Medical Director Legal No-Nos for Medical Spas

Medical Director Legal No-Nos for Medical Spas

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In today’s video, we discuss whether being “Medical Director” is a Legal Trap for your Medical Spa.

By the end of today’s video, you’ll get a sense as to whether it’s a good or bad idea to have a “medical director” in your medical spa, or to be a physician who acts as a medical director for a medspa.

I’m Michael H. Cohen, founding attorney of the Cohen Healthcare Law Group. We’ve advised many medical spas on healthcare legal compliance issues.

People like the term, “medical director” because it gives the medical spa an aura of legal compliance and suggests to the public that an MD, a physician, is in fact directing the medical side of the medi-spa.

But in fact, having a “medical director,” or, being a physician who serves as “medical director” of a medical spa, can produce the opposite result—that is, enforcement issues.

The reason is that an MD who is a medical director really can only direct the medical staff to do things.  So, if you’re an MD, you’re directing either other MDs, or midlevel healthcare practitioners such as licensed physician assistants (PAs) and registered nurses (RNs).  You might even have a non-licensed medical assistant (MA) who is helping with the technical side.

However, you aren’t necessarily directing the estheticians, cosmetologists and massage therapists.  You aren’t necessarily directing the management, operations, and marketing.  You aren’t necessarily running the part of the overall medical spa that deals with business matters.

In reality, what you’re doing is what you are supposed to do, and allowed to do by law, which is practice “medicine.”  When you practice medicine, you have a cast of supporting personnel, your medical staff, and these are the people you naturally direct.

It’s like the proverbial metaphor of the fish that swims in water but doesn’t even realize it’s a thing called “water,” as opposed to “air” or “earth.”  A fish swims where it’s supposed to swim and allowed by nature to swim, and that is the water.  The fish doesn’t need a title or call itself “Fish Swimmer of Water.” 

Similarly, if you’re a physician who works in a medical spa, you aren’t necessarily required to call yourself “Medical Director” nor does this really add anything, because, the law thinks about the medical spa as more like an organism or system, consisting of two parts: the medical part, which you run, and the business part, which is separate.

The patients belong to the medical doctor, and the physician in effect diagnoses the patient, prescribes appropriate injectable or other medications, and “treats” the patient with aesthetic medical therapies.

You might look at two or the posts on our healthcare & FDA law blog:

First, “Medical Director” Creates Enforcement Red Flags

Second, If Someone Asks You to be Medical Director, Run!

Of course, there are still legal issues such as, for example, importantly: if you’re the management and marketing side of the medical spa—the MSO or Management Services Organization—then how do you maintain customer records, and continue being able to market to your clients, if the law is that the patients belong to the doctor?

Ah, good question.

On the old TV show, Kung Fu, the instructor used to say: “will you walk with me, Grasshopper?”

But we are not hopping between blades of grass!  Compliance is serious business.  We do have tools, tips and—not tricks, but legal strategies to help medical spa owners get more value from their business.

Thanks for watching. Here’s to the success of your medical spa or other healthcare venture, we look forward to speaking with you soon.


  • I would definitely recommend. I needed direction regarding the FDA and how the rules would affect my business. Responsive, accessible, and knowledgeable.

    Richard Freedland
    Richard Freedland GRAMedical, CEO
  • Impressive credentials are only overshadowed by their clear awareness of practical strategies to help Physicians navigate modern healthcare and achieve successful outcomes.

    James Riviezzo
    James Riviezzo Practice On Your Terms

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