I am often asked this question:
I was asked to be a Medical Director for an aesthetic practice. They say I do not have to be on site. My obligation will be minimal. I just have to review an occasional chart. And be available to discuss in case there’s some type of emergency. And I’ll get a reasonable check each quarter. I’d like to supplement my income, and this seems a great way to do that without interfering with my day job.
Well, what is your day job?
I’m a gastroenterologist?
Do you have any special training or experience in aesthetic medicine?
Actually, no.
My intuition has always been that if you are going to supervise another licensed healthcare professional or serve as a director, you should know something about the domain. Right?
And, that’s generally been my advice.
If you know very little about the topic at hand, respectfully take a pass.
Imagine there IS a complication at the medical spa. You’re the person they will call to fix the problem. You can consult Google or PubMed. But you really will not know what to do other than call 911. How do you think your interview with the Board of Medicine will go?
Uh huh.
While that was always my intuition, now at least one Board of Medicine has weighed in.
The North Carolina Medical Board (NCMB) recently wrote:
“A key aspect of the supervisory relationship between physician and PA (or any other APP) is that there must be parity between the knowledge and skills of the supervisee and the supervisor. While there is no issue with a physician’s clinical knowledge and expertise exceeding those of the supervisee, it is never acceptable for the supervisee’s knowledge and, more specifically, their scope of practice, to surpass that of the primary supervising physician. It is NCMB’s view that it is not feasible or appropriate for a physician to supervise a procedure or treatment he or she cannot perform competently themselves.”
In other words, NCMB stated the threshold for being a supervising MD is more than a warm body with a medical license. It’s someone with a fund of knowledge.
Each state addresses PAs and NPs differently. In some states, these providers are afforded significant latitude to practice autonomously. In other states, they are tightly controlled.
If you are asked to serve as a supervising physician or Medical Director, first do a gut check and determine if you have the background, training, and experience. Will you be able to sit through a Board of Medicine interview or a malpractice lawsuit if a patient suffers a complication?
Next, identify what the regulations are in the state where you are being asked to perform services. You should not rely on the supervisee. Your feet will be held to the fire if any regulations are broken.
Then, do some reasonable due diligence on the supervisee. You need to make sure THEY are properly licensed and have the requisite skill sets. Some supervisors have been shocked to learn that their supervisee actually did not even have a license. Or it had lapsed. Or they were the subject of multiple Board investigations or civil lawsuits. Learn that data sooner rather than later.
Finally, decide if it’s worth your time. Will the amount you are being paid suffice for the time commitment and risk?
What do you think?
Sage advice
No. As a young Plastic Surgeon, I served briefly, as MD for a medspa, which was 15m away. No honorarium was offered but I was “hungry” until I received a frantic call from a Fitzpatrick IV laser hair removal client, whose NP had failed to adjust the settings down to account for the background pigment. No harm. No foul. The hexagonal patterns faded without scars and I gained a long term patient. BTW, my resignation from the medspa was swiftly rendered.
There may be other implications: If you are required to serve on-site as a “mentor”, you may be in a situation where you have to be privately in a room with an “attractive” young woman whom you may have to “criticize or critique.”
As a male professional, with “resources” you could become a target for charges of sexual abuse or boundary violations, even if you are completely innocent.
This will destroy your life. You may lose everything. You ABSOLUTELY must insist on a proctor present throughout the entire meeting.
Our Leftist, woke feminist culture defines you as a white professional male as “evil.”
Michael M. Rosenblatt, DPM