Cosmetic procedures are now being added to regular medical practices
Wire Services
Dr. Mira Mogler spent seven years in medical school to become a pediatrician and has treated children with infectious diseases, respiratory distress and severe allergic reactions.
Now she is one of a growing number of medical doctors who are supplementing or replacing their traditional practices with aesthetic procedures such as skin peels, face-lifts and lip augmentations.
Goodbye, insurance companies, hello, cash!
The precise number of doctors taking on cosmetic patients is unknown, but the trend is growing as more treatments come onto the market.
Board-certified plastic surgeons say they are troubled by the trend because some of the procedures are too specialized for many doctors.
Also, the more that physicians who are trained in pediatric, orthopedic and other highly trained specialities begin catering to wealth and vanity, the more dire doctor shortages in some states may become. For example, there are only 13.7 pediatricians per 100,000 in Nevada, compared with 23.9 nationwide.
But this new breed of aesthetic doctors is unapologetic about shifting the focus of their medical careers. Reimbursement rates from insurance companies are dropping, malpractice insurance and administrative costs are rising, and physicians say practices must evolve to stay in business.
"I probably would be doing regular medicine if I didn't have to deal with insurance," said Mogler, who now spends only a few hours a week caring for children in hospitals.
For two decades Mogler had run a traditional practice where sick children and their frustrated parents waited sometimes for hours before being treated. Pediatric work is intense - patients may be biting, kicking and screaming while the doctor makes her diagnoses. Mogler loves children, she said, so she enjoyed the work.
But getting paid was another story. There are scores of insurance providers, and most parents don't know what's covered, so office administrators must sort through the details and wrangle payment from insurers. The process can take months and is a significant percentage of a doctor's costs.
Consider how much easier Mogler's life is now.
Her practice, Health & Beauty Institute, consists of a single room leased in another doctor's office. Mogler charges $299 for a wrinkle treatment, $400 or $800 for lip augmentation depending on how many vials of Restylane are injected, and $1,100 for the latest facial-sculpting injectable. Her equipment is mostly limited to swabs, syringes and the fillers themselves. She has no employees and makes appointments on her cell phone.
She schedules 15 to 20 aesthetic appointments a week. Patients never wait, and Mogler performs all the procedures herself. She works about 20 hours and makes as much money as she did as a full-time pediatrician.
Mogler said she would prefer supplementing a pediatrics practice with the cosmetic procedures, but modern medicine made life too miserable. In fact, she has found the new practice rewarding. She has developed relationships with patients who often see her in preparation for a special event. They're thankful for her services.
Ear, nose and throat specialist Dr. Stephen Seldon switched entirely to cosmetic procedures about seven years ago - opening a new practice called A New You that is managed by his wife, Deborah. Because he is a surgeon, Seldon performs face-lifts in addition to cosmetic procedures like photo facials - which use pulsating light and radio waves to stimulate collagen and reduce wrinkles - as well as hair and mole removal and skin peels.
Deborah Seldon said her husband prefers cosmetic surgery over his ENT practice, in part because he's no longer on call or facing malpractice risks - and because his income has increased by half.
The shift of doctors to cosmetic procedures is creating tension among physicians. Dr. Phil Haeck of Seattle, a director of the American Society of Plastic Surgeons, said that with the flood of new antiwrinkle injectables, some doctors are trying to cash in on the trend, even if they're not highly trained to perform such procedures.
"While much of this is safe, some procedures can have serious side effects if not done properly."
A bigger concern for consumers is that many of the "medi-spas" - companies that blend salon and medical aesthetic procedures - do not have doctors performing the procedures, Haeck said.
Dr. William Zamboni, a Las Vegas plastic surgeon, said it's probably OK for physicians to perform minor cosmetic procedures, but face-lifts and the other more serious procedures should be performed by specialists.
It's consumers who are driving the whole movement. Mogler says that in Las Vegas, the anti-aging procedures are becoming part of a person's ongoing grooming, like haircuts and manicures.
