Physician Resources: Managing your personal finances.

Rachel Strate is an analyst for a local VC firm that I know and has posted this excellent summary of online financial managers.

As I contemplate switching offerings I noticed that the product characteristics that are a necessity for me, include:

  • User Interface - I want an user interface that is intuitive. Sure there is a learning curve with any new tool, but I am hoping for something I can figure out relatively quickly that allows me to slice and dice my data (for example I really like being able to see spending over custom time ranges, not just month-to-month).
  • Bank Access - When I first checked out Mint last year I couldn’t get access to a regional bank I use. That has now changed, but was obviously a major no when I first looked at the company.
  • Security – Many companies in this realm are start-ups, which makes me nervous for two reason. First, have they accurately approached security, encryption and storage? Second, will they still be in business in a year or two and if not, where will my data end up?
  • Reliability – These companies are dealing with my financials and must be reliable. What is the point of using a PFM solution if it doesn’t pull all my transactions?
  • Live-Chat Customer Service - Customer service is a necessity and live chat is just my personal preference. I personally like "on-demand" help, if needed.

Product characteristics I don’t care about:

  • Community - Does the whole web experience need to be social? Many of these companies tout the community aspect and I can see why this might be a draw to some people, but it just isn’t a priority for me to talk to strangers concerning my finances. Aggregation of articles and sites, sure. Random strangers giving me advice, not so important.

 

Players in this space include the following:

Photobucket
Company: Mint
Software / Online: Online
User Interface: Very good
Bank Access: 6,500 banks
Budget Capabilities: Yes, but as a goal section rather than priority
Reporting: Yes
Investment Monitoring: Yes, but still in private beta
Community: No
Security: Verisign, HackerSafe, Truste, plus they do not record the user’s actual name, only email address. Mint provides a whole video of their CEO speaking solely to security plus a scroll down page with each point thoroughly discussed.
Reliabilty: Unkown as I have had limited use
Customer Service: Email only.
Comments: This company has been hyped, but for some reason has never quite worked for me the four times I have given it a shot. Today was the first time I could successful add accounts, only having problems with one regional bank that has image verification security. I figured I would try contacting customer support with the issue. No live chat, but an email function that automatically responded back to me with a “help is on the way” kind of thing (nice). The email said they would contact me concerning the issue within 24 – 48 hours, yet over-promised and under-delivered as I have yet to hear back after 72 hours. One interesting feature is the user can input in his/her zipcode and get a benchmark of what others in the area spend in each category.
Price: Free

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Botox Inauguration

It's inauguration party time. and Washington, D.C. - area cosmetic dermatologists say despite the sagging economy, requests for quickiecosmetic fixes like Botox have picked up during the last few weeks aspeople pretty-up for inaugural fetes.

Wehave been absolutely swamped since the election with people desiringrejuvenation procedures for the upcoming inauguration, saysWashington, D.C., cosmetic dermatologist Tina Alster.

My normal load for cosmetic procedures has doubled.

Plastic Surgery & Dermatology SEO Networking

There have been a tremendous number of changes to Medical Spa MD over the last years. Certainly there will be more. In fact, there are some rather large changes coming.

When I started Medspa MD it was to build a platform from which to recruit physicians as I grew the number of clinics I was running. Almost immediately the site became a platfrom on which doctors started to exchange infomation with each other. As thos of you who have been part of our community can attest, this didn't fare well for a number of IPL and laser companies as well as certain medical spa franchises. (I'm still waiting for the medical spa franchise model I like.)

But I digress.

Medical Spa MD has gone through a number of changes; from a blog to a community, and now there are some additional changes in the works that will grow this site into what is effectively a portal.

In the past week I've had telephone calls with; three plastic surgery and dermatology 'patient community' web sites, a medical association, a medical services company, and I've got a phone call this week with a large asthetic medical trade show and event organizer. There seems to be more than a little interest in what's gong on.

There are a number of capabilities of this site that have been introduced and will shortly be turned on including:

  • Membership Login that will give you access to specific, non-public areas.
  • You'll be able to subscribe to individual pages and have updates delivered to your email whenever there's new content.
  • The Select Partner will launch and Members will be able to see discounted products and services that aren't available to the general physician population.
  • A Medical Spa Directory is being built that will allow patients to find Members that are closest to the.
  • Listings will be enabled that will allow individual physicians to answer questions, link to their site, have a medial spa specific blog, before and after galleries, email contatacts and form building and submission.
  • Before and after treatment galleries for individual technologies like Thermage, Fraxel, Portrait, IPL, CO2 Laser Ablation, etc. (Perhaps we'll break that down into technology companies like Palomar, Cutera, and Alma.)
  • Patient Memberships will be enabled that provide patient-centric content. (Perhaps they'll be able to recieve treatment informaton from local medspas.)

We'll that's a top-of-the-head list. I'm sure I've missed something but it's late.

Medica Spa Expo in LA: Program

Also, here's the program for the Medical Spa Expo.

(I'd love it if those of you who are going would fire me off an email wrapup.) There are actually a couple of speakers that I don't know... or who weren't memorable I guess.

It's $50 for the convention floor and $600 to attend both days. They used to have a medical spa tour which was something of the highlight, but I didn't see it on the site.

Medical Spa Trade Shows in LA

Matrix FractionalThe Spa & Resort Expo is opening February 21-22, 2009 Los Angeles Convention Center. Here's a link >

I've personlly been to this show at least six times in LA, NYC, and Miami.

The New York show is my personal favorite since I lived in Manhattan for ten years. It also has the best showing medspas if you're looking for drama. LA and Miami just don't have the skyline.

Here's some of the lasers and IPL's that'll be hawked:

 

Matrix Fractional CO2 Laser
Sandstone Medical Technologies
sandstonemedicaltechnologies.com
The Matrix Fractional CO2 Laser uses “Gold Standard” Resurfacing technology. The laser delivers Micro-Thermal Zones of energy leaving small areas untreated. The Matrix is fast and affordable.
Booth(s) #: 624

 

 

 

AlmaPixel® CO2 OMNIFIT handpiece
Alma Lasers
www.almalasers.com
Alma Lasers’ fractional ablative solution, the Pixel® CO2 OMNIFIT handpiece, represents the best of both worlds for skin resurfacing. It combines the proven effectiveness of an ablative approach with the patient comfort level and convenience that approaches a non-ablative solution.
Booth(s) #:619

 

 

Canfield
The Reveal Imager
Canfield Imaging Systems
www.canfieldsci.com
The Reveal Imager takes high quality images of surface and sub-surface skin features. Designed for the skin care counter, it is ideal for spas, medical spas and traditional medical practices.
Booth(s) #: 610

 

 

Synergie

 

 

 

Synergie ELITE
Synergie By Dynatronics
www.dynatronics.com
Introducing the NEW Synergie ELITE effective proven treatments with a sleeker sexier look. System includes FDA cleared cellulite reduction, inch loss, and body contouring, microdermabrasion and light therapy.
Booth(s) #:211

 

 

VASER LipoSelection VASER LipoSelection®
Sound Surgical Technologies
www.vaser.com
VASER LipoSelection®, by Sound Surgical Technologies, is a minimally invasive body contouring procedure that can be performed in-office and provides practices additional income while expanding their continuum of care.
Booth(s) #: 710

Affirm CO2

 

 

 

 

Affirm CO2
Cynosure, Inc.
www.cynosure.com
The new Affirm CO2 LaserSkin Renewal Workstation, with a proprietary scanning delivery system, combines ablative CO2 skin resurfacing and collagen rejuvenation in a single laser.
Booth(s) #: 618

 

 

 

 

SlimLipo<sup>TM</sup>
SlimLipoTM body sculpting laser

Palomar Medical Technologies, Inc.
www.palomarmedical.com
The SlimLipoTM body sculpting laser offers a blend of 924 nm and 975 nm wavelengths for preferential absorption by fat and dermal tissue, respectively. Together, these unique SlimLipo wavelengths result in efficient fat "melting" and overlying skin retraction.
Booth(s) #: 736

Thermage changes its name to Solta Medical

Thermage Inc., has changed its name to Solta Medical Inc. and unveiled a new logo, along with a new logo and website for the Thermage product.

Theremage the company bought Reliant Technologies, maker of the laser resurfacing device Fraxel, for $87.5 million in a cash and stock deal last year. The new ticker symbol will be "SLTM" and is listed on the Nasdaq.

The design of the new Thermage site a fine change from the stagnant templates that most of the IPL and laser companies use. We'll have to see how it works for them.

From the Solta press release:

Thermage, Inc. (NASDAQ: THRM) announced that effective today it has changed its corporate name to Solta Medical, Inc. At the open of the NASDAQ exchange this morning, Solta Medical, Inc. will begin trading under the symbol “SLTM.”

"The name and ticker symbol changes are a great start to the New Year and a key milestone in the integration of the acquisition of Reliant Technologies, Inc. The new company combines the industry’s two leading brands, Thermage® and Fraxel®, under a new corporate name that will now form a global leader in aesthetic energy devices,” said Stephen J. Fanning, chairman of the board, president and CEO. “Solta Medical will focus on providing superior anti-aging solutions for patients and physicians by offering the gold standard of care for tightening, contouring and resurfacing of the skin with Thermage and Fraxel treatments.”

Solta Medical also announced the expansion of its industry-exclusive customer loyalty program which allows physicians to lock-in preferred pricing for Thermage and Fraxel treatment tips along with other preferred customer benefits to help physicians grow their practices and increase practice profitability.

“Thermage and Fraxel are the strongest aesthetic device brands available to physicians today,” said Suzanne Bruce, MD, dermatologist and president of Suzanne Bruce and Associates in Houston, Texas. “By combining these two brands into one company and expanding the customer loyalty program, Solta Medical is opening a number of new opportunities for doctors to conveniently and cost-effectively access a full suite of safe and effective anti-aging solutions.”

Doctor calls Botox a fraud

Both Sharma and Naik agree that Botox — the biggest fad in cosmetic procedures — is also “the biggest fraud”. The injectible contains bacteria that paralyses muscles on being injected into the skin, giving a ‘youthful’ wrinkle-free appearance. But because the effect of Botox is temporary, regular touch-ups are essential. “In the case of frequent use, the damage to the muscles may force a patient to undergo a face-lift at an early age. This scam allows for doctors and dermatologists to set themselves up for a steady income from their patients.” warns Sharma.
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Laser Hair Removal in New Jersey

Via a comment via Andrew D. Swain, Esq.

In New Jersey, laser or IPL hair removal can only be performed by a physician, and the term physician is defined as a person holding a plenary license issued by the New Jersey State Board of Medical Examiners.

New Jersey has consistently recognized that the use of a laser or light based device on a patient’s skin can only be used by a licensed physician. The use of a laser or light based device in a physician’s office is regulated by the State Board of Medical Examiners.

The State Board of Medical Examiners reviewed prior inquiries to determine whether non-physicians can use laser or IPL devices for hair removal. According to published Minutes, the Board has determined that only licensed physicians can use such devices for hair removal. On June 20, 2003, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that laser hair removal can only be performed by a physician.

The June 20, 2003 minutes stated:

b. The Committee reviewed a fax from Wanda Cooper, Sona International Corporation inquiring (1) as to whether a physician assistant is considered a nurse and therefore subject to the ruling of the Board of Medical Examiners regarding Thermolase laser; (2) as to whether the Board of Medical Examiners governs the Physician Assistant Committee and (3) whether a physician assistant can perform laser hair removal under the direct supervision of a physician.

As to the first question, it was the consensus of the Committee that physician assistants are not nurses.

As to the second question, the Board of Medical Examiners governs the Physician Assistant Advisory Committee.

As to the third question,consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform Thermolase laser hair removal as these procedures are deemed the practice of medicine and may not be delegated to a nurse or any other licensed health care professional other than a "physician".

A letter will be sent to Ms. Cooper so advising along with a copy of the statutes and regulations which govern the practice of physician assistants in the State of New Jersey.

On September 19, 2003, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that laser hair removal can only be performed by a physician, and that IPL photofacial or IPL procedures would be referred to the Medical Board to determine their position.

The Board stated:

c. The Committee reviewed a fax from Bryan A. Manhardt, PA-C, Allergy Asthma & Sinus Center, Somerville, NJ 08876, inquiring as to whether procedures for Microderm abrasion, Laser hair removal, IPL photofacial, Botox injections and Collagen injections can be performed under the supervision of a physician. The Committee determined, as to Laser hair removal and Botox Injections, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform these treatments as these are deemed the practice of medicine and may not be delegated to a nurse or any other licensed health care professional other than a "physician".

As to procedures Microderm abrasion, IPL photofacial and Collagen injections there is no policy statement from the Board of Medical Examiners at this time. A letter will be sent to Mr. Manhardt so advising, along with a copy of the draft proposal as it relates to these procedures which is not yet law.

d. The Committee reviewed a letter from Dr. Edwin P. Schulhafer, Allergy, Asthma & Sinus Center, inquiring as to whether nurses, physician assistants or nurse practitioners in the State of New Jersey can perform the following procedures: Laser hair removal; Laser skin rejuvenation; Endomology; Intense Pulse Light (not a laser but a visible light); Botox injections; Collagen injections and Microdermabrasion.

It was the consensus of the Committee that, as to Laser hair removal and Botox Injections consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform these treatments as these are deemed the practice of medicine and may not be delegated to a nurse health care professional other that a "physician". The Committee has no jurisdiction over nurses and nurse practitioners. This inquiry will be referred to the Board of Nursing.

As to laser skin rejuvenation, Endomology, Intense pulse light (not a lser but a visible light), Collagen injections and Microdermabrasion, there is no policy statement from the Board of Medical Examiners at this time. A letter will be sent to Dr. Schulhafer so advising along with a copy of the draft proposal as it relates to these procedures which is not yet law.

On April 16, 2004, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that IPL devices used for hair removal can only be performed by a physician.

The published minutes from April 16, 2004 stated:

b. The Committee reviewed a letter from Jason Staback, PA-C, inquiring as to whether it is legal for physician assistants in the State of New Jersey to use IPL (Intense pulse light) device for the purpose of hair removal, made by Palomar. He stated that it is categorized as a category 2 device. It was the consensus of the Committee that a letter be sent to Mr. Staback advising based on the limited facts presented, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform laser treatments as these procedures are deemed the practice of medicine and may not be delegated to a nurse, or any other licensed healthcare professional other than a "physician". To the current time, the performance of microdermabrasion and glycolic acid peels have also been considered the practice of medicine but unlicensed personnel have been permitted to perform theses procedures under the supervision and direction of a physician . However, please be advised that the Board is further investigating this latter issue and obtaining opinions from appropriate expert professionals. If the Board promulgates a regulation in this regard in the future it will be noticed in the New Jersey Register. Mr. Staback will be so advised.

On September 17, 2004, the committee stated:

The Committee reviewed a letter from Thomas Geary, PA-C, inquiring as to whether a physician assistant in the State of New Jersey can perform hair removal, tatoo removal and resurfacing if the supervising physician is a D.O. The Committee determined that based on the limited facts presented, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform laser treatments as these procedures are deemed the practice of medicine and may not be delegated to a nurse, or any other licensed healthcare professional other than a "physician".

In New Jersey, a physician cannot delegate laser hair removal procedures, laser skin resurfacing, or laser skin rejuvenation, to a physician’s assistant, a nurse, or any other licensed healthcare professional other than a "physician", which is defined as a licensed medical doctor. This position was stated on October 21, 2005, May 18, 2007, and reaffirmed again in September 2007. See Minutes, Physician Assistant Advisory Committee, September 21, 2007.

As recently as January 15, 2008, the New Jersey Board of Nursing did not approve of a licensed practicing nurse to administer IPL therapy. The Nursing Board Minutes stated:

Re: Inquiry from Doug Doyle, Esq., questioning whether Licensed Practical Nurses may administer “intense light pulse” therapy.

The Committee reviewed the e-mail and an article regarding Intense Pulse Light Therapy (IPL). The article stated that “IPL systems work on the same principles as lasers in that light energy is absorbed into particular target cells with color (chromophores) in the skin. The light energy is converted to heat energy, which causes damage to the specific target area.”

The Board of Nursing does not have regulations regarding administration of intense pulse light. On November 16, 2004, the Board of Nursing discussed this issue and made a motion to refer the issue to the New Jersey Board of Medical Examiners concerning the use of medical light–emitting devices (Lasers).

Consistent with the Board’s decisions of November 16, 2004, the Committee recommends that Mr. Doug Doyle’s question be forwarded to the New Jersey Board of Medical Examiners for review and comments.

As of 2008, the New Jersey Board of Medical Examiners consistently has taken the position that the use of laser or IPL device is the practice of medicine.

You can search the website of the New Jersey Board of Medical Examiners to review meeting minutes to update the above research. http://www.state.nj.us/lps/ca/bme/minutes/bmemin.htm. And, you and your employer should consider consulting an attorney or the medical board in your state for further clarification.

Comparison of what's in a Dermal Filler: Radiesse, Restylane, Perlane, Juvederm Ultra, & Sculptra

What's in Restylane or Perlane? Here's a synopsis.

Radiesse

1.3 cc syringe, active ingredient is 30% "powdered synthetic bone"
Very good for nasolabial folds, cheekbones, jaw lines. Not good for lips. Lasts about 3-6 months after the 1st treatment, about 12-18 months after the second treatment. Considered "semi permanent" because the collagen that it stimulates will last for years after the product has dissolved. Cannot be dissolved with any chemicals such as Hyaluronidase. Can also be used on the backs of the hands.

Restylane

1.0 cc syringe, made out of cross linked Hyaluronic acid.
Lasts about 6 months. Tends to absorb a little water, which causes some temporary swelling. Good for nasolabial folds, lips, mild to moderate wrinkles. It can be dissolved with Hyaluronidase. Lasts from 3-12 months; 6 months is about average.

Perlane

1.0 cc syringe, similar to Restylane
The "particle size" in the Perlane is larger, which makes the Perlane thicker. It tends to be used for deeper wrinkles and contouring. It is very good for deep nasolabial folds, straightening the jaw line. It can be dissolved with Hyaluronidase. Lasts 3-12 months; 6-9 months is about average.

Juvederm Ultra ( Juvederm 24 HV outside the US)

0.8 cc syringe, similar to Restylane
Injects very smoothly and tends to flow nicely under the skin. Very good for lip enhancement. Absorbs a little less water than Restylane so there is a little less swelling, which may be important in the lips. Even though the syringe is smaller, there is a higher concentration of Hyaluronic acid in the material which gives it about the same amount of Hyaluronic Acid as Restylane. It can be dissolved with Hyaluronidase. Lasts 3-12 months; average is about 9 months, less in the lips.

Juvederm Ultra Plus (aka Juvederm 30 HV in other countries)

0.8 cc syringe, similar to Juvederm Ultra, but 20% thicker
Very good for deep nasolabial folds. Softer than Radiesse, less likely to leave a palpable lump in the skin.

Sculptra

One vial can produce 6-10 cc of material.
Comes as a powder, must be mixed with water and local anesthetic at least 2 hours prior to use, preferably mixed 24 hours prior to use. The initial effect only lasts for a few days. The fluid is absorbed, but the powder is left behind. The powder causes the skin to get thicker. 3-6 treatments, space 1-2 months apart, are needed. Vigorous massaging is needed 5 times per day for a few weeks after the material is injected (this is done by the patient at home). Very good for replacing lost volume in the cheeks.

Plasticos Foundation

Buddhists have a saying that expresses the essence of Plasticos Foundations' philosophy: Give me a fish, and I eat for a day. Teach me to fish, and I eat for a lifetime. In accordance with this philosophy, Plasticos team members often work under difficult and primitive conditions correcting deformities such as cleft, cleft palate, hair lip, hare lip, webbed hands or feet, burn scars, tumors, etc. And of equal or even greater importance, as they operate, they simultaneously train local surgeons, anesthesiologists and nurses in reconstructive surgical techniques and patient care, so their work can continue long after the team has gone.

MISSION STATEMENT

To provide reconstructive plastic surgical training and care to those in need, regardless of their ability to pay, and to advance the field of Plastic Surgery through education and research.

GOALS

To improve the lives of others through Plastic Surgery, we will provide direct reconstructive plastic surgical care worldwide, primarily to children in need. Through our intervention, we will enhance the lives of those with correctable deformities. Whenever possible we will train and assist surgeons in host countries in the art of Plastic Surgery, enabling them to carry on this work. We seek to advance the field of Plastic Surgery through training, research, and public education. To this end, we will establish host-country medical alliances, domestic patient care and educational programs.

VALUES

We believe all individuals, especially the young, negatively affected by correctable deformities deserve to be made whole. Through direct care, training, research and public education, we will use kids plastic surgery as the reconstructive vehicle to mold and shape these lives. We believe that we enrich our own lives in direct proportion to how much we benefit those less fortunate than ourselves and empower others to do the same.

Why chiropractors can not use lasers and IPLs for cosmetic treatments.

Here'a an email I received on chiropractors performing cosmetic medical treatments with IPLs and lasers.

This is probably in response to the discussion about Florida Chiropractors offering laser and IPL treatments.

I've removed the name and eveidently there was some emotion involveds with the ALL CAPS.

Per Chapter 460: Why light is not in the scope of chiropractic medicine unless used to treat...

...and treatment of the human body in which vertebral subluxations and other malpositioned articulations and structures that are interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated, or treated, thus restoring the normal flow of nerve impulse which produces normal function and consequent health by chiropractic physicians using specific chiropractic adjustment or manipulation techniques taught in chiropractic colleges accredited by the Council on Chiropractic Education.

See below - obviously IPL's and Lasers ARE ONLY IN THE SCOPE OF PRACTICE WHEN TREATING THE ABOVE

- HAIR REMOVAL AND AESTHETIC MEDICINE IS OBVIOUSLY NOT vertebral subluxations and other malpositioned articulations and structures that are interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated

AND WHERE IS AESTHETIC MEDICINE TAUGHT BY AN ACCREDITED COLLEGE OTHER THAN THE ONE DOCTOR WHO IS CURRENTLY SELLING THESE DEVICES AND TEACHING CE CREDITS TO OTHER DOCTORS IN ORDER TO USE THAT AS THE DEFENSE FOR WHY IT IS IN CHIROPRACTIC SCOPE - WHICH MAY ACTUALLY WORK IF IT WERENT FOR THE VERBIAGE THAT THE TEACHINGS ARE thus restoring the normal flow of nerve impulse which produces normal function and consequent health by chiropractic physicians using specific chiropractic adjustment or manipulation techniques

HAIR REMOVAL AND OTHER AESTHETIC TREATMENTS BEING PROVIDED ARE NOT WITH THE PURPOSE OF RESTORING THE NORMAL FLOW OF NERVE IMPULSE WHICH PRODUCES NORMAL FUNCTION AND CONSEQUENT HEALTH BY CHIROPRACTIC PHYSICIANS USING SPECIFIC CHIROPRACTIC ADJUSTMENT OR MANIPULATION TECHNIQUES

SO Chiropractic physicians may adjust, manipulate, or treat the human body by manual, mechanical, electrical, or natural methods; by the use of physical means or physiotherapy, including light, heat, water, or exercise; by the use of acupuncture; or by the administration of foods, food concentrates, food extracts, and items for which a prescription is not required and may apply first aid and hygiene

IS IN DIRECT REFERENCE TO

treatment of the human body in which vertebral subluxations and other malpositioned articulations and structures that are interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated, or treated, thus restoring the normal flow of nerve impulse which produces normal function and consequent health by chiropractic physicians using specific chiropractic adjustment or manipulation techniques taught in chiropractic colleges accredited by the Council on Chiropractic Education.

If 1- vertebral subluxations ,
2)malpositioned articulations ,
3) structures that are interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated

were not referenced in Chapter 460 - then IPL's & other light devices used for AESTHETIC purposes would maybe have a chance of being in the scope of Chiropractic Medicine but no where in any of the medical records of these physicians, the advertisements or anything else will you likely see any reference to treatment of ailments , just services provided to enhance aesthetics.

Silicone Breast Implants Video: Absolutely Safe?

Silicone Breast Implants: I received promotional materials for a movie 'Absolutely Safe', a documentary film about problems with silicone breast implants.

The information about this is lengthy but I've include three promotional videos that deal with testimony about silicon breast implants before the FDA in 2003, ruptured implants, and a plastic surgeon discussing failure rates and removal of implants.

Plastic Surgeon on Silicone Breast Implants

Every year, more and more women and teenagers in the U.S. are choosing to receive breast implants.

The American Society of Plastic Surgeons reports that last year nearly 400,000 women in the U.S. received breast implants. Yet amidst this booming industry lies a complex story of questionable regulation and research, health risks, and women determined to do anything to have the "perfect" breasts. Do women considering implants know about the risks? Are manufacturers and the medical community providing women with all of the facts necessary in order to provide "informed consent?" Today, this procedure has become so popular that high school teenagers receive implants as graduation presents, however few consumers, physicians or regulators are asking whether these medical devices are as safe as the FDA purports them to be.

On November 17th, the New York Times published an article reporting on a letter to congress from a group of FDA scientists accusing top FDA officials of engaging in "serious misconduct" by tampering with the approval process of medical devices. Breast implants are classified as medical devices.

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Illegal Botox auctions on Ebay?

Online auction site eBay has agreed to remove illegal Botox adverts in the UK after 240 unlawful listings were found over five days, a consumer watchdog said.

Via: Telegraph article; UK

16 companies and individuals were found to be advertising the prescription-only medicine to the public, with many unaware they were breaking the law.

Ebay had agreed to remove the promotions following a complaint by Which? and under the guidance of the Medicines and Healthcare products Regulatory Agency (MHRA), Which? said.

Adverts offered discount vouchers for Botox treatments and encouraged trade with "introduce-a-friend" offers.

A seller from Texas offers auction shoppers 100 units of Allergan's Botox Cosmetic. The seller markets this Botox by explaining that self-injecting Botox is easy and a money saver.

When having this treatment at the Spa, I started to think that it wasn't that hard to do after watching the girl at the MedSpa do mine, and started talking with her about options of doing it at home. She was able to obtain quantities of the products they use at the Spa for me to use at home and share with my friends (mostly other Moms). I am just a real person who wants to share my amazing find and perhaps make a little money in the process.

Medical Spa MD: 11,000 comments and growing.

Medical Spa MD's forums are by far the most active physician community of any blog on cosmetic medicine.

In fact, there are more than 11,000 comments and and posts on topics from Palomar Medilux treatments to interesting facts about individual medical spa franchises.

It's this community of physicians that add such value to this site and I wanted to thank you all for contributing your insight and knowledge.

If you're new to Medical Spa MD I'd like to invite you to add your voice to the discussion.

Forums and discussions that are currently the most active:

Here are some forums that are new:

Discussions of posts:

Free care a moral obligation for cosmetic medicine?

Via Kevin MDs post:

Two lawyers write an article in JAMA, saying that it's the physician's moral obligation to give free care. They seem immune to the financial pressures doctors face, and as lawyers, really are not in a place to lecture:

Ludwig and Nestle adopt a scolding tone to physicians that ask for immediate co-payments and attempt to collect on overdue bills. The authors site the AMA’s ethical opinion that urges 'compassion and discretion in hardship cases.'

This brings up an interesting point; is there a moral oblication for plastic surgeons and dermatologists to preform free or lower priced treatmens for those unable to pay retail?

It's been my experience that cosmetic preactices to NOT do this as a rule. (There are a number of plastic surgoeons and dermatologists I know that travel to third world countries but I'm not counting that for this meaning. In fact, my former physician parther was oddly against any type of discount in this area.)

If you're a physician, I'd be currious to learn why you either offer or refuse to offer free care for patients who are unable to pay.