Medical Spa Lawyer
Paddy Deighan, the Premier Medical Spa Lawyer

Ethical Considerations in an Aesthetic Medical Practice

Ethical Considerations in an Aesthetic Medical Practice

There is no question that aesthetic medical providers face a higher risk of professional liability. Aesthetic medical providers take great care in selecting appropriate liability insurance coverage. However, it is equally true that such providers also face a greater risk of ethical allegations and they can come from a variety of sources (unlike liability that typically stems from the provider – patient relationship). Ethical allegations can result from advertising or conduct unrelated to your practice of medicine. Additionally, aesthetic medical patients have higher expectations from aesthetic medical procedures and they demand a higher level of outcome and expectation. If they do not receive their expected outcome, it is your fault!! Many attorneys that represent disgruntled patients in a professional negligence matter will suggest that the patient file ethics violations first. If there is a finding of ethical violations from the state, the attorney will utilize this finding to allege negligence in the liability claim.  Attorneys can argue that it is “unethical” to utilize a medical device or product in an “off label” manner. Virtually every aesthetic medical provider utilizes medical products and devices in an “off label” manner (Botox Cosmetic, dermal fillers and many laser procedures are examples). The attorneys will instruct the client/patient to file the ethics complaint that alleges that the treatment was “off label” and therefore unethical, per se. Accordingly, aesthetic medical providers are at a higher risk of ethics complaints than their traditional medical colleagues.

I have discovered that most aesthetic medical providers are not clear on what they should do if they have an ethical situation.

The first consideration in this discussion is patient selection.  If your instincts tell you that a particular patient may expect too much or have unrealistic expectations, do not treat them!  I advise providers that “it is not the patients that you treat that will make you successful, it is the patients you choose NOT to treat that will make you successful.” Marketing 101 dictates that it takes 10 successful patients to get one referral but it only takes one disgruntled patient to lose 10 patients. Many ethical issues arise out of unrealistic expectations of the patient. Avoiding certain patients from the outset will substantially lower your risk of ethical allegations. Patients complain to a medical board because they are not happy in the result and of course it is the provider’s fault.

In regard to patients, document EVERYTHING in the chart…and document proximate to the time of the discussion with the patient. Do not document a chart a week after the patient discussion!

The next significant source of ethical situations is advertising.  We can devote an entire series on this topic, but for the purposes of this article, understand the advertising and issues are highly correlated.

Finally, ethical situations can arise from conduct in your personal life that is entirely unrelated to the practice of medicine. Even Driving While Intoxicated charges have resulted in providers facing the state medical board. The trend is toward more scrutiny.

There is a global ethical issue that many aesthetic providers fail to consider and it can be very damaging.  I will state in advance that this seems totally unreasonable, BUT you have a duty to disclose to your state medical board and certification board any conduct which may become an ethical issue in the future. If something occurs in the office that MAY put you in an ethical conundrum, you have to report it. Failure to report it can give rise to additional sanctions or loss of board certification. Affirmatively reporting also decreases the risk of severe sanctions for alleged unethical situations because you cooperated in advance.

I strongly recommend that whenever you feel that you are in an ethical conundrum, write to the state medical board and ask for their guidance.

This is very powerful.  They cannot charge you with an ethical violation if they participated in the course of action! They may choose not to respond to your query, but the fact that you sought their guidance and counsel is very compelling.

So, What DO I Do When I am Notified of an Ethical Investigation?

If you receive a letter from your state board licensing board, pay strict attention to the action items that the board is requesting. The boards typically ask for a response within ten days.  I suggest that you formulate an initial response that acknowledges receipt of the allegation and tactfully denies that any unethical conduct was conducted.  Also indicate that your initial response is a preliminary one. You will provide a more thorough reply after you review the chart and interview any staff members that were involved in the patient care. I should also mention that any of your staff can create unethical situations and the medical provider is responsible for these too. Everything stated in this article pertains to the medical providers and staff since you are responsible for their conduct. An example of provider ethical liability for a staff member is when a staff member divulges confidential information.

I suggest that you send a definitive response about thirty days after your initial reply. Do NOT wait for the state board to ask for the additional response. The definitive response will include your version of an incident as well as any supporting documentation. It is important to interview staff members that may have engaged the patient and include a summary of their version of the incident. The fact that you thoroughly investigated the matter prior to response will go a long way toward a successful outcome. It is prudent that you do not say anything negative about the patient!  Remember that if the patient has anger issues, unrealistic expectations or other psychological issues, you should not have treated them! Refer to the disgruntled patient with empathy and respect in all of your correspondence.  Express sorrow that the patient feels that something unethical occurred.

You may not receive any additional correspondence from the state licensing board for a long period of time (a year is not unusual).  This does not indicate that the board is no longer pursuing the matter. The entire process can take up to three or four years. It is also prudent to hire an attorney to represent you. Many physicians indicate to me that they are afraid to hire an attorney because it may appear that they are guilty.  There is nothing further from the truth. There are procedural guidelines and rights that you have and it is proper to hire an attorney to represent you. The state boards expect this and it is the responsible thing to do.




Another aspect of ethical allegations is that you have a duty to report the allegation to your certification board and most organizations to which you are a member.  The certification boards require this as a condition of your board certification or membership. Failure to report alleged ethical violations will frequently result in loss of board certification!! This also applies to member organizations such as the American Society of Plastic Surgery (ASPS) or the American Academy of Dermatology (AAD). In fact, if you read the regulations of certification boards and member organizations, you will see that you have to report a wide variety of events such as Driving While Intoxicated or alleged insurance fraud from even a home owner’s insurance claim.

In order to comply with the licensing board or member organization requirements, you only need to send a letter that indicates that an allegation has been made against you and that you are appropriately responding to the allegation and that you believe there is no merit to the allegation. You will probably never hear from them again, but you will have complied with the requirements for certification or membership. Most of your colleagues have not complied with these notice requirements, and if you do comply, there is a much greater chance that nothing will happen to your certification or membership.

Paddy Deighan J.D. Ph.D




25 Responses to “Ethical Considerations in an Aesthetic Medical Practice”

  1. Hello there, I uncovered your website by the use of Search engines when you are evaluating an identical matter, your web site showed up, it seems good. I have included in my own favourites|combined with bookmarks.

  2. Hey there! I understand this is somewhat off-topic however I needed to ask.
    Does building a well-established blog such as yours take a lot of
    work? I’m brand new to blogging but I do write in my diary every day.
    I’d like to start a blog so I can share my experience and feelings online.
    Please let me know if you have any recommendations or tips for brand new aspiring bloggers.
    Appreciate it!

  3. Gossip Girl is produced by College Hill Pictures, Alloy Entertainment in association with Warner Bros.
    Look no further pertaining to today’s coolest, sleek and stylish promenade gowns to the
    New Year. Its have the strapless dress, the herve leger
    strapless dress from our Herve Leger collections are
    inspired by previous designs and outside influences. Frye
    is always a great brand to look at when looking for premium boots, and they have a
    great selection of cowboy styles. Your job would be a lot easier if
    you could simply hide them under layers and layers of blankets and comforters, but children will want to go out,
    play, and explore outside. Donovan also shot
    photographic essays in documentary style such as ‘The Lay about Life,’ which is comprised of
    images from an ordinary kitchen in Notting Hill
    Gate with people smoking and eating breakfast round a
    cramped table, a payphone and Graffiti from the area.
    Lady Gaga Opens 2011 MTV VMAs and Goes Topless in a MTV VMAs Promo Clip.
    With the celeb trend phenomenon at its recent state,
    it is not unusual to locate designers attempting their ideal to
    get their most recent fashions showing on today’s hottest celebrities.
    And that’s the reason why super star evening attire are a primary hit of all.
    If a celebrity trend is meant to be repeated by the general public,
    you will be able to compliment rather than stare with horror at the woman
    in front of you at the local grocery store check-out line.

  4. However, there are also a couple of things to remember.
    As long as you follow this very carefully with strict compliance
    for 3 weeks, you will be able to keep your last diet weight.
    In his office in Miami, Florida he has diagnosed in
    excess of 30,000 women and men with metabolic and weight
    difficulties. Remember, healthy diets are essential for safe and quick weight loss.
    This is the other major category of reasons when HCG stops working.

  5. ‘ Propecia is meant to be used in men suffering from male pattern baldness after consulting a doctor.

    If the drugs damage cell activity during the anagen phase, then hair loss is noticeable within a couple of weeks.
    Autoimmune problems such as baldness and psoriasis are known to be exacerbated by stress; daytime fatigue and emotional distress are the most commonly reported symptoms of sleep deprivation.

  6. Two questions frequently asked by Network Marketers are What kind
    of business records do I have to keep for the IRS. It provides comprehensive solutions to every
    accounting problem related to your business. It
    is being embraced by students all over the world with a great vigor;
    a course called Sage line 50 certification was pursued by a
    record no.

  7. I couldn’t simply hide in my own bedroom until the balding area disappeared — if it
    was still going to vanish. A study published in The Journal of Dermatology revealed
    that chlorine causes discolouration and a change in hair
    texture. The Hair Transplant Network gives an estimate of $4 to $8 per graft for a FUT
    procedure and $6 to $10 per graft for a FUE procedure.

  8. Shock hair loss is generally caused by physician error when doing the treatment, so picking a physician who understands exactly what they are doing is essential.
    It can affect the appearance, confidence, and maybe even the self esteem
    of a person. Because of this, you need to clean your hairs and make them tidy at all
    the times.

  9. Make sure you know how long it requires to recover from a plastic surgery process ahead of agreeing to it.

    In recent years the term “mommy-makeover” has become more common. With an type of plastic surgery, there will
    be a recovery process.

  10. Remember how you used to loathe and detest having
    to rake those ghastly piles of leaves. Will you need to eat less than the overindulgence we
    have gotten used to. How many people withing the past year do
    you know that has gotten fatter and gained weight,
    even a pound or so.

  11. Okay, so you have a decent starting portfolio of ‘glamour photography’
    shots you’ve taken and assembled to show the possibilities
    of your range and depth of photographic artistry. You can correct and adjust the ready made design pattern at
    your will. Make room for your trendy new wardrobe by going through your
    old clothes and getting rid of unwanted clothes.

  12. Shock hair loss is generally caused by physician error when doing the treatment, so
    picking a physician who understands exactly what they are doing is essential.
    Vitamin B5 is also very much necessary to stop hair fall and then it well also helps the hair to grow quickly.

    The step-by-step method of using castor oil for hair loss treatment:.

  13. Then visit this endorsed web-page and discover how Accountant
    Burnsville can benefit you. They will allow you to upload and download
    accounts from anywhere. The online offering will cost you $99 to setup up with monthly fees.

  14. The leading plastic surgery clinic in Sydney specializes in offering all
    types of cosmetic surgery including Face lift, otoplasty, Rhinoplasty, Scar –
    Revisionn, Fat injection and Eyelid surgery. Treatments for Treacher Collins syndrome commonly require
    surgery to remove the area in which blockage
    occurs. There is no question that how you look has an impact in the workplace.

  15. If or when your favorite game in your youth was creating clothes
    for your toys as well as creating creative changes
    in your very own apparel, then I think people such as you are
    absolutely those which are destined to become a fashion designer.
    Instead try a nice pair of wool or cotton chino dress
    trousers with a button down shirt, sweater vest, tie, and sport jacket.

    Healthy clear beautiful skin is a must for models because bad skin does not photograph well.

  16. Lisa Beverley writes highly informative and researched articles for end
    consumers about a variety of Weight and Diet including remedies, weight loss diet and
    simple weight loss, slimming, weight loss products, bodybuilding supplements and diet
    tips. It is also mandatory to take the correct diet to gain maximum
    from these drops. Numerous people avoid visiting their doctors because of these injections being painful.

  17. The car moving company should have niche experience in providing
    car shipping to Europe or West Africa. These are the small distance shifting companies offer their good quality services within the city or
    in range of 50 to 70 km distance. You will have to move
    everything from knickers to sneakers, from books to items,
    from carpets to computer systems, from DVDs to new music system.

  18. That will be everything else you have zero need to begin doing.

    Simeon was the first individual to realize, that everyday consumption of
    this hormone facilitates metabolism. In addition to the lack of information we have
    on the effects of this type of diet long term and the poor nutritional practice that it is based on, the expense is astronomical.
    Another problem is that after the HCG diet is no longer being followed,
    feelings of hunger will return, more calories are going to be consumed,
    and the weight will start to pile back on. The use of oil,
    body creams and other hygiene products is prohibited. This is supposed to burn fat and limit hunger urges, making weight loss quick and effective.

    Considering the dangers of weight loss injections, especially HCG combined with low calorie diet restrictions one must agree that seeking
    professional assistance before embarking on any fast weight loss solution will be better.
    The insoluble skin protects the seed while it is on the tree or vine
    and is rich in vitamins and antioxidants. Even though it is such a small amount what this forces your body to do is now that you are producing 700 calories your body shifts to start pulling
    your energy from your calories again. What do you do,
    if you just have to have something extra to

  19. Just follow the instructions, every person can fix these problems.
    It’s very vital that you get Plumbing Alameda work made by a specialist.
    Do not just ask any plumber to come over and do some immediate repairs.

  20. When scrubbing and cleaning, make sure you get to all the spots of your body.
    Contact with eyes can result in extreme irritation, which can even be
    serious. Now, thanks in part to celebrity endorsement, using fake tan has really taken off, with a huge range of tanning products
    on the market. If you plan to do it on yourself,
    just do this 4-step process and you will fine. There is no need to wait for the current shade to wear out before a fresh coat.
    Once finished wash your hands thoroughly to remove all colour
    and then finally rub the backs of your hand and
    your wrists across your tummy to transfer fake
    tan and ensure the colour around your hands is even. The professionals use
    the spray by releasing a mist of the lotion covering the person from head to toe.
    With credentials like that we knew he could turn our skin from drab to fab in no time.

    The FDA recommends looking for another tanning salon if you are not offered safety equipment.
    It is now time to change this as women these days are more empowered and considerably have the same
    roles as men in our society.

  21. The car of the future will have a reader for in town traffic following coded
    and buried cables in the traffic lanes. For women with considerable height
    the tall yoga pants can provide comfort and durability.

    So, Long Yoga Pants are highly flexible meant for various
    poses and exercises.

  22. The surgeon will recommend the style that is medically proper for
    your condition. For just under $40, this unit features a zippered fabric door, four
    pockets, and 24 shoe compartments. So, Long Yoga Pants are highly flexible meant for various poses and

  23. However, sometimes we need to do something a little more adventurous, or perhaps a
    little more pointedly self-serving. Some of the popular cosmetic surgery procedures – notably
    the head lift – are popular attributable to aging skin circumstances accelerated by experience of
    the sun. Plastic surgery procedures for the most
    part, are considered, major surgery.

  24. I’m impressed, I have to admit. Rarely do I come across a
    blog that’s both educative and interesting,and without a doubt, you’ve hit the nail on the head.

    The problem is something not enough pedople are
    speaking intelligentpy about. Now i’m very happy that I found this during
    my search for something regarding this.

  25. Hello admin do you need unlimited content for your site ? What if you could copy content from
    other sites, make it unique and publish on your website – i know the right tool for you, just search
    in google:
    kisamtai’s article tool

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: