The Downside of The Beauty Business Boom

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.

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Fast forward to the fast-paced world of today where social media equates word-of-mouth advertising. Young doctors who have spent a week at a filler course and 2 days at a laser seminar are setting up their own aesthetic practices by the dozens, buoyed by their new found confidence and newly acquired skills. But recent surveys have shown that the beauty clinic boom is accompanied by rising patient complaints and a fall in consumer satisfaction. As fast as these beauty clinics are opening, many are in droves closing as well, taking with them hard-earned cash of patients who have invested in beauty ‘packages’ sold by these new businesses with zero track record. So what is driving this boom and bust in beauty business?

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Dr A (not his real name) delivered several hundred babies, conducted several thousand pelvic exams and diagnosed everything from infections to infertility. But this year, with a little additional training (exactly 3 days at a filler training course), he has entered a new field: cosmetic medicine. When asked why he wanted to venture into a field outside of his specialty, Dr A explained, “Honestly, I saw what an easy life my aesthetic colleagues were having, and I just wanted in.” Isn’t it a little bit unethical to be doing something not because you believe in it but for the money, we asked. “Not really, I may not personally have a passion in beauty, but if it keeps my patients happy, why not?”

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“Aesthetic medicine isn’t rocket science. I believe I have learned all I needed to keep my patients happy.” ~ Dr B, owner of a one-month old aesthetic clinic.

Dr. B (not her real name) started off as a GP. Then she joined a large aesthetic practice comprising of both aesthetic  doctors and plastic surgeons some years back. After three years of being trained from scratch whilst on the job, she decided she knew enough to start out on her own. She may be short on medical expertise but she feels she is big on business savvy.  Armed with with a few low cost generic lasers and a small range of local OEM creams which she then relabeled, she launched her own aesthetic clinic recently. When asked how she was going to continue improving her skills and knowledge now that she is alone as a one-woman show (she has no colleagues and peers to collaborate with nor seniors to mentor her) Dr. B replied with remarkable confidence “Aesthetic medicine isn’t rocket science. I believe I have learned all I needed to keep my patients happy. I don’t think there is any need for further education in the field of aesthetics, there really isn’t anything I cannot learn from the internet”.

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Armed with with a few low cost generic lasers such as Exilis, Dr B launched her own aesthetic clinic to much fanfare.

“I think that it is all about marketing. If you know how to market well, you can have one laser, and you can sell them in five different ways to your patients, so why not? Some clinics even have their clinic assistants performing the laser treatments, so the doctor don’t even have to lift a finger. If you think of it like a business, then all you need is one laser and a good marketing plan” she laughs.

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Some clinics use trained therapists, not doctors to administer laser treatments.

Not all doctors share her exuberance however. “When you use a generic medical license to practice other forms of medicine,” he said, “there is an inherent danger to patient safety” says Dr Connolly, a plastic surgeon from Ohio. “There is also something inherently wrong about ‘business-type’ doctors who set out after a few years on-the-job training with the sole aim of making money. Medicine should be about passion, it should be about doing the best for your patients. If you are not passionate about what you do, then you shouldn’t be doing it. It certainly shouldn’t be about using the lowest cost devices to generate the greatest profits from your patients!”

Dr. Mark L. Jewell, a plastic surgeon in Eugene, Ore., who is a past president of the American Society for Aesthetic Plastic Surgery, said the advent of physicians from other fields was likely to confuse patients, who do not always investigate a doctor’s training when looking for a cosmetic medical expert. Even more confusing to consumers is that many nonspecialist physicians are marketing themselves using terms like “cosmetic surgeon,” “aesthetic surgeon” and “laser surgeon,” he said.

“If patients are tempted to commit to any packages, my advice is to look at the track record of the clinic, and not to commit if the clinic is less than five years old.”

“Next thing you know, chiropractors will be doing liposuction,” Dr. Jewell said. “And psychiatrists will be ‘head surgeons,’ giving you Restylane with your Prozac.”

“The problem about the rise of these new clinics is their lack of track record. These doctors then go on to sell packages to patients which they cannot possibly fulfill, then when their clinics or salons close down, the patients are left high and dry” comments Dr Lowe, a dermatologist from New York. “If patients are tempted to commit to any packages, my advice is to look at the track record of the clinic, and not to commit if the clinic is less than five years old.”

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