Is my doctor being dishonest? I get asked this by patients a lot and the answer is likely no, but you need to be mindful of who is paying your doctor. Many physicians work as consultants for various companies. I have worked for a variety of companies as a consultant (skincare, implants, injectables, even a cardiac device company!) For your doctor, this can be very rewarding. We get access to new and exciting products in development, and have input in their use and design.

These companies pay a consulting fee for our expertise. Some doctors also are paid for speaking engagements. As a speaker, you are typically teaching doctors or other practitioners how you use a company’s product or device. These relationships do not require the doctor to only use that product, or prevent us from pointing out problems or negative things about it. Doctors are more likely to work for companies they like and believe in as you probably would have guessed.

So how does this affect your doctor’s care and use of the products? There have been studies that show that something as small as a free pen can influence how a doctor behaves. It’s very important to consider these types of biases as a physician when you make recommendations to a patient. We all have biases, every single one of us. It’s important to be mindful of this and work to make recommendations that are as free from them as possible. Presence of bias by itself should not lead to discrediting recommendations or research, it just means you need to account for that when you evaluate what is presented.

As a patient, it’s never wrong to ask your doctor if they consult for any medical companies, and if that influences their recommendations for you. Feel free to ask about other brands or devices they may not recommend and get an explanation for why they do not use them or recommend them. I typically use Allergan implants. They are great devices and we have a consignment in our operating room which makes ordering and using simple. Sientra and Mentor also have good implants and I would have no problem using them if my situation changes and I am at a facility that works with those companies.

Plastic surgery is a strange world compared to normal medical specialties. There is an aspect of sales intertwined with the medicine. Plastic surgeons often carry skincare, supplements, and own lasers/devices. You will likely be recommended the products they carry. This in itself is not worrisome as well, but if your surgeon is pushy about the exact brand they carry without a good explanation why it’s better, you should also be mindful of that.

Surgeons usually carry brands and devices they believe in, which is why we recommend them. Your surgeon should have good reasons why they recommend what they do, and again you should never feel uncomfortable asking questions about why that brand or device.