Cosmetic's in FP?

Discussion in 'Family Medicine' started by CosmoDaNP, Sep 9, 2004.

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  1. CosmoDaNP

    CosmoDaNP Family Nurse Practitioner 5+ Year Member

    Mar 28, 2004
    Question for all the wonderful contributors to this forum.

    The physician (Board Certified FP MD for 13 years) I work for (I'm an FNP) is interested in taking on some cosmetic procedures within the practice. The nearest plastic surgeon is over four hours away and he feels he can do some minor enhancements in the office. While I personally am in NO WAY interested in shooting Botox I would appreciate hearing what options are availble to those Family Practice Physicians who are interested in this avenue.

    What procedures can safely and legally be done by a Family Physician in their office? What's the norm?
    Where would one obtain training for these procedures?

    Thanks for any advice you might have.

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  3. LADoc00

    LADoc00 There is no substitute for victory. 10+ Year Member

    Sep 9, 2004
    Are you serious? If the nearest PS is hours drive this guy had better hope the nearest malpractice attorney is AT LEAST that far. Botox does go wrong. Overall PS patients have the HIGHEST complication rate of any type of surgery. Stop and think about that for sec, we are talking all comers including heinous Whipple patients and PS patients still have more problems. Why? H-I-G-H M-A-I-N-T-E-N-A-N-C-E. I feel for FPs tho, their income is like HALF that of starting dentists and thats general dentists, orthodontic guys kick their butt.
  4. CosmoDaNP

    CosmoDaNP Family Nurse Practitioner 5+ Year Member

    Mar 28, 2004
    Thus the reason he's still doing OB (lucked out on malpractice rates) and does EGD's, Colo's, colposcopy, vasectomies in office and minor in office skin lesion removals and suturing.

    I agree, Plastics is a big pain that I don't think an FP needs to get in to. I'll be quite happy making my rounds at the hospital and seeing my nice routine care patients in the office. Doc does, however, want to bring in this "new client base".

    I think the Botox is already on order ::shudders:: :smuggrin:

  5. doc05

    doc05 2K Member 10+ Year Member

    May 24, 2003
    sounds like doc likes to jump at the chance to make a quick buck.
  6. ny skindoc

    ny skindoc Senior Member 10+ Year Member

    Jul 30, 2002
    There are many FPs who have added cosmetic procedures to their practices.The most commonly done are Botox,microdermabraison,glycolic acid peels.Some do filling agents.There are potential side effects but usually not too many problems for someone EXPERIENCED.Anything more aggressive should not be done by a generalist.Cosmetic patients are far more demanding of time and energy than other patients.They are paying out of pocket and expect results and satisfaction.They cannot be squeezed in between diabetic visits.The practitioner must be very dedicated to make these things work,but some FPs do it and make good $$.
  7. sammccreedy

    sammccreedy Member 5+ Year Member

    Jul 18, 2004
    What do you feel is the best route for an FP to obtain training in the above mentioned procedures (short of going back through another residency)


  8. dr_almondjoy_do

    dr_almondjoy_do So Very Happy to Be Here! 7+ Year Member

    May 10, 2003
    New York

    Also look online for primary care dermatology, non invasive dermatology, etc.

    There are certification classes out there now that provide training towards doing "non-invasive" dermatologic procedures.

    Some inlcude:
    hair removal
    micro dermabrasion
    botox injections
    IPL (something with a laser that treats skin conditions)

    The more invasive stuff is not within the scope of FP, but these minor procedures are. They can even be performed by a well-trained technician that will run the machines for you, much like an MRI tech or a U/S tech.

    Certification will not keep you away from liability, but at least you'll be formally trained in certain techniques. You still have to be careful, much like anyone that does it, including the dermatologist.

    Don't let anyone turn you away from it unless they have tried and failed. We are in the business of treating the sick, but don't forget that it's a business none the less. As long as you are good at what you do, you'll be fine.
  9. dr_almondjoy_do

    dr_almondjoy_do So Very Happy to Be Here! 7+ Year Member

    May 10, 2003
    New York
  10. erichaj

    erichaj Banned Banned

    Dec 28, 2003
    WOW, I can't believe all the walls you have put up for yourself as an FP.

    Lets see:
    cosmetic pts are more high maintenance, hmmm, kinda like the 75 year old medicare pt. with a million drugs and medical problems that you get 50 dollars to see right.

    Your fear is based out of ignorance.

    Yes, there are comlications, and a responsible doctor will learn those and learn how to deal with them. They will let their pt. know about them before treatment.

    Your needle filled with botox is no different than the plastic surgeons needle filled with botox. And he can do no different about the complications than you could. same goes with filler and laser skills. In fact most plastic surgeon offices use nurses to do their laser treatments.


    A quick buck??????????????????

    These are medical procedures that enhance peoples lives. Botox can be used for aesthtic and medical purpuses (back pain, neck pain).

    There are many other non-surgical techniques that can change peoples lives.

    They don't train dermatologist and plastic surgeons on botox and fillers and lasers in residency. They know about as little about as you do when you finish residency. Their hands are not the hands of god. You are just as capable of learning these skills. You need to be responsible and learn them well. But once you do, you will offer a well needed service to you community.


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