Navigating Aesthetic Dermatology With Integrity

In the rapidly evolving field of aesthetic dermatology, maintaining transparency and ethical standards is paramount. Kavita Mariwalla, MD, a double board-certified Mohs surgeon and dermatologist practicing at Mariwalla Dermatology in West Islip, New York, was an author contributing to Moving the Needle on Ethics, a book published earlier this year by Allergan Aesthetics in collaboration with other medical aesthetics experts to bring more awareness to ethics in aesthetics. The variety of expert articles and interviews emphasize the need for “industry-wide transparency and integrity to meet the expected increase in global demand for aesthetics treatments.” The book is available to download. Mariwalla discussed the importance of credentialing, patient education, and ethical considerations in both clinical practice and social media engagement.

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EP: 1.Navigating Aesthetic Dermatology With Integrity

Credentialing and Transparency in Practice

One of the foundational elements of ensuring transparency in dermatology, according to Mariwalla, is proper credentialing. “It’s really important to credential yourself at all times,” she emphasized. This includes clearly displaying one’s degrees and board certifications on their website. She advocates for explicit transparency about who is treating patients, ensuring that titles such as esthetician, nurse practitioner, or physician assistant are clearly indicated on business cards and attire. “Credentialing is key to maintain transparency, so patients know who is treating them, who is behind that laser, who’s behind that needle, and what their training and degree is in.”

In addition to credentialing, Mariwalla stressed the necessity of educating patients about the risks and benefits of any procedure. “Just because we can do it doesn’t mean that we always should,” she asserted. Comprehensive discussions about potential risks allow patients to make informed decisions, a cornerstone of ethical medical practice.

Ethical Considerations in Patient Consultations

During patient consultations, Mariwalla identified three key ethical considerations: necessity of the intervention, qualifications of the practitioner, and alignment with personal ethical standards. She noted the importance of evaluating whether a patient truly needs a procedure, especially in cases where unrealistic expectations or body dysmorphic disorders might be present. “We do have times where patients have body dysmorphic disorder, or they are chasing an ideal that’s not really possible,” she explained. In such scenarios, educating patients and being comfortable with saying no is crucial.

Moreover, transparency about the qualifications of practitioners performing procedures is essential. Ensuring that all providers have the necessary training to prioritize patient safety is a non-negotiable aspect of ethical practice. Mariwalla also advised treating patients with the same level of care and consideration one would offer to family members. “If you would tell your own family no, then treat your patient with that same level of respect, and then you’ll always be able to walk that ethical line,” she said.

Navigating Social Media’s Ethical Challenges

The rise of social media presents unique ethical challenges for dermatology clinicians. Mariwalla offered several guidelines to navigate this landscape effectively in the book’s chapter, “Demonstrating Integrity on Social Media.” She encourages the use of before-and-after photos to showcase expertise and destigmatize aesthetic procedures while reminding patients that results are not guaranteed. Mariwalla explained, “It’s really important that you always say that these results are not guaranteed and that not everyone is going to have the exact same outcome because different people have different needs.” The book emphasize how consults are important to the process to help ensure better patient outcomes.

Mariwalla also advises against following trends blindly and stresses the importance of showcasing one’s expertise authentically. “Make sure that your social media posts and your accounts reflect who you are as a doctor,” she said. This includes upholding the persona of a physician with unique expertise and not succumbing to the lure of popular yet inappropriate trends.

Prioritizing Patient Safety

Patient safety is at the forefront of ethical dermatology practice, and the main reason to reinforce why patients should go to trained physicians who understand the anatomy of the face, which help mitigate risks. Mariwalla underscored the importance of full disclosure regarding the risks associated with procedures. For instance, she highlighted the necessity of discussing potential complications, such as blindness from fillers, even if it might dissuade some patients. “Patients deserve to know. Hopefully, that will never happen to you. But nonetheless, I think patients need to be aware of these risks,” she mentioned.

In addition to educating patients, maintaining a safe clinical environment is crucial. This includes proper handling of syringes, regular servicing of machines, and adherence to safety protocols. “You really need to have codes of conduct, codes of care, and a certain standard that you uphold in all aspects of your office,” she asserted.

Upholding Ethical Standards in Training and Education

To maintain high ethical standards, Mariwalla believes dermatology clinicians should focus on their areas of expertise and avoid pontificating on topics they are not well-versed in. She also cautions against engaging in reaction videos or content that speculates on celebrity procedures. Mariwalla said, “Rise above sort of the gossip or the salacious magazine style, reporting and demonstrate your true expertise in all things, hair, skin, and nails.”

She encourages dermatologists to separate their professional and personal social media pages, ensuring that their professional presence reflects their commitment to patient safety and ethical practice. Transparency about sponsored content is also essential to maintain trust with patients.

The Importance of Ethical Conversations

Reflecting on her contribution to the recently launched book Moving the Needle on Ethics, Mariwalla highlighted the need for open discussions about ethics in aesthetic dermatology. She noted the importance of amplifying the voices of qualified professionals to guide patients accurately and ethically. “We can make sure that the people who are giving advice in a proactive community-based way, that those voices are amplified,” she concluded.

Reference

Allergan Aesthetics launches "Moving the Needle on Ethics" to elevate the conversation around ethics in aesthetics. News release. Allergan Aesthetics. March 25, 2024. Accessed June 7, 2024. https://news.abbvie.com/2024-03-25-Allergan-Aesthetics-Launches-Moving-the-Needle-on-Ethics-to-Elevate-the-Conversation-Around-Ethics-in-Aesthetics