The Texas Medical Board (TMB) regulates physicians and their delegation of medical procedures, including those performed in med spas. Med spas offer cosmetic and aesthetic treatments that often involve medical procedures such as Botox injections, laser procedures, and dermal fillers. Physicians overseeing these services as medical directors must comply with strict regulations, or they may face disciplinary action from the TMB. This article outlines some of the key considerations of medical director accountability in med spas.
Regulatory Framework for Med Spas:
Med spas operate under Texas laws governing the delegation of medical procedures, primarily outlined in:
Texas Occupations Code Chapter 157 (Physician Delegation)
Texas Administrative Code Title 22, Part 9 (Texas Medical Board Rules)
Texas Administrative Code Rule §193.17 (Nonsurgical Medical Cosmetic Procedures)
Texas Administrative Code Rule §169.26
These rules establish that only licensed physicians, or properly delegated qualified persons may perform medical procedures.
Circumstances Leading to TMB Disciplinary Action:
Physicians may be subject to disciplinary action by the TMB for failing to comply with these regulatory requirements in several ways:
- Unlawful Delegation of Medical Procedures
Med spas must operate under a physician’s supervision.
Physicians can delegate medical procedures to unlicensed individuals (e.g., estheticians, cosmetologists, or medical assistants) only with a properly drafted standing orders.
The delegating physician must ensure that those performing procedures have appropriate training and competency.
- Failure to Provide Adequate Supervision
The TMB requires a physician to establish a written protocol for delegated cosmetic procedures.
Supervision must be continuous and adequate - remote supervision without any real oversight may result in violations.
Physicians must be available for consultation and address complications.
- Practicing Medicine Without a License or Allowing Unlicensed Practice
If a physician fails to provide adequate oversight but allows a med spa to function independently, the business may be engaging in the unlicensed practice of medicine - a serious violation.
A physician can be held accountable if they lend their license to a med spa without active involvement in patient care.
- Noncompliance with Ownership Laws (Corporate Practice of Medicine Doctrine)
Texas allows non-physicians to own med spas but requires oversight and supervision from a physician medical director. The extent of the supervision is spelled out in Tex. Admin Code §169.26 and §193.17
Med spas cannot be jointly owned by a physician and a non-physician, without violated the corporate practice of medicine laws.
- Failure to Maintain Proper Patient Records & Informed Consent
The TMB requires physicians and the spas they supervise to maintain detailed medical records for every patient receiving treatment at a med spa.
Consent forms must clearly outline risks, benefits, and alternative treatments before procedures.
Consequences of Noncompliance:
If the TMB determines a physician has violated med spa regulations, they may face:
Administrative Penalties: Fines or sanctions against their medical license.
License Suspension or Revocation: Repeated or severe violations may result in loss of medical license.
Legal Liability: Physicians may face lawsuits from patients injured due to improper delegation or lack of supervision.
Best Practices for Physicians Overseeing Med Spas:
To avoid disciplinary action, medical directors should be actively involved in med spa operations and patient care, ensure proper delegation by limiting procedures to trained, qualified personnel, develop and enforce written protocols for non-surgical cosmetic procedures, conduct regular on-site supervision rather than relying solely on remote oversight, and follow ownership and compliance laws to prevent unlicensed medical practice.
Conclusion on Medical Director Accountability in Med Spas
Texas physicians overseeing med spas must strictly comply with regulatory requirements to avoid TMB disciplinary actions. By maintaining direct supervision, ensuring proper delegation, and adhering to legal guidelines, physicians can operate within the law and protect their medical licenses while providing safe, high-quality aesthetic services.
Feel free to reach out if you need more specific information or further clarification.
Weitz Morgan is a leading law firm in Texas in providing comprehensive advice and guidance to med spas. With a deep understanding of the unique challenges and complexities faced by this rapidly growing industry, our team of experienced attorneys is dedicated to helping med spas navigate the legal landscape successfully.
We recognize that med spas operate at the intersection of healthcare and beauty, which necessitates a multifaceted approach to representation. Our firm offers a range of services, including a flat-fee med spa formation package and an outside general counsel subscription, tailored to meet the specific needs of med spas, ensuring compliance, mitigating risks, protecting licenses, and fostering a legally sound business environment.
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