Friday, November 24, 2006

Botox, anyone, with your martini?

Recently, I was invited to a friend's place for a get-together, except it wasn't just any get-together, besides drinks and good conversation, there was going to be a doctor performing free botox injections. This is not the first time I've heard of a botox party, but it is the first time I've been invited to one. Well, my friend's primary care doctor was the one who was going to be giving the botox injections. She told me it might be a good idea for me to talk to her. "She's been doing it for a year now, and it's been very lucrative for her," my friend chimed. So let me get this straight, her internist, with several weekend CME courses has started performing botox injections on her patients. About a year ago, that very same friend was telling me how her doctor was struggling financially. Let's be honest, more and more doctors, faced with insurance reimbursement cuts, are turning to other means to make more ching-ching. The self-sacrificial doctor that chose this profession to serve society is becoming extinct. But, then again, that same doctor used to make a good living doing what they loved 25 years ago. Everywhere I turn, doctors are trying to bite a chunk out of the cosmetic cookie: Dermatologists doing liposuction, ENT's doing 1-year "Plastics" fellowships to be able to do rhinoplasties and face lifts, and Ophthalmologists doing "Oculoplastics." A Dermatologist I know spends at least $5,000 in marketing to drive his cosmetics practice (I'm sure every cent well-worth it since he continues to spend it month after month without seeming to go broke), and he drives around in a Porsche.

Botox parties are a way of getting botox neovites to try it out, then get hooked. It sounds like what drug-dealers do. It's free the first time, but thereafter it's about $400 a pop. Wow! I never make that type of money in one office visit, no matter how thorough it is. But, trust me, in the name of beauty, women of all sorts will sacrifice their earnings for a little drink of the fountain of youth. I even had a male patient asking me about botox, because he was concerned that work colleagues were misinterpreting his expressions because he tends to furrow his forehead when talking without meaning that he is angry. Now that is a reason for botox if I ever heard one! What's next? Ok, botox does have a very useful application -- to stop excessive underarm sweating. This is a major problem for some people who don't want to be embarrassed at work by dripping armpits. Otherwise, are we really becoming such a wrinkle-phobic society? In my neighborhood, there are more plastic surgeons and dermatologists than primary care physicians.

I'd like to believe that I will never have to turn to botox to make the money necessary to meet the ever-increasingly expensive demands of modern living. I mean, common, we're living in a time when people are willing to pay $5 for a coffee. The real estate market has exploded recently. The ceiling is being raised on everything. And whereas the ceiling is rising, traditional medicine is being paid less and less. The hope that I could live a similar life (and I'm not talking about excessive luxuries, just essentials, like a home, possibly one or two nice vacations per year) like doctors did 25 years ago, are slim, but still there. Perhaps I am just deluding myself by sticking to my ideals. I became a doctor to help people in a certain (non-cosmetic) way, and that did not involve seeking the most lucrative treatments or procedures. I have an ideal practice I'm trying to create. I'd like to think that I can become successful and make a decent living doing just that -- by providing good integrative medicine to my patients. If I'm going to make extra money, I'd rather make it investing in real estate or the stock market -- something just won't let me go the cosmetic route (for now).

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