Laser therapy has been used frequently for the benefit of certain dermatological applications such as tattoo removal, acne scars, spots port wine, and skin blemishes for over a decade. However, in recent years, laser treatment for hair removal and wrinkle treatment has grown significantly in popularity, which has subsequently increased the demand for laser treatment providers. Since state law governs the question of who can perform these procedures, is important for all current and potential providers of laser treatment that is familiar with Michigan law, including the Code Michigan Public Health provision delegation regarding the use of lasers for dermatological use. In addition, the December 5, 2005, the Department of Michigan Community Health (MDCH) issued a position paper regarding the use of laser equipment by health professionals, which clarifies the relevant law on the subject.
According to the MDCH position statement, laser treatment falls within the definition of the Public Health Code of Michigan's practice of medicine because the treatment is the diagnosis, treatment, prevention, cure, or alleviation of disease human disease, defect, complaint, or any other physical or mental care, advice, device, diagnostic test, or by other means … "So Therefore, in general, dermatological laser procedures should be performed by a licensed physician. However, MCLA 333.16276 allows a licensee, registration, or any other person "to perform laser procedures for dermatological purposes, provided the procedure is done under the supervision of a physician authorized. In particular, the delegation will not be allowed unless the patient involved has knowledge and consent to the laser treatment procedure is performed by a non-medical. This provision allows for greater delegation of medical assistants and nurses to perform these laser procedures without supervision, provided and when the procedure is performed in a health center as narrowly defined by the Public Health Code of Michigan (eg hospital). It is also noted delegation that the provision not allow medical assistants and nurses to delegate the authority to make these laser procedures to another person.
The essence of this authority for delegation laser procedures, as outlined in the statement and clarified the position MDCH is the definition "supervision", as all providers of laser treatment should be well aware that the ultimate responsibility for the tasks and duties performed by a delegated person lies with the licensed physician. Monitoring involves the monitoring of, or participation in the work of another individual for a professional license health in circumstances where at least all the following conditions are met:
These conditions clearly show the high level of care and attention that a license Physicians should exercise when contemplating the possibility of delegating the authority to perform the laser treatment. The licensed physician is not only ultimately responsible the outcome of the procedure, but also must be available to attend (in person or by telephone or radio), the person delegated at all times.
The provision MCLA 333.16276 delegation is limited in application to the use of lasers for "dermatological purposes." This means any purpose connected diagnosis and treatment of conditions of medical necessity and cosmetic skin, hair, and nails by different surgical procedures, reconstructive, cosmetics, and non-surgical. Therefore, this provision permits the delegation of procedures such as laser hair removal or removal of acne scar, but does not allow the delegation of laser procedures unrelated to the practice of dermatology, including laser eye surgery.
A licensed physician is considering delegating the authority to use laser treatment for dermatological purposes should address the issue in a prudent manner and thorough, as Michigan law on the issue is rigorous. In particular, great care must be taken to determine whether a person has the qualification and training suitable for laser procedures. This corner performance offers two tips to help licensed physicians contemplating this delegation.
Tip 1 – Be sure to do your homework when selecting a representative individual:
In accordance with MDCH's position statement an individual can be entrusted to a person licensed or unlicensed. That said, it is recommended that the approved medical practitioner to perform a thorough investigation into the background, education and training of any prospective person delegated to ensure the individual is empowered to do so, as it is reasonable to assume in practice "a adequate education or training "can mean at least one certification in laser treatment. The licensed physician must maintain a personal file of each delegate that includes any and all certificates and other documentary evidence of training in laser treatments. In summary, licensed physicians would be nice advised to err on the side of "over-qualified" when selecting a person delegated, such as licensed physician should be aware that he or she is responsible ultimately to the outcome of any of the procedures delegate.
TIP 2-Do not overlook the requirement to establish written procedures and protocols to guide the person delegated laser use:
A doctor must provide a representative with extensive hands on training with laser treatment to be delegated. In addition, a physician must establish a detailed written procedure or protocol to help the person delegated. This protocol can be in the form of a manual, step by step instructions to guide the person. The duties required and the tasks of person delegated must be clearly detailed in the written protocol.
Moreover, the performance of the delegated person should be regularly reviewed and evaluated. The delegated person should keep a detailed record of all procedures performed laser under the supervision of a licensed physician. These records must also be reviewed by licensed physician on a regular basis. It is vital that people not only suitably qualified officer in the background, but also keep a record of work satisfactorily perform these procedures with laser.
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