Unauthorized medical spa operator tests state law on remote supervision

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Medical spas are booming in Wisconsin, but are the safety rules up to par? FOX6 investigation reveals a loophole in state law that could allow unlicensed providers to perform medical procedures without a doctor in sight.

At Regenesys Laser & Wellness in Sheboygan there are no doctors in the clinic. Yet, they claim to perform thousands of cosmetic laser treatments each year, including laser hair removal. State law states that laser hair removal is a medical procedure that can only be performed by a physician or someone supervised by a physician.

But what exactly does it mean to “supervise” a medical procedure? Experts say the answer could have far-reaching implications for your safety.

They are partly day spa and partly medical clinic. And there are now over five thousand across the United States.

“It’s a booming industry,” said Barbara Zabawa, founder of the Center for Health and Welfare Law.

Medical spas – or medi-spas for short – are among the fastest growing segments of the healthcare industry.

“It’s kind of a gold rush,” said Bryan Polcyn, FOX6 investigator.

“It’s totally a gold rush right now,” said Amy Brunner-Koch, owner of Aspen Medical Aesthetics and Laser Clinic in Méquon.

Amy Brunner Koch

“It is to the patient’s benefit to seek out a medically supervised medi-spa,” she said.

Aspen’s most requested treatment is laser hair removal.

“Everyone wants to do it,” Brunner-Koch said.

She tells potential clients that this is a low risk procedure, as long as it is performed by well-trained and licensed professionals. Without adequate training or supervision, the American Board of Laser Surgery (ABLS) says the procedure could leave a patient with permanently discolored skin or, even, burns.

And that’s why Brunner-Koch says Aspen only uses licensed estheticians, nurses, and medical assistants to perform the treatments. It requires each of them to undergo extensive training. And, perhaps most importantly, she keeps a doctor on the staff of the building.

“Our doctor watches all the protocols, he writes them down, and then goes through the settings with all of us,” she said.

And Dr Warren Seiler says that’s how it should be.

“The doctor must be on site, readily available,” the doctor said.

Dr Seiler is Executive Director of ABLS, which released a 2016 report calling for increased training and supervision of licensees who perform various cosmetic procedures, including laser hair removal. In his home state of Alabama, he says, state law is clear.

“The doctor has to see the patient first,” he said.

Dr Warren Seiler

Wisconsin law requires that laser procedures be supervised by a physician who can supervise the work. But state regulators say those terms are undefined.

“What exactly does ‘supervision’ mean? Dr. Seiler asked. “It’s incredibly vague.”

And that brings us to Aaron Gabrielse.

“I am an expert,” Gabrielse said.

In fact, according to one of his company’s websites, Gabrielse claims to have performed over 70,000 procedures in a 22-year career.

That’s almost nine procedures a day, seven days a week.

And yet Gabrielse is not a doctor. Instead, he says he “works under the license” of a doctor who is hardly ever in the same building.

Gabrielse owns Regenesys laser and wellness in Sheboygan, Wisconsin. The man he pays to be his “medical director” is Dr Jonathan Cotter in Wausau. It’s a two and a half hour drive from ReGenesys.

All of this is information that Gabrielse volunteered when FOX6 Investigators sent a producer into ReGenesys with a hidden camera.

“He comes to our office once a year,” Gabrielse said of Dr Cotter. “But he’s not in the room, no.

Gabrielse said Dr Cotter didn’t need to be there. He just needs to be confident that Gabrielse is doing a good job.

“A doctor wouldn’t let you work under his license, especially remotely like I do, if he didn’t believe you weren’t going to do something stupid and make a mistake.”

Dr Cotter says Gabrielse “always does a good job” and the two “communicate often” on a “mostly remote basis”.

In an email to FOX6 News, Dr Cotter wrote: “I don’t think the scarcity of on-site attendance has compromised the quality of care.

Industry executives are not so sure.

“Does that sound like sufficient supervision? Asked FOX6 investigator Bryan Polcyn.

“No,” Dr. Seiler said.

“I would say it’s very light supervision,” Zabawa said, “and I would be uncomfortable with that arrangement.”

Lawyer Barbara Zabawa founded the Center for Health and Wellness Law in MacFarland, Wisconsin, to help providers – including medical spas – navigate the patchwork of rules and regulations that apply to everything from injections to Botox with cryotherapy, chemical peels, micro-needle and laser treatments.

“We don’t have any real formal direct guidelines,” Zabawa said.

Barbara zabawa

The Wisconsin Department of Security and Professional Services – or DSPS – admits that some of these rules are “subject to interpretation”.

“The law has a lot of ground to catch up,” Zabawa said.

During a phone call with FOX6 News, Gabrielse said he actually wanted more regulation of laser services in Wisconsin. However, he would only agree to talk about it on camera if we agreed not to ask about one thing – his 2006 conviction for prostitution. FOX6 did not agree with these conditions, so Gabrielse declined our request for an interview.

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Fifteen years ago, Gabrielse posted an ad on Craigslist offering to trade laser hair removal services for “all-in” services, including sex. He told an undercover police officer that she could provide him with “sex services” for $ 250 to $ 300 an hour until her balance of $ 2,500 in laser services was paid off.

They agreed to meet at a local hotel where officers arrested Gabrielse. They discovered that he had hidden a video camera on a chair under a desk. It was recording.

“It’s not OK,” said Kim Dietz, a massage therapist who previously worked in the same building where Regenesys is located – a building now owned by Gabrielse and his wife.

Kim dietz

Dietz came to FOX6 earlier this year in hopes of educating the public about Gabrielse’s unauthorized practice and his conviction for sex service.

“If you were caught trying to swap massage services for sex, what would happen?” FOX6 investigator Bryan Polcyn asked.

“I wouldn’t have a license,” Dietz replied. “I would have to find another job.

DSPS never took any action against Gabrielse.

“Because he doesn’t have a license!” Said Dietz. “This is the problem.”

Gabrielse is not a doctor, nurse, esthetician or cosmetologist. In reality, according to a database of state professionals, he has no license at all.

But does he need it? DSPS declined to answer because, according to a spokesperson, this question concerns a pending complaint against Gabrielse – a complaint filed by Dietz.

“It’s just disturbing that he’s allowed to keep doing what he’s doing,” she said.

She filed the complaint in January, then asked the state for an update in May. It was only after FOX6 began asking questions that the DSPS officially opened the case for investigation on August 31.

“If it’s the Department of Safety and Professional Services, I guess I would expect more,” Dietz said.

Dr Seiler says Wisconsin needs to better define what it means to supervise a laser procedure.

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“This is where their problem lies,” said Dr Seiler. It has already helped other states improve their rules and regulations.

“It’s not a difficult business to update,” he said.

But it’s increasingly important, he says, as more and more people put their skin in the game.

Gabrielse tells FOX6 he is ashamed of the actions that led to his conviction in 2006. He says he made amends and is still married to a woman who supported him.

As for his medical director, Dr Jonathan Cotter claims he was unaware of the sex affair for laser services until now. He called it “very disturbing”, but said it “contrasts dramatically with the exemplary and honorable way Aaron has always shown me.”


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