The medical profession is changing before our eyes. To be a physician today requires more than clinical skills and a basic business skill set. As a society, we are more connected than ever. Physicians need to function effectively both in the real world and the virtual world. In addition, federal and state regulation is playing a greater role in dictating the way we interact with patients and the details of how we practice medicine and run our businesses. Meeting these legal and regulatory standards can be onerous and add hours to the workday and financial strain to office overhead.

The combination of increased regulatory burdens and changing social conditions is producing an environment with decreased privacy for physicians and patients. It seems anathema: HIPAA was instituted to protect patient privacy. However, the electronic medical records mandates were formulated to collect patient data. And physician records of Medicare and insurance payments are available to the public.

The aesthetic physician is not immune. Consulting honorarium collected from any pharmaceutical company by a physician is visible on government websites even when the drug or device is used only for cosmetic purposes. Electronic documentation may not reflect a physician's thought process as well as the written chart, which could be problematic in a malpractice suit. Keeping up an active website and social media presence is de rigor for the aesthetic practice, but also opens the physician to new types of legal risk. Are before and after photos guarantees of success for new patients? Does a physicians presence online and in the media make him or her a public person for whom libel might be permitted? And how much should the physician worry about potential damage to a medical reputation from anonymous negative comments posted on online physician review sites? How does a physician and practice protect their brand?

This edition of Modern Aesthetics® tackles a breadth of these and other issues of privacy, branding, regulation, and protection. Topics range from setting rules for employees' use of social media (personal and business), new platforms for physicians to build their brand online, how to use patient photographs online for marketing and media purposes, best practices for navigating the complex world of insurance, and tips for protecting your inventions.

Physicians who started practicing 30-plus years ago mourn the golden age of medicine, when they could evaluate and treat patients based on their medical judgment, document in a way that reflected their thought process, and accept fair payment for which most patients had insurance. Those of us who began our careers since then have seen our autonomy errode. These issues are not going away and will likely become more restrictive. It is inevitable that every detail of how physicians practice medicine will face increasing scrutiny. As individuals and groups, core cosmetic physicians must address current and future challenges in order to continue to take the best possible care of patients and enjoy doing it.

Co-Chief Editors

Heidi Waldorf, MD, FAAD, and

Steven Dayan, MD, FACS