Introduction
COSMETIC MEANS “TO BEAUTIFY AN APPEARANCE”
AESTHETIC MEANS “TO LOOK PLEASING”
THE AMERICAN COLLEGE OF AESTHETIC AND COSMETIC PHYSICIANS™
HISTORY AND POLITICS OF AESTHETIC/COSMETIC MEDICINE
& THE AMERICAN SOCIETY OF AESTHETIC/ COSMETIC
Aesthetic / Cosmetic medicine was in its infancy stages in the 1980s and 1990s. Until recently in the mid 2000 decade, aesthetic / cosmetic medicine has exponentially taken off and is now a very well accepted field of medicine. The drive of this explosive growth has mainly been due to technological advances.
PHYSICIANS™
Aesthetic means “to look pleasing” and Cosmetic means “to beautify an appearance”. www. medicalaestheticsociety. org/history.htm
Aesthetic / Cosmetic medicine is a field in medicine that usually involves minimal cutting, no general anesthesia, and patients are usually self pay. This relatively new field of aesthetic / cosmetic medicine basically involves three main categories. 1. INJECTABLES – such as Botox and dermal fillers specialties perform aesthetic procedures. Within the to help decrease the look of the natural aging United States, some states allow medical technicians process. to do procedures with supervision by a physician. Similarly, many states also allow nurses to perform 2. LASERS – this technology has rapidly surpassed procedures with supervision by a medical doctor. some of the traditional medical training and can be While other states allow these procedures to be used for a wide variety of applications such as hair performed by nurses without supervision as long as removal, vein removal, collagen stimulation, the facility has a medical director present in the nontraditional liposuction, hair stimulation, teeth building. However, the majority of states require whitening, and many more. that only physicians perform these aesthetic procedures. 3. MINIMALLY INVASIVE CUTTING AND SUTURING – These are minor procedures that do not require This is now possible because new technology have general anesthesia such as hair transplants and made procedures more simple, easier to use, and certain skin lifts etc... more accessible to the doctor and patient. Many previous procedures that required a hospital Of course, these three categories are presented to operating room are now noninvasive and office simplify a more involved field of medicine. based procedures. Since many of these procedures are currently done in private medical offices, Aesthetic Medicine is constantly evolving and is hospitals cannot dictate which specialty can do the not what one learned in medical school. procedures based on hospital politics or policies. Traditionally aesthetic and cosmetic medicine has Another large factor that allows a large variety of been a field that was exclusive to dermatologist and physicians to perform these procedures is simply plastic surgeons. Currently, physicians from all that most patients are “self pay”.
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These procedures are considered “elective” or “cosmetic” which are not considered a medical necessity. This disables insurance companies or the government in determining which type of physician can perform or be compensated for these aesthetic procedures (since insurance companies or the government are not the ones reimbursing these physicians). With advancing technology and new discoveries in medicine, different medical fields experience changes. For example, at one time cardiothoracic surgeons were the leaders, authoritative figures, and money makers in a hospital. With the invention of the stent, cardiologists have literally overthrown these historic giants. There have been turf wars among specialties for ages. The best example of this has been seen with interventional cardiologists, interventional radiologists, and vascular surgeons competing to do similar or the same procedures. Many fields in medicine overlap, this can be seen with a family practitioner delivering a baby and doing well child exams on that baby - thus, taking the job of an OB/GYN and pediatrician. This can also be clearly seen with a family practitioner performing colonoscopy in a small rural town but being hindered from performing them in large metropolitan cities because of turf wars and politics. Many specialties feel entitled to different procedures. However, entitlement does not translate to being more qualified. [No field of medicine would be foolish enough to criticize each other given the vast array of medical knowledge each specialty holds] Botox injections or the use of lasers are not beyond the scope of medical knowledge to most physicians who get appropriate training. This field of medicine was not created to take away from the dermatologist or plastic surgeon that spent countless years of training in their respected field. The reality is that the plastic surgeon and the www.medicalspasreview.com
cosmetic derma surgeon will never be at a loss of business from other specialties practicing aesthetic / cosmetic medicine. Dermatologists take care of complicated skin conditions such as cancer and plastic surgeons spend hours in the operating room performing complicated reconstructive surgeries. These procedures can never be emulated or performed by a non trained physician of other fields.
Introduction Permission to publish: American College of Aesthetic and Cosmetic Physicians PMB 6882 2711 Centerville Road, Ste 120 Wilmington, DE 19808
The danger lies in the fact that since the procedures associated with aesthetic and cosmetic medicine are minimally invasive, this might give healthcare professionals the false sense of being complacent that nothing can go wrong. This word of caution also applies to the dermatologist or surgeon who might not have been trained in these minimally invasive procedures or use of lasers. Just because a healthcare provider of any specialty can perform some of these procedures, that does not mean they should. Health professionals who plan to implement aesthetic / cosmetic medicine into their practice should have appropriate training and understanding of the technology, as well as a complete understanding of the risk and complications associated with the practice of this type of medicine. The bottom line is that all physicians and healthcare providers who choose to take part in this exciting field of cosmetic and aesthetic medicine are moving forward together and we need to stay ahead of the current technology and remain advocates for patient safety. ■
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