The scientific journal “Dermatologic Surgery” published an article revealing that only 22.52% of the Missouri medical spas examined had a physician on-site during cosmetic medical procedures and that most of those treatments are performed by non-physician staff.
Schaumburg, Ill., March 17, 2025 (GLOBE NEWSWIRE) — A new study published in the January 2025 issue of Dermatologic Surgery – the official scientific journal of the American Society for Dermatologic Surgery (ASDS) – reveals a concerning lack of physician supervision and discrepancies in the level of training among those performing cosmetic medical procedures in Missouri medical spas. The study findings highlight the need for regulatory oversight of medical spas to prevent harmful patient outcomes, as suggested by the American Society for Dermatologic Surgery Association’s (ASDSA) “Medical Spa Safety Act.”
The study, “Pulling Back the Curtain: A Cross-Sectional Analysis of Medical Spas in Missouri,” examined the level of physician involvement in medical spa treatments across the state. Despite 94.59% of medical spas reporting affiliation with a physician, only 22.52% had a physician on-site during cosmetic medical procedures. The study also found that the majority of those treatments – including botulinum toxin injections, dermal fillers and laser procedures – are performed by non-physician staff, with the average ratio of non-physicians to physician affiliates per spa being 2.1:1.
Missouri currently lacks formal statutes defining the supervision and training required to perform cosmetic medical procedures. Unlike states with stronger regulations, Missouri’s lack of oversight creates significant variability in medical spa staff qualifications and patient safety measures. Without clear laws governing medical spas, patients may unknowingly receive treatments from individuals with limited medical education and training, increasing the risk of complications.
“Patient safety must be the priority, and this study highlights an alarming gap in oversight at Missouri medical spas,” said M. Laurin Council, MD, MBA, ASDS/A President and co-author of the study. “ASDSA recognizes the substantial threat that unregulated medical spas can pose to patients and calls for appropriate supervision, oversight and training by qualified on-site physicians, as well as advocating for medical spa procedures to be based on patient outcomes and quality care.”
Additionally, the study found a lack of transparency in medical spa operations. Some facilities were unable to confirm whether they stocked critical emergency medications, such as hyaluronidase for dissolving dermal fillers in case of complications. Others could not verify their level of physician involvement, leaving patients without clear information about who would be administering their treatments. Per ASDSA’s position on “Protecting the Public From Practitioner Misrepresentation,” the Association supports clear and transparent communication with the patient about who will be providing care and opposes false and misleading advertisements that provide unclear information about licensure and training.
ASDSA encourages patients to ensure medical procedures are performed or directly supervised by a physician, especially by a board certified dermatologist as recommended in the “Medical Spa Safety Act.” This model legislation calls on states to regulate medical spas and keep medical procedures under the oversight of physicians, along with requiring medical directors to have training on all procedures being performed. The model bill also includes additional staff education requirements, notification to the public if a physician is not on-site, medical malpractice coverage for personnel taking care of patients and options for mandatory adverse event reporting.
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About the American Society for Dermatologic Surgery Association (ASDSA)
With a membership of 6,400+ physicians, ASDSA is a 501(c)(6) association, dedicated to patient safety and advocacy on behalf of dermatologic surgeons and their patients. For more information, visit asds.net/ASDSA.
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About the Journal
Dermatologic Surgery, published in the Lippincott portfolio by Wolters Kluwer, is the official publication for the American Society for Dermatologic Surgery, American College of Mohs Surgery, International Society of Hair Restoration Surgery and the Dermatologic & Aesthetic Surgery International League (DASIL). This respected monthly journal is exclusively devoted to dermatologic surgery, publishing the most clinically comprehensive and up-to-date information in its field. Dermatologic Surgery provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The DermSurgery Digest Podcast is available on Spotify, Apple Podcasts and ASDS Learn. Follow the podcast on Facebook, X (formerly Twitter) and Instagram.
CONTACT: Kristin Hellquist American Society for Dermatologic Surgery Association 847-956-9144 [email protected]
