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Understanding "Core" Physicians

What is the definition of a 'core' physician?

On April 30th, I conducted a webinar for Palomar Medical, Inc. on the topic of optimizing Local Search Engine Optimization tactics to boost your practice on local internet placement and ranking. Soon after the webinar, I was contacted by many physicians with many questions. I felt confident in answering all of them, except for one. And, that question was "what is the definition of a "core" physician"?

I was stumped.

I've searched the Internet for a documented answer and found none. I then perused quite a few physician's websites where it was clearly stated they were "core" physicians. It was also clearly stated that those medical specialties that were not deemed as being "core" were not qualified to perform certain aesthetic procedures. Not to be accused of being "flippant" by a physician as in one of my previous posts, I had thought that it was experience, training and number of successful procedures performed that made a physician "core" in that particular aesthetic modality?

Even on review and educational websites such as RealSelf, all non-"core" specialties were removed.

The answer I received from RealSelf stated : "RealSelf is no longer hosting profiles for participants who do not meet specialty designation criteria set forth by updated RealSelf policies. We have encountered problems with doctors and other medical personnel answering questions far outside their expertise or specialty and, in some cases, even dispensing inappropriate and dangerous advice to our readers. The aforementioned changes have been implemented in an effort to prevent these situations from arising."

Not to elicit any aggressive comments here, and I mean no disrespect to any medical specialty in particular, I just would like to be enlightened as to where the definition of "core" was derived from and what medical specialties that includes?

Reader Comments (8)

great article! can't wait to hear more.

04.6 | Unregistered CommenterHarold

Thahks for you opinion, but i sow same to this site.

04.6 | Unregistered CommenterDen

This is interesting Paula and I have wondered what "core" meant myself a few times. I believe the term "core" must have originated from Realself because this is the only site where this term is referenced so highly. According to a page I was reading on Realself under the heading "Doctor listing criteria" (, ... "The term "core aesthetic" is widely recognized as specialty areas of medical training, certification, and practice that require physicians to possess demonstrable knowledge associated with performing a variety of cosmetic procedures and diagnosing related conditions. While there may be excellent doctors from non-core specialties who can deliver cosmetic services in a safe manner, our community is not designed for them..." Realself list core physicians as Dermatologists, Dermatologic Surgeons, Plastic Surgeon, Facial Plastic Surgeon, and Oculoplastic Surgeon.

It is interesting to note that whoever wrote this info. on Realself is stating the term "core aesthetic" is "widely recognized". I guess they mean widely recognized by Realself. My husband answers vein and venous related questions on Realself as a "non-core" physician, even though he has board certification in General Surgery, Phlebology (non-ABMS), is an RVT, one of the first Surgeons to use the laser for laser vein ablations, has attended every vein conference avail during the last 10 years, and written & published numerous vein abstracts. I frankly find it so annoying to read an answer by a "core" physician who has had no training in Veins during residency or outside, answering a Vein question. (with an incorrect answer also!)

I think this whole situation leads to a greater problem in medicine. In the last 10 years, aesthetic procedures have vastly changed from invasive with long down times, to minimally invasive. When this occurred there were so many of the "core" physicians who did not want to take part in this revolution so the laser companies marketed to other specialties who were interested in these new innovations. Many of these "non-core" physicians learned how to perform and treated thousands of patients successfully before the "core" physicians jumped on board. I can only hope that some of the real "non-core" pioneers of some of the minimally invasive procedures that core physicians are now performing can have the recognition they clearly deserve. Of course, this can only be achieved by having an ABMS Board Certification in Cosmetic Surgery. Let's let some of the non-core physicians prove they know how to successfully perform these minimally invasive procedures!

**** Disclaimer: this is in no way an assault on any Realself entitled "core" physician. There are so many skilled and caring Plastic Surgeons and Dermatologists who have training in both invasive and minimally invasive procedures also!

-Wendy Hovorka

04.7 | Unregistered Commenterwendyh

Wendy: A very well written comment.

RON BERGLUND, Minneapolis, MN

Wendy, beautifully written! Thank you so much for taking the time to answer!

Wendy: With all due respect, there's a huge gap between doing some minimally-invasive procedures, and getting an ABMS certification in a surgical field. Your husband, for one, knows that it was 5 years of hard labor and a whole lot of studying to pass his General Surgery board exams. I'm sure he values his General Surgery Certification as much as I do my own certifications (GS, PS)

Hypothetically: Would he mind if the gastroenterologists started doing bowel resections and laparotomies - because, after all, they are very familiar with the GI system? And isn't General Surgery mostly surgery of the Gi tract? They could have their own American Board of Gastro-enterological Surgeons. And they have endoscopy centers...they could throw a few lap cholecystectomies on the schedule after their scopes are finished!

I'm kidding, of course. That would be a disaster, and very bad for patient care. I'm sure your surgeon husband would be unimpressed with this proposal, too. Maybe he would say "That's ridiculous...we're the real surgeons. We're the ones that have done the real training."

It's all about knowing where to draw the line, isn't it?

04.22 | Unregistered CommenterTF

The ironic part is that in many plastic surgery offices (a "core" specialty), Botox and fillers are done by nurses.

my question is this. Where do "core" doctors get the training to do non invasive procedures? I am not a surgeon so I don't do surgery. I am however well trained on non invasive procedures. Realself rejected me because I am not a surgeon-go figure.

06.4 | Unregistered Commenterlaserdoc

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