Beauty versus medicine: the nonphysician practice of dermatologic surgery.
BACKGROUND
This investigation was initiated because of a growing concern by the American Society for Dermatologic Surgery about the proliferation of nonphysicians practicing medicine and its impact on public health, safety, and welfare.


OBJECTIVE
Prompted by an alarming rise in anecdotal reports among dermatologic surgeons, the study sought to determine whether there was a significant increase in the number of patients seeking corrective treatment due to complications from laser and light-based hair removal, subsurface laser/light rejuvenation techniques, chemical peels, microdermabrasion, injectables, and other cosmetic medical/surgical procedures performed by nonphysicians without adequate training or supervision.


METHODS
A survey of 2,400 American Society for Dermatologic Surgery members in July 2001 and in-depth phone interviews with eight patients who experienced complications from nonphysicians performing cosmetic dermatologic surgery procedures were conducted.


RESULTS
Survey data and qualitative research results attributed patient complications primarily to "nonphysician operators" such as cosmetic technicians, estheticians, and employees of medical/dental professionals who performed various invasive medical procedures outside of their scope of training or with inadequate or no physician supervision.


CONCLUSIONS
The results underscore the need for improved awareness, legislation, and enforcement regarding the nonphysician practice of medicine, along with further study of this issue.
Brody
Harold J
HJ
Department of Dermatology, Emory University Medical School, Atlanta, Georgia, USA. haileyandbrody@mindspring.com
Geronemus
Roy G
RG
Farris
Patricia K
PK
D000488:Allied Health Personnel; D003625:Data Collection; D003869:Dermabrasion / Q000009:adverse effects; D062109:Dermatologic Surgical Procedures; D006204:Hair Removal / Q000009:adverse effects; D006801:Humans; D007407:Interviews as Topic; D053685:Laser Therapy / Q000009:adverse effects; D010789:Phototherapy; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D012086:Reoperation; D014481:United States