Saturday, July 08, 2006

Regulating medi spas and office plastic surgery

Florida has recently passed a law increasing oversite requirements in the booming medi-spa business. The spa industry has grown an average of 38% in the last year alone, according to The Spa Association's 2005 study, making it the third largest leisure industry in the United States. Medi-spa's generally are clinic environments offering some of the less invasive treatments like fillers, BOTOX, micro-dermabrasion, light chemical peels, laser hair removal, and some of the non-ablative skin treatments intensed pulsed light, Thermage, etc...).

The increasing market for these services has driven a number of entrepreneurs into operating these medi-spas. Many of these were initially opened by Physicians with little or no background in the treatments they were offering. It was very common for ER docs or Family Practicioners to suddenlyredefinee themselves as providers of "Aesthetic Medicine" or whatever they called themselves. Increasingly, a number of industryinterestss have moved into this and establishing franchises paying some random Doctor to 'pimp' hislicensee out in order to operate.

The stumbling block with this industry is that Physicians are not cheap labor. Up until now, many of these services were being delivered by nurses or even simply employees with no advanced degrees. Oversite was notoriously nonexistentt by the medical directors at these spas. There have been reports of some nurse practicioners who have been particularly egregious in opening their own place sans supervision.

After a number of adverse outcomes with "safe" technologies (peels, fillers, & IPL) legislators have gotten involved.The American Society for Dermatologic Surgery found that half of its 2400 members reported an increase in complications in the past year from laser procedures performed by non-medical personnel.

• Virginia man, age 20: Coast Guard cadet died of allergic reaction to drugs given to him before a laser hair removal treatment according to the
• Shiri Berg, age 22, North Carolina: North Carolina State student died of a lidocaine overdose, a common numbing cream applied to the skin before a laser hair removal treatment.
• Terri Bowling, age 36, Pennsylvania: Deep second degree burns on legs from laser hair removal procedure performed by a spa technician. The actual photo is seen below.

This is what just played out in Florida. The loose oversite requirements that were flouted before, are now requiring the direct supervising physician to be board eligible or board certified in dermatology or Plastic Surgery. Behind sciencesnces, there was furious lobbying by some of the manufacturers of various lasers & related devices. This type of law has the potentialsignificantlyntly cut into their market for sales of their equipment.

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