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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Business Law
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Experience:  All corporate law, including non-profits and charitable fraternal organizations.
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Customer Question

I am currently planning on opening a tattoo removal clinic in florida and the regulations confuse me completely.

All regulations in regards XXXXX XXXXX use for lasers point to hair removal but nothing in regards XXXXX XXXXX removal.
I am not a physician nor a nurse, but are still getting certified for "hair removal"
I have a physician that supervises my facility and is in touch for any emergencies.

Can please someone help me out on this one?

I believe this is what they call an actual "loop hole" as there is absolutely no straight answer to this.

thanks
Submitted: 2 years ago.
Category: Business Law
Expert:  Law Educator, Esq. replied 2 years ago.
I am sorry, but according to the FL Department of Health, "In Florida, tattoo removal using a laser can only be done by a Florida-licensed physician or by a Physician Assistant (PA) under supervision, or an Advanced Registered Nurse Practitioner
(ARNP) working under a protocol signed by a Physician" See: FL DOH Tattoo and Tattoo Removal FAQ. Furthermore, the FL Department of Health considers the use of lasers the practice of medicine, which includes tattoo removal and not just hair removal. http://www.doh.state.fl.us/mqa/medical/me_laser.html

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Customer: replied 2 years ago.

Thanks but you just basically said the exact same thing I was reading for the past 4 days.


 


this is what I am talking about:


 



F.S.A. 458.348


“Protocols requiring direct supervision.--All protocols relating to electrolysis or electrology using laser or light-based hair removal or reduction by persons other than physicians licensed under this chapter or chapter 459 shall require the person performing such service to be appropriately trained and work only under the direct supervision and responsibility of a physicXXXXX XXXXXcensed under this chapter or chapter 459.”


- In office setting where supervision not on-site, primary health practitioners limited to supervising 4 offices in addition to the


primary office location; Specialty practitioners limited to 2; dermatologists limited to 1.


Expert:  Law Educator, Esq. replied 2 years ago.
I understand what the statute you have says relating to hair removal but the medical board has ruled that the laser use for tattoo removal is also practice of medicine, regardless of what the law you have specifically directed at hair removal states. The medical board and Department of Health have the sole discretion to determine what is the practice of medicine and that is the problem. The statute you have only addresses one particular use, but the board has a right to set standards and interpret the laws on medicine practice and the Board of Medicine considers "the commercial application of a laser or IPL upon human tissue to be the practice of medicine." This is prosecuted under FS 458.357 as the unauthorized practice of medicine.
Customer: replied 2 years ago.

I understand that the medical board says that, but all documentation points to "ELECTROLYSIS"


 


even on the link in regards XXXXX XXXXX and tattoos it says to read into "ELECTROLYSIS"


 


And that statue writes:


 



(2) Licensed electrologists may not use laser and light-based hair removal or reduction devices unless they:


(a) Have completed a continuing education training course approved by the Council pursuant to Rule 64B8- 52.004, F.A.C.;


(b) Have been certified in the use of laser and light-based devices for the removal or reduction of hair by a national certification organization approved by the Council and the Board;


(c) Are using only the laser and light-based hair removal or reduction devices upon which they have been trained; and


(d) Are operating under the direct supervision and responsibility of a physician properly trained in hair removal and licensed pursuant to the provisions of Chapter 458 or 459, F.S.


(3)(a) The supervising physician, initially upon assuming duties as the supervisor and semiannually thereafter, shall review and inspect the techniques, procedures, and equipment utilized by the electrologist in the performance of laser and light-based hair removal or reduction.


(b) The supervising physician shall ensure that the electrologist has received semi-annual training in the areas of infection control, sterilization, and emergency procedures.


(4)(a) The supervising physician and the electrologist shall develop jointly written protocols regarding the medical condition for individuals to receive laser and light-based hair removal or reduction treatment; specific conditions and the procedure for identifying conditions that require direct evaluation or specific consultation by the physician; treatment of routine minor problems resulting during or from laser and light-based hair removal or reduction; and detailed procedures to be followed in the event of emergency situations developing during the performance of or as a result of laser and light-based hair removal or reduction. These written protocols must be signed, dated, and maintained in a readily available location on the premises where the electrologist practices. One copy shall be maintained by the supervising physician and one copy must be filed with the Department of Health. The written protocols which are kept on the premises of the electrologist will be readily available for inspection and review by agents of the Department of Health or the Board of Medicine. The parties to a protocol must notify the Department within 30 days of the termination of their professional relationship.


(b) The written protocol shall include and require that the initial consultation with each patient must include an examination and assessment by a physicXXXXX XXXXXcensed pursuant to Chapter 458 or 459, F.S.


(c) The written protocol shall include a statement that the electrologist does and will maintain professional liability coverage that includes coverage for incidents arising from laser usage in an amount not less than $100,000.


(5) Pursuant to Section 456.072(1)(i), F.S., any physician who knows that any electrologist is engaged in unsafe practice must report that electrologist to the Department of Health immediately.


(6) Any physician who provides supervision to an electrologist must keep the Board informed of the number of electrologists the physician is supervising. No physician is authorized to supervise more than four (4) electrologists at any one time.


Specific Authority 478.43 FS. Law Implemented 458.331(1)(v), 458.348(3), 478.42(5), 478.43(4) FS. History–New 9-12-01, Amended 2-28-02.


 


Now as you can read it says that a licensee can perform laser treatments, but has to be trained and licensed for ELECTROLYSIS.


 


even in this statue it does not cover tattoo removal but only hair removal.


and this is exactly what confuses me.


Expert:  Law Educator, Esq. replied 2 years ago.
The statutes themselves you have correctly found do NOT say anything about tattoo removal, is it the holding of the board that rules it is the practice of medicine and they prosecute for the violations. The statutes certainly do not specify laser tattoo removal and it is called a gray area, but it is prosecuted by the board of medicine and the Department of Health.
Customer: replied 2 years ago.

so gray area? how do I interpret this and what do you mean by prosecuted by the board of med and DoH?


 


Aren't I good if I have a license for electrolysis which is required to fire a laser?


 

Expert:  Law Educator, Esq. replied 2 years ago.
The DOH can file criminal charges for unlicensed practice of medicine against you is what it means. If you have a license for electrolysis, you still need the supervision by a licensed doctor required by the board of medicine and DOH.
Customer: replied 2 years ago.

that is what I said in the very first post.


 


I have a physician who is going to supervises my facility. not always on site though, which is also written our weird on the statue.

Expert:  Law Educator, Esq. replied 2 years ago.
As long as he is the supervising physician and you are performing within the scope of your license, then you are likely fine or at least have a very good defense. I must have misunderstood that you were going to be doing this on your own without supervision, but if you have supervision you would be covered.
Customer: replied 2 years ago.

well no problem,


 


when we get to the supervision part. it says on the website that electrolysis licenses people need to be in direct supervision but it also says it can be office setting off site supervision.


 


can you help me clarify that?


 


thanks

Expert:  Law Educator, Esq. replied 2 years ago.
This means that the supervision has to be available, whether they are available by phone or by come into the office again another gray area and the whole idea is the doctor should at least be available to consult and come in on an emergency basis and also come in on at least a periodic basis . The regulation on this is about as clear as mud even to the DoH who enforces it.
Customer: replied 2 years ago.
Right, this is just the area that scares me.
As you can see I am trying to cover all aspects and if they ever walk in ad say where is your supervision, I will say: on speed dial.

So you believe that direct supervision can be interpreted as phone or consulting supervision?
Expert:  Law Educator, Esq. replied 2 years ago.
As long as the doctor is available to get to the facility in a reasonable time and makes regular times that they are normally present in the shop, then they will consider that direct supervision in most all cases. To have a doctor on the phone an hour away from you would not likely qualify.
Customer: replied 2 years ago.
One last thing I your good :)
The doc will be away about 15 minutes.

The electrolisys certification on the doh website says 30 hours but if I look up those schools who offer it, it says 320 hours.

Can you explain that to me and maybe give me a line out on what steps to make and where to file?

Thank you very much
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you.

The schools are offering you their program, the state says the minimum program has to contain those 30 hours. The DoH only requires the 30 hours as stated on their site and you can contact them about a list of approved schools in your area.

As far as the outline of the steps to follow, I am afraid I do not know what you are seeking about that, you already know where to file, through the DoH for your license, so I do not know what else you are asking here.
Law Educator, Esq., Attorney
Category: Business Law
Satisfied Customers: 91861
Experience: All corporate law, including non-profits and charitable fraternal organizations.
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