Can an NP Practice Aesthetic Medicine Autonomously?

Can an NP Practice Aesthetic Medicine Autonomously?

In today’s video, we’re going to look at some rather esoteric rules of physician supervision of nurses and figure out how an aesthetic medical practice by the nurse can navigate, if it can, some restrictive health care legal rules.

Hello, I’m Michael H. Cohen, founding attorney of Cohen Healthcare Law Group.

Sally’s a Doctor of Nursing. She has a small practice where she wants to do aesthetic injections part time. She knows that let’s just take a state, let’s say Florida, one of the many states where nurse practitioners can practice primary care independently.

So, the question is, does she need to hire a medical director if this is all she wants to do? Well, she could look to Florida statute section 458.348, which addresses physician supervision of nurse practitioners, NPs and physician assistants (PAs).

There’s also a declaratory statement by the Florida Board of Medicine, which addresses autonomous nursing practice. Now, section three C states that where the services offered at the office are primarily dermatologic or skin care services, which include aesthetic skincare services other than plastic surgery, then these clinical services must comply with enumerated standards, and among them there has to be a board certified, board eligible dermatologist or plastic surgeon supervising.

Okay, so what’s supervising? But fundamentally also what’s primarily? Because if the services are not primarily dermatologic or skincare services, then presumably you don’t need a supervising dermatologist or plastic surgeon. Much more profit for Sally. If her services are primarily aesthetic, it’s not primary care. So, it’d be a good idea to have that supervising physician again. It’s the client’s decision whether to take the regulatory risk.

But bear in mind that stakes are high because unlicensed practice of medicine is a criminal charge. So, it’s good to read and interpret the statute carefully. Talk to you soon.

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