Board mulls tightening medical spa oversight
Board mulls tightening medical spa oversight
November 14, 2007
By Joyzelle Davis
Rocky Mountain News
Colorado regulators on Thursday will consider tightening physician oversight at clinics that perform Botox injections, laser hair removal and other medical spa treatments, citing concerns that patients could be hurt because of inadequate supervision.
Physicians would be required to personally examine each patient before the treatment begins and monitor the quality of services on a weekly basis as part of the rule revision contemplated by the Colorado Board of Medical Examiners.
Doctors now can delegate services to a nonphysician or a nurse as long as the physician is within a 30-minute commute of the clinic. Critics charge that some spa operators have exploited that loophole - originally intended to allow technicians to provide routine services such as dialysis - to hire "ghost doctors" who never step foot in the clinics.
"Unfortunately, entrepreneurialism has trumped quality and safety in Colorado," said Dr. Joel Cohen, an Englewood dermatologist who lobbied the medical board for stricter rules.
Fueled by the boom in nonsurgical procedures to help keep signs of aging at bay, the number of medical spas in the U.S. has soared to about 2,500 from only 45 five years ago, according to the International Medical Spa Association.
While getting high-tech laser treatments might be easy these days, doctors warn the procedures still are risky. If the procedures are performed improperly, possible side effects include scarring, burning, eye damage and adverse reactions to medications.
Allied Health Association, a national association of medical spas in Lone Tree, claims fears of injuries are overblown. The group, which provides malpractice insurance, said it receives more claims involving burns from wax hair removal than from the laser method.
The medical board "is taking a blanket approach, and it's the wrong blanket approach," said Kenneth Callison, director of Allied Health. Regulators should focus on drafting training and insurance requirements for technicians instead of mandating more physician oversight, he said.
Colorado isn't alone in taking a closer look at physician oversight at medical spas. California and Arizona are considering similar laws, and Florida and Utah are among the states that have strengthened medical supervision in recent years.
"The industry is still so new and so young that (regulation and training) hasn't caught up with it yet," said Hannelore Leavy, chair of the New Jersey-based International Medical Spa Association. "I feel sorry for the consumer. You have to be diligent and ask as many questions as you can and get familiar with the treatments ahead of time."
For Cohen, the proposed rule change doesn't go far enough. The medical board stopped short of requiring direct on-site supervision, meaning doctors still could be as far as a 30-minute drive after the initial consultation as long as there are written protocols and emergency medical plans in place.
"When a physician is on site, the issue gets addressed so much more quickly," Cohen said, adding that he treated four patients Friday with injuries from unsupervised aestheticians or nurses.
Thursday meeting set
The Colorado State Board of Medical Examiners will meet at 9:30 a.m. Thursday at 1560 Broadway, Suite 1380, in downtown Denver.
Proposed change
Ô A delegating physician must either be on the medical spa's premises or readily available. A physician also can be within 30 minutes response time if there are specific, written protocols and emergency medical protocols in place.
Ô Physicians must provide ongoing inspection over the delegated services.
Ô Physicians must personally assess each patient prior to the performance of medical-aesthetic services and provide follow-up care or referrals in the event of an adverse outcome.
Ô Physicians must maintain documentation of the physician's relationship with the patient.
Votes:21
Comments: 0