Aesthetic Medicine (eBook)

CHAPTER 1

Who Are You?

Who are the providers of aesthetic medicine? This is not a matter defined by turf; it is a matter defined by training.

THE PROVIDER AND PRACTICE

You are a medical professional with a degree from an accredited medical school. You have completed your residency and possibly elected a fellowship in accredited programs that include training in aesthetic medicine and surgery, namely, plastic surgery, otolaryngology, dermatology, ophthalmology, and perhaps dentistry, and you have received board certification related to your specialty. If you do not see yourself in this description, be cautioned: today's prospective client/patient is better informed and places more emphasis on credentials than you might realize. Who you are as a medical professional, by definition and by recognized credentials, is essential to your success.

Unfortunately, it is not always easy for the public to determine a medical professional's qualifications. There are other specialists providing aesthetic services; some are nonphysicians, whereas others are qualified providers who are crossing into territory beyond their scope of training. Establishing your specialty and services should be the simplest portion of your plan for a nonpayor practice: provide what your patients want; supply where there is a demand. But it's not that easy.

Your patients may sometimes be motivated to request the latest treatment of the moment, a procedure that may not even be appropriate for them. However, if the service you provide is not of genuine value, you'll lose credibility. What your patients want may not be within your scope of training. If you choose to build a practice by providing services outside the scope of your specialty, be prepared for a tough climb. A dentist should not augment lips and a plastic surgeon should not offer dental veneers; a dermatologist should not perform breast surgery, and a facial plastic surgeon or ophthalmic plastic surgeon should not perform body contouring.

If you practice without value or perform procedures outside the scope of your specialty, you build your practice on pillars of sand. Without a strong foundation, your patients, public, peers, and even staff will eventually question your credibility. Aesthetic medicine is a service and a business; it is based on your reputation and credibility. Your credibility is not measured by the visible outcome alone, but by the clinical outcome, the service experience, and the value paid to accomplish your patient's—your customer's—goals. Before you can endeavor to practice successfully, you must first define your practice, legitimately and conventionally, and with coyote wisdom.

RELATIVE WISDOM: Coyote Wisdom*

*Coyote Wisdom is the title of a book by Lewis Mehl-Medrona, MD, that explores the mind-body connection to healing patients through storytelling.

You will not succeed in the business of aesthetic medicine based on the services you provide alone. Your patients and peers will measure your success by the following parameters:

■ Outcomes: The physical results you achieve, and how those results and the means to produce them meet your patients’ goals and respect their limits.

■ Experience: The connections to your practice, including every detail and every person in your practice that interrelate to create an experience. Success is affected by each encounter or variable, by each experience as a whole, and by the collective experiences resulting from your services.

■ Value: The product of your practice or its value consists of your investment and sacrifice in time, money, patience, humility, and stress.

When you define, refine, or change your practice, invest in a new skill or technology, hire a new employee, or redecorate your reception area, you must consider how your actions will affect outcomes, experiences, and value.

YOUR ROLE

The vast majority of physicians practicing aesthetic medicine are in private practice. As a private practitioner, you are the proprietor making both clinical and business decisions or delegating them. Ultimately the responsibility is solely yours. You may time-share offices, facilities, equipment, or even staff, but the business entity is wholly owned by you. There are many other roles you may fulfill from both a medical and business perspective. They are not all mutually exclusive and include:

■ Partner: You and another physician of the same, complementary, or different specialties may share the ownership of the business entity—your practice.

■ Fellow: Before you establish your practice or during the course of your practice you may train and work under the supervision of another physician. You should accept only accredited fellowships. In this capacity, you will learn new skills, techniques, and practice lessons from your mentor; you will also observe and absorb experiences that will help you shape how you do or do not wish to practice.

■ Employee: You may work for another physician, practice group, or even a corporate entity, hospital, or university. You may have only clinical duties, or defined management or administrative duties as well. Like any employee, you are part of a team and part of a hierarchy with an opportunity to grow.

■ Contractor: In this situation, you are a fee-for-service contractor, or you have a contract wherein you collect fees and pay a percentage to the business entity to which you are contracted. Contract positions are most often short-term opportunities that can evolve into more serious business relationships, or not.

■ Professor: You teach your specialty and accordingly practice your specialty.

■ Supervisor: You oversee a group of physicians or providers or oversee a facility.

■ Director: You lend your expertise to shape the policy and operations of a practice, program, or business entity.

■ Network participant: You are part of a group of physicians with some common ground, such as belonging to the same hospital group. Network participants are also commonly those who are preferred providers to specific insurance companies and who agree to prenegotiated rates or to see a specific number of patients. In the practice of aesthetic medicine you may perform reimbursable procedures that include appearance enhancement. You must know what is permissible and appropriate to submit for reimbursement and what is not, and practice accordingly.

IN PRACTICE: The Business of Medicine