Look, I get it. I don’t sit in judgment of every doctor who goes into aesthetics. I understand it. Medicine is exhausting, the bureaucracy is soul destroying and the pressure can be relentless. The money isn’t all that too. It’s only natural doctors look sideways at alternate careers.

In university, I used to say I’d leave medicine. I still think about it. If I am honest, I’ll probably leave, because of the money. I want my children to have certain opportunities that NHS medicine simply does not offer. But despite my own selfish hedonistic pursuit of money, ultimately the job still needs to sit within my moral compass, something that still feels noble.

I’d rather do medicine for free, my kind of medicine – human, holistic and uncorrupted. Then make money hollowing out a noble profession.

Once upon a time Medicine wasn’t just about employment or a way of paying bills. It was and to some extent still is a trusted vocation. When you enter medicine, you inherit a code. You are entrusted with something larger than yourself. That’s why medical aesthetics, for me, feels like the prostitution of honour. Not in the sense of individual shame but in trading away the nobility of the oath. The Hippocratic oath wasn’t written to justify vanity. It was a promise that we exist to heal, not decorate.

A patient is someone who entrusts their vulnerability to you. A customer is someone who pays you for a service. Patients trust you to put their welfare above all. Customers expect you give them what you ask for. A doctor is meant to embody a vocation, not a hustle. Once doctors are seen as vendors – trust begins to corrode. When Aesthetics dominates, the profession risks becoming indistinguishable from other service industries and thus the profession loses its soul.

Modern society is drenched in comparison, image obsession and appearance anxiety. What it needs from doctors is not complicity but clarity. Doctors should be the voice of reason, health and perspective. Not the endorsement of ‘beauty culture’ but the resistance to it. But, in aesthetics the doctor becomes the merchant of insecurity: profiting from the very wounds we should be helping to heal.

Now, Happiness is a legitimate component of health. If a safe procedure alleviates genuine suffering, then fair play. Mental wellbeing matters. Health is also about how we experience ourselves in the world and appearance is a part of that. A procedure can temporarily relieve the suffering of the self-consciousness – despite it being rooted in social constructs.

Adults should be able to make choices about their own bodies – provided they are fully informed. Autonomy is one of medicines central principles – to deny it risks paternalism. If Aesthetics is practiced with safety, honesty and transparency – can it still be noble? If a doctor refuses to exploit insecurity, sets boundaries and uses their skill to provide a form of care?

The argument that if doctors step away then people may seek these procedures from less qualified providers, it’s harm reduction not honour. A priest selling crack with a promise of purer stuff and clean needles may reduce some harm – but it will annihilate moral authority.

Doctors are not saints. We compromise, we fatigue and we bend under pressure. I can’t condemn colleagues for making choices under the strain of a system that devalues them. But understanding is not the same as endorsing.

Like a strike day scab – collectively the effect is corrosive. Piece by piece the profession loses its anchor. The word doctor begins to blur. The covenant becomes a contract, the vocation a transaction. At a time when society needs doctors to guide it away from obsession with appearances, our voice becomes faint, because we have joined the course instead of resisting it.

So that’s my opinion. Medical aesthetics may be many things but it’s not medicine. I don’t mean to offend, just stating what my compass tells me. After all, who am I?

Bilal