Warren B. Seiler III, MD
John Di Saia, MD
Beatriz H. Porras, MD
Shervin Naderi, MD, FACS
Edward Zimmerman MD
Paula Di Marco Young, BS RN
Seth A. Yellin, MD FACS
Dr. Kevin D. Light
Stephen Weber MD PhD
Brian K. Sidella
Sabine Zenker, MD
Daniel Kaufman MD
Brian Howard MD FACS
Mickey A. Couvertier
Lila Bratani MD
Alex Denes MD FACP
39 CommentsMedical Spa MDs: What's your problem?
OK, since 90% of poll takers responded that they'd like something enough to pay at least something, it looks like I'll write something on medical spas. Of course if Dermacare starts voting that number might drop.
So I thought I'd ask for input as to what, if any, information the 10k monthly readers of this site would like to know more about (yes... increasing new patient flow will be in there automatically)
Operations? Hiring? Technology? Finaincing? Where to buy a whetstone to sharpen your Botox needles so you can resue them? How to compensate your minions? How to keep get out of a medical spa franchise? Non-compete agreements?.... whatever.
I'd just like some imput and interaction that can help provide some guidence about what you'd like to know the most so I don't waste as much time as I might.
Just leave a comment or send me an email.
Reader Comments (39)
What you've come up against sounds like bullying and harassment to me. You're not practicing outside your scope of practice if you hold an unrestricted license. It is 100% legal and ethical. You do have legal recourse. I would suggest talking with a lawyer. I don't care if the PS you're speaking about is chief of plastics at you're university. He/She has no right to harass you like that. And you have every right to defend yourself. Obviously, the PS and derms have fears of loosing their patient base.
And if I may add. This is a good case for developing our own specialty of cosmetic medicine.
Sorry my mistake. I misunderstood. You're right....they crossed the line of profesionalism and business ethics.
Where is your aesthetic practice? If you have another practice internal marketing is the least expensive.
I have had some of the same problems. I have had some of the derms take pot shots at me in the same way. Patients will tell me this and keep coming back to me for aesthetic procedures. All you can really do is do your job and do it well. Excellence is the only way you will survive in this market.
I agree that we need to compile all of the data on the different technologies. At this time it is best to talk to others that already are using the technologies you are looking at. I searched the internet to see clinics using the technology and found that most were more than happy to talk about their technologies. Remember, talk to a lot of different people not just the sales rep. You are spending a lot of money and it is well worth your time to do some research.
I recently was looking for a good IPL and talked to many people and it came down to the Sciton BBL and the Palomar Starlux. I was leaning toward the Palomar but decided on the BBL when I talked to others and they did not likethe cost of the multiple heads and replacing the heads on the Starlux. This adds up in the long hall and acts just like having consumables.
We should form a purchasing group to buy in quantity.
Perhaps this site could be used in some way to organize something like that, an group of physicians who have buying power. What do you think Jeff? Could Surface organize some type of affiliate group and/or use your site to offer this as some form of service to other physicians?
I do think it may work to purchase radiesse, restylane and botox through joint efforts. Could even purchase hard goods such as 4X4's syringes etc. The only issue I can think of is making sure you are distributing to qualified individuals and you would not get dircet support from the manufacturers.
My first thoughts are bulk orders and split shipping for things like fillers, and technology consumables; Thermage cryogen canisters etc. Only for licensed physicians of course so there would be some checking to ensure that. I'd check with my lawyers too.
I'd like to gauge the acceptance of something like this so comments and thoughts would be appreciated.
I can not believe that nobody is refilling the candela, thermage canisters.
By the way the AACS has a buying consortium. I have not used it and know very little about it. You must be a member of the AACS.
You are absolutely 100% correct. If you've looked at my posts I've been calling for an independant specialty board for some time. There is power in numbers.Its the only way were going to get the derms and PS off our back. (although they will be eligible for membership...) A medical board in "Aethetic Medicine" is exactly what we need. It is very possible to do. There are several steps that need to be followed to be recognized by the AMA and eventually by the ABMS. The board must be in existance for a minimum of 5 years to be recognized by the AMA and also have 1000 AMA members. But, I think there are enough of us practicing Aesthetic Medicine that we can hit those numbers. I recommend going to the AMA web site. There you will find a list of criteria that needs to be fulfilled. If you are interested please respond. I think if we can get 10 Docs to form a governance board we'll be on our way. I have already thought about this issue and I have developed a working model for a set of rules and regulations. But, its way too time consuming and expensive for one person. I think a group of 10 docs can do it with relatively little time and money commitment. It would be a chance to form a governing board, but also a chance to educate the public about who can perform cosmetic medicine. Many people still think you need to be a dermatologist which of course as we all know isn't true. Let me know if you're interested.
I wish I could say that board was already available but it is not. the American Academy of Cosmetic Surgery is doing exactly this. They were just recognized as a board in California after a long legal battle.
The only issue I have with them is that they will allow us Non-core trained docs to be associate members but we can never be fellows or board certified by them.
They have done a lot of the legal battles already. Maybe we "non-core" docs should start putting pressure on the AACS to be more inclusive of us. If enough of us were members and attended the national meetings we might be able to change things to our advantage.
We need to have one voice and the AACS says they want to be inclusive but are not inclusive enough. They will take our money to train us but do not want to truely include us.
In order to develope a specialty there needs to be a non-profit corporation established first. So those of us who are interested can forget about making money from it. It will definitely require legal counsel as well. It could be very expensive initially. We also need to set up a charter of rules and regulations as well as a board of governance. there needs to be in place a College, and also a Board. The board of the college would have the responsibility of certification. But, there is also the stipulation if you read the AMA charter, that board certification must be available to members AND non-members. There needs to be a residency or the option of residency training within the field. And the AMA won't ratify a board if one already exists. Unfortunately, the ABMS has already recognized procedural dermatology as a board. So our field would have to be different from theirs in some way. We also need to have a center of operations. That means an office somewhere with full-time staff dedicated to running the College.
Anyway, all of this is doable. It will take a time commitment and probably a financial commitment as well. But, eventually the financial commitment would be off-set by membership dues.
I'm certainly willing to contribute my time, as well as some money if others are willing as well.
Anyway, the way I see it, A College of Aesthetic (or Cosmetic) Medicine and Surgery dedicated to non and minimally invasive cosmetic procedures is going to happen sooner or later. Either by us or another group. Its just a matter of time.
To not include non-surgeons into their academy is really limiting to the AACS as most of us who are running med-spas aren't surgeons. Anyway, just some thoughts. I'm hesitant to leave my contact info on an open website like this. So let me know how to get in contact with you.
If you'd like to contact or be contacted, I'll be happy to arrange it. Send me you're screen name and email using the contact email link at the top right of this site.
If someone wants to contact someone from this site they can submit their contact info and the person they're trying to reach by the same email. I'll forward those contact requests and the person contacted can decide to reply or not. This should provide enough security.
Jeff
However, for the ABCMS (American Board of Cosmetic Medicine and Surgery) we can develope a "fellowship" program leading to board certification.
Of course the nice thing about starting a board is that the founders will automatically receive board certification status.
I certainly hope we can generate enough interest in this as it would be to our best interest to have a unique specialty, certification, as well as political clout. I do have some connections in Washington DC. So if we get to the point of needing a lobbyist, that can be done too. But, we need to start with the basics. ie, non-profit corp. a charter and mission statement, and web-site as well as a mechanism for implimenting membership. All this will be very expensive. Some of it I have done already. But if we can get 10-20 physicians together who are willing to donate some time and money, like i said it can be done. Of course the more interest we have and the more "founders" we have the less expensive it will be for each doc. Anyway, keep me posted as to you're level of interest and I'll send you an E-mail probably early next week with more info.
Thanks for the support. I'd agree that a line's been crossed but of course it's just that, an theoretical line. Of course it's my patients that have let me in on what's really going on. I'll just deal. To be honest it's slightly fulfilling to have them worried about me and stiffened my resolve
Wow, I never knew about buy and bail. I think this procedure would take time and compromise but it can be done. That’s pretty interesting…Thanks for sharing it