It was a headline that caught the attention of both plastic surgeons and those interested in plastic surgery: In June, the California State Legislature began work on a bill that would require patients to have a physical exam. before being eligible for elective cosmetic surgery. The first committee of the Senate has already approved the bill; then it has to go through the full Senate.
The measure was introduced by Wilmer Amina Carter, an Assemblyman from Rialto. She named the bill after Donda West, mother of popular rapper Kanye West. Donda West underwent cosmetic surgery in 2007 and passed away shortly after.
According to authorities, it was coronary heart disease that caused Ms. West’s death, and the weakened heart likely wasn’t strong enough for surgery. These same authorities said that heart disease should have been detected.
Assemblywoman Carter, in drafting the bill, said it was aimed at so-called “fake” doctors who are looking to make a quick profit and consequently fail to properly test their patients for pre-existing health conditions.
Fifteen of the 17 members of the California Medical Board support the legislation. However, Gov. Arnold Schwarzenegger’s administration is opposed. Your Department of Consumer Affairs says that adequate rules already exist.
The Assembly approved the legislation last month in a bipartisan vote. If the bill goes all the way, he still faces the possibility of a Schwarzenegger veto (he vetoed a similar one last year).
Meanwhile, plastic surgeons across the country and others interested in the practice are watching with great interest, as health and medical problems that began in California tend to spread.
So what’s with this bill and this idea that plastic surgeons can’t perform a procedure unless a physical exam has been done beforehand? Is this a good or bad idea? As with many problems, the answer is not so clear cut.
First, it is absolutely true that those within this practice must go to extreme measures to test their patients. They must ensure that each patient is a suitable candidate for the procedure they are undergoing. This means not only a physical evaluation, but also a psychological one. There are probably more people who would be disqualified for psychological reasons than physical ones.
However, adding a layer of bureaucracy to this profession, making it our responsibility to check on a patient’s current affairs, making sure they receive proper medical care, seems beyond the scope of what we should be doing. Yes, we should ask patients about their history, but I don’t know if we should become government enforcers.
A better solution would be for relevant associations, such as the ABPS, to pass guidelines requiring plastic surgeons to properly screen patients or risk losing their membership. This would motivate surgeons to do their job well, without forcing us to assume the role of gatekeepers to the government.