Medspa Nightmare: Erbium Laser Resurfacing by Non-Physicians.

I had lunch today with a NP who had left a medspa chain a few months ago. (I won't identify him or the medspa chain since I didn't speak to him about posting this.)

During our conversation we discussed why he had left the medspa he was with after only eight months. He reeled off a list of things that caused him to feel that he wasn't a good fit but there was one thing that took me by complete surprise. He told me that the 'estheticians were performing erbium laser resurfacing'.

I thought that I must have misunderstood, but no, this medspa chain has a erbium laser and the technicians are the ones performing the treatments. Not docs, not NP's not PA's... just estheticians on their own.

Errrr..... that's not good and I said so. In fact, as far as I know, it's illegal on any number of fronts.

I'm wondering what everyones reaction is to this?

Comments

[L.A. D.O.]

While I do not agree with estheticians using this laser, they may very well be more trained on the procedure than a doc, NP, etc. Most everybody learns these techniques post-graduate and there is no reason why any human being wouldn't be able to handle this laser. However, I do believe it is illegal and should be avoided at all costs. It seems that a physician just has more to lose by burning somebody than Joe Technician someone found on craigslist.

[Dexter]

It all depends on the depth of the peel. We don't let our aestheticians do the peels but we will let our RN and PA. Our peels are usually between 4-20 microns which keeps them well within the epidermis basically a little deeper than the stratum layers. The laws probably vary from state to state.

[R2]

We allow our estheticians to do several of our treatments (hair removal, skin tightening, IPL). We only allow one of them to do a fractional resurfacing. Our medical director is on-site and is actively involved and supervising.

I believe training is very important, but honestly most nurses, PA's and some MD's never got trained in these technologies in their programs. I definitely don't think most estheticians are knowledgeable or mature enough to do peels, but a few are. A few are much better with clients than many nurses and even some docs.
The one esthetician that we allow to do the fractional resurfacing is much more driven to learn and takes such better care for clients than most nurses I've come across.

I know a few plastics in our town are using medical assistants for many of their laser treatments also. Do people have the same reservations about medical assistants doing these treatments as estheticians?

[Ronald Berglund]

I am not sure about other states, but Minnesota law makes it clear that physicians can ONLY delegate laser operation to licensed MEDICAL personnel. I have not seen any state which ever recognized an "aesthetician" as a medical position. It has always surprised me that aestheticians have been operating lasers in so many clinics.

[dauntless]

In florida only docs,pa's and ARNP's can operate lasers with one small exception electologist can use a laser but only for hair removal. Despite this I have a close "friend" who has personally met nurses, estheticians, medical assistants etc. who are doing these procedures illegally jeopardizing themselves ,their doctor and their patients.

[John]

How about Pure Med Spa ? They have managers that prescribe Botox and fillers,when the MD or nurse is not on site. They are not regulated health care professionals, however for some reason they will write down for you at a consult what you need, how many units of Botox and so on. This is really bad and I feel sorry for the poor patients.