New York regulations tend be fairly similar to most states in the US, but in my experience have been extremely difficult to source, while some have yet to be officially defined or declared. I would avoid looking for answers through the NY Educational Board, or on existing clinics websites (doctors) and focus your hunt to the NYS Health Board. I’m not to say that it will be any easier to find what you are looking for there either, but it is up to the NYHB to author these types of regulations according to state law. As of right now the state is being extremely liberal with how they monitor and enforce these "suggested" parameters, and will usually implement and refer existing codes and medical regulations that do not pertain to laser treatments to shut down and punish clinics that are not providing safe and responsible treatments to the public. For example if you are not using FDA approved equipment, injure the public, etc, the NYHB will investigate the company and can usually find and enforce several existing violations that steam from cleanliness, to practicing without a medical director. So with that being said I traditionally recommend that my students and new clinic owners follow a few proactive suggestions that will aide and protect them as a technician and business owner.
My suggestions for self-regulating clinics would be to...
Use an FDA approved laser. There are a lot of inexpensive poor quality lasers that can be bought from over seas. These devices are ineffective and have a high chance of causing scaring when in the hands of an inexperienced or under educated laser tech. You get what you pay for in this industry and its best to find a new or refurbished laser (depending on budget) that has a great reputation and can offer clients expected results. If you are using anything less you are not only hurting your new business, but hurting the industry as a whole by perpetuating some of the negative stereotypes that were once associated with the removal process.
Hire a Medical Director. This is a common regulation in a majority of states in the US and can often add legitimacy and on-call medical support to your business. A Medical Director is a Medical Professional who is a licensed and board certified MD, or Dermatologist who is responsible for overseeing protocol and guaranteeing that your clients are being treated in a safe and responsible manor. An MD should also be required to review all client medical charts, looking for any abnormalities or possible side effects that could be caused by medications, infections, allergies, etc. In some states the MD is required to be on site (direct supervision), but as of right now that doesn’t seem to be nor have I been able to locate a source that requires it in the state of NY. A Medical Director is a hired employee and you both will-need to jointly determine/contractually agree on the rate of pay or percentage he or she receives for their service.
Obtain your own Laser Malpractice Insurance policy. By having your own coverage you will avoid the dependency of being on your Medical Directors Malpractice insurance. This will make you more attractive to possible MD’s and protect you from being sued. Laser Malpractice Insurance can run between $1000-$2000 a year, which is a small price to pay for the protection and counsel that it provides to a new clinic owner.
Last get Laser Certified by an experienced and reputable educator/program. Take a course, or take two courses, tattoo removal is an evolving education and the best teachers and technicians are the ones who have seen and experienced the most. With the rapid progression of the industry and technology do your homework and see which course best fits your goals. If you are looking to offer more then tattoo removal find a school or educator that offers a well-rounded full-spectrum course. If you want to focus on tattoo removal then take a class for that subject from a teacher/program that focuses on tattoo removal. Ultimately you want to attend a program that can help you grow and your business and knowledge before and after the class is over. With any type of business and education you will have choices, just take the time to evaluate your decision and find which one best suits your goals, learning style, and development needs.
Below I have provided the most recent sets of regulation-based information that I have been able to find to date. If you would like to delve deeper, I would suggest calling and emailing the Health/Medical board of NY or consult a lawyer. Like I said it is very difficult to locate actual statutes, but I encourage all to do their own due diligence before practicing any laser aesthetic procedures on the public. Since I have been through this process numerous times I will tell you that you get more suggestions then hard answers and when you actually talk to the right person and ask for some actual statues or written laws to review, the trail usually goes cold and quite. It is my belief that it is this way because they are not looking to actively over-regulate or shut down hundreds of NY based laser aesthetic business that are currently self-governing in a responsible manor, but they will simply step-in with fines, penalties, and suspensions if a clinic is not practicing in a safe and responsible way (see above recommendations).
In August 2002, the NY State Board of Medicine passed a resolution "recommending" that the use of lasers and intense pulsed light for hair removal be considered the practice of medicine and thus be performed by a physician or under direct physician supervision.
**This is the recommendation of the states medical board, and it is referring to laser hair removal; which uses a different protocol, depth penetration, and lasing equipment. My opinion is that this “recommendation” could be voted on and enforced at anytime should they feel the need too, (most likely due to some sort of continuous strain of public incidents). Since there are already a large number of laser aesthetic based clinics currently practicing without “Direct Supervision” and there have been little to no incidents in that last 10 years as a result of not having “Direct Supervision” there is really no reason for the states health board to act in an official or aggressive manor. As of right now I would say that the large majority of current companies who practice tattoo removal in NYS are doing it in a very safe and responsible manor.
Section 6530 of the New York Education Law defines professional misconduct and includes: 24) Practicing beyond the scope of practice permitted by state law and performing professional responsibilities a licensee knows he/she is not competent to perform (25) Delegating professional responsibilities to a person when the licensee delegating such responsibilities knows or has reason to know that such person is not qualified, by training, experience or by licensure to perform.
**Section 6530 (https://www.health.ny.gov/professionals/office-based_surgery/law/6530.htm) is the “Definitions of Professional Misconduct” according to the state of NY. It is designed to establish when it is appropriate for a licensed medical professional to have his or her medical licenses “revoked, suspended or having other disciplinary action taken, or having his or her application for a license refused, revoked or suspended or having voluntarily surrendered”. In my opinion this is saying, that if the person (technician) is not professionally educated, experienced, or qualified to perform these types of procedures then the responsibility of treatments cannot be delegated upon them by a “Licensed” medical professional (Medical Director). If they are referring to the practice of aesthetic based lasers, which isn’t directly mentioned. Then in theory anyone can be permitted to treat clients as long as a “Licensed” Medical Director/Professional has “proof” that they are deemed “Qualified” due to experience or being professionally educated on the process of laser based hair or tattoo removal treatments.
I know that there is a ton of information to review here, but I hope it is helpful to you. I am not a lawyer, so please do not take this as legal advice. I again encourage you do your own research, before going forward.
Thank you for taking the time to read my latest blog, I hope this information is helpful to you. If you have any other questions or would like to discuss lasers or training options in more detail, please do not hesitate to call or email me anytime. I am always available!
Lorenzo Kunze, II CLS/MLS
Owner & Lead Instructor- International Laser Academy