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Med Spa Success Strategies
Med Spa Legal Roundtable: Ghost Medical Directors, Compliance Pitfalls & Competitor Reports
00:42:03
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- [00:02]
A
Welcome to MedSpa Success Strategies. I'm your host Ricky Shockley with MedSpa Magic Marketing. And this is where med spa and aesthetics practice owners come to discover strategies and tactics that help them better market and manage their practices so they can grow, improve profitability and have greater impact for their teams, their patients and their communities. Today I'm excited to be joined by Samara and Sarah. Samara Bell and Sarah Schickman both come from Legea Law where they help healthcare providers navigate the legal side of growing a practice. Samara is an attorney focused on transactional and strategic work with a specialty in mergers, acquisitions and partnerships for physicians, dentists, veterinarians and other medical providers. She earned her BA from Colgate University and her law degree from Suffolk University Law School. Sarah is a healthcare lawyer and entrepreneur with more than 16 years of experience. She and her team have guided over a thousand clients through contracts, intellectual property funding and regulatory hurdles. And she's led several multimillion dollar ventures herself, including a med spa that grew from a single room to over 12 locations, generating more than $13 million a year. Together they bring both legal expertise and the operator's perspective to building and scaling a health care business. Samara and Sarah, excited to have you on the podcast. I know today our roundup is going to be mostly legal related things, legal and compliance. There's a lot going on in the space. So one of the first things we wanted to talk about today was the stuff that's going on around medical supervision. And I actually had a follow up question on this already for both of you that I'm already thinking of that came up in a different conversation, but I guess just the synopsis on what you're seeing across the landscape right now when it comes to regulating medical supervision in med spas across the country.
- [01:39]
B
Yeah, I mean it's definitely a hot topic. We're seeing a lot of enforcement. We're seeing issues where people have a medical director, they sign a contract and they don't see them again, not good. You know we're seeing, it's, you can't just do that anymore. Right. The medical director, you know, they should come visit you once a month, something like that. You know, they need to be reviewing a minimum number of charts. You know, it's not just kind of a ghost physician. Right. And you know it's everything's really state specific too. So depending on the procedures you're doing, you know you want to check and so with attorney on your state guidelines, you know what some things, who do you need on Site, you know, what supervision do you need for that? Certain lasers, things like that, and different medical procedures with that.
- [02:27]
A
How are practices? I don't know, maybe everyone feels like they already have a pulse on this. But how do you find the practices do with actually keeping up with it since it is state specific and things are changing? Do you find that a lot of times when stuff pops up, business owners don't even really know that they're doing anything wrong? It's kind of a surprise to them?
- [02:44]
B
Yeah, all the time. I mean, we have a lot of clients who generally want to do the right thing. You know, these aren't people who are looking for workarounds or shortcuts. They want to do the right thing. And, you know, it's one of those things. You ask ChatGPT and you get four different answers. And so it's, you know, it's, it's really hard to keep up. You know, we're, it's our job to keep up with it. And so, you know, we're kind of in the know that way, but it's, it's hard to even find the answer. And there's a lot of misinformation. We have, you know, plenty of clients are like, my friend told me I, you know, I don't need a medical director to do this or, you know, I'm allowed to do this procedure and it's just kind of really hard to know what's.
- [03:23]
A
What are you finding? Is there any sort of common thread so smart you mentioned like, like making sure the medical director comes out once a month. Are there any common things that. I know there's a lot of state specific regulations, but you feel like are the big ones that are broadly applicable just across the country that are checklist items for probably everybody listening?
- [03:41]
B
Yeah, I mean, the medical director needs to be available, you know, by phone at least any emergencies, adverse events, for sure. You know, they should be reviewing a minimum number of chart. We usually say 10% per quarter, something like that. You know, assisting with protocols. You know, those are kind of the main things that don't really change too much state by state.
- [04:07]
A
If you had to ballpark it. How many practices do you think are doing that? Those three things?
- [04:14]
B
That's a tough question.
- [04:16]
C
Not many.
- [04:18]
A
Yeah. So it's just been something that's kind of like an unspoken, there's just been like not real accountability around it.
- [04:26]
B
Yeah. And a lot of times, you know, people know about it because unfortunately they've gotten in trouble and the board has come and said, hey, you're not doing this and they, they didn't know they should be doing that. Right. But it's, it's definitely on the low end of, you know, practices who, who know and are doing the right thing.
- [04:45]
A
Yeah, that's always kind of been my surface level knowledge of these relationships is it always felt like the medical directors like, I don't know, just like agreeing to license their face for a picture of the website, and then that's pretty much it. Are, Is there ever a challenge, if people do want to go and start doing this a little bit more by the book, that their medical director is actually not even equipped to do those things or they're not realistically going to be willing to, like, be on call if there's a medical emergency, for example.
- [05:15]
B
Yeah, I mean, I think it's a conversation to have upfront with your medical director and so to get on the same page and say, hey, here's what the gig looks like, you know, so they, they understand, you know, there are plenty of, you know, the physicians, medical directors out there who think it's just kind of a monthly paycheck and, you know, see you and I see you. But I think it's, you know, having that meeting of the minds in the beginning, and so they're not surprised when you're calling them and you have a real issue.
- [05:43]
A
Yeah. Do you find that that's a struggle with their availability if they are doing other things that they're just not even able to serve that function properly?
- [05:52]
B
Possibly. I mean, there are definitely plenty of medical directors who know, don't care, head in the sand. Right. But then there are others who are, you know, genuinely happy to be medical directors, and they, and they know what it entails. And there are some, you know, really great medical directors out there. Maybe they get a bad rap sometimes as a, you know, kind of occupation is the right word. But, you know, there are plenty that understand and do the right thing.
- [06:16]
A
So if. Go ahead, Sarah, were you going to say something?
- [06:18]
C
Yeah. And we see sometimes online, it's almost like a race to the bottom where people are saying, who has the cheapest medical director in North Carolina? Can I find I'm paying 300, and some other person's like, I'm paying 200. And they're like, I have a medical directorship company, you know, where we, if we sign up 10 people, you get a $50 credit. So all those types of models at the end end up getting people in trouble because you're paying your medical director $300 a month. You can't really expect them to come to your practice or review any significant number of charts.
- [06:51]
A
Yeah.
- [06:52]
C
And the regulators, when they see a copy of your contract and they see that you're paying this person $300, they realize what it is. So if you're in this kind of situation, what we advise clients is to, like Samara said, have an honest conversation with the medical director, say, oh, like our, you could blame us. Our attorneys told us you need to be more involved. This is what's needed. And then the medical director may say, okay, well this is not for me. Or they may say, okay, well instead of $300 a month, I need to charge you 600 hundred or, or a thousand or whatever. But you're going to be much more compliant then, so it's going to be worth the investment.
- [07:31]
A
Yeah, that makes sense. How do, how do businesses generally get in trouble? Like, how do these things get flagged? How real is the threat? I think, I think you have two different kinds of people. You have people like me that they feel like if I even know this threat exists, it feels imminent and like it's at my doorstep. And then other people that feel like it's a one off and it's never going to happen to me. So I guess first thing is how real is the threat of regulators coming and knocking across the country?
- [07:56]
B
Yeah, I mean it's, it's, you know, definitely a real threat. We see it all the time. Sometimes it's a competitor who's kind of tattling on you, which is unfortunate, but it happens. You know, other. Sometimes we see like New York City, they just did, you know, recent, the last few months investigations, just blind investigations, just kind of, you know, walking into med spas undercover and seeing, you know, what they find. So it's, it's certainly a real threat.
- [08:26]
A
And so if you do find yourself facing this and you haven't been as buttoned up as you should have been, do you have general guidelines and recommendations for sort of how to proceed next steps? Because I'm sure that's a scary moment for a lot of people, especially if they're not aware they've even been doing anything wrong and they start to realize there's maybe an issue that's been flagged.
- [08:46]
B
Yeah, I mean, the good news is it's, it's all fixable. Right. And so, you know, when we have existing practices, what we do is kind of like first a mini compliance audit. Like, hey, are you doing good faith exams? Hey, are you paying your medical director flat fee? You know, some kind of bullet point Items, you know, is your insurance tight, things like that, you know, to make sure. I know that it can be overwhelming, and I hear that, you know, from clients a lot. But I think you'll have the peace of mind once you just correct some things. And then it's just maintaining it in the future. So, you know, that's kind of the easiest way to think about it. That's not so overwhelming.
- [09:23]
A
So is usually that first step from regulators is like, slap on the wrist, get it together. It's not so much like, close your doors, we're putting the chains on, nobody's coming in here anymore.
- [09:34]
C
We've had first valuations be like, here's your fine, it's over a hundred thousand dollars.
- [09:39]
A
Oh, geez.
- [09:40]
C
So it just depends on what they find. Like in some states, if they find, for example, research use only peptides, they will find you per vial that they find in your practice. In some states, if there's a patient complication, like, so not a competitor complaint, but a real patient complication, and the patient or their family files something against you, they may come and as the first step, say, okay, this is a stop order for your practice. So it could be pretty serious right away too.
- [10:12]
A
Interesting. On that same note, you both mentioned this idea of competitors sometimes flagging that this is going on if they have like a suspicion. I have a random question. I guess. How many times is the competitor just fishing to send the auditors out there just to see if they're doing anything wrong versus actually having some sort of an instinct that there is something going wrong? So this kind of ties into the idea of the cyber harassments that I saw on your social media feeds that you see businesses trying to bully and harass other businesses.
- [10:43]
C
Yeah, I think, look, in a lot of states you could do anonymous reporting. And so people report each other for good reasons and bad reasons all the time. In the states where anonymous reporting is allowed, we see a lot more cases. And because the investigators don't have to tell you who initiated the complaint, sometimes they do. Sometimes we've had people be kind of, I don't want to say dumb enough, but weirdly, a competitor would put their name on the complaint, maybe by accident, maybe they thought it was going to be confidential. So we've had that those situations too. So yeah, I think it happens a lot with competitors. It happens a ton with disgruntled employees or ex employees. Those are the main two. Not patients for sure. And the investigators treat these complaints similarly. It's not like they just drop it right away because they Think it's a competitor.
- [11:41]
A
Yeah. So. So the three things that everybody needs to make sure they're doing or make sure your medical director is actually coming out and visiting the office. How many, how many people do you think are doing that? Is that maybe I'm not just aware of this. Is that pretty common that medical directors are actually visiting the offices? Or is it that a lot of people are operating beyond the technical boundaries of the relationship and not really doing that?
- [12:05]
B
I'd say the latter.
- [12:06]
A
Yeah. That's a lot of it.
- [12:09]
B
Yeah.
- [12:09]
A
So that is a good checkbox then. Like an action item for people listening is like make sure that is it once a month. Is that the cadence? That kind of is. Usually puts you in a safe place. Monthly.
- [12:19]
C
Once a month would be great. Even once a quarter would be very good. So like at the minimum, once per quarter, but once a month would be great. And then documenting each visit, like sending an email and saying thank you for coming by today or thank you for being on Zoom with us today. For example, make it in person just so you have this documentation so that if there's a problem, you could show. Well, These are the 10 times the medical director was here.
- [12:44]
A
And then you mentioned auditing 10% of charts. Is that a pretty standard thing across the country that most people should be doing that? They probably aren't.
- [12:53]
C
Yes. And depends on the state. But in the states where there's some medical director supervision required, especially in the states that don't have full practice authority for nurse practitioners. In the states where the corporate practice of medicine is prohibited. Yeah, I would say in those situations it would be good for the medical director to review at least 10% of charts. They don't have to review them every single day. They can just do a random selection once a month or once a quarter. But it would be a good, a good practice. Many states, though, don't have a law that says 10% or 9% or 11%. It's just a best practice. So it's not like, okay, if your medical director reviewed 10%, you're automatically compliant, or if they only reviewed 9%, you're not.
- [13:39]
A
Yeah. So just a general rule of thumb, but do something, have them have some sort of a pulse on eyes on it. And I think the last one was, of those three, those first three was they have to be on call in case of a medical emergency. Do you recommend having that documented somewhere that they have an agreement that like they are reachable or is it just sort of as long as you have a medical director, you assume that that's the case.
- [14:01]
C
Yeah.
- [14:01]
B
I mean, that should be in your medical director agreement. It should be in your protocols, too, that, you know, something happens, you can reach the medical director, and that should be, you know, one of your first
- [14:11]
A
calls who's usually creating the medical director agreement. So we have a business associates agreement that we send to clients, and we're the ones that usually originate the doc, who actually originates the medical director agreement. Is it the practice's responsibility or is it typically the medical director's responsibility?
- [14:27]
C
Whoever acquired a lawyer. Sorry.
- [14:29]
B
Yeah, yeah, go ahead.
- [14:31]
C
I think we have the same answer. I mean, it's like whichever party is the one that's investing in legal services and wants to be protected is. You're usually the one presenting the medical director agreement to the other. So the advantage of having a lawyer on your side is you have a document that favors you. So if you're, let's say, the management company, and you're hiring the medical director company, and you're doing this whole PC, mso, MSA structure. So the medical director's PC is hiring the MSO for management services. Right. And then the medical director is going to be working for the PC as a medical director. Maybe I'm getting too technical, but there'll be this agreement between the PC and the medical director, and you want that agreement to be as broad as possible. If you're the one hiring the medical director, you want them to do as much as possible. So. So if you have the lawyers on your side, that's the kind of agreement you're going to present to the medical director. But if you're the medical director, you may say, Well, I have 20 practices that I'm managing. I want to put the bare minimum here. Maybe I want to do. I want to do more, but on paper, I don't want to commit to more. So it just depends on who's the one hiring the lawyers.
- [15:43]
A
So in reality, if both people were doing their due diligence, it's sort of a contract negotiation, and you're trying to find the middle ground that both people are happy with. But a lot of times it's one person or the other that's initiating it to make sure that other I's are dotted and the T's are crossed. It sounds like, yeah. How many people are operating without those agreements? Is that a pretty common thing? People have a medical director, but it's sort of a handshake deal that they have a medical director, they pay them, and they assume that the invoice is proof of agreement. But there's not actually an agreement.
- [16:10]
B
Yeah, definitely. Plenty of people. I mean, they come to us maybe because, you know, something happened. Right. And they have questions and they have nothing on paper for, you know, what, what, what the answer is. And it's definitely best practice to have a written agreement.
- [16:26]
A
Awesome. This is something we hadn't talked about, so if this is totally out of left field, we can skip it. But I have a podcast guest coming up that's talking about the concept of accreditation. And there are some companies that are doing accreditation now. Are you all familiar with that and what goes into accreditation? Is that something you recommend or. I'm just vaguely familiar with it recently.
- [16:44]
C
Yeah. I think the accreditation is only as good as the accrediting body. Right. So there is no accreditation law that says your med spa has to be accredited. And many people can form an accredited, an accreditation society or company that say, okay, we're going to issue the credit, the accreditation. You know, you pay us x amount of money and we'll inspect you. Or maybe it's free for the first few. So there are lots of companies kind of trying to get into that space, but it remains to be seen how persuaded by that the regulators will be. Because at the end of the day, that's not like a legal thing that they're getting. It's more like a strong marketing thing.
- [17:29]
A
Got it. Yeah. Like we, like, we use a company for HIPAA compliance, but they're not actually a legal entity. They're just an accreditation service. Same kind of thing.
- [17:37]
C
Same kind of thing.
- [17:39]
A
Interesting.
- [17:39]
C
All right, may have some kind of insurance. Right. So if they're certifying that you're HIPAA compliant, for example, and you're actually not, then a claim could be filed with them saying they falsely did something. Right. But most of the time, like, you probably are HIPAA compliant and there's probably no problem. So they don't really take on that much liability.
- [18:00]
A
Makes sense. Was there anything else on the cyber harassment side other than just people reporting each other? Was there something more to that or was that the gist of
- [18:09]
C
talk a little bit about that. It's such a crazy situation, really, because there exists these rules from the medical boards and the nursing boards that talk about professionalism and not harassing or bullying your colleagues in any way, including online. But today there's this kind of. I think people have realized that if you post content online that's defamatory in some way or salacious saying, like, oh, this person did this treatment, it was all wrong, or this, this device is all, you know, messed up. That gets you lots more views, lots more followers than if you just post like, oh, here's a before and after picture of beautiful lips. So I think people have realized this and they're like, okay, look, let me post like the 10 horror stories I saw last week. So I think a lot of that is happening. But what people are not realizing is let's say like someone posts online about the bad practices of somebody else and let's say God forbid that person who was posting the bad practices of other people gets into some, some trouble for any reason. What they post about other people will be used against them. They're going to say, oh well, you had a complication yourself. And here you posted saying good injectors don't have these kind of complications. So you yourself said that this makes this essentially means that you're guilty of whatever we're accusing you of.
- [19:30]
A
What do you say?
- [19:32]
C
So people have to be really careful with this stuff.
- [19:34]
A
Yeah, everybody's just rage baiting for views.
- [19:37]
C
Yeah, exactly.
- [19:40]
A
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- [22:02]
B
Yeah, I mean, I think, you know, kind of where we were this time last year. It's, it's very different. You know, there were some major lawsuits that the manufacturers lost in the fall. And you know, it's really making sure you have, you know, proper consent, proper paperwork in place, you know, knowing where you're getting GLP1s from. But otherwise, you know, we're, we're seeing a lot or way fewer cease and desist letters from manufacturer attorneys. And it's kind of, you know, the landscape has calmed down in terms of, you know, enforcement is the right word but, but it's, you know, it's still crucial to have the proper paperwork and consents in place for sure.
- [22:47]
A
But, but in terms of like the compounding and regulations and the fear around, like where are we sourcing? I think one of the conversations I had last year was in order to source the product properly, we might have to adjust where we have like some sort of a modification where it's not the exact version of the, that the pharmaceutical manufacturers, all of that sort of off the table, it's back to status quo and there's really not as much going on there. So it's sort of operating within the norms that it was 18 months ago in terms of how People are sourcing product and the risk of regulation around sourcing product.
- [23:18]
B
Yeah, I mean it's definitely, definitely reduced risk now you know, you want to make sure you have patient reasons in your, in your charting and documentation that way as well is another thing. But you know, otherwise it's say compared to where it was calmer.
- [23:35]
A
Now is there anything upcoming that like, that is pending like the, in the legal system or in the courts right now that could change any of that or is it sort of settled as is for now and just seeing how things go for the next however, so long?
- [23:51]
B
Yeah, I mean it's, it's always evolving. Right. So it's, you know, always something can, can pop up. And so we are kind of in a wait and see holding pattern I would say at this point.
- [24:03]
A
You all did mention auditing your sources, making sure that you have a feel for where can you talk a little bit more about that auditing where you're sourcing product from.
- [24:13]
C
Yeah, so a lot of times people are buying things from the cheapest place, which of course has some financial advantages in the short term, but in the long term could have some pretty serious consequences. So if you are going to get GLP1s or other peptides, definitely get them from a pharmacy, not from some weird unlicensed distributor and confirm that the pharmacy is actually licensed to ship to your state. We've had a lot of situations where clients are buying things GLP1s and other peptides from pharmacies or alleged pharmacies. And actually it's not a pharmacy or it is a pharmacy and it can't ship to for example California or Illinois or Texas. So just make sure ask your pharmacy for a copy of their license to ship to your state and don't buy from, from non pharmacy sources. And then of course you can get a certificate of purity from these places. But again like it's hard to, to trust those certificates. Like they, they're only as good as the company that's set that's sending you the, the paper and those papers could easily be forged. So there are these third party verification companies where you could essentially let's say you buy, if you're buying enough volume, let's say you buy 100 vials. You would send one vial to this third party testing company and they would come back to you and say okay, is this actually what it is? And does it have any problems? So people have been doing that, but it's also, it's kind of a, it's an evolving field because the FDA still trying to curtail compounding of the ones that are not in shortage anymore. So the Tirzepatide and semi glutide and while they're trying to make it stop, it's still happening very much full force. But we have seen like big cases of companies getting in trouble, like medv for example and a few others who are doing like huge 50 state distribution of, of GLP1s.
- [26:15]
A
Yeah, interesting. You. So we talked a little bit about these different states have different regulations highlight real, not specific necessary to GLP1s. But with all the stuff that's going on across the country, are there any cases or any things in specific states that are on your radar that we could run through? Sort of a highlight hit list.
- [26:34]
C
Samara, do you want to talk about maybe Indiana, some of the, some of the other states like that who've issued like new guidance about this?
- [26:44]
B
Yeah, I mean we're, we're starting to see, you know, pharmacy boards in certain states, you know, come out with guidelines and regulations and they're strict. And so you know, a lot of times we see nursing board, we see medical board, but you know, when the pharmacy board gets involved, it's, it's kind of ramping it up. And so I think the trend is, you know, pharmacy boards and states and state guidance with, with peptides. And that's kind of what we're seeing and where it's heading, kind of what state will pop up next. Right.
- [27:22]
A
We don't know anything beyond the pharmacy boards, just like who can practice and changes with requirements for medical supervision. I think I saw some tiles on your all's Instagram feed that hinted at certain things going on across the country. Just the last, I don't know, three to six months in different states beyond just the pharmacy board.
- [27:42]
B
Yeah, I mean one of, one of the big ones I was just thinking about is in New York with NPs in New York. So, you know, right now NPs can, can obtain independent practice authority. And so they, they don't need a collaborative medical director, which, which is a big deal. And so July 1st of this year, the temporary law that allows them to do that is set to expire. And so if it's not extended or if it's not made into permanent legislation, that's a major issue. And NPs would need to pivot. They need to have a formal collaborative agreement with physicians. And so we have a lot of clients who are concerned, hey, is this going to pass or that, you know, what's going to happen with it? Well, if what will be a grace period. Right. If they say we're not making this into law. And so it's, you know, it's a pretty big deal and it can just affect so many people.
- [28:38]
A
Yeah, that's a good one.
- [28:39]
B
Any.
- [28:39]
A
Anything else going across the country? I feel like I've heard things, but maybe I'm just making stuff up. Maybe I'm seeing ghosts here.
- [28:44]
C
Well, in other states, like Indiana, for example, there's a new requirement of a responsible person and that person being on site, and that person can't be an rn. So they're essentially saying an NP or PA has to be on site at all medical spas. So there are, like, new regulations like that. And then Georgia recently came out with. It was interesting, a few weeks ago, Georgia. Georgia's medical board published what they called a advisory memo on existing law. So they kind of said, we're not changing the law, we're just explaining what the current law is. But they made it pretty strict about, like, MSO structures and the medical director being in state and how good faith exams have to be done. And then just less than a week ago, they came out with a new statement saying, okay, we realized we went like, very broadly in there and kind of said a lot of things and a lot. The community is very upset. So now we are re evaluating. And all that happened within like, a span of a month. So I think there's just a lot happening where there are complications happening. Medspas. The. There's tremendous pressure for these boards to act. At the same time, some of them are acting very quickly, and then they get a lot of blowback and they're trying to backpedal.
- [30:01]
A
Yeah, overcorrecting, essentially. And so it's just one of those things that's maybe bubbling across the country to keep an eye out for, make sure you're keeping up. Was there any tool or any place that you recommend for people to keep up with what's going on in their state?
- [30:14]
C
Yeah, they should subscribe to our blog.
- [30:16]
A
I. I put that in the show notes.
- [30:18]
C
I would definitely say, like, we publish a lot of the new regulations that come out. The. It's tricky because the regulations come from many different places. So it's not like there's a central. Because this is all state law.
- [30:30]
A
Yeah.
- [30:31]
C
There isn't like a central database that says, okay, in New York, these are these four places to check. In New Jersey is these three places to check. So the best way is, like, to have to be in touch with a law firm that you're comfortable with and, and listen to what they say on their webinars like this one and their blog posts.
- [30:50]
A
Yeah, we'll make sure we put that in the show notes with the other links as well. One of the things that I had in my notes here that I don't want to forget you mentioned with the GLP1s going back a minute here of, of really practices that want to be super responsible is sending their product out for independent testing to kind of verify it on their own. So that was kind of a cool way to differentiate from marketing standpoint. I know a lot of people are struggling with GLP1s from a marketing and advertising standpoint because it has been so commoditized. Just showing people that you've done your due diligence on some of this stuff I think instills confidence. So do you, do you recommend both of you, like as you're dialing these things in, is there some advantage to communicating it in your website and your marketing so that people do feel more comfortable that you are dotting your eyes, crossing your T's and taking your responsibility seriously or does it seem just like unnecessarily patting yourself on the back for doing the basics?
- [31:41]
C
I think it's both and I'm curious to hear what Samara thinks too on this one. I think, I think it is good to put on your website. You know, we had, we did third party testing and this is pure or whatever. I think even better. One way to really differentiate yourself from these big online players is, is to pair it with some in person program where the person comes in every month, they, you check their weight, they get a free spa treatment. You know, you look at all of their labs and you kind of talk about other vitamins that they could be doing and things like that. So to really pair it with a, like a good in person regimen is what I think helps get away from the 99amonth or whatever. We're seeing some.
- [32:29]
A
Yeah, it's just, it's just become a race to the bottom of just like if you're just rubber stamping the sale of the product, you're not differentiated. It's going to be a challenge either way on the lane of peptides. I haven't talked about this a ton on the podcast and I know I've had people talking about, I know from an advertising standpoint sort of a nightmare to try to advertise because a lot of these platforms don't like you talking about it. But what are you all seeing right now with peptides? What are Some of the challenges and some of the trends on the legal side of peptides.
- [32:57]
B
Yeah, I mean, I think one of the big ones is, you know, can I use research use only peptides? We get that question pretty frequently. And the, you know, the short answer is they're not safe for human use. People don't like that answer. But that is the answer right now, you know, and so, you know, then it's. Well, my friend said they're, you know, things like that, but that it's very clear right now. Right. They're not safe for human use. That's what research use only is. You know, there's, there's kind of a range of different peptides. It's really important to have the right paperwork. You know, having consent if something's not FDA improved having that in your consent so patients have a clear understanding of, of what they're getting. And similar to the GLP1 points that Sarah made, knowing what you're getting, where you're getting it from is couldn't be more important.
- [33:54]
A
Do practice owners know if they're getting excited? I know with anything in the health side of the business right now, everybody's just trying to get excited about the next new thing. And with peptides, I know that's one that's falling into this bucket. When practice owners are even exploring this as an option, do they know if what they're buying is clearly labeled research only?
- [34:16]
C
I think it, there's a lot of kind of shady labeling I would say where. So for example, technically it's supposed to say research use only on the label. But a lot of times when it gets shipped, the suppliers say as a courtesy to you, we put your clinic's name on your, on the. And it covers the research use only piece. Or it would say something which has actually no meaning. That's it would say something like for professional use only or for clinic use only or for provider use only. Again, these are just marketing terms.
- [34:55]
A
Yeah.
- [34:55]
C
They don't really legally change the fact that these are research use peptides. So yeah, I would say if at all possible not to buy those right now because there's just so much viability. If there's patient complication, it's going to be on you to prove that your research use peptide did not cause it and it's going to be really hard to do.
- [35:20]
A
And is that the bulk of the supply right now is technically all these things are supposed to be labeled as research use only?
- [35:25]
C
I mean, yes and no. There are plenty of pharmacies selling them too. Even though they're not really supposed to be. So I don't know. I'm. The bulk of the inexpensive supply is the research use only. But there are certain pharmacies that are also selling them now as well.
- [35:44]
A
But even the pharmacies that are selling them are really operating in a gray area of the law.
- [35:48]
C
Yes. Some of those compounds are not supposed to be compounded right now because they're considered dangerous by the fda. But in July, the FDA is having a hearing on this. And those peptides that Joe Rogan mentioned on his podcast or RFK Jr mentioned to Joe Rogan on the podcast, maybe some of those will get reclassified. But right now many of the common ones, like BPC157 are all considered dangerous by the FDA and they're not supposed to be compounded by pharmacies.
- [36:20]
A
So. So our practices that are doing this, I assume it's pretty common. Like I just googled peptides near me. I see Google results where there's a bunch of people doing it. Are most of those people just running the play of they ask for pretty permission or ask for forgiveness instead of permission and they're just banking on the fact there's no regulation. They're basically just accepting the risk. Like they, there's no version of this that people are doing right now that's just totally green lit.
- [36:42]
C
Correct.
- [36:43]
A
Interesting.
- [36:43]
C
There is no, there is no totally green lit version there. They are going to be asking for forgiveness.
- [36:51]
A
Yeah. So it's a risk tolerance thing. Like, you better have, you better know that you're, you're rolling the dice here by doing this. Yeah.
- [36:57]
C
And look, I mean, we all know people who are doing these things. You know, maybe they work, maybe they don't. But I think that it is, it is risky territory for sure. And we, I'm sure we're going to see cases where there were complications and people are going to get sued.
- [37:13]
A
Yeah. Are there anything else with these just like, other than peptides that you see emerging on the health and wellness space? I know there's a lot of. I feel like a lot of these things are so new that they're really not even proven to do what they're claiming to do? Are there any other legal issues that you see with any other service offerings on the health and wellness side right now beyond weight loss and peptides or not so much?
- [37:38]
C
I don't know. Nothing comes to mind. What about you, Samantha?
- [37:42]
B
Yeah, I mean, peptides are definitely kind of all the rage right now.
- [37:46]
A
Yeah, that's one of those too. Like you said, Sarah do we even know if these things do anything? Maybe they do, I guess to be determined, but. Okay. That's a, that's a level of risk I know I'm personally not comfortable with. If something's. Something's not perfectly greenlight, I'm not do. I'm not doing it. But awesome. Well, that was really helpful. Thanks for doing that roundtable. I think we crammed a lot of different stuff and was there anything we didn't cover that you feel like it's on the radar that practice owners should be aware of in the legal spot side, compliance side.
- [38:16]
C
Let me just look.
- [38:17]
A
Yeah, like anything. I know you're probably dealing with a bunch of random things. I think Samara, I had asked you about. We've noticed these. I think this is maybe really new. I got alerted to this from some of our marketing agency groups. Maybe this is another psa. For what it's worth, in California there are lawyers, you'll remember when the, the big thing was Americans with Disabilities act compliance. And there were like these shakedown requests from law firms for websites that weren't compliant with ADA laws. I guess the new version of this are some of the California privacy laws. And so law lawyers in California, from what I understand, and I got alerted from a marketing agency group and then we had a client get hit with one of these. Literally days later they're using the California privacy laws to, to try to apply it to how websites cookie your information. And I guess the laws were originally like wiretapping laws and so now like cookie consent, it's been alerted to us that like you really need good cookie consent on your websites. Has that been on your radar at all? I know that's pretty new even to our radar. And it's comes up on the marketing side with websites.
- [39:19]
C
Yeah, it's something that we've heard of, especially the big meta chains have been targeted by this. So yeah, a few of our clients are, are facing lawsuits around this. And it's, it's also an evolving field because a lot of them are trying to get these lawsuits completely dismissed because the law was not intended for, for this situation. But yeah, this whole cookie consent and also like who. Like even uploading your audience, for example, into Facebook so they could build a lookalike audience is not good. So yeah, there's a lot of, a lot of things about that. We're updating our templates for those kind of things as part of like our clients membership with us. We have a bunch of templates that they can download. So we're updating our templates to catch up with some of these recent trends with this, because it's definitely a stretch of the law.
- [40:16]
A
Yeah, it seemed like it for sure. If it's any help, the thing that we've been doing is there's a couple plugins not to plug. Not to plug anybody's specific tool, but there's like, Termageddon was one of them. Cookie. Yes, was another one of them. And by default, when you apply these plugins to your website, it doesn't actually load the screen scripts in the proper order. So you think you've got it covered. But the tools that some of these firms are using to try to hunt down these lawsuit threats, if the scripts still load in an improper order before the cookie consent blocks them. So you think you've installed the plugin. I talked to a web designer. He's like, no, we got it covered. And I just put it in Claude, the AI tool. Claude Cowork. And it ran this whole thing. It's like, no, you're actually not compliant because the way the scripts load. So for what it's worth, hopefully that's a little bit of an extra psa. But both of you, thank you so much for joining us. Where can people learn more about the firm they want to work with? You get additional resources. We want to make sure all of these things are in the show notes.
- [41:09]
C
Yeah, they can go to our website, which is Lingealaw.com they could find us on Instagram at Lyngia Law. And we offer free consultations to new clients, so they could always schedule one online and they'll talk to us and hopefully they'll fall in love with us. And even if not, they'll learn something new.
- [41:27]
A
Yeah, if any of you followed the space, you've probably seen their name pop up. So we'll make sure all of those things are in the show notes if you want to work with Samara and Sarah. Thank you both for joining us. Look forward to having you on in the future.
- [41:37]
B
Thank you. Thanks so much.
- [41:40]
A
Thanks, everyone for tuning in. This podcast is a production of medspa Magic Marketing. If your med spa or aesthetic practice is in need of digital marketing services, help with advertising. Advertising on Facebook, Instagram, Google lead generation, and booking more appointments, please visit Medspamagicmarketing.com.