Q&A with ASPS President Gregory Greco, DO

Ahead of Plastic Surgery The Meeting 2023 in Austin, Texas, the Plastic Surgery Resident Editorial Board collaborated on a set of question to be addressed by ASPS President Gregory Greco, DO, Red Bank, N.J. The questions were not only designed to gain insight on his year in leadership, but to also draw invaluable advice and guidance to residents as they pursue a career in plastic surgery.

PSR: What inspired you to pursue plastic surgery as a career – and what do you love most about it?

Dr. Greco: Like most pet-owning kids, I thought I wanted to be a veterinarian. Working for veterinarians while in high school and college convinced me to pursue a career in surgery. These jobs convinced be that I loved being in the O.R., as well as the art of surgery. While in medical school, I had the opportunity to work with Joseph Reichman, MD, a plastic surgeon who served as a mentor and role model – and that experience solidified my love for plastic surgery.

PSR: What moment best-defined your career as a plastic surgeon?

Dr. Greco: Over the course of nearly 22 years of practice, there are so many "moments" that can't be captured in words. However, I can recount one situation that changed my approach to patient care. As a surgery resident, I remember being on call, making my evening rounds and coming across a 35-year-old patient who had undergone a colectomy. It was obvious that she wanted to talk to someone, beyond the officious daily rounds chat. I silenced my pager, sat in a chair and just listened. Several months later, a gift appeared for me at the hospital. It was just a sweatshirt, but it came with a note thanking me for listening and letting her know that someone cared about her – beyond her diagnosis and vitals. To this day, every time I enter my exam rooms, I take a seat – no phone, no computer, just me – to listen to my patients.

PSR: When you think back upon your training, who inspired you?

Dr. Greco: So many people inspired me. As a traditional pathway resident, I completed nine years of residency, general surgery and plastics. Surgical training is one of the most rigorous things a physician can undertake. I was always inspired by surgeons who were not only technically gifted but also kind, compassionate and empathetic to their patients. These surgeons treated residents similarly in a caring and respectful manner. I realized that I felt an obligation to these attending surgeons to work harder and not disappoint them on rounds, in the O.R. or at the patient's bedside. I also got involved in my state societies and ASPS early in my career, which helped me meet so many inspirational leaders.

PSR: If you go back in time, what mistakes would you try to avoid during your residency program?

Dr. Greco: I'm not sure "mistakes" is an appropriate word – however, if I look back, I could have done better about knowing when to ask for help. I would also try to get a research mentor. Residency is difficult enough from a clinical standpoint, and continued scholarly activity output can be difficult if you don't actively pursue it. I think this can set the stage for your academic career. If you realize in residency that research, outcomes studies, etc., are integral to practice, then you easily incorporate it into your clinical practice. The best part of residency training is learning what not to do.

PSR: What's the most important attribute of a resident?

Dr. Greco: GRIT. As I said, surgical residency is difficult – and becoming a doctor and a surgeon is a privilege that most will never get to achieve. It's incredible to realize that what you do every day – no matter how trivial it seems to you – will affect someone. Being a patient or having a loved one as a patient is stressful. I watch my surgical residents sometimes get agitated about having to place orders, discharge patients or see consults in the E.D. I frequently remind them that every patient deserves 100 percent of you, all the time. Get away from the computer and go see the patient.

PSR: What's your most important career advice for residents?

Dr. Greco: Practice where you want to be and do what you want to do. Don't worry about how many plastic surgeons are in the area; who tells you not to come; or why the community doesn't need another plastic surgeon. Go, do great work, take call and service your community in a kind and caring manner. Have an actual human answer your office phone and, most importantly, don't be greedy. It seems like simple advice, but that simple advice works nearly 100 percent of the time. I have given it to many graduating seniors residents in many different surgical specialties.

PSR: What strengths and areas of opportunity do you see with international plastic surgery residents?

Dr. Greco: International residents offer a wonderful practice perspective for our U.S.-based residents. Depending on the economic climate and cultural norms of their home country, these residents are often training in very different ways than their U.S. counterparts. There's an opportunity for aesthetic, procedural and technical nuance that can go unnoticed in U.S.-based programs.

PSR: What's been your greatest achievement – and of what are you most proud during your ASPS presidency?

Dr. Greco: First, I'm incredibly humbled and proud of being able to represent ASPS and plastic surgery on the national and world stages. I think my greatest achievement is the creation and workshopping of the Private Academic Initiative for Research and Education (PAIRe) Program, which will create virtual and in-person collaborations among residents, faculty and private practitioners throughout the country. The initiative is in its early stages of development and will be beta-tested later next year. The ultimate goal is to increase scholarly opportunities for residents in training.

I'm also very proud of ASPS participation in repealing the sunsetting of the S-codes for microsurgical breast reconstruction. We launched a massive grassroots campaign, developed a four-pillared national approach and I personally testified to CMS, which ultimately cited the ASPS position papers for its reasoning to repeal the sunset of the S-codes.