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Wrinkles? No prob. Mole? Get in line

Patient get a Botox shot to her brow

TEXT OF STORY

Bob Moon: Now if you want those annoying, unsightly wrinkles to disappear, you'll probably be able to find a dermatologist to give you a Botox shot within a week. But if you're worried about a mole that seems to be changing, you'll probably wait about a month for that same doctor. That's the conclusion of a new study in the American Academy of Dermatology's Journal. From the health desk at WGBH, Helen Palmer reports.


Helen Palmer: This would seem to be a case of follow the money. Diane Baker, president of the American Academy of Dermatology, says cosmetic procedures are lucrative:

Diane Baker: Anywhere from $400 to $1000 for Botox... and a medical problem could be as low as $50 or less for a visit.

But analysts say this study, which showed an eight-day wait for Botox versus 26 days for evaluating a mole, highlights the direction American medicine is taking. Paul Ginsburg of the Center for the study Health System Change:

Paul Ginsburg: This is clearly a case where dermatologists are responding to economic incentives.

Ginsburg says patient's pay up-front for cosmetic treatments. Normally, doctors have to file reams of forms and wait weeks for insurance payments. Some observers see a positive lesson here. Glenn Melnick teaches health care finance at the University of Southern California:

Glenn Melnick: The market does work. It works in general, and it works in health care as well.

Melnick says increasingly, patients are paying more out of pocket. This power means they can also get better and more timely service. Dermatologist Diane Baker says she and her collegues aren't money-grubbing -- only 10 percent of their income comes from cosmeitc procedures.

And all dermatologists keep appointments open for emergencies. She says people worried about possibly cancerous moles should absolutely insist they're seen urgently.

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