How about some Botox after your flu jab?

WHEN Ms Maria Loh went to her family doctor in Tampines two months ago, she found him shuttling between his consultation room and an aesthetic treatment room that had not been there before.

The 41-year-old financial planner needed treatment for muscle pain. There was another woman in the other room. It looked like she was getting a facial treatment.

'My waiting time was almost double the usual and, when he was treating me, I couldn't help wondering if he was paying attention to my illness or that woman's facial treatment,' Ms Loh told The Sunday Times.

From Pasir Ris to Pasir Panjang, a rash of family clinics run by general practitioners (GPs) such as Ms Loh's doctor are now offering cosmetic treatments.

Because they are not trained in surgery, GPs can perform only non-invasive aesthetic procedures, such as giving injections to iron out wrinkles, plump lips and dissolve fat.

It was recently reported that at least 20 GPs had been quizzed by the Health Ministry in the last five months over complaints about poor aesthetic practices.

The ministry is now studying the possibility of regulating aesthetic medicine, something it has always left to the medical industry.

The Singapore Medical Council (SMC) received six complaints last year about GPs who practise aesthetic medicine. Because these cases are being investigated, the SMC told The Sunday Times that it could not discuss them.

But ever since GPs got into the lucrative business about eight years ago, a debate has arisen within the medical community over whether GPs who dispense cosmetic services should be regulated.

There are over 1,400 registered GPs in Singapore but no official figures on the number who now offer cosmetic work as well.

On one side of the debate, plastic surgeons and dermatologists say GPs lack formal training in such procedures and may not know how to deal with complications.

But GPs say their experience stands them in good stead and that they will not venture into complicated cosmetic work.

The Sunday Times recently visited 10 such GPs, all in family clinics in various HDB neighbourhoods. It made inquiries about having some cosmetic work done.

All 10 clinics offered aesthetic treatment, from Botox jabs and chemical peels to laser rejuvenation and Intense Pulsed Light (IPL) therapy to mesotherapy.

The prices of some of the procedures seemed quite uniform: between $80 and $120 for a chemical peel and about $250 for IPL.

But the GPs' Botox prices varied, with starting rates ranging from $160 to $600.

While almost none tried to pull off a hard sell, some clinics had more business savvy. They had package deals and interest-free instalment options for payment.

At The Healer Clinic & Surgery in Serangoon North, Dr Ling Chuen recommended its 'bestseller' - microdermabrasion - to get rid of the dead outermost skin surface with light abrasion. He has four to five patients who come in once a week at $150 a session, including a mask treatment.

Dr Ling then offered the Sunday Times reporter a package of five sessions, with a 10 per cent discount.

At another clinic, the Yio Chu Kang MRT Clinic, our reporter was offered a $350 package for three procedures: Fluorescent Pulsed Light (FPL), which uses light to penetrate different skin layers, microdermabrasion and laser treatment to get rid of facial spots.

When asked, the doctors consulted said they were not specialists but added, without elaborating, that they had received training in aesthetic medicine.

Dr Ling of The Healer Clinic & Surgery had three certificates on his wall. They were for an American Society of Aesthetic Medicine & Intradermalmesotherapy three-day aesthetic course held in Singapore, a six-hour laser course in medicine and surgery, and a graduate diploma in family dermatology from the National University of Singapore.

One GP admitted that he did not perform all the procedures. He said microdermabrasion was administered by his 'girls', whom he trained personally.

Another boasted that his staff nurse, trained by him, had done microdermabrasion on 500 patients so far. 'Women won't like it if men touch their faces,' he said.

But at least half of the 10 doctors dissuaded our reporter from requesting several procedures, saying they were not necessary.

The Family Care Clinic & Surgery's Dr Cheah Wai Yee suggested cheaper options such as pills and a cream instead of laser treatment.

A few were candid about botched jobs by GPs, conceding that the reports of bruising or sagging eyelids after Botox, or chemical burns after a peel, were not myths.

But almost all gave the same assurance. As one doctor put it: 'It won't be so bad that we can't deal with it. Even if it's very bad, we'll definitely send you to specialists to get it treated.'

Should GPs be administering aesthetic procedures such as Botox? E-mail your views to suntimes@sph.com.sg

A TEAM of Sunday Times reporters checked out 10 general practitioners who offered cosmetic procedures. This was their experience:

Several doctors talked them out of wanting certain procedures, saying that these were either unnecessary or that cheaper options were available.
Most took the time to explain the procedures and spell out the possible risks involved.
The majority were not pushy, although at least three dangled packages at discounted rates.
However, one doctor was visibly impatient when a reporter-patient said she wanted to think about whether to take up his offer or not.
Nearly all highlighted skin-care products they sold, saying these would improve skin condition.