November 30, 2022

Understanding Who Can Open a Med Spa

Moxie Team

As demand for medical spas increases, more and more entrepreneurial nurses and physician assistants are considering joining this fast-growing industry. Before exploring the possibility of owning a med spa, it’s essential to know the complexities that guide who can open and own a medical spa.

The medical spa industry is booming! In 2022, the estimated value of global med spa industry is a whopping USD 14.4 billion. What’s more, the industry is expected to grow by an impressive 14.82% yearly for the next decade.

The variety of practical, effective, non-surgical services offered by med spas has fuelled this popularity among the general public. Treatments typically offer at med spas include:

  • Injectables (dermal fillers and neuromodulators such as Botox)
  • Skin treatments (micropeels to medicated facials)
  • Laser-focused treatments (full-field laser resurfacing to micro-ablative RF treatment)
  • Microblading, IV therapy, and more

Because these treatments are medical in nature, they need to be administered by licensed healthcare professionals—such as MDs, DOs, NPs, PAs, or RNs. The industry's growth, paired with this embedded need for trained experts presents an exciting opportunity for healthcare professionals with an entrepreneurial spirit.

Each state has laws regarding who can open or own a med spa and who can administer specific treatments. This article will examine who can open a med spa and discuss the regulations for MDs, DOs, NPs, PAs, and RNs to better clarify how these professionals can open a med spa business.

Who Can Open a Med Spa?

Firstly, a med spa is a medical practice, and each state’s medical board is responsible for regulating who can open medical practices in their jurisdiction. The regulations and laws vary from state to state, so it is essential to understand the specifics of a given state. Differences between states include various aspects of control and oversight, who can manage and work at a med spa, and who must be present or supervise treatments.

Throughout the United States, it’s most common for MDs (Doctors of Medicine), DOs (Doctors of Osteopathic Medicine), NPs (Nurse Practitioners), and PAs (Physician Assistants) to open and operate med spas. That said, there are some caveats: most states require a licensed physician to open a med spa, while others allow anyone with enough business acumen (medical licenses are not necessarily required). Furthermore, in other states, a non-physician (medically credentialed or otherwise) can form a Management Services Organization (MSO) and partner with a Medical Director to establish a med spa.

It’s important to note that there can be significant differences across state lines that you will need to investigate.

Can MDs and DOs open Medical Spas?

In general, MDs and DOs can open and operate med spas in every state. Depending on the jurisdiction, they may need to be board certified in a specialty area or have additional qualifications. Additionally, state regulations will dictate who—in addition to a licensed physician—is allowed to perform and supervise treatments.

What Is the Corporate Practice of Medicine?

The primary purpose of business is to generate profit. Still, the practice of medicine prioritizes patient care first and foremost. The Corporate Practice of Medicine (CPOM) doctrine is a set of laws created to protect patients from potential financial conflicts of interest. These laws aim to prevent the commercialization of medical services, ensure patient rights are respected, and prevent outside influences from affecting a doctor’s judgment.

CPOM laws enacted in many states make it difficult for non-physician entities to open or have majority ownership in medical practices. In other words, a licensed physician must be the owner and operator of a med spa.

Current CPOM states that do not have any nonprofit exceptions include:

  • Colorado
  • Illinois
  • North Dakota
  • Washington
  • D.C.
  • Maryland
  • Oregon
  • West Virginia
  • Georgia
  • Montana
  • Tennessee

Can NPs, PAs, and RNs Open Medical Spas?

While most states require a licensed physician to open and be the full or majority owner of a med spa, some states allow NPs, PAs, or RNs to partner with a Medical Director (licensed physician) to open a med spa. Additionally, many of these states typically require an NP or PA to hire a licensed physician as Medical Director or to administer most medical procedures.

Depending on state regulations, non-physician practitioners may need additional qualifications. In most states, these healthcare professionals are limited in who they can hire, what treatments they can offer, and who must be present or supervise the work (a licensed physician is commonly required to supervise treatments, if not own most of the practice).

Where Can NPs Open Med Spas?

Currently, Nurse Practitioners can independently open and own med spas in states in which they have full practice authority:

Alaska Arizona Colorado Connecticut
D.C. Delaware Hawaii Idaho
Indiana Iowa Maine Maryland
Massachusetts Minnesota Nebraska Nevada
New Hampshire New Mexico North Dakota Oregon
Rhode Island South Dakota Vermont Washington

Additionally, Nurse Practitioners can partner in opening and owning med spas in many other states, provided they work with the Medical Director and hire additional licensed physicians to work within the practice.

Where Can PAs Open Med Spas?

Physician Assistants can open and own med spas in the following states, provided they employ a Medical Director and hire additional licensed physicians:

Arizona Florida Hawaii Iowa
Maine Massachusetts Michigan Mississippi
New Hampshire North Carolina Oklahoma South Carolina
Utah Wyoming

Where Can RNs Open Med Spas?

Registered Nurses cannot open med spas independently due to licensure restrictions. However, they do have options:

  1. They can own an already established med spa in states that allow non-physicians to own a medical practice once they’ve obtained the required certifications and experience;
  2. They can hire a licensed physician as a Medical Director or;
  3. They can partner with a Medical Director through a Management Services Organization relationship (more on this below).

States where non-medical personnel can own a medical practice:

Alabama Alaska Delaware Florida
Hawaii Idaho Louisiana Maine
Mississipi Missouri Nebraska New Hampshire
New Mexico Ohio Oklahoma Utah
Vermont Virginia Wyoming

How Can Anyone Own a Med Spa?

In states where only licensed physicians are eligible to open med spas, NPs, PAs, and RNs can still help open and benefit from the success of a med spa in a more roundabout way.

Although many states have enacted corporate practice of medicine laws, there is still a way for non-physicians to become involved in med spas and benefit financially by forming a Management Services Organization (MSO). MSOs are specialized administrative entities that sell services to med spas.

What Are Management Services Organizations (MSOs)?

Management Services Organizations (MSOs) are specialized administrative and management entities that provide staffing, administrative, and management services to a partner medical practice.

MSO arrangements are beneficial whenever a non-physician (healthcare professional or otherwise) wants to be involved in the ownership of a med spa, as they can sell the services of qualified professionals (nurse injectors) to the medical practice. MSOs offer various administrative and management services to providers that can help streamline operations, cut down on time wasted by duplicate services, and give small practices access to the same specialist care as larger ones.

What Does a Medical Director Do at a Med Spa?

Medical Directors are typically licensed physicians who collaborate with medical spas to provide expert medical guidance and legal partnership. It’s important to note that qualifications for who can serve as Medical Director vary from state to state.

Medical Directors advise on the most effective treatments, protocols, and regimens that offer the best results for clients. They may also consider and approve any new procedures or service offerings. Since Medical Directors who work with a non-physician partner also assume risk and legal liability, assessing each other closely during initial conversations is vital.

Due to varying state regulations, it’s essential to research the specific requirements for a given state or locality before looking for a Medical Director for any practice.

In Summary

For non-physicians to open med spas in a state that requires a physician to be the owner of the med spa, you’ll need to partner with a Medical Director (licensed physician). They’ll own the medical practice, while you, as the non-physician, would own the MSO that sells services to the practice. As the MSO owner, you would benefit financially from the growth and success of the practice.

Careful research is necessary to ensure that the best corporate structure is in place for your med spa. By understanding who can open a med spa or serve as Medical Director, you will be better equipped to make an informed decision that works best for you and your business.

Starting a med spa can be incredibly complex and overwhelming, so we’re here to help. Learn More About Moxie and How We Can Help You Open Your Own Med Spa >

*This article is intended to provide a general guide on what professional licenses and conditions are needed to operate a practice or perform certain treatments. This information alone does not authorize, certify, or confer the ability of anyone to perform these treatments, practice outside their scope, or violate the corporate practice of medicine.

While based on currently available information, the rules and policies on scope of practice issues and ownership can, and do, change frequently. Specific training, education, supervision, protocol and regulatory requirements will differ depending on each person's situation in their state. Therefore, each person must examine their own professional situation, skill level, regulating board guidance, and scope of practice before proceeding.

You should not act upon this information without seeking knowledgeable legal counsel that takes into account the laws of your specific jurisdiction. All uses of the content of this site, other than personal uses, are prohibited.

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