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.

These new expectations are part of an evolving definition of total health and, thus, should be included in the protocol of modern medical care delivery. Therefore, we can view the PCP offering medically based aesthetic treatments as simply another point on a continuum of care that aims to treat the patient in their totality as a physically, mentally and an emotionally complete person. This is completely logical as patients live longer (fifty is the new forty, etc.). And because these expanding needs are so widespread in society, there is a powerful trend of expanding aesthetic and rejuvenation medicine beyond the exclusive realm of dermatologists and plastic surgeons whose numbers are quite small compared to the number of PCPs.

New technology now allows the PCPs to perform many desired procedures easily, safely and effectively. These procedures are also becoming more cost effective as new laser technology drives equipment prices lower. But the more important reason for this trend is that patients trust their primary care practitioner and would prefer the convenience of being treated by the same practitioner who manages their total healthcare needs.

Let’s review some statistics that will bring these trends into clearer perspective inside the practice of OB/GYN, a specialty hit hard by economic demands. In a 2008 survey performed by the journal Contemporary OB/GYN, those specialists reported that 63.3% offered the ancillary service of radiology/ultrasound (not very surprising). But fifth from the top of the list was “cosmetic procedures” with 16.3% offering those services to their patients. That’s nearly one in five OB/GYNs offering cosmetic procedures where lasers play a key role. Laser hair removal was the most frequently performed procedure by these physicians with 9.2 procedures per month being performed on average by those offering the service. Other laser procedures performed by this group included skin rejuvenation – 6.8 procedures per month; spider vein removal – 6 procedures per month and Rosacea treatment – 5.5 per month on average.

Converting those treatments into dollars (and remember most of these are cash-based, not reimbursed) Contemporary OB/GYN found that laser hair removal added on average $2,757 per month to the practices offering those services; spider vein removal added $2,520 on average, skin rejuvenation added $2,413 per month on average and Rosacea treatments added $1,972 per month on average in those practices offering those various services. Obviously, many practices owning the appropriate laser offer several or all of the above, some just one or two services.

Patient demand for aesthetic services in the U.S. now stands at over $14 billion and is still growing at double digit rates, despite the downturn in the economy. The patients in PCP waiting rooms right now are the very people who want these treatments, not only for the sake of vanity, but precisely because of the stagnant economy. Many realize that to compete in today’s job market, it is imperative they look more youthful and healthy in the job interview. It’s truly amazing that the same patient who will argue with your office manager over the exact amount of their co-payment will immediately write a personal check for $250 or so, for a 15 minute laser hair removal treatment which obviously needs no complicated coding or delayed billing.

PCPs who have properly integrated these aesthetic treatments into the core practice are very successful. A good deal of consideration should be given to the analysis of what treatments to offer, what device to use, cost, safety, presentation, integration into the medical practice, as well as qualified and professional marketing of aesthetic services. What is suitable for a specialized cosmetic dermatology or plastic surgery practice may not be suitable for an FP or OB/GYN.

An appropriate integration of aesthetics with medical procedures typically requires a minimum of time away from the core medical practice. Many PCP’s can spend half a day a week, and still bring approximately $60,000 to $100,000 in annual profit to the practice bottom line.