Little Health Law Blog
Our healthcare and business law firm works with many providers and other allied health professionals who are beginning their journeys of opening a Medical Spa. Medical Spas have been growing in popularity across the country. Medical Spas are unique practices as they involve many medical and non-medical procedures. There are many factors to consider in opening a medical spa, and this series focuses on key factors to consider when opening a medical spa in Georgia. Although our healthcare law firm has assisted numerous clients in establishing a medical spa from the ground up, each client continues to present unique issues requiring our firm to research and analyze the nuances of each client’s intended setup. This Georgia Medical Spa Series is intended to provide a useful overview of some key laws, rules, and regulations impacting medical spas.
This post in the Georgia Medical Spa Series focuses on the use of a Physician Assistant in a medical spa. This post does not discuss the restrictions governing a Physician Assistant owning a medical spa or employing his/her supervising physicians. If you have questions regarding this blog post or would like to speak with counsel regarding opening your medical spa practice, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
Physician Assistant
A Physician Assistant (“PA”) is an individual “who is licensed to a supervising physician and who is qualified by academic and practical training to provide patients’ services not necessarily within the physical presence but under the personal direction or supervision of the supervising physician.” O.C.G.A. § 43-34-102(7). O.C.G.A. § 43-34-106 requires practices using PAs to post a notice that the practice is using a PA.
Most clients of our healthcare and business law firm need to know what exactly each licensed professional they employ can and cannot do. Below is an overview of some basic activities and how a PA can be involved:
Laser Treatments
As stated by the GCMB, generally, “anyone who is not a physician with an active Georgia license that provides non-ablative cosmetic laser services” requires a laser license. GCMB Cosmetic Laser Practitioner FAQ, available here. There is an exception that for “a PA with Board approved additional duties” who does not supervise an individual that requires an Assistant Laser Practitioner License, no separate laser license is required. However, for PAs who are supervising an Assistant Laser Practitioner (such as an esthetician), they need a Senior Laser Practitioner license.
IV Therapy
IV therapy can only be administered after a patient has been “evaluated by a physician, nurse practitioner, or physician assistant for diagnosis and treatment.” Aug. 8, 2019 GCMB Meeting Minutes; see also Ga. R. & Reg. § 360-3-.02. A PA must either provide the treatment themselves or directly by order, after establishing a therapeutic relationship, the treatment is to be carried out by an appropriately licensed professional. Note, a physician can only delegate the authority to order IV services to a PA under a job description (or an advanced practice registered nurse (“APRN”) acting under an appropriate nurse protocol agreement). O.C.G.A. §§ 43-34-23, 43-34-25, 43-34-102. A job description is:
[A] document, signed by the primary supervising physician and the physician assistant, in which the primary supervising physician delegates to that physician assistant authority to perform certain medical acts and which describes the professional background and specialty of the primary supervising physician and the qualifications including related experience of the physician assistant; and includes a general description of how the physician assistant will be utilized in the practice. A job description shall not be required to contain every activity the physician deems the physician assistant qualified to perform but shall confine the activities of the physician assistant to those in the scope of practice of the primary supervising physician.
O.C.G.A. § 43-34-102.
Botox
Botulinum toxin is a dangerous drug under the Georgia Dangerous Drugs Act. This Act provides, in part, that “[n]o person shall prescribe or order the dispensing of a dangerous drug, except a registered practitioner who is: (1) Licensed or otherwise authorized by this state to prescribe dangerous drugs; (2) Acting in the usual course of his professional practice; and (3) Prescribing or ordering such dangerous drug for a legitimate medical purpose.” Not all licensed health care providers are considered “registered practitioners” under the Georgia Dangerous Drugs Act. Rather, “practitioners,” under O.C.G.A. § 16-13-21(23), only includes:
(A) A physician, dentist, pharmacist, podiatrist, scientific investigator, or other person licensed, registered, or otherwise authorized under the laws of this state to distribute, dispense, conduct research with respect to, or administer a controlled substance in the course of professional practice or research in this state;
(B) A pharmacy, hospital, or other institution licensed, registered, or otherwise authorized by law to distribute, dispense, conduct research with respect to, or administer a controlled substance in the course of professional practice or research in this state;
(C) An advanced practice registered nurse acting pursuant to the authority of [O.C.G.A. §] 43-34-25 [ . . . ]; or
(D) A physician assistant acting pursuant to the authority of subsection (e.1) of [O.C.G.A. §] 43-34-103 [ . . . ].
Practices can use a PA to prescribe and order the administration of Botox. The GCMB has confirmed this point in its meeting minutes by stating: “In addition to physicians, PAs can inject toxins and fillers with a Board approved job description and Additional Duty Request.” March 4, 2021 GCMB Meeting Minutes. An additional duty request is when a PA requests approval from the GCMB to perform medical tasks that are not customarily learned during PA training and are to be performed outside the physical presence of a supervising physician. The request form can be found here.
If you have questions regarding this blog post or need counsel relating to your professional responsibilities after an arrest or conviction, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
*Disclaimer: Thoughts shared here do not constitute legal advice.