Cosmetic Services Boost FP Revenues
Family Practice News, Jan 1, 2000 by Christine Kilgore
Managed care contracts were starting to take a bigger bite out of Dr. Howard Schoenfeld’s income, and he felt that his family practice in East Windsor, N.J., was becoming “stagnant.”
So last fall, Dr. Schoenfeld and his partner bought a $10,000 microdermabrasion machine and added skin rejuvenation to their menu of services. He hopes patients will embrace microdermabrasion, which sandblasts the skin withg corundum crystals to remove wrinkles and acne scars.
If the venture succeeds, he plans to make an even larger investment in cosmetic care by buying hair removal lasers and other dermatologic equipment.
Dr. Schoenfeld is one of a growing number of FPs who are expanding their scope of practice by adding cosmetic procedures. Some are buying the equipment, while others choose to lease it.
Although the American Academy of Family Physicians isn’t yet tracking the trend, vendors say that they’re selling cosmetic devices to more physicians in general and to more FPs in particular. For now, hair removal devices are the most popular choice among family physicians, vendors say.
Patient demand is driving the trend, according to FPs across the country.
“Patients know me, and they really appreciate being able to have [cosmetic treatments] done here,” said Dr. Melinda Screws, an FP in rural Dublin, Ga. Dermatologists in her area are too busy with skin cancer to even offer cosmetic services, she said, and plastic surgeons are too far away.
The movement toward integrating cosmetic and primary care services has accelerated in part because family physicians and others now can choose from an array of new tools that are easier–and often safer–to use than the more invasive [CO.sub.2] and erbium lasers that dominated the cosmetic services landscape several years ago.
Dr. Screws started offering cosmetic services last fall after she bought a $130,000 machine called MultiLight, a sort of cousin to the laser. MultiLight, sold by ESC Medical Systems, Needham, Mass., releases intense pulsed light to remove hair and to treat leg veins, other vascular skin lesions, and various pigmented lesions.
Since she began using the pulsed light device, Dr. Screws also has sought out training in the use of Botox and glycolic acid peels–services that she plans to add soon in response to patient requests.
Dermatologists and plastic surgeons buy 80% of cosmetic laser devices, but family physicians, ob.gyns., and vascular surgeons are starting to snap up lasers, too, according to Gerald E. Puorro, president and CEO of Candela Corp. a Boston-based firm that is one of the largest manufacturers of cosmetic laser systems. In fact, Candela exhibited its wares at the AAFP annual meeting for the first time last year.
Dermatologists are keenly aware of the professional rivalry that this surge of interest in cosmetic care is producing.
“There’s a fear that if nonexperts in skin disease start removing hair, before you know it they’ll be doing many other procedures,” said Dr. Jeffrey Dover, an associate professor of dermatology at Harvard Medical School in Boston.
That fear translates into concern about losing market share. “It seems like there’s a microdermabrasion machine or laser on every street corner,” said Dr. Rick Wilson, a dermatologist in Plano, Tex.
It’s clear that adding cosmetic services can be lucrative. Dr. Lori Ann Musto, who integrated cosmetic services into her family practice in the wealthy California community of Pacific Palisades 3 years ago, earns $8,200-$9,500 for each half-day that she performs cosmetic laser services.
Dr. Musto, who spends about half her time on cosmetic procedures, prefers to lease equipment so she can keep pace with rapid changes in the technology.