As spas and then medical spas have become more and more popular, the race to regulate these facilities and providers has been somewhat ad hoc.  Hence, systems for managing spas and measuring a spa’s safety and performance have been divided among countries, states or regions. Here are a couple of guidelines for your spa or wellness center.  Of course also please refer to your local guidelines of policy and law when choosing the best option for your business.

Models for Medical

One of the most popular  models for offering medical treatments is for the spa to employ a nurse who is trained in laser use and injectables to work at the spa part time doing services that estheticians cannot perform. Sometimes a similar setting occurs when a nurse from a plastic surgeons office leases a room several days a month paying a flat fee to the spa and taking in earnings for the plastic surgeon’s office. This type of arrangement makes for a nice referral base between the surgeon’s practice and the spa.

“Physician run” spas are the flip side of the scenario with the question remaining what does “physician run” actually mean? In the early years of laser clinics “physician run” meant that a physician was in some way involved. Many of those facilities left important facts murky like which parties would be responsible for a law suit; was the physician usually on the premises and did the physician see each patient and prescribe care accordingly?  There some facilities that are promoting medical spas with the promise that a physician will not be necessary yet many countries and regions require that the facility have a full time physician as a primary figure in the organizational chart of the entity.

Scope of Practice

Several states are taking the position that a physician must see patients in the facility and prescribe treatments that qualified technicians or nurses can perform. The physician is ultimately responsible for all legal requirements and for ensuring the health and safety of the patient. While not defining the standard of training that the technicians or licensed professionals must have, the regulatory agencies are making it clear that the physician is putting his or her license and insurance on the line and should act as their own regulatory body. Physicians who with little thought offered their name and license to a spa sometimes find themselves wrapped up in a law suit where they are responsible for a service that they didn’t prescribe or witness. In retrospect, these physicians must be wondering why they became involved.

Defining who is qualified to do which procedures is another tough topic. Just because a spa owner of director is a physician the quality of care is not necessarily guaranteed if the realm of services is beyond the physician’s scope of practice. For instance, an ophthalmologist who was primarily doing plastic surgery in his eye practice without an anesthesiologist once hired me to do a business plan for a medical spa. That type of arrangement is obviously frightening. As medical spas continue to crop up defining a scope of practice for each type of position along with treatment examples is crucial towards protecting the consumer against injury, harm and fraud in the future.

SPAA Licensing Program

Spa Secure is an international licensing system. Introduced in 2004, Spa Secure was designed to be a self-regulating system working in cooperation with state and federal governmental agencies like the Public Health Department and the Board of Barbers and Cosmetologists and the wide variety of global spas, wellness centers and medical spas.. Spa Secure works by performing mystery shopping of member spas looking for unsafe practices, sanitation procedures, health and safety measures and scope of practice issues. A test is administered to the management and technical staff of the spa.  To find out more about Spa Secure please go to Please go to the link to go to Spa Secure information