Medical director
In most states, yes — a med spa needs a medical director. A medical director is the physician (or, in some states, a nurse practitioner) who provides the clinical oversight a med spa’s medical treatments require: standing orders and protocols, accountability for the medicine, and — directly or through a delegated prescriber — the authority behind the Good Faith Exam. The role is commonly a contracted, part-time relationship, and it’s distinct from owning the practice: you can own the business and contract a medical director for the clinical authority. Whether a medical director is required, and whether it must be a physician, varies by state — we map yours inside.
The free 7-minute assessment maps the structure, the requirements, and the exact next step to your credential and your state. No card. Built by Faisal Darwiche, NP — 27 years, three practices.
A medical director is the prescriber who stands behind the medicine. They provide clinical oversight, set and sign the standing orders and treatment protocols, take responsibility for patient safety, and hold or delegate the authority behind the Good Faith Exam. In many med spas it’s a contracted, part-time role rather than a daily operator.
In practice, the medical director makes the med spa’s treatments properly ordered: the protocols an RN injects under, the prescriptive authority for the products used, and the clinical accountability the law expects. They may perform the Good Faith Exam themselves, delegate it to another prescriber, or the practice may use a telehealth-GFE service for the per-patient piece — but the clinical buck stops with the director.
No — and people conflate the two constantly. Owning the med spa means owning the business: the brand, lease, staff, and cash flow. Being the medical director means providing clinical oversight under contract. You can own the business and contract a medical director for the medicine; the director doesn’t own your practice.
This is the single most common point of confusion. Hearing “you need a physician” makes people assume a doctor has to be their partner or their boss. They don’t. In the standard structure the non-physician owner controls the business (often through an MSO), and the medical director is a contracted clinical role — paid for the oversight, not an owner of the practice you built.
A medical director is typically paid a fair-market-value fee — usually a flat monthly or hourly amount for the oversight provided. What the arrangement must avoid is fee-splitting: the payment can’t be a percentage of medical or treatment revenue. Tying compensation to a cut of the medicine is the structure regulators scrutinize most.
The reason is the same logic behind the corporate practice of medicine: clinical judgment shouldn’t be financially steered by the volume of treatments sold. A flat, fair-market-value fee keeps the oversight independent. The specific figure depends on your market and how involved the role is — we don’t publish income or fee numbers here, because they vary and we won’t pretend otherwise.
A medical director agreement spells out the clinical relationship: the scope of oversight, the standing orders and protocols, who performs the Good Faith Exam, training and chart-review responsibilities, the fair-market-value fee, insurance and liability, and how either side can end the contract. It’s a clinical contract — have a healthcare attorney paper it for your state.
Not identically. Most states require a physician’s clinical oversight for a med spa’s medical services, but whether the role must be a physician (versus a nurse practitioner with the right authority), and how involved that person must be, varies by state. A few full-practice-authority states let an NP fill more of the role.
So the honest answer to “do I need a medical director?” is almost always yes for the clinical oversight — but the shape of the role is state-specific. That’s what the assessment maps: whether your state requires a physician medical director, what oversight it expects, and how it fits your credential. The final agreement should always be reviewed by a healthcare attorney in your state.
In most states, yes — a med spa’s medical treatments require a prescriber to provide clinical oversight, standing orders, and the authority behind the Good Faith Exam. Whether the role must be a physician or can be a nurse practitioner, and how involved they must be, varies by state. We map your state’s requirement inside the assessment.
In some states, yes — particularly full-practice-authority states where an NP can hold prescriptive authority and provide clinical oversight. In other states the medical director must be a physician, especially where cosmetic treatments are classified as the practice of medicine. It varies by state, which is what we map inside.
No. The medical director is a contracted clinical role, not an owner. You can own the business — the brand, lease, staff, and cash flow — and contract a medical director for the clinical oversight. People conflate the two, but providing medical direction and owning the practice are separate things.
Typically a fair-market-value flat fee — a set monthly or hourly amount for the oversight provided. It can’t be a percentage of medical or treatment revenue; that’s fee-splitting, which regulators scrutinize. The exact figure depends on your market and how involved the role is.
Fee-splitting is paying for medical oversight (or referrals) as a cut of medical revenue rather than a flat, fair-market-value fee. It matters because it can steer clinical judgment toward selling more treatments — which is exactly what the rules guard against. A medical director should be paid a flat fair-market-value fee.
Faisal Darwiche, NP — 27 years as a nurse practitioner and three practices opened, including one later sold. My Practice Academy is the operating system for opening and running your own aesthetic practice — the clinical work and the business, in the right order.