Are Medspa Franchises Cheating Patients?

The following comment by Another Ex was left as part of the discussion on Dermacare Laser Clinics:

I as a doctor was pressured to sell elective procedures and product, which goes against the medical ethics that governed my practice for so many years.

The problem with getting a client in the treatment room and deciding that the sold package is inappropriate is that Dermacare (at least not in the corporate clinics) does NOT GIVE REFUNDS. I was performing 80 to 90% of the laser treatments and was not available to double check every recommendation made by the sale consultant before money was collected.

It is tough to sell $3900 worth of product to someone who would be better served by a plastic surgeon than by the 3D package.

A doctor cannot defend himself in a malpractice suit with the excuse that he was doing good business or doing what he was told by the office manager. When a nonmedical professional is in authority over a physician, the physician is still liable for the results of doing what he is told. I agree that good business is not always good medicine and vice versa. There has to be a compromise. No company, employer, or senior partner will take the hit for me in a malpractice suit. Ultimately, each doctor has to be responsible for his reputation and license.

I heard a rumor that a corporate medical director was left without corporate legal backup when appearing for a malpractice claim.

Double Dermadare You, any comments?

This comment touches on a point I've made repeatedly, that medical spa franchises using a business model designed to remove the physician as far from the patient as possible are inherently dangerous for the doctor as well as the patient.

While I don't recommend a 'money back guarantee', it's common for a 'sales force' to oversell the treatment leaving the patient dissatisfied. Happens all the time. I can see that physicians (and patients) could potentially find themselves in something of a quandry where the businesses main concern is to sell.

Comments

[Cutter MD]

As I remember it it's "First, do no harm". I can't see how these medical spa franchises where patients are seen by non-physicians and sold on elective procedures fit.

I practice cosmetic medicine. I also see every patient and make the diagnosis. Leaving this step in the hands of a non-physician is not only dangerous (as stated above), it boarders on unethical in my opinion.

Perhaps I'm in the minority of physicians these days.

[LH]

Cutter MD,

I agree with you. I even see my laser hair removal pts prior to treatment. This allows the pt to meet me which is good PR as well as I am able to direct my nurse to which laser and settings I want her to start with. I do all of the more invasive procedures.

I have one medispa by me that pts are only seen by a nurse or a PA never the plastic surgeon that owns it. I have an issue with this. Look at Florida they made rules so that only derms and plastics can "supervise" a second clinic for which they very rarely are on premises. So are florida's laws good medicine. Basically the plastics/derms are trying to legislate all others out of business.

I also have a new medispa coming to the area backed by a huge health system and it appears to be taking the same route. A plastic surgeon does not make enough money doing hair removal or even seeing the hair removal pt. They do not want to waste their time. They get paid a heck of a lot more to put in a pair of boobs.

So the question is, is it better to have a cosmetic procedure done by a physician that focuses completely on cosmetic/laser procedures (even if they are not "core" trained) or go to a clinic run by a plastic surgeon/derm or some franchise that the physician never sees the pt?

The above is directed at the derm/plastics/franchises that are doing the above. I specifically have a problem with the derm/plastics docs that say no one but core physicians should be doing these procedures and then they have a nurse or a midlevel do the procedure and not even under direct supervision.