Physician Ethics & Cosmetic Medicine: Are you a money-hungry whore?

The post on LS, a dermatologist that's pissed at OBGYN's and FP docs in cosmetic medicine has 51 comments as I write this.

 
Certainly there will probably be more.

I've posted three comment from that thread here. Disenchanted is not generally happy with docs whose  

Disenchanted thinks that physicians who are not plastic surgeons or dermatologists are 'money-hungry whores'. (emphasis mine)

As a second year resident having survived internship and still possessing a genuine interest in patients suffering from disease, this whole thread saddens me. No wonder the prestige of the physician has fallen, what a bunch of money-hungry whores. You can have all the lasers and cosmetics and make your money...better yet just trade in your MD for a cosmetology degree and think of all the lives you can make better and impact you will have on the world. Non-plastics/derms who do cosmetics have no professional integrity. All of the above posts are just sad justifications for selling out. I want an FP who will provide appropriate preventive care to my family (if you don't like how GME are reimbursed, spend the time/resources you put into cosmetics courses into a lobby for change). I guess since there's finally some awareness that Obs are cashing in on unnecessary C-sections (hysterectomies etc), need more ways to make cash money. My 2c, flame on brothers and sisters.   

LH thinks he's somewhat naive.

Disenchanted, You probably are barking up the wrong tree. So what you are saying is it is OK for derm/plastics to do cosmetic procedures and anyone else that does is a money-hungry whore? I do not get the difference.

I think your opinion will change after you have done this for a while. I would like to speak to you in about 15 years when you have worked 70hours per week been up for 36 hours straight and delivering hundreds of babies in the middle of the night. You get about 1 week vacation per year and your family forget what you look like. All of this to continue to have to work harder to make the same income.

Also, you may want to understand that some of us actually enjoy the artistic side of cosmetic procedures. I also enjoy it because I get to spend more time with the patients.

So I have chosen to alter my career path and that makes me a whore in your eyes. I am OK with that and will not lose an ounce of sleep over it. It is much easier to change my path than the entire practice of medicine. I have fought many a battle including the political ones. It is best for you to look at the serenity prayer "God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference".   

(Prodocs also comments)

DermaDoc also has something to say.

If I may chime in here for a moment - I am guessing Disenchanted is a resident who went directly from high school to undergrad to med school to residency and has never had a real job or real responsibilities in his/her life. I have been through residency, built a practice, served the underprivileged, and spent many sleepless hours on call taking care of 'real' patients. And I still do because it is who I am. I find it more indicative of a poor attitude that someone in residency already has a grudge against people that may horn in on the money making territory as a matter of free competition rather than settle for our dwindling reimbursements, skyrocketing overhead and more and more demanding professional obligations. I've done my time and no one else is going to pay my mortgage but me. I am not abandoning my patients at al, I am simply making my life better so I can be at my best when they need me.

On the other hand, the medical field looks like crap these days, so I can understand a little bitterness on the part of a resident who has already put a bunch of years into training with a constant stream of bad news about their prospects for a decent lifestyle and working conditions.

So Disenchanted, don't take it out on us if we are in survival mode. Find what you love doing and do it regardless of the payoff. I thankfully have found that place myself. Not alot of cash but I actually enjoy what I do, and that is fine with me.  

As for myself, I'll point out that Disenchanted's suppositions rests on a number of key points that are tenuous at best:

• That no physician should be able to change their mind or practice after deciding upon a specialty.
• That, for some reason, physicians who decide on a 'cosmetic' specialty like plastic surgery or cosmetic dermatology have somehow taken the high road (This one I really don't understand.) and since they chose one of these early on that they are somehow more ethical that physicians not 'core trained'. (Why Disenchanted gives them a pass on this I have no idea.)
  
• That physicians choosing  to perform or offering cosmetic medicine are neglecting the obligation they have to their patients.

Since consulting, I've been approached by physicians from the following specialties: Plastic Surgeons, Dermatologists, Anesthesiologist, General Practitioners, Emergency Room Docs, Internist, Family Practice, Cardio-Thorasic Surgeons, General Surgeons, Psychiatrists, ENT, OBGYN, (I know I'm forgetting a lot).... and even a Pathologist. I've said no to many more than I've said yes to, and I have met a number of physicians who I felt were money-hungry and yes, even unethical. But not many. 

I also have nothing bad to say about Plastic Surgeons or Dermatologists. 

Certainly I understand how Disenchanted feels. But I'm afraid that the holes in the argument are just too big. I would have thought that Disenchanteds derision would have been more thoughtfully focused on Plastic Surgeons and Dermatologists performing cosmetic treatments. Certainly skin cancer should be the focus of Dermatologists and Plastic Surgeons should be performing cleft-palate repair. I would think that Disenchated should laud the Family Practice doc who frees up these specialist for their needed work since it's really not that hard to perform a Botox injection and the patient's right there for their flu shot anyway.

It brings to mind the following quote: "If you're not a liberal when you're twenty you have no balls. And if you're not a conservative when you're forty you have no brains." 

Comments

[KB]

Anyone who is not a dermatologist, ENT, oculoplastic has no business doing any aesthetic procedures. All PCPs, PA, RN whatever should be malpracticed out. Read the article in this last months issue, July 2007; Skin and Aging , www.skinandaging.com page 28: The Impact of Core Specialist. PCP's are NOT invited to the Cosmetic Boot Camp and this is the sole reason for blogs like these.
Kenneth Beer MD
PALM BEACH ESTHETIC CENTER
1500 North Dixie Highway, Suite #305
West Palm Beach, FL 33401
Tel: 1.561.655.9055
Fax: 1.561.655.9233
Email: info@palmbeachcosmetic.com

[DermaRogue]

Doker Beer: You show a great ability to cut-and-paste the same comment on multiple threads..wow. All I can say is hopefully you're loved at home, because you'll find none here.

[Pro Docs]

Dr. Beer

First, I don't understand your statement, "... (we) are NOT invited to the Cosmetic Boot Camp and this is the sole reason for blogs like these". Thank you for dis-inviting me. I have no desire to pay you to teach me what I already know so I wasn't coming anyway. But, "blogs like these" are where like minded professionals come to converse, share information, ideas and experiences, engage in good natured banter, gossip and help each other. I really don't understand your beef with "blogs like these". Most of the professionals who frequent this blog are friendly, nice, courteous, intelligent and positive. Unfortunately, we get the occasional visit from the Br. Beers of the world who are rude, unkind and insulting.

Did you really think it would be helpful for you to use your comments here as a piece of advertisement for your business and list your name, the name of your spa, the address of your spa, the phone and fax number of your spa and your spa's email address? Did you think the readers of your comments would be so dazzled with your brilliance and insight that they would call for an appointment?

The most troubling, for me, is the tone of your message and your over all "know it all, I am THE expert" attitude. You insulted and demeaned the professionals who regularly use and contribute to this site. So, since we are dealing with insults and just for fun, lets take a look at what some of your patients and staff say about you. The following statement, by your patient, was cut and pasted from another public website where your (former) patient is a registered member:

" Very long wait to see Dr. Beer even though I was on time for my appointment. Doctor was not friendly in fact he did not shake my hand or smile. He had a flat affect the entire visit & did not offer advice or help me in any way. Did not seem to care about my skin problems overall. Offered very little help & was very unsympathetic. He provided samples of a prescription medication but then denied my access to these medications with a prescription unless I paid to see him again. Very rude & arguementative over the phone when I asked for his assistance for adult acne. Female staff members stated he is typically unkind to his patients & unpleasant to work with. Will look for a new dermatologist in West Palm Beach as Dr. Kenneth Beer was not looking out for my best interest. I deserved better & thus will not go to see him again."

So, it's not just your demeanor on this site, even your staff says you are unkind to your patients and unpleasant to work with. I feel much better now because I thought you had something against me personally. Now I know you are just an all around jerk.

I really have much more to say but I will save it for another time. Jeff and DermaRogue said most of what needed to be said above. If you want to continue our conversation I will be very happy to accommodate you.