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'He says he is a dermasurgeon and yet he is not even a doctor'

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Dr. John Caribe has been licensed as a dentist in the state of New York for 20 years. He has hospital privileges at his local community hospital where he performs oral surgery and other dental procedures. Five years ago, Dr. Caribe received a medical degree from the University of Health Sciences Antigua, St. Johns, Antigua. He never completed any postgraduate training; nor did he complete any part of the Federation Licensing Examination (FLEX) or the United States Medical Licensing Examination (USMLE).

Despite not having a license to practice medicine, Dr. Caribe attaches the M.D. designation to his name. He advertises his name as John Caribe M.D., dermasurgeon, in local newspapers, the Yellow Pages and in some radio ads. He, in a very short period of time, becomes a major user of nonablative lasers, fillers, peels and botulinum toxin. Unfortunately, in an equally short period of time, his technique-induced complications begin to show up in the offices of nearby board certified dermatologists and American Society for Dermatologic Surgery-member dermasurgeons. These physicians become incensed with what they are seeing and seek some method to preclude Dr. Caribe from continuing to perform cosmetic procedures. The local dermatologists very quickly determine that Dr. Caribe is a licensed dentist and is legally able to perform many cosmetic procedures. Legal counsel suggests that they file a complaint with the local state medical board accusing Dr. Caribe of practicing medicine without a license. Will that work?

A case decided in Kansas in September of 2004 is relevant. In that case, Dr. Steven Thomas, a dentist licensed in Kansas, used the M.D. designation after his name. He had obtained a medical degree after attending medical school on a Caribbean island. Dr. Thomas, after completing his medical school education abroad, never completed any postgraduate training; nor did he complete any part of the FLEX or the USMLE. He did not have a license to practice medicine in Kansas. The Kansas State Board of Healing Arts (Kansas State Board of Medical Examiners) brought an action against him asking the court to stop him from using the M.D. designation and to declare his use of M.D. unlawful - despite the fact that the Kansas Dental Board approved Dr. Thomas' corporate charter name as "Steven L. Thomas, D.D.S., M.D., and Chartered."

The court further noted that 1.) Any damage that Dr. Thomas might suffer by not being able to use the M.D. designation was outweighed by the potential harm of misleading people about his credentials; and 2.) Dr. Thomas' using the M.D. designation in any manner would tend to mislead or confuse the public because the M.D. degree is commonly associated with a certain course of training that Dr. Thomas never obtained.

The court also found no trouble limiting Dr. Thomas' "free speech" argument in preventing his professional use of the M.D. designation where such speech might be deceptive or fraudulent.

However, the court did state that Dr. Thomas could use the M.D. designation in academic or social environments. The court simply did not allow him to use the M.D. designation in any area in which the public, patients, hospitals or other health care practitioners could be misled by the individual's designation.

It is unlikely that the dermatologists in Dr. Caribe's area will be able to stop his practice of cosmetic dermatologic procedures. However, they may have greater success in preventing the use of the M.D. designation after his name.

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