It's interesting to see that in Florida, a physicians Botox skills depend upon if she's inside her primary clinic. Surprise.

The most obvious remedy is to allow only laser clinics and medspas with direct physician oversight ( physician on location during every treatment ) should be allowed to operate. But the Florida Derms don't seem to want that. It seems that they want to be allowed to oversee clinics off site but prevent all other docs from doing so. This should destroy a number of businesses. It will be interesting to see how they enforce this against doctors.

From SPATRADE - Jul 5, 2006

Last week Gov. Jeb Bush of Florida signed into law a bill to limit the
number of satellite offices certain physicians can have and what type of
procedures they can do in them.

Starting July 1, the law restricts the number of satellite offices for primary care physicians to four. For specialists, excluding dermatologists, the limit will become two. For dermatologists and offices with aesthetic skin care services, the restriction will initially be two satellite offices no more than 25 miles apart in the same county or 75 miles apart in contiguous counties. As of July 1, 2011, dermatologists could only have one satellite office.

The International Medical Spa Association has adamantly spoken out against the regulation of which type of doctor can perform medical spa procedures.

"Why are dermatologists or plastic surgeons better qualified to supervise
offsite procedures than any other physician? After all, it is possible for
either class of physicians to get their board certification without taking a
single course in medical spa treatments," says IMSA president Eric Light. "A
case could be made that a board certified family practitioner would be
better positioned to take a holistic approach to aesthetic care. And if
there is an injury, why wouldn't a board-certified emergency specialist be
less qualified to deal with the problem?"

The law also restricts operation of a satellite office--only dermatologists
and plastic surgeons can perform Botox, medical microdermabrasion, chemical peels and laser rejuvenation treatment. That means primary care physicians and other doctors can only perform esthetic services in their primary offices. There were previously no restrictions on the number of satellite offices any doctor could supervise.

"The governor's action will help to ensure patients that the skin care
treatment they receive at medical spas and other satellite offices, which
provide dermatologic care for the majority of patients they see, will be
supervised by physicians with an expertise in skin care and skin disease,"
said Dr. Dan Meirson, immediate past president of the Florida Society of
Dermatology and Dermatologic Surgery, which, with the Florida Medical
Association, supported House Bill 699 as a way to promote patient safety.

West Palm Beach dermatologist Dr. Steven Rosenberg, chair of the FSDDS
legislative committee, said patients at medical spas have suffered injuries
such as burns from lasers because employee supervision was lax. "I want to
express to the governor the medical community's appreciation for his
decision to put patient protection over corporate profits," Rosenberg told
the Florida press.

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