Primary care providers chose their profession out of a desire to help patients live better and longer lives according to the Hippocratic Oath. But the winds of change are blowing stronger across the landscape of medical practices throughout America. Now, more than ever, practitioners wishing to fulfill their calling are increasingly challenged on all sides by the pressures of time, patient demands, and complexity in the health insurance industry, government involvement and economics.

Many primary care providers (PCPs) find themselves on a treadmill, trying to maintain the highest standards of care while also endeavoring to achieve the rewards they and their families deserve to compensate the years and high cost of medical training and the long hours devoted to this most noble profession. There are several strategies to bring the economics of medical practice back into balance: work more hours and see more patients (not usually possible); raise fees (not practical given insurance industry dynamics); cut costs further (many practices are already close to a point of diminishing returns); or offer new, cash-based medical services.

The first question many PCPs have when they consider the topic of offering aesthetic laser services is: are these procedures medical treatments? All aesthetic lasers currently on the market are federally regulated medical devices under the jurisdiction of CDRH/FDA. Virtually every state regulates the use of these lasers and limits their use to either a medical doctor (M.D., D.O., D.M.D.-M.D.) or to a nurse or physician’s assistant, operating the device under the license and supervision of the doctor.

Since the time of Hippocrates, physicians have focused on healing the sick and injured. During the last 20 years or so, physicians have increasingly turned their attention to patients who were neither sick nor injured in a traditional sense. Consider the dramatic rise in prescriptions for conditions such as clinical depression, anxiety, incontinence, restless leg syndrome, insomnia and many other conditions that are not typically life-threatening. Society has now accepted the idea that part of a person’s health and well-being relates to their emotions and their psychology. And not surprisingly well-being is strongly linked to physical appearance. So it is understandable that once basic health needs of populations have been satisfied, patients want to look and feel better. PCPs can meet this need by offering quality aesthetic services using good marketing and customer care practices. Read the rest of this entry »

Several lasers are used for lipolysis – a recognized technique for fat reduction. It has been demonstrated that (i) fat liquefaction is induced through a temperature elevation of the adipocyte cells, and (ii) fat volume reduction depends on total cumulative energy delivered at the treatment site. Which wavelength (920nm, 980nm, 1064nm, 1320nm, and 1440nm) is the best?

Studies and substantial anecdotal evidence show that the penetration depth of wavelengths between 900 and 1320nm is very similar – around 1.5mm. The only minor difference is at 1440nm, which is more absorbed by subcutaneous fat. The irreversibly damaged volume of tissue is also similar for wavelengths between 920 and 1320nm. Practitioners obtain the total of about 4cm3 with 3750J delivered to the tissue.

With laser lipolysis, thermal elevation of a given volume can be obtained provided that the penetration depth remains in this nominal range. This explains why similar end results can be obtained using 920nm, 980nm, 1064nm, and 1320nm. Thermal build-up is the main factor behind adipocytolysis and skin contraction. Successful outcomes are dependent primarily on the movement of the optical fiber inside the tissue and even and stable delivery of the laser energy. It’s the hands of the surgeon that truly make a difference!

This is a good video report, which covers most of the things a consumer should know about tattoo removal by a medical laser. Join Neil Sadick, MD, as he performs laser tattoo removal and provides tips for what to expect from the procedure.

Laser Tattoo Removal
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