March 28, 2024

Cover Story; Med Spas

Face Value

Loosely regulated, the medical spa business in Florida is growing fast, selling everything from $350 Botox injections to $2,000 laser hair removal treatments.

Amy Keller | 12/1/2006
Florida's demographics have made the state the second-biggest medical spa market in the country after California. Solana Medspas CEO and co-founder John Buckingham has helped investors, including Sidella, set up eight franchises around the state and predicts he'll have another 100 locations statewide within the next five to seven years. The affluent Baby Boomers flocking here in droves aren't content to let nature take its course as they age, Buckingham says: "Boomer women don't want to look like their mothers. They've worked hard. They're at the top of their game. They don't want to age gracefully."

What's also made the Sunshine State attractive for med spa operators is a permissive legal and regulatory climate. For one, Florida is among only a handful of states that does not have a corporate practice of medicine law. Typically, those measures prohibit corporations and other non-medical entities from employing doctors -- in order to keep physicians out of situations in which they might have to put a company's economic interests ahead of a patient's needs.

In Florida, the lack of such statutes means that corporations and investors are free to invest in medical practices. Physicians own and operate some medical spas, but many are owned and run by businesspeople with no medical training who hire a physician to serve as the "medical director" of their spa.

The law requires physicians to supervise and control the actual medical practices. But lax regulations have helped spa operators find creative ways to offer both medical and non-medical procedures under one roof. And the loose regulations mean that the nature of the supervision varies greatly.

Physicians themselves may not be required, for example, to perform the procedures administered at the spa -- or even to be on-site while the spa is operating. Certified electrologists can't conduct laser hair removal unless a physician is on the premises. But physician assistants and advanced registered nurse practitioners may perform laser hair removal and give various injections under the physician's "indirect supervision" -- meaning the doctor must be reachable by phone but doesn't have to be on premises. Supervising physicians are required to post a schedule of their regular office hours and the hours they're not on-site.

Another issue is the types of doctors who serve as medical directors. Many medical spas prefer to contract the services of a plastic surgeon or dermatologist, since the specialties seem to fit the cosmetic services the spas offer. Any physician may perform most cosmetic procedures, however, and a host of doctors, ranging from emergency room physicians to gynecologists to pediatricians, has jumped at the chance to supplement the income from his or her regular practice by affiliating with a med spa. That is about to change. But it's unclear whether the change will make the spa treatments any better or any safer -- or whether it will just hand over the lucrative med spa procedures to a smaller group of physicians.

Tags: Around Florida, Healthcare

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