Aesthetic/Cosmetic Procedure

Advanced Practice Columnist / Guide · Jun 29

California requires a Standardized Procedures document for each procedure you are performing in your clinical practice. The rules and guidance are in the BRN website. I work in a hospital where some NP's and PA's perform specific invasive procedures and we have formal Standardized Procedures for each of those procedures individual NP's can perform and these are reviewed and signed with the attending who is responsible for making sure the NP has the skill and that physician back up is available in case complications occur. The skills are matched: if it is an ICU procedure an Intensivist physician is the signing attending.

In your case, you are saying that an Internal Medicine physician will be signing off on your procedures...is this person trained in the procedures you are referring to? If not, that can be a problem. I advise you to speak to a lawyer knowledgeable in making sure the Standardized Procedures meet the conditions set up by the BRN.

There is also AB890, a law that took effect 1/1/23 that may allow some NP's to practice independently without standardized procedures under certain conditions. I am not familiar with how this will apply to aesthetic or cosmetic practices. It can be tricky because California strictly stated that the roles the NP performs must be in alliance with their NP training and only specific training tracks were named: FNP, AGNP, AGACNP, PMHNP etc. In theory, cosmetic practice is not part of those training programs so it would be tough to prove that your program had the didactic and clinical exposure to this field to justify independent practice.