plastics in family medicine

[akhim]

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if you spend all your elective time in residency doing plastic surgery, is it then possible to do the bread and butter procedures once you graduate? like lipo, breasts, butt

 

[andon]

i doubt it. i have heard of family docs doing a lot of botox and other non surgical stuff

 

[DIce3]

The minimum time to complete an integrated plastics residency is six years. This is a brutal residency/fellowship. There is ZERO chance you could competently do any real plastics cases after a three year FP residency where you will spend 1 to 3 months doing general surgery at a PGY-1 level. Focus on being a solid primary doctor.. three years is barely enough.

 

[notinkansas]

Absolutely not. If you want to be a plastic surgeon, do that residency. Doing real surgery is not something to learn on the side

 

[cabinbuilder]

if you spend all your elective time in residency doing plastic surgery, is it then possible to do the bread and butter procedures once you graduate? like lipo, breasts, butt

My attending who taught us in clinic has a very lucrative business doing lipo to abdomen, thigh, butt, and neck. I don't know if he does breast. He also does laser facials, hair removals, etc. He does botox too.

I have another friend who is FP who does a lot of laser hair removal and laser peels well. It comes down to how much CME and courses you take to become proficient.

 

[cabinbuilder]

if you spend all your elective time in residency doing plastic surgery, is it then possible to do the bread and butter procedures once you graduate? like lipo, breasts, butt

My attending who taught us in clinic has a very lucrative business doing lipo to abdomen, thigh, butt, and neck. I don't know if he does breast. He also does laser facials, hair removals, etc. He does botox too.

I have another friend who is FP who does a lot of laser hair removal and laser peels well. It comes down to how much CME and courses you take to become proficient.

Both of these physicians have their own private practice so aren't governed by some higher up admin idiot telling what they can and can't do.

 

[tony montana]

Both of these physicians have their own private practice so aren't governed by some higher up admin idiot telling what they can and can't do.

Finally!! Some common sense!!! 😎

 

[akhim]

My attending who taught us in clinic has a very lucrative business doing lipo to abdomen, thigh, butt, and neck. I don't know if he does breast. He also does laser facials, hair removals, etc. He does botox too.

I have another friend who is FP who does a lot of laser hair removal and laser peels well. It comes down to how much CME and courses you take to become proficient.

Both of these physicians have their own private practice so aren't governed by some higher up admin idiot telling what they can and can't do.

thats interesting because i know of an ob/gyn who does some plastics procedures out of his office. i dont know if he's board certified in plastics, but he definitely does augmentations. i heard through the grapevine that he gained surgical experience offshore, came to the states, did ob/gyn, and now runs his clinic.

so technically, if you run you're own office and you're competent to do a procedure, you can essentially do anything you want.

 

[cabinbuilder]

thats interesting because i know of an ob/gyn who does some plastics procedures out of his office. i dont know if he's board certified in plastics, but he definitely does augmentations. i heard through the grapevine that he gained surgical experience offshore, came to the states, did ob/gyn, and now runs his clinic.

so technically, if you run you're own office and you're competent to do a procedure, you can essentially do anything you want.

Wouldn't need to be board certified. OB/GYN has plenty of surgical skills learned in residency it wouldn't be a reach to be able to do some basic augmentations. It's not that hard to do.

 

[Shinken]

Both of these physicians have their own private practice so aren't governed by some higher up admin idiot telling what they can and can't do.

They might not have admin people telling them what to do, but what are the malpractice coverage increases that go with this type of practice?

There are FP docs that are trained to do some surgical procedures, but don't perform them in practice because their insurance carrier either denies them the coverage for such procedures, or the increase in premiums is not worth it.

akhim said "if you run you're[sic] own office and you're competent to do a procedure, you can essentially do anything you want" - although technically true, without the proper malpractice coverage, doing "anything you want" can expose you to huge risk, whether competent or not.

 

[notinkansas]

Doing an OB/GYN residency gives one considerable more surgical skill than doing a Family Medicine residency. There is a reason why even integrated plastic surgery programs include a couple years of general surgery rotations. It is possible to imagine that with some extra training, someone with OB/GYN experience could handle the extra surgery.

There are brief stand alone courses for things like chemical peels and botox. These things are NOT the same as breast or butt cases (or even lipo) I know there are some stand alone courses for lip- but I'd be VERY leery with that. You need true surgical training be able to do things like breast cases. What do you want to do? Implants? What will you do when you give your patient a pnemothorax during the case (it happens- I've seen it happen) Reductions? How will you understand the geometry needed for a reduction? What will you do with post op complications (infections? wounds that won't heal?) Biopsys? Do you know how to do a cancer operation and get all the margins? Do you know when an axillary node dissection is indicated and when to do it? These are things that must be learned over time in a surgical residency dedicated to teaching them.

Others have mentioned liability. There is also the issue of getting credentialed at a hospital or surgery center to perform these procedures. Even if you use an outpatient surgery center for, say, breast cases, you have to be able to admit the patient to a hospital if there is a complication. I'd be very leery of doing lipo in FM. Even with a course, there is just too much potential for thing to go very wrong.

Even if it's possible- just because you can doesn't mean you should.

 

[EdibleEgg]

Can you do it? Yes. Should you? No

As a Family Physician that works in the ED and spends a significant amount of time doing endoscopy, I'm not really in favor of people telling me what I should and shouldn't do. However, I don't think this this is a good idea. There is an FP locally that does some of this stuff. I've seen some of the bad outcomes (but then again, I've seen some bad outcome from plastic surgeons, too). That stuff's not really medicine anyway. A monkey could do Botox, but why would you want to waste your valuable training time?

 

[Bacchus]

My attending who taught us in clinic has a very lucrative business doing lipo to abdomen, thigh, butt, and neck. I don't know if he does breast. He also does laser facials, hair removals, etc. He does botox too.

I have another friend who is FP who does a lot of laser hair removal and laser peels well. It comes down to how much CME and courses you take to become proficient.

Gotta agree with this. I had a lecture on a rotation from an FP trained doc who doesn't do any FP.

She bought a few lasers, some ultrasound machines, etc. and runs an extremely profitable business in one of the Philadelphia suburbs.

She's doing LASER hair, lightening, etc. She does Botox. She does ultrasound fat "destruction" (for a lack of better words.)

She does extremely well for herself. She's competent. Her patients come back for more.

 

[deleted87716]

Anyone can learn that kind of stuff. It's not really "plastic surgery." It's cosmetic fluff-and-buff, and a waste of a medical education if that's all you're going to do.

I should add that learning it and making a successful business out of it are two completely different things.

 

[akhim]

well i would think that cosmetic plastic surgery is more about the business than it is about practicing medicine. and youre right thats not really plastic surgery. its more like the cosmetic procedures you would find in a dermatologist office. but from the post, I guess as an FP, its possible to do some sort of cosmetics to make a little extra money.

 

[Bacchus]

Anyone can learn that kind of stuff. It's not really "plastic surgery." It's cosmetic fluff-and-buff, and a waste of a medical education if that's all you're going to do.

I should add that learning it and making a successful business out of it are two completely different things.

I agree. This attending I talked about is focusing on a few techniques and has mastered them. Through her choice of techniques she has both happy and eagerly paying patients.