Eva S over at RealSelf has published another winner topic that should be on the minds of all plastic and cosmetic surgeons: A medical license may not be as trustworthy as you thought.

It would seem logical that when a doctor administers fake Botox or repeatedy botches a plastic surgery procedure, they would lose their medical license. Unfortunately for consumers, even in these extreme cases of negligence, it's really hard for a doctor to actually lose their medical license.

Caught injecting fake Botox?  The doctor gets probation

Recently a Sacramento dermatologist was injecting patients with an illegal, fake Botox. Instead of losing his medical license, Dr. Timothy Rosio was placed on probation.

This wasn't the doctor's first encounter with his medical board. The Sacramento Bee reported that Dr. Rosio had been convicted in federal court of two counts involving misbranded drugs, and accused of dishonesty for failing to disclose two suspensions by the UC Davis Health System involving liposuction, ethical issues and quality of care issues.

In just under 3 years, Dr. Rosio can legally see patients again for Botox or other treatments.

Repeated botched jobs & DUI convictions

Donda West’s cosmetic surgery-related death highlighted the fact that a questionable track record can have no impact on a doctor's ability to see patients. Dr. Jan Adams, the surgeon who operated on her the day before she died, had four malpractice judgments against him (source: California Medical Board), plus two DUI convictions and a complaint for failure to provide child support. It was only after Donda West's death that Dr. Adams voluntarily surrendered his medical license.

Only the "worst of the worst' doctors lose their license.

Read it all. Better still, Dr Brent Moelleke's original comments to a RealSelf discussion forum question are worth repeating here:

Patients find comfort in checking the Medical Board websites for violations, probation, letters of reprimand, etc. It is certainly bad when a doctor is on probation, has committed acts of negligence, or has many malpractice suits. However, a clean Medical Board record does not mean a surgeon is a fine surgeon; it could just mean they have not been caught yet, or have not committed sufficiently bad deeds to register on the Medical Board website. On the flip side, I know of fine doctors who have an ominous sounding violation, publicly posted, because they did not register their change of address in time!

Patients also think they are “covered” if they are having surgery with an uncredentialed, non board-certified doctor because “they can sue if the doctor screws up”. Unfortunately, this is also a difficult burden to prove. Just because a doctor has a bad outcome does not mean he or she committed malpractice. Likewise, if a doctor has a lifetime of below average outcomes, none of which fall “below the standard of care”, they will continue to deliver bad care, or in the case of plastic surgery, subpar plastic surgery, indefinitely.