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Medical Spa Business Forum > RealSelf.com has kicked out all non-core physicians!

I got an email from a physician friend of mine that realself.com had just eliminated all the profiles of physicians who were not boarded plastics or derms. I looked at my profile and sure enough... gone. (Boarded but non-core)
The email that realself.com sent to my buddy stated that the reason they've eliminated non-core profiles is that the non-core doctors 'weren't giving the right answers!'

Get that: The non-core doctors weren't giving the right answers!

Eh... Who do you think is the arbiter of what the right answer is? Last I knew the MD and DO was the designation of a license to practice medicine... ANY medicine. Patients are entitled to real second opinions, not 'approved' opinions. What realself.com has done is cave to a small group of protectionist plastic surgeons and dermatologists who want to keep cosmetic medicine to themselves.

The last I was aware of Plastic Surgery was about SURGERY, not IPL.. and Dermatology treats DISEASES of the skin, not Botox.

This is really pissing me off! RealSelf.com just lost any proponent from my side. (unintelligible tirade)

The comment "a licence to practice medicine - any medicine" really bothers me.

RealSelf: Rather than practicing a branch of medicine that you may be legally permitted to practice by the statutory definitions of your state medical licence, you should instead be practicing the kind of medicine that you are trained, competent / expert, etc. in. These may not be one and the same.

Rather than saying "my huge ego allows to me to consider myself an expert in everything - even in fields that I'm not residency trained in", why not put patient welfare first, and limit yourself to fields where you are a credentialled expert.

I certainly don't want a non-board certified person doing my neurosurgery, or my open-heart surgery...why is cosmetic medicine and plastic surgery any different.

Even though the flight attendant might be able to read some of the dials in the cockpit, I sure don't want him or her flying the plane!

I am a board certified dermatologist in practice for 24 years. I practice on the north side of Atlanta in a relatively affluent area. There are many med spas, ob-gyns, internists, family practitioners, and dentists performing cosmetic procedures in my part of town. Over the last few years I have held many hands and attempted to reverse horrific problems caused by non-board certified dermatologists and non-board certified plastic surgeons. I have seen patients with second and third -degree burns from improper use of lasers. Several of these patients have required skin grafts and have permanent disfigurement. One of my dearest patients went to an M.D. who said she was a dermatologist and she is so disfigured that she and her husband have moved to North Georgia where they live a rather cloistered life. I have one patient who lost vision in her left eye due to improper Botox use, and I have another patient with partial vision loss due to improper injectable use. Currently I am working on a staged-excision of Sculptra beneath a patient's left eye. Five years ago I lost a patient due to a melonoma that was treated by an ob-gyn with a diode laser...she was told it was just a "liver spot"...a mother of 3 who had already survived lupus cardiomyopathy! I also have met several patients with brown polka-dots and zebra-stripes. And then of course I have myriad patients on skin care regimens that are biochemically incompatible. Unfortunately, I do not think these problems will end by the self-policing of doctors. They will be corrected as usual by opportunistic lawyers. There is big money to be made by the legal profession. We can sit back and watch as the lawyers move, as usual, from California, to Florida, to New York, and New Jersey, and clean this up for us. After so many years as a board certified dermatologist, I continue learning every day, and improving my techniques every day, and continuing my CME every day. And every day I feel I could have done a better job.

I'm either just another dumb blonde or there's a lot of responsibility that comes with my credentials. Respectfully submitted, Christine Glavey MD

Many plastic surgeons and dermatologists do cosmetic lasers and procedure part-time and are no more expert than a non-core who is full-time and dedicated to his or her craft.

The problem is that the laser companies sell lasers to doctors who should not get them and then they don't support those doctors with continuing education. Heck ... most laser companies don't know how to use their own lasers! See the blogging about Lumenis!

And then we have the derms and plastics who exclued the non-cores from their clubs and conferences and then they complain about those non-cores. Grow up!

And then we have experts and luminaryies who are bought and paid for by the laser companies. They are dishonest and spew misinformation. See the blogging about Mitch Goldman, MD.

My point is that there are many causes of the problems in cosmetic medicine. The problems are HUGE and it is not that the non-cores can't do it. Let's make sure everyone who does cosmetic medicine has the opportunity to become expert!

Laser Surgery IS NOT neurosurgery and it is not cardiac surgery! That kind of comparison is not valid. Most internists are smarter, better looking and have better hand eye coordination than most dermatologists.

Derms and Plastics, get off your high horse and do something productive and helpful.

I fix the problems caused by incompetitent Dermatologists and Plastic Surgeoins everyday. These guys rent their lasers and have their nurses doing their procedures.

I am a board certified internist and I added cosmetic procedures to my practice 5 years ago. While practicing solely as an internist I looked at countless rashes and skin lesions because my patients asked me too. Should I send every brown spot to a dermatologist? As an internist, I should be trained well enough to know when something is malignant or benign. Or if I'm uncertain, follow the derm motto, "when in doubt, cut it out".

Secondly, is it better for the patient to have their filler and botox done by a nurse in a plastic surgeons office? If a nurse can be trained to do these procedures, why can't I? I have received extensive hand on training with Botox and fillers over the past 5 years (not "sales" courses with plastic heads).

In many offices technicians do the laser and IPL procedures. Hopefully someone with knowledge helps select the patients and the machine settings but not always. I do all of my own laser procedures (even hair). Again, I continue to research and read to improve my outcomes.

Dermatologists and Plastic Surgeons who finished training more than 10 years ago had to learn botox, fillers and most lasers like I have (courses, reading and preceptorships). I don't think anything taught in a derm residency 10 years ago helps a dermatologist be a better botox injector.

This will continue to be a "turf war" because it can be fun and profitable. However, there are many people jumping into the business purely for the profit. Until there is a specific board certification for this area of medicine it will be "up for grabs". Even among the "core" physicians there is some disagreement of what procedures belong to whom. The problem is not usually the type of physician doing the procedure, it's poor training, inexperience and even greed.

Where are all the Cosmetic Dermatology Fellowship programs?
I don't think there are many.
Dermatologists are not trained in cosmetic dermatology.

Who has screwed up the whole field?
The Luminaries (who are Derms and Plastics) who will say anything for a first class plane ticket to a conference.
They lie, they mislead ... they do not tell the truth!

Cutera lasers do not work.
Goldman lies in his Lumenis Webinars.
The Laser Company Executives are a bunch of inbred idiots!

Don't blame the Cores!
The Cores will rise up and tell the truth.
Be very careful.

We are upset about Florida and California.
We are upset about being excluded from Societies and Conferences.
We are burning mad about this RealSelf thing.

RealSelf in in our sites now. Their CEO just made a huge mistake.

There is a NEW Paradigm.

" A great vision is needed, and the man who has it must follow it as the eagle seeks the deepest blue of the sky." -- Crazy Horse / Tashunkewitko

It is time for hero to rise from our ranks!!!!

Non-Core Man!!!!!!!!!!!!!!!!!!!!

Faster than a Speeding Photon.
More Powerful than a Near InfraRed Crystal
Able to Burn, Blister and Scar Dark Patients in a Single Pulse!
It is Non-Core Man!!!!!!!!!!!!!!

Non-Core Man.

Christine Glavey,

I am on the other end and have had to clean up or get involved in things screwed up by derms that dable in aesthetic medicine.

When I had my primary care office I found a melanoma on one of my pts that had seen a derm. She also did not survive.

We probably all have these stories going both ways. So jump on board and help with real problems.

I do have to ask how a patient went blind from Botox?

I think there are problems with the way things work. I have issues with the FP, OB-Gyn, Derm or Plastic Surgeon starting a "med-spa" and purchasing a few lasers hiring a nurse and letting them go. That is the problem when there is no over site.

03.5 | Unregistered CommenterLH

@ Sick of the posturing & ego,
Duly noted and to be honest, I wrote that first comment in anger. HOWEVER, we're not discussing open heart surgery here. RealSelf.com is stuffed with 'do you think I'm fat" questions and 'How much does Botox hurt?". IT's clearly just a marketing forum for realself.com to make money by promoting physicians. That's it. It's a marketing vehicle. Any physician that thinks they're dispensing medical advice in a forum like that is... well, they're not.
SO, I'll take my drubbing and keep my ego in check, but those of us practicing medicine for more than a decade all have stories to tell that include core docs in EVERY field. Let's keep the general finger pointing to a minimum but that won't change the real reasoning. Greed.

Im surprised no one has mentioned the real reason this has happened.

Remember the recent affiliation agreement between RealSelf and the plastic surgery society? Must involve big money for such an odd affiliation. So after this, "core docs" can now push turf agenda.

@ Florida PA,
I'm unaware of this agreement between RealSelf and the plastic surgery society... Can you detail?

RealSelf: I will agree with you on one of your points - "plastic surgery is about SURGERY". I'm not here to bicker about lasers or botox, which many can do well, provided they understand the anatomy, physiology, wound healing, and have a talented eye and a good sense of judgement. I'm here to speak about SURGERY, not dermatology or other stuff.

Board-certification in Plastic Surgery is the most appropriate way to train for physicians that wish to perform aesthetic surgical procedures! The 6 to 7 year training program, btw, is just as long as cardiac surgery or neurosurgery training, as mentioned earlier....so they may be more comparable than you might think, in terms of dedication and devotion to mastery of the field. If you want to be a real plastic surgeon, then do the residency time in plastic surgery. If you trained in some other surgical specialty, great- that makes an excellent background prior to your residency in plastic surgery!

But please, don't claim you're "plastic surgeon equivalent". There are no short cuts here. Only people who pretend there are.


03.5 | Unregistered CommenterTF

This issue is not about "plastic surgeons"

There's a difference between plastic and cosmetic surgery

In fact, many plastic surgeons do very little training in cosmetic surgery [much less, cosmetic dermatology]...

My mentor graduated not too long ago from one of the most prestigious INTEGRATED plastic surgery program and the amount of cosmetic surgery she did was subpar!!

My mentor had to go to Europe and do a one year fellowship in cosmetics so she could return to the states and do "cosmetic surgery"

All while being a PLASTIC SURGEON!!!

So as you can see, just because you are a plastic surgeon it does not mean you are as trained to do cosmetic as someone who trains in cosmetic surgery.

Respectfully,

Medhacker

There is no official, ABMS-approved training program in "cosmetic surgery", medhacker. It's not currently a recognized residency track, as I suspect you well know.

Since Plastic Surgery encompasses so many areas: burns, craniofacial surgery, oncologic reconstruction, pediatric plastic surgery, aesthetic surgery, head & neck oncology, hand surgery, microsurgery, wound care, and so on - why would it be surprising that your mentor wanted to specialize and do a fellowship, especially if she came from a program that was strong in general reconstruction. It's a lot to master, which again speaks to the value of passing the Plastic Surgery Boards!

Personally, I think that a plastic surgery residency, followed by an aesthetic surgery year is a great training method, for those who want to pursue aesthetic plastic surgery. I'd challenge you to propose a better method.

There are excellent fellowships for postgraduate plastic surgeons here in the US (Manhattan Eye & Ear, for example) - but they are extremely competitive, even compared to getting into a general plastic surgery residency, which in itself is one of the most competitive surgical specialties.


03.5 | Unregistered CommenterTF

TF,

Calll it cosmetic surgery or call it aesthetics surgery. I suspect you know we are both talking about the same thing.

And the point is, it does not seem that U.S. trained plastic surgeons are getting much training in cosmetics/aesthetics...

If this is the case in general for most plastic surgeons, then there's no reason why a PS (plastic surgeon, hereforth) should claim to own the cosmetic/aesthetic surgery turf.

I agree PSs are better trained in plastics than perhaps anyone else.

I can't say the same for cosmetics/aesthetics and PSs.

The best way to train in cosmetics/aesthetics I suspect will be a matter of opinion. Therefore, in my opinion a better way to train in cosmetic/aesthetics is...to train in cosmetics/aesthetics...

PSs can and do also train in cosmetic/aesthetic surgery, as you can see from my mentor's example...but so do other physicians train in cosmetic/aesthetics surgery...

In regards to aesthetic lasers, it would be hard to find many plastic surgeons or derms for that matter, who have a full grasp of laser physics, fundamentals of optics, tissue interaction, and chemical engineering. These are the basics of laser aesthetic medicine, partly the reason why ASLMS was formed, joining many practioners together.

03.5 | Unregistered CommenterPhs

dear christine and all,

first of all, i would agree that there are practioners, md and other wise, who practice hack aesthetics and that could give us all a bad reputation, however i have not seen a correlation with particular medical specialties.

like LH i have had to cleanup messes from derms and plastics who were either under trained or (in all fairness) just had a bad day. my primary specialty is im i am also bc in critical care medicine, pulm, and sleep. i started aesthetic practice 5 yrs ago and have done training with aesthetic derms and plastics and been encouraged by them. i also have done 100s of cme hrs and completed the aesthetic fellowship of the a4m - accredited by the university of s, florida. many of my colleages there were (to their credit )core physicians. at least 50% of my practice is referals from the derms and plastic people in my area and likewise i send them pts with derm path and surgcal problems. i am also a diplomate of the american board of laser surgery and a fellow in the aslms and have published papers and am engaged in ongoing research in aesthetics.

the closest analogy from my primary specialty: i give grand rounds on treatment of asthma etc to physicians of all specialties and in fact do mini fellowship months for docs who want to practice in the icu managing mi s, ards, sepsis, etc. my point is that rather than restrict practice to certain speciatlies standards need to adopted which ensure excellent training and techniques and that rather than fight with each other, share our knowledge freely, so that our pts benefit from the best care possible. this way the reputation of all of us can be enhanced with the public and all seroius practioners benefit.

Positiveagingdoctor: Let's put this another way - in general, is it best for patient care if someone who is not boarded in critical care medicine is running a busy tertiary-care ICU, when there are CCM-boarded physicians readily available?

03.6 | Unregistered CommenterTF

@TF, We're not discussing face lifts and breast implants here (as far as I can tell), we're discussing Botox, Restylane and Thermage. Someone please tell me why a board certified plastic surgeon has a greater right to perform laser hair removal than any competent doc?

(Actually, if you've noticed, since laser hair removal has become something of a commodity there's no rush to protect that.)

How many board certified plastic surgeons or dermatolgist do 100% of all their laser hair removal procedures, botox, fillers, IPL, ? Please. I have never seen a plastic surgeon spending 45 minutes removing hair on a guys back.

03.6 | Unregistered CommenterPhs

TF,
point well taken. but truthfully, a motivated, caring well trained internist, general surgeon,even plastic surgeon could easily manage mi, resp failure from copd/ pneumonia , post op general surg pts,drug od, etc.. post op hearts, sepsis, ards might be better with ccm. just as non plastics should not be doing implants, abdominoplasties, and face lifts.

another point is unfortunately there are an inadequate # of derms, plastics, ccm, and sleep docs nationwide. (esp. in my area). i have fought long and hard to oppose my specialties associations' (accp, sccm) position on "closed" icu and other restrictive practices because there are not enough of (any )of us to go around. as i implied above, i believe the answer is a post graduate pathway into aesthetic medicine with rigrous training and standards for which any clinical specialty could be eligible. from the tenor of these posts there may be too much turf to protect for this to work. i was totally unaware of this (naive i guess) as in my area we all (mostly) cooperate and each of us is happy for all the qualified help we can get!

To "Leggo" and Phs: As I said in my very first post, "I'm not here to bicker (about who does) lasers & botox". My point has been about qualifications for performing aesthetic plastic surgery, and that plastic surgery residency is, so far, the best, most widely accepted, officially approved method for doing this.

And it's open to anyone who has completed the pre-requisite training. There's no conspiracy here.

03.6 | Unregistered CommenterTF

TH said:

"My point has been about qualifications for performing aesthetic plastic surgery and that plastic surgery residency is, so far, the best, most widely accepted, officially approved method for doing this."

I beg to differ TH

Plastic surgeons in the U.S. receive insufficient training in aesthetics surgery/cosmetic surgery.

To the point that most have to supplement their plastic and reconstructive training with additional cosmetic and aesthetics surgery training.

MH

Medhacker:

I've invited you to give me specifics about your ideal "cosmetic surgery" residency program. So far, you haven't suggested any alternatives, other than "more cosmetic surgery", which is, of course, a circular argument.

Plastic Surgery training gives more aesthetic surgery training than any other surgical training program, bar none, and more training in the principles of flaps, delicate handling of tissues, careful wound repair, and appreciation of relevant surgical anatomy than any other surgical program relevant to this topic.

Perhaps you feel there is still not enough training in the aesthetic area - well, that point is interesting. Let's discuss.

03.6 | Unregistered CommenterTF

TF

As a counterpoint to your suggestion that it is only a PS who has the ideal training to perform aesthetic surgery...In matters of facial aesthetic surgery, what is your view regarding an otolaryngologist specializing in facial plastic surgery? Few would argue that this is also a highly sought-after and competitive residency training which consists of 1year of general surgery + 4 years of otolaryngology (head and neck surgery, rhinology, otology, and of course Facial Plastic Surgery). This reflects four years of surgical and medical training pertaining solely to the anatomy, function, and pathology of the face, neck, nose, and ears. The otolaryngology board exam has an entire quarter of the exam dedicated to facial plastic and reconstructive surgery. Moreover, many facial plastic surgeons complete a competitive fellowship in facial plastic and reconstructive surgery subsequent to their residency training. So how could you so forcefully state that :

"Plastic Surgery training gives more aesthetic surgery training than any other surgical training program, bar none, and more training in the principles of flaps, delicate handling of tissues, careful wound repair, and appreciation of relevant surgical anatomy than any other surgical program relevant to this topic"

Certainly there are variations between training programs and this is true for any surgical/medical field, but when it comes to matters of the face, I think it is inaccurate to state to plastic surgeons are the only ones qualified to perform facial aesthetic surgery. At the end of the day, the surgical residency training is certainly a valuable prerequisite, but not the only factor in a surgeon's ability to perform aesthetic surgery. Post-residency experience/training ultimately has no substitute. Just a thought.

Justathought: If you read what I wrote, I didn't say that PS was the ONLY method, just what I consider the best method to train aesthetic plastic surgeons. Yes, ENT does have overlap with PS, but only if you are above the clavicle! ENT doesn't help you with the other 80% of the body! I certainly know some facial plastics docs that do a great rhinoplasty or facelift...but I sure wouldn't want them to be operating on breasts, or doing abdominoplasties, where they would be pretty much completely unqualified.

And, of course, there's plenty of stuff in the ENT curriculum - like dealing with tonsillitis, middle and inner ear disorders, sinus surgery and so forth - that has little or no application to aesthetic plastic surgery - and that's time out of your 4-5 years of training that doesn't help in this arena.

So, again - what would your proposal be for the ideal training method?

03.8 | Unregistered CommenterTF

TH Said:

Medhacker:

I've invited you to give me specifics about your ideal "cosmetic surgery" residency program. So far, you haven't suggested any alternatives, other than "more cosmetic surgery", which is, of course, a circular argument.

Plastic Surgery training gives more aesthetic surgery training than any other surgical training program, bar none, and more training in the principles of flaps, delicate handling of tissues, careful wound repair, and appreciation of relevant surgical anatomy than any other surgical program relevant to this topic.

Perhaps you feel there is still not enough training in the aesthetic area - well, that point is interesting. Let's discuss.



Hi TH,

It isn't only my opinion or the opinion of my mentors who are PR surgeons.

In fact a 2008 survey published in the Journal of Plastic and Reconstructive Surgery concluded that U.S. PRS seniors felt inadequately prepared in facial plastics, minimally invasive, recently developed body contouring techniques, fillers, botox, and skin resurfacing.

You may see the abstract here ---> ABSTRACT

It should not come as a surprise since the average minimum cosmetic surgery case requirements for U.S. plastic surgery programs is 7 facelifts, 8 eyelid surgeries, six nose surgeries and 10 breast implants. Obviously entering one's practice with 7 facelifts, 8 eyelid surgeries and 10 breast implants does not make someone an expert or better than other specialties.

Of course, some residents get more training but they are more the exception than the norm.


Based on this I adopt the opinion that, just because someone is a plastic surgeon does no make them better than another specialty to do aesthetics/cosmetics. I do not mean to discredit PR surgeons, I just want to point out the evidence that makes me conclude that claiming superiority on aesthetics/cosmetic procedures by PR surgeons is no more than a symptom of turf war.

And so to answer your question regarding what I think the best training in aesthetics would be:

I hope it does not sound circular, I think is commonsensical that the best person to do aesthetics/cosmetics is one with the most training in aesthetics/cosmetics and the management of their complications - irrespective of specialty with some obvious limitations.


How many procedures should someone in such a program perform to be considered qualified? I'd rather not speculate. I prefer evidence based medicine, so gathering up such data to determine minimmum numbers is of the esence and better than adopting positions based on opinions instead of facts.


Respectfully


Medhacker

The plastic surgeons and the dermatologists should stop whining and complaining.

If you want to control Aesthetic Medicine, start enough Fellowship programs and start producing real experts.

Yes, REAL EXPERTS ... not dermatologists who do it a few hours per week and not plastic surgeons who do not do it at all (they have their nurses and physician extenders do it).

Put up or shut up.

You guys are like little whiny girls.

We ARE NOT talking about Plastic Surgery.
We are talking about Lasers and Lights and fillers and Botox!

We may be talking about Body Conteuring which includes LipoSuction (Laser Assisted) (this is a real grey area).

Let's make sure we keep this simple.

RealSelf.com has deleted the non-cores from all of Cosmetic Medicine including Botox, Lasers and Lights.

My prediction is that they will reverse this decision soon or they will decline and be beaten up by competition.

The non-core doctors will not stand for this type of disrespect.

Remember, we all went to college and medical school with these arrogant people who later became Plastic Surgeons and Dermatologist. We know who they are and we know they are no better than us (even thought they think they are better).

03.8 | Unregistered CommenterME

How does RealSelf.com make money?
What is their business model?
Who are their investors?
Who is their CEO?

I wonder if RealSelf's investors know that RealSelf has just shot itself in the foot! More specifically, do they realize that the CEO and Founder of RealSelf is an idiot?

RealSelf.com has just made itself irrelevent!
Who cares what RealSelf does?
They will be gone in a year or two without the non-cores.
Watch them reverse their decision within months!

If I was an investor, my money would be OUT of RealSelf and into an area not managed by a idiot!

Inspiration behind RealSelf.com
150,000 reviews about hotel towels, none about laser treatments

RealSelf.com was founded by Tom Seery in 2006 after his wife pointed out that it was far easier to get informed about hotel towels than a $2,000 laser skin treatment. Our team is passionate about closing this information gap by creating an authentic forum to share opinions and experiences, much in the way hotel consumer review sites have done so for travelers.

To complete the picture, invited experts, many who are leading authorities in aesthetics, cosmetic surgery and dermatology, participate on RealSelf.com without a commercial relationship or exchange of fees. We look to premiere medical organizations and recognized medical experts to integrate safety information, scientific data and accepted standards.

Note to Tom: some of the top experts are not plastic surgeons or dermatologists! You used us and now you are dumping us! This is all about money and greed. We know this and others will soon know this!

Our beliefs
• RealSelf.com takes responsibility to provide an open and safe forum for discussing pros, cons, potential risks, and everything in-between about cosmetic treatments and procedures. IT IS NO LONGER OPEN

• RealSelf.com gives a voice to consumers who can freely ask real questions, share real experiences, and give an opinion. REALSELF DOES NOT GIVE VOICE TO NON-CORE PHYSICIANS FOR PROVIDERS

• RealSelf.com can elevate consumer confidence by giving the real, unvarnished, unedited perspective on cosmetic treatments and whether they’re worth it, or not. MOST PLASTIC SURGEONS AND DERMATOLOGIST DO NOT TELL THE TRUTH. THERE WILL BE NO CONFIDENCE IN THE "REALSELF" PERSPECTIVE WHEN THEY EXCLUDE MOST OF THE AESTHETIC PROVIDERS.

Note to Tom: Wake up. Bad decision. Reverse it ASAP or face extinction (you will be outcompeted by a "real" open and honest forum). Now RealSelf is just a recruiting place for Plastic Surgeoins and Dermatologists.

Are you a board-certified plastic surgeon, facial plastic surgeon, or dermatologist? Get a free profile and participate to grow your web presence


Note to Tom Seery and all the PS and Derms. Go luck. Good-bye. Good riddens!

Your slight only makes us more determined and gives us energy. We WILL NOT be bullied. We will not be intimidated. We KNOW the truth.

03.8 | Unregistered CommenterWhoCares

The Investors:

Rich Barton
Richard Barton is the Chairman and Chief Executive Officer of Zillow.com. Before creating Zillow.com, Rich founded the online travel site Expedia. Expedia was started within Microsoft in 1994, and then spun out of Microsoft in 1999; Rich served as the President, Chief Executive Officer and a Director until March 2003. By that time, Expedia had grown to become the largest online seller of travel in the world. Rich also worked from 1991 to 1994 in various product management roles for Microsoft. He is currently a venture partner at Benchmark Capital and on the board of directors of Netflix and most recently, Avvo, Inc., an online company focused on the legal industry. Rich holds a Bachelor of Science degree in Industrial Engineering from Stanford University.

Second Avenue Partners
Second Avenue Partners is a Seattle-based provider of management, strategy, and capital for early stage companies. The firm’s venture fund is directed at emerging Internet businesses in the high-tech field. Second Avenue Partners investment approach is to make early-stage investments in promising ventures and build long-term relationships, actively assisting its portfolio companies in becoming market leaders.

http://www.realself.com/investors

Tom Seery, President & Founder
Tom has spent close to a decade on consumer web products, most recently for Expedia.com. At Expedia Tom launched the Experiences by Expedia vacation business and consumer-focused product extensions such as last minute travel.

Prior to Expedia Tom developed the affiliates program for VacationSpot.com -- the first online vacation rental search engine-- and managed large-scale projects for Unisys Corporation. Tom has masters degrees from Drexel University and the University of Washington and his bachelors from Connecticut College.

His team of geniuses:

http://www.realself.com/realself-seattle-team

3,000 doctors were recently removed from the RealSelf.com Find a Doctor listings and Ask a Doctor feature in order to improve the site consistency and experience for our community members.

Among those removed are doctors featured as "cosmetic surgeons" on popular TV makeover shows. We're proud to point out that our standards are higher than these media outlets.

To be a recognized expert on RealSelf.com, the individual must be a board-certified physician in one of the following specialties: Plastic surgery, Facial plastic surgery, Dermatology, Oculoplastic surgery. These specialties are often referred to as “core aesthetic specialties” as described in our comprehensive policies.

Why the change?

First, it should go without mention that we view it as our responsibility to provide the community with high quality information about aesthetics for the skin, body, and smile. Getting educated about all of the various treatment options and cosmetic procedures is daunting to even the most informed consumer. The more hype and hyperbole we can strip out, the better.

Secondly, we're not the medical experts. Instead, for medical opinion, we rely upon the volunteer participation by doctors who've demonstrated to medical authorities that they've achieved a clearly defined standard of training, education, and knowledge related to a specialty area of medical study.

It may very well be the case that all 3,000 of the doctors removed from the site offer quality aesthetic services. Yet, we believe standards in aesthetics are in place for good reasons, not the least of them, patient safety. RealSelf is not in the position to develop or offer an alternative means of recognition for expertise.

"I do not teach anyone; I only provide the environment in which they can learn."
- Albert Einstein

Of the tens of thousands of conversations on our site, with discussions ranging from acne scar treatments to Zoom teeth whitening, a key point of consistency is that we're the unbiased facilitators. We present information in a format that helps consumers make informed decisions.

Comments about the change in doctor listings? Please feel free to share. We're always open to feedback.

Some of the most experience and knowledgeable experts in the field of aesthetic medicine come from non-core backgrounds. Most plastic surgeons have their nurses doing the lasers treatments and injections. Most Dermatologists do aesthetic medicine part-time. The true experts are the doctors who do cosmetic medicine full-time. Some are dermatologists, but many come from non-core specialties.

Deleting all non-cores is not smart and is not in the best interests of the patients who come to this site. Tom, you are shooting yourself in the foot.

"At the County Fair, when all the folks guess the weight of the hog, there is a large variation in the guesses, but if you take all the guesses and average them, the average is usually within one pound of the true weight of the pig" -- R. Rox Anderson, MD.

I thought this is what RealSelf was trying to do. Get all opinions on the table and then let the people decide what made sense after seeing a wide variety of thoughts and opinions.

RealSelf.com has just removed a significant voice at their County Fair. They have infact, removed a voice that is most likely to know the weight of the pig. I think that excluding the non-core voice will make RealSelf's value and relivence much less.

Bad move, Tom. You really should reconsider. I can be reached at jeff4459@aol.com if you have any questions.

03.19 | Unregistered CommenterJEE

Not only are Realself.com's standards 'higher' than medial outlets, they're higher than medical licensing! Nice.

"with discussions ranging from acne scar treatments to Zoom teeth whitening" Wow. Zoom teeth whitening? Better get a specialist. The arrogance is astounding.

Yeah. I'm with Ex Realself.com MD. Toms comment is disingenuous at best. Eliminating the voices of three thousand licensed physicians gives proof to the lie that Realself.com is an "unbiased facilitator". Give me a break.

03.19 | Unregistered CommenterDermgal

Dermgal,

Don't worry. I have heard that MAPA MAN, Dr. Jeff Epstein and his crew are working on a solution to this problem.

It seems RealSelfish.com has sold out for the almighty dollar!! That does not mean three thousand knowledgeable physicians will be with out a voice.

03.19 | Unregistered CommenterFlorida PA

Does non-core mean physicians without formal surgical training?
Or, physicians interested in performing peels and laser services who did not received expensive training in the treatment of burns during their residency training?
Does it really make sense to anyone to have anyone other than a surgeon answering questions about plastic surgery. or, a plastic surgeon or a derm answering questions about lasers, particularly ablative lasers?

03.20 | Unregistered Commentermkel

mkel,

You have to be kidding. The better question is do you want a dermatologist that has not used a CO2 laser since residency answering questions or a non-core physician that uses the laser every day? I will take the non-core physician every time. The derms around me all dabble in the laser world but know little about it and the plastic surgeons have a nurse do the procedures.

So now who are you going to trust?

03.20 | Unregistered CommenterLH

I do my own CO2 and Nd:YAG lasers.
No nurse doing it here.


TF (a PS)

03.20 | Unregistered CommenterTF

TF,

I believe that from you. I have a ton of respect for you.

LH

03.20 | Unregistered CommenterLH

"I do not teach anyone; I only provide the environment in which they can learn."
- Albert EinsteinIt

It is intersting an ironic that Tom Seery would use Albert Einstein to prove his point. Albert Einstein was a clerk in a patent office when he developed his special theory of relativity, which, as we all know, changed the world of physics forever. It just goes to show what one can do without a "formal" education.

To exclude "non-core" physicians from a dialogue on cosmetic medicine is truly a disservice to the entire industry.

Thie battle between "core" and "non-core" is territorial battle and one of semantics only. In the end, a patient will patronize the physician who gives him/her the best results irrespective of training.

It is commonly believed that liposuction is the domain of plastic surgeons, yet, I cannot tell you how many redoes I've had to do by board certified plastic surgeons.

Just food for thought.

03.21 | Unregistered Commenterbobox doc

...and one would think that screening for the most common diseases is the domain of primary care physicians, but yet I keep finding previously undiagnosed diabetics in patients presenting to me for tummy tucks with obvious abdominal obesity and metabolic syndrome.. These patients literally say, "I came in here for a tummy tuck - and you saved my life".

I do refer them back to their primary care physicians, but with the relevant investigations completed, and patient teaching done.
And, I don't slam these physicians in print.

As you say bobox doc (sic), "food for thought".

TF, your friendly neighborhood PS

03.22 | Unregistered CommenterTF

For the record:

According to the biography on Einstein at nobelprize.org:

Albert Einstein was born at Ulm, in Württemberg, Germany, on March 14, 1879. Six weeks later the family moved to Munich, where he later on began his schooling at the Luitpold Gymnasium. Later, they moved to Italy and Albert continued his education at Aarau, Switzerland and in 1896 he entered the Swiss Federal Polytechnic School in Zurich to be trained as a teacher in physics and mathematics. In 1901, the year he gained his diploma, he acquired Swiss citizenship and, as he was unable to find a teaching post, he accepted a position as technical assistant in the Swiss Patent Office.


So, Einstein was indeed formally trained as a physicist and mathematician. He just couldn't find a teaching job, and so he took the job at the Patent Office, which allowed him plenty of spare time to think about interesting topics. He wasn't some sort of hobbyist who dabbled in physics after taking a couple of weekend courses.

03.22 | Unregistered CommenterTF

TF,

I think you have validated the argument that it is not JUST the training of the physicin that matters. It is the physician and their interest in what they do that matters.

I think there are many non-core physicians in the aesthetic market that know more about the lasers, injectables and minimally invasive procedures than core physicians. I probably put more time into staying up with new procedures and patients options than most core physicians.

I work with more lasers and technology for aesthetics than all of the dermatologists in my area combined. As I have talked to local plastic surgeons, i have learned how little they know about lasers. I think you probably have more knowledge of lasers than 99% of plastic surgeons.

So again i ask the question: Who would you want using a laser on you? the core trained physician that uses the laser once every couple of weeks(that is if they even do the procedure and do not have a nurse do it) or the non-core physician that uses the laser on a daily basis.

03.22 | Unregistered CommenterLH

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