Buyer Beware!

It never ceases to amaze me that doctors have sworn a Hippocratic Oath to do no harm. At least not intentionally. But every now and then I see advertisements by doctors promoting cosmetic procedures for which they are not formally trained in, other than maybe, just maybe, a weekend course to learn Botox or laser lipo.  This medical hooliganism will only get worse with time. And why is that?


(The following comments are not meant to point out why Obamacare is or is not in the best interest of the country. The following comments point out an unforeseen consequence of more insurance or government bureaucracy. The increase in bureaucracy was going to happen, with or without Obamacare, in an ultimately unsuccessful, although admirable, effort to rein in costs.)


Anyway, back to my point! With Obamacare and more regulations and bureaucracy in general, more and more doctors will want to find a way to practice in a way to sidestep insurance companies or the upcoming healthcare exchanges. The only way to do that is do more cosmetic procedures – which are cash only and not subject to third party payors like the insurance company or the government. So it makes life a lot easier for a doctor to practice medicine that doesn’t require all of that bureaucracy.


Enter, cosmetic procedures. By taking a course over a weekend on cosmetic medicine (Botox and fillers) or cosmetic surgery (laser lipo), the doctor can perform these cash pay procedures and make their life easier by avoiding insurance reimbursement, etc. But what makes the un-trained doctor’s life easier, does not make the patient’s life any easier.


See an example below of a patient that saw an orthopedic surgeon who wanted to avoid insurance and government bureaucracy by learning how to do laser lipo…well, sort of.  The biggest problem here is that if you only take a weekend course, you may learn how to do a procedure, but not when to do a procedure.  The patient below, clearly has excess skin, not excess fat. At least it’s clear to a trained plastic surgeon but I understand that would not be clear to an orthopedic-surgeon-turned-laser-lipo-weekend-warrior! And when you have excess skin, that skin needs to be removed (see example here of an appropriate necklift patient). If you have excess fat, fat needs to be removed by way of liposuction (see example here of an appropriate neck liposuction patient). But this patient’s problem was excess skin, not fat. So when the wrong procedure was performed (laser lipo), the excess skin shriveled up and left him with this unfortunate result.

Patient demonstrating excess neck skin, not excess fat. More amenable to necklift rather than laser lipo (which is what patient received, as seen in ‘after’ photo).
This is what happens when the wrong procedure (laser lipo) is performed by the wrong (untrained) doctor

What started out as an easier lifestyle choice for the orthopedic surgeon, led to revision surgery by a board certified plastic surgeon. Certainly didn’t make things easier for the patient!


So beware, with more regulation, more doctors may try cash-only cosmetic procedures but to your detriment.  Lastly, you may ask, why are there no laws against a doctor performing procedures for which they are not trained? Politics, my friend, politics!


Please tell me what you think are the major reasons patients go to unqualified doctors? Is it better marketing? Is it the assumption that if a doctor says they can do something, the public inherently trusts a doctor to be honest?


Check back soon to learn how to determine if your cosmetic surgeon is a board certified plastic surgeon.


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