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Entries by Paula D. Young RN: Medical Spa (46)


Proposed Change In PA State Cosmetic Laser Regulations Would Force Laser Clinics To Close

New regulations proposed in PA and would require physicians to be on-site during all cosmetic laser and IPL treatments.

Notice to all physicians, nurses, nurse practitioners, physician assistants, estheticians and laser technicians in PA: I'm asking your help to oppose a new regulations in Pennsylvania requiring changes to who can perform cosmetic laser and IPL treatments.

This law is attempting to be passed through regulatory agencies and implies that estheticians are negligent with the use of lasers and cause harm to patients.  Many of the physicians I spoke with stated they have treated many patients harmed at the hands of other physicians.

The new regulation will stipulate that only physicians, nurses, nurse practitioners and physician assistants will be permitted to operate an aesthetic laser and if the operator is not a physician, the physician must be on-site during the use of the laser and must perform an assessment on the patient prior to treatment.

This would effectively eliminate the use of estheticans and laser techs from performing any laser-based treatment and could force many clinics to drastically change their business models, or close altogether.

Click to read more ...


Understanding "Core" Physicians

What is the definition of a 'core' physician?

On April 30th, I conducted a webinar for Palomar Medical, Inc. on the topic of optimizing Local Search Engine Optimization tactics to boost your practice on local internet placement and ranking. Soon after the webinar, I was contacted by many physicians with many questions. I felt confident in answering all of them, except for one. And, that question was "what is the definition of a "core" physician"?

I was stumped.

I've searched the Internet for a documented answer and found none. I then perused quite a few physician's websites where it was clearly stated they were "core" physicians. It was also clearly stated that those medical specialties that were not deemed as being "core" were not qualified to perform certain aesthetic procedures. Not to be accused of being "flippant" by a physician as in one of my previous posts, I had thought that it was experience, training and number of successful procedures performed that made a physician "core" in that particular aesthetic modality?

Even on review and educational websites such as RealSelf, all non-"core" specialties were removed.

The answer I received from RealSelf stated : "RealSelf is no longer hosting profiles for participants who do not meet specialty designation criteria set forth by updated RealSelf policies. We have encountered problems with doctors and other medical personnel answering questions far outside their expertise or specialty and, in some cases, even dispensing inappropriate and dangerous advice to our readers. The aforementioned changes have been implemented in an effort to prevent these situations from arising."

Not to elicit any aggressive comments here, and I mean no disrespect to any medical specialty in particular, I just would like to be enlightened as to where the definition of "core" was derived from and what medical specialties that includes?


Cosmetic Surgery For NY Teachers: No wonder our school taxes are so high!

Now I know why there seems to be a reprieve in the economic status of the medical aesthetic market. I just couldn't believe this article on so I am posting it in it's entirety for your viewing pleasure:

Buffalo, N.Y. Teachers Spend $9M in Taxpayer Cash in '09 on Cosmetic Surgery 

Buffalo teachers rang up nearly $9 million worth of taxpayer-covered cosmetic surgery in 2009, according to the state-appointed authority overseeing public school finances.

The Buffalo Fiscal Stability Authority found that last year's costs for elective procedures such as chemical peels and other skin treatments were up $8 million over 2004's $1 million tab for cosmetic surgery.

The procedures, provided under the teachers' union contract, accounted for 9 percent of the district's total spending on health benefits for employees and retirees, The Buffalo News reported Thursday.

About 10,000 school employees are eligible for the benefit. District officials said teachers or their dependents accounted for 90 percent of the approximately 500 people who received cosmetic surgery last year.

The president of the Buffalo Teachers Federation said the union has agreed to give up the benefit in the next contract and said teachers may be simply rushing to use the benefit while they can.

Board of Education member Christopher Jacobs said the cost increase "smacks of abuse" and is asking the district and the city comptroller to investigate.

 - I'm thankful for the boost to our industry, but not this way! Unbelievable!

This guest post is written by Paula D. Young RN, author of Advanced IPL & Laser Training For Non-Physicians and co-owner of Young Medical Spa in Center Valley PA.

Submit a guest post and be heard.


Refuting Negative Online Reviews

Protecting your medical spa, personal, and professional reputation online can be damn near impossible.

With internet marketing opportunities on the rise, today's aesthetic clinicians are faced with a "double edge sword". One side, if you don't advertise yourself on the internet you have less of a chance to gain presence and new business over your competitors. The other side of the blade is that you are opening yourself and your practice up to negative comments and reviews.

While patients do have a right to exercise The First Amendment, what we really find in our industry is that positive reviews don't come freely. Seldom does a "customer" of a business post how wonderful a place is or what a great experience they had. Typically, rave reviews are solicited by the business encouraging their customers to post reviews if they are "happy". Whereas, someone who is disgruntled in some sort of way has no apprehension whatsoever in posting their views on the internet.

With many sites not requiring the identity of the poster to be verified, this opens up the "Wild West", so-to-speak, for anyone to post anything he or she desires. This also includes your competitors who can acquire an email address with any vendor, then post anonymous false reviews of you and your practice.

How can you combat this? First, you have to be diligent in canvassing your reputation on the web. You have a choice to let the comments go, or research them to see if you can determine who they are so you can have the opportunity to correct the review (if it is a legitimate complaint). You can also report the review to the posting internet site with a clear description of why you believe the post should be removed. However, there is no guarantee you will even receive a response.

Many social media marketing gurus state that all positive reviews on a business tends to make the consumer think something is a little fishy with the business, so one bad review can add to the business's authenticity. Take book reviews on Amazon for example. I know I read through them all, good and bad, then make my decision. After reading a few, you get a general idea of what reviews are just "out there" (i.e., insults, poor language, obscenities, etc.) and which ones are more reliable and genuine.

David Goldberg, M.D., J.D. has written an excellent article for Dermatology Times entitled "Physicians have limited recourse against online defamation". This is a must read article for any clinician!

From the post:

There are known instances of dentists being accused online by their competitors of being child molesters. Similarly, laudatory online comments can be written by the physician himself.

One way to try to work around such frivolous online statements is to have patients sign a waiver that has them promise, in case they are not happy with their care, that they will not post online comments to that effect. The way such contracts are enforceable is as follows.

In general, websites acting as platforms for outside commentary are not liable for defamation suits. They are, according to North Carolina neurosurgeon/attorney Jeffrey Segal, M.D., J.D., subject to copyright laws. Waivers can be written to assign copyright to the treating physician. If the treating physician asks the patient to sign such a "copyright" waiver, the physician can claim ownership of any anonymous review of the practice and demand that such an online review then be removed. There are now examples of website posts removing such deleterious copyrighted comments.

Needless to say, not all patients will agree to sign such a waiver. Some may feel such waivers are simply "gag orders." The reality is that disgruntled patients are free to speak with family, friends, other physicians, lawyers, hospital peer review committees or credentialing committees. There are many appropriate places where patients can express their views.

This guest post is written by Paula D. Young RN, author of Advanced IPL & Laser Training For Non-Physicians and co-owner of Young Medical Spa in Center Valley PA.

Submit a guest post and be heard.


Medical Spa MD: Change In Federal Gift Certificate Law

On Sunday, August 22nd, the new federal gift certificate law went into effect. What does this mean to your medical spa?

In essence, the new law sets a 5-year minimum term for most gift certificates sold in the U.S. and it doesn't shorten any minimum terms required by your State law. Period.

The new law is just extending the terms of expiration if they previously were less than 5 years. If your State had a minimum term of more than 5 years, such as MA (7 years), your term will not change.

In addition, if your State does not permit you to apply an expiration date, such as the Stets of CA, CT, FL, ME, MN, MT, NH, RI and WA, of course those terms would still apply to any gift certificates you sell.

Gift certificates sold prior to August 22nd will be grandfathered in. If you have questions you can always visit the National Conference of State Legislatures.

If you have any questions about whether this new federal law pertains to you, you should check your state laws regarding gift certificate expiration, or consult with your legal representative or accountant.


New Medical Spa Regulations for Arizona & Texas

Arizona Medical Spa Regulation Update: Esthetician & IPL Laser Technicians

Arizona requires all training providers be registered with the state to provide training to comply with their requirements. The program shall provide a provisional certificate to the applicant verifying the successful completion of the didactic training.

An esthetician who has been using laser and IPL devices before the effective date of this amendment to this section may continue to do so if the esthetician applies for and receives a certificate pursuant to this section before October 1, 2010. Arizona state legislature requires a laser technician who wishes to perform cosmetic laser procedures and procedures using IPL devices to successfully complete 40 hours of didactic training as required by agency rules at a certified training program.
More Information From State Website

Texas IPL & Cosmetic Laser Regulations Update

The Texas Legislature has passed legislation in House Bill 449that establishes a regulatory program for laser hair removal. The Department of State Health Services is charged with implementing that program. The legislation requires every laser hair removal facility to be licensed by the department. It also requires that each individual who performs laser hair removal procedures, except physicians, be certified by the department. By September 1, 2010, every laser hair removal facility must be licensed and each individual who performs laser hair removal must be certified.

However, the adoption of the laser hair removal rules and implementation of the laser hair removal program has been delayed for a number of reasons, including the request from state leadership for each state agency to submit a plan to reduce budgets by 5%, as well as implementing an agency hiring freeze to help address the state's budget situation. Work on implementation, however, does continue forward.
More Information From State Website

Information adapted from Aesthetic Trends & Technologies

Guest post by Paula D. Young RN, author of Advanced IPL & Laser Training and the Medical Esthetician Training Manual & Study Guide and head of operations at Young Medical Spa.

Submit a guest post and be heard.


Estheticians: Learning About Acne & Laser Therapies

Ten-to-one you talked about acne briefly during your esthetics program. The acne patient at a medical spa, however, differs greatly than the patient you would see in a day spa. With the proper understanding of the etiology of acne and treatment modalities available, you can help keep your acne client's flare-ups under control.

In the Advanced Medical Spa Aesthetics Training Course, Chapter 12, Acne Vulgaris is discussed in depth. Understanding the disease itself is the key to deciding what therapies would be efficacious for your clients. The first section of the chapter discusses the etiology of Acne Vulgaris, various representing characteristics from the comedone stage to the cystic and scarring stage, medical treatment modalities such as antibiotic regimens or lightening agents, and the use of lasers.

At a medical spa level, most estheticians are involved in the treatment and care of acne patients. Their involvement typically includes product dispensing, facials, perhaps some light chemical peels (Chapter 4), or even microdermabrasion(Chapter 3) for acne scarring. Depending upon the State an esthetician is practicing in, therapy for some acneic clients can involve laser therapies. This chapter will help the esthetician learn how IPL therapies can be used to treat active acne as well as fractional lasers that can treat the scarring left behind (Chapter 15).

Acne is more than skin deep and, whether or not you can provide laser therapies to your clients, having knowledge of them and when to use them is quite valuable to your client and to your medical director.

Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

Submit a guest post and be heard.


Re-evaluating Your Medical Spas Skin Typing Practices

If patients haven't already started coming to your practice for laser hair removal for silky smooth summertime skin, they're probably starting now. And now is a more dangerous time than ever for them to start laser therapies especially if you or your staff isn't adequately trained on proper skin typing and assessment.

If you're like most practices, you will request a patient complete a skin typing worksheet to determine their Fitzpatrick Skin Type. A couple of problems arise here. First, you're depending on your client to complete the chart and be accurate and honest. Many technicians only look at the final score and never really go over each question. Are they really blonde, or is their hair colored? Do they really tan easily without burning if they're a freckled red-head? Verifying each answer the client has chosen is the responsibility of the technician who should be comfortable "overruling" an answer upon using their own eyes to verify.

Another problem that can arise is exposure to the sun, tanning beds, spray or bottle tans. This is the time of the year where your client may start false tanning. This pigment applied to the skin can very much interact with the laser parameters you have set; therefore, you will need to make an adjustment. Or, they could walk in on a Monday after getting some sun on Saturday and their legs will be a little "pink" to them which should look like a big red flag to you!

Even though a patient may be a repeat client, that shouldn't rule them out from completing a new form and being reassessed prior to treatment this time. Just because they weren't tanned last year when they had their chin and upper lip done doesn't mean they won't be tanned this year when they come in to have their legs treated.

Skin typing should be performed at every laser session, not just the initial visit, as there could be subtle changes each session. If you are a laser technician or aesthetician who is uncomfortable with skin typing your clients, or you have staff personnel you feel lack the necessary understanding of proper skin typing, you might want to consider the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course available on MedicalSpaMD exclusively. The Patient Selection Chapter discusses Laser Applications, Patient Selection, Skin Color, Skin Typing, The Fitzpatrick Classification Scale, Skin Classification by Ethnicity Type, Medical History, Physical Examination, and Contraindications for Treatment.

Great patient results begin with proper education to develop solid standards of practice. Your patients don't want to get burned, and neither do you.

Submit a guest post and be heard.

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