Ala. Admin. Code r. 540-X-11-.07

Current through Register Vol. 43, No. 1, October 31, 2024

Section 540-X-11-.07 - Procedure And Device Requirements For Physicians And Delegates

Physicians and delegates involved in the use of LLBDs must complete a minimum number of procedure/device-specific training hours, a minimum number of observed procedures, a minimum number of supervised procedures, and a minimum number of cases under supervision as set forth below.

(1) Ablative Laser Skin Resurfacing:

(a) Prior to performing procedures with any category of LLBD, physicians must complete eight (8) hours of training in the device or device category, unless the physician received training on the device in residency, in which case only four (4) hours of training are required.

(b) Level 1 and 2 Delegates shall not perform these procedures.

(2) Non-Ablative Laser Photorejuvenation:

(a) Physicians must complete eight (8) hours of training on each device unless he or she received training on the device in residency, in which case only four (4) hours of training are required.

(b) Level 1 Delegates must complete twelve (12) hours of training on each device, which includes observing the procedure performed by a trained physician and performing ten (10) cases under the direct supervision of a trained physician. After twenty (20) cases have been performed with a physician seeing a patient prior to the procedure, a Level 1 Delegate may treat a patient without a physician seeing the patient at the initial and each subsequent visit.

(c) A Level 2 Delegate must complete twenty (20) hours of training on each device, which includes observing the procedure performed by a trained physician or Level 1 Delegate, and performing fifteen (15) cases under the direct supervision of a trained physician. After twenty (20) cases have been performed with a physician seeing a patient prior to the procedure, a Level 2 Delegate may treat a patient without a physician seeing the patient at the initial and each subsequent visit.

(3) Intense Pulsed Light (IPL) and Broad Band Light (BBL):

(a) Physicians must complete eight (8) hours of training on each device, unless he or she received training in residency, in which case only four (4) hours of training are required.

(b) Level 1 Delegates must complete twelve (12) hours of training on each device, which includes observing the procedure performed by a trained physician and performing ten (10) cases under the direct supervision of a trained physician. After performing twenty-five (25) supervised cases, a Level 1 Delegate may treat patients for subsequent patient visits without direct supervision by the physician after the physician sees the patient in consult. After performing fifty (50) cases, a Level 1 Delegate may treat patients without direct supervision by the physician for the initial consult and patient consent.

(c) Level 2 Delegates must complete twenty (20) hours of training on each device, which includes observing the procedure performed by a trained physician and performing fifteen (15) cases under the direct supervision of a trained physician. After performing twenty-five (25) supervised cases, a Level 2 Delegate may treat patients for subsequent patient visits without direct supervision by the physician after the initial patient consult and consent, provided that the physician shall review the device settings for cases 26 through 50 prior to treatment. After performing fifty (50) cases, a Level 2 Delegate may treat patients for the initial treatment visit and subsequent visits without direct supervision by the physician after the physician has seen the patient in consult and consent.

(4) Photoepilation/Laser Hair Removal, Vascular Conditions and Lesions, and Pigmentary Conditions:

(a) Physicians must complete eight (8) hours of training on each device, unless he or she received training in residency, in which case only four (4) hours of training are required.

(b) Level 1 Delegates must complete twelve (12) hours of training on each device, which includes observing the procedure performed by a trained physician and performing ten (10) cases under the direct supervision of a trained physician. After performing twenty-five (25) supervised cases, a Level 1 Delegate may treat patients for subsequent patient visits without direct supervision by the physician after the physician sees the patient in consult. After performing fifty (50) cases, a Level 1 Delegate may treat patients without direct supervision by the physician for the initial consult and patient consent.

(c) Level 2 Delegates must complete twenty (20) hours of training on each device, which includes observing the procedure performed by a trained physician and performing fifteen (15) cases under the direct supervision of a trained physician. After performing twenty-five (25) supervised cases, a Level 2 Delegate may treat patients for subsequent patient visits without direct supervision by the physician after the initial patient consult and consent, provided that the physician shall review the device settings for cases 26 through 50 prior to treatment. After performing fifty (50) cases, a Level 2 Delegate may treat patients for the initial treatment visit and subsequent visits without direct supervision by the physician after the physician has seen the patient in consult and consent.

(d) A solitary pigmented lesion shall be evaluated by a physician prior to any treatment with an LLBD device.

(5) Tattoo Removal.

(a) Physicians must complete eight (8) hours of training on each device, unless he or she received training in residency, in which case only four (4) hours of training are required.

(b) Level 1 Delegates must complete twelve (12) hours of training on each device, which includes observing the procedure performed by a trained physician and performing ten (10) cases under the direct supervision of a trained physician. After performing twenty-five (25) supervised cases, a Level 1 Delegate may treat patients for subsequent patient visits without direct supervision by the physician after the physician sees the patient in consult. After performing fifty (50) cases, a Level 1 Delegate may treat patients without direct supervision by the physician for the initial consult and patient consent.

(c) Level 2 Delegates must complete twenty (20) hours of training on each device, which includes observing the procedure performed by a trained physician and performing fifteen (15) cases under the direct supervision of a trained physician. After performing twenty-five (25) supervised cases, a Level 2 Delegate may treat patients for subsequent patient visits without direct supervision by the physician after the initial patient consult and consent, provided that the physician shall review the device settings for cases 26 through 50 prior to treatment. After performing fifty (50) cases, a Level 2 Delegate may treat patients for the initial treatment visit and subsequent visits without direct supervision by the physician after the physician has seen the patient in consult and consent.

(6) Non-Laser Skin Rejuvenation:

(a) Physicians and Level 1 and 2 Delegates must complete official certifying training by the device manufacturer or be trained by a physician certified by the manufacturer to use the device.

(b) Level 1 and 2 Delegates must complete eight (8) hours of training on each device, which includes observation of five (5) area-specific treatments by a trained physician and performing ten (10) treatments under the direct supervision of a trained physician. After completing ten (10) treatments under direct supervision, a Level 1 or 2 Delegate may complete ten (10) additional treatments without direction supervision by the physician, provided that the physician reviews the treatment plan and device settings prior to the treatment. After performing twenty-five (25) supervised cases, a Level 1 or 2 Delegate may consult, consent, and treat patients without direct supervision by the physician. Thereafter, treatments may be performed under locally remote supervision.

(7) Endovascular Radiofrequency and Laser Ablation (EVLA):

(a) Physicians must complete eight (8) hours of training on each device within a residency or fellowship program.

(b) Level 2 and 3 Delegates shall not perform these procedures.

(8) Laser-Assisted Liposuction (LAL) and Power-Assisted Liposuction:

(a) Physicians must complete eight (8) hours of training on each device within a residency or fellowship program.

(b) Level 2 and 3 Delegates shall not perform these procedures.

(9) Laser-Assisted Surgery

(a) Physicians must complete sixteen (16) hours of training on each device within a residency or fellowship program.

(b) Level 1 and 2 Delegates shall not perform these procedures.

Ala. Admin. Code r. 540-X-11-.07

New Rule: Filed August 16, 2007; effective September 20, 2007.

Amended by Alabama Administrative Monthly Volume XLI, Issue No. 08, May 31, 2023, eff. 7/15/2023.

Previous Rule .08 was renumbered .07 per certification published May 31, 2023; effective July 15, 2023.

Author: Alabama Board of Medical Examiners

Statutory Authority:Code of Ala. 1975, §§ 34-24-50, 34-24-51, 34-24-53.