The New York Times on Monday published a scathing indictment of dermatology practices, which stated that dermatology is becoming a two-tier business: the higher-paying customers seeking cosmetic procedures will frequently receive a higher level of care compared with medical patients for whom health insurance pays fixed reimbursement rates.

In the article,  Donald Richey, a dermatologist in Chico, Calif, says that he has two office telephone numbers: calls to the number for patients seeking an appointment for skin conditions like acne and psoriasis often go straight to voice mail, but a full-time staff member takes calls on a dedicated line for cosmetic patients seeking beauty treatments, such as Botox.

A study published last year in the Journal of the American Academy of Dermatology found that dermatologists in 11 American cities offered faster appointments to patients calling about Botox than for those calling about a changing mole, a possible sign of skin cancer.

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John Di Saia's Truth in Cosmetic Surgery blog this week ran a photo comparison of Barack Obama in his youth -- prior to his rhinoplasty -- and then more recently, after his nose job.

Dr. Di Saia wrote, “The old Barack image features a more rounded nasal tip. His later images look consistent with a minimal tip rhinoplasty to me. It makes for a more 'Caucasian' look. Maybe...”

As they say, a picture is worth a thousand words.

The above photo was taken from the MakeMeHeal.com site, which also commented on the possiblility of Michelle Obama having had plastic surgery -- not likely, according to the blogger who posted the above photo. In the same blog entry, the author comments on the possible plastic surgery that may have been performed on John McCain's wife, Cindy.

Although this New York Daily News article talks about physicians in the Big Apple, it is a trend story that applies to all regions of the US (and beyond).

The article props up what we've suspected for months: Plastic surgeons are doing their most to keep heads above financial tides, as they take on more injectables-related business to combat the shrinking economy and to counteract the well-reported drop in the number of patients booking costly surgical procedures.

But wait, it's not only plastic surgeons who are out for a piece of the action.

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