Spa bill sponsor revokes support

His about-face coincides with the arrival of a new client at his law firm. Some question his motive.

Published June 14, 2006

TALLAHASSEE — For patients, the growing popularity of freestanding medical spas offers a range of skin care treatments without the long waits to see a dermatologist.

But with medical safety concerns on the rise, doctors see the trend as potentially dangerous to patients, not to mention a threat to their livelihood.

A bill unanimously approved by the Legislature and awaiting action by Gov. Jeb Bush would narrow the scope of care that nurse practitioners and physician assistants can give without the direct supervision of a dermatologist or plastic surgeon.

If Bush signs the bill into law, a primary care doctor could supervise no more than four satellite offices, and specialists could supervise no more than two. In 2011, the number of satellite offices supervised by dermatologists would be reduced from two to one.

The carefully negotiated legislation won support from medical groups, but has drawn criticism from a nationwide network of medical spas.

It also has placed a key lawmaker in an odd spot  because he sponsored the measure, then backed away at about the time his law firm began working to defeat the bill on behalf of a medical spa client.

That lawmaker is Rep. Joe Negron of Stuart, who is seeking the Republican nomination for attorney general.

Every year in the Capitol brings new, high-stakes turf wars between medical groups over so-called scope of practice issues. The latest bill is partially a response to the steady growth of satellite medical offices that offer a wide range of health care services, and plans by large retail chains such as Publix and Wal-Mart to offer “retail medicine.”

Negron filed the bill (HB 699) at the request of the Florida Medical Association. Working with the  influential doctors’ lobby, the Florida Nurses Association and others, he spent months negotiating the details, and the bill cruised through the House on a unanimous vote on April 19.

But two days later, Akerman Senterfitt, the law firm that employs Negron as an of-counsel  attorney, was hired by

Palomar Medical Technologies of Massachusetts to defeat the bill. Palomar markets myriad devices used by medical spas.

Negron confirmed he no longer supports the bill, but stopped short of calling for a Bush veto.

“That’s up to the governor,” Negron said.

Negron said changes were made to the bill that he did not support, and he also wanted the bill to give the state Board of Medicine more power over operation of the satellite offices. The Senate refused to agree with that, and some medical groups staunchly opposed the idea.

Negron said his change of heart had nothing to do with his law firm’s client. “I am not aware of any client that may or may not have engaged my law firm,” Negron said. “My policy has consistently been to pursue my legislative agenda without regard to any client my law firm may or may not have.”

Sen. Durell Peaden, R-Crestview, who sponsored the Senate version, said he was astounded by Negron’s about-face.

“He wrote the damn bill,” Peaden said. “I was sort of blown away.”

The retired doctor, whose son is a physician’s assistant, said the law is needed to safeguard “the integrity of the health care delivery system.”

Ed Jaffry, one of three Akerman lobbyists hired by Palomar to defeat the bill, said he never discussed the bill with Negron. The lobbyist said he was a logical choice to fight the bill because he has opposed similar legislation in recent years on behalf of another client, the Florida Nurse Practitioners’ Network.

“What it’s intended to do,” Jaffry said of the bill, “is force patients to use dermatologists for procedures that for God knows how long have been done by advanced registered nurse practitioners, who are supervised by physicians.”

Barbara Lumpkin, the longtime lobbyist for Florida nurses, said she hopes Bush signs the bill because it stops any new restrictions on nurse practitioners. Lumpkin also said she remains mystified by Negron’s stance on the issue.

“I know he says it has nothing to do with the money, but it seems funny that he totally had a change of heart,” Lumpkin said. “It’s just amazing.”

Dozens of people have sent letters or e-mails to Bush on both sides of the issue.

Florida Medical Association lobbyist Sandra Mortham urged her members to e-mail Bush in support of the bill, which she described as “the negotiated bill to ensure patient safety for those consumers receiving aesthetic care.” Bush has until June 27 to act on the bill.

But some health care professionals view the bill very differently. Jean Aertker of Tampa, an advanced registered nurse practitioner, told Bush the bill is mainly about money.

“Do you think that the dermatologists would seek this bill if it were not the lucrative medical spa business at stake here? This is a cash cow for them,” Aertker told Bush.

Eric Light, president of the New Jersey-based International Medical Spa Association, issued a warning on the group’s Web site: “Your right to work in and/or own a medical spa is under attack!”

He said he was concerned that the Florida proposal could be copied by other states.

Steve Bousquet can be reached at bousquet@sptimes.com or (850) 224-7263.