Sandman1 - 1:47 am on Sep 8, 2010 (gmt 0)
tedster -- for the SF plastic surgery result, I am seeing one domain at the top with eight bullets under it (four each in two columns). The bullets list pages on the doctor's site -- "contact us," "labiaplasty," etc.
Under that doc, I see local search results and then organic search under the local.
For "San Francisco plastic surgeon," I don't see anything unusual.
I just did a search for "Los Angeles Unified School District" and got a similar multi-result listing for LAUSD with regular organic search results underneath.