Cut-price incentives and budget procedures put pressure on doctors to compromise on ethics and standards of care, which could cause patients health problems later in life.
DUBAI // Doctors are warning those interested in cosmetic surgery about aggressive marketing and sales tactics used at some practices to promote plastic surgery.
Dr Sanjay Parashar, chief executive and director of the Cocoona Centre for Aesthetic Transformation, said high-pressure sales environments were putting a strain on doctors and managers to hard-sell nips and tucks in a drive to meet targets, while some plastic surgeons were promoting the kinds of offers or two-for-one deals one might expect to find in a supermarket or shopping mall.
When non-plastic surgeons own plastic-surgery businesses, corporate investors have expectations on the return for their -investments, Dr Parashar said.
“This puts a lot of pressure on the doctors and managers to achieve targets in a stipulated period of time. And targets lead to compromise on the ethics, quality and medical fundamentals,” he said.
“Hard-sell tactics are adopted by non-professionals and they often are willing to perform the surgery within a day or two.”
Budget plastic surgery is another cause for concern for Dr Parashar, who said such tactics muddied the line between running a successful business and practising medicine ethically.
“For example, some centres offer Dh5,000 for liposuction or Dh7,000 for rhinoplasty,” he said. “How is it possible to perform this procedure by a certain standard of medical care?”
Dr Parashar said that cut-price incentives could entice people who had not previously considered surgical or non-surgical procedures, to have more work done, potentially heightening the risk of post-operative complications. These could include infection, bleeding, wound breakdown, deep vein thrombosis and pulmonary embolism.
Dr Luiz Toledo, a cosmetic surgeon in Dubai, warned patients against being taken in by deals that seemed to good to be true.
“Do not treat your body with someone that offers cheap alternatives to good treatment, such as Groupon offers – you can’t buy something for nothing,” he said. “Surgery is expensive and if the doctor uses the best hospital, crew and materials, the price is not cheap.
“I have heard of clinics offering Botox treatment for prices cheaper than the price of the Botox vial. Either they are diluting the product many times or they are using cheaper, non-approved drugs instead.”
Dr Toledo said a good plastic surgeon would never try to push a procedure on a patient.
“If the surgeon starts with, ‘by the way, why don’t you do your nose?’ when a patient comes in for breast surgery, you know something is wrong.
“There is one situation when the plastic surgeon can offer an extra treatment, such as when a patient comes for a nose job and the surgeon verifies that the patient has a weak chin, which makes the nose look bigger than it actually is.
“Then he can offer an alternative or concomitant chin augmentation.”
Dr Maurizio Viel and Dr Roberto Viel, of the London Centre for Aesthetic Surgery in Dubai, said it was important that patients did not “bargain hunt” for the cheapest surgeries – such as an offer of a Botox procedure for Dh500, because it would often end with problems farther down the line.
They said patients should try to have at least two consultations with established, reputable surgeons who are based in the UAE, rather than with visiting surgeons, because this helped with post-operative care. Patients should also feel comfortable with the surgeon.
“It is important to not seek surgeons who pressure their patients and are hard-sellers – if the patient is uncomfortable with the doctor, they should not go ahead,” said Dr Maurizio Viel.
Dr Roberto Viel said patients should not feel rushed into undergoing a procedure, and surgeons should always give -patients time to consider the surgery if they were unsure.
“We don’t think it is just Dubai where patients face unethical surgeons but all over the world – from London to New York,” he said.
“It is important for patients to be savvy and to be armed with questions if they don’t understand the implications.”
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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Starring: Rose, Jisoo, Jennie, Lisa
Directors: Min Geun, Oh Yoon-Dong
Rating: 3/5
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Power: 154bhp
Torque: 250Nm
Transmission: 7-speed automatic with 8-speed sports option
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Company Profile
Name: Thndr
Started: 2019
Co-founders: Ahmad Hammouda and Seif Amr
Sector: FinTech
Headquarters: Egypt
UAE base: Hub71, Abu Dhabi
Current number of staff: More than 150
Funds raised: $22 million
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Banthology: Stories from Unwanted Nations
Edited by Sarah Cleave, Comma Press