At this beauty salon, the doctors are definitely in

This month’s odd medical news emanates from Tarzana, in the San Fernando Valley -- surely one of the few places on Earth where three board-certified physicians are practicing what they call Happy Medicine out of a room in a hair-cutting shop.

In their salon gig, for a few hours each week, the medics administer Botox, collagen and laser treatments to erase lines, wrinkles and unwanted hair for patrons who may also be getting a cut, a color and a pedicure.

“At first I was skeptical, coming to such a nontraditional environment to perform medical procedures,” says Jeffrey B. Glaser, a full-time anesthesiologist and now part-time aesthetician. “But I knew women were getting botched jobs performed by unskilled personnel at salons all over the city. Nurses and others who are not well-trained are doing this. I knew I would do it better, do it correctly.”

Glaser, 34, and his partners in the new venture -- Steven Freedman (an OB-GYN) and Jerome D. Vener (a head, neck and facial plastic surgeon) -- each maintain their separate, full-time medical practices. Now they also spend a few hours (and make a few bucks) each week at the Michael Joseph Furie beauty shop on Ventura Boulevard. Vener, 52 and in practice 21 years, is a beefy, avuncular type who sees the irony in their experiment, now a month old. “I know, I know. We’re guys who trained for years to become dedicated doctors. Now we’re doing bikini lines and sculpting hearts on women’s private parts with a laser? In a salon?” Well, yes, they are. But they are mostly working on more public parts of the anatomy, specializing in facial enhancement for men and women via the face-plumping injections and laser treatments.

Vener says he realized years ago that he had two types of patients: “the sick ones, who came to have tumors removed and other serious procedures. And the healthy ones, who simply wanted their looks enhanced.” His colleague, Freedman, was also getting requests from patients who wanted enhancements of the face and other regions. Both doctors had been trained in laser, Botox and collagen, Vener says, and about three years ago they formed a separate company to do the beauty work.

Then Glaser, who’s also trained in all the procedures, came to them with the idea of starting a part-time practice in one of the Valley’s oldest hair and makeup shops. The owner, Julie Edwards-Specter, says she thought it was an interesting idea and offered them an unused back room.

“What we do here is the happy stuff. We do it because it’s fun and we’re good at it,” Vener says. “This shop is a totally appropriate place for that kind of thing. Actually, it’s much more appropriate than sitting in an office next to patients who’ve had parts of their faces removed.

“We still spend most time helping sick people, but only because we’re altruistic. Because there’s no money in disease. There’s something wrong with the system when a physician doing a minor Botox injection is paid more than he would get for an appendectomy or tonsillectomy. That’s a fact.”

Vener says the average Botox injection costs about $300; a tonsillectomy or appendectomy reimbursement is about $100. “If the doctor gets lucky, he may get $120,” he says. “Because of insurance reimbursement problems, it’s impossible for doctors to make a living,” he says.

Glaser interrupts, looking disturbed at this turn of conversation: “Money is not the main issue for me,” he says, looking sincere as he rubs his chin. “I’m a firm believer in what we do here, and how it helps people. Look how smooth my neck and chin are,” he adds, explaining that for years he felt like a wolf-man, with excessive amounts of hair growing on the underside of his chin and down his neck.

With laser treatments, the unwanted growth was removed permanently, he explains, and then goes on to document cases of patients with deeply furrowed brows, acne scars, spider-veined noses, all sorts of unfortunate superficial problems that were abated simply, with injections or laser treatments. “I believe we’re performing an incredible service for these people. It may be minor, but it changes lives.”

A beautician who specializes in eyebrows appears and asks Vener to consult with a woman who is having permanent brows done. “I want to know about these veins,” the woman says, pointing to a nose carpeted with tiny red lines. Vener says he can probably remove them with laser treatments and she decides to schedule an appointment. Just like that. “You see how easy and natural it is to do this work in a setting like this?” Vener asks.

Statistics would prove him right. There has been much recent growth in the business of so-called aesthetic spas and medi-spas -- places where people enjoy traditional spa amenities combined with various beauty enhancing medical procedures. A medi-spa can be a luxurious hotel-like retreat where a doctor oversees laser, collagen and Botox procedures -- or it can be a strip mall storefront where skin-enhancing procedures are administered by nurse practitioners. (In California, aestheticians, cosmetologists and electrologists may not administer Botox or laser procedures.)

The three doctors have simply distilled the idea to its most common denominator. Even people with little time and money for self-indulgence must remain reasonably well-groomed. When they get to their salon for a color or cut and learn that their frown lines can also be removed, the doctors figured, it would be a winning combination. Although it’s early, there are signs that they were right.

“Payment has not been a problem here,” Glaser says. “I’m a Blue Cross provider and people are always asking if I can write off the co-pay. They say they can’t pay their phone bill, their doctor bills, they tell me their troubles. But when it comes to looking more attractive, some of those same people arrive with fistfuls of cash -- cash they’ve saved because they are so determined to have the procedure.”

On a recent Saturday, Ilene Tucker, a nurse at UCLA Neuropsychiatric Institute, was in the shop for a laser treatment “to even the skin tone on my face.” She said she’d been to Freedman for a gynecological exam and asked him about sun damage to her skin caused by years as a lifeguard. “He thought the laser treatments might help,” so she signed up for five treatments. Did it bother her to get them at a beauty salon?

She laughed and thought for a moment. “I’d be bothered if a beautician treated me at a doctor’s office -- but not if a doctor treats me in a beauty shop,” she said. “Actually, I like the atmosphere here.”

Glaser says that before they started the business, the doctors checked with their malpractice carriers and with the Medical Board of California. “We wanted to make sure it was all right to practice in this setting. They said it was fine. As long as we’re practicing good medicine, they don’t care where we practice it.”

Candis Cohen, spokeswoman for the Medical Board of California, says she knows of nothing in the law that prohibits laser, Botox or collagen treatments being done in a beauty salon. “Botox can even be given in a home at a Botox party,” she says.