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Limited training among some cosmetic surgery doctors worries state officials

TAMPA — A Tampa doctor accused of allowing unlicensed assistants to perform liposuction should have his license suspended for a year and pay a $50,000 fine, the Florida Board of Medicine decided Saturday.

The board's action was a move to address the growing concern about physicians with limited cosmetic surgery training working in medical spas.

Many patients don't realize that popular cosmetic treatments, from laser hair removal to liposuction, can inflict serious harm. In an alarming case, a South Florida physician recently had to give up his license after a patient died following complications from a liposuction procedure.

Florida's dermatologists and plastic surgeons urge patients to seek doctors with board certification in their specialties or at least formal, accredited education in the cosmetic procedure they're offering. While some note that's merely them protecting their business, experts agree it can take homework for patients to spot a physician who is ill-prepared to perform cosmetic treatments.

"For consumers, it's a difficult situation," said Dr. Steven Rosenberg, a West Palm Beach dermatologist on the board, noting the lack of regulation for many clinics doing cosmetic services. "We really have no idea what environment the medical spas are providing."

The Tampa case, heard Saturday in Orlando, highlights some potential red flags:

The charges stemmed from a woman who came to Dr. Yves N. Jean-Baptiste for liposuction. Jean-Baptiste had trained and received board certification in family medicine. About two years ago, he began to perform cosmetic procedures at his north Tampa practice, YJB Medical and Weight Clinics, after completing a three-day "intensive, hands-on training course" in Weston, according to his attorney.

Jean-Baptiste said he performed more than 250 liposuction procedures, his attorney noted without serious complication. But the July 2009 case illuminated his safety breaches.

State health officials said Jean-Baptiste allowed two people unlicensed to practice medicine to perform liposuction on the patient, identified as D.S. Her medical records didn't show a proper exam before the procedure, how much anesthesia was used, or the amount of fat removed. And Jean-Baptiste hadn't registered his office, then on Gunn Highway, as a surgical facility as required.

The physician declined to comment, but he disputes the charge that his assistants performed the liposuction, according to information his attorney presented.

Through his attorney, Jean-Baptiste acknowledged the employees he called surgical technicians were unlicensed medical assistants and his poor medical record keeping.

The patient did not appear to suffer lasting harm. Her complaint followed a billing dispute, noted the doctor's attorney, Jon Pellett of Tampa. In a letter to the doctor's office discussing a refund, she said she planned to return for back liposuction and was "truly pleased with the work done by everyone in your office and could not be happier with the results!!"

But members of the board of medicine were not impressed.

"I think he's in a lot of trouble because he doesn't have a surgical background," said Dr. Trina Espinola, a St. Petersburg surgeon on the board, which moved to increase the recommended fine from $10,000 to $50,000.

"This is really scary," Brigitte Goersch, an Orlando businesswomen and consumer member of the board, said while rejecting claims that the fines were excessive. "If you want to practice medicine again, then you need to do it safely for the citizens of Florida. I would suggest that you be happy this is what the discussion is."

After a one-year suspension of his license, Jean-Baptiste would face three years of probation, during which he would require some supervision. His license is currently suspended under emergency orders. He must now decide whether to accept the board's discipline or seek a trial before an administrative law judge, his attorney said.

This kind of case underscores how a weekend of coursework doesn't prepare physicians to perform procedures such as liposuction, said Chris Nuland, a Jacksonville attorney representing Florida's plastic surgeons and dermatologists. In recent years, he said they have grown concerned about the rise of untrained professionals, whose patients they end up treating when complications arise.

"Just like you wouldn't want a psychiatrist doing your brain surgery, you need to wonder who is doing your (cosmetic) surgery," he said. "What is their training, and is this because it is a cash business, or because it's what they have been trained to do their entire careers?"

Letitia Stein can be reached at lstein@sptimes.com or (813) 226-3322.

Limited training among some cosmetic surgery doctors worries state officials 08/08/10 [Last modified: Monday, August 9, 2010 1:31pm]
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