You probably assume that medical procedures are performed by providers with proper training. Unfortunately this is not always the case, even when these procedures are performed by doctors.
Here are some questions that you should ask any place where you are considering to have a laser procedure:
1. Ask who will actually perform the procedure. What licensing and training does that person have? Who trained them? Will they perform the entire procedure or hand it off to someone else?
2. Are physicians immediately available (on location) during procedures?
3. What safeguards are in place in case of an emergency?
4. How do they deal with complications? Individual responses to lasers vary and at energies that produce good results even well trained and experienced laser dermatologists cannot avoid complications 100% of the time. Injections can affect facial nerves or occlude blood vessels. Complications should be very rare, but it is important to know what happens in that contingency (especially if the procedure is not performed by a physician) and whether immediate response is required to avoid long term damage.
5. Ask whether laser treatment is appropriate for your skin type, hair color, complexion and body area. Suggest that the operator test a small patch of skin before you undergo the procedure. People with conditions like diabetes, a difficulty with wound healing, or a tendency toward keloid scarring may be especially vulnerable to complications and should talk to a qualified physician before undergoing laser treatment.
6. If your skin has more natural pigment or if you are tan, you should exercise extreme caution before having a laser procedure.
7. If you are not being treated by a dermatologist, have a skin check first. An operator not trained in dermatology could treat with a laser and lighten something that looks like a sun spot but is actually a skin cancer, obscuring the disease until it is more advanced.
8. If you will be treated with a laser or energy device, make sure the device is the appropriate brand name, and ask if it was purchased from or at least refurbished by the manufacturer. There are many copycat or counterfeit devices, and you should stay away from any place that employs such devices, as they have not been subject to FDA review for safety and efficacy. Lasers contain complex optics that can fall out of calibration and thus it is important to be properly maintained, if purchased second hand they should be inspected by the manufacturer, and if time-shared among different locations they should be frequently checked and recalibrated. When you go to a reputable laser dermatology practice you will be treated with devices purchased from the manufacturer, properly maintained, and typically not time-shared with other locations.
At Union Square Laser Dermatology, we are committed to patient safety in all of our procedures, which are personally performed by our physicians who have trained in these procedures. Dr. Chapas, Dr. MacGregor, Dr. Chwalek, Dr. Gmyrek and Dr. Idriss have extensive experience and medical and fellowship training in the physiology of the skin, skin surgery, laser medicine, and cosmetic treatments so that they can provide the safest and most effective care for their patients. Vascular procedures are performed by Dr. Audrey Rosinberg, a board-certified vascular surgeon.
COSMETIC PROCEDURES AND PATIENT SAFETY
The popularity of cosmetic procedures and the growth and wide availability of effective non-invasive technologies have resulted in a large number of medical cosmetic procedures that are not performed by physicians trained in these procedures. This in turn has led to an increase in patients seeking medical attention for complications from such treatments.
In a recent survey by the American Society for Dermatologic Surgery 41 percent of responding dermatological surgeons reported an increase in patients seeking treatment due to damage caused by non-physicians performing laser and light rejuvenation techniques, chemical peels, laser hair removal and other skin procedures. Additionally, the importation and use of non-FDA approved or compounded substances have resulted in adverse events and even death.
State legislatures are responsible for passing legislation to regulate the practice of medicine, however patient safety legislation often cannot keep up with the pace of the technological change. Until states pass appropriate laws to regulate the practice of medical procedures, it is often up to the patient to decide who can perform their desired cosmetic and medical treatments safely and effectively.
To learn more about patient safety or the non-physician practice of medicine please visit the website of the American Society for Dermatologic Surgery. Their photo booklet of patient complications contains examples of complications from errors during cosmetic tratements (WARNING: this booklet contains graphic images).