Cosmetic injections to relax wrinkles and add volume are predominantly performed by physicians, according to a new study in the May 2021 issue of Dermatologic Surgery, the peer-reviewed journal of the American Society for Dermatologic Surgery (ASDS).
In the study, researchers investigated procedures at 492 dermatology and plastic surgery practices from US metropolitan areas. Practices were asked who performs injectable treatments, and according to the replies, the vast majority of injections were given by board-certified dermatologists and plastics surgeons.
“Only 18.35% of dermatology and 25.4% of plastic surgery practices had nurse practitioners and physician assistants giving injectables—both with and without oversight of the supervising physician onsite.”
— authors and ASDS members Matthew Belcher, MD, Ashley Decker, MD, and Naomi Lawrence, MD
Highlights Growing Demands
Although the large majority of dermatology and plastic surgery practices are not delegating cosmetic injections to non-physicians, the study highlights the growing demand of minimally invasive cosmetic procedures and the increasing number of non-physicians who can legally perform cosmetic procedures, offering a cost-effective supply of hands-on care. The differentiating factor of physician providers is the rigor and length of training.
Historically, physicians maintain authority of patient care to ensure patient safety and quality of care. This reflects the ASDS/A position that providers need dermatologic expertise to perform injectable treatments, because only physicians have extensive medical education, training and aesthetic acumen to deal with complicated facial anatomy and possible complications.
“The role of non-physician practitioners in dermatology and plastic surgery practices is controversial and highly debated. However, studies have shown that non-physician providers are being increasingly used in the delivery of dermatological care. We were surprised to see that a significant number of practices that use non-physician injectors could not verify on-site supervision at all times.”
— Naomi Lawrence, MD
The American Society for Dermatologic Surgery Association (ASDSA), a 501(c)6 advocacy organization, promotes patient safety and has over 6,400 board-certified dermatologists as its members, supporting the Board-approved position requiring on-site physician supervision of all non-physician providers to ensure patient safety.
ASDSA also opposes decision-making based on financial gain to ensure the best quality of care and patient outcomes, as stated in its position on Physician Oversight in Medical Spas.
“[Patients need to understand] there are risks of temporary and permanent side effects from improper techniques, and different injectables have a wide range of properties and associated adverse events.
“The injector needs to be sufficiently experienced with the products being used, maintain a detailed understanding of facial anatomy and be prepared to provide appropriate treatment in the case of adverse events. The ultimate responsibility for each patient’s outcome rests on solely on the supervising physician.”
— Ashley Decker, MD
Another way ASDSA is helping keep patients safe from unqualified providers is its new Medical Spa Safety Act model legislation. It calls on medical spas to keep medical procedures under the supervision of physicians (especially board-certified dermatologists). The model requires on-site supervision of any non-physician providers, along with requiring medical directors to have training on all procedures being performed.
Other tenants of the bill can include additional education requirements; notification if a physician is not on-site; and options for mandatory adverse event reporting. ASDSA also promotes patient safety by encouraging its members to report adverse events to its new Cutaneous Procedures Adverse Events Reporting (CAPER) Registry, a joint effort between ASDSA and the Northwestern University’s Department of Dermatology.
[Source(s): American Society for Dermatologic Surgery, PRWeb]
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