However, a spokesman for the reverse-auction service says these concerns are unfounded. What's in a name? Launched in 1995, Medicine Online Inc. is a privately held California corporation and developer of two healthcare sites — http://www.mol.net/, for physicians and healthcare professionals, and http://www.medicineonline.com/, for consumers. However, it wasn't until the company launched http://www.bidforsurgery.com/ in early 2000 that consumer and media interest skyrocketed, says David Puffer, Medicine Online's chief operating officer."The name bothers a lot of physicians," he admits, "but we had a choice between getting patients to refer to them and having a name that they liked." Mr. Puffer says that, in late October, the site was generating about 100 inquiries daily — for procedures ranging from cosmetic surgery and dentistry to laser vision correction and podiatric surgery. The site's expansion has been slowed, though, because only 400 plastic surgeons had registered to participate, he adds. Surgery as commodity Cosmetic surgeons interviewed for this article appear unlikely to sign up. Not only do physicians lose money by joining such schemes, "They are inheriting the worst cosmetic patients of all — price-shoppers who admit from the start that they only care about one thing — the cost of the procedure. Doctors who do this deserve what they get," says Joel Schlessinger, M.D., a board-certified dermatologist and general cosmetic surgeon who is president of Skin Specialists PC and president-elect of the American Society of Cosmetic Dermatology and Aesthetic Surgery. However, Mr. Puffer counters that the lowest price wins the patient only 10 percent of the time. "The most important part of the bid from the consumer's perspective is the credentialing information" the site provides, he says. Others express concern that http://www.bidforsurgery.com/ "takes out the physical exam ahead of time," says Dan Mills, M.D., a plastic surgeon in private practice in Laguna Beach, Calif. Therefore, he says, both the American Society for Aesthetic Plastic Surgery, for which he serves on the ethics committee, and the California Society of Plastic Surgeons, of which he is president-elect, would judge the site as "not in line with good practice of medicine." Quoting blind A patient shopping for a breast reduction might not know that several types of reductions exist, Dr. Mills says. He adds that some prospective patients think they need a breast reduction "when really they need a lift with maybe a little keel wedge resection. How can I quote a price, sight unseen, without talking to the patient and doing the physical exam?" Moreover, he says quoting a price for the quickest and easiest type of surgery — when it's rarely what the patient needs — breeds distrust. |