Plastic Surgeons Call for Accreditation as a Med Spa Patient Safety Tool

An editorial in the Aesthetic Surgery Journal is renewing calls for stronger oversight of medical spas, arguing that voluntary accreditation and certification programs can play an important role in protecting patients.

The editorial, “MedSpas: Patient Safety and Accreditation,” was authored by a group of board‑certified plastic surgeons and leaders in aesthetic medicine, including Robert Singer, MD; Mark Jewell, MD; Renato Saltz, MD; and Thomas Fiala, MD. The authors describe a medical spa sector that has grown rapidly across the United States while remaining subject to uneven and often unclear regulatory frameworks at the state level.

“The world of MedSpas today is essentially like the Wild West of retail medicine,” the authors wrote, pointing to wide variation in ownership models, physician involvement, staff training, and oversight. In many jurisdictions, medical spas operate without consistent standards despite offering medical treatments that carry real risk.

Growth Outpacing Oversight

According to the editorial, the number of medical spas nationwide now rivals the number of major retail chains, with some estimates placing the total at more than 13,000 clinics. The authors argue that regulatory structures have not kept up with consumer demand for non-surgical aesthetic procedures.

Unlike ambulatory surgery centers or hospitals, most medical spas are not subject to comprehensive facility‑level regulation. Oversight is often limited to professional licensing statutes that focus on individual providers rather than the systems, protocols, and governance structures of the practice itself.

“In most cases this translates to no oversight, no standards and in some cases no accountability,” the editorial states, emphasizing that patients often cannot easily distinguish between a well‑run, physician‑directed medical practice and one operating with minimal supervision.

The editorial argues that inconsistent standards erode public trust and complicate the work of regulators, as enforcement often occurs only after harm has occurred.

Accreditation and Certification

Rather than calling exclusively for new legislation, the editorial frames accreditation and certification as practical tools to fill regulatory gaps. The authors describe accreditation as a structured, third‑party process that evaluates whether a facility meets defined standards related to governance, training, emergency preparedness, infection control, and documentation.

They compare accreditation to longstanding quality‑assurance systems in other areas of healthcare, noting that such programs provide transparency for patients while encouraging continuous improvement among providers.

The editorial characterizes accreditation as a “Seal of Good Housekeeping” for medical spas, offering an external signal of compliance with recognized safety and operational benchmarks.

Importantly for policymakers, the authors stress that accreditation does not replace state or federal regulation. Instead, it can complement existing laws by reinforcing standards of care, clarifying expectations, and promoting accountability where formal regulation may be limited or fragmented.

Medical Director Accountability and Governance

The authors argue that meaningful physician involvement is essential to patient safety and that certification standards should require active, documented oversight rather than supervision in name only.

“The Medical Director is now a key figure, with multiple responsibilities and direct involvement,” the authors wrote. “It’s not a figurehead‑type position.”

This is worth reinforcing. In a medical practice, medical leadership must be directly responsible for clinical protocols, delegation decisions, credentialing, and emergency readiness.

Consult your state med spa legal summary for specifics on who can be a medical director, how many people they can supervise, what supervision means (can it be done remotely? how far away can they be?) and more.

Med Spas in the Public Eye

Medical spas are medical practices. And while members of the AmSpa community are proactive in setting the standards for clinical practice and legal compliance, the med spas that make the news can color public perception of the profession as a whole.

Certification and accreditation programs can help reputable med spas adopt healthcare-grade standards for patient safety by:

• Establishing uniform expectations;
• Encouraging medical oversight; and
• Providing patients with clearer information about practice standards.

Wider adoption of accreditation could support patient safety while allowing reputable practices to differentiate themselves. Strengthening standards through education and accountability remains essential to protecting patients and preserving public trust in medical aesthetics.

Demonstrate your med spa’s commitment to patient safety. Access state legal summaries, business toolkits, SOPs, intake/consent forms and accredited education that make compliance easy: become a member of the American Med Spa Association today.