As part of the continuing efforts to rein in inappropriate dermatological care, the FSDDS in April 2010 led a coalition of health care providers opposing efforts to allow electrologists to perform laser hair removal without the benefit of an on-site physician. Backed by representatives from the Florida Academy of Phyiscian Assistants, the Florida Society of Plastic Surgeons, and the Florida Medical Association, FSDDS President Albert J. Nemeth, M.D. and General Counsel Chris Nuland convinced the Florida Board of Medicine to allow the current rule, which requires direct physician supervision of electrologists performing laser hair removal. to remain intact.

While this victory was important, it is but part of an ongoing struggle by the FSDDS to control what sees as the unlicensed practice of medicine in many medical spas. Whether it be laser hair removal by electrologists, dermal filler injection by nurses, or other medical procedures being performed by non-physicians, the FSDDS has consistently advocated that these paraprofessionals must operate under the direct supervision of a physician. Not only does direct supervision simply make sense from a patient safety perspective, but Florida explicitly states that medical assistants and electrologists performing laser hair removal work under the “direct supervision and responsibility” of the supervising physician. Moreover, nurses receive statutory protections from accusations of the improper practice of medicine only if they work under the direct supervision of a physician.

Although ARNPs and physician assistants are exempt from the direct supervision requirement, physicians are reminded why these professionals are called “physician extenders.” They are meant to be part of a physician-led team, and the physician therefore bears the ultimate responsibility for their actions. FSDDS members should always ensure that those who work under their licenses work only within the scope of their training and professional licensure.