Family physician involvement in aesthetic medicine in British Columbia: a cross sectional environmental scan

BACKGROUND: Aesthetic medicine is a rapidly expanding area of practice that operates outside the publicly funded healthcare system in Canada. As a result, physician involvement in this sector is not captured in administrative data sets and the extent of family physician participation remains poorly characterized. We conducted an environmental scan of the publicly observable footprint of aesthetic medicine in British Columbia (BC), including clinics advertising minimally invasive procedures, and the physicians publicly associated with them with specific attention to the representation of family physicians. METHODS: Clinics were identified using Allergan Canada’s public clinic locator and supplemented with an independent Google search. Clinics offering onabotulinumtoxin A and hyaluronic acid dermal fillers were included. Physicians affiliated with included clinics were verified through the College of Physicians and Surgeons of British Columbia (CPSBC) registry. Descriptive analyses were performed to characterize clinics and physicians including specialty distribution, training background, and clinic staffing. RESULTS: A total of 171 clinics and 299 physicians were identified. Family physicians represented the largest specialty group (192/299, 64.2%), followed by dermatology (13.7%) and plastic surgery (10.0%). Most providers were Canadian trained (67.6%), and gender distribution was balanced (53.5% male, 46.5% female). Forty-eight physicians (16.1%) reported additional training, and nine practiced across multiple sites. Clinics were concentrated in the Mainland/Southwest region (62.0%), with over half employing allied health professionals, most commonly registered nurses. Ownership information was reported for 21.0% of clinics, and documentation of prescriber oversight was inconsistent. CONCLUSION: This study provides a conservative estimate of aesthetic medicine activity in BC and identifies family medicine as the most represented specialty among publicly listed providers. These findings highlight the need for more comprehensive data on privately paid medical services to better understand practice models and how aesthetic medicine fits within Canada’s evolving primary care landscape.