Understanding Scope of Practice: Who Can Do What in Your Med Spa?

You've just hired a talented new Registered Nurse and a certified Aesthetician. Can the RN perform a new patient consultation for Botox? Can the Aesthetician operate your new IPL laser for a photofacial?

The answer to these questions is not a matter of opinion or skill; it is a matter of law. Scope of Practice defines the procedures, actions, and processes that a healthcare professional is legally permitted to perform in a specific state. Violating these rules is one of the fastest ways to lose your license and endanger your entire business.

While the rules vary by state (and you MUST consult your state's legal summary), here is a general hierarchy of roles and responsibilities in a med spa:

The Aesthetician:Aestheticians are skin care specialists, not medical providers.

• Can Typically Do: Superficial services that do not penetrate the dermis. This includes standard facials, microdermabrasion, and very superficial chemical peels.
• Cannot Do: Any procedure that involves injections (Botox, filler, PRP), medical-grade lasers, or anything that requires a medical diagnosis or prescription.

The Registered Nurse (RN):RNs are highly skilled medical professionals who excel at performing tasks.

• Can Typically Do: Administer medical treatments after they have been prescribed. This includes injecting Botox and fillers, performing laser treatments, and administering IV therapy.
• Cannot Do: An RN's role is not diagnostic. They cannot perform the initial Good Faith Exam, diagnose a patient's condition, or independently create a treatment plan. They are executing an order from a prescribing provider.

The Nurse Practitioner (NP) & Physician Assistant (PA):NPs and PAs are advanced practice providers who can diagnose, treat, and prescribe.

• Can Typically Do: Almost everything a physician does within the med spa setting. They can perform Good Faith Exams, diagnose conditions, develop treatment plans, and perform all aesthetic procedures.
• The Caveat: They must operate within the terms of their collaborative or supervisory agreement with the medical director, as defined by state law.

The Medical Director (MD/DO):The physician is at the top of the clinical hierarchy.

• Can Do: Everything. They have an unrestricted license to practice medicine.
• Must Do: They are ultimately responsible for everything that happens in the clinic. They must provide proper supervision and delegation for every medical procedure performed by the team.

An engaged medical director doesn't just lend their license; they establish the compliant framework of delegation for your entire team. A MedSpire-connected physician will help you create clear delegation logs and protocols, ensuring everyone on your team is operating safely and legally within their scope of practice.