Can any specialist open a "MedSpa" that offers beauty treatments?

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HriRish

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Say you're a cardiologist. Can you open a "MedSpa" that offers treatments like microdermabrasion, Obagi peels, IPL treatment, botox, and other fillers/non-invasive treatments? What certifications would this require? Can any physician, regardless of his specialty, open such a place?
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HriRish said:
Say you're a cardiologist. Can you open a "MedSpa" that offers treatments like microdermabrasion, Obagi peels, IPL treatment, botox, and other fillers/non-invasive treatments? What certifications would this require? Can any physician, regardless of his specialty, open such a place?
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Is this a question to which you think allopathic medical students have the answer? Do you think they teach us that?
 
Can any physician, regardless of his specialty, open such a place?

Yes.
 
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I've seen an internal med doc do this.
 
no you have to have the medical expertise of a board certified dermatologist to do this

that's why it's so competative
 
Leonidis I said:
no you have to have the medical expertise of a board certified dermatologist to do this

that's why it's so competative
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100% wrong.

When you get a state medical license it is to "Practice medicine and surgery."

A psychiatrist is technically licensed to do heart surgery.

While many hospitals will not allow you to practice w/o a board certification, technically a PGY-1 who passed step 3 could quit residency, open a med spa, and do med spa stuff the rest of his life.
 
I know a CT surgeon who opened a med spa that does botox, veins, and other cosmetics. She stopped practicing CT surgery like 10 years ago and has a very successful cosmetic practice.
 
HriRish said:
Say you're a cardiologist. Can you open a "MedSpa" that offers treatments like microdermabrasion, Obagi peels, IPL treatment, botox, and other fillers/non-invasive treatments? What certifications would this require? Can any physician, regardless of his specialty, open such a place?
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Anyone can do this, and anyone does. There is usually no reason for a plastics or derm person to open a free standing med spa. They just integrate it into their practice. They may brand themselves as a medspa and not take insurance, but the scope of what they provide is going to be much wider than a typical "MedSpa."

I would say almost all of the typical "MedSpa" type places are owned by someone who has zero residency training in that area. A sample from my area would be EM doc, ENT doc (hasn't operated in ages, but I guess this counts as somewhat relevant residency training), pathologist, pediatric sub specialist (don't know what his fellowship training is in I haven't met him personally), etc.

An unrestricted medical license is unrestricted. Cosmetic "medicine" is done by anyone and everyone who can score a medical license. All the things you listed FYI can be done either by a PA or NP, and many of them just by a tech, so a lot of times it isn't even the doc doing it, although people tend to be willing to pay more to have a physician do it. The things physicians tend to focus on in these places is ultrasound or laser lipoplasty as well as things like hormone pellet placement (testosterone) and weight loss drugs,

That said given that any doctor can do it, and the fact that medicine has tons of republicans who fantasize about being rich and owning their own business, and have no sense of their own limitations, the competition is fierce. No barrier to entry + lots of people who want out of real medicine + those people have tons of assets and easy access to loans = market saturation.
 
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Thanks a bunch for the insights folks. My question then is, if ANY specialist can theoretically open such a practice that encroaches upon MUCH of what a dermatologist (Especially a cosmetic based practice) or to some extent, what a plastic surgeon with a focus on the aesthetic side of things does, then WHY is the competition to match into DERM/Plastics so HIGH? I mean theoretically, with market saturation and everyone scrambling to make a quick buck piggybacking on the "MedSpa" craze, you would expect that Derms and other specialists that charge a pretty penny for the same service would have a harder time attracting referrals and patients. Am I missing something here? I know certain sub-specialties in Derm are more focused on things like Mohs surgery, cancer, etc, but the vast majority of what I've seen shadowing Derms has been cosmetic related stuff.
 
HriRish said:
Say you're a cardiologist. Can you open a "MedSpa" that offers treatments like microdermabrasion, Obagi peels, IPL treatment, botox, and other fillers/non-invasive treatments for the underserved? What certifications would this require? Can any physician, regardless of his specialty, open such a place for the underserved?
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Since this is SDN, I fixed your original post for you in order to avoid any confusion. You're welcome.
 
HriRish said:
Thanks a bunch for the insights folks. My question then is, if ANY specialist can theoretically open such a practice that encroaches upon MUCH of what a dermatologist (Especially a cosmetic based practice) or to some extent, what a plastic surgeon with a focus on the aesthetic side of things does, then WHY is the competition to match into DERM/Plastics so HIGH? I mean theoretically, with market saturation and everyone scrambling to make a quick buck piggybacking on the "MedSpa" craze, you would expect that Derms and other specialists that charge a pretty penny for the same service would have a harder time attracting referrals and patients. Am I missing something here? I know certain sub-specialties in Derm are more focused on things like Mohs surgery, cancer, etc, but the vast majority of what I've seen shadowing Derms has been cosmetic related stuff.
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A few things.

First a family doc isn't going to refer a pt to a medspa operated by a underqualified person (i.e. non-derm boarded). Referrals are a huge part of medicine.

Second people spending their OWN money (non-insurance) most often research the doctor. Many people would much rather have a properly trained derm or plastic surgeon for a premium price.

Third, our culture is increasing the number of people wanting plastic/cosmetic stuff. Think kim kardasian.
 
Leonidis I said:
no you have to have the medical expertise of a board certified dermatologist to do this

that's why it's so competative
Click to expand...

VenusinFurs said:
False.

It's caveat emptor.
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link2swim06 said:
100% wrong.

When you get a state medical license it is to "Practice medicine and surgery."

A psychiatrist is technically licensed to do heart surgery.

While many hospitals will not allow you to practice w/o a board certification, technically a PGY-1 who passed step 3 could quit residency, open a med spa, and do med spa stuff the rest of his life.
Click to expand...

sarcasm_detector.jpg
 
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moto_za said:
You can open one w/o doing a residency.
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I've never heard of someone opening up a practice without completing a residency. Do you have any sources on this being done in the past?
 
link2swim06 said:
A few things.

First a family doc isn't going to refer a pt to a medspa operated by a underqualified person (i.e. non-derm boarded). Referrals are a huge part of medicine.

Second people spending their OWN money (non-insurance) most often research the doctor. Many people would much rather have a properly trained derm or plastic surgeon for a premium price.

Third, our culture is increasing the number of people wanting plastic/cosmetic stuff. Think kim kardasian.
Click to expand...

Nobody gets a referral to a med spa for botox. Referrals are for insurance purposes. Med spas are doing things not covered by insurance. You clearly know nothing about the industry.

If you go to a derm or plastics person most likely you will get botox from a PA or NP there as well. As for paying the premium price, you will be paying a HUGE premium for not any better service. People are not that dumb. 98% of the patient population is perfectly willing to get botox at $8 a unit from a NP at the close med spa, rather than drive an hour and pay $13 a unit to get it from the derm's NP, or pay $25 to get it from the actual dermatologist.

Botox and fillers is very commoditized. Everything else he listed in the OP is done by techs/estheticians, everywhere.

Are there plastic surgeons with Harvard diplomas doing botox in Hollywood? Yeah, I'm sure, and I'm also sure they charge a gazillion bucks to do it. But that is not representative of 99% of the market/customers. Also despite the fancy diploma I guarantizzle you those Hollywood types aren't getting any better botox than they'd get from a random nurse with some experience. It isn't rocket science.
 
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Anigma07 said:
I've never heard of someone opening up a practice without completing a residency. Do you have any sources on this being done in the past?
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It can be done anywhere. It's only rare because you need some capital, and it is hard to get capital if you are making an urgent care salary due to never completing residency.
 
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HriRish said:
Thanks a bunch for the insights folks. My question then is, if ANY specialist can theoretically open such a practice that encroaches upon MUCH of what a dermatologist (Especially a cosmetic based practice) or to some extent, what a plastic surgeon with a focus on the aesthetic side of things does, then WHY is the competition to match into DERM/Plastics so HIGH? I mean theoretically, with market saturation and everyone scrambling to make a quick buck piggybacking on the "MedSpa" craze, you would expect that Derms and other specialists that charge a pretty penny for the same service would have a harder time attracting referrals and patients. Am I missing something here? I know certain sub-specialties in Derm are more focused on things like Mohs surgery, cancer, etc, but the vast majority of what I've seen shadowing Derms has been cosmetic related stuff.
Click to expand...

I have a hard time believing you have followed a Derm. The scope of dermatology does not overlap very much with the typical med spa practice. Med spa's are not diagnosing and treating medical conditions. They are saying, here is a facial and microderm from our esthetician, would you like a spray tan too. Oh and we have a PA that does botox and juvederm, you could use some of that. Why don't you get your fat sucked out by the doctor using a vaser, and he'll also implant some testosterone pellets to help with your sex drive!

Plastic surgeons are surgeons they do hardcore operations on patients under general anesthesia. Dermatologists are experts in skin conditions. These are not in the scope of a cosmetic spa practice.
 
Textbookversion said:
Nobody gets a referral to a med spa for botox. Referrals are for insurance purposes. Med spas are doing things not covered by insurance. You clearly know nothing about the industry.

If you go to a derm or plastics person most likely you will get botox from a PA or NP there as well. As for paying the premium price, you will be paying a HUGE premium for not any better service. People are not that dumb. 98% of the patient population is perfectly willing to get botox at $8 a unit from a NP at the close med spa, rather than drive an hour and pay $13 a unit to get it from the derm's NP, or pay $25 to get it from the actual dermatologist.

Botox and fillers is very commoditized. Everything else he listed in the OP is done by techs/estheticians, everywhere.

Are there plastic surgeons with Harvard diplomas doing botox in Hollywood? Yeah, I'm sure, and I'm also sure they charge a gazillion bucks to do it. But that is not representative of 99% of the market/customers. Also despite the fancy diploma I guarantizzle you those Hollywood types aren't getting any better botox than they'd get from a random nurse with some experience. It isn't rocket science.
Click to expand...

And you clearly can't read. My whole point is IF a pt asked their PCP about something cosmetic they would get referred to a derm office NOT med spa. This subset of the pt population is guaranteed to the derm over the medspa MD. Not to mention a lot of people already have a derm for non-cosmetic skin issues...these people would just have their derm likely do the procedure.

Also I disagree...people seek out good doctors providing cosmetic stuff. There are entire online communities devoted to it http://www.realself.com/.

And most medspa's do more than botox. Unless you are getting cosmetic surgery...you go to the experienced doc for his experience not his ability to stick a needle into your skin.
 
link2swim06 said:
And you clearly can't read. My whole point is IF a pt asked their PCP about something cosmetic they would get referred to a derm office NOT med spa. This subset of the pt population is guaranteed to the derm over the medspa MD. Not to mention a lot of people already have a derm for non-cosmetic skin issues...these people would just have their derm likely do the procedure.

Also I disagree...people seek out good doctors providing cosmetic stuff. There are entire online communities devoted to it http://www.realself.com/.

And most medspa's do more than botox. Unless you are getting cosmetic surgery...you go to the experienced doc for his experience not his ability to stick a needle into your skin.
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Read my posts. I go through the specific other services offered. You can't name one because you are just BSing online and don't know what you are talking about.
 
To the OP,

Search for similar facilities, call them, and ask how they're structured. If that's beyond your comfort level. Take the information gleaned from your "model" facility, search the public records (most in the US are available online), articles of incorporation, corporate officers, fillings, do background checks (credentials, criminal record, property records, professional licensure, etc.,). Take the list of names and go to the state medical board online service for license verification and/or practitioner profile (most have detailed bios, specialties, training, disciplinary action). If you're still curious, and want to know how much money is involved, you can start by visiting county clerk online property appraiser, the appraised taxable values will be there, then go to the clerk of courts, review civil, criminal dockets, judgements, proceedings (you'll get a nice picture of any litigation past, present, pending. If you're really curious, track down the owners of record, repeat with personal data, real estate, boat registration.

Generally if you have the funds you can hire the people (medical) to work for your company.
 
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ruprecht said:
To the OP,

Search for similar facilities, call them, and ask how they're structured. If that's beyond your comfort level. Take the information gleaned from your "model" facility, search the public records (most in the US are available online), articles of incorporation, corporate officers, fillings, do background checks (credentials, criminal record, property records, professional licensure, etc.,). Take the list of names and go to the state medical board online service for license verification and/or practitioner profile (most have detailed bios, specialties, training, disciplinary action). If you're still curious, and want to know how much money is involved, you can start by visiting county clerk online property appraiser, the appraised taxable values will be there, then go to the clerk of courts, review civil, criminal dockets, judgements, proceedings (you'll get a nice picture of any litigation past, present, pending. If you're really curious, track down the owners of record, repeat with personal data, real estate, boat registration.

Generally if you have the funds you can hire the people (medical) to work for your company.
Click to expand...

...srs?

Sent from my Nexus 7
 
Textbookversion said:
That said given that any doctor can do it, and the fact that medicine has tons of republicans who fantasize about being rich and owning their own business, and have no sense of their own limitations, the competition is fierce. No barrier to entry + lots of people who want out of real medicine + those people have tons of assets and easy access to loans = market saturation.
Click to expand...

Most doctors don't have tons of liquid assets, and without these it is difficult to get a sizeable loan (more than 50-100k). I have been involved in several business deals since 2005, and it is getting progressively difficult for a small businessman to get loans without collateral.
 
Textbookversion said:
Nobody gets a referral to a med spa for botox. Referrals are for insurance purposes. Med spas are doing things not covered by insurance. You clearly know nothing about the industry.

If you go to a derm or plastics person most likely you will get botox from a PA or NP there as well. As for paying the premium price, you will be paying a HUGE premium for not any better service. People are not that dumb. 98% of the patient population is perfectly willing to get botox at $8 a unit from a NP at the close med spa, rather than drive an hour and pay $13 a unit to get it from the derm's NP, or pay $25 to get it from the actual dermatologist.

Botox and fillers is very commoditized. Everything else he listed in the OP is done by techs/estheticians, everywhere.

Are there plastic surgeons with Harvard diplomas doing botox in Hollywood? Yeah, I'm sure, and I'm also sure they charge a gazillion bucks to do it. But that is not representative of 99% of the market/customers. Also despite the fancy diploma I guarantizzle you those Hollywood types aren't getting any better botox than they'd get from a random nurse with some experience. It isn't rocket science.
Click to expand...

Precisely. As this person posted in the derm forum as well, it's clear that cosmetics belongs to no one, and anyone with a license and the correct training can do it. Patients don't normally care if they go to a derm or an IM or FP or EM or plastic -they search for the best price and get stuff done as a result of word of mouth. My mom for example goes to an IM for botox, and she was told of this doc by her friend who also goes to this doc to get botox. She doesn't care if he went to Harvard or random med school, all she cares is that he charges a fair price and does a great job.
 
You have to realize that, by law, a physician can legally perform any medical procedure. It's just a matter of whether you'll feel comfortable enough to do it. The procedures you mentioned don't appear to be that difficult to learn and a quick google search brings up weekend courses. So yes, any specialty can do it and no real "certification" is required, other than your medical license. This is true for ALL medical procedures. You just better be darn confident you won't injure anybody and that a malpractice insurance company would cover you for that procedure.
 
To clarify, hospitals and clinics require physicians to have a list of "privileges" that they are allowed to do. This includes things like injections, mole removals, etc. You need to demonstrate competence in the things you are privileged for, some of which are assumed simply by completing a given residency, and others that need to have documentation of competence (i.e. case log, mentor attestation, etc.). So internists can't just decide to do a lap appy or something, they need to have privileges for that.

In a medspa scenario, the licensed providers can do whatever the medspa owners "privilege" them to do, procedure-wise. They may let their providers do anything without having seen or done it before, for all the public knows; kind of a buyer-beware situation. Obviously, some places are going to be better about this than others.
 
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Smurfette said:
To clarify, hospitals and clinics require physicians to have a list of "privileges" that they are allowed to do. This includes things like injections, mole removals, etc. You need to demonstrate competence in the things you are privileged for, some of which are assumed simply by completing a given residency, and others that need to have documentation of competence (i.e. case log, mentor attestation, etc.). So internists can't just decide to do a lap appy or something, they need to have privileges for that.

In a medspa scenario, the licensed providers can do whatever the medspa owners "privilege" them to do, procedure-wise. They may let their providers do anything without having seen or done it before, for all the public knows; kind of a buyer-beware situation. Obviously, some places are going to be better about this than others.
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What if you are the MedSpa owner? Say for example if you open a place up right out of medical school. Or do you need board certification to open up your own practice?
 
Anigma07 said:
What if you are the MedSpa owner? Say for example if you open a place up right out of medical school. Or do you need board certification to open up your own practice?
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Nope. Assuming by 'right out of med school' you mean that you have passed step 3, done intern year and have a unrestricted medical license in your state.
 
link2swim06 said:
Nope. Assuming by 'right out of med school' you mean that you have passed step 3, done intern year and have a unrestricted medical license in your state.
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I'm a little ignorant on this but aren't interns considered first year residents, meaning that they are committed to a residency program. Or do some programs consider internship separate from residency so after you take Step 3 you can go on your own?
 
Anigma07 said:
I'm a little ignorant on this but aren't interns considered first year residents, meaning that they are committed to a residency program. Or do some programs consider internship separate from residency so after you take Step 3 you can go on your own?
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Well there are prelim programs which are only 1 year and would allow you to get a license.

But I have never heard of someone quitting to do a med spa after pgy-1. Without being board certified/eligible (in a specific specialty) it's basically impossible to ever work for someone, more difficult to get insurance to reimburse you, and much more difficult to get malpractice insurance.
 
Pons Asinorum said:
Is this a question to which you think allopathic medical students have the answer? Do you think they teach us that?
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I don't know about your medical school but ours does teach us this and about legal issues in general. ANYONE CAN HANG A SHINGLE IN ANYTHING!!! Whether this is practical or not is another discussion.
 
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