learning botox and collagen

[jolene]

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Does anyone have any experience with learning botox and collagen as cosmetic procedures? If so, what courses would you recommend. There are several day long courses that run around $1500 that look like they are geared toward nurses. There are manuals that you can buy instead. Is it enough to buy the manuals. Where do you order the materials? What is the cost and how much markup?

 

[prominence]

bump

 

[8744]

Does anyone have any experience with learning botox and collagen as cosmetic procedures? If so, what courses would you recommend. There are several day long courses that run around $1500 that look like they are geared toward nurses. There are manuals that you can buy instead. Is it enough to buy the manuals. Where do you order the materials? What is the cost and how much markup?

Wouldn't you feel slightly unethical injecting botox? I'm not anti-cosmesis but I think I'd draw the line at that. It seems like with botox we've crossed the line from providing a necessary service to catering to the whims of the silly and over-indulged.

 

[erichaj]

Does anyone have any experience with learning botox and collagen as cosmetic procedures? If so, what courses would you recommend. There are several day long courses that run around $1500 that look like they are geared toward nurses. There are manuals that you can buy instead. Is it enough to buy the manuals. Where do you order the materials? What is the cost and how much markup?

Botox now goes for about 10 to 12 dollars per unit. It takes about 25 to 50 units per patient. It costs about 500 dollars for a 100 unit vial. Once you mix it , it goes bad in a couple of weeks so you want to have a couple of patients to treat at one time.

Retylane is a popular dermal filler that goes for about 250 dollars per one cc syringe. You can charge double.

The courses are for doctors and nurses. But you will need more than just one course to be good at it. You want a hands on , course for several days.

You will have to market yourself to get clients. The cost for that will depend on how you do it.

You can order botox from Allergan. www.alleran.com
I forget the restylane website, but I believe juvederm (same thing as restylane) can be purchased from Allergan as well.

Good Luck.

 

[deleted87716]

Wouldn't you feel slightly unethical injecting botox? I'm not anti-cosmesis but I think I'd draw the line at that. It seems like with botox we've crossed the line from providing a necessary service to catering to the whims of the silly and over-indulged.

I'll preface this by saying that I have no interest in doing these sort of cosmetic procedures. Money aside, they don't interest me.

The only reason that people perform these procedures is financial. If you're performing profit-motivated procedures in the same practice where you're also doing conventional medicine (presumably not profit-motivated...at least, that's the ideal), there exists the potential for at least a perceived conflict of interest. For that reason and others (mainly marketing), I think cosmetic practices are best kept wholly separate from conventional medical practices; the successful ones usually are.

 

[Miami_med]

I'll preface this by saying that I have no interest in doing these sort of cosmetic procedures. Money aside, they don't interest me.

The only reason that people perform these procedures is financial. If you're performing profit-motivated procedures in the same practice where you're also doing conventional medicine (presumably not profit-motivated...at least, that's the ideal), there exists the potential for at least a perceived conflict of interest. For that reason and others (mainly marketing), I think cosmetic practices are best kept wholly separate from conventional medical practices; the successful ones usually are.

Why is trying to make money in one's practice against the ideal? Even if one is not "profit motivated," wouldn't it be easier to serve your patients if you could pay for your overhead with some cosmetic procedures?

 

[MiesVanDerMom]

Why is trying to make money in one's practice against the ideal? Even if one is not "profit motivated," wouldn't it be easier to serve your patients if you could pay for your overhead with some cosmetic procedures?

I agree. What if making extra money on these procedures then allowed you to, for instance, give a break to your uninsured patients having trouble paying, or allowed you to spend more time with each patient? Why shouldn't the money of those with more-money-than-sense go towards helping people in the reverse?

 

[deleted87716]

Why is trying to make money in one's practice against the ideal? Even if one is not "profit motivated," wouldn't it be easier to serve your patients if you could pay for your overhead with some cosmetic procedures?

What would you think of a doctor who sold products in his/her waiting room? Most medical organizations oppose this sort of thing, by the way.

Same thing. Proceed at your own risk.

 

[Faebinder]

What would you think of a doctor who sold products in his/her waiting room? Most medical organizations oppose this sort of thing, by the way.

Same thing. Proceed at your own risk.

I honestly see nothing wrong with it.... as long as you don't misrepresent the product by claiming it does something that it doesn't. You are of course somewhat responsible for the product even though you are not the company making it... you should look to see if the product does infact what it is supposed to do. You are the person with the knowledge and this is the office of your business and thus the responsibility.

Medicine is a business, whichever way you spin it... and as mentioned above, make the extra money to pay for those who couldn't afford it is a good thing.


----

On a second topic, you just reminded me of thread I was reading a while ago, with someone stating that having price list outside showing how much you charge for X and Y is unethical vs someone else saying that's the way it should be. All I can think of is... I remember the days of undergrad when I was not medically insured and I would dread of thinking of going to a doctor because I was not sure of how much it will cost. If I knew upfront that normally this costs XXX amount I would at least have thought about not waiting or canceling.

The average person has NO IDEA how much does a doctor charges but they hear from everyone that medical bills are EXPENSIVE.... so I can understand that they dread going in because they are afraid of the suddenly 500 dollars they will owe. The best they can relate to is the dentist which they have gone to and had their tooth drilled and suddenly wanted 600 for a root canal and 600 for a crown.

 

[deleted87716]

On a second topic, you just reminded me of thread I was reading a while ago, with someone stating that having price list outside showing how much you charge for X and Y is unethical vs someone else saying that's the way it should be.

It's certainly not unethical, but unless you're in a cash-only practice or providing a non-covered service, it's nearly impossible. When you bill insurance, you're dealing with innumerable combinations of copays, deductibles, discounted fee schedules and secondary insurance coverage, none of which is available at the point of care. There's literally no way for me to tell a patient in advance what his ultimate out-of-pocket cost will be for anything that's being billed to his insurance. It's a game of wait-and-see. The only payor we can come close with is Medicare ("regular" Medicare, not a Medicare HMO), and that's because it's the same for everyone.

 

[aphistis]

It's certainly not unethical, but unless you're in a cash-only practice or providing a non-covered service, it's nearly impossible. When you bill insurance, you're dealing with innumerable combinations of copays, deductibles, discounted fee schedules and secondary insurance coverage, none of which is available at the point of care. There's literally no way for me to tell a patient in advance what his ultimate out-of-pocket cost will be for anything that's being billed to his insurance. It's a game of wait-and-see. The only payor we can come close with is Medicare ("regular" Medicare, not a Medicare HMO), and that's because it's the same for everyone.

For what it's worth coming from a non-MD, I can vouch that this is something dentists contend with every day of their practice lives. There's certainly nothing wrong with offering elective cosmetic procedures alongside your "conventional", medically indicated treatment, and I don't think it compromises patients' respect for you or the profession to offer them as part of your procedural repertoire.

Yes, it requires a sufficiently developed ethical compass to separate the two and not try to con patients into medically unnecessary elective treatment, but that certainly shouldn't be beyond the ability of anyone intelligent enough to become a doctor in the first place.

 

[Miami_med]

For what it's worth coming from a non-MD, I can vouch that this is something dentists contend with every day of their practice lives. There's certainly nothing wrong with offering elective cosmetic procedures alongside your "conventional", medically indicated treatment, and I don't think it compromises patients' respect for you or the profession to offer them as part of your procedural repertoire.

Yes, it requires a sufficiently developed ethical compass to separate the two and not try to con patients into medically unnecessary elective treatment, but that certainly shouldn't be beyond the ability of anyone intelligent enough to become a doctor in the first place.

Of course, we could also con someone into non-elective types of treatment that are unnecessary or futile, so the compass is necessary either way. This is really why, though I will probably not practice FP, that I really believe in the importance of the PD. You NEED to trust your doctor.

By the way Kent, I see no problem with selling products. It seems to me to fall under the exact same principle as I stated above. If you are not a con man and selling legitimate products to people who need them or desire them and understand what the product is, I see no problem with it.

 

[erichaj]

What would you think of a doctor who sold products in his/her waiting room? Most medical organizations oppose this sort of thing, by the way.

Same thing. Proceed at your own risk.

Every single time you write a script you are acting as a salesman for the drug companies. You do it becasue you feel that it will help that patient.

If you sold a product in you office that you felt will help that patient, then there is not problem.

As far as those medical organizations. Many are corrupt and in the pockets of the FDA and the Drug companies. They don't want you to do anything that will get in the way of their profits.

I remember when the ama came out with a position statement that vitamins were a waiste of money. Now, most doctors give pre-natal vitamins ( at the least) to help their pregnant patients aviod complications.

By the way kent, when you write a script to help your patient you may just be giving into the lies that the drug companies have fabricated to make you believe that that patient actually needs that medication.

Lets look at some of these examples:
Vioxx
Phen phen
just to name a couple of famous ones.

If someone feels that they can improve their self esteem by putting a few shots of botox in their forehead or they have a better chance of finding a mate because they look younger, then so be it.

People spend their money on all kinds of things. They buy cars to make them look better or clothing or whatever..
As a physician I'm not their moral authority.

If they have diabetes I will help them with it. If they want botox and I do that procedure I will help them with it.

 

[erichaj]

Physicians say it is impossible to tell a patient how much something costs because of the complications of codes in office visits. They are right.

The solution is to go cash and give discounts. Put your prices on the wall in your office and stop letting insurance companies manipulate you.

If office visits were not covered by insurance you could set you own price.

If set it low, you would do more volume. If you set it high, you would do less.
If set a middle ground, more people would have access.

Dentist do this and they have been doing this for years. The average office visit for a doctor is around 65 dollars with insurance. A huge chunk of that goes to the salary of the billing person chasing after the insurance companies. Cut the middle man out and you can pass the savings on.

Yes, you will have to compete with other doctors in pricing and quality by adding value to your services or volume or price matching. But, you are already doing that in many ways.

 

[deleted87716]

For what it's worth coming from a non-MD, I can vouch that this is something dentists contend with every day of their practice lives. There's certainly nothing wrong with offering elective cosmetic procedures alongside your "conventional", medically indicated treatment, and I don't think it compromises patients' respect for you or the profession to offer them as part of your procedural repertoire.

I beg to differ. I've changed dentists in the past because I got tired of them trying to sell me something every time I went in for a routine visit.

 

[deleted87716]

If you are not a con man and selling legitimate products to people who need them or desire them and understand what the product is, I see no problem with it.

Most salesmen believe in their product, even if they are misguided. Physicians are not immune to this.

 

[deleted87716]

Every single time you write a script you are acting as a salesman for the drug companies. You do it becasue you feel that it will help that patient.

If you sold a product in you office that you felt will help that patient, then there is not problem.

The difference is that I do not profit in any way from prescribing a certain drug. That would not be the case if I sold products in my office.

Now, most doctors give pre-natal vitamins ( at the least) to help their pregnant patients aviod complications.

I recommend vitamins, but I don't sell them. Huge difference.

As a physician I'm not their moral authority.

But I am my moral authority.

The sale of products by physicians to patients is a form of self-referral, and should be avoided whenever possible. Such sales may be ethically questionable due to the high degree of influence that physicians often possess with regard to their patients. This influence derives from physicians' professional and social authority, specialised knowledge, and power to provide or withhold access to medical care.

Physicians have a fiduciary duty not to exploit their patients' trust. Other well-established physician obligations include beneficence and avoidance of harm to patients. The concept of beneficence means that the recommendation of a health-related product should be evidence-based and that alternatives should be explored with the patient, especially if these might be less expensive. The concept of avoidance of harm means that the patient's personal safety should not be placed in jeopardy by the product and that the physician should consider the patient's financial vulnerability. For example, the physician should consider whether a less expensive version of a given product might be available at a pharmacy or health product store.

The following three key problems arise from the sale of products by physicians:

1. Any product sold by a physician carries an implied stamp of approval. This may lead patients to assume that the physician personally endorses the product and vouches for its value and/or efficacy.

2. Concerns exist about whether purchases by a patient from a physician can be considered truly "voluntary." Office-based selling can place subtle pressure on the sick and vulnerable to buy, and may lead to a misplaced desire on the part of patients to please or secure the physician's favour by purchasing a product.

3. The sale of products in a physician's office effectively turns it into a marketplace, undermining the status and reputation of medicine in the process.

Source:
http://www.cpsns.ns.ca/publications/office-sales-2001.htm
http://www.annals.org/cgi/reprint/131/11/863.pdf

 

[erichaj]

The difference is that I do not profit in any way from prescribing a certain drug. That would not be the case if I sold products in my office.



I recommend vitamins, but I don't sell them. Huge difference.



But I am my moral authority.

The sale of products by physicians to patients is a form of self-referral, and should be avoided whenever possible. Such sales may be ethically questionable due to the high degree of influence that physicians often possess with regard to their patients. This influence derives from physicians’ professional and social authority, specialised knowledge, and power to provide or withhold access to medical care.

Physicians have a fiduciary duty not to exploit their patients’ trust. Other well-established physician obligations include beneficence and avoidance of harm to patients. The concept of beneficence means that the recommendation of a health-related product should be evidence-based and that alternatives should be explored with the patient, especially if these might be less expensive. The concept of avoidance of harm means that the patient’s personal safety should not be placed in jeopardy by the product and that the physician should consider the patient’s financial vulnerability. For example, the physician should consider whether a less expensive version of a given product might be available at a pharmacy or health product store.

The following three key problems arise from the sale of products by physicians:

1. Any product sold by a physician carries an implied stamp of approval. This may lead patients to assume that the physician personally endorses the product and vouches for its value and/or efficacy.

2. Concerns exist about whether purchases by a patient from a physician can be considered truly “voluntary.” Office-based selling can place subtle pressure on the sick and vulnerable to buy, and may lead to a misplaced desire on the part of patients to please or secure the physician’s favour by purchasing a product.

3. The sale of products in a physician’s office effectively turns it into a marketplace, undermining the status and reputation of medicine in the process.

Source:
http://www.cpsns.ns.ca/publications/office-sales-2001.htm
http://www.annals.org/cgi/reprint/131/11/863.pdf

1. You don't profit form writing scripts. Yet you write them because you believe it will help your patient. someone else will profit. Remember those free lunches when you were a resident. Did you eat those? You did right. we all did. Thats called manipulation by the drug companies. We are in their pockets. Who cares if YOU profit from that. The point is you (doctors) act as the means for that.

2. Recomend vitamins but don't sell them? Then the patient goes out and picks up some crap that does not work and waistes their money. If you are you own moral authority, you might get the best vitamins out there and sell it in you clinic so that you patients health is best taken care of by you and not some MBA with dollar signs in his eyes.

2. The physicians office has always been a marketplace. The fact that people come to you and you take money to help them makes it a marketplace.

Physicians are always getting on their soapbox talking about Moral and moral authority. We are no more moral than anyone else.

Bottom line: If you are a good doctor you will do good things (as much as possible for your patients. Just like if you are a good banker or lawyer or dentist or teacher or whatever.

 

[deleted87716]

1. You don't profit form writing scripts. Yet you write them because you believe it will help your patient. someone else will profit. Remember those free lunches when you were a resident. Did you eat those? You did right. we all did. Thats called manipulation by the drug companies. We are in their pockets. Who cares if YOU profit from that. The point is you (doctors) act as the means for that.

The issue of drug rep influence over prescribing is completely separate from shilling products in your office. There are ethical concerns in both, but different ones. I'll don't want to further derail the thread, as we're already veering off the original subject. Feel free to start another if you want to talk about drug rep influence (not a bad subject for discussion, IMO).

If you are you own moral authority, you might get the best vitamins out there and sell it in you clinic so that you patients health is best taken care of by you and not some MBA with dollar signs in his eyes.

I'll usually suggest Puritan's Pride brand supplements (they've received good marks by independent reviewers), or refer them to www.consumerlab.com to choose for themselves. I'm not about to start selling vitamins for the reasons already mentioned, and I would look askance at anyone who did.

Physicians are always getting on their soapbox talking about Moral and moral authority. We are no more moral than anyone else.

But we are expected to be, like it or not.

Edit: As a reminder, the only reason we ended up talking about his is because I suggested that a physician would be ill-advised to try to combine a cosmetic practice with a conventional medicine practice. It's best to separate them because of the need to heavily market cosmetic services. That's where the potential for conflict of interest arises. "Well, if Doctor Schmo is shilling Botox and laser hair removal, how do I know he's not just a greedy bastard all the way around? Maybe I don't really need that chest x-ray after all...and I'll bet he's getting a kickback for that blood pressure medicine he prescribed for me, too."

 

[erichaj]

The issue of drug rep influence over prescribing is completely separate from shilling products in your office. There are ethical concerns in both, but different ones. I'll don't want to further derail the thread, as we're already veering off the original subject. Feel free to start another if you want to talk about drug rep influence (not a bad subject for discussion, IMO).



I'll usually suggest Puritan's Pride brand supplements (they've received good marks by independent reviewers), or refer them to www.consumerlab.com to choose for themselves. I'm not about to start selling vitamins for the reasons already mentioned, and I would look askance at anyone who did.



But we are expected to be, like it or not.

Edit: As a reminder, the only reason we ended up talking about his is because I suggested that a physician would be ill-advised to try to combine a cosmetic practice with a conventional medicine practice. It's best to separate them because of the need to heavily market cosmetic services. That's where the potential for conflict of interest arises. "Well, if Doctor Schmo is shilling Botox and laser hair removal, how do I know he's not just a greedy bastard all the way around? Maybe I don't really need that chest x-ray after all...and I'll bet he's getting a kickback for that blood pressure medicine he prescribed for me, too."

If he is doing botox and hair removal he could be a greedy bastard??????

Wow, where did that come from. 😱

I guess I could say every doctor that goes into a specialty that makes more money than FP is a greedy bastard. I doubt the GI guys went into GI because they loved sticking a long tube up someones ass.

I have to say kent, up to now you had some good points (I did not agree with most of them, but I could see where you were coming from), but now with that last comment you just sound arrogant and a little bitter.

Give me a break.

 

[deleted87716]

I have to say kent, up to now you had some good points (I did not agree with most of them, but I could see where you were coming from), but now with that last comment you just sound arrogant and a little bitter.

Give me a break.

Eric, if you're unable to read my posts without getting personal, please add me to your "ignore" list.

Consider this me giving you a break. 🙄

Edit: You'd be surprised what patients believe. Some of them actually do think we get kickbacks for prescribing certain drugs, and that we can go on exotic vacations courtesy of the pharmaceutical industry if we meet some "quota." The doctor-patient relationship ain't what it used to be. The last thing we need now are more reasons for patients to stop trusting us.

 

[erichaj]

Eric, if you're unable to read my posts without getting personal, please add me to your "ignore" list.

Consider this me giving you a break. 🙄

Edit: You'd be surprised what patients believe. Some of them actually do think we get kickbacks for prescribing certain drugs, and that we can go on exotic vacations courtesy of the pharmaceutical industry if we meet some "quota." The doctor-patient relationship ain't what it used to be. The last thing we need now are more reasons for patients to stop trusting us.

I hate threats. You forget where we are and who your talking too.

We are in student network and your speaking with someone at your own level.

Kick me off , who cares. Just don't do the threat thing. 🙄

I did'nt insult you, Just told you how you are behaving. by the way, you just proved my point.

 

[Miami_med]

Most salesmen believe in their product, even if they are misguided. Physicians are not immune to this.

Well Kent, that doesn't change the fact that you sell a service to your patients all the time in your office. That is seeing you. How often do you tell a patient to come back? I need to see you in one week, two, a month, a year. Do you do office procedures? You are always selling, whether you like it or not. You can do it honestly and morally with services, botox, vitamins, or whatever else. If you can't, there are plenty of places to rip people off without cosmetic procedures.

 

[deleted87716]

I hate threats...Kick me off , who cares. Just don't do the threat thing.

Please quote the "threat." 😕

Frankly, I don't know what you're talking about anymore. It's like we're having two completely different discussions.

 

[deleted87716]

that doesn't change the fact that you sell a service to your patients all the time in your office. That is seeing you. How often do you tell a patient to come back? I need to see you in one week, two, a month, a year.

Not the same thing at all. I'm not making this stuff up, folks. Refer to the links provided in an earlier post for clarification.

Edit: Here is the relevant excerpt, from this article:

Question: Physicians are always involved in self-referral, whether it is to advise a return for follow-up, or a recommendation to use their own services as specialists as in a surgical or medical subspecialty. Self-referral is in the very nature of the practice of medicine. Does the policy mean that self-referral should be avoided whenever possible?

Answer: The doctor-patient relationship often involves periodic follow-up visits that continue until the physician refers the patient to another health care professional or until either the patient or physician terminates the relationship for some other reason (most commonly, the completion of treatment). Although follow-up visits may be considered a form of physician self-referral, they are generally considered good medical practice that provide continuity of care, convenience to patients, and reduced transaction costs. Of course, follow-up visits that are undertaken primarily to generate or increase the physician's income are always inappropriate.

 

[erichaj]

Not the same thing at all. I'm not making this stuff up, folks. Refer to the links provided in an earlier post for clarification.

Edit: Here is the relevant excerpt, from this article:

The post you put up, in the last sentence it states, follow up visits can be inappropriate. So can self referals. So can selling vitamins or botox or anthing else. As long as it is done correctly it is ok.

Just because some guy or someone put an article on the net doesnt mean he is right.

The president of United States started a war with Iraq. 60% of the nation think his is wrong.

I just want to know who decides what is wrong and right for a physician. Let me answer that question. It called Medicare.

As long as you take this insurance or really any private insurance they get to dictate their version of ethics to you.

In the private world that will not happen. In the private world we are bound by another set of ethics. The real ones. The ones that say "fair is fair" and don't cheat people. Those are the ethics I go by.

And if I want to sell vitamins in my office then I will. (I don't really, I don't know enough about which ones are the best etc.)

Oh the threat I was refering to was the part where you rolled your eyes and said consider this your break. I believe you were refering to you being a moderator on this website. If you did not mean that, then disregard that sentence.

 

[deleted87716]

Oh the threat I was refering to was the part where you rolled your eyes and said consider this your break. I believe you were refering to you being a moderator on this website. If you did not mean that, then disregard that sentence.

When I moderate, you'll know I'm moderating. There'll be no need to read between the lines.

Just because some guy or someone put an article on the net doesnt mean he is right.

You mean those "guys" from the Ethics and Human Rights Committee of the American College of Physicians, published in the Annals of Internal Medicine...?

 

[erichaj]

When I moderate, you'll know I'm moderating. There'll be no need to read between the lines.



You mean those "guys" from the Ethics and Human Rights Committee of the American College of Physicians, published in the Annals of Internal Medicine...?

1. When I want to speak my mind, I will.

2. Those ethics guys, are just a bunch of guys. like you and me. That is it.

Hey, terrorist think they are ethical. 😕

Bush thinks he is ethical. To some he is. To others----

So, althoug I respect those guys, I don't have to agree with them. In this case they are not entirely right.

 

[Faebinder]

erichaj.... you read too much... Kent's post ment exactly what it ment.. he is exasperated with you..

Kent.... You are wrong on this one.. sorry.. erichaj's point on sales is very valid. Is the cardiologist who echos everyone ethical? Is the family medicine person who botox sells everyone ethical?


Both of you need to agree to disagree... Let it go (for now).

 

[lateness]

em makes it a marketplace.

Physicians are always getting on their soapbox talking about Moral and moral authority. We are no more moral than anyone else.

Bottom line: If you are a good doctor you will do good things (as much as possible for your patients. Just like if you are a good banker or lawyer or dentist or teacher or whatever.[/QUOTE]

you have to put yourself in the patients position. they already have a preconcieved notion that the physician is a moral authority whether we are or not, so you should at least try to use common sense and some experience to be more moral... especially than bankers or lawyers, whose business is completely different... trust me, i have them in my family, and they are very greedy... bottom line is the money, not helping people, manipulating people or companies to get more money...
doctors have to be more moral, you cant manipulate a patients feelings to try to sell them, something they may or may not need, (cosmetics)...
but if you were greedy, you would manipulate their meds, so that they get sicker,or stay sick enough, (as long as you dont kill them )so that you can keep treating them, cmon, you have to be somewhat more moral than lawyers... 😱

i could have never gone into medicine solely for money, i had so many other job offers that pay more,, but i had to deal with living overseas for a bit, plus doing something i despised and bored me to death.. 😴

 

[Miami_med]

When I moderate, you'll know I'm moderating. There'll be no need to read between the lines.



You mean those "guys" from the Ethics and Human Rights Committee of the American College of Physicians, published in the Annals of Internal Medicine...?

I thought that a lack of common sense was a prerequisite for getting into a committee. I usually know I'm right when I disagree with most of these guys.

P.S. That was a jab at the committe, not any individual

 

[erichaj]

em makes it a marketplace.

Physicians are always getting on their soapbox talking about Moral and moral authority. We are no more moral than anyone else.

Bottom line: If you are a good doctor you will do good things (as much as possible for your patients. Just like if you are a good banker or lawyer or dentist or teacher or whatever.

you have to put yourself in the patients position. they already have a preconcieved notion that the physician is a moral authority whether we are or not, so you should at least try to use common sense and some experience to be more moral... especially than bankers or lawyers, whose business is completely different... trust me, i have them in my family, and they are very greedy... bottom line is the money, not helping people, manipulating people or companies to get more money...
doctors have to be more moral, you cant manipulate a patients feelings to try to sell them, something they may or may not need, (cosmetics)...
but if you were greedy, you would manipulate their meds, so that they get sicker,or stay sick enough, (as long as you dont kill them )so that you can keep treating them, cmon, you have to be somewhat more moral than lawyers... 😱

i could have never gone into medicine solely for money, i had so many other job offers that pay more,, but i had to deal with living overseas for a bit, plus doing something i despised and bored me to death.. 😴[/QUOTE]


People choose to be Ethical or unethical.
Is there a potential for doctors to manipulate their patients. Yes.
Is there a potential for the patient to manipulate their doctor. Yes.
Does a patient that walks into you office and asks for botox need it. NO. Do they want it. YES, they asked for it.

If I give them a quality service, have I done them right? YES.

So where is the problem?

Would you rather your patient go to a vitamin store and purchase vitamins from a 16 year old that tells them, yeah this vitamins is great. Or, from you who (if you are a good doctor) has researched a series of vitamins and chose the best ones out there for you patients.

If my job as a physician is provide information and care to keep my patients healthy, one could argue that it is not moral not to sell vitamins.

 

[erichaj]

The last post talks about how lawyers and banker are greedy and just want money and the same morals do not apply for doctors.

It suggest that we have to be more moral. Or have a different value system.

I just have a few questions.

1. why is it ok that the banker and the lawyer can screw you but the doctor cant? (I'm not suggesting that they should)

2. Where is it written that it is ok for a banker to take me to the cleaners for 100K but if he comes to my office I have to be fair and moral? And who wrote it?

3. More importantly, where is it written that I should bend over and take it in the a$$ by everyone just because I chose to go to medical shcool, do a residency, get into debt, Become a doctor, make a good living and help others?

4. Where does it say that I should constantly yield to those bankers, lawyer and whoever the hell thinks I should yield to them?

 

[Newdoc2002]

This thread went way off base so you should either shut it down or call your differences set and go on your ways.

The original topic is one of good debate in primary care as lots of FP's and others struggle with overhead, schedules, no shows, a threatend medicare cut (which I fear will go through with a lame duck congress). These extra income procedures may make the difference for some docs as they wonder if they just need to close up shop and go work for Kaiser or the local MultiSpec Mega Group.

You know you've seen patients roll up in their $35K SUV's and complain about the cost of their $100 visit. Americans priorities are whacked unless they are dog sick and Ms. 55 year olds frown lines are more important to her than excercise, quitting smoking and keeping a good diet.

Not only to justify, but maybe the FP doing the cosmetic procedure will get the patient to do some screenings they've been neglecting like PAP or Colon, Breasts, etc.

 

[deleted87716]

This thread went way off base so you should either shut it down or call your differences set and go on your ways.

We don't close threads unless they violate TOS.

I considered splitting off the posts related to selling products in offices into their own thread, but several of them are intertwined with those on cosmetic produres (the original topic), and there isn't any good way to do it without disrupting the continuity of both threads.

I would like to see this thread get back on track, however. If anyone wishes to continue discussing the issues related to physicians selling products in their offices, the war in Iraq, lawyers and bankers, etc., please start a new thread.

Thank you.

 

[fuel200]

The original point of the thread is where to learn such procedures. And that is something that might be of interest to many FP's. I heard via the grapevine that the American Association of Plastic Surgeons/Dermatologists, offer such courses at seminars whose cost varies from 700-2000. Can anyone comment with specific anecdotes/websites?

 

[Faebinder]

The original point of the thread is where to learn such procedures. And that is something that might be of interest to many FP's. I heard via the grapevine that the American Association of Plastic Surgeons/Dermatologists, offer such courses at seminars whose cost varies from 700-2000. Can anyone comment with specific anecdotes/websites?

How will you go about advertising this to your patients after taking a course?

 

[erichaj]

How will you go about advertising this to your patients after taking a course?

Send out a letter to all of your patients, give a discount to them and their family members. Place a deadline for the discount.

Use the revenue from that to generate new patients by placing other ads. Use a small advertising firm (low cost) to help you develop and expand your market.

Take a deeeeep breath and hope that all works out well. Your dong business now, it is far away from the safety net of medicine.