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A recent article in the New York Times reports that medical practices in Prague are offering cosmetic enhancements to nurses as an employment incentive – free of charge.  One nurse opted for breast augmentation and liposuction.

The piece raises some interesting ethical questions: While the procedures could certainly be beneficial to individual nurses in the short term, would such a practice harm the nursing profession as a whole?  

According to reporter Dan Bilefsky, nurses in the region “insist they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.”  Critics argue that the incentives could promote an idealized body image for nurses, in a profession already suffering from misconceptions about technical competence.  A spokeswoman from the Czech nurses association argues that nurses are still perceived as “low level workers” with little to offer besides manual labor.  Nurses after all, aren’t intended to be models, but caregivers that provide an enormous benefit to the medical profession and the public they serve.  A misplaced emphasis on their physical appearance could undermine public perceptions of their competence and value.

Still, others may not see any problem with offering incentives through procedures like breast augmentation or rhinoplasty; perhaps they’re analogous to employee discounts at a retailer, vacation packages, or other career perks.  

The supposed ethical problems brought by these surgical incentive programs probably shouldn’t be directed at the programs alone, but rather toward the underlying sexism and discrimination affecting nurses in the region.

Doctors once believed that off-label use of Botox – a drug developed for treating muscles spasms – would be fairly limited. If you do a little research however, you’ll find that physicians are using the neurotoxin for many other interesting purposes.

Last March, the New York Times published a story on the off-label use of Botox to help those who have suffered a stroke and have trouble relaxing certain muscles. According to the experts, “only about 5 percent of the stroke patients who could benefit from its use ever get it.”

Many doctors use Botox to treat headaches, and their basic procedures are hardly different than those of wrinkle treatment. It isn’t entirely clear how the Botulinum toxin provides relief; it may work to inhibit certain pain-transmitting nerves. But evidently, many people suffer from fewer headaches after being treated with Botox.

As reported in the Journal of the American Academy of Dermatology, researchers from Allergan Inc. conducted surveys about sweating, revealing that almost 3 percent of the U.S. population (7.8 million people) believe their sweating to be excessive. At the time of the survey (in 2004), less than half of the respondents had sought medical help for the problem. Botox blocks the localized release of a specific chemical that stimulates sweating, and so the FDA approved it for this use years ago.

Patients with even more obscure conditions have found success using Botox. In Feb 2008, USA Today reported that radio personality Diane Rehm (of National Public Radio) had received routine off-label Botox treatments for a vocal disorder called spasmodic dysphonia.

Aside from these therapies, surgeons and dermatologists are finding even more cosmetic uses for Botox.  Dr. Lawrence Reed recently told an ABC news affiliate that “we’re at the tip of the iceberg where Botox is going to be used.” Reed has apparently been pioneering some interesting new cosmetic applications.  For patients with acne, Dr. Reed injects Botox just below the skin: “It decreases the muscle pump and blocks the production of oils, so we use it for acne,” he claims. Other patients of Dr. Reed found received Botox to relax certain muscles (one patient made her eyes appear larger) and to supplement laser skin resurfacing.

Just a few words of caution:  If you’re considering Botox for any off-label use, make sure you choose a qualified physician. Despite the optimism surrounding Botox as a ‘wonder drug’, there have been complications and side effects associated with off-label use and inexperienced providers.  If you’re interested in Botox treatment around Maple Valley, Washington, contact us, or see our homepage.