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« How to: Hire estheticians for your medical spa or clinic. Part 1 | Main | Aestheticians And The Doctors Who Love/Hate Them, Part 2. »

An anesthesiologist moving into cosmetic medicine.

I had occasion last Friday to be visited by an anesthesiologist from Denver, who is interested in learning more about Surface Medical Spas.

Dr. Nelson is currently a member of a rather large group of anesthesiologists (55). In choosing her residency, she had felt that anesthesiology was a good fit since it was procedure oriented, and a high paid specialty. She has since been slightly disenfranchised, and to be honest - bored. She is also not terribly excited by the fact that she does a lot of pediatric anesthesiology, and is on call as a junior member of her group so that she has interrupted weekends and evenings.

Dr. Nelson called me a few weeks ago to ass about Surfaces cosmetic and business training for physicians. I spoke with her at some length about what we did, and what I thought we might be able to help her with. I suggested she come visit us, if she felt so inclined, to learn more.

(I have found in the past that, speaking on the phone is great, as far as it goes - but, the amount of information that you can convey over the phone during a half-hour or hour-long phone call is just not that great. Whereas, six hours of speaking with sedition's and staff, and treatments performed, and consolations done, and how our office is run, conveys a huge amount of information, and has always been extremely beneficial.)

Dr. Nelson in on a Thursday, and had booked a plane ticket home on Friday at around 2:00 - which didn't give us much time. I met Dr. Nelson for breakfast, and we talked about both where she was as a physician, where she wanted to be, how she might go about getting there (moving from Anesthesia into cosmetic medicine, is still a bit of a stretch) I was impressed with Dr. Nelsons interest and drive. She had already spent a tremendous amount of time researching her options and had looked at several of the current batch of medspa franchises and licensing consultants. She half-jokingly referred to several of them as 'evil'.

Doctor Nelson and Doctor Bergstrom spent a brief period of time just talking and chatting about history and backgrounds before was invited into one of Doctor Bergstrom 's consultations.

(Surface consultations are performed very differently than what is typically done. First of all they are free. Secondly they are an hour long. Our patients are able to spend an hour of physician time discussing anything they want, including how much stuff hurts, how much stuff costs, whatever... )

After the consultation, Doctor Nelson had maybe about another hour that I spent talking to her before she had to catch her plane. She was, I think it is safe to say happy that she came. She expressed to me a number of times during that hour that she felt she had found her new home.  In fact, one of the direct quotes was, "I want to be Doctor Bergstrom," which I found both humorous and flattering.

It will be interesting to find out if or how she pursues both her contacts with Surface as well as any other potential avenues. We left it with her thinking about what her options might be in the near future. Whether she joints Surface in some capacity, or opens up a clinic of her own, I  wish her the best of luck.


Reader Comments (10)

I went from anesthesia to non-surgical cosmetic medicine and it was not a "stretch" at all. Anesthesiologists in pain management.were using botox years before many other specialties in our pain clinics yet when I ordered my first vial for my office allergan made me jump through hoops because I was not a dermatologist. Botox,and fillers? Who knows more about safely putting a needle into a correct body part better than an anesthesiologist? Compared to performing a transforaminal cervcical nerve block and injecting a pontentially lethal local anesthetic (which takes great technical skill and courage),botox and fillers into superficial muscles and/or the dermis is whole lot easier and less stressful.
Who better to do sclerotherapy? Some of the first and largest phlebolgy clinics in the US were started by anesthesiologists. And yes anesthesiologist like any other doctor can have an artistic eye.In addition, having spent years seeing what plastic surgeons are and are not capable of we know when to refer and when to not to refer.Anesthesiologists were the first to pioneer many specialties including intensive care practice, pain management,and interventional pain management.I know quite a few anesthesiologists working as cosmetic physicians. I believe an anesthesiologists preoperative internal medicine knowledge,operating room expeience with all surgical specialties,pharmaceutical and anatomical knowledge and procedureal technical skills(CVP's,Swan-, Ganz catheters, arterial lines,spinal cord stimulators etc,)makes it quite easy for an anesthesiologist to transition to cosmetic medicine.Plus all the gadgets we employ to monitor organ systems etc.,learning laser and light based treatments was quite easy.Anesthetic creams,local nerve blocks, concious sedation,anesthesiologists obviously have an advantage here too.The more I write the more I realize non-surgical cosmetic medicine has been quite easy compared to anesthesiology and I would compare my outcomes and aesthetic results to any other specialist.One thing I miss about anesthesiology,was that it was much more about how can we share our business and medical pratice experiences to do things mor efficiently for the doctor and clinically better for the patient. Unfortunately I have found some physicians in the field of plastic surgery, dermatology, aesthetic medicine and cosmetic medicine at times try to limit business and medical knowledge and opportunity to exclude another physcian or specialty for fear of competition.I have found this sit to be refreshing and I thoroughly enjoy the openess and freedom of business and medical knowledge this site seems to support.By the way I have a second medspa in Tampa I have opened and I would like to sell because I have found running two is to demanding for me. Only anesthesiologists need apply.Just kidding!!I'd be happy to talk to any specialty physician thats interested.
Welcone aboard, being an OB and working with anesthesia alot , I would rather have you work on me more than most Derms,maybe any, your right you do have great qualifications. I believe any physician that really is interested in anesthetics will study, train, and learn from others. I believe all of us are good doctors and skilled in medicine but have become a little bored and unapreciated in our fields.

I agree with you on derms and plastics wanting to limit business and medical knowledge. Look what they did in Florida with the recent law changes. They have legislated others out of business.

I have been completely amazed at the difference in training. Plastics and derms want thousands of dollars to teach you how to best care for the patient. In some cases they will not train you unless you are a "core-trained" physician. In family medicine it has always been come on over and I will show you how to do it and it will not cost you a dime.

Most other specialties are the same. If I wanted to learn to do conscious sedation I could easily find an anesthesiologist to teach me and allow to work side by side with them until I felt comfortable and it would not cost me a dime.

Not all derms or plastics are this way but many are so concerned about compitition. I have a friend that is a derm and has always been ready and able to teach me flaps etc. I just wish that they were all more open.

They also need to know that there are not enough of them out there. Derms refuse to increase the number of residency slots. Again they do not want the compitition.

04.1 | Unregistered CommenterLH
The difference is entirely understandable.

Family practice, internal medicine, etc. are all third party reimbursement. Physicians in these practices are hourly labor.

Cosmetic medicine is different. It's a free market economy and operates like one. It's certainly understandable that physicians coming from an underwriting system will be frustrated by real business practices but that's the way that real businesses operate. (read the medical spa market category)

Cosmetic medicine is a business. Those that realize this and embrace it will have a chance. Physicians who ignore it will get steamrolled right out of business.

I'm reminded of one of my tech reps who attended a plastics conference in Park City where the general atmosphere was one of ridicule for the 'non-surgical' cosmetic treatments. They're deluding themselves as well. The technologies will only get better. There are already plenty of treatments now that can't be addressed through surgery.

This is a competitive business. Better learn to compete.
Don't worry about me. They are starting to realize they can not compete with me. The most important technology in my clinic is me. Patients come back because of me.

Jeff, you seem to think this is all business but it is not. It is the practice of medicine and I will argue that the clinics that base their models completely upon the business side of things will be the ones to fail.

I want you to look at what is happening to a lot of franchises. They are going down because they are just a business. Clients realize when they are just a number so they then go to people like me to be taken care of by someone who actually cares about them and their results.

Also, as an FP I was never hourly labor. I ran that as a business as well. I made more money than most derms in this country.
04.1 | Unregistered CommenterLH
Docs fail at this for a variety of reasons. Most often because they don't focus on the business side, they think it as a technology problem. The franchises fail because they have a poor business model and often try to remove the physician from the business.

Certainly there are exceptions to every rule but aiming to be an exception is not the smartest thing to do.

To expand on the hourly labor comment: Physicians are only paid for what they actually do. Perhaps you were employing PA's or whatever but that's a basic rule. Most docs only have so many hours they can work and can only bill for what they do. = hourly labor. Utilizing mid-levels is a variation on a theme.

But I'll take you off my 'docs to worry about' list.
I am not sure I understand your docs to worry about list?

It really comes down to the fact, are you going to put everything into it (including the business side) or are you going to dabble in it. If you are going to dabble in it you may as well quit now. This is not for the faint of heart.

I hope you do not think I am some stupid FP that has my head buried in the sand and does not understand business. It really depends on where you are trying to go. It appears as though you are hoping to rule the cosmetic medicine world. I do not want to. I do not want to put up with hassles of a lot of employees most of all physicians.

I agree that many of the franchises try to take the physician out of the business and that is their downfall. Docs do not want to work for someone else and then have a bunch of people operating under their license. Unless they have a large stake in the business. If there is a problem and the physician losses his license he can never practice again. For the businessman he is just out a few bucks. So as a physician I would never work for a large company that wants to use my medical license to support many sites and use a bunch of midlevels.

So with this said, I will guess that most of these small physician owned medispas are going to outlast the chains. Most of us are not out to conquer the world we are just trying to take our piece of the pie. The facilities that have knowledgable and friendly physicians are going to survive.

I promise that I will survive. I am already past what most of the medspa's annual revenues are in the first 3 months of this year.
04.1 | Unregistered CommenterLH
"I am not sure I understand your docs to worry about list?"

Ehhh.... that was a reference to your previous post, "Don't worry about me."

Guess it wasn't funny enough to be clear.

I now understand the "don't worry about me". I must have been interupted in the middle of that post. I guess I should have reread it before I posted it.
04.1 | Unregistered CommenterLH
So what's going to hold back the legislation that took place in Florida from occuring in California? I read somewhere that it is already in the works.

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