Two practices can both call themselves a med spa and still differ greatly in who performs treatments and who is responsible for your care. Texas rules point to concrete things you can ask for and confirm. Here they are, for anyone comparing practices around Dallas.
Start by finding the delegating physician
There is no Texas license or registration for med spas. Cosmetic injections are nonsurgical medical cosmetic procedures, and a licensed physician has to delegate them. In the Texas Medical Board's rule, that physician is called the delegating physician.
Under Texas rules, a practice offering these procedures has to display the delegating physician's name and Texas medical license number in every public area and every treatment room. Check the walls. If the information is missing, ask for it.
Next, search for the physician in the Texas Medical Board's public license look-up. Keep in mind that, by the Board's own statement, part of each profile is reported by the licensee and the Board does not verify it.
Board certification
Find out which specialty the physician holds board certification in, and from which board. Then check that answer with the board itself.
Who is allowed to treat you
It matters who does the injecting. Texas rules require the person carrying out a delegated procedure to be appropriately trained and to have a written protocol that the delegating physician has signed and dated. Before you are treated, the physician, physician assistant or advanced practice nurse has to give you the name and title of the person who will do it, and that person has to wear a name tag or similar identification listing their credentials.
Titles you are likely to see:
- Physician (MD or DO): may delegate the procedure to trained staff
- Physician assistant: works under a physician's delegation
- Advanced practice registered nurse, a group that includes nurse practitioners: according to the Board of Nursing, prescriptive authority is exercised when a physician has properly delegated it
- Registered nurse: the Board of Nursing permits delegated medical acts only if the five criteria it lists are met
The Texas Department of Licensing and Regulation says estheticians and cosmetology operators are not licensed to inject Botox or fillers, and not licensed to use lasers for hair removal.
Looking at before and after photos
Photos are useful once you know what to check.
- Give more weight to pictures of the practice's own patients than to manufacturer images
- Find patients whose age, skin tone and concern resemble yours
- Make sure both photos use the same lighting, angle and makeup
- Ask how much time passed between the treatment and the second photo
What a good consultation looks like
You should leave a consultation knowing more than when you arrived. The provider asks about your health before recommending anything, is honest about what a treatment can and cannot achieve, and gives you the plan and prices in writing. A good provider will also tell you when a treatment is unnecessary.
Leave if
Someone tries to sell you a package within minutes, before asking about your health history, or offers a discount that expires today.
More you can check
Two further points to raise:
- Some facilities choose to hold accreditation. QUAD A (the American Association for Accreditation of Ambulatory Surgery Facilities) lists a MedSpa Program. Ask a facility which accreditation it has and who granted it, then confirm with that accreditor.
- Ask whether the practice has malpractice insurance.
Med Spas of Dallas builds its listings from public sources and from each business's own website. We do not check licenses.
- The delegating physician's name and Texas license number are on display
- The Texas Medical Board look-up confirms that physician's license
- You were given the name and title of the person treating you, and their name tag lists their credentials
- A physician, physician assistant or advanced practice nurse is in the building or immediately available
- The before and after photos show the practice's own patients
- Your health history was covered in an unhurried consultation
- You received prices in writing