Some of the states (like Colorado) that were less rigorous regarding physician oversight and what constitutes medical treatment are now changing their requirements.
Of course this is far from the direct, on-site supervision that is now the norm in most states, but it's a step in that direction. I would guess that it will take a high-profile problem with a treatment and there will be further tightening.
Via the Denver Post: Medical spas get supervision rules.
"It just got a little safer to get Botox in Basalt, skin laser care in Louisville and wrinkle fillers in Fort Collins.
Thursday, the state's medical board approved rule changes that specify, for the first time, what so-called medical spas need in terms of oversight and training from physicians.
No more Botox parties with alcoholic drinks in people's homes.
No more California doctors "overseeing," in name only, the use of lasers and other devices in mountain spas.
And medical directors must visit spas weekly to ensure that procedures are followed and equipment is used appropriately.
"This is fair," said Carol Hiller, owner of the Harmony Laser Center in Fort Collins. "We didn't want that kind of thing anyway."
Hiller and other business owners fretted last year when it appeared that Colorado might require a supervising physician to be present when a staff member is conducting a procedure such as a Botox injection or laser skin treatment.
Joel Cohen, an Englewood dermatologist, said he felt the board "missed an opportunity for patient safety" by not forcing a supervising physician to be on-site during medical procedures.
"Many states have appropriate regulations to ensure physicians are on-site during procedures," Cohen said.
Theresa Pacheco, a University of Colorado Denver dermatologist who directs a university-run cosmetic clinic in Cherry Creek, agreed.
"In Texas, if you go in for a chemical peel, it will be done by the physician, the nurse or a physician assistant — not an aesthetician," Pacheco said.
Colorado is one of a few states in which a physician can delegate that responsibility to aestheticians, she said.
Pacheco said she regularly sees patients who had problems at other medical spas, where aestheticians often perform procedures. Last week, she said, it was a woman burned on the chest by a laser treatment gone awry.
"First they're embarrassed that they were seeking cosmetic improvement," Pacheco said. "Then they feel confused about who is the doctor, and why was the doctor not there..."