Medical spas in the US and elsewhere have increased in numbers and are popular as medical tourism destinations. Several countries have reported problems of medical spas undertaking medical procedures that neither the spa nor the staff are qualified to do. Unfortunately, this reflects badly on the majority who are professional. They have tended to fall between the gaps in legislation, but one of the first countries seeking to remedy that is the USA. Nationally, the number of medical spas around the country has grown from 500 in 2004 to 2,500 today. If this growth rate continues, more states will follow the four who are preparing regulations, and almost every sate has discussed the idea.
According to the International Medical Spa Association, the official definition for medical spa is a facility that operates under the full-time on-site supervision of a licensed health care professional. The facility operates within the scope of practice of its staff, and offers traditional, complementary, and alternative health practices and treatments in a spa-like setting. Practitioners working within a medical spa will be governed by their appropriate licensing board, if licensure is required.
The death of a nurse, who had a liposuction procedure performed, has raised concerns over the safety of medical spas to the level that several states are progressing legislation. The proposed legislation is now travelling through several state medical boards in Massachusetts, New York, Florida, and Utah. Proposed legislation would require owners of medical spas to have certain credentials, dictate which procedures can be performed, and set a minimum level of training for those performing particular procedures. Legislation does not want to stop consumers having medical procedures in spas, but to ensure that the procedures are performed safely and by someone with the correct training.
The concern of cosmetic surgeons is the lack of training or experience of some employees at medical spas. An employee of a medical spa may start out performing one procedure and move to another more difficult procedure without much experience. Indeed, lack of experience with certain medical procedures has resulted in serious consequences for some customers, but more common is minor problems such as second-or third-degree burns from improperly conducted laser hair removal procedures.
Medical spas in the US offer treatments including laser hair removal and liposuction, as well as massages and other traditional spa treatments. The types of procedures performed in medical spas have expanded to include chemosurgery for skin cancer and reconstructive surgery.
Massachusetts health officials want to crack down on medical spas, following the lead of Florida, which has been preparing legislation for three years. In Massachusetts a medical spa task force has been set up to advise the state legislature on how best to regulate the facilities. It would prefer a system of federal regulation of medical spas as it would be more cohesive than a state-by-state model but believes that is unlikely to happen, as medical and other professional boards, like nursing, electrology and aestheticians boards, are regulated and licensed by individual states. But the government has just decided to take insurance regulation away from states into a national body, so national regulation is a possibility. The task force has proposed that spas be required to get licenses from the Massachusetts Department of Public Health, and recruit a physician or nurse with special training to remove age spots or tattoos with a laser. Non medical practitioners - cosmetologists, electrologists, and aestheticians - will be allowed to remove body hair using a laser, but only after special training and certification. The task force reported that doctors and other professionals not specifically trained in dermatology have begun offering laser skin procedures, presenting an unacceptable risk to patients.
Regulating medical spas is complicated because they combine many different professionals under one roof, including cosmetologists, electrologists, aestheticians, nurses, and physicians. In most US states each of these professions is licensed by its own board, and each has its own standards. There are no overall regulations governing who can do certain cosmetic procedures and what type of training is required, and there is no requirement that medical spas be licensed.