| Special Report con't.... |
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| Couples therapy: Dermatologist Rhoda Narins and her husband,
David, a former head of urology at White Plains Hospital.
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Challenged by declining fees for medical services, increased rates for malpractice insurance, and the enormous hassle of dealing with HMOs, doctors in all specialties have been joining the beauty gold rush, turning to aesthetic elective procedures in place of traditional medical ones. Some are abandoning existing practices and reinventing themselves; others are just adding lucrative cosmetic treatments to their practices to create medical-aesthetic hybrids — ophthalmologists who do laser facials, dentists who do "smile lifts" and Botox. They're capitalizing on the boom in anti-aging technologies, answering the demand for vanity procedures, piggybacking on the spa trend. In the process, they're trading in their distinguished but spartan offices for posh, soothing, salon-inspired surroundings. Above all, they're opting for more money and less heartache.
Physician's Medical Law Letter recently sent out a questionnaire to 100,000 subscribing doctors nationwide, asking if they would be interested in expanding their practices into fields including spa medicine. The response was 70 percent positive. "Most of these people are surgeons with years of training; I didn't think they would be that interested," says publisher Bill Priest. "I see it as a backlash. Doctors' salaries in general have decreased by 10 percent over the last few years, even in the midst of inflation, and malpractice insurance is prohibitive. Some doctors have started selling creams and lotions to offset the losses."
"Why should a guy want to remove someone's gallbladder for $500 when he can get $500 for giving a shot of Botox?" asks Alan Matarasso, one of the city's top plastic surgeons. "When I went to college, someone who had a 3.8 went to medical school. They could be assured of a gratifying profession and financial security. Now a Wall Street guy in his first year out of college can make more than a doctor who gets out at 35 and has to pay back loans on $35,000-a-year tuition. And what does Medicare pay him, $10 a visit? That's what's inspiring everyone to give Botox."
"Unless you are a very, very dedicated person, it is too difficult to be in medicine nowadays," says Eugene Wexler. "There are no doctors sitting in their offices on Park Avenue anymore. They are running around to four or five different places, a clinic here, a clinic there, a union health facility. A doctor can do three boroughs a day, plus the operating room. It gets to you after a while —- you start to burn out. Almost everyone in New York is with an HMO, and you have to hire extra staff just to do the paperwork. I don't know one doctor I spoke to when making this change who wasn't jealous. In fact, I don't know too many doctors, aside from cosmetic doctors, who aren't looking to get out of medicine."
The aesthetic influx is even making Pat Wexler worry. "The romance has been taken out of medicine," says the bubbly redhead, who has designed cosmetics lines for Donna Karan, Calvin Klein, and Almay. "Physicians feel they are working for Big Brother. They can no longer make their own decisions about a patient because their course of treatment is rejected by HMOs. People involved in oncology and surgery have to deal with so many frivolous lawsuits that take years to litigate. In beauty, you are independent; you don't have to answer to anyone. In a few years, there aren't going to be doctors practicing who are in love with what they are doing. You and I are not going to be able to get good medical care. Eugene didn't leave because of the compensation. He left because he was frustrated with the system."
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Next page: "We've ended up with a dating service as well as a practice."
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| Photo by Patrik Andersson. |
| From
the May 27, 2002 issue of New York Magazine.
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