By Patrick O'Brien, JD, legal coordinator for the American Med Spa Association

Training and education are valuable tools that can help you grow and develop your practice. However, before you spend a fortune on training, make sure you legally are able to perform the procedures. Education, skill and competency—these or similar terms are found throughout rules and regulations that govern medical and nursing practices, and they communicate the uncontroversial idea that a person should have some skill to safely perform a medical procedure on another person. But training and education alone won't empower you to perform procedures—only a professional license or certification can do that.

This is the case with all professional licensure, from barbers to lawyers to nurses and doctors: Completing courses will give you the important skills you will need in your future profession. But it is the state-granted license that legally authorizes you to offer those professional services to others. You can quit reading this blog right now (please don't) and go attend a barbering program to learn how to give the smoothest shaves known to man, but you will be breaking the law if you start practicing before getting a barber's license from your state's barbering board.

Laser or injection training can be invaluable, but it is useless to a medical assistant (MA) or nurse in a state that prohibits a physician from delegating injections to nurses or unlicensed individuals. As is often the case, "who can do what" varies significantly from state to state. (AmSpa Members can click here to check their state legal summary.) For example, in Texas, an MA with proper training and supervision is able to perform Botox injections. However, in California, MAs may not perform injections, nor may license vocational nurses (LVN)—only registered nurses (RN) and higher may perform those procedures there. In Florida, the nursing board has consistently denied RNs from including Botox injections in their scope of practice. Similarly, the Rhode Island Board of Nurse Registration and Nursing Education holds the stance that RNs and LVNs are not able to inject Botox or other fillers. AmSpa advises that as a best practice, medical aesthetic practices should only utilize RNs and higher for cosmetic injections, even if your state permits others to perform the procedures. But whatever you choose to do, it isn't a good idea to spend time and money training up an employee who legally can't use the training.

Now, the professional license that grants this authority doesn't necessarily need to be your own. Many states allow appropriately trained people to perform procedures under the delegation and supervision of a licensed professional. In these cases, showing documentation of the appropriate training and skill is critical for compliant delegation of the procedure.

Laser hair removal and tattoo removal technician "certifications" are other common areas where this crops up. Most states do not recognize such certifications and restrict the use of lasers only to individuals with medical or nursing licenses. Even in states with laser technician licenses, the person must complete a particular state-approved education course and then apply for licensure with the state; simply taking any training course won't do. So before signing up for training, find out how your state treats laser technicians and if that course meets state requirements.

Investing in training, education and skill development is crucial to having a successful medical aesthetic practice. But because states have different rules on professional scopes of practice, supervision and delegation, it is important to make sure your money is wisely spent. You must be sure that your state's licensing boards include the new procedure in your scope of practice.