05/04/2026
And this is why, when people ask me if I'd consider being the "medical director" (on paper only of course...)of such a business - whether it's a MedSpa or a business that provides un-necessary at-home IV fluid concoctions - I am quick to say no. Easy money they say.... They are not looking for a medical supervisor, they are looking for a "title", a medical license to make them look legit on paper. They are not considering the legal, ethical or professional responsibility that such a title assigns to the "MD". These places are businesses - all about profit. There's no standard of care. The services they provide may seem benign.... but when something goes wrong, who suffers? The patient. Who's responsible? The M.D. No thank you. Proceed at your own risk.
She walked into a place that called itself a medical spa. Three months later she was still in the hospital, and the prosecutor told her: you went there of your own volition. What did you expect.
The person who almost killed her had no medical training. She had ordered the product off Alibaba. It was contaminated with mycobacterium. She had no malpractice insurance. She had no license to lose. No prosecutor would touch the case. No lawyer would take the civil suit, because there was no money to recover.
That is the aesthetics industry in 2026. It is a 20 billion dollar business. As big as the NFL. And almost nobody is checking who is holding the needle.
Last year, people in 11 states landed in hospitals from fake Botox ordered off the internet. A woman in Texas died at an IV bar when an unlicensed person hung potassium and ran it into her arm like a martini order. There were HIV cases out of an unlicensed spa in New Mexico. None of this is fringe. This is happening in strip malls and hair salons and weekend pop-ups in every state in the country.
And the people doing it often have no idea they are practicing medicine without a license. They took a two-day course. The course promised them a medical director on paper. Now they are independently injecting strangers' faces with whatever they could order online.
Kate Dee is a board-certified radiologist who left breast imaging for aesthetics ten years ago and watched the industry explode around her. She wrote a book called "Med Spa Mayhem" because she could not keep quiet about what she was seeing in her own field. The way she puts it: physicians worry about losing their license if they do something wrong. If you don't have a license, you don't have one to lose.
So here is what to ask before anyone touches your face, your skin, or puts a needle in your arm. Who am I seeing today, and what is their license. Who is the medical director, and can I see them. Is the person holding the needle qualified to do a good faith exam. If the answer is "an RN comes by once a month," walk out.
Send this to the friend who just booked Botox at a place she found scrolling Instagram. Send it to your sister who keeps mentioning the IV bar that opened next to her gym. Send it to anyone you love who walks into a "medical spa" assuming the word medical means something there.
Listen to the full conversation on The Podcast by KevinMD. Link in the comments.
What is the most concerning thing you have seen or heard about a med spa or IV bar in your community.
