Medical Spa MD: Physician community of skin clinics, laser centers, plastic surgeons, dermatologists and aesthetic doctors practicing nonsurgical cosmetic medicine.
The Fractional CO2 Laser chat transcript: The various Fractional Technologies. Lumenis UltraPulse, Reliant Fraxel, Juvia, Sciton ProFractional, Lutronics, Cutera Pearl Fractional, and others. Depth of Penetration, Energy Levels, Length and Width of Ablation and Coagulation, % Surface Area Covered etc.
Ok, I'm more than just a little tired of some of the bull shit that certain laser clinic and plastic surgery directories spamming the site and posting positive anonymous reviews of their services and laser hair removal listings.
So, there are about to be some very public spankings.
Medical Spa MD has attained some popularity, and some clout with physicians running laser clinics. I receive regular iquiries from docs looking for advice on cosmetic lasers and I personally know of a number of doctors who have printed out reviews from Med Spa MD and asked cosmetic laser sales reps about them. There are laser companies who are now Medspa MD members and (to my current understanding) are welcome members to the community.
However, there are some cheap laser clinc and plastic surgery directories that think that you're an idiot and post comments like those below. (There've also been some physicians offering their 'expertise' as trainers who have tried this to promote their training.) Don't. You've been warned.
1800laserhair.com: I don't know if 1800laserhair.com is posting these comments as part of their corporate policiy or if it's just a rogue individual salesman who's doing it for them. I also don't care. My guess is that they're some small little hack job outfit. It pisses me off personal that whoever this is thinks that this won't be found out.
Here's an example of laser clinc directory, 1800laserhair.com who posted this rave review to Med Spa MD under the name Dr. Don:
I have the two Candelas yag alexandrite and a light sheer diode. I use a service tech that is awesome and reasonable. I can't remember his name right off but I got his name from this great referral network I belong to. Call 1-800 Laser hair ask for Nancy or go to their website WWW.1800laserhair.com There may be a link but I think I got the guys name directly from Nancy. His name is Robert something... BTW anyone slow or having advertising or marketing issues, I am getting tons of referrals from the 1-800-laser hair network. You have to meet their criteria, they are very picky and exclusive but if they will accept you join!!! Two colleagues of mine were denied I am not sure why. The leads are great worth every dime. I resisted their advice at first, them I put my wife in charge of all of it, she followed their program to the letter now we are so overwhelmed with calls for laser (Not really what I want to be doing but I better not complain because laser hair removal is supporting my practice through this crappy economy. Nice plug for them...tell them Dr. Don sent you...I may get some referral bonus!! LOL
Back to Laser Hair removal service. I don't have a service contract. Don't get them. I regularly get laser check-ups. Robert (the service guy) calls my office when he is in my area. By getting him in when he is already in my area he gives me a break on service costs. I get the check-ups and do preventative laser maintenance. Also Nancy (the 1-800 laser hair removal lady) gave me a monthly weekly and daily check list that tells us how to properly maintain our lasers in between service visits. I have not had a significant laser repair cost in 7 years and I haven't had to replace a laser yet going on 10 years. After we got our staff to follow the checklist diligently we saw a significant drop in repair costs. My staff was going through thousands of dollars worth of parts yearly and I was watching our profits go to Candela, I too despise them. They have terrible service and they have been so shady. I think they would sell their grandmothers if they could make a buck!!! Their service contracts are totally over priced. bad plug!!
I really don't use the light sheer much but I keep it for a back up, just in case. Robert can usually fly in for emergency repairs next day. So I have never really needed it.
Posted As: DrDon
Posted Email: wtawtawdba@yahoo.com
Posted Link: www.1800laserhair.com
Comment Posted From This IP Address: user-24-96-114-40.knology.net (24.96.114.40)
I have to laugh at these claims of exclusivity. "You have to meet their criteria, they are very picky and exclusive but if they will accept you join!!!" Sure.
If I were Candela I'd be contacting my legal department about now. This is a perfect case of liable; posting damaging comments as fact under an assumed name. Candella can't be happy that these laser hair removal guys are bad-mouthing them and servicing their lasers at the same time.
Does anyone fall for these laser hair removal guys? I'd be interested in hearing what any identified physician using 1800laserhair.com thinks about their "tons of referrals from the 1-800-laser hair network."
If anyone has an email from 1800laserhair.com that they have archived in their inbox, I'd be interested in seeing it since the IP address is included. We could compare the two. I'd expect that they change their IP address shortly if they happen to match.
PS: This IP address has been banned.
The ASAPS (American Society for Aesthetic Plastic Surgery) reports 10.2 Million Cosmetic Procedures in 2008. The Aesthetic Society, after collecting multi-specialty procedural statistics since 1997, says the overall number of cosmetic procedures has increased 162 percent since the collection of the statistics first began. The most frequently performed nonsurgical procedure was Botox injections and the most popular cosmetic surgical procedure was breast augmentation.
Top nonsurgical cosmetic procedures among men and women in 2008:
Botox - 2,464,123
Laser Hair Removal - 1,280,964
Hyaluronic Acid (including Hylaform, Juvederm, Perlane/Restylane) - 1,262,848
Chemical Peel - 591,808
Laser Skin Resurfacing - 570,880
Top surgical cosmetic procedures among men and women in 2008:
Breast Augmentation: - 355,671
Lipoplasty (liposuction) - 341,144
Eyelid Surgery - 195,104
Rhinoplasty - 152,434
Abdominoplasty - 147,392
source: ASAPS press release
“For the first time in the twelve years these statistics have been collected liposuction is a runner up in popularity to breast augmentation. There is no doubt that this turnabout will generate discussions in the medical community and the public at large,” Alan Gold, MD, Aesthetic Society president, reflects that “changes in fashion, i.e. décolletage baring styles, might be a factor behind this change.” Racial and ethnic minorities accounted for 20 percent of all cosmetic procedures in 2008. Hispanics again led minority racial and ethnic groups in the number of procedures: Hispanics, 8 percent; African-Americans, 6 percent; Asians, 4 percent; and other non-Caucasians, 2 percent. Location and Fees
Top surgical and nonsurgical cosmetic procedures among men and women in 2008:
Surgical
# procedures
Nonsurgical
# procedures
Breast Augmentation:
355,671
Botox
2,464,123
Lipoplasty (liposuction)
341,144
Laser Hair Removal
1,280,964
Eyelid Surgery
195,104
Hyaluronic Acid
(including Hylaform, Juvederm, Perlane/Restylane)1,262,848
Rhinoplasty
152,434
Chemical Peel
591,808
Abdominoplasty
147,392
Laser Skin Resurfacing
570,880
Top cosmetic procedures for WOMEN:
Surgical
# procedures
Nonsurgical
# procedures
Breast augmentation
355,671
Botox
2,239,024
Lipoplasty
309,692
Hyaluronic Acid
(including Hylaform, Juvederm, Perlane/Restylane)1,200,420
Eyelid surgery
166,426
Laser Hair Removal
1,101,255
Abdominoplasty
143,005
Chemical Peel
554,492
Breast Reduction
139,926
Laser Skin Resurfacing
532,008
____________________________________________________________________________________________________
Women had almost 92 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on women was over 9.3 million, a decrease of over 11 percent from the previous year. Surgical procedures decreased 15 percent; nonsurgical procedures decreased by 11 percent. Since 1997, surgical procedures increased 104 percent, while nonsurgical procedures have increased 233 percent.
Top cosmetic procedures for MEN:
Surgical
# procedures
Nonsurgical
# procedures
Liposuction
31,453
Botox injection
225,099
Rhinoplasty
30,174
Laser hair removal
179,708
Eyelid Surgery
28,678
Hyaluronic Acid
(including Hylaform, Juvederm, Perlane/Restylane)62,428
Gynecomastia
19,124
IPL laser treatment
46,887
Hair transplantation
18,062
Microdermabrasion
39,824
____________________________________________________________________________________________________
Men had over 8 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on men was over 800,000 a decrease of over 21 percent from the previous year. Surgical procedures decreased 18 percent; nonsurgical procedures decreased 22 percent. Since 1997, surgical procedures have decreased over 15 percent while nonsurgical procedures have increased 239 percent.
Frequency of cosmetic procedures by AGE GROUP:
% of total
Age
# procedures
Top surgical procedure
Top nonsurgical procedure
45%
35-50
4.6 million
Liposuction
Botox
26%
51-64
2.7 million
Eyelid Surgery
Botox
22%
19-34
2.2 million
Breast augmentation
Laser Hair Removal
6%
65 and over
634,667
Eyelid Surgery
Botox
2%
18 and under
160,283
Rhinoplasty
Laser Hair Removal
Racial and Ethnic Distribution
Over fifty-three percent (53 percent) of cosmetic procedures in 2008 were performed in office-based facilities; 26 percent in freestanding surgicenters; and 19 percent in hospitals. Americans spent just under $12 billion on cosmetic procedures; $7.2 billion was for surgical procedures, and $4.6 billion was for nonsurgical procedures.
Some doc named Halliday in East Syracuse NY injected fake Botox into twelve of his patients and has now received a $20,000 find as put on probation for three years. He's also restricted to practicing medicine only when monitored by another doctor who periodically reviews his records. Nice.
Here's the article:
Halliday is an ear, nose and throat doctor who practices at 4939 Brittonfield Parkway. The state Board for Professional Medical Conduct charged Halliday with 10 counts of professional misconduct including gross negligence, gross incompetence, negligence on more than one occasion and incompetence on more than one occasion.
In a signed consent agreement, Halliday pleaded no contest to two negligence allegations that he failed to advise a patient of her treatment options and failed to obtain an adequate pre-operative history from another patient. The no-contest plea satisfied all the charges against him. The uncontested charges relate to the absence of documentation, said Charles Patton, Halliday's attorney.
"In consultation with me, Dr. Halliday considered the cost and time away from his patients, which defending himself against these allegations in a lengthy proceeding would require," Patton said. "He has elected to resolve this issue by consent agreement so that he might focus his attention entirely upon patient care."
In its statement of charges against Halliday, the board said he injected 12 patients in June 2004 with unapproved botulinum neurotoxin. That drug is made from the same highly potent toxin that can cause botulism, a severe form of foodborne illness. A purified version of the toxin is used to treat wrinkles. It affects the ability of muscles to contract, smoothing out frown lines to make them nearly invisible. Botox is the only type of botulinum toxin approved by the U.S. Food and Drug Administration.
The board said the version Halliday used was labeled, "For Research Purposes Only -- Not For Human Use."
In June 2005, Halliday wrote to the 12 patients and informed them the drug they received was unapproved and he was unaware of any patients who experienced harmful effects from it, according to the board.
Halliday ordered the botulinum neurotoxin from Toxin Research Inc., the board said. That Tuczon, Ariz., company sold the cheaper, unapproved Botox substitute to more than 200 doctors nationwide, according to the FDA.
Chad Livdahl and Zarah Karim, owners of the company, were convicted of fraud and misbranding a drug and sentenced to prison in 2006. Toxin Research Inc. sold the product to doctors from Manhattan to Las Vegas who learned about the drug at conferences put on by the company, according to the FDA.
Reuters has this press release from French drug maker Ipsen about it's Botox killer, Reloxin:
French drug maker Ipsen's (IPN.PA) anti-wrinkle treatment Reloxin, a possible rival to Allergan's (AGN.N) Botox, reduced forehead wrinkles and had few side effects in a U.S. study published on Monday.
Ipsen said in January the U.S. Food and Drug Administration had extended to April 13 its review of the company's injectable botulinum toxin product for possible approval.
A study involving 1,052 people, published in the Archives of Facial Plastic Surgery, showed that Reloxin improved the appearance of moderate to severe forehead lines.
Within a week, 93 percent to 95 percent of the people in the study responded to the treatment, consisting of five injections at a time, the researchers said. One treatment typically worked for almost three months.
The patients received up to five sets of five injections over the 13 months of the study.
Only one person dropped out of the study due to side effects related to the drug, the researchers said.
Ipsen in 2006 granted Scottsdale, Arizona-based Medicis Pharmaceutical Corp (MRX.N) rights to develop, distribute and commercialize Reloxin in the United States, Canada and Japan for aesthetic use and Medicis funded the study.
The company declined to comment on the findings, citing the ongoing FDA review. The drug is approved for fighting wrinkles in 23 countries, but not the lucrative U.S. market.
"It had a good safety profile and was effective, but we did not do a head-to-head comparison (with Botox). That's the next step, of course, something that probably will be done in the future," said Dr. Ronald Moy of the California Health & Longevity Institute, one of the researchers.
"It will be a good alternative for consumers and may be less expensive," Moy added in a telephone interview.
The drug is made from a toxin made by the bacterium Clostridium botulinum, which also causes botulism food poisoning.
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.
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:
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.
Dear Physician and Medical Aesthetic Practice Owner,
You attended numerous training and certification courses, hired a top notch staff, have the latest products and equipment, designed an aesthetically astute office environment, invested in a comprehensive marketing strategy, and probably hired some consultants along the way. So the million dollar question is... who’s answering your phone?
Your entire investment was focused on getting new patients in the door, but let’s face it, they just don’t walk in, they call first. Surveys show that more than 80% of all business transactions involved a phone call at one point. And, if the person on the other end of that line doesn’t have the right demeanor, personality, knowledge base and selling skills, you might as well list your lasers on eBay.
Are the associates responsible for answering your phone pleasant, easy to understand, knowledgeable about policies and procedures, know how to effectively utilize the HOLD button (if absolutely needed!), how to leave a message, how to get consults in the door, and, most importantly how to handle a difficult caller?
This is truly a marketing and business strategy you should be focused on even more so than what form of advertising you should use. Advertising only works if you can get people in your door.
At our laser clinic, we use effective strategies to help our associates take ownership of what they do. All of our associates responsible for phone calls are trained on all our procedures and FAQs of the procedures. They also need to know our website and menu of services inside and out. We have phone scripts at a finger’s touch and I ask them to smile when they answer the phone because it will show in their voice.
It may seem like a “Big Brother” tactic to most, but I have randomly recorded calls through our pay-per-click campaign which helps me take a quick pulse of what their strong points are (so they can be praised) and what their weak points are (so I can redirect them).
In the long run, we all win. We’re getting solid leads coming in the door and they receive bonus checks for consults they have been able to schedule from cold calls. It truly gives them a feeling of ownership and accomplishment!
So, can I call you sometime?
Regards,
Mystery Caller
Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course and Advanced IPL & Laser Training course for medical estheticians and laser technicians.
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Medical Spa MD hosts anonymous comments. I made the decision to allow that after some careful thought when I first launched the site. (Of course, almost all comments on the web are anonymous.)
There are both benifits and drawbacks to anonynimity. With the number of cease and desist letters I've received I'm aware that not everyone is happy when they're pilloried in public by namless commenters. Here's a story from the AP on doctors who are asking patients to sign what amounts to a gag order befor they'll treat them.
The anonymous comment on the Web site RateMDs.com was unsparing: "Very unhelpful, arrogant," it said of a doctor. "Did not listen and cut me off, seemed much too happy to have power (and abuse it!) over suffering people." Such reviews are becoming more common as consumer ratings services like Zagat's and Angie's List expand beyond restaurants and plumbers to medical care, and some doctors are fighting back.
They're asking patients to agree to what amounts to a gag order that bars them from posting negative comments online.
"Consumers and patients are hungry for good information" about doctors, but Internet reviews provide just the opposite, contends Dr. Jeffrey Segal, a North Carolina neurosurgeon who has made a business of helping doctors monitor and prevent online criticism.
Some sites "are little more than tabloid journalism without much interest in constructively improving practices," and their sniping comments can unfairly ruin a doctor's reputation, Segal said.
Segal said such postings say nothing about what should really matter to patients — a doctor's medical skills — and privacy laws and medical ethics prevent leave doctors powerless to do anything it.
His company, Medical Justice, is based in Greensboro, N.C. For a fee, it provides doctors with a standardized waiver agreement. Patients who sign agree not to post online comments about the doctor, "his expertise and/or treatment."
"Published comments on Web pages, blogs and/or mass correspondence, however well intended, could severely damage physician's practice," according to suggested wording the company provides.
Segal's company advises doctors to have all patients sign the agreements. If a new patient refuses, the doctor might suggest finding another doctor. Segal said he knows of no cases where longtime patients have been turned away for not signing the waivers.
Doctors are notified when a negative rating appears on a Web site, and, if the author's name is known, physicians can use the signed waivers to get the sites to remove offending opinion.
RateMd's postings are anonymous, and the site's operators say they do not know their users' identities. The operators also won't remove negative comments.
Angie's List's operators know the identities of users and warn them when they register that the site will share names with doctors if asked.
Since Segal's company began offering its service two years ago, nearly 2,000 doctors have signed up. In several instances, he said, doctors have used signed waivers to get sites to remove negative comments.
John Swapceinski, co-founder of RateMDs.com, said that in recent months, six doctors have asked him to remove negative online comments based on patients' signed waivers. He has refused.
"They're basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive," Swapceinski said.
He said he's planning to post a "Wall of Shame" listing names of doctors who use patient waivers.
So... where to come down? The right to criticize and protect yourself, or additional protections for individuals who may be the recipient of negative comments.
Sona, Solana, Dermacare, medical spa frachises and consultants, RealSelf.com, Cutera, Thermage, Lumenis... these companies have taken some heavy hits around here from disgruntled docs. Would you want unhappy patient to have a high profile forum like this one that they could use to damage your reputation and business?
It’s happened in Florida and now in Massachusetts. State legislators and physicians are trying to establish some guidelines and laws to protect the public from sustaining injury by unlicensed or untrained service providers.
We’ve read the of the lipodissolve horrors where people are offering lipodissolve, laser treatments and botox in their garage for heaven’s sake! It’s hard to believe it has come to this, but cosmetic medicine has turned into a “cash cow” for anyone!
I’m getting so sick of the turf wars amongst doctors of which specialty should be doing what... I mean seriously... can’t you all get along? Instead of fluffing your feathers to establish dominance over cosmetic medicine you should ban together to eliminate the bottom feeders who are performing services in their garages to protect the practice that IS cosmetic medicine! These are the people who are ruining your reputations! The unskilled, the unlicensed, money grubbers (and yes, I am also including lawyers here!)!
Let us also not forget that nurses and aestheticians are fighting over positions as well. There’s no certifying board for aesthetic nurses, or medical aestheticians. Here’s a funny story... when I started our medical spa with my husband years ago, I contacted both the heads of the nursing board and the cosmetology board. Since I hold both licenses I asked if I was allowed to perform a facial. I was told it’s a gray area. The nursing board said I could, in fact, perform a facial under the direct orders of a physician if the facial were deemed medically necessary. What physician do you know who will write an order for a facial? What physician wants to manage facials, and waxing, and massage, and the products which are dispensed? The cosmetology board said I could not perform a facial because the practice isn’t licensed or inspected by the board.
Huh?
With the economy the way it is, it’s no wonder everyone is jumping on the “medical spa” bandwagon! I mean, it’s like an ATM machine with no fees and no penalties. The perspective boards are all looking at each other and wondering who’s responsibility it is to be monitoring them.
The time is now upon us where legislation will take precedence, once again, on how we perform medicine and who may perform it. The powers that be will decide for us exactly if IPL is a medical device, or not. If the removal of a sunspot or tattoo can be removed by a physician, PA or nurse. Who may do cosmetic procedures, what training they must have and what certifications must be obtained prior to plucking an eyebrow (I digress, but you get my point).
Although we agree that certain treatments be performed or directly supervised by a physician, the fact is, there are many other services that aren’t deemed medical in nature. Should a physician be controlling those as well?
No current board has jurisdiction over all professions within a medical spa or laser clinic so, most likely, a new board will emerge with regulations, standards and licensing fees to add to our current practice.
It will take a few years to establish a task force and develop legislation for most states. But when all is said and done, what will arise is higher fees for service for the client, more inspectors showing up on our doorstep, higher licensing fees and insurance rates, and less control, once again, on how we treat our patients.
Are you ready for another government agency to take control of YOUR profession?
Author: 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.
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To join this live fractional laser resurfacing chat, just click this button (at the right time).
Participate in the conversation as Fraxel, Lumenis, MiXto, Juvia, Dot, Lutronic and others (even a PreOwned Laser Dealer) try to convince MAPA Man to purchase their Fractional CO2 Laser. Fractional Erbium and Cutera Pearl Fractional will also be invited.
Wednesday's Chat is going to be about all the Fractional Technology.
We are going to discuss it all! Everyone is Welcome. We will have experts on the Sciton ProFractional, Lumenis UltraPulse, Juvia, Fraxel and others
Discussions include treatment perameters, effectivness, cost, the technolgies and anything else of interest. All interested parties are invited. Reps who identify themselves and are willing to engage in open discusion are also welcome.
To participate: Click the launch window button above at the scheduled time.
Looking forward to seeing you.
It seems that if you're not a boarded plastic surgeon or cosmetic derm, you're no longer wanted to participate on RealSelf.com.
I guess that eveyone who didn't identify themselves as a boarded Derm or Plastic found their account uncerimoneously deleted without warning. Nice. All the docs who worked to answer questions evidently weren't answering them 'correctly' or to Real Selfs satisfaction and they're out.
There's some lively discussion on the physician forums: RealSelf.com has kicked out all non-core physicians!
A few months ago, I was attending a function in NJ where some physicians were in attendance. Through the course of discussion, some of us became involved in a discussion about NJ State law which prohibits nurses from injecting Botox or dermal fillers. While many of us sat there with our jaws dropped in disbelief of what we were witnessing, a plastic surgeon went into a soliloquy about why nurses shouldn’t be injectors.
There he stood on his soap box declaring his supremacy over all that was injectable as highly experienced nurses began interjecting some factoids about how nurses are specialized in IV therapies, take more time to attend training courses, and overall exhibit better patient care. It went on and on with no outcome other than shattered egos.
The truth is, many States permit nurses and PAs to inject Botox and dermal fillers as well. While many physicians may hold true to their stance that a skilled board certified dermatologist or plastic surgeon should be doing the injections, what truly matters is the skill, experience and knowledge of the injector. My point is, there are as many physicians out there who should not be doing injectables as there are nurses.
While Botox has had as many horror stories as, say, laser hair removal or lipodissolve, the truth is (if you care to do some research) that the majority of the issues with Botox were due to the fact that they were administered by either non-licensed or untrained personnel such as estheticians. In regards to nurse injectors, many of the State laws declare they can perform the injections under the direct supervision of a physician who has performed the initial examination of the patient and has written orders for it.
The initials after a person’s name should not be the deciding factor when clients choose a practitioner to inject their Botox or fillers. What is important is excellent knowledge of facial muscle anatomy, training, certification, education in the latest techniques, and hands-on experience.
Author: 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.
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Medical Spa MD get's a nice mention in PSP (Plastic Surgery Practice) as the Expert to Expert forum for Physicians. MAPA is also mentioned a number of times.
Frustrated by the lack of attention from many laser systems firms and after getting nowhere with the call center, some physicians have turned to airing their dissatisfaction in online public forums, and by firing off "e-mail carpet bombs" to the top executive management layer of these companies. The Web is filling up with their support horror stories.
One place to witness this in action is at MedicalSpaMD.com, where expert-to-expert (E2E) discussions offer insight into the high levels of anger and frustration among many physicians who claim they have been left in the dust after they signed the contract to buy or lease a laser system. Names are named. Specific problem areas are cited. Company responses—and lack of response—to complaints are aired in public.
"Direct your anger at the laser companies who do not support the doctors who buy their lasers," writes one impassioned and disgruntled practitioner on Medical Spa MD's Physician Clinical Exchange forum. "By their inaction, and active blocking of 'clinical exchange,' these companies, and specifically their executives, make treatments with their lasers risky and much less effective!"
The issue is complicated by the type of clinical support requested by physicians. For example, some want to know how they can use their laser systems in procedures that would easily be considered off-label by the FDA.
Laser systems firms have to be very careful when addressing these types of support questions. Sometimes, they offer personalized support to their customers. Some firms do not address them at all, and others promote these off-label uses in unofficial and backdoor ways and then publicly refute them.
This sort of problem does not reach a flashpoint in a vacuum. The lack of quality after-sale clinical support from laser systems firms has been one of those issues in the aesthetic industry that few will openly talk about. To be fair, some laser systems vendors offer very good customer support. Others, however, offer levels of mediocrity rather than levels of excellence in this area.... Read the rest of the article.
From the 'its tough all over' front, Thermage (Solta Medical) reports a loss
Solta Medical, Inc. (SLTM: News Thermage) reported fourth quarter net loss of $15.04 million or $0.57 per share, compared to net income of $990 thousand or $ 0.04 per share in the same quarter of last year.
Non-GAAP net loss for the quarter was $3.50 million or $0.13 per share, compared to net income of $2.08 million or $0.08 per share in the year ago quarter.
Net revenues for the quarter declined to $9.55 million from $16.58 million in the prior year quarter.
On a pro forma combined basis as if the acquisition of Reliant Technologies was effective as of October 1, 2008, revenue for the fourth quarter would have been $20.1 million, which is based on Thermage standalone revenue of $8.7 million and Reliant standalone revenue of $11.4 million. This compares to revenue for both companies of $35.5 million in the fourth quarter of 2007 on a pro forma combined basis.
Are there any Lasik or Laser Eye Treatment Clinics around who also offer other cosmetic surgery or medical spa treatments?
There are dental medical spas I know of but I'd be curious to find out if there are any that are offering Lasiks. Accourding to Wikipedia:
The surveys determining patient satisfaction with LASIK have found most patients satisfied, with satisfaction range being 92–98 percent. A meta-analysis dated March 2008 performed by the American Society of Cataract and Refractive Surgery over 3,000 peer-reviewed articles published over the past 10 years in clinical journals from around the world, including 19 studies comprising 2,200 patients that looked directly at satisfaction, revealed a 95.4 percent patient satisfaction rate among LASIK patients worldwide.
Fractional CO2 Laser Disccusion:
Participate in the conversation as Fraxel, Lumenis, MiXto, Juvia, Dot, Lutronic and others (even a PreOwned Laser Dealer) try to convince MAPA Man to purchase their Fractional CO2 Laser. Fractional Erbium and Cutera Pearl Fractional will also be invited.
Discussions include treatment perameters, effectivness, cost, the technolgies and anything else of interest. All interested parties are invited. Reps who identify themselves and are willing to engage in open discusion are also welcome.
To participate: Click the launch window button above at the scheduled time.
Looking forward to seeing you.
Physicians, plastic surgeons, and dermatologists practicing nonsurgical cosmetic medicine in medical spas, laser clinics and aesthetic practices.
A community of dermatologists, plastic surgeons, laser clinics, & skin clinics world wide.
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