Part 1: A Guide to Florida's State Laws and Regulations for Med Spas
Frequently asked questions regarding medical spas in Florida
Who can own a medical spa?Only licensed physicians can own a medical spa. Under the Illinois Medical Corporation Act, a medical spa, or any entity that provides medical treatment, must be owned and operated only by persons licensed under the Medical Practice Act of 1987 (the Medical Practice Act governs the medical licensing of physicians). This includes all directors, shareholders, agents, employees, and officers of the medical spa. A person who is not licensed under the Medical Practice Act cannot lawfully have any part in the ownership, management, or control of the medical spa at any time. The reason for this requirement is to prohibit a business corporation or lay person from controlling the medical decisions of a physician or professional staff. This legal concept is known as the "corporate practice of medicine." Medical decisions must always be controlled by a physician, not a lay person or corporation.
Can a nurse, esthetician, Physician Assistant (PA) or Nurse Practitioner (NP) own a med spa by employing a medical director?No, only physicians may own med spas. A typical scenario of illegal med spa ownership occurs when a nurse opens a med spa and employs a physician as "medical director," but the nurse's company runs the med spa in its entirety--overseeing all treatments, including medical treatments. In these situations, the physician serving as the medical director generally does not have any ownership interest in the med spa, but is rather operating as an independent contractor for the med spa. This is illegal and is considered the unauthorized practice of medicine. Not only can the nurse-owner be charged with illegally practicing medicine, but the physician-medical director will likely also be charged with "aiding and abetting" in the unauthorized practice of medicine. Only physicians can own med spas, no exceptions!
Can a nurse, esthetician, PA or NP take a commission for administering laser treatments or injectables like Botox?Nurses, estheticians, PA's and NP's cannot work on a commission basis when performing medical treatment. Under the Illinois Medical Practice Act, it is illegal for physicians to share a percentage of their medical professional fees with anyone other than licensed physicians with whom they practice. The medical corporation (or physician) can pay its employees, like nurses and estheticians, a reasonable salary. However, that salary cannot be based upon a percentage of profit (commissions) made by the nurse because such an arrangement is considered profit sharing which is strictly prohibited. Pursuant to the Illinois Medical Practice Act, fees generated from medical treatment must be paid only to a lawfully formed medical corporation, or directly to a physician. Under this Act, a physician may not directly or indirectly divide, share or split any professional service fee or other form of compensation for professional services, or directly or indirectly pay a percentage of the physician's service fees, revenues or profits with any non-physician (nurses, estheticians, physician assistants, etc.). If a nurse is working on a commission basis, the State of Illinois considers this to be engaging in "fee-splitting" and the unauthorized practice of medicine. The State of Illinois may revoke, suspend, or refuse to renew the license of any physician that is splitting fees with non-physician practitioners by paying the non-physician practitioners a commission.