5 Questions to Ask At Your Medical Spa

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True or False (answers below):

1. Botox and laser treatments are easy and can be done by an aesthtician or spa staff.

2. A physician must be present at all times in a spa that performs procedures.

3. Chemical or facial peels are safe and can be done in a beauty salon.

The term “spa” is derived from a town in Belgium where healing waters have been used to promote health since Roman times. “Spa” is now loosely used to describe any relaxing environment or beauty salon where rest, health and beauty are promoted.

At one time it was easy to distinguish among a beauty salon, barber shop and a doctor’s office. Not anymore. As cosmetics has become more medical and medicine has become more cosmetic, the two have met in the ubiquitous Medi-Spa. An establishment labelled a medical spa or medi-spa is generally one where medical procedures are performed or medicines are administered in the pursuit of beauty.

There is nothing inherently wrong with extending the field of medicine to include the state of beauty. Nor do I think it is problematic for the field of cosmetics and aesthetics to use medicine and surgery to accomplish its goals of making you more beautiful. But as a consumer, the burden is upon you to know what you are buying and from whom.

The allure of income from cosmetics is great, and physicians of all specialties have incorporated it into their medical practices. Gynecologists offer Restalyne, opthamologists offer Botox, family practice physicians have laser hair removal in their offices.

You do not need to be a dermatologist or plastic surgeon to perform cosmetic medicine. In Southern California there is even a pediatrician who treats cellulite (on adults, of course). This does not mean that he is unqualified to perform your cellulite treatment — he might be quite good at it.

More concerning is the fact that many people with no medical license are performing procedures. Ultimately, it is your responsibility to ask what qualifications and experience people treating you at the medi-spa have so you can make an informed decision.

Anytime an injection is given, a prescriptive device (such as a laser) is used, or a drug is prescribed, a licensed physician must be responsible for your care. Only licensed providers such as registered nurses, nurse practioners, or physician assistants can perform procedures. Other staff such as medical assistants or aestheticians are not licensed and are prohibted from practicing medicine.

The next time you go to the spa, be sure to ask the following questions for your safety:

  1. Who is performing the procedure?
  2. What is his or her license?
  3. What experience has he or she had?
  4. What are some complications or bad outcomes that have occurred?
  5. Is a physician present in the facility or nearby to assist if there is a problem?

Photo: Axel Hecht

Answer to questions 1-3: false.

Is Your Physician Board Certified?

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Is the milk you drink rBST-free? Is your physician board certified?

Many people take the time to buy hormone free milk, but they don’t make an effort to choose a physician who is board certified. That’s a shame.

Asking a friend or family member might be a good way to choose a hairdresser, but it is not a good way to choose a physician. Medicine is difficult. The same way that you want the pilot of your next flight to be maintaining his or her skills and knowledge of flying, you also want your physician to maintain his or her skills in medicine. The truth is, you are much more likely to die from your doctor’s mistake than from a pilot’s mistake.

Being board certified is no guarantee that your physician is good (or nice!), but it does assure you that your physician is committed to continuing education and is learning advances in medicine. It also assures you that your physician has completed the necessary training and passed a certification exam for the field of medicine he or she is practicing. Having a license means only that they completed the minimal requirement to practice medicine. Maintaining active board certification means that your physician has undergone yearly continuing education and has passed a re-certification exam every few years.

Certainly there is more to being a good physician than completing residency and passing written and oral examinations. But studies show that high exam scores do correlate with practicing better medicine.

There are 24 board specialties. You can check to see if your physician is board certified by going to the American Board of Medical Specialties site at ABMS.org, registering, and putting in your physician’s name. It is a free and confidential service. You can have a nice glass of rBST-free milk in the meantime.

Post written by Dr. Jeffrey Benabio, Copyright The Derm Blog 2009.

Photo: Ingrid Taylar (flickr)