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End Poverty

Cosmetic Procedures in Family Medicine

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5 hours ago, ZBL said:

They are “allowed” to do anything they want. 

Exactly. The scope of practice in FM is very wide, as long as you feel competent.  Botox, cosmetic fillers, derm biopsies, can all be done. Just need to make sure you do some self work or courses to be competent. Because if you make a mistake, and its clear you didn't do due diligence to be safe... good luck with the malpractice.   

With botox especially, you have to be careful of the regions, age groups, and type of clientele. Some docs i've worked with have been burned, because they agreed to do botox for overzealous clients, and the results being unpredictable sometimes, led to a suboptimal result. This lead to alot of backlash from said clients. Wasn't worth their headache. Also product types and expiries are an issue too if you are only doing it casually here and there.  You also want to do it enough for certain regions to feel competent in agreeing to do so safely, and being able to ensure good results.

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6 hours ago, JohnGrisham said:

Exactly. The scope of practice in FM is very wide, as long as you feel competent.  Botox, cosmetic fillers, derm biopsies, can all be done. Just need to make sure you do some self work or courses to be competent. Because if you make a mistake, and its clear you didn't do due diligence to be safe... good luck with the malpractice.   

With botox especially, you have to be careful of the regions, age groups, and type of clientele. Some docs i've worked with have been burned, because they agreed to do botox for overzealous clients, and the results being unpredictable sometimes, led to a suboptimal result. This lead to alot of backlash from said clients. Wasn't worth their headache. Also product types and expiries are an issue too if you are only doing it casually here and there.  You also want to do it enough for certain regions to feel competent in agreeing to do so safely, and being able to ensure good results.

Agree. Cosmetics is one of those things that unless you do it with high frequency (which is not as easy in FM), the cost to you is actually too high - both from a medical risk perspective, legal issues, patient satisfaction and overall financial cost. 

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22 hours ago, JohnGrisham said:

Exactly. The scope of practice in FM is very wide, as long as you feel competent.  Botox, cosmetic fillers, derm biopsies, can all be done. Just need to make sure you do some self work or courses to be competent. Because if you make a mistake, and its clear you didn't do due diligence to be safe... good luck with the malpractice.   

With botox especially, you have to be careful of the regions, age groups, and type of clientele. Some docs i've worked with have been burned, because they agreed to do botox for overzealous clients, and the results being unpredictable sometimes, led to a suboptimal result. This lead to alot of backlash from said clients. Wasn't worth their headache. Also product types and expiries are an issue too if you are only doing it casually here and there.  You also want to do it enough for certain regions to feel competent in agreeing to do so safely, and being able to ensure good results.

Do derm residents receive training in these procedures? I always thought that they do, but when I talked to one of the residents in my school, I was told that he did not receive any training in this area. Is it dependent on the school/program?

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It is a core competency of dermatology, along with other cosmetic procedures like laser, peels, injectables, topicals and surgical (lipo, blephs, scar revision, etc.) that is testable on the Royal College exam, so residents are supposed to get exposure. How much exposure might depend on program. 

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1 hour ago, sWOMEN said:

TIL derms do blephs 

Yup. From the Royal College standards of cosmetic training for derm:

”Indications, technique, limitations/expectations and complications of cosmetic dermatological procedures including lasers, dermabrasion, chemical peels, liposuction, soft tissue augmentation, hair replacement, sclerotherapy and facial cosmetic surgery including blepharoplasty and rhytidectomy.”

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