Is Your Medical Spa Provider Legal?

There has been a proliferation of medical spas popping up everywhere due to the steady increase in consumer demand for minimally invasive medical aesthetic services.  In Virginia, this has been compounded by the lack of state laws that prohibit non-physicians from owning and operating medical practices. Unfortunately, opportunists, many with little or no knowledge of legislation governing the practice of medicine and even worse, improper or no medical education or credentialing are setting up shop, hoping to get rich in this lucrative and growing industry.  

In an informal survey of the Hampton Roads area, there have been practices identified who have unlicensed employees prescribing and injecting Botox® and Dermal Fillers, performing laser treatments, and even those that lack a qualified Medical Director and/or physician oversight. Whether they call themselves a Medspa, Medical Spa, Medi-spa, Medical Aesthetics Practice, or Non-Surgical Aesthetic Medicine Practice, if these entities are providing medical procedures they are considered medical practices in the state of Virginia and must comply with the code of the Virginia Board of Medicine.

Are you a patient at a non-compliant medspa? Are you wondering if your medspa is operating legally?  Ask a few key questions:

• Is this a medical practice (providing medical procedures)?  The answer is "yes" if any provider is performing any service that achieves its result by stimulating, altering, or destroying living tissue. (examples:  laser, IPL, RF, Microneedling, injection of neuromodulators, soft tissue fillers, PDO threads, cryolipolysis) 

• Does the Medspa have a Medical Director?  Must be a physician (MD or DO) or an Independent Nurse Practitioner (must meet all requirements set forth by Virginia Board of nursing).  If the answer is "no" the medspa is operating illegally in the state of Virginia.  Furthermore, the Medical Director doesn't have to be a particular type of doctor BUT does need to be trained in the procedures he or she has oversight for to be able to effectively and appropriately provide safe oversight.  The best Medical Directors are those that actively see patients and are involved in the practice.

• Are all personnel who are providing medical treatments properly licensed medical professionals? (Nurse, NP, PA, MD, DO) In the state of Virginia, unlicensed persons are not permitted to independently prescribe and inject Botox, fillers or perform laser procedures. This includes master estheticians who can legally perform IPL or BBL (there are special rules for laser hair removal), but cannot legally fire a facial laser, inject or perform microneedling. Some procedures can be legally provided by unlicensed persons in Virginia under physician delegation and with direct and immediate supervision.

• Are you being seen by a doctor, nurse practitioner, or physician's assistant at least once a year for a medical evaluation and consultation and to prescribe your treatments?  It is a requirement not only in Virginia, but nationally that a medical practitioner prescribe any medical treatments before they are performed.  Nurses may administer certain procedures under the doctor's orders and supervision, but are not licensed to prescribe.  

Non-compliant medical spas are detrimental to public health and safety.  If you know of a non-compliant medical spa, you may report them anonymously to the Virginia Board of Medicine at http://www.dhp.virginia.gov/PractitionerResources/Enforcement/FileaComplaint/

Chan Nguyen, MD is the Co-founder, Medical Director and a provider at Riva MEDSPA and The Rejuvenation Institute of Virginia, 2244 Sunstates Court, Suite 106, Virginia Beach, VA 23451.