Medical Estheticians: Physicians not necessary.

I had a hell of a time trying to think of a title for this post. Here are some I discarded:

 

• I've got a laser and I want money or I'll shoot.
  
• Cosmetic Medicine: Medical degree not required.
• Someone took my money and gave me this Medical Esthetician Degree.
  

An esthetician posted over on the IPL & Laser discussion boards that she'd like to start practicing aesthetic medicine:

"I want to get into laser Hair Removal but not sure where to begin. I am statring to look at equipment to lease but really stuch on which way to go. I want a machine thatwill grow wit me and my business. I will start with hair removal and go from there. In school we learned on a Cutera machine but I was just looking at the Harmoney. I could really use some advice from people who have already done this before. As well I am sure I need insurance to perform services."

Sytax, grammar, and punctuation aside, there were a number of (what I considered to be well meaning) replies that attempted to inform Ashley that these were medical procedures and that she, as an esthetician, was going to have a hard time doing them off on her own. Not to be dissuaded, Ashely replied with this:

"I am not interested in Laser surgery. I am refering to laser hair removal, photo facials, capillary treatments. A medical degree is not required. These services are performed by a medical esthetican "

Now there's a declaration of fact and no mistake.

Evidently Ashleys either lives outside the US, she's been misinformed, or she feels that medical schools a mere formality thats been replaced with esthetician school.

I'm supprised that she's been treated "wit" such kid gloves since she's left the domain of the esthetician boards and posted to a site that clearly states 'physicians' at the top. Of course JK offered to hire her.

Here's my response:

 You have to be kidding.

• There is no such licensure in any state for "Medical Esthetician". (Someone provide a link to a state site if I'm wrong.)
• All the treatments listed are medical treatments: You've got to be kidding with this.
  

There are plenty of posts on this site that deal specifically with this issue: Who can fire of an IPL and under what circumstances.

Under Categories & Topics: Medspa Legal

Under the discussion areas: Medical Spa Legal

Cosmetic Surgery "Unneeded" Medicine?

Crabby Old Lady from Blogher thinks that cosmetic medicine is an unnecessary waste of a physician.

...The physician, who is described as clinical instructor in plastic surgery at a renowned west coast medical school where he is also an attending physician in plastic surgery says, according to the publicist’s email, that “there are cases…where the right procedure can turn a child around from being depressed to self-confident.”

Riiiight. A little surgical intervention will correct all those unruly, adolescent growing pains. And in case the surgery doesn’t lift her depression, why not drop some Paxil in her morning orange juice and give her a list of pro-ana websites to help keep her weight down...

...Might this doctor’s “acceptable motivation” in promoting teen and tween cosmetic surgery be a new Mercedes Benz? As the baby boomers age into elderhood in the next few years, it won’t be cosmetic surgeons they need and we can’t afford to lose more doctors to this unneeded specialty.

 and these counter comments from A Stitch in Haste

these are precisely the kind of pronouncements you would see under socialized medicine. Corrective eye surgery? "Unneeded" — just wear glasses! Orthodontics? "Unneeded" — that's cosmetic! Paxil? "Unneeded" — use talk therapy instead! Birth control? "Unneeded" — use condoms! Expensive end-of-life "extraordinary efforts"? You know the answer.

You might be a Medical Spa Entrepreneur if...

A lot of physicians think that they have entrepreneurial experience. After all, they started or ran a medical practice, and isn't that what a physician entrepreneur does? Maybe, depending on your own definition. Well, here's mine. These are not all necessarily descriptive of the current situation, and they are not all things I'm proud of or would recommend. Most of them certainly were not intentional, but they are all taken from my personal experiences. Some are humorous, some are not.

These days I'm happy to say that the vast majority of these things are behind me. Much of what is detailed below was brought about by the speed with which we are/were growing. Nowdays I'm usually home at night,Surface clinics have excellent staffs that I adore and count as friends, and I'm starting to have some free time again to devote to other persuits. Life is good.

And now, without further ado...

You might own a Medical Spa if...

 
You've 80k in credit card debt from cards you never knew you had.

You've averaged 60-80 hours per week of work for the past seven years.

You can personally have the most advanced medical treatments available but receive the poorest quality care.

You've found yourself at 2am painting treatment rooms in your underwear.

You spend two days without sleep because you know you're going to have to fire someone even though you're firing them for stealing from you.

You're accountant calls while you're leaving for vacation to tell you that your newest location is 25k in the hole so far this month and checks are bouncing.

You have employees that make five times what you do.

You eat all of your meals off of paper plates using plastic utensils. 

Without trying you've succeeded in convincing all your employees to never try to start their own business.

When someone asks you what you're doing this weekend you say "Working, of course, just like any other day."

You go to the gym once every six months and kid yourself that it makes a difference. 

Every six months you see the same guy at the gym who's obviously in shape and think "How in the world does anyone have time for that?"

6pm feels like 1pm.

Your staff clocks out while you're having lunch.

You drive home in the dark every night of the year.

You drive 60k miles between clinic each year.

You're ear aches at the end of the day from having a cell phone pressed against it for hours.

When people ask what you do you answer," I answer questions all day".

You have a bet with yourself on how long after meeting a woman and telling her what you do she asks, "What do you think I should have done?"

You learn never to answer the above question.

You have the most overwhelming sense of Deja Vu every time a physician with any type of rinky-dink cosmetic practice tells you that he's thinking about franchising his business.

Your wife is reduced to tears at a fourth of July parade when a patient accosts her demanding to know why your physician, Dr.Y, has ruined her life.

The physicians complain that the front desk is booking too much time for something and changes the default in the schedule. The front desk complains that the physicians take that much time and change it back.

You've closed, locked the doors and gone home leaving a patient still sitting in a treatment room.

You walk into the clinic kitchen while the staff is discussing horror stories of performing Brazilian hair removal in graphic detail.

You wonder if the computers ever actually work when you're not there.

You have to chase down a woman who's attending a free seminar and trying to make off with $600 in product samples. 

You feel almost euphoric just thinking about what it would be like to not owe anyone any money.

You develop a deep and abiding hate of yellow page salesmen.

You wonder why, when every salesperson on earth is deeply committed to helping you 'grow your business', they're never around when you're signing payroll checks. 

You've told someone not to start a new medical spa on their own because you sincerely can't bear the thought of someone going through what you've been through.

Just closing the doors and moving to South America seems like a perfectly viable option.

You've worked multiple Christmas days.

A physician you've trusted and put in a position of power starts having patients pay him directly inside the treatment room and sets up a secret merchant account so that he can swipe a card and have the money deposited directly into his personal account.

After you fire the above physician, he breaks into the clinic and steals equipment. While you're on the phone the next morning with the police, his wife calls and leaves a hysterical message asking 'How you could do this to us?" and threatening to sue you.

A patient asks "Why is ________ at the front desk insisting that she deliver deliver products and take payment at my house?" 

You've paid the federal government more in business taxes than you've paid yourself.

A physician calls you and asks for your help since American Laser Clinics has an armed guard in his waiting room to prevent him from seeing his own patients while at the same time their performing treatments using him as their medical director.

The same physician tells you that he's been doing this for thirty years and know how to run a clinic better than anyone while dismissing reports showing his declining performance as a 'computer problem' and asking you for money so that his kids can continue to go to private school and he doesn't have to sell his airplane.

The same physician thinks that all his new patients are coming through excellent word of mouth and his superior charisma while dismissing the $16,000 you spent last month advertising his services.

You have to deal with this physicians office manager who's decided to get even with you for not hiring her so she takes every opportunity to sabotage you.

You find yourself expanding to a physician why you can't advertise in a fashion magazine using before & after images of extremely unattractive sagging bellies and thighs from 80 year old morbidly obese patients even though 'the results are good'.

You don't worry about filing taxes late because you know you're not in a situation where you could possibly owe the government any more money.

You've felt a sense of relief when an employee has quit because now you don't have to lay them off.

You're an expert on what does and doesn't count as a business expense.

You've slept on the floor of your office or on the couch in a waiting area more than once.

You've seriously considered buying a cot for your office.

You wonder where the last five years went.

You realize your wife must be a very special person because what other woman would put up with all this and still like you?

You have 6 horses you never ride, a gym membership you never use, children you hardly see, and family vacations you don't go on. 

You look at every medical spa you drive by in your car thinking, "I bet the guy running that medspa is making a lot more money than I am."

You have a surge of bile when you're at a medical convention and a consultant says to a packed room of physicians, "Of course you can make $250,000 per treatment room right now," and then proceed to tell everyone that the key is to 'not let any patient leave until they've bought product and booked another appointment.

You wonder how the above consultant got anyone to listen to her, ever. 

You're able to write a list like this in a half hour right off the top of your head.

This just a partial list of course. I may add to it. And of course these are all in the past.

Dr. 90210: Robert Rey MD's saves plane from geriatric flight attendant pusher.

This is just too funny. Dr. Rober Ray, the Brazilian plastic surgeon from Dr. 90210, finally got a chance to utilize his training and show why he has all his scrubs without sleeves.

From CBS news: An elderly man on an American Airlines flight was restrained by passengers, including television's "Dr. 90210," after he got out of his seat and shoved a flight attendant late Monday, officials said. 

Dr. Robert Rey, a plastic surgeon who practices martial arts, told The Associated Press he got out of his seat and intervened when he heard the man make a "big noise" as he pushed a female flight attendant toward the cockpit.

"When you get a black belt, at that stage your brain just clicks into action," the doctor said. "I restrained this gentleman in a very aggressive way without hurting him." 

Of course the story continues with this:

Flight crew members described the man as "very frail".

Klaatu Burado Nicotine; Translation: "Ain't medical science wonderful."

 From Uncertain Principals

...There is, however, one scene that has become unintentionally hilarious over the past fifty-odd years. Two Army doctors are outside the room where Klaatu (Michael Rennie) is being held, and they have a conversation that goes something like this (paraphrased, from memory):

Doctor 1: How old would you say [Klaatu] is?

Doctor 2: Thirty-five, or thirty-eight.

Doctor 1: He told me his age yesterday when I examined him. He's seventy-eight. He says his life expectancy is one hundred and thirty-eight.

Doctor 2: How is that possible?

Doctor 1: He says their medical science is just that much better that ours.

And then Doctor 1 leans over and hands Doctor 2 a cigarette, and they both light up.