Physician Agreements and Med Spas

In Texas, structuring physician agreements for med spas requires balancing state corporate practice of medicine rules, delegation regulations, and business arrangements. A well-drafted agreement should clearly define the roles, responsibilities, and legal boundaries between the physician and the med spa. Here’s a breakdown of the key elements to include.

Corporate Practice of Medicine (CPOM) Considerations:

• Ownership Restrictions: In Texas, non-physician’s may own a med spa, but they cannot do so in conjunction with a physician. Meaning, a doctor and a non-doctor cannot jointly own the med spa and be in compliance with the State’s corporate practice of medicine doctrine.

Medical Oversight and Delegation:

• Good Faith Exams: Agreement should clarify that the physician (or an NP/PA under delegation) performs the required initial patient exams before treatments like Botox or fillers.

• Delegation of Duties: Spell out which services can be delegated to nurses, NPs, or PAs under Texas Medical Board rules and under what supervision (i.e., on-site, off-site, telemedicine).

• Standing Orders & Protocols: Reference the use of written protocols and standing delegation orders, signed and maintained by the physician.

Compensation Structures:

• Flat Fee or Hourly: To avoid fee-splitting violations, compensation should usually be a flat fee, hourly rate, or fair market value retainer, not a percentage of revenue.

Liability and Compliance:

• Medical Liability: The agreement should allocate responsibility for medical malpractice coverage.

• Compliance Duties: The physician must ensure compliance with Texas Medical Board rules, HIPAA, OSHA, and state med spa laws.

Term, Termination, and Renewal:

• Term Length: Typically 1–3 years with automatic renewals. A best practice is to include a 1-year term so that the provisions of the agreement and compliance can be reviewed annually.

• Termination: Allow for termination with cause (loss of license, non-compliance, etc.) and without cause with notice.

Confidentiality and Non-Solicitation:

• Confidentiality: Protects patient information and business trade secrets.

• Non-Solicitation: Reasonable restrictions on soliciting patients or staff if the physician leaves.

Practical Provisions:

• Medical Director Duties: Outline expectations (chart review, training, patient oversight).

• Access to Records: Clarify the physician’s right to access medical records (cannot be restricted).

• Dispute Resolution: Include how dispute should be resolved prior to litigation, including the use of mediation, and if in litigation whether it will be in civil court or arbitration.

Conclusion on Physician Agreements and Med Spas

Structuring physician agreements in Texas med spas requires more than just a business mindset—it demands careful attention to legal compliance, medical oversight, and the realities of Texas’ corporate practice of medicine restrictions. By clearly defining roles, responsibilities, and compensation within a compliant framework, med spas can build strong physician relationships that protect both patient safety and the business. The key is to ensure that the arrangement reflects Texas Medical Board rules, avoids fee-splitting, and promotes transparency. With the right agreements in place, med spas can grow confidently while minimizing legal risk and maintaining high standards of care.

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.