There is an interesting and worrying piece in the New York Times about dermatologists in the US. The charge is that patients attending with medical skin complaints are treated as second class compared with those patients seeking cosmetic interventions. The latter make more money for the MDs. The insurance company payout for seeing people with ‘ordinary’ medical skin complaints is low, say some dermatologists in defence.

There are lots of reasons why I find this disturbing. The ultimate outcome of demand-based medicine means that the largest dollar shouts loudest. But this does not match who is in need of most medical care. Why on earth should patients with serious skin complaints be dealt with less quickly than those who want a few wrinkles pressed out? Medical magazines in the UK frequently offer courses for doctors or nurses wanting to do a bit of cosmetic botox. Dentists, too, are getting in on the act. Is this really a good use of time and training? 

The other thing that bothers me is our apparant obsession with being wrinkle free. What kind of society is it that proclaims itself to think ageism a terrible thing  – but then spends vast amounts of time and money trying to superficially avoid the signs of maturity?