What Doctors Need to Know Before Becoming a Med Spa Medical Director

The booming med spa industry in Texas offers physicians new opportunities to expand their practices and partner with growing aesthetics businesses. However, taking on the role of medical director is not a simple formality. It carries significant legal, professional, and financial responsibilities. From navigating Texas’s corporate practice of medicine restrictions to ensuring proper delegation and supervision of staff, physicians must understand the rules before lending their name or license to a med spa. Failing to comply can expose doctors to liability, regulatory investigations, and damage to their medical licenses. This article outlines the key considerations every doctor should evaluate before agreeing to serve as a medical director at a Texas med spa.

Medical Director Responsibilities:

• The physician is ultimately responsible for all medical treatments offered, even if delegated to nurse practitioners (NPs), physician assistants (PAs), or registered nurses (RNs).

• Responsibilities include:

  • Establishing protocols and standing orders.

  • Supervising delegated providers.

  • Reviewing charts and treatment plans as required by Texas Medical Board (TMB) rules.

  • Ensuring patient safety and standard of care compliance.

Delegation Rules:

• Physicians can delegate certain procedures to NPs, PAs, and RNs, and unlicensed individuals as long as the appropriate agreements and protocols are in place.

• Procedures like injectables, IV therapy, or laser treatments are medical acts and require proper delegation.

• Texas law requires supervision for treatments and regular chart reviews.

Liability and Risk Management:

• Medical directors carry liability for patient outcomes and may face TMB complaints or malpractice claims if standards are not followed.

• Many physicians require med spa operators to carry professional liability insurance and list them as insureds.

• Proper documentation and informed consent processes are critical.

Compensation Structures:

• Texas allows ownership of spas by non-doctors but prohibits fee-splitting with non-physicians.

• Medical directors cannot receive a percentage of revenue from medical services.

• Any ownership arrangement must comply with CPOM laws.

Compliance with Advertising Rules:

• Medical directors are responsible for ensuring marketing does not mislead patients.

• Texas has strict rules around:

  • Before-and-after photos

  • Use of the term “board-certified”

  • Avoiding guarantees of results

Time Commitment and Presence:

• A “paper medical director” arrangement (where a doctor is barely involved) is risky and often flagged by regulators.

• The TMB expects real involvement—training staff, setting protocols, and reviewing patient care.

Contract Considerations:

Before signing on, physicians should ensure contracts clearly spell out:

• Scope of duties and authority

• Indemnification clauses

• Termination provisions

• Insurance requirements

Conclusion on What Doctors Need to Know Before Becoming a Med Spa Medical Director

Serving as a medical director for a Texas med spa can be a rewarding opportunity, but it comes with significant responsibilities and legal obligations. Physicians must understand the limits of delegation, the risks of improper ownership structures, and the importance of active oversight to stay compliant with Texas Medical Board rules. With the right contracts, protocols, and safeguards in place, doctors can help med spas deliver safe, high-quality treatments while protecting their licenses and professional reputations.

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.