An expert evaluates the nationwide trend toward requiring on-site supervision by physicians in medical spas

You have seen the horror stories reported on the nightly news. Yet another unwitting patient who sought aesthetic enhancements has been scarred for life at a medical spa because there was no physician on site. Is this a 6 o’clock news scare to boost ratings or something of genuine concern?

The verdict is still out. However, this real or perceived threat to patient safety has spurred a nationwide legislative groundswell. State legislatures are moving briskly to enact laws to protect their citizens from medical spas that do not have a physician on site to oversee training, procedures, and treatments.

Are the states going too far? Well, it depends. Every state has laws and requirements covering the use of laser and other light-based devices. What is different now is that states that have been historically more lenient than others are now enacting stricter laws governing the use of these devices.

According to physician–attorney David J. Goldberg MD, JD, an expert in the legal aspects of the medical-spa industry, the laws “are not just confusing, but they are often changing.” An article by Goldberg that explores legalities concerning physician extenders in plastic surgery practices will appear in the November issue of PSP. He will describe actions taken in recent years by medical boards and state governments in New Jersey, Florida, and California.

What’s the Solution?
For medical spas to be successful and in line with regulations, they should be owned or overseen by physicians. This is important, because physicians have the training to supervise staff on all procedures. This increases patient safety and reduces possibilities for medical error.

Hannelore R. Leavy, founder and executive director of the International Medical Spa Association, says, “There are many medical spas operating throughout the United States whose medical director is not necessarily an MD. A medical doctor overseeing the proper protocol and training at several locations, as long as they are within reach during hours of operation, is perfectly acceptable.”

By having a physician to oversee the medical spa, she continues, “Licensed health care professionals, as well as properly trained aestheticians and other therapists, can perform many of the noninvasive medical-spa treatments.

“Ownership should not be solely by medical doctors but should be open to entrepreneurs and spa owners working with the medical profession in unison for their patients’ welfare, well-being, health, and beauty. By involving all industry components, only then can we move forward to combine medicine and spa to help improve the quality of the patients who are living and staying active and healthy longer than any generation before us.”

Beauty or Medical Treatment?
How you define your treatments—as beauty enhancements or medical necessities—determines your vulnerability to state laws. As you know, there is a plethora of “boards” that oversee both the beauty and medical industries.

For example, a state board of cosmetology may oversee aestheticians in the spa environment. Different boards govern different types of medical-spa–based treatments and delineate who can provide or administer treatments and in which settings.

Be sure you take the time to analyze each treatment you offer to ensure that it complies with the rules of the appropriate state boards. In addition, it is important to evaluate your malpractice coverage and make sure that each treatment option offered is covered under your policy.

The Bottom Line
In the words of Abraham Lincoln, “Public opinion in this country is everything.”1 Embrace a business philosophy of keeping patients’ and the public’s concerns at the top of your business priorities. When safety and patient satisfaction are your ultimate business goal, you can avoid unnecessary regulatory intervention in your business practices.

Plan, be responsive to the marketplace, be mindful of the government’s quest to increase patient safety, reduce medical errors, and maintain a business venture that is strong on ethics. The laws are increasingly becoming more protective of the patient, and you can expect that trend to continue in the next 5 to 10 years.

Cheryl Whitman, a beauty-industry consultant for more than 20 years, is the founding board member of the Medical Spa Society and an active member of the Day Spa Association. She is the CEO of Beautiful Forever, a nationwide medical-spa consulting firm. You can reach her at (201) 541-5405 or [email protected].

1. Lincoln A. Speech, Columbus, Oh, September 1859.