Understanding Who Can Open a Med Spa 👩‍⚕️🔍

The appeal of the med spa industry is undeniable. Billions of dollars flow through this rapidly growing market each year, offering a tempting opportunity for healthcare professionals with an entrepreneurial spirit. 

In 2023, the estimated value of the global med spa industry was a whopping USD $18.6 billion. What’s more, the industry is expected to grow by an impressive 14.82% yearly for the next decade.

But surely, for aspiring med spa owners, this path can be very confusing. Not just how to open a med spa, but who can?

State regulations vary wildly, leaving many wondering: Can I even open a med spa as a nurse practitioner (NP), physician assistant (PA), or registered nurse (RN)? How to open a med spa as a nurse? What qualifications do I need?

This article covers just that. By the end of it, you will understand the legalities of med spa ownership in the US, from the ground up. All your questions about, “Who can open a med spa?” will be answered.

Disclaimer: The information provided in this article is for general informational purposes only and does not constitute legal advice. It is recommended to consult with your respective state boards, a licensed attorney, or your malpractice carrier to ensure that you are practicing within the letter of the law and adhering to all regulatory requirements.

The regulations regarding aesthetic treatments and medical spas can vary from state to state and may change over time.

Who can open a med spa?

Treatments typically offered at med spas include injectables (dermal fillers and neuromodulators such as Botox, Dysport, Xeomin, or others), skin treatments (micro peels to medicated facials), laser-focused treatments (full-field laser resurfacing to micro-ablative RF treatment), microblading, IV therapy, and more.

A med spa is a medical practice because these treatments are typically medical in nature. They therefore need to be administered by licensed healthcare professionals — such as MDs, DOs, NPs, PAs, or RNs.

Here's a cheat sheet on the key players in med spa ownership:

• MDs (Doctors of Medicine) and DOs (Doctors of Osteopathic Medicine): These licensed physicians generally have the most straightforward path to med spa ownership nationwide. Depending on your state, you might need additional qualifications or certifications on top of your medical degree.
• NPs (Nurse Practitioners) and PAs (Physician Assistants): You might be wondering, “Can a nurse open a med spa?” While some states allow NPs and PAs to own med spas directly, most require them to partner with a Medical Director (a licensed physician) who oversees operations and ensures compliance with state regulations. 
  
  This can be a fantastic option, allowing you to leverage your expertise while ensuring your med spa operates within the legal framework. Try and network with potential medical directors in your area to find someone who aligns with your vision and practice philosophy.

• RNs (Registered Nurses): While RNs typically cannot own med spas independently due to licensing limitations, there are still ways to get involved. Some states allow RNs to purchase established med spas that already have a Medical Director in place. 

Here is a related action step: Research your state's laws to see if this ownership structure is an option for you. Similar to NPs and PAs, RNs can partner with a Medical Director to co-own and operate a med spa. MSOs can be a valuable tool for non-physicians who want to be involved in med spa ownership.

Don't be discouraged by the legalities — with a little research and potentially the right partner, you can turn your med spa dream into a reality.

Moxie can help. We understand the complexities of starting a med spa, and we're here to guide you through the process, every step of the way. You can move to the bottom of the article to contact us right away, or keep reading as we explore this topic in more detail.

Can MDs and DOs open medical spas?

MDs (Doctors of Medicine) and DOs (Doctors of Osteopathic Medicine) have a clear advantage when it comes to med spa ownership. In most states, you can leverage your medical expertise and experience to open and operate your med spa business.

However, it's not quite as simple. You would need a license to practice. This one's a no-brainer — you'll need a valid medical license to operate a med spa in any state.

While MD/DO ownership is generally allowed nationwide, specific regulations can differ from state to state. Some states might require additional qualifications, like board certification in a specific area relevant to med spa services (like dermatology or aesthetics). Others might have specific protocols for the supervision of certain procedures.

We recommend that you don't wait until you're ready to launch to research your state's med spa ownership requirements. Familiarize yourself with the legal requirements early on to avoid any roadblocks down the line. 

Here's a great resource to get you started: American Medical Spa Association – Who Can Own a Medical Spa.

What is the Corporate Practice of Medicine?

Have you ever wondered why it is that you don't see massive corporations running hospitals or medical practices? That's thanks to a concept called the Corporate Practice of Medicine (CPOM).

Here's the gist of it: CPOM is a set of laws established by many states to prioritize patient care over pure profits. These laws prevent corporations from owning or controlling medical practices, potentially compromising a doctor's professional judgment in favor of financial gain.

Why is this important for med spas? Because med spas are considered medical practices in most states. So, CPOM can impact who can own and operate a med spa.

In some states, CPOM dictates that a licensed physician must be the sole owner of a med spa. This can be a hurdle for non-physician healthcare professionals like NPs, PAs, and RNs who dream of med spa ownership. 

Don’t worry; Moxie is here to help. We'll explore alternative ownership structures that can help bridge the CPOM gap.

For your reference, here's a list of states with stricter CPOM regulations that don't allow non-profit exceptions (meaning even non-profit organizations can't own medical practices):

• 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?

While MD/DO ownership is the most straightforward path, the good news is that there are ways for NPs, PAs, and RNs to get involved. Let’s discuss the different avenues available.

Partnering with a medical director is a common option for NPs and PAs in many states with stricter CPOM regulations. How this works is that you collaborate with a licensed physician (the Medical Director) who oversees operations and ensures compliance with state laws. This allows you to leverage your expertise while adhering to the legal framework.

We recommend you seek a medical director who aligns with your vision and practice philosophy to ensure a smooth partnership.

Regulations around medical director involvement can differ. Some states might require the MD to be physically present during specific procedures, while others allow for more flexibility.

NPs with full practice authority

In certain states with relaxed CPOM restrictions (see list below), NPs can enjoy greater ownership independence. These states allow NPs with full practice authority to own and operate med spas independently, without a mandatory medical director.

The key takeaway here is that it all boils down to your state's specific regulations. Don't be discouraged — research your state's laws and explore the possibilities.

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

Some states, such as Maryland and Nebraska, require an initial period of supervision or mentorship before granting full independent practice authority.

Kansas and New York have specific requirements like practice hours and collaborative agreements that need to be met before achieving full independent practice status.

The list reflects the most recent updates as of 2024 and includes states with both full practice authority and additional specific state conditions. Here are some great resources for additional help: (Nurse.org)​​ (Nursing Process)​​ (AANP)​​ (Incredible Health)

Important note: Our list is intended for informational purposes only and may not be exhaustive. Always consult your state's medical board or a qualified legal professional for the latest and most accurate regulations regarding med spa ownership.

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. Here are the states and some additional details:

These states allow PAs to open and operate med spas, but they must follow specific guidelines, such as having a supervising physician or medical director and adhering to state regulations regarding medical procedures and supervision agreements. 

Here are some great resources for additional help:​ (American Med Spa Association)​​ (Yocale)​​ (Doctors For Providers)​​ (Face Med Store)​.

Can an RN open a med spa?

While Registered Nurses (RNs) can't own med spas independently due to licensing limitations, here are the options available to them:

• Owning an existing med spa: In some states, RNs can purchase established med spas that already have a Medical Director in place. This allows you to leverage your business acumen and passion for the industry while ensuring compliance with regulations.
  
  Action step: Research your state's laws to see if this ownership structure is an option for you.

• Partnering with a medical director: Similar to NPs and PAs, RNs can collaborate with a licensed physician who acts as the Medical Director. This partnership allows you to contribute your nursing expertise while the Medical Director oversees the overall operations and ensures adherence to legal requirements.
  
  Pro-tip: Network with potential Medical Directors in your area to find someone who aligns with your vision and goals.

• The MSO advantage: Management Services Organizations (MSOs) are a great tool for non-physician healthcare professionals who want to be involved in med spa ownership (more on this later).

Don’t let licensing limitations hold you back, explore the possibilities in your state and consider alternative ownership structures like established med spa ownership, partnerships with medical directors, or working with an MSO.

States where non-medical personnel can own medical practices (this list may not be exhaustive; always consult a legal professional):

How can anyone own a med spa?

It’s time to talk about the powerful tool at your disposal that we mentioned earlier — the Management Services Organization (MSO).

What is an MSO?

An MSO is your one-stop shop for med spa business operations. These specialized companies provide various administrative and management services to partner medical practices.

In states with strict CPOM laws, MSOs can be a game-changer for non-physician healthcare professionals. While you can't directly own the med spa itself, you can own and operate the MSO, which provides crucial services to the practice. This allows you to participate in the med spa's success financially.

Through the MSO, you can offer the services of qualified professionals like nurse injectors to the med spa. This way, you can leverage your skills and experience within the industry.

But MSOs aren't just beneficial for non-physician professionals. Partnering with an MSO offers a variety of advantages for med spas themselves.

MSOs handle administrative tasks like staffing, billing, and marketing, freeing up valuable time for medical professionals to focus on patient care.

By eliminating duplicate services, MSOs can help med spas save money and operate more efficiently. Even smaller med spas can gain access to the expertise of specialists through MSO partnerships.

What does a medical director do at a med spa?

A Medical director is a licensed physician who partners with a med spa to offer expert medical oversight and legal compliance. They ensure everything runs smoothly and that your med spa stays on the right side of regulations.

Medical directors wear many hats. They advise on the most effective treatments, protocols, and regimens to deliver optimal results for your clients. They help consider and approve the introduction of new procedures or services to keep your med spa at the forefront of the industry. 

Since medical directors share some of the legal responsibility with non-physician partners, careful assessment during initial consultations is crucial.

The qualifications for medical directors can vary by state, so it's essential to research the specific requirements in your area before starting your search. 

Remember, a good medical director is a partner, not just a name on a document. Take your time to find someone who aligns with your vision and values.‍

Wrapping it up

Congratulations on taking the first step towards your med spa dream. Now that you understand the ownership structures, medical directors, and MSOs, you're well on your way to a successful business.

Here's a quick recap:

• MDs/DOs: The most straightforward path — licensed physicians can generally own and operate med spas independently in most states.
• NPs, PAs, and RNs: Explore alternative options. Partner with a Medical Director, work within an established med spa in certain states or leverage MSOs for indirect ownership.
• Medical Directors: These licensed physicians provide crucial medical oversight and legal compliance.
• MSOs: For non-physician professionals, MSOs offer a valuable alternative. By owning and operating an MSO, you can sell essential services to a partnered med spa and share in its success.

Moxie: Your med spa partner 

Now that we know who can open a med spa, remember that you don't have to do it alone.

Moxie is here to empower you every step of the way. With our comprehensive resources and industry insights we'll equip you with everything you need.

We go beyond simply providing resources. Here's what sets Moxie apart:

• In-depth resources: Access our library of informative articles, checklists, and templates specifically designed for med spa entrepreneurs.
• Expert guidance: Our team of industry veterans is here to answer your questions, address your concerns, and provide personalized advice tailored to your goals.
• Moxie network: Connect with qualified medical directors and other essential partners to streamline your launch process.

Visit our website today to explore our resources, schedule a free consultation with a Moxie advisor, and discover how we can help you build the med spa you've always dreamed of.