Written by Joseph O’Connell, M.D.
Have you ever been invited to a “Botox Party”?
They’re usually at a girlfriend’s home or sometimes held in a location unusual for medical services, such as a hair salon or an art gallery. You’re tempted by the apparent low price and the prospect of a fun evening out with friends. Today, Botox and similar drugs, known as neurotoxins and fillers aren’t just for wrinkles. The more skilled injectors can change facial shape and even shore up loose necks.
Before you head into the dining room for your injection, there are a few things you might want to consider:
• What do you know about the training and skill of the provider? Does he or she have an office or admitting privileges at a local hospital if a problem were to occur? Are they reachable by telephone or is the only means of contact by email? Will an appropriate medical history, including allergies and medication use, be taken prior to treatment in a HIPAA compliant setting? Plastic surgeons spend four years in medical school and a minimum of six years in a residency program in which neurotoxins and fillers are an integral part of our training.
• Does the provider have professional liability insurance and, if so, does it provide coverage for a surgical procedure performed in a private home? Mine doesn’t.
• If you’re considering hosting a party, ask your insurance agent if your homeowner’s policy will cover the costs of medical or hospital care for an attendee. You might want to purchase a supplemental umbrella policy if the company will sell you one. If a needle turns up in a landfill or some other unexpected location, expect an expensive visit from the United States Environmental Protection Agency for improper disposal of medical waste.
• Because alcohol is usually provided and there’s the inevitable peer pressure, the question arises as to whether you are truly giving your informed consent for the procedure(s) you’re about to undergo. The injector shouldn’t be partaking in the alcohol.
• Neurotoxins and fillers must be injected using a meticulously clean or sterile technique. In Connecticut, we must cleanse treatment areas with a special product that kills all foreseeable bacteria and viruses, including HIV, hepatitis and tuberculosis, after each patient. Is the dining room table or living room chair where you’re being treated cleansed in this manner? I doubt it. How is the provider washing his or her hands between patients? Are they using a bar of soap in the bathroom? Also, it’s unlikely that a fellow party attendee will divulge that they have hepatitis C or HIV in a group setting.
• Watch for the bait-and-switch. There’s almost no medical reason to treat multiple areas, to use multiple products at one sitting or to purchase creams for afterward. Doctors have an ethical obligation not to sell you something that isn’t in your best interest. Lay people don’t.
• If the price is too low, be suspicious. When it comes to these events, there are often multiple layers of middlemen and none of them works for free. The homeowner must receive some benefit as does the “organizer” (or hair stylist) and even the doctor providing the product when the injector is a nurse or physician assistant. Most doctors pay roughly the same amount for injectables — provided it’s a legitimate U.S. product. The market is rife with illegally imported and even counterfeit products, so it’s buyer beware. Legitimate U.S. Botox will have a hologram clearly visible on the box. Ask to see it along with the lot number. If it sounds too good to be true, it probably is.
• Ask if the provider will enroll you and then accept the national Allergan rebate program known as Brilliant Distinctions. If not, ask why. You might end up paying more in the long run.
• Like it or not, aesthetic services are taxable in our state. If you’re asked to pay only in cash and it’s an even amount, you might want to check with the Department of Revenue Services to see if the provider has a tax ID number and is complying with the laws that we all must follow.
• There are still other issues like maintenance of medical records, emergency preparedness and proper lighting.
• Don’t be fooled by confusing medical “boards” and other essentially meaningless credentials. There’s no American Board of Medical Specialties that certifies “injectors” or “aesthetic physicians” and there’s no approved board with Allergan, “aesthetic” or Botox in the title.
• What about procedures in hair salons and dental offices? Sorry, but these locations are outside my cleanliness/sterility comfort zone.
Unfortunately, when considering a medical or surgical procedure in the home, there’s more to it than meets the eye and I believe that it’s part of a physician’s duty to inform patients fully. If you’re invited to a Botox party, think first and do your “homework.”