Cosmetic Surgery Under Scrutiny

USA Today recently presented a multi-part series on cosmetic surgery. The first segment brought attention to the issue of physicians of many specialties diversifying into cosmetic surgery. I have discussed scope of practice before, and there are pros and cons with regulation of the cosmetic market. It is

But it is also important to acknowledge that there is a lot of self-interest and bias in the statements made on the subject by practitioners in all the relevant fields, including mine. If legislators ever took the step of placing cosmetic surgery solely within the purview of board-certified plastic surgeons, those surgeons would personally benefit. But the benefit to consumers would be highly questionable, and would likely not be enough to justify such an extreme step.

A key consideration that gets little attention is that many fields were pioneered by surgeons whose core training was in other areas. Thoracic and cardiovascular surgery, transplant, hand and plastic surgery, all were developed by surgeons stretching out into new areas. The obvious difference was that these fields were developed to solve difficult clinical problems, and not due to business considerations.

The next segment of the USA Today series described problems that have resulted from corporate entry into the cosmetic surgery field. Three firms were profiled, and in the interest of disclosure, I have provided independent-contractor services to one of them.

The general conclusion was that corporate efforts such as intense marketing and utilizing economies of scale is an unfavorable development, and associated with less satisfactory clinical outcomes. That conclusion is debatable. What is not debatable is that this type of market activity benefits consumers wishing to obtain equivalent services at much lower prices. It happens all the time in the retail economy, though the concept is new to this particular segment of the service economy.