How "doable" is it to do private cosmetics as a family doctor?

[Hustler101]

Botox probably being the most common one that a family doc could easily do, followed by skin care... and then hair transplant perhaps?
Would setting up a practice for this be highly doable for a family doc? Could one acquire a significant number of patients? And would it still be very lucrative?

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[deleted480308]

Doc in my hometown did it instead of taking over his father's fm practice.....makes significantly more money

 

[VA Hopeful Dr]

I know someone from my med school who just quit residency after a prelim year, took a bunch of weekend "certification" classes, bought a laser, and opened up an aesthetics clinic.

I don't know if he's actually financially successful doing this, but he comes across as uber-sleazy.

There's definitely plenty of places for us FM docs to learn to do this stuff. That said, I agree that unless its just an adjunct to your usual practice, then I think its kinda sketchy.

 

[PIacebo]

Didn't think this was actually feasible. Do you have to get recertified?

 

[Hustler101]

There's very little regulation of a lot of aesthetics stuff. As long as you have a medical license you can prescribe/perform it. And since you are mostly relying on cash pay not insurance reimbursement you cut out a lot of middleman.

Facial scrubs/chemical peels, laser therapies (hair removal, etc), botox.

The trick is you have to compete successfully for services and market aggressively, especially in a competitive market.

I think that's the key. Of course prices will naturally be cheaper than derms for example if you're an FM + you'd have to market really hard.

Any ideas on how much money is in this if you're an FM?

 

[MrChance2]

I think that's the key. Of course prices will naturally be cheaper than derms for example if you're an FM + you'd have to market really hard.

Any ideas on how much money is in this if you're an FM?

A. Don't think like this as a premed.

B. I'd be surprised if derm vs FM matters too much here. It would be like any other business, grow it as you wish. If you have 5 locations with multiple doctors and PAs you're probably filthy rich. Why not just skip med school and open a bunch of laundromats or car dealerships or something though?

 

[Hustler101]

A. Don't think like this as a premed.

B. I'd be surprised if derm vs FM matters too much here. It would be like any other business, grow it as you wish. If you have 5 locations with multiple doctors and PAs you're probably filthy rich. Why not just skip med school and open a bunch of laundromats or car dealerships or something though?

1) Much higher risk

2) Nothing to fall back on if your business doesn't go so well

 

[ChEMD]

Please discuss these aspirations during your interviews.

Actually, scratch that. Just center your personal statement around them. After all, why waste the money going to interviews.

 

[Hustler101]

Please discuss these aspirations during your interviews.

Actually, scratch that. Just center your personal statement around them. After all, why waste the money going to interviews.

So using your skills and training to help others in the area of cosmetics is somehow a bad goal? Someone who can fix acne has a HUGE positive impact on the lives of his patients.... (it's not even a goal of mine right now at the moment obviously, just basic discussion)
With that logic plastic surgeons doing cosmetics and making a million a year are all bad and evil right?

Never understood the logic behind hating a doctor who highly values money but also values providing a good service. You don't need to sacrifice one for the other...

 

[ChEMD]

So using your skills and training to help others in the area of cosmetics is somehow a bad goal? Someone who can fix acne has a HUGE positive impact on the lives of his patients.... (it's not even a goal of mine right now at the moment obviously, just basic discussion)
With that logic plastic surgeons doing cosmetics and making a million a year are all bad and evil right?

Never understood the logic behind hating a doctor who highly values money but also values providing a good service. You don't need to sacrifice one for the other...

It's more the fact that you seem to be trying to find the easiest way to make a dollar. No one goes into family medicine with the intent of providing the best cosmetics care possible. If that were the goal, you'd probably want to go into something like plastics, ENT, or derm, where you are actually trained during your residency/fellowship to do cosmetic work. No, the only people who go into family medicine with the intention of doing cosmetics are the ones that want the easiest possible route to make some money, regardless of whether they're the best person to do the job.

 

[Hustler101]

It's more the fact that you seem to be trying to find the easiest way to make a dollar. No one goes into family medicine with the intent of providing the best cosmetics care possible. If that were the goal, you'd probably want to go into something like plastics, ENT, or derm, where you are actually trained during your residency/fellowship to do cosmetic work. No, the only people who go into family medicine with the intention of doing cosmetics are the ones that want the easiest possible route to make some money, regardless of whether they're the best person to do the job.

The amount of work it takes to make a dollar nowadays is astronomically higher than 20-30 years ago. Just by pursuing medicine you're inputting an insane level of work relative to the general population. Not to mention reimbursements go down, inflation occurs, while the amount of work required to make the same money goes up.
Also getting into plastics/derm isn't very practical for most med students.

Nonetheless, someone who is able to achieve the same result with less work is someone who I would consider wise. Not someone who spends extra years of prime time living for the same exact outcome.

 

[MrChance2]

"Nonetheless, someone who is able to achieve the same result with less work is someone who I would consider wise. Not someone who spends extra years of prime time living for the same exact outcome."

Have you considered dentistry? I know a dentist that does Botox, they make good money. I'm not sure if you could do the skin stuff or not. I don't hate your plan and you seem like you will eventually make a lot of money if you're willing to put in a lot of work for it. I just think MD/DO are not really the best more money with less effort degrees, even given their "fallback" potential of taking care of sick people. I honestly don't think medicine is worth it if "result" translates directly to income.

 

[Hustler101]

"Nonetheless, someone who is able to achieve the same result with less work is someone who I would consider wise. Not someone who spends extra years of prime time living for the same exact outcome."

Have you considered dentistry? I know a dentist that does Botox, they make good money. I'm not sure if you could do the skin stuff or not. I don't hate your plan and you seem like you will eventually make a lot of money if you're willing to put in a lot of work for it. I just think MD/DO are not really the best more money with less effort degrees. I honestly don't think medicine is worth it if "result" translates directly to income for most people.

I'm pursuing medicine because I would enjoy it. I definitely could not do dentistry even if it paid a million a year.

15 years ago or even 10 years ago business could have been a more lucrative path. Nowadays though everything is overly saturated and most successful business guys I know work like dogs and cant even crack family doctor money. Being someone who knows those making upper class incomes (ex. 300k annually), most got there by luck and/or rare talent. Medicine is pretty much the only secure path to getting there in today's ultra-competitive society.

 

[Kahreek]

It's more the fact that you seem to be trying to find the easiest way to make a dollar. No one goes into family medicine with the intent of providing the best cosmetics care possible. If that were the goal, you'd probably want to go into something like plastics, ENT, or derm, where you are actually trained during your residency/fellowship to do cosmetic work. No, the only people who go into family medicine with the intention of doing cosmetics are the ones that want the easiest possible route to make some money, regardless of whether they're the best person to do the job.

sdn is abot exploring ideas, sharing knowledge. I sympathize with you opinion, but dont be so judgmental.

 

[caffeinemia]

Just wait till you accidentally give someone a iatrogenic hemifacial palsy because you popped some botox into their parotid. Sure it'll go away in 6 months, but maybe they'll be drooling their way to the lawyer... 🙂. Doable? Yes. Wise? Unlikely.

 

[Alabama938]

If you really want to pursue cosmetics, plastic surgery is the way to go. One needs surgical training to perform cosmetic procedures. I would advise following the path that you're most passionate about. Many patients earns money no matter the specialty

 

[FiveOClock]

FMs are not qualified to do cosmetics. End of story. Medicine has been ruined by regulations in all the wrong places. But keeping unqualified doctors from performing things they are not qualified to perform is necessary. If you want to do cosmetics, then go derm or plastics. If you do not have the opportunity to go derm/plastics, consider other ways to make money that are not so blatantly harmful and deceptive to your patients.

Going into primary care is an incredible service to your community and one of the noblest career choices one can make. Let's keep it that way.

 

[sazerac]

This guy http://www.myhairbacknola.com/faq/ is my primary care physician. He did a residency in FM.

He treats my aches and ailments, and doesn't try to upsell new hair.

 

[Hustler101]

FMs are not qualified to do cosmetics. End of story. Medicine has been ruined by regulations in all the wrong places. But keeping unqualified doctors from performing things they are not qualified to perform is necessary. If you want to do cosmetics, then go derm or plastics. If you do not have the opportunity to go derm/plastics, consider other ways to make money that are not so blatantly harmful and deceptive to your patients.

Going into primary care is an incredible service to your community and one of the noblest career choices one can make. Let's keep it that way.

NPs are doing botox now... cosmetics is a vague term and it depends on what you want to do specifically...

 

[PMMA]

Botox probably being the most common one that a family doc could easily do, followed by skin care... and then hair transplant perhaps?
Would setting up a practice for this be highly doable for a family doc? Could one acquire a significant number of patients? And would it still be very lucrative?

It depends on your location primarily. If you're in a less competitive market, I'm sure you could be successful.
In a competitive area, your problems are twofold.

1) Your volume will be profoundly affected by the nearby presence of Plastics and Derm trained physicians. From a purely marketing standpoint: Plastics >>>>>>>>>>>> FM. In reality, though, you could be anyone and learn to do Botox.

2) Medical-legal. If you have a complication doing hair transplant for example, and you get sued, you're may be in a difficult situation as you will be seen as the hack who tried to bat out of his/her league.

Bottom line: if you really wanna do cosmetic work and crush it: do Plastics. Longer training but with that goal in mind, it is worth it.

 

[FiveOClock]

NPs are doing botox now... cosmetics is a vague term and it depends on what you want to do specifically...

When I say cosmetics, I mean anything more complex than what an aesthetician does. So obviously no one objects to low concentrate chemical peels, microderm, etc being done by NPs and even less trained.

NPs doing more complex cosmetics (like botox) is purely criminal. If doctors had a real lobby instead of AMA, we could potentially stop such dangerous and indiscriminate abuses.

 

[VA Hopeful Dr]

FMs are not qualified to do cosmetics. End of story. Medicine has been ruined by regulations in all the wrong places. But keeping unqualified doctors from performing things they are not qualified to perform is necessary. If you want to do cosmetics, then go derm or plastics. If you do not have the opportunity to go derm/plastics, consider other ways to make money that are not so blatantly harmful and deceptive to your patients.

Going into primary care is an incredible service to your community and one of the noblest career choices one can make. Let's keep it that way.

So are neurologists not qualifed to do Botox for migraines, or is it just the cosmetic part you disagree with? As an FP can I do botox for migraines but not crow's feet?

Oh, and just to add some snark to this - please med student, continue to tell me what I am and am not qualifed to do (ignoring the hyperbolic CABG or brain surgery).

 

[fancymylotus]

I'm just gonna invest in mimelim's vein clinic...

Can he hire Kaus? That would be great.

 

[path or no path]

FMs are not qualified to do cosmetics. End of story. Medicine has been ruined by regulations in all the wrong places. But keeping unqualified doctors from performing things they are not qualified to perform is necessary. If you want to do cosmetics, then go derm or plastics. If you do not have the opportunity to go derm/plastics, consider other ways to make money that are not so blatantly harmful and deceptive to your patients.

Going into primary care is an incredible service to your community and one of the noblest career choices one can make. Let's keep it that way.

Would you please get off your high horse?

 

[charmiedermie]

Can he hire Kaus? That would be great.

The question is whether Kaustikos can be convinced to do a full-time vein clinic without feeling like poking his eyes out. 😛

 

[seminoma]

FMs are not qualified to do cosmetics. End of story. Medicine has been ruined by regulations in all the wrong places. But keeping unqualified doctors from performing things they are not qualified to perform is necessary. If you want to do cosmetics, then go derm or plastics. If you do not have the opportunity to go derm/plastics, consider other ways to make money that are not so blatantly harmful and deceptive to your patients.

Going into primary care is an incredible service to your community and one of the noblest career choices one can make. Let's keep it that way.

Lol, all of this.. just lol. You're right that FMs aren't qualified to do cosmetics. Until they get whatever certifications they need to be qualified.

 

[fancymylotus]

The question is whether Kaustikos can be convinced to do a full-time vein clinic without feeling like poking his eyes out. 😛

$$$$$$$$ of course! 😀

 

[Hustler101]

Just wait till you accidentally give someone a iatrogenic hemifacial palsy because you popped some botox into their parotid. Sure it'll go away in 6 months, but maybe they'll be drooling their way to the lawyer... 🙂. Doable? Yes. Wise? Unlikely.

And what are the odds of a plastics or derm guy doing that in a relative basic procedure vs. an FM doing it? If the odds are almost identical, then you might as well be an FM.
Also lets not forget 2 things here:

1) Extra years of residency are lost income for someone doing the same cosmetics stuff that an FM is doing in theory

2) 2 people with a few years experience in X and Y procedures will be essentially equal in terms of skill/knowledge in X and Y.

So I would conclude that an FM doing cosmetics could potentially bring in more money long term while also saving time (given 1 and 2). The only "risky" period of time is the initial phase of practice until his skills are perfected.

 

[Law2Doc]

I know several FM doctors who do Botox. Plenty of several day courses you can attend to learn the techniques. Then it becomes all about advertising and positive word of mouth. Probbly easier to promote in more superficial big coastal cities than in rural locations. As with anything in medicine, the more you do, the better, and probably safer, the results, so it's not the best thing to just dabble in once in a while. There's certainly money to be made, but also liability (you are injecting poison into people -- what could go wrong, right?). Not a terrible side business for an artistic (it's about aesthetics and symmetry more than skill) FM who likes procedures. But not trivial to get a steady flow of patients through the door without putting up a lot of ad money or really working the social media. The one positive is if you do it well you get repeat business as those patients won't get any younger or less vain.

 

[Winged Scapula]

I will "inject" a little personal experience here.

When I joined my partner in practice, she had a Medi-Spa where she did some injectables, cryolipolysis etc. She described it as a way to relieve some of the stress associated with a largely cancer based practice and to have some fun. I viewed it as a money making endeavor, mostly encouraged by her husband. It lasted about 2 years. Here were the issues (and she now admits it was a mistake):

1) marketing is key; if you are in a community with plastic surgeons and derms you are going to have a hard time convincing people you will do a better job
2) price: plastic surgeons and dermatologists who do a lot of aesthetics purchase larger volume of injectables and therefore can offer cheaper prices. Sometimes Botox is offered as a loss leader - those ads you see for $5.00/unit? Botox costs more than that wholesale; they are getting you in the door and offering other services which are more lucrative. As an FM, you don't have that opportunity
3) because the injectables have expiration dates, you must do a fair volume so as not to lose stock
4) your malpractice provider will likely require you to purchase an additional rider on your policy, thus costing you more
5) assumption (by patients and referring physicians) that you are only interested in making money; this last one was the death knell for my partner's Medi-spa. Patients were complaining about the "ads" in the patient rooms and we had a couple of referring physicians call about it.

YMMV but in general, there is a stigma, mostly in the medical community and amongst savvy consumers, against FM and non-PRS/Derm doing these. That being said, a skilled practitioner with an aesthetic eye could develop considerable expertise and a good practice if handled the right way.

 

[seminoma]

I will "inject" a little personal experience here.

When I joined my partner in practice, she had a Medi-Spa where she did some injectables, cryolipolysis etc. She described it as a way to relieve some of the stress associated with a largely cancer based practice and to have some fun. I viewed it as a money making endeavor, mostly encouraged by her husband. It lasted about 2 years. Here were the issues (and she now admits it was a mistake):

1) marketing is key; if you are in a community with plastic surgeons and derms you are going to have a hard time convincing people you will do a better job
2) price: plastic surgeons and dermatologists who do a lot of aesthetics purchase larger volume of injectables and therefore can offer cheaper prices. Sometimes Botox is offered as a loss leader - those ads you see for $5.00/unit? Botox costs more than that wholesale; they are getting you in the door and offering other services which are more lucrative. As an FM, you don't have that opportunity
3) because the injectables have expiration dates, you must do a fair volume so as not to lose stock
4) your malpractice provider will likely require you to purchase an additional rider on your policy, thus costing you more
5) assumption (by patients and referring physicians) that you are only interested in making money; this last one was the death knell for my partner's Medi-spa. Patients were complaining about the "ads" in the patient rooms and we had a couple of referring physicians call about it.

YMMV but in general, there is a stigma, mostly in the medical community and amongst savvy consumers, against FM and non-PRS/Derm doing these.

How dare you offer relevant and unbiased information on sdn.

 

[Hustler101]

I will "inject" a little personal experience here.

When I joined my partner in practice, she had a Medi-Spa where she did some injectables, cryolipolysis etc. She described it as a way to relieve some of the stress associated with a largely cancer based practice and to have some fun. I viewed it as a money making endeavor, mostly encouraged by her husband. It lasted about 2 years. Here were the issues (and she now admits it was a mistake):

1) marketing is key; if you are in a community with plastic surgeons and derms you are going to have a hard time convincing people you will do a better job
2) price: plastic surgeons and dermatologists who do a lot of aesthetics purchase larger volume of injectables and therefore can offer cheaper prices. Sometimes Botox is offered as a loss leader - those ads you see for $5.00/unit? Botox costs more than that wholesale; they are getting you in the door and offering other services which are more lucrative. As an FM, you don't have that opportunity
3) because the injectables have expiration dates, you must do a fair volume so as not to lose stock
4) your malpractice provider will likely require you to purchase an additional rider on your policy, thus costing you more
5) assumption (by patients and referring physicians) that you are only interested in making money; this last one was the death knell for my partner's Medi-spa. Patients were complaining about the "ads" in the patient rooms and we had a couple of referring physicians call about it.

YMMV but in general, there is a stigma, mostly in the medical community and amongst savvy consumers, against FM and non-PRS/Derm doing these. That being said, a skilled practitioner with an aesthetic eye could develop considerable expertise and a good practice if handled the right way.

Number 2 - will that always be an issue?
Like how easy/hard is it to find an area that doesn't have too many plastics/derm guys but has a sufficient population base?

 

[Winged Scapula]

Number 2 - will that always be an issue?
Like how easy/hard is it to find an area that doesn't have too many plastics/derm guys but has a sufficient population base?

The issue is more complex than just finding an area without competition.

You also have to find an area with people who are interested in aesthetics. One of the issues I didn't post above is that my partner was attempting to run a Medi-Spa in an area populated by an older population - not middle age/Cougar type of population but *old*, Medicare type. These are not your prime target. I will stereotype but also suspect that an area without PRS and Derm is that way for a reason - the patients just aren't there for aesthetic procedures. Not every woman (or man) is interested or can afford Botox, etc.

 

[seminoma]

Number 2 - will that always be an issue?
Like how easy/hard is it to find an area that doesn't have too many plastics/derm guys but has a sufficient population base?

Yes. Good luck finding an area that cares about aesthetics and also doesn't already have at least one PRS/Derm group in practice or scoping out the territory.

 

[Hustler101]

Yes. Good luck finding an area that cares about aesthetics and also doesn't already have at least one PRS/Derm group in practice or scoping out the territory.

I would figure that marketing/business skills/working the social media will be crucial then.

 

[seminoma]

I would figure that marketing/business skills/working the social media will be crucial then.

Yes, but as @Winged Scapula mentioned above it would be a significant uphill battle for many reasons. No offense to the FMs in the house, but I'm sure most lay people would prefer a "Plastic and Reconstructive Surgeon" to be the one poking around their face. I'm fairly confident a FM can become just as proficient at a given aesthetic procedure as a PRS, but the floor of possible outcomes is likely not as low in the PRS office.

Who would you want performing maintenance on your Ferrari? The mechanic who only works on Ferraris for a living or the guy at Firestone who is certified to work on Ferraris?

 

[FiveOClock]

Would you please get off your high horse?

No plans to do that, no. Most people (myself included) will not be practicing FM in rural America. I have the greatest respect for those who choose to do this especially when they could have done many other things.

So are neurologists not qualifed to do Botox for migraines, or is it just the cosmetic part you disagree with? As an FP can I do botox for migraines but not crow's feet?

Oh, and just to add some snark to this - please med student, continue to tell me what I am and am not qualifed to do (ignoring the hyperbolic CABG or brain surgery).

I have no problem with neurologists doing Botox for migraines. Since you are a highly educated physician (no snark), I'm sure you can see the difference between treating headaches and treating crow's feet. Should an FM be treating headaches with Botox? I honestly don't know; you tell me whether you feel qualified to do that (again, no snark).

 

[VA Hopeful Dr]

I have no problem with neurologists doing Botox for migraines. Since you are a highly educated physician (no snark), I'm sure you can see the difference between treating headaches and treating crow's feet. Should an FM be treating headaches with Botox? I honestly don't know; you tell me whether you feel qualified to do that (again, no snark).

Am I? No, never had any interest in it. But then again, I don't do scopes or deliver babies and there are FPs who do. I do colpo's but know plenty of FPs who do not. That's the beauty of the field, variety based on interest. Its all a matter of what you're comfortable doing.

 

[VisionaryTics]

I would figure that marketing/business skills/working the social media will be crucial then.

That's very true, and that's another reason I think FM would work against you.

The aesthetic patients are very savvy. They research the hell out of everything. They see multiple doctors before having a procedure done. They know where their physicians went to med school, residency, and fellowship. They talk to other people on forums and review sites like realself.com. It's very competitive and draining, even for board certified PRS/FPRS physicians.

 

[MrChance2]

I doubt your average South Florida type botox client puts much stock in the post medical school training of their doctor. We are all in the medical/health fields here and I think SDNers put MUCH more research into their life decisions than your average patient. I don't think I even knew exactly what a resident was until I started looking into going to medical school. Still though, I think you should help people instead 🙂

 

[username456789]

I doubt your average South Florida type botox client puts much stock in the post medical school training of their doctor. We are all in the medical/health fields here and I think SDNers put MUCH more research into their life decisions than your average patient. I don't think I even knew exactly what a resident was until I started looking into going to medical school. Still though, I think you should help people instead 🙂

You clearly know nothing about cosmetic patients.

Also, Botox and fillers does help people. You may want to reconsider your phrasing.

 

[MrChance2]

.

 

[calvnandhobbs68]

Despite common knowledge, many types of medical offices provide private cosmetics, including family medicine doctors, dentists, and even gynecologists. Though many decide to visit dermatologist and plastic surgeon specialists for services such as Botox, skin care, and hair transplants, it is not uncommon for people to ask their family doctor about these services.

Americans spend over $10 billion on aesthetic procedures annually, but it is best to invest into this practice only after thorough evaluation of your local market.

First, determine whether your general clientele would demand this service, based on the average cost of these procedures and the population's demographics.

Another important consideration is your medical office's proximity to the nearest cosmetic provider. If your office is close to a dermatologist, it may not be worth investing into cosmetics.

Also know that these services will require marketing, purchase of equipment and medical supplies, and other expenses. While taking upon this service could increase your yearly revenue by $50,000 to $100,000, it depends on your area, available funds, and medical knowledge.

Apparently even EM too, amirite?

Respect though, apparently this guy is ballin so hard the office is only open T 4-6pm, W-F 12-6pm and Sat 12-4pm. Time for me to open a medispa.