I was very encouraged this week to see the State of California come one step closer to passing the Patient Safety Bill. It is a fabulous piece of legislation, which will put controls on med spas operating without any direct medical supervision. AB 1548, a bill co-sponsored by the ASDSA (American Society for Dermatologic Surgery Association,) and CalDerm, has passed through every step of the California State Assembly without one dissenting vote. It now moves to the State Senate for consideration. If passed, the bill would provide the Medical Board of California, and other law enforcement and consumer protection agencies, with improved enforcement tools to prosecute larger entities engaged in the unlawful practice of medicine. These corporate owned medical spa and laser hair removal chains commonly practice without a doctor on the premises, or contain a "ghost medical director" for the purpose of appearing legitimate.While the convenience of having an anti-aging treatment performed at a local spa or shopping mall can be appealing, this convenience could jeopardize your health and safety. I feel these unsupervised med spas place patients in unnecessary risk. Think about it, if an allergic reaction or true emergency were to arise, there is no doctor on site to handle the problem. Additionally, physician extenders (nurse practitioners [NPs] and physician assistants [PAs],) providing procedures in these types of settings are proving not to be well trained. I like to say, "They don't know what they don't know." Left without supervision and with their subpar training, the result is patients with unsatisfactory outcomes.You would not believe the number of corrections I have done in my practice resulting from sloppy med spa work. I must see one or two cases a week from patients with scars and pigment left from improper laser treatments, and an even higher amount of patients coming in with uneven, drooping eyebrows resulting from Botox injections done by providers with an untrained eye. Studies have shown higher complications when procedures are performed by these physician extenders without direct physician supervision and "non-core" physicians (physicians that are not cosmetic dermatologist nor plastic surgeons) who are not sufficiently trained. I'm sure you have heard the adage; "you wouldn't go to a brain surgeon to have open heart surgery." So, why take such a risk with your beauty to save a buck or two?The success of any cosmetic procedure is highly dependent on the knowledge and trained eye of the person performing it. Dermatologists and plastic surgeons take years and years of in-depth training before conducting cosmetic procedures. The same cannot be said for "non-core" providers, who often take weekend courses on anti-aging techniques and open a clinic the weekend after. That is why the American Academy of Dermatology recommends all treatments be performed by a core physician or under the direct supervision of one.Despite all these risks, corporate med spas continue to be big business. According to the International Med Spa Association, the number of med spas has grown by 85% in the past two years, and is currently up to 2,500 nationally. The Aesthetic Medicine News reports that annual revenues from med spas are in excess of $2 billion. The good news is that, as I write this, there are more than 15 states proposing bills to curb these types of med spas. That is very encouraging.I cannot stress enough the importance of consulting with a board-certified dermatologist or plastic surgeon before having a cosmetic treatment. With their in-depth medical training and experience performing these procedures, we can safely perform cosmetic procedures each year with excellent results.Original post blogged on b2evolution.
