Acne scars are depressions and raised areas on the skin left behind after an inflamed pimple breaks the barriers of a pore. There are two common types of acne scars: hypertrophic or keloid scars and atrophic or depressed scars. Hypertrophic scars are raised tissue and atrophic scars are depressions.
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In 2000, the Board revised rules and regulations on the use of lasers and light activated devices to incorporate board policy. The rule states that non-physician personnel performing hair removal on patients must have appropriate training in laser usage and the supervising physician must be on the immediate premises during the procedure. However, when the procedure is performed by a trained physician assistant, the supervising physician is not required to be physically present in the building where the surgery is being performed.
In April 2002, the Board adopted a rule stating requirements that must be met before unlicensed personnel may perform hair removal using lasers and light activated devices, including that the supervising physician must be on the immediate premises at all times during a procedure 16.10.13.7 DEFINITIONS: C. “Medical therapeutic or cosmetic medical procedure, device, or treatment” means a treatment or procedure that uses any of the following, if the procedure or treatment alters or damages or is capable of altering or damaging living tissue, to improve the patient’s appearance or to achieve an enhanced aesthetic result: (1) injection or insertion of a biologic or synthetic substance for soft tissue augmentation; (2) application of a chemical substance; (3) application of microwave energy; or (4) application of a federal food and drug administration approved prescription device that uses waveform energy of any kind, including, but not limited to lasers or intense pulsed light. D. “Certified” means the medical assistant has been awarded a certificate .
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16.10.13.8 USE OF MEDICAL THERAPEUTIC AND COSMETIC DEVICES. Medical therapeutic or cosmetic devices penetrate and alter human tissue and can result in complications such as visual impairment, blindness, inflammation, burns, scarring, hypo-pigmentation and hyperpigmentation. The use of medical therapeutic and cosmetic devices is the practice of medicine as defined in Section 61-6-1 NMSA 1978. A. Limitations. (1) Medical assistants are limited to using medical therapeutic and cosmetic devices that are non-incisive and non-ablative. 16.10.13 NMAC 1 16.10.13 NMAC 2 (2) Medical therapeutic and cosmetic devices may only be used by a medical assistant who is certified pursuant to Subsection D of 16.10.13.7 NMAC and when the supervising physician is immediately available on the premises. B. Responsibility of the supervising physician. A physician who is trained in the safety and use of medical therapeutic or cosmetic devices may supervise medical assistants who perform hair removal and other therapeutic or cosmetic procedures using devices that use waveform energy consistent with the following requirements. (1) The supervising physician must provide the following services before treatment by a medical assistant is initiated: patient history, physical examination, diagnosis, treatment protocol, and preparation of medical record. (2) The supervising physician shall review any adverse outcomes or changes in the treatment protocol. (3) The supervising physician shall assure the patient is informed and aware that the individual performing the procedure is a medical assistant and is under the physician’s supervision. (4) The supervising physician shall provide the patient instructions for emergency and follow-up care. (5) The supervising physician shall prepare a written protocol for the medical assistant to follow when using the medical therapeutic or cosmetic device. The protocol may include pre and post care treatment related to the procedure as long as the treatment is topical and non-injectable. The physician is responsible for ensuring that the medical assistant uses the medical therapeutic or cosmetic device only in accordance with the written protocol and does not exercise independent medical judgment when using the device. (6) The supervising physician shall assure compliance with the training and reporting requirements of this rule. (7) The supervising physician is ultimately responsible for the safety of the patient, regardless of who performs the treatment using the medical therapeutic or cosmetic device or procedure. C. Training requirements. Medical assistants who use medical therapeutic or cosmetic devices must have training and be certified on each device they will use. The training on each device must include the following: (1) physics and safety of the medical therapeutic or cosmetic device; (2) basic principle of the planned procedure; (3) clinical application of the medical therapeutic or cosmetic device, including wavelengths to be used; (4) indications and contraindications for the use of the medical therapeutic or cosmetic device; (5) pre-operative and post-operative care; (6) recognition and acute management of complications that may result from the procedure; and (7) infectious disease control procedures required for each procedure. D. Reporting requirements. The supervising physician shall complete a “certificate of training” form and submit it to the board prior to the use of a medical therapeutic or cosmetic device by the medical assistant. The form will be device-specific and document training for each medical therapeutic or cosmetic device used by the medical assistant. E. Public communication. Any public communication offering the performance or administration of a cosmetic medical procedure or treatment shall identify the physician or surgeon responsible for the provision of, or the direct supervision of the procedure or treatment. [16.10.13.8 NMAC – Rp 16 NMAC 10.13.8, 4/18/02; A, 12/30/05; A, 7/22/08]
The MPA, Section 61-6-16(6)(3) states that the Act does not limit or prevent a physician from delegating any task or function to a qualified person otherwise permitted by state law or established by custom, except the dispensing of dangerous drugs. LASERS & LIGHT ACTIVATED DEVICES FOR HAIR REMOVAL New Mexico allows a non-physician to perform laser or light activated hair removal. However, these services to be performed under the supervision of a licensed physician. The rules require: * the supervising physician must have interviewed the patient and recorded appropriate history and physical information; *the unlicensed person who will be performing the hair removal must have been trained on the procedure; *the supervising physician must be on the immediate premises at all times during the procedure; * the unlicensed person performing the service must be fully insured under the physician’s medical malpractice policy; * the patient must be informed that the person providing the service is not a physician; and * the Board must have a record of non-licensed staff who are performing these services.
