I've had a problem with psoriasis on my foot for years. Recently it became rather bad, and I visited a well-known dermatologist in Kilpauk (who also practices at one of Chennai's best-known hospitals).
I have a mistrust of new doctors, so I cross-checked all items on the prescription. They all looked standard stuff for psoriasis; the ointment, in particular, was similar to something I've been prescribed once before (a different preparation of betamethasone, a corticosteroid). So I went ahead with the treatment and the problem cleared up within a week, as it had before.
I then told the doctor that the problem tends to recur after I stop the treatment (even if I keep the area moisturised). She said there is another tablet that she would consider prescribing, but wanted some blood tests done first to be sure it is safe to take it.
Today I went there, blood tests in hand. And while I was waiting, two people got up to the reception to speak. One guy introduced himself as from the company that makes Botox, and he said the young woman next to him will be sitting in the doctor's clinic assisting her; meanwhile they wanted to inform and educate us about this treatment.
I promptly announced that I am cancelling my appointment, scratched my name, wrote the doctor a brief note, and walked out.
I had already been disturbed, on my first visit, at the sight of Botox advertisements in the doctor's clinic, telling patients how they could keep the wrinkles away and stay looking young; but I ignored it because I had strong recommendations to this doctor. (And, for all I know, she is indeed very good.)
There was a time when doctors would not prescribe medicines that were advertised to the public. For example, if you needed an aspirin, they would prescribe not Aspro (advertised in the glossies of the time, and on TV) but Disprin (not advertised). I know times have changed, and I have even seen a few Disprin ads. I can also understand a doctor prescribing Botox for someone who needs it (I first heard of it, years ago, in the context of treating writer's cramp).
But cosmetic Botox is another matter. And direct-selling it to patients, in a doctor's clinic? I find that utterly unconscionable. I mean -- the thing is a neurotoxin, derived from bacteria that cause a deadly form of food poisoning (botulism). Its therapeutic use is in paralysing muscles -- which is sometimes good (alleviating writers cramp), but sometimes surely unnecessary (paralysing facial muscles, which allegedly cause wrinkles not to form). At best, it should be suggested by a doctor after carefully explaining the pros and cons of the treatment -- not direct-marketed by a pharma company on her premises!
And if the doctor indulges in this sort of practice, how can I be sure that the pill that she was going to prescribe me was in my interest and not in the interest of some pharma company or the other?
I've heard it said that the reason for the wooden appearance of several Hollywood celebrities (think Nicole Kidman) is their excessive use of Botox; one quote that sticks in my mind (I forget where I saw it) is, "few actresses are able to look angry any more". [UPDATE: found it.] Well, sometimes I do want to look angry. For example, right now.