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The device companies are interested in selling their devices, and they're not necessarily interested at this point in selling the devices to a doctor who is properly trained to do them. So if I am an internist or an anesthesiologist who happens to own a Medispa, even though I've never done a liposuction or a body-contouring procedure in my career, I'm still able to get a CoolSculpting machine and offer this service to patients.
The problem with that is that when your only tool is a hammer, then every patient is going to look like a nail, and anyone who comes in, you are going to be pushing them towards CoolSculpting where it might not be the appropriate procedure. The patient may have a skin problem. The patient may have a fat problem that's too large to be addressed by CoolSculpting, and that means that that patient is going to be wasting their money on a procedure where a different surgical procedure is going to be a better choice for them than the CoolSculpting.