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Cover Story; Med Spas
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Loosely regulated, the medical spa business in Florida is growing fast, selling everything from $350 Botox injections to $2,000 laser hair removal treatments.
Dr. Steven Rosenberg, a West Palm Beach dermatologist and chairman of the Florida Society of Dermatology's legislative committee, says the impact on medical spas was just "one small component" of a bill intended to give the board of medicine the responsibility to determine the appropriate levels of supervision for certain "physician extenders" like nurse practitioners and physician assistants -- a hotbutton issue that had been on the Florida Medical Association's radar for six years.
 TRICKS OF THE TRADE : Dr. Sharon McQuillan (right) owns Ageless Aesthetic Institute in Sarasota, where she trains others how to inject Botox and operate laser equipment. |
Nevertheless, Rosenberg believes any move to regulate the industry is probably a good idea. "Who knows what kind of sterile procedures they're providing, what kind of care they have for an emergency situation. The reality is medical spas didn't exist when most rules and regulations were developed, and now they sort of fall through the cracks," he says.
Sidella believes enforcement of existing regulations is haphazard. He says a new employee told him that a competing med spa was using aestheticians to perform Botox injections, in violation of Florida statute. When he called to report the incident to the Department of Health, he "got frustrated. They didn't want to hear it. They didn't even seem to know what a med spa was."
Moreover, members of the med spa industry argue, the Legislature could have taken more effective steps than limiting the field to plastic surgeons and board-certified dermatologists. For instance, if lawmakers were concerned about burns from laser hair removal, they might have required all physicians in the medical spa industry to be trained in intense pulsedlight technology and other types of aesthetic laser-procedures. Dr. Sharon McQuillan, who trains other physicians how to inject Botox and operate laser equipment at her Ageless Aesthetic Institute in Sarasota, says that discriminating against the type of doctors who can operate a med spa is counterproductive. "We have trained many anesthesiologists who are wonderful with a needle. If they can put a catheter in a baby's vein, they're pretty good at doing Botox," she says.
Dr. Steve Cimerberg, a family practitioner and licensed osteopath who runs the Advanced Medical Spa in Plantation, won't feel any repercussions from the new law because his spa is his primary practice, but the physician clients he teaches to use laser equipment might. Why limit med spas to just plastic surgeons and dermatologists, he asks, when "there are physicians from other specialties that are trained just as well or better."
McQuillan says that while H.B. 699 may prevent some chains from putting unsupervised personnel in "potentially harmful" situations, it didn't ensure that all med spas will deliver consistent and safe treatments. As a result, she is spearheading an effort to develop practice standards for the industry. McQuillan says she is working with the American Academy of Family Practitioners, the American Academy of Osteopathic Physicians, the American Academy of Ophthalmologists and a number of other organizations to establish a set of "best practices" for the light-based treatments and fillers, as well as competency requirements for practitioners that the state board of medicine could implement. "We want to standardize the way these procedures are offered, so practitioners can practice effectively."
For now, says Solana Medspas cofounder Buckingham, the only ones hurting financially in the medical spa industry are the gynecologists, family practitioners and others who will soon be shut out of the Botox gold mine. "I can't believe the doctors were caught napping in your state," he says.
