All Training Must be Accredited
Every training course must be accredited for continuing education credits. These credit statements all follow the same general format…
This Activity has been reviewed and approved for 10.0 Credit Hours by (name of joint sponsoring organization). Credits accepted by (AMA Category 1, AANP, AAPA, AANC, ADA) for continuing education.
A missing credit statement or name of the joint sponsor means the course is not formally accredited. Often credits with the AMA Category 1 designation will also be accepted by AANP (for nurse practitioners), AAPA (for physician assistants) and AANC (for nurses). Generally for dentists, the accreditation statement should specifically state acceptance by ADA. Step 5 will summarize the most popular training programs and if they have the required credit accreditation statement listed. Of course, some programs may post credit statements despite the credits being expired, so calling their joint sponsor to confirm their CME coverage can be a wise move prior to investing in a training course.
Isn’t All Aesthetic Training Equal? Are We Not Just Learning Protocols?
Whether you went to a top-ranked medical or nursing school or a local community-based program, you learned largely the same curriculum. Aesthetic Services like Botox® and Dermal Filler Training Classes have much more variability. While you must attend an accredited course, it does not guarantee a quality training experience. In fact, some aesthetic training programs fall far short of any standards of care. This includes all aesthetic training programs that are unaccredited, or focus on teaching treatments as a protocol. Training instead should teach the anatomy, physiology, and judgment needed to design a successful treatment for every patient encounter.
Aesthetic procedures rely on rules and boundaries which must be learned. Yet, protocols have no place in designing aesthetic treatments or selecting the right patients. For example, a procedure as straightforward as Forehead Botox® could have 7 different doses and dozens of different placement patterns. These need to be considered in order to perform the optimal treatment, custom-designed for each individual patient.
Can “Advanced” Courses Actually Make You a Worse Aesthetic Provider?
Become an “Aesthetic Professional” not an “Injector”…
The rampant use of the term “injector” over the last few years identifies a disturbing trend in Aesthetic Medicine. It puts all skilled professionals who happen to do the same injection procedure on the same level, regardless of their experience, skill level, bedside manner, and ability to design and customize a treatment plan. The rise of nurse-run training programs, and nurse-run practices has accelerated this trend as Nurses are 5 times more likely than NP’s, PA’s, MD’s, DO’s and DDS’s to identify themselves as an “Injector”. Nurses are trained to follow rules and protocols in the clinical setting. It is an effective way to ensure that inpatients receive consistent care and monitoring on the way to recovery. But this does not translate well into aesthetic medicine.
Aesthetic Procedures are not Hospital Practice
Nevertheless, a term like “injector” diminishes the procedure to a mechanical skill following a protocol instead of an art. Nurses who train in aesthetic procedures can be very successful avoiding the “injector” and protocol mindsets and focus more on treatment design and variation in the context of each individual patient’s needs. Even if the state rules require a collaborative treatment design, nurses still should train in the same manner as all other aesthetic professionals. This includes the following important aspects of treatment design…
- Normal Anatomy and Function while Focusing on the Anatomical movement or deficit that creates the problem.
- Changes Due to Aging
- Chemical Nature, metabolism and action of injected agents
- Treatment Design and Variations, not maps or protocols.
- Adjusting Treatments based on experience and results
- Knowing boundaries and avoiding complications
- Avoiding “fringe” applications for a procedure that decrease success and increase complications
- Avoiding training that focuses on conveying fancy but meaningless titles like “Master Injector” or “Advanced Injector”
- Finally, avoid all training programs that offer “Basic” and “Advanced” or “Levels 1, 2, and 3”. These skills are not that difficult. There is no reason to unethically withhold information from the basic course just to scam the attendee into paying to learn the “fringe” applications that few patient’s actually want. Many single level trainings include facets of Botox® like Masseters, DAO, bunny lines and brow lift that other “advanced” classes teach. Nobody should take your money a second time to train you in these straightforward, but lesser-performed indications.
Know Who Will Train You
protocol-based training involves reading the course outlines carefully, and knowing who will be in charge of your training and the hands-on supervision. Learning from another aesthetic professional who has many years of experience designing treatments AND supervising nurses and nurse practitioners provides the best training opportunity. Learn from the people who are potentially going to collaborate or supervise you, instead of learning from less experienced peers. Transparency and Legal Issues
Why is This so Important?
The course has an MD Trainer: anyone with proper licensure (See Step 1) can do hands-on training. The MD must be licensed in the state of training and take responsibility for the students who will work “under” him/her for hands-on.
You will have an NP or PA Trainer: NP’s, PA’s, and RN’s can do hands-on training under this teacher assuming the teacher is licensed in the state of training, and has unrestricted ability to perform the procedure in the state of training. If the state requires an NP or PA to collaborate in any way with an MD, that MD must be present or available during the training (varies based on wording of state rules and regulations) and must be listed on the consent form for all patients.
If your trainer is an RN: That trainer’s collaborative MD or NP (some states) who is the provider of record who ordered the toxin or filler for hands-on MUST BE PRESENT to perform the Good Faith Exam on each patient, and must be named on the consent form. An NP, MD, or DDS, cannot receive AMA Category 1 CME credits from an RN educator in a field that RN’s do not routinely practice autonomously. Do not take such a course.
If your trainer is a Dentist: This is the ideal situation if you are also a dentist but problematic for RN, NP, and PA’s since there is no formal supervisory relationship between the professions when providing aesthetic clinical services to patients like you will be doing in hands-on. This is a serious gray area and should be avoided.
