Line up to have you lips plump!

This morning when I got to the clinic our first cosmetic patient was getting her lips plumped up with Restylane. It turned out that it was a nurse from the ICU who I had met while I was rotating at the ER. She had just finished her shift and was in need of fuller lips! I help the doctor with the procedure and half way through she said "Hey, Dr. J how do you think you are going to learn how to do this if you do not start practicing?" So she said I could do the lower lip. Fortunately I have seen this procedure done several times back in the clinic days. I grabbed the syringe and penetrated the vermilion border of the lower lip and filled it with the restylane collagen like substance. Then I massaged it to smooth it out. 

The patient was very nice to allow me to practice on her and she was happy with the outcome. I could see doing some of this for $$. The patients are so thankful and can't get their credit cards out fast enough. The interesting thing is that later today we had 2 patients (non-cosmetic) who were being managed for chronic conditions, 1 was diabetes that this doctor diagnosed and is now treating and the other was life saving diagnosis and now treatment for hypertension, who came in complaining about bills and refused to pay. They were convinced that they did not have to pay and they were angry and offended that the doctor had continued to bill them and that their insurance had not paid for the entire amount of the charges. It came down to the fact that their insurance paid 80% of the discounted fee and the patients were responsible for the remaining 20% of the discounted fee. Neither of them wanted to pay and ultimately may refuse to ever pay. 

I just find it interesting that when a doctor makes a diagnosis for a patient and then provides life saving treatment, the patients sometimes refuse to pay and bitch and moan about how they have been ripped off. On the opposite end of the spectrum, the doctor plumps up a patients lips and she is overwhelmingly happy and pays right away, often prior to the procedure and follows up with thank you letters and christmas cards etc. The medical patients are mad at the doctor and may even change doctors believing that they got a raw deal while the cosmetic patient tells all her family and friends how great the doctor is and names one of her children after the doctor. What the hell is wrong with society? No wonder so many doctors are moving to a more cosmetic practice.