Medspa • Best Practice
Who Can Open a Medical Spa?
By Jade Alexander . Oct.13.2025
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Ownership, licensing, and compliance tips for a profitable medical aesthetic business.
Opening a medical spa blends healthcare with beauty and wellness, but unlike traditional beauty and wellness businesses, ownership of a clinical practice is governed by state law. Use this guide to understand who can open a medical spa, what license you need to open a medical spa, and how to structure a compliant medical aesthetic business.
TL;DR
Who can open a medical spa? Usually, physicians (MD/DO); some states allow NPs/RNs with physician oversight. PAs generally cannot own on their own.
Dentists/chiropractors may participate but only within their licensed scope.
What license do you need to open a medical spa? A medical license (to perform/oversee care) plus business, facility, and device permits; non-physician owners typically need a medical director and formal supervision & collaboration agreements.
Always verify your state’s rules before forming an entity or marketing services.
Not legal advice. Confirm with your state medical and nursing boards and a healthcare attorney.
Who Can Open a Medical Spa?
In most states, MD/DO physicians may own and operate the clinical side of a medspa. Some states permit nurse practitioners (NPs) and registered nurses (RNs) to own or co-own a medspa, typically with documented physician oversight and collaboration. Physician assistants (PAs) usually cannot own independently, although some states allow minority co-ownership with a supervising physician. Dentists and chiropractors may participate, but their role is restricted to the scope of their licenses.
What License Do You Need to Open a Medical Spa?
Medical license (MD/DO) to perform or supervise medical procedures
Business license for your locality
Facility/device permits (e.g., laser registrations) where required
Professional licenses & certifications such as NP/RN/PA, aesthetician, laser technician, etc.
Controlled substances registration (if applicable)
Insurance for and malpractice + business requirements
If the owner is not a physician, you’ll need to retain a qualified medical director and maintain standing orders, treatment protocols, consent forms, and QA processes.
Medical Aesthetic Business Basics: Ownership vs. Clinical Practice
Ownership refers to who holds equity and control. This varies by CPOM—Corporate Practice of Medicine—rules. Clinical practice refers to who can diagnose, prescribe, inject, or operate devices. Note: many states allow some non-physician ownership, but they still require physician supervision of medical services.
Role-by-role (credential snapshot)
Role | Can Open & Own? | Independent Practice? | Notes |
Physician (MD/DO) | Yes (most states) | Yes (within state scope) | Commonly serves as medical director; MD/DO + residency |
Nurse Practitioner (NP) | Varies by state | Sometimes | Often requires collaboration or supervision; autonomy differs by state |
Registered Nurse (RN) | Select states | No | Ownership sometimes allowed; MD oversight for procedures |
Physician Assistant (PA) | Generally not (solo) | No | Needs to work under physician; some states allow minority co-ownership |
Dentist or Chiropractor | Varies | Limited to discipline | May be recognized in limited ways; scope-restricted participation |
State-by-State Considerations
Doctor-only states: Clinical ownership and control is limited to physicians.
Mixed states: Allow NP/RN ownership with defined physician oversight.
Operational overlays: Chart review rules, on-site or tele-availability, delegation limits, device-specific rules, and advertising standards can materially impact staffing, scheduling, and marketing.
The Role of Medical Directors & Supervision
A medical director (often an MD/DO) typically:
Establishes protocols, standing orders, informed consents, and QA
Defines who can perform what (scope + device authorizations)
Maintains supervision and collaboration agreements (NP/RN/PA)
Oversees adverse event and incident reporting processes
How to Launch a Compliant Medical Aesthetic Business
Here are the ten steps to launching a compliant medical aesthetic business:
Research state law (CPOM, scope, supervision, devices, advertising).
Choose your structure (PC/PLLC; consider an MSO for non-clinical ops).
Engage a medical director; create protocols, consents, QA.
Map roles to scope with a clear “who-does-what” matrix.
Secure licenses & permits (business, professional, devices).
Stand up HIPAA policies, training, credentialing, incident workflows.
Obtain malpractice & business insurance aligned to services.
Implement PM/EHR, scheduling, inventory, incident logs.
Launch compliant marketing around service menu, website disclosures, and ad review.
Audit annually any laws, training, insurance, and protocols needed.
Medical Spa Compliance Checklist
☐ Ownership aligned with state CPOM rules
☐ Medical director engaged; protocols, standing orders, QA in place
☐ Scope-of-practice matrix by role; supervision & collab agreements current
☐ Licenses & permits verified (business, professional, device)
☐ HIPAA-compliance program (policies, training, consent library, incident reporting)
☐ Insurance covers offered services (malpractice + business)
☐ Advertising reviewed (claims, before/after, pricing)
☐ Annual compliance review scheduled
FAQs
Who can open a medical spa?
Physicians in most states; NPs/RNs in some states with physician oversight; PAs rarely as sole owners. Dentists/chiropractors may participate only within their licensed scope.
What license do you need to open a medical spa?
A medical license (to perform and oversee care), plus business, facility, and device permits, and appropriate professional certifications; non-physician owners generally need a medical director.
Do I need a medical director?
In practice, yes—to supervise medical services, maintain protocols, and ensure quality and regulatory compliance.
Conclusion
Requirements vary state by state. A successful medical aesthetic business starts with state-compliant ownership and credentialing, a clear scope-of-practice map, and documented supervision. Build that foundation first, then scale with strong operations and client experience.
Not legal advice. Confirm with your state medical and nursing boards and a healthcare attorney.
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