Sunday, August 3, 2008

Top medical ethicist slams unprincipled plastic surgeons

The head of the Israel Medical Association's ethics bureau has attacked plastic surgeons who place illegal advertisements, aggressively market needless operations and "use people" to make their fortunes.


Prof. Avinoam Reches, who is also a senior neurologist at Hadassah University Medical Center, was speaking on "The Ethics of Esthetics" at Thursday's all-day Israel Medical Convention, organized by Hadassah and two other hospitals and sponsored by a variety of groups at the Jerusalem International Convention Center.

Reches said esthetic surgery was a NIS 500 million to NIS 600m. industry in Israel, and presented dozens of advertisements from newspapers and Web sites in which plastic surgeons promised to make people "beautiful," based on exaggerated expectations, and change their lives

Plastic surgeons often...

Some unethical practitioners offer journalists a free makeover and then expect them to write flattering copy, according to Reches. One ad shows a doctor wrapped in (false) bandages and sitting in an idiotic pose on a surgical table to promote his specialty. This, insisted Reches, was "an embarrassment to the medical profession." Such physicians "create mass psychoses and turn doctors into 'renovators' of the human body."

Some plastic surgeons offered "Botox parties" to which women were invited as a group and underwent injections for their wrinkles one after another, Reches said. Promotions for "discounted" plastic surgery appear in catalogues along with TVs and vacuum cleaners. He conceded that public hospitals, including Hadassah's for-pay Hadassah Optimal, offered esthetic surgery that was not covered by health funds, and that their standards were much higher and not aggressively marketed.

Although doctors were permitted to advertise, they could not include prices or make exaggerated claims about their skills and experience, Reches said.

Most of the advertising violations investigated by the IMA's ethics bureau involved plastic surgeons, he said. "They buy whole pages in newspapers and invent questions that they answer. They create diseases that don't exist and illegally give names of famous people who used their services. They also display parts of the body that may not be published in such ads."

Dr. Roni Moscona, an experienced plastic and reconstructive surgeon at Rambam Medical Center in Haifa and the private Ramat Aviv Medical Center, said he could defend his profession but not doctors who advertised and made exaggerated claims. "I believe that a doctor will get patients if he is a good doctor; the word spreads," Moscona said.

Although plastic and reconstructive surgeon can't claim to save lives, Moscona said, it did improve the quality of life of many patients, and satisfaction rates in the US, for example, were "between 80 percent and 90% - a figure that no other medical specialty can beat."

As no parent would hesitate to improve a child's looks with orthodontic treatment, Moscona added, there was no reason why people who were disfigured or terribly unhappy with their body should not try to change them. But he denounced surgeons who performed unnecessary surgery, as on the now-deformed Michael Jackson, and said doctors were now allowed to advertise within limits, thanks to a Supreme Court decision by then court president Aharon Barak.

Moscona criticized the Health Ministry for allowing companies to put its stamp of approval on products that falsely claimed to improve the shape of breasts "without surgery or pain," and showed an ad that said it even had kashrut approval from the Rabbinate. Ministry approval means only that something is not harmful to health - but not that it offers any benefit.

Moscona said he had hundreds of letters from patients who said he "changed their lives" by eliminating physical deformities.


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