Frequently asked questions

A medical director is a licensed physician who takes clinical responsibility for the medical services a practice provides. In most states, the treatments that define a medical spa — botulinum toxin, dermal fillers, laser and energy-based procedures, intravenous therapy, prescription weight management — are the practice of medicine. A licensed practitioner has to order and supervise them, and a business owned or managed by non-physicians cannot supply that on its own.

Whether your specific menu requires a physician, and what that physician must do, depends on your state and on the licenses your staff hold. That is the first question we answer.

No, and the difference is the whole point. Regulators and plaintiffs' attorneys both look for the arrangement where a physician collects a monthly fee, never sets foot in the practice, never reviews a chart and could not name the devices in the treatment rooms. That arrangement does not protect anyone.

Meaningful medical direction means signed protocols the physician actually wrote, documented chart review, real availability for consultation, and the authority to stop a treatment. That evidence is what stands up later.

It is the evaluation that has to happen before a patient is treated: history, examination of the treatment area, confirmation that the patient is an appropriate candidate, and authorization of a specific plan. Who may perform it — physician, nurse practitioner, physician assistant — and whether it may be done by telehealth varies by state and sometimes by treatment.

We confirm the rule for your state and build the exam into your booking process so it does not become the step everyone skips on a busy Saturday.

It depends entirely on your state. Some states permit an RN to inject under physician delegation and supervision; others restrict injection to advanced practice providers or physicians. Estheticians are barred from injecting essentially everywhere, and medical assistants face tight limits — a point that surprises a lot of owners who inherited their staffing model from a previous employer.

We put the answer in writing, per person and per treatment, so nobody is guessing.

Often the arrangement is real but thin: a signed agreement with no protocols behind it, no chart review happening, no delegation matrix, no credentialing files, and no one tracking whether the state's rules changed last year. That is the common case, and it is fixable without replacing anyone.

We can work alongside your existing physician to build the missing infrastructure, or serve as medical director ourselves if you would rather change.

An investigation usually starts with a document request: protocols, delegation records, training files, patient charts, consent forms, and the medical director agreement. Practices that have those documents current and consistent tend to resolve matters quickly. Practices that have to assemble them retroactively tend not to.

Our clients get support responding to board inquiries and carrier requests, and we coordinate with your attorney. We do not provide legal representation.

Very little. Ownership rules, supervision levels, injection authority, good faith exam requirements and laser rules are all set state by state, and the differences are substantial. A structure that is textbook-correct in one state can be an unlicensed-practice problem across the border.

We review the target state before you commit to a lease, and place a physician licensed there.

No. We provide medical direction, clinical oversight and compliance services. We are not attorneys and we do not give legal advice. For questions that require a legal opinion — entity formation, contract enforceability, responding to a lawsuit — you need a healthcare attorney licensed in your state, and we are glad to work alongside yours.

It depends on your state and on how much documentation already exists. A practice that mainly needs protocols and a delegation matrix moves faster than one that also needs an entity restructure and new staffing. We give you a realistic timeline after the initial review rather than a number chosen to sound impressive.

Pricing depends on your state, the size of your service menu, the number of locations and how much clinical oversight your model requires — a single-location practice offering facials and laser hair removal is a different engagement from a three-state group running GLP-1 and hormone programs.

We quote in writing after the initial review, with the scope spelled out, so you are comparing like with like.