Turf War in Cosmetic Surgery
The public has corrected
itself of the impression that doctors are wealthy. They say that on the
average, a medical practitioner in this country earns about 5 to 10% of
what he can earn as a nurse in the US; unsurprisingly then, the exodus of
Filipino doctors to the more affluent nursing field. It is logical for
doctors to remain behind when they belong to the positive extreme of the
average financial curve. In the surgical field (discounting the eye
doctors and the OB’s), the heart surgeons were making their financial mark
in the past decades only to be apparently eclipsed by the transplant
surgeons of today. But in the 70’s and 80’s the Plastic surgeons* were
enjoying the rewards of their practice when cosmetic surgery was almost
exclusive to them. Today, the general topography of medical practice has
been unfavorable to the doctors. Perhaps in these trying moments of
medical practice – the need to provide for their respective families –
other specialties have encroached in the practice of the seemingly
promising cosmetic surgery. Media and fashion are responsible for beauty
with health to be a priority even in the era of fiscal crisis and rise of
oil price. Today’s cosmetic surgeons emerge from the general surgery, ENT,
ophthalmology, maxillofacial surgery and dermatology. Alarmingly, more
doctors from the other specialties, even the general practitioners and the
fresh graduates are putting their hands on cosmetic surgery. Worse, there
are non-doctors already involved in the practice of cosmetic surgery!
Who has the full right to
practice cosmetic surgery? Should they come from the ranks of a certain
training program, board, or specialty-society? Certainly, a patient
seeking a surgical procedure would expect the surgeon to be well
trained and capable of handling complications that might
arise. Too many cosmetic surgeries are done by non-qualified doctors.
Legally, for now, anyone with a medical license can perform
cosmetic surgery. Again, there is an emotional debate among practitioners
on who is qualified to perform cosmetic operations! A number of new
training programs, board specialties, and medical societies have emerged
in order to achieve such rightful claim. Surgeons trained in plastic and
reconstructive surgery are often criticized of their rightful claim in the
practice of cosmetic surgery. Others suspect that Plastic surgeons are
guilty of defending their own financial turf rather than genuinely
demonstrating their concern on competency in the practice of cosmetic
surgery. Nevertheless, the same can be said of the others who
indiscriminately perform cosmetic surgery, that they are building their
financial coffers at the expense of their patients. The debate can be
endless.
Should the law settle
this? Is it time for the Philippine Medical Association (PMA) to make a
stand on this issue? Or should we allow the course of natural selection
to take precedence? Meaning, let the best surgeon stay in practice.
Award the right to practice cosmetic surgery to those who have the best
results, to the surgical specialty with the most satisfied patients. But
by then, the casualties of complications would have sacrificed a
significant number of patients before we know the rightful hand to hold
the knife. That is why competency in training is crucial. A formal
surgical training teaches the surgeon safe procedures and enables him to
anticipate problems. Suffice to say that any form of surgery has its
inherent risks and possible complications, including all forms of cosmetic
operations. Even the best surgeons here and abroad are not immune to
possible complications. Ironically, nobody can refute a successful
operation by anyone, even by an unlicensed practitioner. However, when
problems arise, you are in better hands with the surgeon who is well
trained and capable of handling
complications.
“Most surgeons have a
defect, congenital or acquired, of exaggerating the number of operations
they do and of underestimating the failures. Some may call this lying;
the more forgiving might say that it is evidence of rampant optimism” (R.
Goldwyn). At the end of the day, it’s your choice of surgeon to operate
on you. Check his credentials. Or, you can simply hope that your choice
of doctor knows what he is doing!
*Plastic Surgeons are
those who have formally finished a training program in Plastic &
Reconstructive Surgery, and perform cosmetic surgeries (on normal patients
who want body improvements/beautification) as well as reconstructive
operations (cases like burns, trauma, cancer defects, congenital
anomalies). Cosmetic surgeons are those who only perform surgery for
beautification.
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