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 VOLUME 116