The Courtier Society
posted by Frank Pasquale
Just a quick note on an issue I’ve been covering a bit here: the fast-growing “beauty business” of cosmetic surgery. The NYT has a good piece on the topic, reporting that
Five years ago, cosmetic medicine was primarily the domain of plastic surgeons, facial surgeons and dermatologists — medical school graduates who undergo several years of training in facial skin and its underlying anatomy. But now obstetricians, family practitioners and emergency room physicians are gravitating to the beauty business, lured by lucrative cosmetic treatments that require same-day payments because they are not covered by insurance and by a medical practice without bothersome midnight emergency calls.
The new trend toward doctor-courtiers has raised interesting issues for licensing boards; though “all doctors with state medical licenses are allowed to administer all kinds of treatments . . . doctors have not commonly set up shop in fields far outside their expertise.” But that’s becoming common now. The president of the American Board of Medical Specialties criticizes the trend, but we can expect it to grow as the demand for favored appearance grows.
What to do? Well, I’d like to float two suggestions. Medical education is pretty heavily subsidized by the federal government. Perhaps, to the extent doctors opt out of traditional healing fields and take on the vocational equivalent of celebrity hairdressing, some of that subsidy could be “clawed back,” ala extant Medicaid lookback provisions that scrutinize beneficiaries’ spending habits in the years before they apply for benefits. I would only propose this going forward, so as not to upset current doctors’ reliance interests.
Another approach would build on legal challenges to cosmetology regulation. If these cosmetic interventions are really so easy that one can do a weeklong course to understand them, why require the involvement of doctors at all? I know we need to look out for the safety of those who opt for the procedures. But perhaps not at the cost of diverting qualified doctors from the healing arts to utterly frivolous ars amatoria.
December 1, 2006 at 4:42 pm
Posted in: Health Law
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Responses (3)
Heidi Kitrosser - December 2, 2006 at 12:01 pm
Nice post, Frank. There’s also an interesting op-ed in yesterday’s NYT following up on the story and tying it to a growing desire among the “merely” rich to become “super-rich,” including through lucrative cosmetic surgery practices:
http://www.nytimes.com/2006/12/01/opinion/01fri2.html
Heidi Kitrosser - December 2, 2006 at 12:02 pm
Oh, just saw that that was your second link! You’re one step ahead of me.
Frank - December 2, 2006 at 12:18 pm
Thanks! Yes, I really want to blog on that op-ed a bit more….luckily the NYT’s occasional economic columnist, Robert H. Frank, does some very good stuff on these inequality issues, and has a great book coming out next year on how inequality hurts the middle class.
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