Podiatry Providers Seek Assistants: Cosmetology Licensed Foot Care

In a recent issue of PM News [April 26, #5913] a podiatrist asked about the possibility of hiring cosmetology trained assistants to help relieve the load of Routine Foot Care. This is a legitimate question for busy podiatry offices who are finding innovative ways to take care of their patients. Here are some points to consider in deciding if this might be viable in your busy podiatry practice:

Do you have a large amount of “nail trimming only” patients?

If so, you may find the following interesting:

  1. Routine foot care, as defined by Medicare, includes the following tasks: trimming and thinning thickened nails, reducing calluses and applying moisture. Cosmetology-licensed nail technicians can perform these exact same tasks under their licenses. Specially trained nail technicians who have achieved certification in advanced foot care will not only be able to perform these same tasks, they are trained to recognize and refer any “out of normal” observations they make upon their intake evaluation.
  2. Nail trimming is usually not reimbursable by insurance or Medicare: these treatments are usually cash services, payable upon rendering. These services are healthy for the practice–they can be the “bread and butter” but non-medical nail trimming by a trained assistant can bring in that same cash.

Is your schedule jam-packed with Routine Foot Care?

If non-medically driven trimming services are overwhelming the physician or podiatrist, higher-level treatments compete for appointed time. Hiring a well-trained assistant who can take on the non-medical nail trimming, callus reduction and foot care is a good way to free up the schedule.

Is it legal for your office to hire a nail technician?

The answer to this question is…”Yes, if done right.”   Here are some considerations:

In a practice facility, you can have both a Medical Board-sanctioned podiatry practice as well as a Cosmetology Board-licensed “salon” IF ALL REQUIREMENTS OF THE BOARDS ARE MET.

With an existing licensed medical practice you already know what is allowed in your facility. In most states, NO cosmetic services may be performed in the medical treatment rooms….but there is nothing that says there can’t be a separate non-treatment space designated for “cosmetic services only.”

Also generally, you cannot perform medical treatments in a licensed Cosmetology Salon, but there’s nothing to say a salon can’t be adjacent to a medical treatment area. Usually, in a cosmetology salon (or a salon “room”) you must meet the requirements as set forth by the Board of Cosmetology in your State. In most states:

  1. There is a minimum space requirement (usually a certain number of square feet per practitioner, which most treatment rooms will fulfill)
  2. There is a need for access to hot water (in some states, it must be in the same room, in some states just “near by”)
  3. There may be a requirement for access to a restroom (in some states, within a certain number of feet away)
  4. There might be a requirement for ventilation in the room (which is often already in place with A/C intake and venting)

The idea is to set up a separate room, licensed as a “Salon” and all the cosmetic services are done in this space by a cosmetology-licensed nail technician or cosmetologist. No medical treatments in this room. In other rooms, medical-only treatments may be performed–no cosmetic services in those rooms. The patient can move between the rooms…being seen for a medical evaluation or treatment by the podiatrist in a treatment room and then “cleared” for cosmetic services in the cosmetics room.

How do you go about setting up this type of practice?

You must carefully designate the spaces, follow all the rules for BOTH your Medical Board and your Cosmetology Board. This take some planning:

  1. Working with a nail technician who is already familiar with her licensure and scope of practice is ideal.
  2. We suggest hiring a consultant versed in this concept — Janet McCormick has assisted with several successful “foot spa” facilities and podiatric/cosmetology practices. You can contact her directly to book a consultation at (863) 273-9134.
  3. View the materials provided in the newest addition to Nailcare Academy’s course line up:  Cosmetic Foot Care in a Medical Practice .

Click here to read more about this course.


Setting up a “cosmetology salon” room in your medical practice can have many benefits – you not only are making sure your patients are getting excellent nail trimming in a safe, aseptic environment and keeping them out of public “nail shops” which don’t have your high standards, you are creating a physician extender which will allow you more freedom in your practice of medicine.