"Do I need a license to fire a laser in my state?"
This question is probably one of the first things you'll ask yourself when researching your state's laser regulations.
The answer may be dependent on the "Board of (insert your pre-existing profession here)." It's all a matter of one phrase: The Scope of Practice.
The Scope of Practice
For example, if you're a nurse researching what's required to open a laser hair removal clinic, you should consult both the Board of Medicine AND the Board of Nursing. These may state that you need a medical director, but the onsite or offsite requirement may allow you to do more. In an even more loosely regulated state, if the Board of Nursing views laser hair removal treatments to be within the scope of practice of a nurse, a medical director (MD or DO) may not be required.
The same could be said for electrologists, estheticians, and cosmetologists, looking to do laser treatments.
What if I'm a non-MD/DO physician?
On the other hand, if you're a chiropractor, dentist, optometrist, or other non-MD/DO physician, you should consult your regulatory board to see if your governing body considers the use of a laser as being within the scope of practice. We've observed that non-MD/DO physicians most often have a hard time proving the "Scope of Practice" argument to their boards. However, it's always worth calling and presenting your case to find out for yourself.
After sorting out whether or not you need a license, it's time to determine who in your state can qualify as a medical director for your clinic.
Nurse Practitioners, do your research!
Nurse Practitioners (NP) could potentially satisfy the onsite/offsite medical director requirement in many states. Again, it'll depend on the scope of practice, and to what degree the NP has prescriptive authority. Some states will show that an NP has full prescriptive authority, which would indicate that they may be able to serve as a medical director for a laser clinic. Some states show NPs have limited prescriptive authority, typically requiring a collaborative agreement with a physician.
Even if the Board of Medicine says a medical director is required, if the Board of Nursing says the NP may fire the laser or delegate the firing of the laser without oversight from a physician, a Nurse Practitioner may serve as medical director.
"Look for ways to satisfy requirements in your state, utilizing the scope of practice to your advantage. Or, conversely, make sure you are offering procedures within your scope of practice or operate under the delegation of a professional who is allowed to delegate these treatments. Consider alternatives for medical directors, if your state allows it.
Boards of Nursing and Medicine don't always align, so always double and triple-check your paths to market, while following the rules."
- Justin Arnosky, VP of Clinical Education for Astanza Laser