A new study showing increasing numbers of lawsuits being filed against non-physicians performing laser surgery has important implications for patient safety, according to the American Society for Dermatologic Surgery Association (ASDSA).
The first-ever comprehensive study of laser surgery liability claims, published Wednesday in JAMA Dermatology, shows patients are filing more injury lawsuits in recent years when laser treatments are performed by non-physicians outside traditional medical settings.
The study shows that despite only one-third of laser hair removal procedures being performed by non-physicians—including registered nurses, nurse practitioners, estheticians or "technicians"—they accounted for about 85% of injury lawsuits from 2008 to 2012, with 64% of procedures being performed outside a traditional medical setting.
"This study is critically important in demonstrating to policymakers that laser hair removal is indeed a medical procedure and should be treated as such," said ASDS/ASDSA president Mitchel P. Goldman, MD. "Increasingly, electrologists, cosmetologists and other non-physicians are seeking the legal right to perform laser hair removal, arguing that these are not 'serious' procedures because they are cosmetic. The health and well-being of patients is at stake."
Study authors said laser surgery—laser hair removal in particular—has recently been more widely available in medical spas, "non-medical facilities offering esthetic and cosmetic procedures." The majority of laser treatments in medical spas are performed by non-physicians of varying certifications as permitted by state regulation, the study found.
"Whether a state legally defines laser hair removal or other laser procedures as the practice of medicine directly affects what types of patient protections are in place," said Goldman. "Cosmetic medical procedure laws vary greatly from state to state, and that means so do patient safety protections."
"Despite these trends and clear inconsistencies in state regulations, no study to date has quantified the effect of these practices on medical professional liability claims," said co-author Mathew M. Avram, MD, JD, a member of the ASDS/ASDSA Board of Directors.
The ASDSA Board-approved position statement asserts the practice of medicine includes any act or procedure using a mechanical device if it damages—or is capable of damaging—living tissue. This includes laser hair removal, with the exception of FDA-designated over-the-counter devices.
As such, these procedures should only be performed by appropriately trained, licensed physicians or appropriately trained licensed allied health professionals with a physician onsite and immediately available, Goldman said.