Hostile doctors and the clinics they run.
Having consulted with many physicians about incorporating some form of cosmetic practice into their clinic, I've noticed that one of the biggest problems that these physicians have is changing the way they 'think' of medicine. (Noticed is something of a simplification since 'beaten over the heat' is a more accurate description.)
Cosmetic medicine is a new world for doctors who are used to third party reimbursement, nasty collections letters, physician referrals and seeing 30 or more patients a day. Docs today are angry; Irritated by long hours, pissed at malpractice premiums, feeling unappreciated and defensive.
There's no justice in Germany either. A German court ordered an OB/GYN doctor to pay $769 a month in CHILD SUPPORT to one of his former patients - a woman who got pregnant despite the IUD (contraceptive device) he inserted. This is horrendous. Sue your doctor if you get pregnant? An unintended yet healthy baby is evidence of bodily harm? No contraceptive is 100% accurate! The article says that "the implant could no longer be found in the woman's body." This does not mean it was the doctor's fault. IUD's fall out in up to 7% of women in the first year of use. That's part of the reason they have a string that dangles out of the cervix into the vagina, meant to be checked on a regular basis by the woman to ensure proper placement. This is totally outrageous, uncivilized, and another reason why it takes serious courage to try to help anyone in this world of blame.
[update - thanks to the correction of a German commenter, it was not an IUD that failed but another device, probably like Implanon but I don't know what's available in Germany. The underlying principle is still unbelievable. Overlawyered has some more links to this, and a decent discussion starting in the commentary.]
The Trial Lawyers Association is changing its name to the American Association for Justice. George Orwell is smiling somewhere, the skies are getting clearer every day, and no child is being left behind.A doctor acquaintance of mine just got destroyed with a $20,000,000 jury award in a bogus malpractice case. I typed it into google and found this page, which is unrelated. I felt nauseous reading the top guy's credentials. The best thing he's done is apparently winning "the largest medical malpractice verdict ever won in the District of Columbia ($24 Million), (which was) reported by USA Today, Dateline NBC, Jet Magazine, the Washington Post, the Baltimore Sun and affiliates of ABC, CBS and NBC." Way to go! I bet his pockets were full after that one! Those doctors on the other end deserved utter destruction, all those years they spent working 120 hours a week for $30,000 a year, all those hopes they had of helping people, of making a difference. All those efforts pale in comparison to the $24,000,000 he got the jury to cough up.
Dr. Charles is right.
But... cosmetic medicine is a different animal and angry docs fare poorly when the anger they have towards the system spills over into their interaction with patients and staff. (Yes, I know angry docs fare poorly everywhere.)
Whenever I'm interviewing a physician I ask myself if they're an angry doc. If I think they are, it's a non-starter. I can work with a lot but can't change the way that someone fundamentally views the world and their situation. I can't change the way that an angry physician deals with patients, staff, and me. It just doesn't work. It's true that there are lots of angry docs out there and you might know some that you think are successful and that the fact that they're angry doesn't hurt them as a business. I don't.
If you're thinking about entering cosmetic medicine because you're angry and think that someone owes you, get ready for more of the same. In cosmetics as in regular medicine, it's still all about them.
Follow-up: Dr Charles sent me a very nice email that included the following:
"...Although you said "I'm right", I did find your post kind of annoying, labeling me as an "angry MD." There is so much more than that unipolarity in defining my approach to medicine, but at times we all get angry."
I did not mean to apply a blanket angry label to Dr. Charles. In fact, he seems to be a well read and thoughtful physician with a respected blog. My apologies to Dr. C. Nothing at all personal intended.
This post, and other I'm sure I will write, are meant to delineate the difference between general and cosmetic medicine for docs looking to make a change or choice.
Of course anger is not only confined to physicians, pharmacists have it too.