastic and reconstructive surgery. This study will attempt to determine a relationship between the volume of different plastic surgical procedures and various economic indicators. Leading indicators, those that tend to change ahead of the economy, include issuance of new building permits. Lagging indicators, those that tend to change after the economy, include Consumer Price Index (CPI) and the average prime rate charged by banks. Coincident indicators, those that tend to change with the economy, include Gross Domestic Product (GDP) and personal income.
METHODS: Information from the American Society of Plastic Surgeons’ annual reports on plastic surgery statistics available on the internet, (http://www.plasticsurgery.org/Media/Statistics.html) was collected from the year 2000 through 2011. Information regarding the total number of reconstructive, cosmetic surgical and cosmetic minimally invasive procedures was collected. For the years 2000 and 2001 information regarding cosmetic surgical procedures was not directly reported, so the number of reconstructive surgical procedures was subtracted from the total surgical procedures to obtain this value. Yearly economic indicators were collected from readily available websites.
RESULTS: In terms of the total number of plastic surgery procedures performed there was a significant positive relationship with GDP, GDP per capita, personal income, CPI (all), and CPI (medical), and a significant negative relationship with the issuance of new home permits. There was a significant positive relationship with total cosmetic procedures and GDP, GDP per capita, personal income, CPI (all), and CPI (medical), and a significant negative relationship with the issuance of new home permits. There was a significant positive relationship between cosmetic surgical procedures and the issuance of new home permits and the average prime rate charged by banks. There was a significant positive relationship with cosmetic minimally invasive procedures and GDP, GDP per capita, personal income, CPI (all), and CPI (medical), and a significant negative relationship with the issuance of new home permits. There was a significant negative relationship between reconstructive procedures and GDP, GDP per capita, personal income, CPI (all), and CPI (medical).
CONCLUSIONS: Cosmetic minimally invasive procedures involve less downtime, are generally less expensive than surgical options, and are widely available making it easier for patients to decide on them quickly during good economic times. This study demonstrated a similar relationship between several economic indicators and the volume of different classifications of plastic surgical procedures performed as a study performed by the authors last year. Furthermore, it is apparent plastic surgeons must be proficient at performing minimally invasive cosmetic procedures in order to maintain a clientele and offer patients a more affordable option during tough economic times. This may lead to further business growth during more favorable economic times.


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