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Friday
Mar132009

Massachusetts Medical Spa Task Force Report

Massachusetts has just delivered it's Medical Spa Task Force Report: Download it here as a PDF.

MA has launched a multi-party task force to recommend legal and oversight requirements for medial spas, skin clinics, laser clinics and for IPL and laser treatments.

EXECUTIVE SUMMARY

In recent years a new type of business enterprise has emerged, one that mixes traditional salon
treatments, like hair and nail care, with medical procedures like Botox B injections and laser skin  treatments. These so-called "medical spas" have proven popular with an aging population of baby
boomers and others seeking an expanded menu of services to enhance beauty, "restore" youth and improve self-esteem.

The International Spa Association reports that the number of medical spas in the United States grew
from 472 to 976 between 2004 and 2007, a 105% increase in just three years. No figures specific to
Massachusetts are available, but there is no reason to think that the growth of medical spas here is any
different from the growth nationally.

Medical spas combine many different licensed professions under one roof. This presents regulators
with the distinct challenge to create a regulatory structure that respects consumer demand and the free
market, but still holds p;blic safety as paramo;nt. How can the ~immonwealthe nsure that patients
receive treatment of whatever form only by professionals who are properly trained and licensed?
In the spring of 2006, Senator Joan Menard introduced legislation to create a task force to study this
issue. The bill, which was enacted as Chapter 81 of the Acts of 2006, provided for a Task Force
composed of representatives of the separate Boards of Registration in Cosmetology, Electrology,
Nursing and Medicine, as well as dermatologists, plastic surgeons, nurses and consumers.

The Task Force first met in November 2006, and began its work by conceptualizing the issue as a matter of determining three factors:

  • What procedures are at issue?
  • Who may perform these procedures, and under what conditions and supervision?
  • Where may these procedures appropriately be performed?

The Task Force heard from representatives of the spa industry and device manufacturers and received
overviews of the current regulatory environment from the various Commonwealth Boards of Registration. The Task Force also reviewed information from national organizations involved in the
industry and articles from the medical literature and surveyed what other states have done in this area.
At the conclusion of this fact-finding process, the Task Force set about addressing the three guiding
questions above.

A list of procedures, both traditional salon treatments and medical procedures, was developed, and the
Task Force adopted a three-tiered system of classification based on risk to the patient. Level I
procedures were defined as those strictly cosmetic in nature, such as hair and nail care. Procedures that
met the definition of the practice of medicine or nursing and that must be performed by a licensed
physician, or a nurse in collaboration with a physician, were classified as Level 111. Those procedures that are of an intermediate nature -laser hair removal, for example - are classified as Level 11, and the ; Task Force recommends a level of training for licensed professionals performing such procedures and defines the appropriate supervision for each. As a general matter, most Level I1 procedures would require a registered nurse or advanced practice nurse to perform them, although electrologists could
perform laser hair removal, for example. Recognizing that new procedures and devices used in medical
spas are being developed almost monthly, the Task Force also recommends creating a standing
advisory committee to periodically review new technologies and procedures and determine how they 4
should be classified and what level of training and supervision should be required for those licensed
professionals performing them.

Having thus determined the "what" and the "who," the Task Force next considered the "where,"
meaning what type of facility is appropriate for medical spa procedures and how those facilities should
be regulated. Ultimately the Task Force concluded that medical spa facilities should be licensed by the
Department of Public Health (DPH) in a manner similar to the way DPH licenses medical clinics.

nonmedicalOther facility-based issues were addressed, including segregation of medical procedures from procedures, ownership models and requirements, employment of clinical directors and the sale
of goods.

The recomme'ndations of the Task Force include draft legislation that defines various terms developed
by the Task Force to describe medical spa regulation. It includes authorization and direction to DPH to
license medical spas for renewable terms of two years, similar to clinic and nursing home licensure
already performed by the Department. The legislation also sets forth requirements and restrictions for
medical spa ownership, staffing and inspection.

Much of the detail for medical spa licensure and operations would be further defined by regulations to
be promulgated by DPH. The legislation includes authorization to the DPH Commissioner to issue
such regulations, and the Task Force report includes guidance for the Commissioner regarding what
the Task Force would expect the regulations to contain.

The Task Force also recommends creation of a new Board of Registration of Aestheticians, and
charging that Board with the responsibility of regulating the prof;tssion. Currently aestheticians are
licensed by the Board of Registration in Cosmetology, but during its deliberations the Task Force
concluded that the skin care practiced by aestheticiis was sufficiently distinct from the hair and nail
care performed by cosmetologists as to warrant a licensing board specific to aestheticians and their
practice.

Other recommendations include changes to Board of Registration in Medicine policies to no longer
classify laser hair removal as the practice of medicine, and to eliminate a ban on the sale of goods from
physicians' off~ces.

The Task Force hopes this report and its recommendations will serve as a model, not just for the
Commonwealth, but for other states, to establish a comprehensive, coherent and regulatory structure
for medical spas.

One final note: the Task Force agreed early on that its recommendations would be a matter of
consensus among the members, each of whom represent different professions, regulatory boards and
points of view. Throughout its deliberations, a remarkable unity of purpose, commitment to patient
safety and thoughtful - not overbearing - regulation was the common goal. The Task Force was, !<>
O however, unable to reach consensus on two issues: creating a new Board of Registration in Aesthetics
and a new Advanced Aesthetician license (see Recommendations 6 & 7). The Board of Registration in Cosmetology, which currently licenses and regulates aestheticians and their practice opposes creating a
new licensing board, believing it to be unnecessary, duplicative and potentially harmful. While the
Cosmetology Board has indicated support for an advanced aesthetician license in the past, it has not
yet voted to create one, and the Board's Task Force members opposed the education and training $7
requirements recommended in this report. A majority of the Task Force and most, if not all, of the
dozens of licensed aestheticians who regularly attended Task Force meetings, respectfully disagree.
The Board of Registration in Cosmetology intends to file separate comments on these matters with the
legislative committees designated by Chapter 81 to receive this report.

Reader Comments (16)

Having read the report, there is much that is sensible in it. I like the concept of the three level stratification, and definitions of what is appropriate training for each of the various treatments performed.
To some extent, however, the MA proposal relies on this mid-level "advanced aesthetician" position for mid-level treatments.

Personally, I would try to divide treatments up without having to resort to creating a new level of bureaucracy. Using currently defined structures / licences also has a higher chance of success.

03.14 | Unregistered CommenterTF

Who is going to teach these subjects? Where did they get their training? By who? How many hours of hands-on instruction will be required? What are the MINIMAL requirements for students to be considered as beginning student (High school diploma or 2 years Cpmmunity College DEGREE). What are the requirements to be a teacher of these subjects? Should teacher be required to have a teaching license. How many hours of training on at least 2 different types of lasers? What exact procedures can they do>? All lasers are for laser surgery who is allowed to perform what on who?

What about current people in the spas, salons, electrology fields? Will the be required to take some courses to catch up with new students? What are requirements to move from class 1 to class 2 or 3 license?

What are the requirement to open a school? Total number of students permitted based on number of teachers?
What subjects must be included such as Biology of skin, infection and its treatment, side effects of lasers, when NOT TO USE A LASER, effects of aging on skin, types of medication to be used on skin, Malpractice Insurance required for treating clients (mandatory or NO LICENSE).

THIS IS ONLY THE BEGINNING. Those making the "NEW" laws know little about each others' fields, therefore, there will be many flaws in the law.

02.12 | Unregistered Commenterlefty2g

leftyg-

Your information is incorect.

The Massachusetts Medical Spa Task Force members consist of professionals from the Medical board, the Nursing Board, and the Cosmetology Board plus MA politicians specifically to provide a comprehensive insight into making these recommendations so "Those making the "NEW" laws know" MUCH about each others' fields, therefore, there should be NO flaws in the law.

MA Medical Spa Task Force Members

Boards:

Nancy Achin Audesse, Board of Registration in Medicine
Gino Chisari, RN, Board of Registration in Nursing
Barbara Kellman, JD, Board of Registration in Nursing
Kathe Mullally, JD, Board of Cosmetology
Catherine Hinds, Board of Cosmetology

Legislature:

Kevin Conlon (on behalf of Senator Joan Menard)
Jennifer Infurna, Representative Koutoujian staff

Appointees:

Stephanie Cogliano, RE
Jeffrey Dover, MD
Faye Marie Jenkins, RN
Karen McKoy, MD
Dianne Quibell, MD
Winifred Nee Tobin, Consumer
Jagruti Patel, MD

Board Staff

Russ Aims, Board of Registration in Medicine
Brenda Beaton, JD, Board of Registration in Medicine
Fallon Onufrak, Board of Registration in Medicine

The only MA school an esthetician can pursue an "Advanced Esthetician" course- 1200 hrs, is at The Catherine Hinds Institute. The founder sits on the board of Cosmetology as well as on the task Force.

Straight off the school's website:

"In January 2008 the Accrediting Commission of Career Schools and Colleges (ACCSC) renewed the accreditation of the Catherine Hinds Institute of Esthetics for an additional five (5) year term. The ACCSC is recognized by the U.S. Department of Education as a national accrediting agency for private, postsecondary institutions that offer occupational vocational programs. The Catherine Hinds Institute of Esthetics has been recognized by ACCSC as a 2008-2009 School of Excellence and as a 2003 School of Distinction."

So this is an accredited school with instructors from every level of study- Cosmetology, Nursing and MD's.

No malpractice Insurance is necessary for a laser tech regardless of their level of study because they are overseen by an MD who carries the malpractice.

And leftg? please, PLEASE, for the love of all thing holy, STOP referring to laser treatments as "laser surgery". Again, all laser treatments are non-ablative, and most are non-invasive. You know- the opposite of surgery.

Better off now.. You are SO WRONG that I think it is ridiculous or worse (my opinion). If you took the time to check it out you will find YOUR DEFINITION OF SURGERY IS WRONG. The goal of laser therapy is to make PERMANENT CHANGES in FUNCTION( LIKE KILL OR DESTROY ROOT OF HAIR FOLLICLE) and to make significant PERMANENT CHANGES IN APPEARANCE (LIKE REMOVE TATTOOS AND WRINKLES AND MANY MORE PROCEDURES THAT YOU DO).
X-RAYS do not break THE SURFACE OF THE SKIN EITHER but they can KILL patient and technician) Lasers are used in medicine as an instrument for surgical procedures they ALTER the FUNCTION AND /OR APPEARANCE OF THE AREA BEING TREATED. YOU CANNOT CHANGE THE DEFINITION OF A WORD BECAUSE IT SUITS YOU DUE TO THE VESTED INTEREST YOU HAVE as a result of a sales pitch by an other with a vested interest (commission) Your LACK OF KNOWLEDGE ABOUT LASERS IS WHY IT WAS SO EASY TO SELL YOU ON THAT IDEA OF BEING NON-INVASIVE. The facts are, a number of states now INSIST (like NEW JERSEY and more that I can not remember at this time) that if you point a laser at a human (I am not sure if it includes animals too) you better be a MEDICAL PERSON WITH A LICENSE AND TRAINING OR ELSE IT IS ILLEGAL. That means YOU CAN NOT EVEN BUY INSURANCE.

By now you must know insurance companies are ONLY INTERESTED IN MAKING MONEY NOT PAYING IT OUT. they understand risk and will make you pay for it. MORE RISK means MORE PREMIUM. UNTRAINED LASER OPERATORS ARE A HIGH RISK. Figure it out.
The PRESENT WEIRD FDA DEFINITION OF HAIR REMOVAL HAD TO BE WRITTEN BY A GROUP OF LAWYERS WITH THE HELP OF LOBBYISTS FROM THE LASER INDUSTRY. THEY NOW HAVE AN "OVER THE COUNTER VERSION" FOR HOME USE. THEY DO NOT CARE ABOUT THE INDUSTRY OR PATIENTS. THIS IS OBVIOUS BECAUSE THE OTC DEVICE HAS INSTRUCTIONS THAT ARE VIRTUALLY THE SAME AS YOUR "PROFESSIONAL" DEVICE FOR WHICH YOU HAD TO BE TRAINED (OR DID YOU... who did it and where?). Did it ever occur to you that when lasers were released there were IMMEDIATELY, SCHOOLS TO TEACH IT. WHERE DID THOSE OPPORTUNISTS GET THEIR TRAINING? YOU HAVE A CASE OF THE BLIND LEADING THE BLIND. SCHOOLS ARE INTERESTED IN MAKING MONEY.... SO THEY TAUGHT SUBJECTS THAT NOBODY COULD COMPARE THEM WIT5H AS THERE WERE NOBODY TO COMPARE WITH.

That means illiterates, or patients with poor reading comprehension, patients who do not understand ENGLISH (how many languages do you want them to print the instructions in?) AND OTHERS WHO ARE JUST PLAIN STUPID (and there are many) CAN BUY THE DEVICE AND GET INTO SERIOUS TROUBLE. BLINDNESS IS ONLY ONE OF THEM.
(You know it only takes a split second for a single flash). Here on the net... FDA lists side effects of lasers. 2 deaths THAT THEY KNOW ABOUT, seizures, coma, cardiac arrhythmias, 1st 2nd and 3rd degree burns, hyperplastic scars, pigment changes (like zebra stripes) IS THAT ENOUGH? YOU KEEP REPEATING STUFF YOU KNOW NOTHING ABOUT. YOU MAY NOT LIKE IT BUT THAT'S THE TRUTH. I worked in a dermatologists office while he was there. He checked each patient before and after each visit and made the laser settings himself. THIS STUFF IS VERY SERIOUS.
There is an expression used in medical schools....see one ...do one...teach one.IF YOU BELIEVE THAT YOU CAN BE A DOC IN AN HOUR BY JUST WATCHING A PROCEDURE. THERE ARE MANY LASERS ON THE MARKET. YOU CAN BUY ONE THAT FITS A PARTICULAR NEED AND BUY A SECOND ONE FOR ANOTHER INDICATION. SCHOOLS DO NOT HAVE THE MONEY TO BUY A FEW LASERS...YET YOU NEED EXPERIENCE ON A FEW DIFFERENT ONE FOR CERTAIN PROCEDURES. YOU ARE DOING SURGERY AND YOU ARE VERY STUBBORN.

02.13 | Unregistered Commenterlefty2g

leftg-

Laser surgery is surgery using a laser (instead of a scalpel) to cut tissue. An example is LASIK eye surgery. You are confusing Laser Surgery with Laser treatments such as Laser Hair Removal.

x-rays have nothing to do with this discussion as the joules (energy) used in xrays are significantly higher than any laser's joules are. They are two completely different devices.

While you are correct that state laws are different and NJ regulates that an esthetician cannot fire a laser, no esthetician buys insurance in any state. The MD that oversees them does.

MD's are regulated by the medical boards. In the event of an accident, like blindness (can't happen if the patient is wearing protective goggles by the way), that MD would lose their license to practice medicine. Why would any MD jeporadize any patient's health and their own license by having an untrained laser tech firing a laser?

You are mis stating that deaths have been attributed to the Laser Hair Removal. There was was a widely publicized case (it was written up in Cosmopolitan Magazine) about a woman named Shari Berg who died in 2004- but she didn't die from Laser Hair Removal.

Sadly, she died from the numbing cream that she applied in her car on the way to her appointment. It was a highly toxic Lidocaine-Tetracaine combination.

That cream was not made by her MedSpa- it was made by a compounding pharmacy. It was a combination never reviewed -- or approved -- by the FDA. So she died from a drug- not Laser Hair Removal.

Furthermore, laser companies won't sell a laser to a non-MD. You have to have a license # on the purchase order.

While I can't speak for every school, the School I hire Advanced Estheticians from does not have their students train at their location. They send the their patients to be trained on multiple lasers by a Plastic Surgeon.

You can rant and rave all you want, but it is not illegal in my state and many other state's for an advanced esthetician to fire a laser under an MD's license. Because Laser Hair Removal it is NOT medically or legally classified as surgery.

You are right about eye shields, however, that is in your office . I alluded to the "over the counter lasers" now available. (I SPECIFICALLY ASKED ABOUT PEOPLE USING THEM WHO ARE ILITTERATE, POOR READING COMPREHENSION, OR DO NOT KNOW THE LANGUAGE AND MINORS) wrote FDA to inquire about the differences , if any, between an OTC laser and a professional one. THEY DID NOT ANSWER. I USED THEIR FORMS TO INQUIRE.
IF the OTC LASERS ARE THAT GOOD YOU COULD BUY ONE FOR $800 AND SAVE A LOT OF MONEY.

DID YOU SEE THE NEWS (IN NY TIMES) ABOUT "WHISTLE BLOWERS" IN FDA REGARDING BEING ORDERED TO APPROVE CERTAIN DEVICES THAT HAD BEEN TURNED DOWN FOR APPROVAL. A number of heads rolled. THERE WILL BE LAW SUITS AND BIG PAY OFFS TO THOSE WHO WERE FIRED FOR BLOWING THE WHISTLE. THE HEADS ABOVE THEM WERE FIRED FOR ILLEGAL ACTIVITY.

Some years ago the Massachusetts Board of Electrology included of a person who owned a school of electrology. SHE WAS ASKED TO RESIGN BECAUSE IT WAS A CONFLICT OF INTEREST TO MAKE LAWS FOR A BUSINESS SHE OPERATED. The same holds true here as Ms. Hinds owns a school that she is making regulations for. That is a DIRECT CONFLICT OF INTERESTS. She can be a consultant but NOT A MEMBER OF THE BOARD. The people making laws and regulations here are NOT FAMILIAR WITH THE LAW OR LAW MAKING PROCESS. THEY ARE STARTING OFF WITH MANY WHO DO NOT KNOW WHAT GOES ON IN A SPA. THEY DO NOT KNOW WHAT CONSTITUTES SURGERY JUST AS YOU DO NOT. By the way, side effects of BURNS ARE NOT INTENTIONAL BUT THEY DO HAPPEN. ZEBRA STRIPES ARE VISIBLE SIDE EFFECTS THAT ALTER PIGMENTATION OF THE SKIN. THAT IS NOT THE INTENT OF LASER SURGERY BUT IT HAPPENS AND THE MELANIN PRODUCING CELLS ARE WELL BELOW THE SURFACE., THEREFORE, YOU HAVE MORE VISIBLE PROOF THAT TISSUE IS BEING ALTERED AND IN MANY CASES THIS IS PERMANENT.There is no point in having laser treatments if the result is not permanent, yet, FDA will NOT allow you to advertise "permanent" hair removal after over 15 years of laser experience.

I believe, AT ONE TIME, a member of the cosmology board in Massachusetts also owned a school. She assisted in adding to the laws for cosmeticians that AFTER GETTING A LICENSE they had to WORK AS AN APPRENTICE for an UNREASONABLE length of time before they could be a full fledged cosmetician to open their own shop. THIS GUARANTEED that the new graduates of the school she owned could not open a spa in competition with her. Also provided a CONSTANT FLOW OF WORKERS in the multiple spas she owned. AND HELPED DELAY COMPETITION. THAT IS ANOTHER CONFLICT OF INTEREST. YOU CANNOT ALLOW PEOPLE WHO BENEFIT FROM THE LAWS THEY MAKE TO BE ON THE BOARD THAT MAKES THE LAWS. That is too obvious. USUALLY A LOBBYIST IS PAID TO DO THAT AND THEY PAY LEGISLATORS FOR THEIR SUPPORT (LOOPHOLE). I'LL GET THE EXACT INFORMATION FROM A PERSON WHO WAS DIRECTLY AFFECTED BY THAT RULE. This problem was remedied.

I am not sure if your explanation of employees being covered by a doctor's insurance is correct. However, many spas and salons, and electrology offices do NOT have a medical director. I m retired now but will contact my former insurance agent for the current story in Massachusetts as they insured electrologists and spas all over the country in all states. When I worked in a derms office for 10 years, I had my own insurance. My daughter is an O.R. NURSE IN A MAJOR BOSTON HOSPITAL. She has her own insurance even though the hospital has some insurance for her,and she is ALWAYS working under a doc as it is in the O.R.

PS: YOU USE LSER "TREATMENTS" TO AVOID THE USE OF THE WORD "SURGERY" BUT IT STILL IS LASER SURGERY. The procedures you do were worked out by docs as it IS SURGERY but they can't be bothered with it as it does not produce the stream of income they like to see OR THERE WOULD BE MORE OF THEM.

The FAMOUS MASSACHUSETTS GENERAL HOSPITAL GAVE UP ALL LASER HAIR REMOVAL AS WELL AS OTHER PROCEDURES AND NOBODY EXCEPT BOARD CERTIFIED PLASTIC SURGEONS, DERMATO-SURGEONS, AND OTHER SURGICAL SPECIALTIES ARE ALLOWED TO USE THEM. NO RNs, NPs PAs, ARE ALLOWED TO USE A LASER IN THIS ETHICAL HOSPITAL RESIDENTS CAN USE THEM UNDER THE SUPERVISION OF A BOARD CERTIFIED SURGEON ONLY..YOU STILL INSIST THEY ARE NON-INVASIVE BUT YOU ARE WRONG...IF YOU DO A NON-ABLATIVE PROCEDURE THE POTENTIAL SIDE EFFECTS SHOW THAT SOMETHING IS GOING ON BELOW THE SURFACE EVEN F YOU DO NOT WANT THEM..

02.13 | Unregistered Commenterlefty2g

Lefty,

Would you please stop entering your posts multiple times. You are already annoying enough without the same post multiple times.

BetterOffNow, I usually like to read your comments and feel that they are thoughtful and honest although I may not completely agree all the time. I am not sure why you continue to argue with lefty. Lefty continues to put posts up that are often nonsense and of no value to the conversation. I would recommend to not argue with lefty and hopefully he/she will go away.

02.14 | Unregistered CommenterLH

Sorry about the duplication. It was not intentional.

IF, as you insist... laser treatments are different than laser surgery... HOW COME THE SIDE EFfECTSC ARE THE SAME?

02.14 | Unregistered Commenterlefty2g

LH- A current patient showed me some of leftyg posts on her phone, not knowing I am BetterOffNow- and asked some similar questions.

I am actually trying very hard not to argue with her personal attacks and comments, but believe that her confusion and misunderstanding of MedSpas and their protocols may be shared by other lurkers.

I'd rather handle the questions and objections here than in the consultation room, but also don't want to hijack this or any other thread.

So leftg this will have to be the last discussion regarding this topic- when I use the term "laser surgery" vs. "laser treatments" I am following the legal and medical definition of those terms- not leftyg's definition.

Laser surgery and laser treatments absolutely do not have the same side effects, as laser surgery is using a laser instead of a scalpel to cut into living tissue.

So we will just have to agree to disagree on this.

Even if I agreed with you (I do not) ... RIGHT HERE ON THE FDA WEB SITE they still list laser side effects as including 2 DEATHS, coma, cardiac arrhythmia, seizures. hyperplastic scars (that's KELOIDS), and you must know about ZEBRA STRIPES, and permanent melanin changes. ETHICAL and LEGAL requirements demand you tell patients about this or do you ignore them? "FULL DISCLOSURE" IS MANDATORY but nobody mentions this to clients. Why do they ignore this?

When you need PERMANENT HAIR REMOVAL YOU WILL SEEK OUT AN ELECTROLOGIST FOR YOURSELF. IF you believe in lasers you will prefer a PLASTIC SURGEON TO AN UNLICENSED, POORLY TRAINED LASER PERSON because YOU KNOW THE DIFFERENCE.

02.15 | Unregistered Commenterlefty2g

Now we are geting into an area I'm very familiar with and well trained to discuss. If the laser client was INFORMED OR ASKED ABOUT ALLERGIES those deaths may have been avoided, however, my doc would use a heart monitor when any CAINE product was used because it was the severe allergic reaction that caused the death of a patient, however, if she did not have a laser treatment she would not have the prepping. PREPPING for any procedure is PART OF THE PROCEDURE.. An allergic reaction is UNPREDICTABLE unless the patient has had them before BUT THAT IS NO GUARANTEE EITHER. All CAINE products can have a cross allergy. It is NOT THE AMOUNT. All you need is the MERE PRESENCE OF THE tiniest amount. Just like ANY OTHER allergy. Compounding did not cause the allergic reaction. HER sensitivity did it. You can not be allergic the first time you are exposed to it. THAT IS WHEN YOU DEVELOP THE ALLERGY. Subsequent times brings you closer to the reaction IF the client will ever get one. She may not get one until the tenth or twentieth time and maybe she will never get one. You take a chance each time you expose her to it. If she has a history of allergies she is more apt to be the one who gives you a problem but not necessarily. IT IS A GAMBLE ANY WAY YOU LOOK AT IT. WHY DO YOU NEED A NUMBING AGENT? DO YOU MEAN TO TELL ME IT IS PAINFUL? I NEVER WOULD HAVE KNOWN IF YOU DID NOT TELL ME. HOW ABOUT THOSE DOCS ON TV THAT SWEAR HOW LITTLE THE SENSATION WOULD BE? WAS THE DOC LYING TO GET ANOTHER PATIENT? I NEVER WOULD HAVE BELIEVED IT. I DO NOT KNOW HOW OFTEN THIS HAPPENS, HOWEVER, I'M POSITIVE IT HAS HAPPENED SINCE THEN AND WILL HAPPEN AGAIN BECAUSE THE PROCEDURE IS SO COMMON.

PLEASE KEEP IN MIND .... ALL DRUGS AND PROCEDURES HAVE SIDE EFFECTS AND/OR REACTIONS. SOME ARE MORE COMMON THAN OTHERS BUT THEY ARE THERE AND YOU CAN NOT STOP THAT. IF a doc is there with the right drugs you are safe, however, an OFF SITE DOC IS USELESS. You can not toss off side effects as a minimal problem. You have to be prepared for the worst.

I recognize you do not want to give up a good living but when you ignore a fact because it is inconvenient to discuss this with the client you are putting a life at stake.

When an excellent hospital like the Masssachusetts Gen'L GIVES UP LASER HAIR REMOVAL AND OTHER LASER PROCEDURES YET INSISTS THAT ONLY BOARD CERTIFIED DOCS TRAINED IN THEIR USE BE ALLOWED TO DO USE THEM IN THIS HOSPITAL.... THAT SHOULD BE A CLUE TO THE SERIOUSNESS OF IT ALL. THEY TOOK IT ON BECAUSE THEY THOUGHT IT WOULD BE PROFITABLE BUT FOUND OUT IN SHORT ORDER THAT THEY MADE A MISTAKE, THEY RETURNED MONEY TO PATIENTS. ISN'T THAT UNUSUAL? THEY MUST HAVE HAD A GOOD REASON BECAUSE THEY DO NOT LIKE TO GIVE UP A GOOD THING. THEY GAVE UP A BAD THING.

02.15 | Unregistered Commenterlefty2g

I've deleted some duplicate posts. Let's try to avoid ALL CAPS and any personal attacks. Thank you, The Management

Lefty you are an OLD FOOL ELECTROLOGIST, go back to selling buggy whips to all of the horse carriages. LASER HAIR REMOVAL ONLY REQUIRES SUPERVISION by a MD. STOP CLOGGING THE BOARDS WITH YOUR RANTS. Take a walk to the park, go feed the pigeons, AND leave us professionals alone. IF YOU WANT TO MAKE A DIFFERENCE TALK TO STATE MEDICAL BOARD. A highly trained and respected ELECTROLOGIST carries a lot of weight with the state medical board. THAT WAS SARCASTIC, BY THE WAY.

02.15 | Unregistered CommenterGolfindoc

Any additional posts with ALL CAPS will get your post removed and possibly get you banned from the site. (Lefty2g, this means you too.)

leftyg- the patient died of anabolic shock due to the compounding of the two drugs together *not* an allergy. No one could have tolerated the amount she used. Her case actually led to tighter regulations and laws for the compounding pharmacies *not* laser hair removal. Google her name to see the amount of laws changed after her death- none affecting MedSpas, by the way.

Some lasers do require a numbing cream, it is not at all uncommon or unusual. A condition called follicular edema can occur- when the hairshaft swells and is also heated -when it touches the sides of the pore it's growing out of it can be anywhere from uncomfortable to painful.

***As far as MGH is concerned-I have a medspa about a mile down the road from them- IMHO the reason their MD's did Laser Hair removal was for the $$$ not because lasers are so dangerous. Because they aren't.

BTW? Their procedure's were significantly more expensive than mine. They probably couldn't get any business which is why they stopped- not because there's anything dangerous about laser treatments when proper medical protocols are followed. I'm not surprised MGH gave up on having MD's perform treatments- it would be like board certified Plastic Surgeons giving manicures. Not necessary or preferred by patients.

***Of course full disclosure is necessary and ethical during a consultation. All possible contraindications are listed in all paperwork that patients sign off on and *of course* it's talked about before any treatments. Each patient is made fully aware because their direct compliance with pre and post instructions is vital to their success.

***You seem confused about which board regulates what. Your daughter as an OR Nurse is overseen by the State Nursing Board. Her MD is overseen by the state's Medical Board. If her MD hires an esthetician to perform laser treatments it would be under his medical license which the Medical Board could revoke. His esthetician would be overseen by the state's Cosmetology Board. The FDA approves of the laser itself and has nothing to do with the procedures as that is completely out of their jurisdiction.

There is a fair amount of oversight in this field, and considering that lasers have been used for over 20 years, every "gotcha" that you can think up has already been thought of and addressed.

FOR YOUR INFO.... If you really want to know.....
State statute defines the use of lasers (and IPL) as surgery and, therefore, such use constitutes the practice of medicine.
FDA says "lasers are prescription devices that can only be sold to and used by those licensed to use them in the state where they practice". That is a quote from FDA on their web site. It is clear and concise. You may want to put a different interpretation to those words but the first error was for the company to sell the laser or IPL to non-medical people with no license to practice. Most operators do NOT have a medical director available. In some cases the doc never visits, yet he allows some offices to use his name. Therefore, he is liable because, "the one with the highest level of training, whose name is used or inferred, is liable" .What is it about that you do not understand?? The problem ends there. IF a Federal regulation or law conflicts with a local law or regulation, the Federal law trumps the local laws.

I do not want to be misunderstood here. MGH gave up hair removal NOT all laser treatments. They have the Wellman Labs for Photo Therapy here.They do all sorts of research using light on the skin. There are many uses for lasers and other lights in medicine. Not all of them are surgical, however, ALL laser MGH was interested in making money too but there were problems using non-medical people doing the procedures.A board certified doc had to be in attendance. This took him away from another patient.They REFUSED to allow anybody who was not licensed do anything on their own. They do not wait for problems. They try to avoid them before they happen. They have a big legal department and access to other outside law firms who are on retainer just for these situations. That is why they refunded money to patients.They are not interested in STRETCHING the law. They just obey it.

The nursing board in MASS. released a decision some time ago that says,"laser hair removal is whithin the perview of nursing practice" to paraphrase them (it is here on the web). This decision was made by some people on the board who have no knowledge of lasers and the problems they can cause in the hands of poorly and/or undertrained operators. There is NO place to get proper training in lasers ere in MA. If they are allowed to continue like this.... RNs will be doing brain surgery next.

02.17 | Unregistered Commenterlefty2g

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