Cosmetic Competition

And whether prices plunge or not, dermatologists say injectable, laser and other procedures performed by physicians who aren't board-certified dermatologists or plastic surgeons can compromise efficacy and patient safety. But medical spa proponents say these concerns are unfounded.

He says advanced procedures such as liposuction are tougher for "dermatologic pretenders," while dermatologists can artfully combine procedures for superior results.

Joseph J. Sozio, M.D., says that as competition among cosmetic treatments providers intensifies, "Dermatologists need to decide what's their passion and focus - traditional dermatology or cosmetic dermatology."

Consumers want more

"People today are relatively sophisticated" about choosing doctors, Dr. Sozio says.

And as patients' awareness of cosmetic options grows, "They're going to seek out physicians who do just cosmetic work" rather than medical dermatologists offering one or two lasers.

"This isn't something one can dabble in part time. The people who are going to do this best will be those who have the most experience," regardless of specialty, he says.

Moreover, Dr. Sozio predicts that patients will favor practices that provide one-stop access to on-site physicians who can meet their demand for increasingly invasive services over time.

Therefore, he says, "It's really a decision as to whether one wants this to be the focus of one's practice and is willing to make the necessary investments in technology, staff and integration with other physicians who do other areas of cosmetic medicine."

Procedures demystified

Experts trace growing competition for cosmetic patients to several sources.

In specialties with higher malpractice premiums than dermatology, physicians seem to view cosmetic procedures as low-risk tools for financial survival, says Amy E. Newburger, M.D., director, Dermatology Consultants of Westchester, N.Y.

"Because our specialty has done such a great job of demystifying these procedures and trying to make it appear that they bear little to no risk," she adds, "other specialties think, 'We can do them, too.'"