COSMETIC TOWN JOURNAL



Cosmetic Surgeons and Plastic Surgeons Argue over Board-Certification

Posted March 18, 2019
Cosmetic surgeons and plastic surgeons are arguing over Board Certified Label

While doctors are normally very supportive of one another, there are times they find themselves having a disagreement. This is now the case with a “territory fight” that is pitting plastic surgeons against cosmetic surgeons. The disagreement involves charges of medical negligence and bias on both sides that was especially evident during a recent California licensing board meeting.

The Heart of the Disagreement between Cosmetic Surgeons and Plastic Surgeons

The rift between the cosmetic and plastic surgeons centers on whether California members of the American Board of Cosmetic Surgery (ABCS) can advertise themselves to others as being “board-certified”. This practice is not currently allowed by the Medical Board of California.

Doctors are allowed to advertise the fact that they specialize in certain cosmetic procedures such as a tummy tuck or breast augmentation. However, they are not allowed to say they are “board-certified” in any certain specialty. The privilege of saying “board-certified” is reserved for physicians that have shown state regulators that they are sufficiently trained and tested in a way that is “equivalent” to an American Board of Medical Specialties board or is certified by an association with a postgraduate training program approved by the Accreditation Council for Graduate Medical Education.

California Grants Exceptions

California law allows boards to grant exceptions and this is the case with four specialty boards that have not met the criteria listed above in order to prove their certification protocols are equivalent. The boards that have been granted exceptions govern sleep medicine, facial and plastic reconstructive surgery, spine surgery and pain medicine.

The medical board has twice rejected the petition of the cosmetic surgeons. However, the ABCS states that its programs are revised and they deserve their own exception. They claim that being board-certified is an important factor in the process of being able to communicate directly with their patients. They claim their ability to directly communicate is lessened since they are not included in insurance plan networks. Instead, they have to rely on marketing materials and Internet marketing.

Their last effort fell short as the board issued a final petition denial after a vote on December 18th.

Free Speech Issue

The president of the ABCS, Alex Sobel, is claiming that the opposition to the ABCS is restricting the growth of the organization. He also called the dispute “a wrongful restriction of commercial free speech” and a longstanding “turf battle” between plastic surgeons and cosmetic surgeons.

One doctor that has been outspoken about her opposition to the petition has been Debra Johnson, MD. She is a former president of the American Society of Plastic Surgeons (ASPS) and is a plastic surgeon in Sacramento. She says the ASPS engaged in “secret shopping” of a fellowship program to ask whether the fellow in training or the doctor would perform a breast augmentation procedure on a patient. The “secret shopper” received an email reply that said “the fellow only watches the surgery and the doctor does all the work.” Dr. Johnson said this reply was “laughable”.

She also said a review of all ABCS members in California showed 24\\% with disciplinary actions as opposed to less than 4\\% of those certified in plastic surgery. She also claimed that 26 members have websites claiming they are “board-certified cosmetic surgeons” and her group was filing 26 complaints to make them stop using these claims.

Finally, Dr. Johnson used an interview to refer to the ABCS as “a bogus board and a marketing tool. We hope they will remain in their scope of practice which is dermatology or ENT or OB-GYN. It is not plastic surgery.”

The medical board hired Neal Fleming, MD, vice-chair of education and director of cardiovascular and thoracic anesthesiology at the University of California, Davis, to verify the training regimen of the ABCS. After reviewing three volumes of documents related to the ABCS and their petition, Fleming decided he could not vouch for the ABCS. In a review that he provided last October, Davis stated that “the educational resources provided by the sponsoring institutions, when listed, appear to be largely limited to a computer and maybe an office. The emphasis is on clinical case volume.”

While this might seem like the end of the story since a state rule prohibits the board from revisiting the issue, Sobel says that, even with the repeated rejections of their requests, the ABCS is not giving up and they are “considering all possible pathways forward.”

It remains to be seen what the outcome will be of this “turf battle” (as it was described by Sobel) between plastic surgeons and cosmetic surgeons. There is no timetable for further action on the part of the ABCS and Sobel has only stated they plan on considering their options moving forward. Once they decide what their next step will be regarding this matter, Cosmetic Town News will provide an update to our readers.

 

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