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CST Web Exclusive: States trying to limit medspa ownership, operation

Article-CST Web Exclusive: States trying to limit medspa ownership, operation

Legislation recently proposed in California seeks to bar corporations from medspa ownership, while an Illinois proposal would bar medspa procedures performed without on-site physician supervision.

Last year, California's medical board and Board of Registered Nursing held three hearings to review laser safety in elective cosmetic procedures. While a 2006 bill gave regulators until January 2009 to formulate recommendations, "What came out of the hearings with the American Society for Dermatologic Surgery (ASDS) and the California Society of Dermatology and Dermatologic Surgery (CalDerm) was that the issue is urgent enough that we wanted action to be taken sooner," says Lisle Poulsen, advocacy and socioeconomic affairs manager with the ASDS Association, ASDS' political arm.

Though California is one of the most progressive states in regulating cosmetic medical procedures, she says the state lacks resources to pursue offenders, while penalties for violating its prohibition of corporate-owned medspas are so low that large chains frequently accept them as a cost of doing business.

"The problem is, many entities are hiring [physicians] to act as rent-a-docs, supervising procedures in name only," says Ms. Poulsen.

To pursue such scofflaws, the ASDS and CalDerm sponsored AB2398, which sets first-offense fines at $25,000. The bill also sought to mandate on-site physician supervision of medspa procedures. But backers dropped this provision over concerns that it would have limited some physicians' and nurses' scope of practice, Ms. Poulsen says.

At press time, the bill had unanimously passed two California Assembly committees. On May 7, it went before the Assembly's appropriations committee. "If it passes that committee," Ms. Poulsen says, "then it would go to the floor of the State Assembly," where it must pass by May 31 or expire. Should it pass the assembly, it will proceed to California's State Senate and, potentially, governor.

Similarly, the State of Illinois' Department of Professional and Financial Regulation has worked with the ASDS to propose an amendment to the state's Medical Practice Act. It would define cosmetic laser treatments as the practice of medicine and require physician exams before these treatments and on-site physician supervision during them. The proposal's public comment period closed May 5.

However, a bill in the Illinois legislature (HB3679) could negate the proposed amendment by allowing electrologists and "just about anyone" to perform laser and intense pulsed light treatments without physician supervision, Ms. Poulsen says. "This bill must make it through the Illinois State Senate committees by May 15 or it dies," she adds. At press time, the ASDS was working to educate the bill's sponsors regarding how many complications ASDS members are seeing from inappropriately trained or supervised laser operators.

Not everyone welcomes the proposals.

"We're beginning to suspect there is now a concerted national effort under way by a couple of very small dermatology-related groups to completely regulate and restrict the medical spa industry," says Eric Light, president, International Medical Spa Association. "It's a shame that some dermatologists are thinking that they should control this industry completely," he adds.

Florida also has mandated that only dermatologists or plastic surgeons can serve as medspa medical directors, says Lauren Olson, P.A.-C., owner and medical service provider at Radiance Advanced Skin and Body Care, The Woodlands, Texas. "I have some concerns about that because if someone is well-trained and licensed to perform these services, they often can perform the services as well as or better than someone who may be a dermatologist who has not had extended training in that area," she says.

As the preceding paragraphs suggest, "Medspa legislation will continue to be a very hotly contested issue," says Ms. Poulsen. Massachusetts and Nevada have formed task forces to address medspa supervision, while similar legislation the ASDS is supporting in New York (SB4173/AB8142) has been assigned to the Higher Education Committees of the state's Senate and Assembly, she reports.

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