Blog: Pretty Hurts

Malcolm Gladwell wrote in "Outliers" that 10,000 hours of practice is the magic number to become an expert at a trade, which is why Dr. Derek Jones gets a little nervous about physician extenders performing dermatologic surgery procedures.

At the annual meeting of the American Society for Dermatologic Surgery in Washington, Dr. Jones reported that RNs receive 500 hours of clinical training, nurse practitioners receive 500-1,500 hours, physician assistants receive 2,800 hours, and dermatologists receive 18,720 hours.

Taking this into consideration, one can understand why Dr. Jones, who is in private practice in Los Angeles, seemed to be disturbed by the syndicated television program "Pretty Hurts," a soap opera-like reality show that documents Rand Rush, RN, (yes, you read that right: RN) as he injects wanna-be celebrity patients in his Beverly Hills office.

"Pretty Hurts is your insider OMFG view into the ridiculous, painful and ugly truth behind maintaining beauty in Hollywood," according to the show's summary. "Once you experience the extreme stop-at-nothing obsession with youth that has become standard in Beverly Hills, you'll never look at 'pretty' the same way again."

According to Rand's website, he is under the supervision (as required by California law) of Dr. Norman Leaf, a plastic surgeon. But, on the show, he appears to be performing with little to no physician supervision.

So who is to blame for non-physicians performing these aesthetic services? "We are," said Dr. Jones. Dermatologists are organizing and teaching at courses geared towards physician extenders.

While he does not believe that it is inappropriate to teach extenders, he said, "What we need here is a rigorous post-training residency program for physician extenders that levels the playing field. We are not going to see physician extenders go away. The genie is out of the bottle." But, he added, more rigorous training would help protect ourselves, our patients, and the specialty.

Dr. Jones disclosed conflicts of interest with Allergan, Galderma, and Merz.

What do you think? Should physician extenders be allowed to perform cosmetic services, such as laser hair removal and cosmetic injections?

-- Amy Pfeiffer

Malcolm Gladwell wrote in "Outliers" that 10,000 hours of practice is the magic number to become an expert at a trade, which is why Dr. Derek Jones gets a little nervous about physician extenders performing dermatologic surgery procedures.

At the annual meeting of the American Society for Dermatologic Surgery in Washington, Dr. Jones reported that RNs receive 500 hours of clinical training, nurse practitioners receive 500-1,500 hours, physician assistants receive 2,800 hours, and dermatologists receive 18,720 hours.

Taking this into consideration, one can understand why Dr. Jones, who is in private practice in Los Angeles, seemed to be disturbed by the syndicated television program "Pretty Hurts," a soap opera-like reality show that documents Rand Rush, RN, (yes, you read that right: RN) as he injects wanna-be celebrity patients in his Beverly Hills office.

"Pretty Hurts is your insider OMFG view into the ridiculous, painful and ugly truth behind maintaining beauty in Hollywood," according to the show's summary. "Once you experience the extreme stop-at-nothing obsession with youth that has become standard in Beverly Hills, you'll never look at 'pretty' the same way again."

According to Rand's website, he is under the supervision (as required by California law) of Dr. Norman Leaf, a plastic surgeon. But, on the show, he appears to be performing with little to no physician supervision.

So who is to blame for non-physicians performing these aesthetic services? "We are," said Dr. Jones. Dermatologists are organizing and teaching at courses geared towards physician extenders.

While he does not believe that it is inappropriate to teach extenders, he said, "What we need here is a rigorous post-training residency program for physician extenders that levels the playing field. We are not going to see physician extenders go away. The genie is out of the bottle." But, he added, more rigorous training would help protect ourselves, our patients, and the specialty.

Dr. Jones disclosed conflicts of interest with Allergan, Galderma, and Merz.

What do you think? Should physician extenders be allowed to perform cosmetic services, such as laser hair removal and cosmetic injections?

-- Amy Pfeiffer

Malcolm Gladwell wrote in "Outliers" that 10,000 hours of practice is the magic number to become an expert at a trade, which is why Dr. Derek Jones gets a little nervous about physician extenders performing dermatologic surgery procedures.

At the annual meeting of the American Society for Dermatologic Surgery in Washington, Dr. Jones reported that RNs receive 500 hours of clinical training, nurse practitioners receive 500-1,500 hours, physician assistants receive 2,800 hours, and dermatologists receive 18,720 hours.

Taking this into consideration, one can understand why Dr. Jones, who is in private practice in Los Angeles, seemed to be disturbed by the syndicated television program "Pretty Hurts," a soap opera-like reality show that documents Rand Rush, RN, (yes, you read that right: RN) as he injects wanna-be celebrity patients in his Beverly Hills office.

"Pretty Hurts is your insider OMFG view into the ridiculous, painful and ugly truth behind maintaining beauty in Hollywood," according to the show's summary. "Once you experience the extreme stop-at-nothing obsession with youth that has become standard in Beverly Hills, you'll never look at 'pretty' the same way again."

According to Rand's website, he is under the supervision (as required by California law) of Dr. Norman Leaf, a plastic surgeon. But, on the show, he appears to be performing with little to no physician supervision.

So who is to blame for non-physicians performing these aesthetic services? "We are," said Dr. Jones. Dermatologists are organizing and teaching at courses geared towards physician extenders.

While he does not believe that it is inappropriate to teach extenders, he said, "What we need here is a rigorous post-training residency program for physician extenders that levels the playing field. We are not going to see physician extenders go away. The genie is out of the bottle." But, he added, more rigorous training would help protect ourselves, our patients, and the specialty.

Dr. Jones disclosed conflicts of interest with Allergan, Galderma, and Merz.

What do you think? Should physician extenders be allowed to perform cosmetic services, such as laser hair removal and cosmetic injections?

-- Amy Pfeiffer