Thursday, November 5, 2009

Medical spas

In yesterday's New York Times there was an article about medical spas.  The article is subtitled: "let the buyer beware".  This is a general premise in economics.  People should be responsible for their own choices (consumer sovereignty).  In other markets we let people make their own choices.  In medical care (particularly with respect to elective procedures outside traditional medical care settings) we may need more regulated markets than exist at present.

Just this morning, my wife asked my son to make sure that some DVDs he had ordered through my wife's eBay account were acceptable.  She was then going to post feedback for the seller.  With eBay everyone is expected to post good or bad feedback so that other potential buyers and sellers working with that individual in the future have all the information they need to determine whether they want to engage the person in a market transaction.  If a person takes the chance despite poor feedback and finds no way to get their money after a bad transaction, they are out some money.  But it is usually just money.

If a person makes a decision to undertake a medical procedure, he may be risking his life.  In the article it mentions a liposuction that lead to a death.  The key is whether consumers understand all the potential consequences of a procedure and judge how a particular provider's expertise (or lack of expertise) affects the likelihood of negative potential consequences.  Unless consumers learn more about the poor consequences and likelihood of these, the government should take at least some role in regulating the market and making more information available for consumer participants in the market.  This is what is being debated in several states as described by the article.

1 comment:

  1. Having practiced as a nurse in the field of plastic and reconstructure surgery and dermatology for the past 20 years, I am all too familiar with the context in the MedSpa article. I consult with many patients who have had treatments at medical spas (especially liposuction) and are left with skin deformities and irregularities. The patients are then told they need another procedure or treatment to treat the defects. These patients are most upset because they say they were not informed of any complications. The most severe of these medical spa cases are the deaths that are reported in the news. Most deaths from liposuction in outpatient settings are from a toxic level of lidocaine administration or too much fat and blood removed, leaving the patient with an electrolyte imbalance and cardiac arrest. It is easy to say buyer beware, but many of individuals seek these medical spa procedures because they are cheap and appear benign because they are situated in fancy surroundings or shopping malls. In 20 years of practice I think maybe 2 or 3 patients have asked if the plastic surgeon I practice with is board certified in plastic surgery (he is). The patients do not ask and I think this is because they assume if a doctor or nurse practitioner is doing the procedure or treatment they have special training (more than 1 year) in the procedures.The patient who knows to research the medical provider will have a hard time looking up the providers state malpractice record. I really blame the states for not taking a more active role in protecting patients from medical providers who take a weekend course and then set up "shop". I would adovocate for added protection for patients in the medical spa area. Medical procedures all have risks and benefits and even in the best of hands, complications can occur. Poor regulations in many states with these medical spa procedures have added unfortunate risks to many outpatient procedures for patients and many oay with their life. I know in my office I spend over an hour pre op going over the surgical procedure, risks, complicstions and post-op course. Education is the key to consumer awareness of this problem.