
Many people assume, erroneously so, that there is some governmental agency that provides oversight as to what type of procedures that any doctor may perform. Whether it is the American Medical Association (AMA) or a state’s licensing board, someone surely must provide control over what a doctor may do. Surprisingly, this is simply not so. Once a doctor is licensed in a state to practice medicine, there are no controls over what one does with that license.
The only regulating mechanism for which doctors may perform what type of surgery is a hospital. This is done by the granting of ‘surgical privileges’ from a hospital committee based on what the surgeon’s training and board certification is. Therefore, plastic surgeons are given privileges in plastic surgery, Ob/Gyns are given privileges in female health and reproductive medicine, and dermatologists are given privileges for treating skin diseases for example. As a general rule, hospitals do not give cosmetic surgery privileges to do facelifts, breast augmentation, liposuction, or tummy tucks to doctors other than plastic surgeons. While such hospital privileges are a real litmus test for qualifications, there is online method to obtain this information from a hospital. You may call your local hospital (or any hospital where your surgeon has privileges) and ask the Medical Staff Office secretary whether your surgeon has privileges to perform cosmetic procedures in that hospital.
Because there are few regulations outside of a hospital that define a doctor’s ‘scope of practice’, it is now common to have almost any doctor perform whatever they choose in their own office or surgery center. Aggressive marketing and price incentives are very alluring for patients. As a result, there are gynecologists performing breast augmentation, liposuction, and tummy tucks as well as dermatologists and dentists performing facelifts, liposuction, and rhinoplasties. As incredulous as this may seem, it goes on in every major city and many smaller suburban areas. While these surgeons may be board certified in their own specialty, this does not mean they are board-certified in plastic surgery. So the real question is not are you board-certified, but board-certified in what?

Dr. Barry Eppley
Indianapolis, Indiana
