Feeling sorry for plastic surgeons

For her new book, American Plastic: Boob Jobs, Credit Cards, and the Quest for Perfection, Laurie Essig spent time interviewing plastic surgeons. She was interviewed herself on Salon, where she was asked what else surprised her — besides statistics like 85% of cosmetic surgery is purchased on credit and over 70% of patients earn less than $60,000 a year. (emphasis added)

One of the things that surprised me is how out of control the cosmetic surgeons themselves felt in all this. I felt a lot of sympathy for the cosmetic surgeons, even when they were telling me that I needed a facelift. Cosmetic surgeons are primarily men, well over 90 percent. They’d gone to medical school and they came out with huge amounts of debt themselves, often well over $200,000. They meant to be reconstructive surgeons, they meant to fix people after horrific accidents or cancer, and they started doing some boob jobs on the side and it started to eat up more and more of their practice because it was so lucrative. They want to send their kids to nice schools, they have mortgages, they have family, and you could see that they felt a little bit helpless as well. It wasn’t what they meant to do.

They seemed just as much products of the system as the middle-aged women going in for a facelift or boob job. They were hoping for a better future. Of course, they create the desire — they advertise, people come into their office and they tell them what they need — but I think that if they hadn’t graduated from school with so much debt, most of them would be selling cosmetic procedures a lot less than they are.

A compassionate view and undoubtedly true. For a similar and depressing take on the financial dilemma of primary care physicians, see the comments following my post on KevinMD, Marcus Welby and the relentless growth of specialization.

Cosmetic surgery and the neoliberal agenda

Don’t be misled by the compassion into thinking Essig’s book lacks critical insight. One of the book’s aims is to show the connection between the current popularity of cosmetic surgery in the US and the economic conditions responsible for this trend. It wouldn’t have happened without neoliberalism (“Rising economic insecurity was met with a fiercely reinvigorated ideology of individual responsibility that led many Americans to seek ‘individual solutions’ to their economic insecurity”) and easy access to credit.

She quotes a Beverly Hills cosmetic surgeon:

Medical credit is a good example of how the rich have gotten richer because of the deregulation of banking. And the poor poorer. …

Using medical credit is stupid for surgeons and patients. These companies are often charging us surgeons 5 percent on top of what they’ve already charged the patient. So they get breast implants for $8,000 and they end up paying $12,500? It’s so stupid. The banks and other middlemen are making the money and these big corporations that back them, like GE … I get a check from GE! But sometimes they’ll say they can’t pay me because the patient isn’t paying them. Really? A huge corporation like GE can’t pay me? …

But these guys [bankers] get all the breaks. Look what we’re doing now. We’re bailing out the bankers when they’re the ones who screwed everything up. No one bails me out if I screw up.

For more online, see Essig’s essay in The Chronicle, “Conscious During Cosmetic Surgery,” plus there’s an author video on Amazon where she discusses her book.

If you appreciate penetrating economic and sociological insight into the intersection of modern medical practice with the American pursuit of perfection, I recommend this book highly.

Resources:

Image: fanpop!

Laurie Essig, American Plastic: Boob Jobs, Credit Cards, and the Quest for Perfection

Genevieve Walker, Plastic surgery’s wicked triumph, Salon, January 28, 2011

Laurie Essig, Conscious During Cosmetic Surgery, The Chronicle, January 20, 2011