Nu U Medical Spas Sued by Illinois AG..Many Med Spas Should Pay Attention

The Illinois Attorney General has filed a lawsuit against Nu U Medical Spas in the Chicago area. The issues presented are remarkably similar to many medical spas owned by non-physicians. This case should be a warning to many in the industry.

The suit alleges that Nu U utilized deceptive marketing and that it is performing unsupervised medical treatments. One of the concerns was over the spas’ use of Lipodissolve to “melt” fat. There are many issues with the use of Lipodissolve but the lawsuit focuses upon the fact that it is not FDA cleared and many organizations such as the American Academy of Dermatology, The American Society for Dermatologic Surgery and the American Society for Plastic Surgery do not condone use of the product. There is little evidence to support its use and a lot of evidence that it does little, if anything.

However, the main issue that I want to discuss is one that affects many medical spas, especially the non-physician owned ones. Lipodissolve is an injected treatment, it requires a physician’s order, but Nu U allegedly administers the fat-reducing treatment without a doctor’s order. Many non-physician owned medical spas have non-medical personal injecting dermal fillers such as Botox Cosmetic, Restylane, Juvederm and Collagen without a doctor’s order. In fact, more often than not a doctor does not even see the patient prior to the procedure. In The Nu U matter, the Attorney General found that fact despite its outward claims, Nu U allegedly “fails altogether to monitor and evaluate patients by licensed physicians.”

Another interesting aspect of the case is something that I routinely blog about: The corporate practice of medicine. The Illinois Attorney General argues that the Nu U Medical Spas have violated the Illinois Corporate Practice of Medicine Statute. Forty-five of the fifty states have such statutes and they are violated openly and routinely. These are serious statutes with severe criminal and civil penalties and I am at a loss to figure out why so many violate these statutes on a daily basis. Oops, I do know why…it is called profit!!

Interesting Question Asked of Me....

I recently wrote a blog about laser hair removal and how it relates to the practice of medicine.  I received feedback about  this blog and I was asked..."if laser hair removal is not the practice of medicine, is laser (and light based) tattoo removal the practice of medicne".

This actually has the same answer...light based tattoo removal is not the diagnosis or treatment of a medical ciondition, so it is not the practice of medicine.  However, the light sources utilized ARE medical devices and they are federally classified.  Tattoo removal can be achieved with lasers or IPL (Intense Pulsed Light) sources.   A laser is a Class IIIb or Class IV medical device and must be owned and operated by a physician (procedures may be delegated to non - physician employees. An IPL is a Class II device and should be utilized by a physician or an appopriate employee of the physician.

Many states have regulations that can expand or limit the use of these devices.  It must be noted that whenever state and federal laws address the same issue, the stricter of the two will prevail.  Seek th eguidance of a health care lawyer whi is well versed in this issue...admittedly we are rare!

Non Corporate Practice of Medicine

I received a call today from a client. She received medical treatments in a medical spa in Southern California.  The provider was an RN who owns the medical spa. I have previously advised the client that the medical spa is not operating legally since it is owned by a non physician.  There was a complication and predictably, there is no physician on site or otherwise available.

Forty-five out of fifty states prohibit non physicians from owning or operating medical facilities. This includes medical spas or medical practices that engage exclusively in cosmetic, medical procedures.  There are limited exclusions to this (such as HMO's).  I do not understand why so many facilities ignore this well-standing premise of law.  In particular, nurses seem to feel that they can own a medical facility and provide treatments since they are fee for service or cosmetic in nature.  Many estheticians seem to believe this as well.

The short version of the story is that only physicians can own and operate a medical facility in the forty five out of fifty states (the notable exception is Florida).  Nurses must be employed by such a facility or otherwise contracted with them.  A medical director or supervisor is not enough to enable a nurse to own or operate a medical spa.

There are legal means in which a nurse and physician may own a medical spa together.  A medical spa is considered to be a medical facility and it must be governed accordingly.