While insurance companies and Medicare continue to cut back on reimbursements for physicians, more and more unqualified doctors in Los Angeles are in many ways being forced to provide cosmetic services, which of course are out of pocket and typically pay much more than any insurance-based surgery. This in many ways dilutes the field of plastic surgery and leads to what the business people call ‘brand erosion’. More importantly, it can be just simply unsafe for patients. Many doctors label themselves ‘cosmetic surgeons’, however there really is no such field in medicine for which a doctor trains. Those who label themselves ‘cosmetic surgeons’ are often doctors in other fields doing plastic surgery, including non-surgical fields such as dermatology, or radiology. Some are general surgeons, but would you want your plastic surgeon taking out your gallbladder? I’d estimate that almost 50 percent of physicians in Beverly Hills performing plastic surgery are NOT plastic surgeons. Perhaps the single most important question every patient must ask their potential surgeon is, ‘Do you have privileges to do this surgery you are about to perform on me in a hospital?’ If the answer is ‘Yes”, then verify that by calling the hospital if there are any doubts. Why is this important? Hospitals (and their Medical Staff Committee) are very strict in providing ‘permission’ for doctors to do surgical cases, and they generally won’t consider a physician to operate outside his or her field. Just as a hospital would find it unsafe and enormous liability for one of their plastic surgeons booking (and performing) a heart transplant case, they don’t want a radiologist or dermatologist doing liposuction, or their general surgeons doing a breast augmentation. But it happens all the time in surgery centers which are far less regulated. So be sure your doctor has privileges in a hospital to do that SPECIFIC case. If he or she tells you that they do in a surgery center only? That generally means nothing, particularly if it is their OWN center where they function as their own credentialing committee.