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

Last week, the Texas Medical Board held a meeting to solicit feedback from stakeholders on possible changes to medical board rules that are in development. Representatives from AmSpa attended this meeting and had conversations with stakeholders and interested parties. The meeting generated some lively discussion regarding the changes, one of which was for Rule 193.17. This rule provides protocols for physician delegation of "nonsurgical medical cosmetic procedures," which encompass most of the treatments offered in medical spas.

It is important to understand that this meeting was to discuss rules "in development" that have not been formally proposed or begun the official process of adoption. These developmental rules may change before being officially proposed—if they are officially proposed at all.

The development committee offered two versions of proposed changes for Rule 193.17. The primary proposed change would require offices that provide nonsurgical medical procedures to post a notice in the treatment rooms and lobby that includes the name and license of the delegating physician, as well as information for making complaints to the Board of Medicine. The specific details of this notice are contained in the current Medical Board Rule 178.

An alternative proposal was also discussed, and it would make three additional changes:

• Physicians would no longer be able to delegate to unlicensed persons;
• A physician or midlevel would need to provide onsite supervision whenever procedures are delegated; and
• The rule would explicitly state that these nonsurgical cosmetic medical procedures constitute the practice of medicine, and facilities providing them would need to be owned by a Texas licensed physician.

The alternative proposed rules generated the most discussion from the stakeholders present. A number of different parties raised concerns and complaints over all three of the proposed amendments. In an email, the Texas Medical Board relayed that these alternative proposed rules would be held for further consideration and possible revision. It assured attendees that it would hold a future stakeholder meeting if these changes were considered again. At present, however, the board is not moving forward to the next stage of the revision process.

The Medical Board also informed attendees that the primary proposal regarding the notice requirements had not received any negative feedback; as such, this change will be presented to the full Medical Board for consideration. The board will consider this change at its June 14 meeting, and if they approve the change, a 30-day public comment period before formal adoption will begin.

Click here to view the present version of the changes that will be presented to the Board. AmSpa will continue to closely monitor these changes and will report any further developments.