Looks can be deceiving. You may think a clinic looks legitimate and the staff may look qualified with many “credentials” advertised — but just because someone in a pretty office is ready to take your money, it doesn’t mean they are qualified to perform real medical procedures.
Thanks to scientific advancements in skin care and plastic surgery, a broad array of medical treatments are increasingly available to help people address common cosmetic concerns. People can now easily find neurotoxin injections — like Botox and Dysport — that temporarily reduce wrinkles; dermal fillers that add volume; and lasers treatments for sun-damaged skin. And it can be done without surgery or much downtime.
Traditionally offered at plastic surgery and dermatology offices, these nonsurgical aesthetic procedures are increasingly being offered at med spas, a $17 billion industry according to the American Med Spa Association.
However, not every med spa is created equal. For instance, aspiring fitness influencer Bea Amma, who advocates for body positivity, went viral earlier this year after experiencing a life-threatening flesh-eating infection from vitamin B12 and “fat dissolving” shots at a Los Angeles med spa. This type of infection could result from contaminated vials or unsanitary practices. Her $800 injections resulted in more than two years of antibiotic treatments, multiple surgeries and $2 million in medical debt.
And she’s not alone: Professional and regulatory bodies are increasingly fielding questions and concerns about what safe and legal care should look like at a med spa.
What is a med spa?
In Georgia, a broad range of businesses fall under the med spa umbrella. These include stand-alone “bars” that offer vitamin therapy and intravenous hydration drips, Botox and aesthetic studios and skin health and wellness clinics.
“A med spa is, by definition, a medical practice — not a spa,” said Amy Anderson, a practice management consultant and co-founder of BrinsonAnderson Consulting.
The “med” in med spa matters. It means there should be a medical director, qualified clinicians to counsel you and safety protocols in place.
How can you know if med spa clinicians are qualified?
“You need to know what people have been trained in specifically,” said Dr. Melinda Haws, a board-certified plastic surgeon in Nashville, Tennessee, and immediate past president of the Aesthetic Society. The organization is the professional society for board-certified plastic surgeons.
Credit: AP
Credit: AP
In Georgia, all clinicians are required to wear an identifier with name and license when providing health care services.
Here’s what to look for:
- The person you see for consultation and treatment planning: This should be a physician (MD or DO), nurse practitioner (NP) or physician assistant (PA).
- The medical director: The med spa needs a physician medical director “who is overseeing the treatment plans, who has put protocols in place and — very importantly — who can help manage complications,” Anderson said.
- The person who actually performs your treatment: This can be a physician, NP or PA, or a registered nurse (RN) if they have an “individualized treatment plan” order from a physician, NP or PA.
Georgia maintains databases that can tell you if a clinician’s license is in “good standing” with the state. You can look up nurses and nurse practitioners using the Georgia Board of Nursing online license verification tool. Search physicians and physician assistants through the Georgia Composite Medical Board.
“Certified” does not always mean “qualified”
In addition to basic credentials, med spas might tout the specialized “certifications” of their clinicians. However, a certification can refer to many things, and identifying legitimate certifications can be challenging.
For instance, physicians should be certified by one of the American Board of Medical Specialties.
You have a right to ask your clinician what their credentials mean. Always question titles such as “advanced master injector” or claims of being certified in specific procedures.
Credit: AP
Credit: AP
Bogus clinics and bad actors
The treatments offered at med spas are, by definition, not medically necessary. As a result, insurance plans do not cover med spa services, and people pay out of pocket. Without insurance oversight, there is little regulation and few formal checks on billing or safety. Lack of regulation often gives rise to predatory practices.
Clinics may use unregulated or counterfeit drugs or devices that the FDA warns can cause serious harm. Many also do not have a medical director, or they employ staff that are unqualified or unlicensed.
In some instances, qualified, licensed people own and operate clinics but engage in profiteering. They might not explore your concerns during the consultation or fail to review risks, benefits and alternative options.
How can you spot a bad clinic?
- If the person who counsels or treats you does not know who the medical director is, it could indicate they do not have one. “This would be a big warning sign,” Haws said.
- If they are the only place that offers a particular treatment, it might be a bogus treatment. “With the industry being as big as it is, with there being over 30,000 injectors in the country, there isn’t just one clinic who is the only place doing anything,” Haws said.
- A price much lower than competitors’ prices can indicate a fake or watered-down product. “Most injectables are pretty commoditized at this point,” Anderson said, “meaning we’re going to see pretty consistent pricing across locations. “If you see Botox normally going for $12 a unit and you find it someplace for $8 a unit, something’s probably off.”
Counterfeit drugs like fake “Botox” can pose serious health risks, such as the risk of botulism, a life-threatening toxin that can cause paralysis and difficulty breathing.
Growing concern among regulators
Georgia regulators are recognizing the need to act. The Georgia Board of Nursing, the Georgia Composite Medical Board and the Georgia Board of Pharmacy are collaborating to enhance public safety measures.
Safety protocols for all
Dermal filler injections used to add volume and enhance facial features carry rare but real risks of blindness and skin death, and vitamin IV therapy treatments can kill you.
“You need to know that your clinician knows the risks and knows how to treat them and that they know what to do if something bad happens,” Haws said.
Ask your clinician what happens if something goes wrong during treatment. Ask them who to call and what to do if you experience a bad reaction after you leave the clinic.
Most importantly, listen to your gut, Anderson said: “If something seems off, it probably is. So get out.”
Chelsea O. P. Hagopian is a registered nurse and ANCC board-certified adult-gerontology acute care nurse practitioner with a clinical practice focus in plastic and reconstructive surgery. She is an assistant clinical professor at the Emory University Nell Hodgson Woodruff School of Nursing and executive director of the Georgia Nursing Workforce Center.
About the Author
