If you can’t make heads or tails out of Florida law on this topic, join the club! The law is clear as…mud. Simply put, ANY physician can provide the required indirect supervision of a mid-level practitioner at a MedSpa IF the physician’s primary practice location is the same one as the MedSpa. If the physician’s primary practice location is different from the MedSpa, then the supervising physician has to be a dermatologist or plastic surgeon ONLY IF the “primary” activity of the mid-level at the MedSpa is dermatologic, aesthetic, skin care services.

Still struggling? That’s because IT MAKES NEARLY NO SENSE AT ALL! “You mean to tell me a primary care physician can co-locate his/her practice with the MedSpa and supervise the mid-level?” Yep. “But that a derm or plastic has to provide supervision if the MedSpa isn’t co-located with the MedSpa?” Uh huh. “And does the level of expertise of the supervising physician factor in at all?” Nope. Not one bit. “And the physician, in any case, can be off-site 100% of the time?” Yep.

What if the APRN wants to provide primary care services at the location and is also an autonomous practitioner? Does that bear on the issue? Maybe. The whole dermatologist/plastic supervising issue only comes into play when the mid-level is “primarily” providing dermatologic or aesthetic services at the location. What does “primarily” mean? Who knows. It’s not defined, and the law that applies (s. 458.348) doesn’t specially authorize rules to be made to answer the question.

As you can imagine, confusion in this space is driving different levels of compliance, from, zero to fully compliant. But getting it right is seriously important to any licensed professional (mid-level and supervising physician alike) because they have professional licenses on the line. Physicians and mid-levels who would like to keep their licenses untarnished will make sure they’re guided on (1) the laws, (2) the options, and (3) the risk of each option.