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International Medical Spa Association -vs- California Dermatologists?

international_medical_spa_association.jpgI received this email today from the International Medical Spa Association:

"Dear Spa Professional,

There has been much press lately about California Assembly Bill 2398 and we at the International Medical Spa Association feel this is a very important matter.

An important hearing was held in Sacramento on April 25th regarding this bill. The committee decided to put this topic on a watch and work with the California Nurses Board to address the educational and supervisional needs at California medspas.

Although it appears this matter is being "shelved" for the moment, this is actually an ongoing issue, relevant to all states, and will now go to the Appropriations Committee. This bill could significantly impact medspa owners, managing service organizations, medspa physicians and staff, medspa consumers and all vendors serving the California medspa industry.

California Assembly Bill 2398

The International Medical Spa Association, an association with a large number of members in California, and over 1,000 members worldwide, is concerned that California Assembly Bill 2398 may be unwarranted restraint of trade that threatens the public's safety and undermines a doctor's or small business owner's right to earn a living.

The Bill has nothing to do with consumer safety. It was drawn up with the support of a special interest group (the American Society of Dermatologic Surgery) representing dermatologists with a vested business interest in restricting who can own or operate a medical spa. Since a dermatologist can become board certified without receiving any training in esthetic procedures, there is no guarantee that these specialists will have any greater knowledge of esthetic procedures than other doctors, healthcare professionals, and estheticians.

The negative comments about medical spa safety and the need for greater supervision made to the committee belie the facts that medical spa malpractice insurance premiums have actually come down over the last two years.

Our Association believes that medical spas need to offer the highest level of care possible. That is why we define a medical spa as "a facility that works under the supervision of a licensed healthcare professional working within their scope of practice, with a staff working within their scope of practice."

We do agree that a non-doctor licensed healthcare professional should be supervised by a MD or DO. However, we do NOT believe that a doctor or DO acting as a medical director should be required to be on-site. Instead, the International Medical Spa Association believes there should be a better definition of "indirect supervision"; including the medical director's distance from the facility and how many facilities he or she can supervise.

Damaging valuable California businesses, restricting access to services, and potentially driving up costs for consumers in order to protect a special class of  physicians is unwarranted, unwise and unfair; particularly when there is no demonstrated risk to consumers and the public health.

The International Medical Spa Association joins with the American Academy of Family Practioners, the American Academy for Anti-Aging Medicine, as well as thousands of physicians and osteopaths in the State of California, respectfully asking that you, as a member of the California legislature, delay the passage of Assembly Bill 2398, and instead return it back to committee for a full and impartial hearing. Please be mindful of the fact that there have been rumblings of various grassroots lobbying efforts, aided by attorneys. A list of Assembly Members is provided for your benefit.

More information is also posted at the MedcalSpaMD Blog.
Kindest Regards,

Eric Light, President
International Medical Spa Association
201-865-2065 / 201-865-3961 (f)

It looks as though the 'International Medical Spa Association' in association with the 'Day Spa Association' is weighing in on this medspa scope of practice issue. Here's the Association's member list.

Nice that they linked to us here. 

Reader Comments (10)

I also saw this email and find it ridiculous. I'm glad to see that you fixed the egregious misspellings, but the link to this site is also broken. The International Medical Spa Association... just the type of thought leading organization that you long to belong to. (not)

I'm glad to see this guy has taken initiative to write this email and from a group against this crazy bill!

05.6 | Unregistered CommenterLADoc

This guy's knowledge is borderline ignorant in my opinion. "doctor or DO" "physicians and osteopaths" - uhmm are you serious? MD and DO (allopathic and osteopathic physicians) are fully licensed physicians / doctors. Given this ignorance in such standard knowledge for someone in the medical field, in my book, discredits any validity that this Eric Light guy might have had to begin with...

Spending time discussing a secretary's unfortunate misspellings (for which I apologize) will only serve to distract from the important issue for discussion. Unfortunately, special interest groups within the medical community have decided to highjack an industry by providing legislators with unsupportable claims of poor consumer safety in medical spas. The truth belies their argument.
The safety record in the medical spa industry as a whole has been outstanding. Despite lurid stories in the press, the medical spa safety record has been so good that medical spa malpractice insurnace premiums have actually come down by as much as 75% in the last three years. What other area of practice can make the same claim?
Since it is not really about safety, what is at stake. Let's start with money and who controls access to it. Many physicians are struugling because of rediculously low insurance reimbursement. So controlling a cash business is very important. Heaven forbid one class of physicians should share with another.
But the argument goes deeper. By claiming that only one or two classes of physicians are qualified to supervise minimally invasive aesthetic procedures, you are actually limiting the scope of practice of the vast majority of physicians, as well as Physician Assistants and nurse practitioners who are well qualified to do due dilligence exams.
Are dermatologists better trained to supervise aesthetic services than a family practitioner? Until recent years dermatology programs provided little or no aesthetic training. In fact, annecdotal evidence suggests that dermatologists have a higher incidence of complications than any other class of physician.
Is a dermatologist better trained to cope with a medical crisis arising out of an aesthetic procedure? I vote for an ER doc. And what about dermal fillers around the eye? Don't eye docs study the underlying muscle structures more rigorously than derms? Family pracitioners...they think holistically, so perhaps they are better positioned to understand the importance of nutrition.
What do consumers want? They want effiucacious treatments; customized to their individual needs; treatments that deliver visible results sooner; with easy access in an environment markedly different from a doctor's office. They don't care about the type of doctor supervising the staff. They just want someone to trust. They want quality supervision - whether that is from someone across the hall or just down the road. They want a well trained staff that is required to mmet a clear set of standards.
Unfortunately, some of this blog's readers seem unwilling to even consider the association's point of view, and instead have digressed to schoolyard name calling. Rather than argue about which class of physician should be permitted to supervise and where they have to be located, let's focus on industry standards and the quality of staff education - particularly important to an industry suffering from the pangs of adolescence.
For example, there is no such thing as a medical esthetician - it is a frequently used marketing term unsupported by any state's licensing board. For example - the term "certification" should not be used to describe "certificates of attendance." For example, staff should not be allowed to work outside their scope of practice simply because they are working under the supervision of a physician. And what do we do about the dermatologist recently arrested for operating a medical spa while his license to practice was suspended?
The International Medical Spa Association, a 7 year old association with over 1,000 members worldwide, believes a medical spa needs to operate under the full time, on-site supervision of a lciensed health care professional, but that professional should be allowed to work within their scope of practice.
Does that mean a naturopath or homeopath could supervise a medical spa? Yes, as long as they were a licensed health care professional and practiced a form of aesthetic medicine allowed under their scope of practice.
Perhaps I am more of a libertarian than I thought, but if you truly believe the medical spa industry needs to be fixed, then focus on what is important...facility standards, efficacy of services, and staff education... and not unnecessary legislation that only serves the needs of a few.

Eric Light, President
The International Medical Spa Association

05.17 | Unregistered CommenterEric Light

Eric Light

AMEN! Brother!!

05.18 | Unregistered CommenterWPS

I agree with Eric except that a homeopath or naturopath should be able to manage and supervise a medical spa. These facilities are still medical so only osteopathic physicians (DO) and allopathic physicians (MD) should run this since they've completed medical school and post-graduate training. Eric - thanks for taking your role in this. I think you should also get laser manufacturers involved as well as the companies making fillers, etc. They have $$$ to fight and a lot of interest.

I appeciate that Eric Light posted. Even if I wholeheartedly supported everything you say the Medical Spa Association stands for I would not trust any organization with John Buckingham of Solana Med Spas and Mo Biring of Healthwest as founding members of still active in the association and represented on the associations website.

For anyone unfamiliar with these two individuals, do a search for them on this site, or even google them. I think any organization is only as credible as its members, particularly its founding members.

You raise a good point. Has IMSA taken any measure to distance themselves from these two nefarious thieves? Eric Light puts himself in the same category by not taking stand against unethical people like Buckingham and Biring who failed miserably in the medspa business and cast a dark cloud on the entire industry

12.3 | Unregistered CommenterIMSA

I suspect CAB 2398 will be back again when the State of CA again has the budget to pursue it. Given the current economic crisis, not much will get passed that requires any cost of implementation and policing.

That said, it only takes one case to push through a law or big changes, like Polly Klaas and the resultant "3 Strikes" law.

We almost had one for HMOs with Fox v Healthnet, but they settled out of court. Look what happened there:

Expect laws to get stricter, not looser overall, just like in Florida with the laser law.

Here's the actual CA bill and analysis, if you haven't read it. Expect it to be back when the economy rebounds.

I think the economy is closing more Southern California medspas than the bill would have, and there are lots of low-profit medspas for sale. I have physician buyers for profitable ones in CA properly priced, but mostly what I find are either inadequately profitable or overpriced.

Keith C. Borglum CHBC
Licensed Medical Practice Broker & Appraiser Lic#s: CA-00767129 FL-BK3206346
Certified Healthcare Business Consultant (CHBC)
Professional Management & Marketing, 3468 Piner Rd, Santa Rosa CA 95401-3954
ph (707) 546-4433 fax 546-4437
Web Page at
CV/Credentials at
Member: Institute of Business Appraisers; National Society of Certified Healthcare Business Consultants;
Industry Expert in Medical Practice Valuation: Business Brokerage Press;
Author:Medical Practice Valuation Appraisal Guidelines & Workbook by PSR Inc.2006

Eric Light hit the nail on the head! The focus of this issue needs to be aimed in the right direction.

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