NY Times: More doctors turning to the business of beauty.

From the NY Times: More doctors turning to the business of beauty.

Five years ago, cosmetic medicine was primarily the domain of plastic surgeons, facial surgeons and dermatologists — medical school graduates who undergo several years of training in facial skin and its underlying anatomy. But now obstetricians, family practitioners and emergency room physicians are gravitating to the beauty business, lured by lucrative cosmetic treatments that require same-day payments because they are not covered by insurance and by a medical practice without bothersome midnight emergency calls.

Dermatologists and plastic surgeons refer to their new colleagues as “out of scope” or “noncore” physicians, and they strongly object to the intrusion, insisting that cosmetic medicine requires lengthy training.

But the dispute also has all the elements of a turf war, with specialists reluctant to cede ground in a field in which Americans spend an estimated $12 billion a year.

“Dentists are doing Botox, and urologists are doing hair transplants and vein removal,” said Dr. Ellen Gendler, a dermatologist in Manhattan who is a clinical associate professor at New York University School of Medicine. “Everyone wants to be a plasticologist.”

...Still, Dr. Kilanko said she understood the discomfort over physicians who practice outside their board certification, and she objected to the suggestion that a dermatologist might perform a Caesarean section after a day course in obstetrics.

“They would have no business performing a C-section,” she said. “But you can’t compare the knowledge of the anatomy, level of difficulty and risk of complications of a C-section with Restylane injections.”

Dr. Gendler, the Manhattan dermatologist, vehemently disagreed.

“They don’t think it’s brain surgery until they have a problem,” she said. “Then the first thing they do is send the patient to a dermatologist.”