In this era of declining insurance reimbursement, physicians are scampering to find ways to supplement their income.
Some otolaryngologists, dermatologists, and ophthalmologists are performing plastic surgery. Even primary care physicians such as family doctors and obstetricians are getting into the act.
Usually these non-plastic surgeons call themselves cosmetic surgeons. Shockingly, nurses now want to inject fillers and Botox, and laser wrinkles independent of surgeons! They are taking one- or two-day courses hoping to learn to perform chemical peels, Botox injections, laser hair removal, collagen and Restylane injections, and other procedures.
In New Jersey one obstetrician advertised a three-day course for obstetricians in breast augmentation, liposuction, and abdominoplasties! With minimal or no formal aesthetic training in a residency program or understanding of the skin and beauty, these doctors are taking advantage of their medical licenses and opening cosmetic practices.
The ad for the three-day course pointed out that ‘‘the investment in time and resources to learn aesthetic procedures is minimal.’’ Just what the public wants to hear! And, according to the ad, ‘‘Upon completion of these seminars, the physician will have sufficient knowledge and hands-on training to safely and effectively perform cosmetic procedures in the office setting.’’
I spent over two years in plastic surgery residency following four years of general surgery learning how to do these procedures. I guess I wasted a lot of time. I should have just taken the three-day course!
Inadequately trained surgeons have been around for a long time. In the 1950s surgeons returning from World War II started new practices after taking two-week courses in rhinoplasty.
Certainly, non–plastic surgeons may be capable of performing some cosmetic surgery within the anatomic boundaries of their specialties. Some ophthalmologists legitimately perform cosmetic eyelid surgery, but how do they justify performing breast augmentations, as one near my office does? Ear, nose, and throat doctors may be capable of performing rhinoplasty, and even other facial cosmetic surgery, but how is it that they are trained to do liposuction of the thighs, as another in New Jersey does?
And dermatologists are not surgeons: their area is not recognized by the American College of Surgeons as a surgical specialty. They may do minor procedures, but their field is medicine of the skin. Even with a one-year ‘‘dermatologic surgery’’ fellowship, their training is vastly different from that of a real surgeon. Yet again, all over the world dermatologists are performing liposuction, face-lifts, and breast augmentations.
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