Legislative Report

Plastic surgeons, cosmetic surgeons to square off over Cortez bill SB194 positioned as free speech issue while the real fight is over money and turf

by Mike Stagg

SB194 positioned as free speech issue while the real fight is over money and turf.

Expect a bruising fight in the Senate Health and Welfare Committee today over Sen. Page Cortez's SB194. If it were a physical brawl, who those most battered might would turn to to repair the damage may well depend on the fate of Cortez's bill.

Cortez frames his bill as a fight over commercial free speech. Others claim that it is a fight over what could be perceived as deceptive advertising.

At the heart of the fight is the boom of cosmetic surgery and the doctors who perform it.

In a phone interview on Wednesday morning, Cortez explains that plastic surgeons must be trained in six sub-areas in order to gain board certification from the field's long-recognized bodies like the American Board of Plastic Surgery, which is itself part of the American Board of Medical Specialties that includes 24 specialties.

Plastic surgeons must learn about bones as well as soft tissue in order to do their work and claim their board certification. Their work frequently involves repairing structural and cosmetic injuries caused by accidents or work injuries.

Cosmetic surgeons, on the other hand, primarily deal with appearances — "tummy tucks, breast augmentation and the like," is how Cortez described it.

Cosmetic surgeons are physicians but their specialized training is not as deep as that of plastic surgeons.

Current Louisiana law restricts the ability of physicians to cite board certifications in their advertising beyond a narrow set of medical certification organizations recognized by the Louisiana State Board of Medical Examiners.

Current law restricts the ability of advertising to proclaim board certification unless those certifications come from the American Board of Medical Specialties, American Council for Graduate Medical Education or the American Osteopathic Association.

Cortez's bill would drop that restriction and would allow any physician to advertise any board certification as long as "the board can be verified as existing and the physician's standing with the board can be verified by the Louisiana State Board of Medical Examiners."

Cortez says his bill would allow cosmetic surgeons to cite their board certifications in their advertising, even though those certifications don't necessarily carry the weight and credibility of the certifying organizations on the current restrictive list.

At the heart of the matter, there are big dollars at stake as well as workload.

Cortez points out that plastic surgeons do a lot of work either in or around emergency rooms. He says cosmetic surgeons aren't interested in that work.

"Cosmetic surgery is elective surgery. It's a cash business. The doctors performing those surgeries really aren't interested in doing ER work," according to Cortez. "If they have to get the full plastic surgery certification, then they could be eligible to be called upon to do that work in some circumstances."

Cortez is predicting a long and heated debate over the bill in the committee. You can watch it here.