Laser Clinic MD

When it comes to the cosmetic laser field, we can sometimes feel adrift at sea with little more than a compass and the stars to guide us. We're either doing laser treatments according to our laser manufacturers' guidelines, which are conservative and often inadequate to produce excellent clinical results. Or we're trying new laser treatment settings without the benefit of knowing what other doctors have tried.

If we discover something important, we have no forum to discuss this information with our colleagues. Many of us experiment in our clinics, but we don't share our problems, successes, failures and thought processes with anyone. As a result, we make little progress because we don't benefit from others' advances and insights.

This has flattened our learning curves. Innovation-if and when it comes-is slow. This needs to change. And it begins with doctors simply talking to each other. Participating in Internet-based user groups is one of the easiest ways to do this. Such a forum allows us to share our ideas, experiences and opinions so that we can learn from each other.

The collective intellectual capacity among us, as cosmetic laser providers, is tremendous. If we all worked together, we would discover and share treatment protocols that are more effective and less painful, and produce fewer complications. We would discover better ways to reduce and treat complications when they do arise. Our field would become stronger, and we'd become better practitioners.

Unfortunately, cosmetic laser practitioners have little clinical exchange compared to other specialists, such as cardiologists. These physicians have thorough initial training with a three-year residency and a one- to three-year fellowship. They have mentors, classmates and large practice groups so colleagues can talk to one another. Publications and newsletters keep cardiologists abreast of developments in the field. They stay in touch with their academic training centers, attend meetings and are members of professional associations. In short, they communicate and connect.

What Do We As Cosmetic Physicians Have?

Contrast this to cosmetic laser medicine. Unlike cardiologists, we don't have highly developed professional networks. Nor do we have the formal advanced training. Our main professional association is the American Society for Laser Medicine and Surgery (ASLMS), which hosts a yearly meeting and produces a monthly journal. The ASLMS is a great professional society, but it doesn't serve all of our needs.

Another source of education is the laser companies, which provide clinical training, Webinars and Web sites. The trainers teach the basics, but they're limited by company protocols, which are reviewed by corporate attorneys, and designed to prevent problems rather than to get excellent clinical results.

The laser companies' Webinars are lectures designed to sell lasers, not provide advanced training. Luminaries are paid to do the Webinars, but there's no access to them for detailed follow-up questioning.

What's more, we have to sit at our computers for two hours listening to basic, redundant information to glean one useful, advanced clinical tip. The content of the Webinars are not made available in any other format?-written summary, cassette tapes or CDs-so it's not widely accessed.

If we go to aesthetic laser manufacturers company Web sites for resources, the information is basic and limited. The marketing material, of course, is fresh and current, but the clinical material is dated and sparse.

Other resources are trade publications that keep us abreast of issues in aesthetic medicine. But these magazines don't get into the details of treatment protocols and how to get the best results.

Finally, we have independent blogs, such as MedicalSpaMD.com. This blog, in my opinion, is one of the best ways to get information and find out what other providers are thinking and doing. Some doctors who blog on MedicalSpaMD are experienced users who share their expertise and opinions?, all of which are extremely helpful. But the drawback is too few physicians blog about specific topics.

Several Solutions

Working with laser companies is one way to combat this problem. Laser companies can be particularly valuable in the clinical exchange arena. These companies have the resources to start, support and nurture this activity. They know who their users are, they can enlist the knowledge of luminaries, and they have company doctors and scientists who understand the clinical applications of their laser devices. It's important to mix all of these elements in the proper environment to spur the best advances and innovations from these groups.

M. Christine Lee, MD, MPH, writes that upstanding laser companies "put more money and resources into product development than in marketing and advertising. They have a corporate philosophy that's based on building relationships.investing in new technology and research.[and] nurturing forward vision."¹

It seems almost foolish not to work with cosmetic laser companies, especially since many providers are getting clinical results that are suboptimal. Furthermore, many patients are experiencing complications that can be avoided. (See RealSelf.com for patient complaints and see MedicalSpaMD.com for physician complaints.)

Although aesthetic laser companies don't provide the clinical exchange we need, we can find useful models to emulate outside our field. For example, a medical device company produces Philips NetForum. This community connects Philips users from around the globe in a virtual users meeting so they can share clinical experiences, learn from peers and optimize results.

I'm sure many innovations have occurred when users simply share ideas and explore insights with each other via this Internet clinical forum. If we had this resource, our field would advance dramatically.

What We're Doing As Medical Spa Physicians

As a physician, I have a responsibility to take my part in this call to action. As a result, we're now forming clinical exchange meetings at our Cherry Hill, N.J., clinic. We get together twice yearly with doctors from 20 to 30 other clinics to discuss what works and what doesn't. Part of our meeting focuses on business and marketing, and the other part addresses clinical issues.

We also work closely with MedicalSpaMD.com. We are active visitors to this site and frequent contributors. This Web site is so important that we've actually bought an intense pulsed light (IPL) system based largely on the opinions of the Web site's bloggers, many of whom have had experience with several IPL systems.

We're also forming Internet-based user groups on our own. These groups discuss everything from fractionated CO2 systems to injectables to treating patients with skin of color. Doctors from around the country and the world, including Greece, Australia, France, England and India, share their opinions and experiences.

In addition, we're setting up systems in which providers who attend conferences or listen to Webinars write summaries of what they've heard. These summaries can be posted on Medical Spa MD for others to learn from. Once these summaries are posted, other providers can read them and comment on the issues they're discussing. Of course, we cannot overlook traditional methods of clinical exchange. These are still important and should be developed further. Conferences, publications, newsletters and professional associations are excellent ways to communicate and exchange opinions and experiences.

Cosmetic laser medicine is still in its infancy. We haven't yet worked out the best protocols and new technology is continually emerging.

We have to quickly learn the best ways to use all of our technology for optimal clinical results. The best way to do this is to communicate with each other so we can learn what others are thinking, doing and experiencing. When we actively participate in this learning, our field will advance more rapidly and dramatically. This will benefit all of us. True to the Chinese maxim, when the tide rises, all boats indeed rise higher.

Reference

1. Lee CM. Lasers: what every patient should know, and what your doctor probably doesn't. The ultimate guide for the best skin ever. Bloomington, IN: AuthorHouse; 2006; 163.