Archive for the ‘Uncategorized’ Category

Elective Procedure Tax Probably Unfair to Women

Tuesday, July 28th, 2009

politicians discuss cosmetic procedure taxMedia outlets all over the country are making a buzz about the proposed cosmetic surgery tax intended to finance health care reform. The LA Times blog Top of the Ticket says the tax would attach 10 percent onto any elective procedure – your tummy tuck, breast implants, or Botox could be taxed. Writers of the Speaker’s Lobby say the tax proposal is probably “off the table” for now, and that the idea likely came from a treasury department official.

This so-called ‘Botax’  or ‘vanity tax’ is being contested in a few different ways, but here are the two common arguments being reiterated:

Would it be gender discrimination?

The tax would be paid almost entirely by women.  Despite the growing popularity of cosmetic procedures for men, women still make up over 90 percent of the patient demographic in the United States.  Obviously, imposing a tax such as the one in question would unfairly discriminate against women.  Think about it this way: would a tax be imposed on men who purchase expensive tattoos, fashionable clothing, or bodybuilding equipment?  It doesn’t seem likely.

Would it affect the rich or the middle class?

There’s a common misconception that’s probably at work here; it’s that “only the rich and famous pursue cosmetic surgery.”  Experience in the industry will show you otherwise.  A 2004 survey conducted by the American Society of Plastic Surgeons revealed that nearly “a third of people considering plastic surgery reported average household incomes below $30,000.”

Recall this New York Times piece by Natasha Singer titled “Who Is the Real Face of Plastic Surgery?”  Ms. Singer discusses the fact that a large number of patients choose to finance their cosmetic surgeries, just as they would a new car.

Surgical Enhancement: A Career Perk?

Friday, May 29th, 2009

Medical practices in Prague are offering free surgical enhancements to nurses as an employment incentive, according to this NY Times article.  One nurse opted for breast augmentation and liposuction, free of charge.  

The piece raises some interesting ethical questions: While the procedures could certainly be beneficial to individual nurses in the short term, would such a practice harm the nursing profession as a whole?  

According to reporter Dan Bilefsky, nurses in the region “insist they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.”  Critics argue that the incentives could promote an idealized body image for nurses, in a profession already suffering from misconceptions about technical competence.  A spokeswoman from the Czech nurses association argues that nurses are still perceived as “low level workers” with little to offer besides manual labor.  Nurses after all, aren’t intended to be models, but caregivers that provide an enormous benefit to the medical profession and the public they serve.  A misplaced emphasis on their physical appearance could undermine public perceptions of their competence and value.

Still, others may not see any problem with offering incentives through procedures like breast augmentation or rhinoplasty; perhaps they’re analogous to employee discounts at a retailer, vacation packages, or other career perks.  

The ethical issues being discussed probably aren’t a product of the incentive programs alone, but rather an objection to the sexism and discrimination that underlie them.

New Cosmetic, Therapeutic Uses For Botox Still Emerging

Thursday, May 28th, 2009

Botox injection works to smooth out facial wrinkles; that’s been firmly established. Surgeons across the country have chosen it as a primary wrinkle treatment. But that’s hardly been the extent of the drug’s usage. If you do a little research, you’ll find physicians using Botox for a wide variety of new and interesting purposes.botox-100units

Years ago, the Journal of the American Academy of Dermatology published the results of a survey (conducted by researchers from Allergan Inc) about sweating. It revealed that approximately 3 percent of the U.S. population (7.8 million people) experiences excessive sweating, and less than half of the respondents had sought medical help for the problem. Botox blocks the localized release of a specific chemical that stimulates sweating, so the FDA has approved it for this use.

Many doctors have used Botox to treat headaches, and their basic procedures are not much different than those of wrinkle treatment. Although it’s not entirely clear how the Botulinum toxin provides relief (it may work to inhibit pain-transmitting nerves), but many patients suffer through fewer headaches after getting Botox treatment.

Last March, the NY Times published a story on off-label Botox use to treat people who have suffered a stroke and experience difficulty relaxing certain muscles. According to the experts, “only about 5 percent of the stroke patients who could benefit from its use ever get it.”

Aside from these therapies, surgeons and dermatologists are finding even more cosmetic uses for Botox. Dr. Lawrence Reed recently told an ABC news affiliate that “we’re at the tip of the iceberg where Botox is going to be used.” Reed has apparently been pioneering some interesting new cosmetic applications.

For acne, Dr. Reed injects Botox just below the skin: “It decreases the muscle pump and blocks the production of oils, so we use it for acne,” he claims. They also found success using Botox to supplement laser skin resurfacing and other procedures.

If you’re considering Botox for any off-label use, make sure you choose a qualified physician. Despite the optimism surrounding Botox as a ‘wonder drug’, there have been complications and side effects associated with off-label use and inexperienced providers.