Follow the medical spa money trail in Florida. A comment worth repeating.

An excellent comment from Denise Curtis (a PA) from a discussion thread on the new regulation governing medical spas in Florida.

Dear MDMan,

All PA's are required to be registered with their state medical boards and by law are required to have continuing education. In NC, the requirements are EXACTLY the same for PA's and MD's, meaning we have to have 100 hours of Category I CME's every 2 years. Furthermore, PA's must pass a national certification exam before practicing and must sit for this exam every 6 years to maintain their certification. Physician Assistant programs now require a BS degree prior to entering PA school and then grant a Masters upon completion. Unlike nurse practitioners, PA's have always maintained their dependence uppon physicians. However, this does not mean that PA's cannot practice independently of their supervising physician.

It is sad that there are many places in this country where a PA is only health care provider willing to work for very low wages to provide basic health care the those rural areas. In those situations, the PA may be the only provider for hundreds of miles. With the passing of these bills not allowing PA's to see patients independently in medical spa settings are they then going to require an MD to be present in all of those health department and rural settings? Think about this for a minute. Basically, they are saying that a PA is not qualified to do laser hair removal but that a PA can provide health care in lower socioeconomic settings. In some of these settings, the PA's run codes, put in A lines, triage critically ill patients, only because there is a lack of MD,s willing to work in those settings.

Do you think this country can afford to put such restrictions on health care? Furthermore, do you think that laser hair removal is more dangerous than running a code?

It is always about the money and control!!!!!

Denise Curtis 

Kevin MD on chiropractic care promo.

Kevin MD is checking on the push from Chiropractors:

From the Chiropractic Association Artilce. "A new survey showing that nearly half of all Americans are concerned about the safety of the medical care they receive should send a strong signal to the health and insurance industries that safer non-drug, non-surgical treatments should be considered whenever possible, according to the American Chiropractic Association (ACA)."

Nothing Brings Out Anger Like Thermage

It's surprising to me how polarizing Thermage as a treatment seems to be. There are 5 threads on Thermage going on in the Physician to Physician discussion area. While the 'pro' Thermage docs seem to be relatively calm, the 'con' side is much more strident in their views. ( It appears that the docs panning Thermage appear to be plastic surgeons but who knows.) It seems to be particular to Thermage for some reason, Cutera's Titan or Fraxel  don't seem to evoke nearly the outrage.

Here's a sample: 

If you feel that you must scam your patients because you don't have a real treatment or can provide a real surgical intervention for them because you're not qualified to be doing what you are trying to "sell" to unsuspecting patients...

Pretty strong stuff. Most doctors hesitate to accuse other physicians of running scams on their patients but Thermage seems to push some right off the edge.

Lawrence Of Arabia & Physician Turf Wars

I was watching Lawrence of Arabia tonight while I caught up on some of my online reading.

While I was reading a quote from a plastic surgeon that condecendingly belittled cosmetic treatments perfomed by physicians who were not 'board certified' plastic surgeons. I find this argument to be entirely self-serving.

I was struck by a parallel from Lawrence of Arabia where Lawrence (Peter O'toole) says:

So long as the Arabs fight tribe against tribe, so long will they be a little people, a silly people.

The turf wars that are common to medicine are pedantic and petty for the most part and docs know it.