SEP 2018

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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Page 28 of 68

Am I trained in the procedures I will be supervising or delegating? A licensed practitioner with the proper education, training and supervision must perform all medical treatments. In the majority of states, physicians must know how to perform the procedures they are delegating and supervis- ing. In the medspa industry, physicians often supervise and delegate medical tasks outside of their specialty or area of expertise, which raises legal and ethical concerns. If you sign on as medical director with- out training in the aesthetic procedures offered, this can be enough for a medical board to take your license. Are my providers working within their own scopes of practice? A physician must have proper training to perform any delegated procedures; similarly, the physician must be sure that the providers to whom tasks are delegated are operating within their licensed scopes of practice. As medical director, the physi- cian assumes ultimate responsibility for all patient care and outcomes. This includes making sure all providers are properly licensed for the work they are doing in the medspa. Is the medspa owner a medical professional? Due to corporate practice of medicine doctrine, medspas must be 100 percent owned by either a physician or, in several states, a nurse practitioner. This means that a phy- sician should not serve as the medical director of a medspa owned by an esthetician or a nonlicensed entrepreneur. Physicians who ignore these laws risk being charged with aiding and abetting the unauthorized practice of medicine and violating fee-splitting statutes. Am I licensed to practice medicine in the state where the medspa is located? National medspa chains are a growing trend, creating potential compliance issues for physicians who want to supervise multiple locations. A physician must be licensed to practice medicine in any state in which they serve as medical director for a business. Solutions do exist for some of these prospective con- cerns. Physicians interested in offering medspa services who lack experience in these procedures can fi nd a host of clinical training options to help them master the vari- ous treatments requested by medspa clients. A properly trained and supervised physician's assistant or nurse prac- titioner can perform the initial patient consultation, and in many states, telemedicine can be used as a tool for the physician to perform the initial consult without physically being present in the medspa. If you are in a state where only licensed physicians are allowed to own medspas, a business model called the management services organization (MSO) model may be created to achieve compliance. This allows the physician to own the medspa, while the MSO handles the day-to-day management of the facility (with the MSO typically paid a portion of revenue). Due to patient safety concerns—as well as the intrica- cies of state laws and medical board guidelines—physi- cians should consult with an experienced healthcare attorney before signing on as a medical director of a medspa. This is particularly important if you will be acting as medical director in a facility that you do not own or operate, if you are from a "non-core" specialty or if the fa- cility is located in a state within which you do not currently reside or practice. Renee Coover serves as general counsel for the American Med Spa Association, 26 SEPTEMBER 2018 | Med Esthetics © GETTY IMAGES LEGAL ISSUES A physician must be licensed to practice medicine in any state in which they serve as medical director of a business.

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