new m.d.
"Glam" Medicine

ast week, while driving down Ventura Boulevard in my rental car, I was broadsided by a radio ad. Between pop songs, a lady with a cool, raspy voice was casually promoting the services of a local plastic surgeon. She was offering free lip injections with breast enhancement surgery. What a deal! She made it sound like a delightful way to spend an afternoon — just breeze in to their aesthetic surgery center, pay a nominal fee, undergo the little procedure, and enjoy new and improved lips and breasts. It made a trip to the barber for a trim sound like a more arduous decision, requiring far more effort, sacrifice and judgment.

In spite of my near paralyzing alarm, I was luckily able to safely pull my rental car into the local In and Out Burger without hitting any parked cars or pedestrians.

There was something shocking about the casual and flippant manner in which she was pitching this procedure, never mind the promotional offer itself. I was chagrined by the placement of this add on a pop radio station, in earshot of any self-conscious and impressionable teen. Does the public not view this as an invasive surgical procedure with numerous risks and significant morbidity? Is there a disparate perception of plastic surgery relative to the rest of medicine that an invasive procedure such as breast augmentation is met with such astonishingly casual regard?

In my opinion, this ad trivializes the capabilities of our colleagues in plastic surgery and distorts the public's perception of medicine in general. I'd even go as far to say that these types of ads erode the credibility and respect our predecessors in medicine have assiduously built over the preceding few hundred years. In the long run, neither patient nor physician will stand to benefit in such a milieu. I must say, for a moment, I was ashamed to be a physician.

For ophthalmologists, particularly refractive surgeons, advertising to the public is commonplace. It allows us to promote our services, and is a tool to educate and motivate patients to further investigate their treatment options. Our refractive procedures are both intrinsically rewarding to us as surgeons, and are relatively safe and painless for our patients; they profoundly impact our patients' lives, allowing spectacle independence and an overall improved quality of life. This is still surgery we are talking about, and we must continue to be mindful and exercise tact and good judgment in the content and context of our advertisements.

The New Advertising Generation

The era of advertising in our profession was ushered in decades ago following the forceful intervention of the Federal Trade Commission and the eventual Supreme Court ruling against the American Medical Association. So, regardless of our wide range of attitudes and perceptions, it is here to stay. Furthermore, physicians of my generation may be more tolerant of advertising. We've been the target of advertisers since we were old enough to flip on the television and watch Scooby Doo. I just hope my generation can be mindful enough to not chip away at the trust and respect we are afforded in our profession, or compromise our unique role in society by promoting tactless advertising. Can we at least stay away from MTV?

Howard Amiel, M.D., is a fellow at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia. His e-mail is howard_amiel@brown.edu.