Must you be a physician to perform laser techniques?

Medical spa owners frequently call for legal advice on the question of whether they need a physician to perform cosmetic laser techniques?

The answer is that every state has different laws regulating the practice of medicine.  State laws also regulate estheticians, cosmetologists, and other beauty industry professionals. 

It's sometimes difficult to know which board regulates laser cosmetic techniques, although the term "laser surgery" gives a good clue.

Our attorneys specialize in guiding medical spas, cosmetics facilities, beauty establishments, and wellness and fitness industry professionals and corporations regarding the legal rules regulating aesthetic medicine and cosmetics procedures such as laser, intense pulsed light (IPL), Botox, Restalyne, and other therapies.

Below is some regulation in Georgia, as an example of how the regulations can pinpoint the legal requirements for companies venturing into this complex legal arena:

§ 43-34-244. (For effective date, see note.) Two levels of license; application
(a) There shall be two levels of a license for a cosmetic laser practitioner: assistant
laser practitioner and senior laser practitioner.
(b) Any person desiring to obtain a license as a cosmetic laser practitioner under the
terms of this article shall make application to the board as follows:
(1) An applicant for an "assistant laser practitioner" license shall present proof that
he or she:
(A) Holds a current valid license or certificate of registration as a physician
assistant, licensed practical nurse, nurse, esthetician, or master cosmetologist, or
has previously held a license or certificate of registration as a medical practitioner;
and
(B) Has received at least three laser certificates from attending laser/intense
pulsed light (IPL) courses as approved by the board, directly taught by a licensed
physician or certified continuing medical education or continuing education educator.
If, after review of the application, it is determined that the applicant is at least 21
years of age; has met the minimum educational requirements; is of good moral
character; and is possessed of the requisite skill to perform properly cosmetic laser
services, a license shall be issued to the applicant entitling the applicant to practice
the occupation of cosmetic laser practitioner at the assistant laser practitioner level
under the on-site supervision of a senior laser practitioner.
(2) An applicant for a "senior laser practitioner" license shall present proof that he
or she:
(A) Holds a current valid license or certificate of registration as a physician
assistant or nurse or has previously held a license or certificate of registration as a
medical practitioner;
(B) Has at least three years of clinical or technological medical experience, or
both;
(C) Has been or was licensed or nationally board certified as a medical
practitioner for at least three years; and
(D) Has received at least two laser certificates from attending laser/intense
pulsed light (IPL) continuing medical education courses as approved by the board,
directly taught by a licensed physician or certified continuing medical education or
continuing education educator. If, after review of the application, it is determined
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that the applicant is at least 21 years of age; has met the minimum educational and
clinical training requirements to perform cosmetic laser services with indirect
supervision; is of good moral character; and is possessed of the requisite skill to
perform properly these services, a license shall be issued to the applicant entitling
the applicant to practice the occupation of cosmetic laser practitioner at the senior
laser practitioner level pursuant to the protocols of a consulting physician.
(c) Any person desiring to obtain a license as an "assistant laser practitioner" who
does not meet the requirements of paragraph (1) of subsection (b) of this Code
section shall also be eligible for a license as an "assistant laser practitioner" if he or
she makes application to the board within nine months of the effective date of this
article and presents proof that he or she:
(1) Prior to the effective date of this article, obtained a minimum of at least 2,000
hours of experience in administering cosmetic laser service; and
(2) Has received at least two laser certificates from attending laser/intense pulsed
light (IPL) courses, directly taught by a licensed physician or certified continuing
medical education or continuing education educator.
(d) Should an applicant have a current cosmetic laser practitioner license or
certificate of registration in force from another state, country, territory of the United
States, or the District of Columbia, where similar reciprocity is extended to this state
and licensure requirements are substantially equal to those in this state, and have
paid a fee and have submitted an application, the applicant may be issued a license
at the appropriate level entitling him or her to practice the occupation of a cosmetic
laser practitioner at that level, unless the board, in its discretion, sees fit to require a
written or a practical examination subject to the terms and provisions of this article.
HISTORY: Code 1981, § 43-34-244, enacted by Ga. L. 2007, p. 626, § 1/HB 528;
Ga. L. 2009, p. 859, § 1/HB 509; Ga. L. 2009, p. 989, § 2/SB 104.
§ 43-34-245. (For effective date, see note.) Expiration of licenses; license renewal
(a) All licenses shall expire biennially unless renewed. All applications for renewal
of a license shall be filed with the board prior to the expiration date, accompanied by
the biennial renewal fee prescribed by the board. A license which has expired for
failure of the holder to renew may only be restored after application and payment of
the prescribed restoration fee within the time period established by the board and
provided the applicant meets such requirements as the board may establish by rule.
Any license which has not been restored within such period following its expiration
may not be renewed, restored, or reissued thereafter. The holder of such a canceled
license may apply for and obtain a valid license only upon compliance with all
relevant requirements for issuance of a new license.
(b) As a condition of license renewal, the board shall require licensees to provide
proof, in a form approved by the board, of a minimum of five hours of continuing
education courses as approved by the board in the area of cosmetic laser services,
equipment safety and operation, procedures, and relative skin modalities, directly
taught by a licensed physician or certified continuing medical education or continuing
education educator.
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HISTORY: Code 1981, § 43-34-245, enacted by Ga. L. 2007, p. 626, § 1/HB 528;
Ga. L. 2009, p. 859, § 1/HB 509.
§ 43-34-246. (For effective date, see note.) Sanctions
The board may impose on a cosmetic laser practitioner or applicant any sanction
authorized under subsection (b) of Code Section 43-34-8 upon a finding of any
conduct specified in subsection (a) of Code Section 43-34-8.
HISTORY: Code 1981, § 43-34-246, enacted by Ga. L. 2007, p. 626, § 1/HB 528;
Ga. L. 2009, p. 859, § 1/HB 509.
§ 43-34-247. (For effective date, see note.) Petition to restrain or enjoin unlicensed
cosmetic laser practitioner
The practice of providing cosmetic laser services is declared to be an activity
affecting the public interest and involving the health, safety, and welfare of the
public. Such practice when engaged in by a person who is not licensed as a cosmetic
laser practitioner or otherwise licensed to practice a profession which is permitted
under law to perform cosmetic laser services is declared to be harmful to the public
health, safety, and welfare. The board or the district attorney of the circuit where
such unlicensed practice exists, or any person or organization having an interest
therein, may bring a petition to restrain and enjoin such unlicensed practice in the
superior court of the county where such unlicensed person resides. It shall not be
necessary in order to obtain an injunction under this Code section to allege or prove
that there is no adequate remedy at law, or to allege or prove any special injury.
HISTORY: Code 1981, § 43-34-247, enacted by Ga. L. 2007, p. 626, § 1/HB 528;
Ga. L. 2009, p. 859, § 1/HB 509.
§ 43-34-248. (For effective date, see note.) Agreement with consulting physician
(a) Any facility providing cosmetic laser services other than hair removal using
lasers or pulsed light devices shall have an agreement with a consulting physician
who shall:
(1) Be trained in laser modalities;
(2) Establish proper protocols for the cosmetic laser services provided at the
facility and file such protocols with the board;
(3) Examine each patient prior to any cosmetic laser service other than hair
removal using lasers or pulsed light devices being performed; provided, however,
that a consulting physician may delegate the authority to perform such examination
to a physician's assistant who is a licensed cosmetic laser practitioner, in accordance
with a job description approved by the board, or to a registered professional nurse
who is also an advanced practice registered nurse as defined in paragraph (1.1) of
Code Section 43-26-3 and who is a licensed cosmetic laser practitioner, pursuant to
a protocol approved by the board; and provided, further, that in facilities subject to
the provisions of Code Section 43-34-249.1 such delegation may be to: (A) a
physician's assistant who is not required to be a licensed cosmetic laser practitioner,
in accordance with a job description approved by the board; or (B) a registered
professional nurse who is also an advanced practice registered nurse who is not
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required to be a licensed cosmetic laser practitioner, in accordance with a protocol
approved by the board; and
(4) Be available for emergency consultation with the cosmetic laser practitioner or
anyone employed by the facility.
(b) Any facility providing cosmetic laser services other than hair removal using lasers
or pulsed light devices shall have a supervisor present at the facility or immediately
available for consultation and supervision either personally or via
telecommunications. The supervisor shall supervise the performance of all cosmetic
laser services performed by a person other than the consulting physician. The
supervisor shall be a physician licensed under this chapter who is trained in laser
modalities or a senior laser practitioner.
(c) (1) Any facility providing cosmetic laser services other than hair removal using
lasers or pulsed light devices shall post a sign listing the consulting physician's name,
emergency contact number, his or her board certification and specialty, and the
address of his or her principal place of practice, and indicating whether he or she is
presently on site at the facility.
(2) If the consulting physician is not on site for any period of time during which the
facility is open, the facility shall post a sign indicating who is presently acting as the
supervisor for the facility and that person's name, emergency contact number, his or
her degrees and qualifications, and the type of cosmetic laser practitioner license
held.
HISTORY: Code 1981, § 43-34-248, enacted by Ga. L. 2007, p. 626, § 1/HB 528;
Ga. L. 2009, p. 859, § 1/HB 509; Ga. L. 2009, p. 989, § 3/SB 104.
§ 43-34-249. (For effective date, see note.) Informed consent
(a) Prior to receiving cosmetic laser services from a cosmetic laser practitioner, a
person must consent in writing to such services and shall be informed in writing of
the general terms of the following:
(1) The nature and purpose of such proposed procedure;
(2) Any material risks generally recognized and associated with the cosmetic laser
service to be performed which, if disclosed to a reasonably prudent person in the
customer's position, could reasonably be expected to cause such prudent person to
decline such proposed cosmetic laser services on the basis of the material risk of
injury that could result from such proposed services;
(3) The name of, degrees and qualifications held by, and type of licenses obtained
by the individual who will be performing the cosmetic laser service, and with respect
to cosmetic laser services other than hair removal, the supervisor and the consulting
physician;
(4) The steps to be followed after the cosmetic laser service is performed in the
event of any complications; and
(5) With respect to cosmetic laser services other than hair removal, the emergency
contact information for the consulting physician and the address of his or her
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principal place of practice.
(a.1) After receiving each cosmetic laser service other than hair removal, a person
shall be informed in writing of the information required by paragraphs (4) and (5) of
subsection (a) of this Code section.
(b) It shall be the responsibility of the cosmetic laser practitioner to ensure that the
information required by subsections (a) and (a.1) of this Code section is disclosed
and that the consent provided for in this Code section is obtained.
(c) Where the consumer is under 18 years of age, the consent of the consumer's
parent or legal guardian shall be required.
(d) The board shall be required to adopt and have the authority to promulgate rules
and regulations governing and establishing the standards necessary to implement
this Code section specifically including but not limited to the disciplining of a
cosmetic laser practitioner who fails to comply with this Code section.
(e) Nothing in this Code section shall prohibit the information provided for in this
Code section from being disclosed through the use of video tapes, audio tapes,
pamphlets, booklets, or other means of communication or through conversations
with the cosmetic laser practitioner; provided, however, that such information is also
provided in writing and attached to the consent form which the consumer signs.
HISTORY: Code 1981, § 43-34-249, enacted by Ga. L. 2007, p. 626, § 1/HB 528;
Ga. L. 2009, p. 859, § 1/HB 509; Ga. L. 2009, p. 989, § 4/SB 104.
§ 43-34-249.1. (For effective date, see note.) Waiver
The board shall have the authority to waive the requirements of subsection (c) of
Code Section 43-34-248 and paragraph (5) of subsection (a) of Code Section 43-34-
249 for facilities offering cosmetic laser services which serve as a principal place of
practice at which a physician regularly sees patients if medical services are regularly
performed at such facilities. For purposes of this Code section, "medical services"
shall mean the general and usual services and care rendered and administered by a
physician.
HISTORY: Code 1981, § 43-34-249.1, enacted by Ga. L. 2009, p. 989, § 5/SB 104.
§ 43-34-250. (For effective date, see note.) Advisory committee
The board shall appoint an advisory committee. The advisory committee shall
include licensed cosmetic laser practitioners licensed under this article and such
members as the board in its discretion may determine. The advisory committee shall
include at least one person licensed to practice medicine under this chapter and
specialized in a field with expertise in the biologic behavior of the skin. Members
shall receive no compensation for service on the committee. The committee shall
have such advisory duties and responsibilities as the board may determine, including
but not limited to consulting with the board on the issuance, denial, suspension, and
revocation of licenses and the promulgation of rules and regulations under this
article. The initial members of the advisory committee may include persons eligible
for licensing under this article. Subsequent advisory committee members must be
licensed pursuant to this article.
 

 

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Michael H CohenMichael H Cohen
Founder
The Los Angeles / San Francisco / Bay Area-based Michael H Cohen Law Group provides healthcare legal and FDA legal & regulatory counsel to health & wellness practices and ventures, including health technology companies (medical devices to wearable health and nanotech), healthcare facilities (from medical centers to medical spas), and healthcare service providers (from physicians to psychologists).Our legal team offers expertise in corporate & transactional, healthcare regulatory & compliance, and healthcare litigation and dispute resolution, in cutting-edge areas such as anti-aging and functional medicine, telemedicine and m-health, and concierge medicine.Our Founder, attorney Michael H. Cohen, is an author, speaker on healthcare law and FDA law, and internationally-recognized thought leader in the trillion-dollar health & wellness industry.