viewpoint
Who Wants to be a "Botoxicologist"?

While I wait patiently to see where my jealous side next rears its ugly head, I have time to reflect on the trends of past decades.

During the 1980s I said that if I were starting a practice I would hang out a shingle that said "Cataractologist." That's what I loved to do. It's what I was trained to do. It didn't hurt that there was an endless supply of Medicare money and patients learning about the miracles of IOLs.

During the 1990s I said that if I were coming out then my shingle would say "LASIKologist." That was pretty obvious. Why set up a high-cost ophthalmology office when with a few techs and a laser you could make a living without hassling with insurance?

What would I do if I were finishing training now? Would I laser-etch a sign saying "Botoxicologist"? Knowing little about the subject only fuels my jealousy. Maybe instead of having expensive examining rooms I would only need a chair for the patient. Instead of a surgicenter I would need a box of syringes and some alcohol wipes. Instead of an insurance office I would need a credit card swiper. Instead of trying to collect $20 co-pays I could forget about them completely. Instead of getting $650 later in the year for taking out a cataract, I could get $900 right now for injecting wrinkles. Instead of a single treatment to each eye, I could treat each patient four times a year.

Maybe instead of surgery patients demanding free care for life, my patients would expect their treatment to wear off in 90 days, and then come back for more. Instead of patients with poor outcomes having years to dwell and maybe sue, my new patients with poor outcomes would be back to normal in 12 weeks when the effect wears off! While the laser market is shrinking, the wrinkle market is still growing wildly!

Is There a Futureologist in the House?

But wait. What if the Botoxicologist ends up following the same path as the Permanent-Eyelinerologist of 20 years ago? Originally applied only by physicians, permanent eyeliner is now available in many cases from folks with a high school diploma and a stint in Cosmetology or Tatooology School.

I think I'll stick to treating sick patients after all. However, those of us who believe that injecting a toxic agent into the critical muscles of the face is best left in the hands of a doctor should see to it that's where it stays.