The Journal of the Arkansas Medical Society Med Journal July 2019 Final 2 | Page 4
COMMENTARY
Sandy Johnson, MD
Thank you Dr. Lee Johnson
D
r. Lee Johnson is the best
brother-in-law ever. In
1997, when we were both
residents, Lee arranged a blind
date for me with his only brother,
Brad. Marrying Brad and becoming a dermatolo-
gist are two of the best decisions I ever made. As you
know, you marry both your spouse and his family.
Fortunately, I married into an amazing family. Lee
wants to make our world a better place to live. He
is doing this by raising three amazing children with
his astonishing pediatrician wife, being a great ER
physician, and now serving as a representative to the
Arkansas House.
This (his first) legislative session dealt with many
medical issues, including scope of practice situations.
Medical Board
Legal Issues?
Call
Pharmacist/Attorney
Darren O’Quinn
1-800-455-0581
www.DarrenOQuinn.com
Little Rock, Arkansas
I encourage all of you (and me) to become familiar
with what is happening on both the state level and
the national level. I am thankful to Lee and to all who
take the time to maintain the professionalism of the
practice of medicine. While Lee was serving as an
Arkansas representative to make our state better,
I was wasting time looking at Facebook. While on
Facebook, I saw a post from an esthetician in our Fort
Smith community who is hiring “MD, NP, BSN, RN,
LPN, MA, Laser tech, Esthetician, Massage Therapist,
Receptionists: all with an energetic personality and
ready to WORK and change your life. Send your re-
sume to xxx.”
This prompted me to review the Arkansas Medi-
cal Act and Regulations that were revised by our Ar-
kansas State Medical Board in August 2018. I also
looked at guidelines set forth by the AAD, the ASPS,
American Med Spa Association, etc. It clearly states
that in our great state of Arkansas, all medical prac-
tices must be owned by a medical doctor according
to Regulation 4-29-305. For example, I need and
have two medical licenses for the state of Arkansas.
One is for me personally to practice medicine, and
one is for Johnson Dermatology for the practice of
medicine to occur at our location. This means that a
nurse or an esthetician cannot own a medical prac-
tice in the state of Arkansas since they cannot apply
for the practice of medicine at their location. I don’t
understand, then, how this person is able to hire an
MD or offer the practice of medicine at her location. I
am also not sure how a local nurse practioner is able
to advertise that she is the “fifth nurse practioner to
open her own clinic in Arkansas.”
The American Med Spa organization also has
clear guidelines about the practice of medicine with-
in a medical spa. There is a link to an article from
their website. The American Academy of Dermatol-
ogy has a position statement about medispas that
reads, “Medical spas are facilities that offer a range
of services, including medical and surgical proce-
dures, for the purpose of improving an individual’s
well-being and/or appearance. The distinguishing
feature of medical spas is that medicine and surgery
are practiced in a non-traditional setting. Procedures
by any means, methods, devices, or instruments
that can alter or cause biologic change or damage
the skin and subcutaneous tissue constitute the
practice of medicine and surgery. These include (but
4 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY
are not limited to) the use of scalpels, all lasers and
light sources, microwave energy, electrical impulses
and all other energy-emitting devices, thermal de-
struction, chemical application, particle sanding, and
other foreign or natural substances by injection or in-
sertion. Any procedure that constitutes the practice of
medicine, including (but not limited to) any procedure
using a Food and Drug Administration (FDA)-cleared
or regulated device that can alter or cause biologic
change or damage, should be performed only by an
appropriately-trained physician or by appropriately-
trained non-physician personnel under the direct, on-
site supervision of an appropriately-trained physician
in accordance with applicable local, state, or federal
laws and regulations.”
As physicians, we all strive to follow the Hippo-
cratic Oath, “first do no harm.” If I have said anything
incorrect, please reach out to me and educate me. If
you would like to learn more, here are some links that
I used to gather information. If you see Lee (or Jen),
please tell them hello from me. Even though we live
within a few miles of each other, I do not get to see
them as often as I like or tell them “Thank you” as
often as I like – for making my life better, personally
and professionally. Stay skintastic.
References:
https://www.aad.org/Forms/Policies/Uploads/PS/
PS-Medical%20Spa%20Standards%20of%20
Practice.pdf
https://www.surgery.org/consumers/consumer-
resources/consumer-tips/patient-safety-advisory-
on-medi-spas
https://www.naplesnews.com/in-depth/news/
special-reports/2019/01/30/miami-doctors-plastic-
surgery-empire-becomes-floridas-deadliest-
clinics/2462068002/
https://www.americanmedspa.org/news/169407/
Want-to-be-a-Medical-Director-at-a-Medical-Spa-
Beware.htm
https://www.littlerockcosmeticsurgery.com/medi-
spa-arkansas/
https://www.hairfacts.com/wp-content/uploads/
sites/5/2010/04/aada-state-regulation-of-medical-
spa-facilities-toolkit.pdf
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