BOOK Summary – Surrounded by Idiots by Thomas Erikson

Lessons for a Plastic Surgery Practice from the Book – Surrounded by Idiots

Running a successful plastic surgery practice requires more than surgical skill. Surgeons and practice managers must also master the art of communication. Patients come in with high expectations, staff bring different personalities to the workplace, and conflicts sometimes arise when people don’t see eye to eye. Thomas Erikson’s bestselling book Surrounded by Idiots offers a framework that makes sense of these challenges.

By dividing human behavior into four main personality types by color— Red (D), Yellow (I), Green (S), and Blue (C) — Erikson explains why people misunderstand each other and how to bridge communication gaps.

In this article, you’ll discover:

A complete summary of Surrounded by Idiots
The four personality types and how they appear in medical settings
How patients, staff, and surgeons interact differently based on personality
Practical applications for plastic surgery clinics in consultations, staff management, and marketing
An overview of Erikson’s other books and lessons for healthcare leaders
Key takeaways to help you build stronger communication skills and better patient outcomes

PLEASE NOTE – I love studying personality types and using behavioural profiling to understand people but am NOT at all a fan of the title of this book – Surrounded by Idiots.

The Four Personality Colors Explained

Erikson’s Surrounded by Idiots framework is simple but powerful. He uses four colors to describe communication styles, adapted from DISC theory. Each color represents a dominant way of behaving, thinking, and responding.

Red – The Decisive Driver (D Type)

Goal-focused, impatient, results-oriented.
In a plastic surgery practice, Reds are often surgeons or business owners who want efficiency and quick results.
Strengths: decisive, bold, and action-oriented.
Weaknesses: can appear blunt, insensitive, or intimidating.

Yellow – The Social Enthusiast (I Type)

Outgoing, charismatic, and energetic.
In a clinic, Yellows are often sales consultants or patient coordinators who love connecting with people.
Strengths: persuasive, optimistic, and engaging.
Weaknesses: may skip details, lose focus, or overpromise.

Green – The Calm Supporter (S Type)

Steady, loyal, and harmony-seeking.
In plastic surgery, Greens are often nurses or admin staff who provide stability and patient reassurance.
Strengths: dependable, empathetic, and cooperative.
Weaknesses: dislike change, avoid conflict, and can be indecisive.

Blue – The Analytical Thinker (C Type)

Logical, structured, and precise.
In a clinic, Blues are often practice managers, financial controllers, or meticulous surgeons.
Strengths: detail-focused, accurate, and disciplined.
Weaknesses: overly critical, risk-averse, or slow to act.

No one is just one color. Most people are a blend, but usually one or two dominate. Recognising these traits helps staff and surgeons adapt communication styles and improve patient experiences.

How Personality Types Show Up in a Plastic Surgery Clinic

The four colors play out every day in consultations, team meetings, and staff-patient interactions. Understanding them can transform a practice.

Patient Personalities

D – Red patients want quick answers, clear results, and short consultations. They prefer a confident surgeon who speaks directly.
I – Yellow patients enjoy storytelling, want to feel special, and value the overall experience as much as the outcome. They respond well to enthusiastic staff and warm environments.
S – Green patients take time to decide. They seek reassurance, stability, and ongoing follow-up. They value patient care coordinators who are calm and patient.
C – Blue patients arrive with research, lists of questions, and demand detailed explanations of risks and benefits. They want evidence, not emotion.

Staff Personalities

D – Red surgeons or managers drive performance but may frustrate slower-paced staff.
I – Yellow sales staff generate excitement but may clash with detail-oriented colleagues.
S – Green nurses bring empathy but resist sudden changes in systems or schedules.
C- Blue administrators ensure compliance and financial order but may frustrate fast-moving Reds and Yellows.

Recognising these patterns prevents miscommunication. For example, a Yellow consultant trying to “sell” surgery to a Blue patient by focusing only on excitement may lose trust. Instead, matching communication to the patient’s type builds confidence and improves conversions.

Common Clashes in Plastic Surgery Practices

Erikson describes how personality differences create tension. In clinics, these clashes often look like:

Red vs. Blue – A surgeon (Red) demands fast scheduling, but a compliance officer (Blue) insists on detailed paperwork first.
Yellow vs. Green – A bubbly consultant (Yellow) wants new marketing campaigns, but the receptionist (Green) resists change and feels anxious.
Red vs. Green – A business owner (Red) pushes staff to close consultations quickly, while a nurse (Green) prefers to give patients more time.
Yellow vs. Blue – A sales coordinator (Yellow) promises a “life-changing” result, while the surgeon (Blue) stresses realistic expectations.

Without awareness, these clashes create frustration and lower team morale. With awareness, leaders can adjust their approach and reduce tension.

Practical Applications for Plastic Surgery Practices

Patient Consultations

Match communication style to patient type.
With Reds: be direct, confident, and efficient.
With Yellows: engage warmly, share stories, and highlight lifestyle benefits.
With Greens: take time, show care, and avoid rushing.
With Blues: provide data, safety details, and written material.

Staff Management

Identify dominant colors in your team.
Place Reds in leadership or decision-heavy roles.
Place Yellows in sales, social media, or patient-facing positions.
Place Greens in patient care, recovery, and supportive roles.
Place Blues in compliance, finance, and systems management.

Marketing and Sales

Target Reds with messaging focused on results and authority.
Target Yellows with aspirational stories and lifestyle images.
Target Greens with testimonials (where permitted) and patient care messaging.
Target Blues with safety statistics, surgeon qualifications, and detailed FAQs.

Conflict Resolution

Encourage staff to recognise differences instead of labeling others as “difficult.”
Train leaders to flex their communication style.
Create systems that balance speed (Red/Yellow) with accuracy (Green/Blue).

Useful Lessons from Erikson’s Other Books for Plastic Surgery Leaders

Thomas Erikson’s other works expand on the same four-color framework, each with lessons relevant to medical practices.

BOOK – Surrounded by Psychopaths

Warns against manipulative individuals.
In clinics: helps staff identify toxic behaviors in patients, employees, or external partners.
Teaches boundaries and protective strategies.

BOOK – Surrounded by Bad Bosses (and Lazy Employees)

Explains workplace dysfunction.
Useful for surgeons and practice managers trying to lead diverse teams.
Offers insights into leadership styles and staff motivation.

BOOK – Surrounded by Setbacks

Focuses on resilience after failure.
Relevant for practices facing negative reviews, difficult outcomes, or business challenges.
Shows how each personality type recovers differently.

BOOK Surrounded by Energy Vampires

Identifies draining personalities.
Helpful for recognising patients or staff who sap energy.
Encourages setting limits and protecting workplace culture.

Criticisms and Limitations of The Four Color Model

The four-color model oversimplifies human behavior.
People are complex and can act differently in different contexts at different times.
The framework is not scientifically rigorous.
Cultural and regulatory differences affect communication.

Still, simplicity is its strength. For a busy surgeon or practice manager, an easy framework similar to DISC is more useful than a complicated theory.

Case Studies – Dealing with Different Personality Types in Plastic Surgery Practices

Case Study 1: The Red Patient

Dr. Lewis, a plastic surgeon, meets a patient who is confident, direct, and impatient. The patient says, “I want breast augmentation — just tell me how soon we can book.”

Challenge: The patient wants speed, but the clinic has standard safety protocols.
Approach: The surgeon mirrors the patient’s directness, explains timelines clearly, and avoids unnecessary small talk.
Outcome: The patient feels respected, the consultation is short, and the booking is made without frustration.

Case Study 2: The Yellow Patient

A cheerful woman arrives for a rhinoplasty consultation, excited about the idea of a “new look.” She wants to know what her friends will think.

Challenge: She is more focused on the emotional outcome than the surgical realities.
Approach: The Patient consultant uses warmth, encourages her enthusiasm, but carefully explains realistic results to balance her expectations.
Outcome: The patient feels supported and excited, but also informed enough to make a responsible decision.

Case Study 3: The Green Patient

A middle-aged man enquires about a tummy tuck but seems hesitant. He says, “I just want to make sure it’s the right decision. Can I think about it?”

Challenge: The patient fears change and needs reassurance.
Approach: The Patient consultant avoids pressure, provides written information, and schedules a follow-up call.
Outcome: The patient feels cared for, returns after reflection, and books surgery with confidence.

Case Study 4: The Blue Patient

A detailed, research-heavy patient arrives with printouts from medical journals. She asks about complication rates, implant brands, and recovery timelines.

Challenge: She may delay making a decision without all the facts to weigh up the risks.
Approach: The surgeon and Patient consultant provide data, safety statistics, and offer extra resources. They avoid emotional selling.
Outcome: The patient trusts the clinic’s thoroughness and books after her careful analysis.

Examples of Scripts for Different Patients

Script for a Red Patient

Patient: “How soon can I get this done?”
Consultant: “We can schedule your surgery within the next four weeks. The procedure itself takes about 90 minutes, and recovery is straightforward. Let me outline the key steps now so you can decide today.”

Script for a Yellow Patient

Patient: “I just want to feel amazing and get my confidence back!”
Consultant: “That’s wonderful — many of our patients feel exactly the same. This procedure can enhance your appearance, but let’s also review what’s realistic so you’ll be thrilled with your result long-term.”

Script for a Green Patient

Patient: “I’m nervous… I don’t want to rush into anything.”
Consultant: “That’s completely understandable. Let’s go through everything at your pace. I’ll also give you written information so you can think it over. We can arrange another meeting when you’re ready.”

Script for a Blue Patient

Patient: “What’s the exact risk of complications with this implant type?”
Consultant: “Great question. The latest studies show a complication rate of less than 2%. Here are the published results, and I’ll provide a detailed information sheet so you can review the numbers at home.”

Key Takeaways from the Book – Surrounded By Idiots – for Plastic Surgery Practices

Patients are not difficult; they just think differently.
Surgeons, staff, and patients all bring unique communication styles.
Recognising colors improves consultations, reduces staff conflict, and boosts conversion rates.
Flexible leaders adjust their style depending on the person in front of them.
A practice that applies these principles builds stronger trust, smoother workflows, and better patient satisfaction.

Taking Action on Surrounded by Idiots

Plastic surgery is a high-stakes, emotionally charged field. Patients invest money, time, and trust into procedures that change their lives. Miscommunication at any stage — from enquiry to surgery — can lead to dissatisfaction, conflict, or lost opportunities.

Thomas Erikson’s Surrounded by Idiots provides a practical lens to improve these interactions. By understanding Reds, Yellows, Greens, and Blues, surgeons and practice managers can communicate with clarity, adapt to different personalities, and build a thriving clinic culture.

When applied to plastic surgery, Erikson’s lessons go beyond theory. They directly improve patient trust, staff collaboration, and practice success. The real takeaway is simple: no one in your clinic is an “idiot” — they just see the world differently.

Tips for Surgeons and Practice Managers

Train staff to spot dominant patient colors within the first five minutes. (Observe and Match their Speed – Fast or Slow Pace? and Style – Feelings/Relationship or Facts/Results?)
Create patient information packs with different emphasis: visual brochures for Yellows, detailed FAQs for Blues, testimonial stories for Greens (outside Australia), and bold outcome / results highlights for Reds.
Role-play common patient scenarios in staff training to build confidence.

FAQs about the Four Color Model from Surrounded by Idiots

Q: Can a patient’s personality color affect their satisfaction with surgical results?
Yes. Reds may be satisfied if outcomes are fast and decisive, while Blues may judge success based on technical precision. Yellows focus on how the result makes them feel socially, and Greens value reassurance and aftercare. Aligning consultation style with their color helps set expectations properly.

Q: How can surgeons quickly spot a patient’s dominant color type in consultation?
Listen for cues in their first few sentences. Reds are direct and to the point. Yellows are chatty and expressive. Greens speak gently and ask for reassurance. Blues ask detailed questions and may bring research with them.

Q: Do surgeons usually fall into one dominant color type?
Many surgeons lean toward Red (decisive, driven) or Blue (precise, detail-focused). However, successful surgeons often flex between both — Red for leadership and decision-making, Blue for surgical planning and safety.

Q: How does the personality color model help reduce cancellations or no-shows?
By tailoring follow-up. Reds respond to reminders of results and efficiency. Yellows benefit from friendly, enthusiastic contact. Greens need gentle reassurance. Blues want written details confirming logistics and safety. Matching communication reduces drop-off.

Q: Can staff with different colors work well together?
Yes, if managed properly. A Yellow consultant can generate excitement, a Green nurse can calm anxious patients, and a Blue practice manager ensures compliance. A Red surgeon drives the team. The challenge is preventing clashes when colors oppose each other.

Q: What’s the risk of misusing the color model in a clinic?
Labeling people too rigidly. Patients and staff are complex and may act differently in different contexts. The model is best used as a flexible guide, not as a fixed judgment.

Q: How can the colors influence patient referrals?
Yellows are natural advocates and great referrers who will enthusiastically share their experience. Greens refer quietly to close friends and family. Reds may refer if efficiency impressed them. Blues might refer when the clinic’s professionalism exceeds expectations but it is highly unlikely.

Q: Can marketing campaigns be color-targeted for better results?
Yes. Reds respond to clear, results-driven messaging. Yellows engage with inspiring lifestyle stories. Greens want to see caring follow-up and supportive environments. Blues look for qualifications, safety data, and accreditation badges.