Dermatologist: A dermatologist is a physician who is trained to evaluate and manage pediatric and adult patients with benign and malignant disorders of the skin, hair, nails and adjacent mucous membranes. A dermatologist has had additional training and experience in the following:

• The diagnosis and treatment of skin cancers, melanomas, moles, and other tumors of the skin.
• The management of contact dermatitis and other inflammatory skin disorders.
• The recognition of the skin manifestations of systemic and infectious diseases.
• Dermatopathology.
• Surgical techniques used in dermatology.
• Dermatologists also manage cosmetic skin enhancements for the skin, including hair loss, scars, and the skin changes associated with aging.

Dermatopathologist: A dermatopathologist is expert in the microscopic diagnosis of diseases of the skin, including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy.

Pediatric Dermatologist: A pediatric dermatologist is a dermatologist who has additional training and expertise in the evaluation and management of skin diseases which occur more commonly or exclusively in children. Examples include: all types of birthmarks, neonatal dermatology, genodermatoses, pediatric infections or inflammatory processes and skin diseases in children with complex medical conditions requiring coordinated multispecialty care.

Dermatologist specializing in Clinical and Laboratory Dermatological Immunology: A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body’s immune system. An immunodermatologist also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.

Is there a difference between a physician who is the medical director of a spa and a physician who performs aesthetic medical procedures in a spa that is not physician-owned?

Yes. The “Medical Director” designation has come to mean different things to different people. Correctly used, it describes a physician who does not practice medicine, but rather one who is responsible for overseeing medical practice within a clinical environment. Thus, the function of a Medical Director is limited to administrative responsibilities, such as reviewing, advertising and marketing materials for regulatory compliance.

When a medical practice offers ancillary spa services or a physician-owned spa offers aesthetic medical procedures, a physician can properly refer to himself or herself as a “Medical Director.” The physician generally wears two hats in these organizations-one as a practicing physician and another as an administrator.

Only a physician-owned spa can legitimately have a Medical Director. Unfortunately, the medical spa industry often uses the term “Medical Director” to lead consumers to believe that a non-physician owned spa is employing a physician to perform medical services. A non-physician owned spa cannot provide aesthetic medical procedures to the public nor can it legally employ a licensed physician. Thus, use of the term “Medical Director” by a non physician-owned spa to mislead the public to believe they employ a doctor who performs aesthetic medical services would be a fraudulent business practice.

Physicians may operate a private physician’s office within a non-physician owned spa, however they must ensure that all advertising and marketing materials used by the spa properly disclose the physician’s relationship with the spa.

Many non-physician spa owners believe they can employ a physician to be their “Medical Director” and perform aesthetic medical procedures within their spa. This is incorrect. Any physician who accepts employment by a non-physician spa owner with the intent of performing aesthetic medical procedures as the spa’s medical director is subject to disciplinary action and increased liability.

Consumers should do a little homework before blindly accepting services from a spa advertising aesthetic medical procedures by a “Medical Director.”

(1)Medesthetics febr 2007 page 20)
Legal Issues by Scott Blair, JD. MIM .)