Pulling Back the Curtain: A Cross-Sectional Analysis of Medical Spas in Missouri.

Background: There is very little legislation defining the degree of supervision and training required to perform cosmetic procedures in Missouri. The medical spa industry, particularly the volume and complexity of cosmetic procedures offered by medical spas, has seen significant growth in recent years.

Objective: To better understand the medical spa workforce, depth, and breadth of aesthetic procedures offered by medical spas in Missouri.

Materials and methods: Cross-sectional study based on standardized telephone interviews, supplemented by website data. Survey responses were recorded, streamlined, and analyzed.

Results: Although 94.59% of medical spas in Missouri are affiliated with a physician, only 22.52% of medical spas have a physician on-site for administration of cosmetic treatments. Nonphysician staff members who administer cosmetic services generally outnumber physician affiliates at Missouri medical spas, with the average ratio of nonphysician staff who administer cosmetic services to MD/DO affiliates per spa being 2.1:1.

Conclusion: There is significant variability in the level of training and supervision of medical spa staff performing cosmetic treatments in Missouri. As the medical spa industry continues to grow and high-risk cosmetic procedures become more commonplace, consistent statewide regulation of medical spas is needed to prevent harmful patient outcomes.