Over the last decade, there has been a dramatic growth in the marketing of plastic surgery services directly to the public. Treating plastic surgery as a commercial product instead of a medical service represents a major departure from traditional patient care, with significant implications for physician ethics, patient safety and the essential doctor-patient relationship. "The Commercialization of Plastic Surgery," appearing in the September/October issue of Aesthetic Surgery Journal, explores corporate medicine business practices in plastic surgery and the potential pitfalls for patients and plastic surgeons.
"The corporate medicine model can be deceptively attractive, promising stunning results for patients and vastly increased revenues for physicians. Unfortunately, many of these claims are unsubstantiated," said article author Eric Swanson, MD, of Leawood, Kansas. "Plastic surgery should not be treated as a commodity, because it isn't one. Unlike most commercial products, the service is not interchangeable - patients are dissimilar, surgeons are unique in their capabilities, and techniques are individualized. Trademarked labels and gadgets will come and go. Only a few will prove to be genuine advancements, and seldom will they be more important than the surgeon's expertise. Patient safety and education should always take precedence over any business concern."
Plastic surgeons for years have been emphasizing realistic patient expectations, avoidance of overselling, truthful advertising, informing patients about complications, presenting alternatives, and insisting on proper training and accredited facilities. Many of these patient protections are not just good practice, but mandated by law and by professional societies. These principles may sometimes be at odds with corporate priorities. Corporate medicine models often include promotion of a trademarked procedure or device, national advertising that promises stunning results, and claims of innovation, superiority, and improved safety. The recommendation for surgery may come first, even before patients meet their doctor, inverting the time-honored sequence of physician consultation prior to treatment recommendation. Further, by turning patients into "clients" and allowing non-physician executives to make decisions that affect patient care, the model negatively impacts the trusted patient-physician relationship.
"Plastic surgeons need to know that by affiliating with a corporation, they are also endorsing its business practices. As physicians and members of professional societies, they need to be sure that these practices remain consistent with ethical medical care," added Dr. Swanson.
"There is nothing inherently wrong with adopting a business model for managing one's practice, and every practice must ultimately be profitable in order to continue to exist. But we must continue to engage the public in an educational dialogue about plastic surgery training and patient safety and encourage them to view sensational claims with appropriate suspicion," said Foad Nahai, MD, Editor-in-Chief of Aesthetic Surgery Journal, in an accompanying editorial to the article. "We can also encourage the device and drug manufacturing companies with which we have relationships to engage in responsible direct to patient advertising that doesn't damage the essential doctor-patient relationship. Our goal should be to help steer patients in the right direction so that they do not become unwitting victims of plastic surgery's commercialization."