I am writing this in English though I really doubt there are any members not able to understand the only language (native Russian) but needing the second one as well to make my message clear. I also doubt that there are English-speaking professionals ever interested in our deeds, but still in case…
Our problems are numerous. The recent establishment in Russia of the two long wished specialties, namely Plastic Surgery and Cosmetology does not seem to bring about any new solutions. The reasonable question from abroad is: “Why than to adopt the disciplines, if this does not address the pressing problems of the professionals?” I have a personal answer for that which I can not make public. I just make a remark here that professionals have never been engaged in the process. The vague and euphemistic answer will probably talk on “importance of the aesthetic medicine, need to consolidate, to educate, to promote and support …” etc. A meaningful talk on our current problems in Russian is hardly possible. That is why I use this opportunity.
Our professional self-image is very important because it determines to a significant degree not only how we conduct ourselves in relationship to the patient and society but also how we want to live our lives personally as well as professionally.
The major problem in regard with this self-image is rapidly growing alienation of those practicing Aesthetic Medicine from medical profession. We are consumers in the eye of manufacturers and we are sellers in the eye of public. Both cohorts treat us the way unthinkable for physicians just 20-30 years ago. The dealers speak eloquently of “big social significance of aesthetic branch of medicine”. They believe they flatter us praising our role “in beauty industry”. Do we really want to end up as “nuts and bolts” in their business, as Lenin once requested from “proletarian” writers, enslaving them to join his crimes?
Advertisings shower us with primitive lullabies aiming at: “helping babies get to sleep” (Wikipedia). And so we do. We stop to alert ourselves as to the content of ads, to the potential hazards to our patients, to experimental proofs etc. The only alerting might be the sweet sounds “discounts, bonuses” generously scattered within these nursery rhymes. Do they lie? Too a strong word, the euphemism ‘informing’ is more acceptable. But information is not the same as knowledge and knowledge is not the same as wisdom. If manufacturers have managed to make us mentally retarded than probably we deserve so.
For the public we, once physicians, are hardly discernable from barbers (with all my respect to them which grows to envy with time). We are not guards or savors anymore, but “what-do-you-want” guys. If people are sure that we shall sell whatever regardless possible drawbacks, so probably we deserve so.
Do you feel hurt? Anyway the field of plastic surgery is my field, and no political correctness stops me. To the public the "plastic surgeon" is the one who does aesthetic surgery. This distortion of image is not totally the fault of the laity since individual plastic surgeons expend considerable effort to make a prospective patient think of a "plastic surgeon" whenever he or she contemplates a cosmetic procedure. The reflex image evoked in the public's mind of the title "plastic surgeon" is of someone who changes a nose, rejuvenates a face, augments or lifts breasts and buttocks and suctions fat. And this is the image that plastic surgeons have in many parts of the world – among not just the public but doctors in other fields and within academia particularly. Another point of contention and jealousy is that they consider cosmetic surgery to be luxury surgery – trivial surgery but generating a disproportionate amount of money compared to what practitioners in other areas of medicine and surgery earn.
Do we pose these questions? Do our leaders do that? Do they exist? Do we want them to? Do we want anything but immediate profit? At last! The last question has the definite answer – yes, we do. We, professionals want a lot.
We need safety for our fiscal affairs, which is political issue. Unfortunately, like in Khodorkovsky’ case, this issue is beyond our scope – we are not citizens. We bow and submit to autocracy.
We need good results and safety for our clients, which must be (but has never been so far) a purely professional issue – the issue of education and standards. We may be industrious in self-education, but what do we do as a professional society?
Do we share our knowledge and manual skills with our successors? No. We sell abortive “courses” and “seminars” at a huge price, unaffordable for most of them.
Do we care for establishing new jobs for graduates in plastic surgery or cosmetology? No, quite opposite is common.
Do we always protect our colleagues who are in trouble? I doubt.
Do we police ourselves to protect the professional image from those abusing it? Never.
Do we try to enhance our knowledge through professional exchange? As a “scientific editor” of the “Plastic Surgery and Cosmetology” magazine I can not help, but have to talk on this subject a bit more. All respected “Peer Reviewed Magazines” require exact setting of aim, materials and methods, well illustrated results, their comparison with literature to accept a paper. All these regulations are absolutely beyond means of our “aesthetic medicine specialists”. Virtually all of them are lacking the foundation of the academic education. Professional adequacy is judged here on the basis of commercial effectiveness. Studying, reading, let along writing – is “a humble pie”, far aside from interests of “bright artists”. That lacking of the scholar attitude was first time displayed to me by Professor James May from Harvard in 1988 when my Russian companions insisted on “cooperation in microsurgical researches” with Americans, who praised us highly that time (God knows why). And Jim pictured to me the abyss between western attitude and our narcissism. His explanations revolved all my life and career. But I am afraid no more than half a dozen of my Russian colleagues have passed through this tough revolution or just able to understand what is it all about.
As cosmetic medicine boom blows up, it goes on recruiting hundreds of novices yearly, starving and striving for instructions. Many of “grown-ups” are longing to professionalism as well, and consume eagerly any “printed matters”. Unfortunately and for the reasons mentioned above, our journals are absolutely inadequate to this hunger. Their portfolio if not totally empty, do not allow proper selection of submissions. The thin volumes have to be stuffed with anecdotes, self-promoting fairy tales, reports of the purportedly successful studies, paid for by dealers be it about laser, endoscopy, implants, dermatology ets. No more than a couple of more or less interesting articles could be extracted from each annual volume, while the rest fills the dusty shelves with no demand. Same time my bounds of PRS, AÐS or ASJ are totally worn out by eyes and fingers of myself and my students, though they do not know English.
This “presidential message” is ment to replace the one of the previous President of SAMS, Vladimir Vissarionov, loaded in September, 2004, six years ago. He wrote: “We shall be glad, if a newly generated community – Society of Aesthetic Medicine Specialists - will prove out useful to and interesting for our partners from near and far abroad”. Probably he ment not partners, but members, though this does not matter. What matters is that I am not glad. Are you?
|Prof. Alexey Borovikiov, Doctor of Medical Sciences, |
President of SAMS,
Scientific Editor of the Journal of Plastic
Surgery and Cosmetology