WANT to look good? Have laser surgery for your eyes and then free Botox for your brow, courtesy of your doctor.
The catch? Your operation has to be posted on YouTube. An ethical row has now broken out in the spiritual home of cosmetic surgery over patients who allow films of their treatment to be broadcast globally so they can get a discount.
One grateful r
ecipient is Michelle Wilder, who left Dr Emil W Chynn, of Park Avenue Laser, armed with the usual post-operative fare: eyedrops, sunglasses and a pair of prescription-free contact lenses. And, oh yes, a DVD of her Lasek surgery so she could experience, in the comfort of her own home, the joy of watching the doctor scrape her eyeballs.
But her viewing pleasure was not Dr Chynn's only concern. He hoped Wilder would be so thrilled with her results that she would post the 10-minute video on YouTube, along with his credentials, a link to his website and a rave review.
As an incentive, Chynn offered either a free Botox injection worth $400 (£200) or a $100 (£50) discount on the $5,000 (£2,500) Lasek operation, which unlike Lasik doesn't entail cutting a flap in the cornea.
"I thought it was a little odd, because I was wondering: 'Who wants to see my surgery?'" said Wilder, 25, a Manhattan accountant. "But then I thought: 'Well, it's just my eye, you can't see anything else about me, so of course I'll post it.'"
Doctors have long recruited patients to help advertise – witness the doctor-patient tag teams on talk shows and 'infomercials'. It has remained an open question as to whether doctors pay or remunerate those smiling patients in violation of the rules of many physician associations. But it's now clear that doctors openly offer 'thank you' rebates and discounts to patients who post videos of their breast augmentations, bright white teeth or nose jobs – or are willing to be taped extolling the virtues of their physician.
Most payments or freebies to post on video-sharing sites such as Revver, Yahoo and YouTube are modest. A few hundred dollars off. Or an $800 (£400) squirt of Juvéderm. Nevertheless, they have raised concerns among medical ethicists and consumer advocates.
Doctors, and patients, have taken to online video postings with gusto. Type in the word "Botox" on YouTube and around 2,400 videos pop up. "Breast augmentation" garners more than 2,000; "Lasik" around 2,000 videos.
The videos, featuring full-on views of needles piercing furrowed brows, scalpels slicing and Clockwork Orange-like eye surgeries, are both disturbing and fascinating.
Most doctors do not see anything ethically unsound about remunerating patients for posting glowing endorsements. "It's really not a conflict of interest, because the rebates are so tiny," Chynn said. "I'm charging $5,000 (£2,500) for the surgery. If we gave $1,000 (£500), that would be a problem."
But medical ethicists are not so sure. "It's disappointing to see commercialism creeping into what should be a very altruistic profession," said Ruth Fischbach, a bioethics professor and the director of the Center for Bioethics at Columbia University. "If you agree to give your testimonial on YouTube, will that doctor treat you better when you come back than someone else who has refused to do this? It puts a lot of pressure on patients. If someone's a multi-millionaire, they would probably just laugh at the idea, but if someone needed money to fill up their gas tanks – $100 is $100."
Rebates, no matter how tiny, may squelch candid reviews of medical care, consumer advocates warn. "With paid testimonials you're running the risk that the consumer's opinion was skewed by dollar signs, and isn't necessarily telling the truth," said Alison Preszler, a spokeswoman for the Better Business Bureau.
"When we're talking about a plumber, the worst that can happen is that you'll end up with a basement full of water. But when it's about a plastic surgeon, you could spend the rest of your life as the Elephant Man."
