A recent report from Australia noted a string of “cosmetic surgery practices” that were ran and staffed by unqualified “surgeons.” This is a problem both in the US and abroad as plastic surgery becomes more and more mainstream, especially the non-surgical procedures like Botox and facial fillers. That said, unqualified “practices” still offer legitimate surgical procedures at a discounted rate, which is certainly the more worrying of the two.
Board certified plastic surgeons discuss on the latest episode of No Spin Live.
Australia? Or Miami?
While this story is in regards to an issue down under, this same issue has been occurring with dangerous frequency in the states. “If it wasn’t for the Australian accents, I thought they were in Miami,” shares board certified plastic surgeon Dr. Jason Pozner. “We’ve got this 50 miles from here, the same stuff is going on, now it’s metastasized to another country. It’s the same thing we’ve been going through in the US for awhile with illegal places doing illegal things with people who think they’re getting something cheaper.”
Perhaps one of the more interesting points is how the businesses were shut down. Dr. Pozner shares that had this exact same story happened in the US, they may have been shut down quicker. “Watching the video was interesting because if it were the US, they would have closed down those places much more rapidly than they did in Australia.”
While “shutting them down” seems like a good thing, that doesn’t necessarily mean the beast is dead. Unfortunately with the legal situations surrounding these enterprises, it’s more like cutting off the head of a Hydra, to have it replaced by 3 more.
Understanding Corporate Medicine in the Cosmetic Industry
Much of the issues has to do with how readily a business can form and the modern marketing tools at their disposal. Dr. Dan Del Vecchio, a board certified plastic surgeon in Boston, describes the typical process: “The corporate practice of medicine is very easy to unwind,” he begins. “If you create a corporation called X, Y, Z Corporation, open up in a strip mall, and hire a [veterinarian] to inject Botox into patients… If you get caught, there are very few consequences. In most states, the practice of medicine without a license is like a $500 fine. It’s not prison time. You don’t go to jail for practicing medicine without a license. And the corporation just dissolves, it’s an LLC!”
A business dissolving because it unintentionally hurt, or killed, a patient isn’t such a big deal. Why? Well, the same people in charge can just begin another business and start all over again. “Nobody gets hurt in the long-run besides the patient, and then they pop up again in another strip mall!” says Del Vecchio. “That’s the problem we see with all of the deaths in Florida with all these boutique clinics – they just open back up. The physician is the only one who is really liable because they have a conscious and licenses that they have to hold. But corporations can just change the name and start again.”
Patients Have to Vet Their Surgeons, Which Can Be a Challenge
Part of the difficulty in addressing this issue is medical licensing isn’t as stringent as one might be led to believe. Receiving a state license to practice medicine – in this case plastic surgery – has very little to do with the amount of training the license applicant has. Because of this, it becomes even more difficult for patients to separate the wheat from the chaff. “These are non-doctors and aren’t under the same requirements we are,” shares board certified plastic surgeon Dr. Brad Calobrace of Kentucky. “That’s what becomes the real problem. The government ultimately has to step in at some point in time. I think they’ve needed to step in for a long, long time, even as it relate to physicians. All you need in most states is a license to practice medicine and really you need no credentials in that particular specialty – especially in plastic surgery – to go ahead and hang your shingle and actually do these procedures.”
Following those steps, a business can be open and operating with little or no vetting from anyone as to their proficiency and experience in the procedures they offer. A slick-looking practice may be relying almost entirely on content marketing to draw their patients, not the fact that their physicians are highly-trained and experienced. The real problem for plastic surgeons who have spent over a decade learning and perfecting their craft is the risk patients undergo in these situations. Never forget, plastic surgeons are physicians, too. What should be the #1 goal of any physician? Patient safety.
“There’s really no training, which is very harmful,” continues Calobrace. “The problem is, the minute we start talking about this, it looks like we’re having a turf war. That we’re worried about people invading our space. What we’re really worried about is patient care and patient safety. We spent many a year to insure that we’re highly qualified to do these procedures. The worst scenario is somebody with no medical training, but almost as bad is somebody with some legitimate training so they can at least put MD on the door but they have absolutely no training in the specialty. They can cause as much harm.”
An Opportunity for Education
The one good thing to come from stories like these is attention. Unfortunately, patients have ended up losing their lives on the operating table or having extreme complications because of unqualified practitioners. For the rest who may or may not end up in such a situation, the more these stories are highlighted, the more likely the possibility that the public at large will learn how to avoid them.
Dr. Bruce Van Natta, a board certified plastic surgeon in Indiana, thinks these media stories may be able to do some good. “I think this is an example of where some of the reality TV shows and things could actually do some good for patient education,” he shares. “If you can show patients that just because it’s cheaper and easy, and that you can get into a lot of trouble, that actually might serve to deter people and maybe encourage them to look a little more carefully to who they’re going to for their procedure.”
It’s difficult for patients in this modern landscape. At the end of the day, it’s yet up to them to heavily vet the practices and surgeons they are seeking procedures from. It’s always key to start with board certification, then move onto the procedures they specialize in and the results they obtain. Then, the one-on-one conversation will ultimately be the deciding factor as to whether or not to move forward.
Make no mistake, there are incredible plastic surgeons all over the world creating the best aesthetic and reconstructive procedures the specialty has ever seen. The results can be yours, too, with the right amount of research and vetting.
William P. Adams, Jr., MD
April 7, 2018 at 9:14 am
The Australians have taken a real leadership role in policing this better and protecting the public from those who have not undergone proper training for these cosmetic procedures. US authorities and State Boards should take note and follow suit!
April 7, 2018 at 12:18 am
Great sessinn guys! Couldn’t agree more, exactly the same problems you have there.