Iowa Administrative Code › Agency 653 - Medicine Board › Chapter 13 - Standards of Practice and Principles of Medical Ethics › Rule 653-13.8 - Standards of Practice-medical Directors at Medical Spas-delegation and Supervision of Medical Aesthetic Services Performed by Qualified Licensed or Certified Nonphysician Persons or Qualified Laser Technicians

Current through Register Vol. 47, No. 3, July 24, 2024
This rule establishes standards of practice for a physician or
				surgeon or osteopathic physician or surgeon who serves as a medical director at
				a medical spa.
(1)
Definitions.
As used in this rule:
"Alter"
means to change the cellular structure
				of living tissue.
"Capable of"
means any means, method, device
				or instrument which, if used as intended or otherwise to its greatest strength,
				has the potential to alter or damage living tissue below the superficial
				epidermal cells.
"Damage "
means to cause a harmful change in
				the cellular structure of living tissue.
"Delegate "
means to entrust or transfer the
				performance of a medical aesthetic service to qualified licensed or certified
				nonphysician persons or qualified laser technicians.
"Medical aesthetic service"
means the
				diagnosis, treatment, or correction of human conditions, ailments, diseases,
				injuries, or infirmities of the skin, hair, nails and mucous membranes by any
				means, methods, devices, or instruments including the use of a biological or
				synthetic material, chemical application, mechanical device, or displaced
				energy form of any kind if it alters or damages or is capable of altering or
				damaging living tissue below the superficial epidermal cells, with the
				exception of hair removal. Medical aesthetic service includes, but is not
				limited to, the following services: ablative laser therapy; vaporizing laser
				therapy; nonsuperficial light device therapy; injectables; tissue alteration
				services; nonsuperficial light-emitting diode therapy; nonsuperficial intense
				pulse light therapy; nonsuperficial radio frequency therapy; nonsuperficial
				ultrasonic therapy; nonsuperficial exfoliation; nonsuperficial
				microdermabrasion; nonsuperficial dermaplane exfoliation; nonsuperficial
				lymphatic drainage; collagen induction therapy (microneedling); fat-freezing
				treatment (cool sculpting); botox injections; collagen injections; and tattoo
				removal.
"Medical director"
means a physician who
				assumes the role of, or holds oneself out as, medical director at a medical
				spa. The medical director is responsible for implementing policies and
				procedures to ensure quality patient care and for the delegation and
				supervision of medical aesthetic services performed by qualified licensed or
				certified nonphysician persons or qualified laser technicians at a medical spa.
				The medical director is ultimately responsible for all medical aesthetic
				services performed by qualified licensed or certified nonphysician persons or
				qualified laser technicians at a medical spa.
"Medical spa "
means any entity, however
				organized, which is advertised, announced, established, or maintained for the
				purpose of providing medical aesthetic services. Medical spa shall not include
				a dermatology practice which is wholly owned and controlled by one or more
				Iowa-licensed physicians if at least one of the owners is actively practicing
				at each location.
"Nonsuperficial"
means that the therapy alters
				or damages or is capable of altering or damaging living tissue below the
				superficial epidermal cells.
"Qualified laser technician"
means any person,
				licensed or unlicensed, who has successfully completed a minimum of 120 hours
				of training, including a minimum of 40 hours of didactic study and 80 hours of
				clinical training, in the safe and effective use of lasers in the performance
				of medical aesthetic services at an accredited laser training program. For the
				purposes of this rule, a qualified laser technician may only use lasers in the
				performance of delegated medical aesthetic services under the supervision of a
				qualified supervising physician at a medical spa. An unlicensed qualified laser
				technician may not perform any other medical aesthetic services defined in this
				rule.
"Qualified licensed or certified nonphysician person
				"
means any person who is not licensed to practice medicine and
				surgery or osteopathic medicine and surgery but who is licensed or certified by
				another health- or skin care-related licensing board in Iowa and is qualified
				to perform delegated medical aesthetic services under the supervision of a
				qualified supervising physician at a medical spa.
"Supervision"
means the oversight of qualified
				licensed or certified nonphysician persons or qualified laser technicians who
				perform medical aesthetic services delegated by a medical director.
(2)
Practice of
			 medicine.
The performance of medical aesthetic services is the
			 practice of medicine. A medical aesthetic service shall only be performed by
			 qualified licensed or certified nonphysician persons or qualified laser
			 technicians if the service has been delegated by a medical director who is
			 responsible for supervision of the services performed at a medical spa in
			 Iowa.
(3)
Medical
			 director.
A physician who serves as medical director at a medical spa
			 shall:
a. Hold an active unrestricted Iowa
			 medical license to supervise each delegated medical aesthetic
			 service;
b. Possess the appropriate
			 education, training, experience and competence to safely supervise each
			 delegated medical aesthetic service;
c. Retain responsibility for the supervision
			 of each medical aesthetic service performed by qualified licensed or certified
			 nonphysician persons or qualified laser technicians;
d. Ensure that advertising activities do not
			 include false, misleading, or deceptive representations; and
e. Be clearly identified as the medical
			 director in all advertising activities, Internet websites and signage related
			 to the medical spa.