Physician Obligations in Good Faith Exams at Texas Med Spas

While many med spa services are performed by non-physician providers, Texas law places certain clear responsibilities on supervising physicians, particularly when it comes to performing good faith medical exams. Med spas and their medical directors must understand these obligations, as it is critical for ensuring compliance and protecting patient safety.

What is a Good Faith Exam?

A good faith exam is a medical evaluation conducted by a licensed physician (or in some cases, another authorized healthcare professional under physician supervision) to determine whether a patient is appropriate for a proposed medical service. In the context of med spas, this typically occurs before procedures like Botox injections, dermal fillers, laser treatments, or prescribing medications such as semaglutide.

The exam is intended to:

• Confirm the patient’s health status.

• Identify any contraindications or risks.

• Ensure the patient is an appropriate candidate for the procedure.

• Document medical reasoning for proceeding or declining treatment.

Key Physician Responsibilities

Direct Patient Evaluation - Texas law emphasizes that physicians must personally evaluate patients in a good faith manner. While some preliminary information may be collected by staff, the physician is responsible for reviewing medical history, current medications, and any risk factors before authorizing treatment.

Assessment of Medical Suitability - The physician must determine if the patient is medically fit for the proposed service. This includes identifying conditions that may increase risk (e.g., bleeding disorders for injectables or photosensitive medications for laser treatments).

Documentation Requirements - Accurate documentation is essential. Physicians must record the patient’s history, findings from the exam, clinical reasoning, and the basis for approving or denying the procedure. Proper documentation protects both the patient and the provider in the event of complications or regulatory review.

Informed Consent - Physicians are responsible for ensuring that patients understand the risks, benefits, and alternatives to treatment. This often involves reviewing consent forms and answering patient questions before the procedure.

Supervision of Non-Physician Providers - If a non-physician provider (e.g., nurse practitioner, physician assistant, or aesthetic injector) performs treatments, the physician must ensure appropriate oversight and compliance with Texas Medical Board rules. The physician must be accessible and involved in patient care decisions, especially for procedures requiring a medical evaluation.

Telemedicine and Remote Oversight - While Texas law allows certain supervisory tasks to occur remotely, good faith exams generally require either an in-person evaluation or thorough, documented telehealth consultation. Physicians must confirm that remote supervision does not compromise patient safety.

Risks of Non-Compliance

Failing to conduct good faith exams or insufficiently supervising providers can result in:

• Complaints to the Texas Medical Board (TMB) against the medical director or the spa.

• Disciplinary actions, including fines, license suspension, or revocation.

• Civil liability in the event of patient injury for the spa and physician.

• Regulatory penalties for the med spa.

Best Practices For Supervising Doctors

• Perform or personally review all good faith exams before any medical procedure.

• Keep thorough, contemporaneous documentation.

• Ensure non-physician staff are properly trained and working under delegated authority within the law.

• Stay updated on TMB guidance regarding telemedicine, supervision, and aesthetic procedures.

• Regularly audit med spa protocols to maintain compliance.

Conclusion Physician Obligations in Good Faith Exams at Texas Med Spas

Good faith exams are a cornerstone of patient safety in Texas med spas. Physicians must take an active, documented role in evaluating patients, authorizing treatments, and supervising non-physician providers. Adhering to these obligations protects the spa and its patients, safeguards physician licensure, and ensures med spas operate within the bounds of Texas law.

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.