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Thursday, Mar 28, 2024

Regulations of Medispas Can Seem Unclear

Medispas are in a strange netherworld when it comes to rules and regulations and safety inspections. An action report published by the Medical Board of California in July 2006 states that a medispa “must be a physician-owned medical practice or a professional medical corporation with a physician being the majority shareholder.” While the Medical Board of California licenses and regulates physicians, they are not responsible for licensing or inspecting medispas. “Medispas are not regulated by any agency because they are treated as a business,” said Medical Board spokeswoman Candis Cohen. The County of Los Angeles Department of Public Health does not inspect or regulate spas or medispas although they license and inspect massage parlors, tattoo parlors and body piercing establishments. An inspector for the County who asked to be unnamed said that it is difficult for consumers to understand where the lines of responsibility lie. Non-medical services provided in a medispa come under the supervision of the State Board of Barbering and Cosmetology which regulates and licenses providers of the type of cosmetic procedures provided by any beauty salon or spa. But other services Botox injections, micro-dermabrasion and laser hair removal are considered medical procedures. As such, they must be performed by a physician, or by an allied health professional (physician assistant, registered nurse or licensed vocational nurse) under the direct supervision of a physician. The Medical Board provided these guidelines about who may perform what type of medical/cosmetic procedure. – Treatments using lasers and intense pulse light (IPL) devices may be performed either by a physician, or by a physician assistant or a registered nurse under the supervision of a physician. – Injectables, such as Botox or Restalyne, may be performed by a physician, or a physician’s assistant, a registered nurse, or a licensed vocational nurse under the supervision of a physician. – Cosmetic procedures are considered medical treatments if they penetrate the deeper levels of the skin. The action report states that any treatment to remove scarring, blemishes or wrinkles (including microdermabrasion and some chemical peels) are considered medical treatments. According to Cohen, this is because, in order to be effective, they have to go that deep under the skin. These procedures may be performed by a physician, or by a physician’s assistant or a registered nurse under the supervision of a physician. You may have noticed the phrase, “under the supervision of a physician,” used several times in the guidelines above. This means that an allied health professional must have an established relationship with a physician to perform those procedures that fall within a specific scope of practice. In the case of a medispa, these paraprofessionals must have a relationship with a physician where they work out protocols for different procedures. The physician does not have to be on-site all the time, but they must be “immediately reachable” and the physician must periodically review the charts of those patients who those allied healthcare professionals are treating.

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