Modern Aesthetics | Editors' Message
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Editors' Message

By: Heidi Waldorf, MD, FAAD and Steven Dayan, MD, FACS


We live in a crowded and busy world. Economically, technologically, socially…complexities are everywhere. As physicians who own businesses and are responsible for the care of patients, we find ourselves working our way through the various intersecting intricacies that now encompass our nation’s healthcare system. Lately, however, changes are coming so fast and furious that many practitioners are finding it difficult to keep up. Perhaps it is with some irony, then, that the very thing that’s meant to ensure fairness and legal security in our increasingly fractured society is actually responsible for much of the hardship many of us struggle to overcome: Regulation.

In theory, while the intent of regulation is good and the objective admirable, in practicality the restrictions, requisite paper work, and administrative work now required of doctors has become a massive burden that’s making good medical care increasingly harder to access and to practice. While some of us may point to the Patient Protection and Affordable Care Act, otherwise known as “Obamacare,” as the source of many of today’s problems in the healthcare industry, the crippling effect of regulation goes well beyond.

Take, for example, the Federal incentive program for use of Electronic Medical Records (EMR). Soon, physicians will pay a penalty on their Medicare reimbursements if they are not “meaningful users” of an EMR. Though the idea of incentivizing physicians to go digital appears to make some sense in the bigger picture, lawmakers are often blind to the logistical details of implementing such laws and also to the realities of medicine. One need only talk to someone with an EMR to learn of the many difficulties entailed in not only implementing the system but also attempting to maintain a similar flow of operations and patient communication.

EMRs are just one slice of the pie, though. The compendium of regulatory affairs physicians must deal with— health insurance, OSHA, HIPPA, Workers Comp, professional/ business insurance, etc.—make it nearly impossible to manage all of the liabilities and regulations needed to run a practice that is also a small business. That may explain why physicians are fleeing from private practice at an alarming rate, the effect of which may be devastating on the healthcare system as well as everyday communities in the not-too-distant future.

In this edition of Modern Aesthetics you’ll find articles that tackle regulation from various angles, from strategies for conducting ourselves and our businesses in the unregulated online world, to understanding and preparing for laws that will affect aesthetic medicine, such as The Sunshine Act and the Affordable Care Act. Given the wide spectrum of regulation, we expect the topic will be something we return to on a recurring basis in future editions of Modern Aesthetics.

The reality is that regulations will likely never go away. And while we need to learn to manage them and live within them, it is incumbent on us as physicians to not let ourselves be regulated into extinction. We owe this not only to ourselves and future generations of physicians, but more importantly to the well-being of our patients.