cosmetics

[powermd]

I'm thinking about taking the plunge into cosmetic injections. If that's what people want and are willing to pay for - and I have the skills to do it more safely and effectively then, like 99% of practitioners doing it... - who am I to deny them?

Have any of you done a cosmetics course you would recommend? What was your experience?

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[SSdoc33]

I'm thinking about taking the plunge into cosmetic injections. If that's what people want and are willing to pay for - and I have the skills to do it more safely and effectively then, like 99% of practitioners doing it... - who am I to deny them?

Have any of you done a cosmetics course you would recommend? What was your experience?

you are a doctor who can look himself in the face every day and know that you are helping people -- rather than looting their bank accounts so they have fewer wrinkles for a few months. dont be a beautician. be a doctor. run a clinic, not a spa

 

[SommeRiver]

People want, and will pay for crack too...You could administer crack safer than like 99% of crack dealers. Who are you to deny them?

 

[powermd]

you are a doctor who can look himself in the face every day and know that you are helping people -- rather than looting their bank accounts so they have fewer wrinkles for a few months. dont be a beautician. be a doctor. run a clinic, not a spa

I understand what you're saying. Cosmetics seems so.. superficial? Cynical?

On the other hand, if done well and with care, maybe there is personal satisfaction to be found in patients feeling better about their appearance.

From a business point of view, we could use some diversification. With the democrats possibly re-gaining control in 2020, times could get tougher for insurance-based procedural medicine.

 

[SommeRiver]

Pumping someone's lips full of collagen and putting Botox in a 26 yo woman's face is EXCLUSIVELY for you, not them...If anything you are reinforcing that person's body dysmorphia. God forbid someone get wrinkles at 65 years of age.

I've watched my 30 yo cousin go down this road and she is no longer the same person. Botox, collagen, all types of absurd skin treatments...Looks nothing like she used to, and far worse IMO.

Parasites IMO.

 

[SSdoc33]

I understand what you're saying. Cosmetics seems so.. superficial? Cynical?

On the other hand, if done well and with care, maybe there is personal satisfaction to be found in patients feeling better about their appearance.

From a business point of view, we could use some diversification. With the democrats possibly re-gaining control in 2020, times could get tougher for insurance-based procedural medicine.

i hear what you are saying.

but we are not talking about fixing a cleft palate, or doing a facial reconstruction on a burn victim, or reattaching an ear after an accident. those cases really truly are meaningful

you cant "take a course" and then believe that you can really make people feel better about themselves by injecting botox or fat or whatever. you will invariably get sucked into laser hair removal, derm products, fat sculpting, etc.

there are plenty of people who do this, and you probably would be pretty good at it, from what i have gleaned out of your posts through the years. but this does change who you are as a doctor and who you are as a person if you go down this road. people will ask you about this at parties. family members will want to know how your practice is going. you will be helping either the "1%" or those who probably cant (or shouldnt) afford cosmetic procedures anyway.

obviously, this is only my take and others may feel differently, but i feel like it is beneath where we should be as physicians.

 

[hyperalgesia]

Personally, I don't want to go down this road, just because it's not my interest - not medical care. But I really don't see anything wrong with it otherwise. Assuming we are talking about procedures that we believe provide predictable results - do no harm.

A lot of derms, plastics and others do cosmetic things. A vascular surgeon I used to know started doing varicose veins and made more money for that than midnight AAA rupture. Pts very happy with results.

It's not our fault that actual medical care is so pathetically undervalued, over-regulated, and underappreciated. If we can use our skills without violating our principles, I say go for it.

 

[SSdoc33]

my best friend in medical school went into ER. complete class act. ethically, morally, etc.

right now, he is making bank doing only ketamine infusions for chronic pain, depression, and psychosis.

you be the judge.......

 

[Ducttape]

imo, a pure money grab.

but... to each his own. at least, please keep your ethics with respect to opioid medications

Is Plastic Surgery Contributing to the U.S. Opioid Crisis?

 

[Doctodd]

i dont think anyone can judge you for doing cosmetics(you didnt specify what exactly) if you do it ethically. Plastic surgeons do it, so why not?

 

[Orin]

No margin, no mission?

It's hard to say what the highest and best use of your life is, but I would echo the concerns about cosmetics if they're done in a predatory manner. Mental illness and addiction takes a lot of forms, and the white coat adds some legitimization of a patient/consumer's beliefs.

 

[manowar rules]

One middle ground could be Botox for hyperhidrosis. I did it on myself, it works great.

 

[Piebaldi]

you are a doctor who can look himself in the face every day and know that you are helping people -- rather than looting their bank accounts so they have fewer wrinkles for a few months. dont be a beautician. be a doctor. run a clinic, not a spa

I disagree with this actually. I for example, as I have mentioned had PRP injections into my scalp a number of times - as a woman who lost a significant amount of hair particularly during residency - for a mix of likely stress, thyroid problems, female pattern baldness, etc - I felt like crap and it took a huge emotional toll. I found one rip of Dermatologist and then a wonderful dermatologist who did wonders, my hair grew back to a large extent and it made me feel much much better. She also charged a reasonable amount and gave me a physician discount. Sure she did not save me from cancer, but it helped me feel much better. It's not evil or bad to help people feel better.

Cosmetics does have a part in one's life - and I think if patients at times felt better about themselves they would have les medical issues. Same thing with my skin - I have exceptionally dry skin that is annoying, itchy, etc. I get facials regularly which has done wonders for my skin. Now it's not much of an issue and I have been told I have flawless skin. I feel much better. Sure the esthetician did not save me from colon cancer or something but it made me feel better.

Again it's not evil. Cosmetics does have a role and it's not a menial one.

 

[SSdoc33]

I disagree with this actually. I for example, as I have mentioned had PRP injections into my scalp a number of times - as a woman who lost a significant amount of hair particularly during residency - for a mix of likely stress, thyroid problems, female pattern baldness, etc - I felt like crap and it took a huge emotional toll. I found one rip of Dermatologist and then a wonderful dermatologist who did wonders, my hair grew back to a large extent and it made me feel much much better. She also charged a reasonable amount and gave me a physician discount. Sure she did not save me from cancer, but it helped me feel much better. It's not evil or bad to help people feel better.

Cosmetics does have a part in one's life - and I think if patients at times felt better about themselves they would have les medical issues. Same thing with my skin - I have exceptionally dry skin that is annoying, itchy, etc. I get facials regularly which has done wonders for my skin. Now it's not much of an issue and I have been told I have flawless skin. I feel much better. Sure the esthetician did not save me from colon cancer or something but it made me feel better.

Again it's not evil. Cosmetics does have a role and it's not a menial one.

eyeroll.

you really think it was the PRP that made your hair grow back? when you said that it worked, i assumed you were a 50 year old guy with male patterned baldness. now i definitely dont beleive that the shots had anything to do with it. that placebo thing is pretty pwerful stuff....

look, i understand and agree that it is important to feel good about how you look. i agree that it can have a role in medical treatment.

but are you going to charge somebody 200 bucks to have their armpit hair lasered off? is that why you went into medical school? are you doing to stick a needle into the crows eyes of a rich 50 year old woman so she can impress the other rich women at her country club? is that how you want to fulfill yourself? by all means, go right ahead, but dont be surprised when the docs doing the dirty work look down on you.

yes, im being judgemental, and some might say that what we do in pain isnt crucial medical care. i agree with some of that. but practice at the top of your license. dont sell out to make a quick buck.

 

[Ducttape]

powermd, you do have the advantage, over plastic surgeons and cosmetologists, of having interactions with patients with significant psychological comorbidities from seeing some chronic pain patients with the same.

so, in that respect, it is better from a societal standpoint that ou be a cosmetician than almost everyone else, and especially those who are only looking at the $$$...

 

[Piebaldi]

eyeroll.

you really think it was the PRP that made your hair grow back? when you said that it worked, i assumed you were a 50 year old guy with male patterned baldness. now i definitely dont beleive that the shots had anything to do with it. that placebo thing is pretty pwerful stuff....

look, i understand and agree that it is important to feel good about how you look. i agree that it can have a role in medical treatment.

but are you going to charge somebody 200 bucks to have their armpit hair lasered off? is that why you went into medical school? are you doing to stick a needle into the crows eyes of a rich 50 year old woman so she can impress the other rich women at her country club? is that how you want to fulfill yourself? by all means, go right ahead, but dont be surprised when the docs doing the dirty work look down on you.

yes, im being judgemental, and some might say that what we do in pain isnt crucial medical care. i agree with some of that. but practice at the top of your license. dont sell out to make a quick buck.

Well yes PRP DOES work, not just for hair, but for other ailments as well. It's up to you whether you want to believe this or not. And yes I have had laser hair removal as well - I also have PCOS and felt awful with some of the hair growth. And no it does not cost $200 a pop to get laser, but that is irrelevant. So yes I feel a lot better about myself - I won't judge you or anyone else really, but I w ould say, for those of us that have to deal with certain cosmetic problems in particular as a result from medical problems, yes cosmetics plays a large role. If I was bald yet hairy on body parts does that make me a bad physician? No. But it would have made me feel depressed, anxious, self-conscious, likely avoid a bunch of things, etc. So it has a negative effect, period. Again I don't know where you or others have had to face that. But for those of us who have, cosmetic treatment does become an effective helpful tool. So perhaps if you have never experienced the flaking skin, or looking at the mirror seeing a bunch of your scalp, or hair growing in places it ought not to as a woman, but I have. and I know how it makes one feel. As a result it makes a difference to have people who do cosmetics and do it well.
Individuals should be allowed to pursue interests and what not without judgment. You don't have to do cosmetics. That's fine. I think having reasonably priced cosmetic treatments is important.
Did my Dermatologist cure cancer? No. But she helped me feel a heck of a lot better, helped my self-esteem, etc. To you, that may or may not be important, but for someone who has to go through that experience, it makes a difference.
And yes, indeed, pain, is not something that is crucial in medicine - and I say this as someone going into pain.

Practicing honest Medicine in whatever form as long as one does it well and in a legitimate, honest, best practice scenario is what matters. So if to some women it's Botox, or laser hair removal, or PRP or whatever, it is up to them. Its not like you or Medicare is paying for it.
They are opting to use their own pockets to pay that. And this is a free society, where we should let others do as they feel is appropriate.

 

[SSdoc33]

Well yes PRP DOES work, not just for hair, but for other ailments as well. It's up to you whether you want to believe this or not. And yes I have had laser hair removal as well - I also have PCOS and felt awful with some of the hair growth. And no it does not cost $200 a pop to get laser, but that is irrelevant. So yes I feel a lot better about myself - I won't judge you or anyone else really, but I w ould say, for those of us that have to deal with certain cosmetic problems in particular as a result from medical problems, yes cosmetics plays a large role. If I was bald yet hairy on body parts does that make me a bad physician? No. But it would have made me feel depressed, anxious, self-conscious, likely avoid a bunch of things, etc. So it has a negative effect, period. Again I don't know where you or others have had to face that. But for those of us who have, cosmetic treatment does become an effective helpful tool. So perhaps if you have never experienced the flaking skin, or looking at the mirror seeing a bunch of your scalp, or hair growing in places it ought not to as a woman, but I have. and I know how it makes one feel. As a result it makes a difference to have people who do cosmetics and do it well.
Individuals should be allowed to pursue interests and what not without judgment. You don't have to do cosmetics. That's fine. I think having reasonably priced cosmetic treatments is important.
Did my Dermatologist cure cancer? No. But she helped me feel a heck of a lot better, helped my self-esteem, etc. To you, that may or may not be important, but for someone who has to go through that experience, it makes a difference.
And yes, indeed, pain, is not something that is crucial in medicine - and I say this as someone going into pain.

Practicing honest Medicine in whatever form as long as one does it well and in a legitimate, honest, best practice scenario is what matters. So if to some women it's Botox, or laser hair removal, or PRP or whatever, it is up to them. Its not like you or Medicare is paying for it.
They are opting to use their own pockets to pay that. And this is a free society, where we should let others do as they feel is appropriate.

feel better now?

i dont see much difference in what a boutique/derm/cormetics practice does vs what a hair stylist does. some people will pay a lot of money for a haircut. and there definitely is a certain dignity and satisfaction in making someone look better. just dont fool yourself that because you have an MD after your name that it makes your "treatments" more legitimate, worthy, or necessary than the girl at the asian nail salon.

 

[Piebaldi]

feel better now?

i dont see much difference in what a boutique/derm/cormetics practice does vs what a hair stylist does. some people will pay a lot of money for a haircut. and there definitely is a certain dignity and satisfaction in making someone look better. just dont fool yourself that because you have an MD after your name that it makes your "treatments" more legitimate, worthy, or necessary than the girl at the asian nail salon.

I don't think that is a well informed opinion. That sounds truly ignorant. You are like Seinfeld calling the Dermatologist a pimple popper. If you think cosmetic treatmets are not legitimate, then you are simply ignorant. You could choose to learn or simply remain ignorant. That is entirely up to you.
And people can say that you being a pain physician is no different than the drug dealer. But that would be a poorly informed statement as well.
If you don't see much difference in what a boutique/derm/cosmetic practice vs what a hair stylist is - I feel sad for you. Truly do. So be as judgmental as you want, and leave other physicians practice as they see appropriate. And it seems racist and also quite ignorant to call it the *asian nail salon* - perhaps as a woman you don't take care of yourself it seems. That is another ignorant statement, and there are plenty of salons that are not run by Asian individuals. There are all sorts of individuals running salons.

You are just shockingly angry and jugdmental. Yikes.

 

[Disciple]

And people can say that you being a pain physician is no different than the drug dealer. But that would be a poorly informed statement as well.

You are just shockingly angry and jugdmental. Yikes.

Nobody should be bad mouthing anybody else's specialty. Pediatricians may be the only doctors allowed to do that.

 

[Piebaldi]

Nobody should be bad mouthing anybody else's specialty. Pediatricians may be the only doctors allowed to do that.

Exactly. All specialties are important and should be respected. That is my point. Bashing/trashing Derm is not cool.

 

[Ducttape]

Nobody should be bad mouthing anybody else's specialty. Pediatricians may be the only doctors allowed to do that.

how about pathologists too?

derm is different in certain aspects than cosmetics. one doesn't have to be a doctor to be cosmetician, and there is science besides just physical appearance with dermatology....

 

[Agast]

and I have the skills to do it more safely and effectively then, like 99% of practitioners doing it... - who am I to deny them?

Uh, I mean I'm pretty good with injections but a dermatologist doing facial botox is definitely more skilled at doing facial botox than I am.

When gravity takes its toll I would only settle for a dermatologist or plastic surgeon working on me. In general I think doctors need to "stay in their lane" when it comes to other specialties.

 

[lobelsteve]

Nobody should be bad mouthing anybody else's specialty. Pediatricians may be the only doctors allowed to do that.

Peds: " They are just little people".

 

[Sig123]

Get yourself trained and do them if you feel inclined. No need to get validation from anyone else on this forum.

 

[hyperalgesia]

Uh, I mean I'm pretty good with injections but a dermatologist doing facial botox is definitely more skilled at doing facial botox than I am.

When gravity takes its toll I would only settle for a dermatologist or plastic surgeon working on me. In general I think doctors need to "stay in their lane" when it comes to other specialties.

Does it really take that much skill to do a subcutaneous injection? I would agree with facial-plastic surgery obviously. And identifying malignancy, etc. But injecting cosmetic botox, I don't think there's much to it. In fact, I would probably allow an experienced PA to do it.

 

[Agast]

Does it really take that much skill to do a subcutaneous injection? I would agree with facial-plastic surgery obviously. And identifying malignancy, etc. But injecting cosmetic botox, I don't think there's much to it. In fact, I would probably allow an experienced PA to do it.

Aesthetics is like art. I’ve seen plenty of bad Botox, if you don’t do it right you end up with witchy eyebrows and weird lines. There is some artistry in placement.

 

[VA Hopeful Dr]

Well yes PRP DOES work, not just for hair, but for other ailments as well.

Pretty sure the jury is still out on that actually

 

[Piebaldi]

Aesthetics is like art. I’ve seen plenty of bad Botox, if you don’t do it right you end up with witchy eyebrows and weird lines. There is some artistry in placement.

Yes, but that's mostly operator dependent rather than specialty dependent. There is a Dermatologist that I went to for example that I ultimately did not have PRP with but after I realized what a rip off he was, and looking at his reviews, he had tons and tons of negative reviews for Botox, etc. My mom for example gets Botox from a family doc and he seems to do a reasonable job. So it really depends on experience the doctor has not so much on the specialty. Sure dermies get some cosmetic experience in residency, but it's not the main focus. So it's not like other doctors can't learn botox, etc. And many many many spas, etc. has nurse injectors vs physician injectors. Again it's more about the experience rather than the specialty.

 

[Piebaldi]

Does it really take that much skill to do a subcutaneous injection? I would agree with facial-plastic surgery obviously. And identifying malignancy, etc. But injecting cosmetic botox, I don't think there's much to it. In fact, I would probably allow an experienced PA to do it.

And not just Botox - but for things like laser, etc. it does not take an MD or a DO, and many other procedures, again it does not take a medical degree to do them. It just requires experience really.

 

[SSdoc33]

I don't think that is a well informed opinion. That sounds truly ignorant. You are like Seinfeld calling the Dermatologist a pimple popper. If you think cosmetic treatmets are not legitimate, then you are simply ignorant. You could choose to learn or simply remain ignorant. That is entirely up to you.
And people can say that you being a pain physician is no different than the drug dealer. But that would be a poorly informed statement as well.
If you don't see much difference in what a boutique/derm/cosmetic practice vs what a hair stylist is - I feel sad for you. Truly do. So be as judgmental as you want, and leave other physicians practice as they see appropriate. And it seems racist and also quite ignorant to call it the *asian nail salon* - perhaps as a woman you don't take care of yourself it seems. That is another ignorant statement, and there are plenty of salons that are not run by Asian individuals. There are all sorts of individuals running salons.

You are just shockingly angry and jugdmental. Yikes.

ok.

you are obviously pretty sensitive about something here.

if you read the thread, i repeatedly support the use of cosmetics in medicine. i gave several examples. you did seem to take one narrative and run with it.

but, personally, i believe there is a difference between what a good, ethical plastic surgeon does, and what we might be able to do. there are boutique medicine shops on every corner run by family docs, IM, ER, basically anybody who doesnt want to work in their primary specialty (mostly because cosmetics pays better, easier hours, etc). now, should i look down on someone who does electrolysis instead of monitoring a dialysis unit? f$ck yeah I should! its not unethical to do this kind of work. but its not exactly being a mensch.

the vast majority of the people the boutiques treat are ones with insecurities, too much time, or too much money on their hands. they need a psychologist, not a needle --much like in pain medicine.

and stop it with the nail salon nonsense. you are looking for something to get pissed off about.

 

[SommeRiver]

Botox for facial wrinkles is utterly absurd. Wonderful substance for ppl with real problems though...Couldn't pay me enough to sell my soul.

If Botox reimbursed $25 this conversation wouldn't take place.

All of a sudden everyone's extreme sentiment about cosmetics disappears. Ppl who were very "caring" and "sensitive" about all this BS would vanish in a puff of smoke.

 

[Piebaldi]

ok.

you are obviously pretty sensitive about something here.

if you read the thread, i repeatedly support the use of cosmetics in medicine. i gave several examples. you did seem to take one narrative and run with it.

but, personally, i believe there is a difference between what a good, ethical plastic surgeon does, and what we might be able to do. there are boutique medicine shops on every corner run by family docs, IM, ER, basically anybody who doesnt want to work in their primary specialty (mostly because cosmetics pays better, easier hours, etc). now, should i look down on someone who does electrolysis instead of monitoring a dialysis unit? f$ck yeah I should! its not unethical to do this kind of work. but its not exactly being a mensch.

the vast majority of the people the boutiques treat are ones with insecurities, too much time, or too much money on their hands. they need a psychologist, not a needle --much like in pain medicine.

and stop it with the nail salon nonsense. you are looking for something to get pissed off about.

You saying the vast majority of people the boutiques treat are the ones with insecurities, too much time, or too much money is the same ridiculous generalization as hillary clinton calling all Republicans (of which I am one) a bag of degenerates. I tend to think of myself as a pretty darn good, ethical, responsible, good human being and Christian, with a pretty good head on my shoulders and pretty sound mental health, so making generalizations like that is not a good thing. Throwing everyone in the same bag is not cool.
i am one of those people who has a pretty nifty CV, not that much time, and reasonable but not obscene money but find certain cosmetic services helpful and appropriate. Many well educated, hard working, responsible, good people use cosmetic procedures.
So generalizing everyone who uses cosmetic procedures as *bad* is plain silly.

You don't have to get them. You don't have to provide them. Fine.

But if we really are going to go down that road, we can also say that many people who go into primary care and certainly nephrology are perhaps physicians who are IMG/FMGs and who otherwise if they could would have gotten into something *better* - but then again we would be generalizing wouldn't we? So generalizing is not good, is my point.

i certainly woudln't want to do IM, ER, or other certain specialties, and don't blame those docs for wanting to do something that pays better with better hours. Why demonize them? If they are not good they will go out of business. If they make their customers/paitents happy good for them.

There is room for all.

 

[hyperalgesia]

I think we just have to recognize cosmetic work is not healthcare. Just like practicing medicine, it can be done ethically or not.

I have much more respect for the family doc who does cosmetic botox than the board certified pain doc who does a "series of 3" on everything and worse.

 

[deleted185747]

I briefly looked into opening a cosmetic practice a few years ago. Apparently Botox is just a gateway drug because the medicine is so expensive that you buy it for about $6/unit and sell it for $8/unit. The laser costs $80,000. Cool sculpting single use probes are very expensive. The companies selling this stuff to docs are making the bulk of the profit. You have to charge a lot to stay afloat, especially when you have to maintain a nice looking office.

 

[Piebaldi]

I briefly looked into opening a cosmetic practice a few years ago. Apparently Botox is just a gateway drug because the medicine is so expensive that you buy it for about $6/unit and sell it for $8/unit. The laser costs $80,000. Cool sculpting single use probes are very expensive. The companies selling this stuff to docs are making the bulk of the profit. You have to charge a lot to stay afloat, especially when you have to maintain a nice looking office.

the coolsculpting typically you can rent vs. buy. Lasers don't typically cost 80,000$. However taking into consideration that laser treatments literally take minutes, you make the profit in bulk.

 

[DODOCSS]

ok.

you are obviously pretty sensitive about something here.

if you read the thread, i repeatedly support the use of cosmetics in medicine. i gave several examples. you did seem to take one narrative and run with it.

but, personally, i believe there is a difference between what a good, ethical plastic surgeon does, and what we might be able to do. there are boutique medicine shops on every corner run by family docs, IM, ER, basically anybody who doesnt want to work in their primary specialty (mostly because cosmetics pays better, easier hours, etc). now, should i look down on someone who does electrolysis instead of monitoring a dialysis unit? f$ck yeah I should! its not unethical to do this kind of work. but its not exactly being a mensch.

the vast majority of the people the boutiques treat are ones with insecurities, too much time, or too much money on their hands. they need a psychologist, not a needle --much like in pain medicine.

and stop it with the nail salon nonsense. you are looking for something to get pissed off about.

doesn't fit the socialist paradigm?

 

[Ducttape]

You saying the vast majority of people the boutiques treat are the ones with insecurities, too much time, or too much money is the same ridiculous generalization as hillary clinton calling all Republicans (of which I am one) a bag of degenerates. I tend to think of myself as a pretty darn good, ethical, responsible, good human being and Christian, with a pretty good head on my shoulders and pretty sound mental health, so making generalizations like that is not a good thing. Throwing everyone in the same bag is not cool.
i am one of those people who has a pretty nifty CV, not that much time, and reasonable but not obscene money but find certain cosmetic services helpful and appropriate. Many well educated, hard working, responsible, good people use cosmetic procedures.
So generalizing everyone who uses cosmetic procedures as *bad* is plain silly.

You don't have to get them. You don't have to provide them. Fine.

But if we really are going to go down that road, we can also say that many people who go into primary care and certainly nephrology are perhaps physicians who are IMG/FMGs and who otherwise if they could would have gotten into something *better* - but then again we would be generalizing wouldn't we? So generalizing is not good, is my point.

i certainly woudln't want to do IM, ER, or other certain specialties, and don't blame those docs for wanting to do something that pays better with better hours. Why demonize them? If they are not good they will go out of business. If they make their customers/paitents happy good for them.

There is room for all.

thing is, i have heard this argument - but to justify having non board certified (or, even specialty trained) physicians and nonphysicians like CRNAs and NPs doing SI injections, FJI, even epidurals.

i do agree that many cosmetic procedures, such as botox, are not procedures that we should be requiring advanced training, but please dont generalize yourself into saying that cosmetic surgeries are fine for everyone to do. there is a bar somewhere where one should not cross, otherwise...
https://theglowup.theroot.com/another-woman-dies-from-an-illegal-butt-injection-medi-1831184217


fwiw, clinton calling "all republicans a bag of degenerates" (your words). she said that half of trump supporters fit into a basket of deplorables. and in retrospect, she was dead on...

 

[Piebaldi]

thing is, i have heard this argument - but to justify having non board certified (or, even specialty trained) physicians and nonphysicians like CRNAs and NPs doing SI injections, FJI, even epidurals.

i do agree that many cosmetic procedures, such as botox, are not procedures that we should be requiring advanced training, but please dont generalize yourself into saying that cosmetic surgeries are fine for everyone to do. there is a bar somewhere where one should not cross, otherwise...
https://theglowup.theroot.com/another-woman-dies-from-an-illegal-butt-injection-medi-1831184217


fwiw, clinton calling "all republicans a bag of degenerates" (your words). she said that half of trump supporters fit into a basket of deplorables. and in retrospect, she was dead on...

Wait you are right - it was a basket of deplorables - not degenerates - sorry my mistake! And no, it wasn't half of trump supporters - it was trump supporters period. I voted for trump and I am one of the nicest, most ethical, conscientious human beings on earth. Let's not even get started on the craziness of being a Democrat and a liberal fruitcake. Ugh. Those people if any is a deplorable would fit the bill.

Anyhow, no I never said that it's ok for non surgeons to do surgeries. Never ever said that. Surgery is very different than other cosmetic procedures. The reality is that nurses can do most of the procedures that derms do (in terms of cosmetics), and frequently do. You don't need a medical degree to do any or most of of those procedures. Again surgeries are a completely different animal and should entirely be done by surgeons. Laser hair removal, botox, coolsculpting, etc etc can ALL be done by non physicians.

 

[Ducttape]

er, no...

i clear up fake news.

it was half of trump supporters. if you dont believe, hear it for yourself.

Read Hillary Clinton's 'Basket of Deplorables' Remarks on Trump Supporters

 

[Piebaldi]

er, no...

i clear up fake news.

it was half of trump supporters. if you dont believe, hear it for yourself.

Read Hillary Clinton's 'Basket of Deplorables' Remarks on Trump Supporters

Why would only half be deplorables? That doesnt even make sense. But then again it's Hillary. So glad she lost. Meh regardless, it's wrong to put everyone in one basket.

 

[deleted185747]

Lasers are $60k - $120k for tattoo removal, hair removal and face resurfacing package. It’s gonna take a while to scale up and be able to pay for that machine. Especially here in California where you have to be an MD to run the laser. In New Jersey anybody can run the laser, even your MA. Other states differ. I didn’t want to be the only person who can run this because if I’m gonna have the headache of employees there had better be a lot of leverage and value added.

 

[drusso]

my best friend in medical school went into ER. complete class act. ethically, morally, etc.

right now, he is making bank doing only ketamine infusions for chronic pain, depression, and psychosis.

you be the judge.......

Does it work? Psychiatrist in town reports good results from his registry.

 

[powermd]

Well this took a turn for the worse!

So has anyone actually been to a useful course?

If I'm going to do this, I'd like to learn how to do it right.

 

[lobelsteve]

Well this took a turn for the worse!

So has anyone actually been to a useful course?

If I'm going to do this, I'd like to learn how to do it right.

Leave the money on the counter. Pokey poke.

 

[Piebaldi]

Does it work? Psychiatrist in town reports good results from his registry.

Don't see what's wrong with this. Ketamine is effective for some patients. The problem is judging all things globally. So perhaps SSdoc does not believe in ketamine. Fine. But for the depressed patient that works, who is now able to get out of bed, and go to work, and have a life - it is effective. Just like for me - the PRP worked. I don't need validation from anyone to tell me this. It worked for me. Period. So saying no it's all evil is judgmental and pointless.

 

[drusso]

Well this took a turn for the worse!

So has anyone actually been to a useful course?

If I'm going to do this, I'd like to learn how to do it right.

What's the difference between offering cosmetics and offering Mu-Shu Pain-Medi-Spa services in a structured opioid refill clinic? I know docs making a killing off of in-house acupuncture, yoga, PT, CBT, and osteopathic manipulation.

 

[nvrsumr]

female er doc and her sis attorney opened a cosmetic practice in my building 5+ years ago and seems like it’s successful nice mommy track side gig. Er doc still works some. I have no issue with someone escaping the er for better everything. I’m sure she sleeps much better at home with her kids rather than on nite shift

I don’t think a cosmetic practice makes more than a busy pain doc.

 

[lobelsteve]

Don't see what's wrong with this. Ketamine is effective for some patients. The problem is judging all things globally. So perhaps SSdoc does not believe in ketamine. Fine. But for the depressed patient that works, who is now able to get out of bed, and go to work, and have a life - it is effective. Just like for me - the PRP worked. I don't need validation from anyone to tell me this. It worked for me. Period. So saying no it's all evil is judgmental and pointless.

Proof of bias. Open mouth insert foot.

Hey, it worked for Holmes, so no need for parachutes.
https://www.vice.com/en_ca/article/jmkn74/michael-holmes-explains-how-to-survive-a-failed-parachute

 

[Ducttape]

Why would only half be deplorables? That doesnt even make sense. But then again it's Hillary. So glad she lost. Meh regardless, it's wrong to put everyone in one basket.

she said half of trump supporters, not half of all republicans. listen to her speech... or read it below. and it will make sense.

The racist, sexist, homophobic, xenophobic, Islamaphobic — you name it. And unfortunately there are people like that. And he has lifted them up. He has given voice to their websites that used to only have 11,000 people — now how 11 million. He tweets and retweets their offensive hateful mean-spirited rhetoric. Now, some of those folks — they are irredeemable, but thankfully they are not America. But the other basket — and I know this because I see friends from all over America here — I see friends from Florida and Georgia and South Carolina and Texas — as well as, you know, New York and California — but that other basket of people are people who feel that the government has let them down, the economy has let them down, nobody cares about them, nobody worries about what happens to their lives and their futures, and they’re just desperate for change. It doesn’t really even matter where it comes from. They don’t buy everything he says, but he seems to hold out some hope that their lives will be different. They won’t wake up and see their jobs disappear, lose a kid to heroin (sic), feel like they’re in a dead-end. Those are people we have to understand and empathize with as well.

 

[Piebaldi]

she said half of trump supporters, not half of all republicans. listen to her speech... or read it below. and it will make sense.

I'll take your word for it. I really rather not read her nonsense.