No Vaccine, No Cosmetic Surgery

No Vaccine, No Cosmetic Surgery

Troy Pittman, MD FACS

Washington, DC

My partner and I recently made the decision to stop seeing unvaccinated patients in our aesthetic surgery practice in Washington, DC.  Ironically, we announced our decision a day before Mayor Bill DeBlasio announced that New York City would require vaccination in order to attend restaurants, gyms, and theaters.

This decision was not an easy one and it was made for several reasons.  To begin with, our main priority is to protect the health and well-being of our patients and staff.  Of course, that’s the obvious PR response that everyone gives.  However, it was also to protect the unvaccinated who would be seen in our office for purely elective cosmetic procedures and MedSpa services.  No one NEEDS to get a facial or a Botox injection.

The backlash on social media has been real.  We’ve been called imbeciles, bullies, and morons and those are some of the more benign ones.  I’ll get back to this but first, let me give you a little background.

This is not our first wild ride thinking about COVID.  When the pandemic started in March 2020 and DC was put on lockdown, we closed our office for 5 weeks and stopped operating for nearly three months when a moratorium was placed on elective surgeries.  As two surgeons that derive much of our practice income from operating, we felt this in more ways than one.  When things opened back up, we dedicated a significant amount of time and effort to keep our patients, our employees and ourselves safe.  We tested every surgical patient, screened employees in the office daily for symptoms, did more temperature checks than a gourmet chef, and donned uncomfortable masks for more than 18 hours a day at times.  At that time, there was no end in sight, but we were making it.  We were keeping everyone safe and healthy.

Let me give you a little perspective on our practice.  My “partner” in the practice is also my husband.  That’s right, we live and work together which just about equates to being together 24 hours a day.  If one of us were to get COVID, the practice is shut down for 2 weeks.  That’s 2 weeks of work lost for our 15 employees and 2 weeks of canceled patients that have rearranged their lives to have surgery.  Aside from the obvious short and long-term health effects, testing COVID positive is a big deal on so many levels.

Then the vaccine came!  I cried tears of joy the day in late December when I received my first shot.  Not only because it was a step toward normalcy but because I was witnessing one of the greatest medical advances of all time.  Science was on our side!  All of our employees slowly received their shots and we formed our protected bubble.  After the second shot, it was hard to not feel invincible.  We could actually see the faces of our patients and co-workers again.  As a physician, it was hard to see a downside to such a medical miracle.  Then politics came into play.

The greatest medical advance of our life became the most politicized medical intervention of our lifetime.  Suddenly the choice to become (or not become) vaccinated became something more than making a choice for your own health and safety.   Just as masks had become less about stopping disease transmission and more about individual liberty, the choice to be vaccinated became somewhat of a political disposition.

And now, the next level of this seemingly never-ending, real-life game of Jumanji, the delta variant.  Ten times more contagious and more pathogenic with the propensity to affect younger individuals at a higher rate.  Unvaccinated individuals have repopulated 96% of the once nearly empty COVID wards.  We are moving in the wrong direction.  While it is somewhat encouraging that the death rate has not started to climb as precipitously as it did in previous case number spikes, we are now back to mask mandates and are once again, in a position to make some hard choices.

Once again we are faced with making the decision between performing a rapid COVID test on every individual that we encounter (a logistically impossible task) or limiting who comes into the office.  So, we chose the latter.

Let us see the forest through the trees here.  We do 100% elective, cosmetic medicine.  We do not participate with insurance and do not see reconstructive patients unless they have a cosmetic concern.  The one exception to this is that we are continuing to see our unvaccinated patients that are in an active phase of recovery from surgery.

Moments after we announced this policy on social media, we were flooded with messages of disapproval.  Ironically, not from any of our current patients.  It’s always amazing how brave people get when showing their bravado in an anonymous forum.  Initially, we tried to respond in a non-emotional, polite manner, trying to explain ourselves and justify why we made this decision.  We quickly realized that this was futile.  At the end of the day, I don’t need to justify my decision to anyone.  It’s my private business and we are committed to providing the highest level of care for our patients.  Ultimately, we don’t owe anyone an explanation.

Having said all of that, we still feel the need to justify that we are doing the right thing.  As I see it, the decision to stop seeing unvaccinated patients is about risk mitigation for both groups.  New data shows that the vaccinated can carry and spread the virus (hence the new mask mandates).  However, unvaccinated individuals make up 98.7% of new cases in DC and 99.3% of new cases in our neighbor Virginia.  The overwhelming conclusion of this is that breakthrough cases are exceedingly rare, and the virus is being perpetuated predominantly by the unvaccinated.  Furthermore, according to the CDC, unvaccinated people are eight times as likely to get the virus, 25 times as likely to be hospitalized, and 24 times more likely to die.  There’s no arguing that this group is high risk!  Not only of being infectious but also of contracting the virus with dire consequences.  We are not discriminating against the non-vaccinated, we are protecting them.  The same applies to the controversial mask mandates.  For the most part, vaccinated people will be fine.  We wear masks to protect the unvaccinated.

Limiting our practice to only vaccinated individuals is not political, it’s responsible.  We are protecting our vaccinated patients and staff from exposure to those that are most likely to have COVID.  We are also protecting the unvaccinated, who have the most to lose, from contracting the virus from a vaccinated carrier.

There is no perfect situation here.  Science teaches us to make decisions that will most likely have a positive effect on the largest number of people.  In the coming weeks, we may even see DC follow in New York City’s footsteps. Regardless of what’s going on outside our doors, we can certainly control what’s going on inside them.  We stand by our decision, despite it not being unanimously popular.

 Dr. Troy Pittman completed his medical training at the State University of New York at Buffalo. He went on to residencies in both General Surgery and Plastic Surgery at Rush University Medical Center in Chicago, IL. Dr. Pittman gained extensive experience in the full spectrum of Plastic Surgery including cosmetic surgery of the face and body, body-contouring surgery after massive weight loss, reconstruction of the face and body following traumatic injuries or major cancer surgery, as well as trauma, burn and wound surgery at the world-renowned Cook County Hospital Trauma Center in Chicago.

Following his Plastic Surgery residency, Dr. Pittman completed a fellowship focused on Aesthetic and Reconstructive Breast Surgery at Georgetown University Hospital in Washington, DC under the direction of one of the world’s experts, Dr. Scott Spear. During his fellowship, Dr. Pittman focused on advanced techniques in breast augmentation, mastopexy/augmentation, implant-based breast reconstruction, and perforator-based microvascular reconstruction of the breast.