States lax in regulating cosmetic surgery
— -- Three patients of a former Phoenix emergency room doctor died after having cosmetic surgery at his offices. That helped persuade the Arizona board of medicine to publish guidelines in early 2008 about the kind of training doctors practicing outside of their specialties need to be competent in the procedures they do. The doctor, Peter Normann, was convicted of two counts of second-degree murder and one count of manslaughter and sentenced to 25 years in prison in September. He is appealing the conviction.
North Carolina's medical board indefinitely suspended the license of ear, nose and throat surgeon Paul Drago's license based on complaints from women who received "substandard" cosmetic surgery procedures and other evidence he was unfit to practice, according to the board's consent order. The board also temporarily suspended the license of a general practitioner doing cosmetic surgery after becoming concerned about his cosmetic practice and finding evidence he operated on family members and prescribed drugs to himself.
The two cases influenced the board's decision in March to adopt a position statement that says doctors who expand their practices will be held to the same standards as more extensively trained physicians and must ensure they have enough education and training.
States are starting to address the growing issue of what some call "practice drift" — physicians working outside of the areas in which they're trained and board certified. In addition to Arizona and North Carolina, at least nine other states spell out in statutes that doctors have to be competent in any procedures they perform.
"This is on the radar of many state boards," says Humayun Chaudhry, a physician and CEO of the Federation of State Medical Boards (FSMB). "What doctors should or shouldn't do when they change their area of focus is a concern for everyone."
As cosmetic surgery surges in popularity and insurance payouts to doctors decline, the temptation for physicians to branch into new, potentially risky procedures has never been greater, regulators, doctors and plaintiff lawyers say. Insurance companies and hospitals typically prohibit doctors from practicing outside of their specialties, but office surgery facilities are unregulated in more than half of states. As interest in cosmetic procedures spreads outside of urban areas and coastal states, there are sweeping differences in state laws governing what kinds of surgeries doctors can perform and where.
"There are so many areas of medicine that are considered to be lucrative, that it's attracted physicians to do those procedures who really aren't trained to do them," says Jim Leventhal, a Denver plaintiff attorney who chairs the American Association for Justice's professional negligence section. "Laws need to be passed which regulate outpatient procedures requiring appropriate training to perform the procedure and appropriate training and equipment to respond immediately should a patient need emergency care."
Unrelated practices
In September, USA TODAY published a two-part series about the risky ways some doctors are responding to a growing demand for inexpensive cosmetic surgery.
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