April 3, 2009
Doctors always know to scrutinize vendors' before-and-after pictures-especially when deciding the next capital expenditure. But what about those images makes them suspect?
At this morning's pre-conference clinical application course at the American Society of Laser Medicine and Surgery annual meeting, Ron Scherl, a marketing imaging and digital asset manager with Soltamedical, provided an overview of how little things, such as lighting and patient positioning, can alter the appearance of wrinkles and cellulite in photographs. Using various before-and-answer pictures, he demonstrated the most common mistakes made in taking patient photographs-which can cast a long shadow on the image's credibility.
Lighting. Before-and-after pictures can be taken under various lighting conditions, making the results suspect. By providing overhead light, shadows make wrinkles more pronounced. Straight-forward light, however, will de-emphasize the offending lines.
Thus, a clear way to analyze photo quality is checking for these shadows in both pictures. Shadows, Scherl says, are important to see, despite recent pushes from clinical imaging software companies to provide shadow-free systems. A straight-on flash (taken with a point and shoot camera) and fluorescent lights can also accentuate different features/results in a patient photo. He recommends two professional light umbrellas for taking pictures in office.
Positioning. Demonstrating examples of how two photos of a patient's stomach can trick the eye, Scherl also stresses consistent positioning. In one photo, for example, the patient's shoulders are hunched forward with the arms at the side. In another, the patient's arms are raised above his head and his posture is much straighter, pulling the skin of the stomach back. Two other photos show the buttocks of one patient in before-and-after style. In the before pictures, the patient is pulling these muscles tighter-accentuating the cellulite around the area. In the other one, the patient's muscles are more relaxed.
"Intentional or not, it is misinformation and it deceives your patient," says Scherl, speaking to the clinical implications in practice. "This misinformation usually just results from a lack of effort or a lack of knowledge."
Good ingredients for analyzing and taking patient pictures include staying with a formula, centering on consistency in lighting, patient positioning and camera positioning.