There are two points that we can never reiterate enough regarding MedSpas: (1) they are medical practices and (2) many of the services they render are considered the practice of medicine.
Accordingly, it is a crucial first step for MedSpas to establish the physician-patient relationship and ensure that a MedSpa patient is a good candidate for the procedures he or she is seeking. This is the purpose of the good faith exam. Good faith exams go by many names, and in fact, the term “good faith examination” has been replaced in many states’ laws. It is common to hear the good faith exam referred to as the “initial exam,” “physical exam,” or “initial consult.” Regardless of the nomenclature, it is important to remember that the good faith exam is an encounter that must happen before a patient receives a treatment to assess their current condition, note their medical history, and ensure they are fit for the procedure. The goal of the good faith exam is to make a diagnosis and determine an appropriate treatment plan for the patient.
Here’s what you need to know about the good faith exam:
Who Can Do It? The good faith exam must be performed by a physician, physician assistant (“PA”), or advanced practice nurse (“APN”). Typically, the PA or APN must be delegated the ability to perform good faith exams by their supervising or collaborating physician. Registered nurses (“RN”) may aid the physician, PA, or APN in administering the good faith exam, but they cannot generate orders for treatment based on the exam. A physician, PA, or APN would need to review the RN’s findings and generate the treatment plan and order.
What Constitutes a Good Faith Exam? The good faith exam proceeds in two parts: (1) obtain a patient’s medical history and (2) perform an appropriate physical examination of the patient. The medical history is a brief account of the patient’s general lifestyle, medical events, and on-going treatments that may contain relevant information regarding the patient’s health. The appropriate physical examination is an assessment of the patient’s physical condition, generally and specifically, of the areas where the patient will receive treatment.
When Does the Good Faith Exam Need to Be Performed? The good faith exam should be performed prior to a patient receiving a treatment for the first time, but it does not have to be performed every time you see the patient. Especially in the MedSpa context, a treatment plan will likely encompass multiple treatments over a period of time. If a patient seeks additional treatments not covered in the initial treatment plan, the patient’s health substantially changes, or enough time has elapsed since the initial good faith exam, a new good faith exam should be performed. It is a good rule of thumb that a good faith exam should be performed at least annually on a patient.
If you have any questions on the good faith exam, patient intake, or treatments constituting the practice of medicine, email us at firstname.lastname@example.org.