I'm on vacation this week which is why I've been so productive with the blog.

I saw this on FOX-News, but it's been picked up by the DrudgeReport as well. Entrepreneurs in New York have come up with "drive-thru" clinics to give BOTOX to walk-in clients. While this is convenient, I think this is a somewhat troubling trend.

Allergan, the parent multi-national conglomerate, who owns BOTOX, the Lap-Band weight loss surgical device, Juvederm skin filler, and other products has taken a page from the pharmaceutical industry in how they market. Allergan bought Inamed Corp. in 2006 to also become the world's largest breast implant maker and are now arguably the world's premier cosmetic medicine complany.

To these corporations, Doctors are an inconvenient middleman in their product distribution systems. Big pharma realized this years ago by slashing their budget for detailing physicians & concentrating it on print and media ads directed at consumers. What they want is for people to show up asking for their drug by name when they go to the doctor.

Allergan has thrust out it's formidable marketing team with huge media pushes for BOTOX & Juvederm (their hyaluronic acid filler aimed at knocking off market-leader Restylane), with TV ads on Grey's Anatomy and other popular shows featuring actress Virginia Madsen (co-conspirator Tony Youn mentioned this here last month).

From the Orange County Register, in an article titled "Allergan rethinks marketing of Botox, implants."

In its new breast-implant campaign, for example, Allergan's marketers imply that implants are artful, like designer clothing. Even though implants are basically plastic bags filled with silicone or saline solution, Allergan portrays them as sources of power, freedom, individuality and self-confidence.

That's a big change from last year, when Allergan bought Santa Barbara-based Inamed and its breast implants for $3.2 billion. Then, the implants were labeled "Style 68," "Style 101," etc.

The old labels were cold and clinical, so Allergan is giving them a new identity that sounds natural, feminine and artful. In a new marketing campaign, they're the "Natrelle collection of breast implants."

Write this down: Expect to see lots of feisty press releases from the anti-breast implant crowd over this for the wrong reasons (ie. a non-demonstrable auto-immune disease risk). The underlying concept of direct-marketing this type of surgery makes me uncomfortable as it will further trivialize what is an operation and aftercare that is anything but simple.

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Believe it or not, advertising of services by Doctors was not only frowned upon, but considered illegal in many instances. What changed that? A case brought by a lawyer (Bates v. State Bar of Arizona) who sued the state bar which was at that time prohibiting all advertising. It worked it's way up to the US Supreme Court (SCOTUS) who sided with the plaintiff and ruled that while states may regulate some aspects of advertising, "...a blanket prohibition against advertising by attorneys was unconstitutional as a violation of the first amendment."

(If your a political junkie like me)It's interesting that the SCOTUS is currently poised to strike down the Bipartisan Campaign Reform Act of 2002 (aka the "McCain-Feingold act") legislation restricting corporate-funded campaign advertising in print and television on similar first amendment grounds after a challenge was heard last week in Washington.




After Bates v. State Bar of Arizona, the American Medical Association adjusted their Code of Medical Ethics position suggesting that there be no restrictions except those "justified to protect the public from deceptive practices....(and that) communications shall not be misleading because of the omission of necessary material information, shall not contain any false or misleading statement, or shall not otherwise operate to deceive" (the current statement can be read here)

Advertising has exploded in Plastic Surgery and related fields in cosmetic medicine. At this point there is little regulation about how your advertise your expertise and skills. Like we've seen over and over in the media, there are case where complications after cosmetic surgery occur and the patient contends that they were led to believe their doctor was a Plastic Surgeon. I highlighted a few cases last year involving scope of practice issues involving Ear, Nose, & Throat (ENT) surgeons doing breast & body surgery called "ENT (ear,nose, & thighlifts?)" and "A monster in Munster...". At least those instances involved surgeons of some kind as opposed to the radio-station contest featuring an ER doctor on probation doing breast I talked about in April. click here.

This argument of misrepresenting one's training frequently becomes an element of claims in malpractice cases under fraud or failure to accurately give informed consent.

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