Five legal considerations for starting a medical spa

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Medical spas are on the rise in South Carolina. Now that we are coming out of the COVID-19 pandemic, people across the state seem ready to take the wrinkles from the last two years off their faces — and who can blame them?

So it is no surprise that we have seen an increase in the number of medical professionals looking to shift away from traditional medical and nursing services (and all the government and private insurance headaches that go along with them) toward the cash business of opening medical spas. However, despite less rigorous regulatory requirements and a simpler payment structure, South Carolina providers looking to start medical spas and/or provide related services still have several legal issues to consider before opening for business.

If you are considering starting a medical spa business or providing related services, here are some things for you to consider:

Are you licensed?

Any good health care attorney should ask you this question because the answer will guide the structure and operation of your business. If you do not have a South Carolina medical or nursing license, you should still be able to move forward with your plans, but you will need to have solid contractual relationships with South Carolina licensed providers to provide certain services such as laser treatments and Botox injections. To avoid corporate practice of medicine concerns and ensure your proposed compensation structure complies with South Carolina law, always have your contracts with providers reviewed by an attorney.

If you are a South Carolina licensed physician, you may want to consider how much time you intend to spend onsite at the medical spa — do you want to be there every day, a few days a week, a few days a month? The answer to this question will influence the providers you hire and the services you provide. If you do not plan to be at the spa every day, you may consider hiring a nurse practitioner to provide services and supervise other staff.

If you are South Carolina licensed nurse or nurse practitioner, you will need to develop a contractual and supervisory relationship with a South Carolina licensed physician in order to properly operate your medical spa. Unless you have a physician onsite, you may not be able to provide all services.

If you want to start a business with more than one type of licensed professional, you will need to carefully consider the structure and organization so as not to run afoul of South Carolina law.

What services will you provide?

Under South Carolina law, whether you need direct or indirect physician or nurse practitioner oversight depends on the type of services you are providing.

If you are a registered nurse, you will need direct (onsite supervision) from a nurse practitioner or a physician to perform Botox injections and laser treatments. If you want to provide cutaneous laser treatments, you will need a physician to examine your patients before you provide the treatments. If you want to perform micropigmentation, you will need to have a physician onsite to provide direct supervision. If you want to provide facials, you will need a licensed esthetician.

Regardless of what services you provide, you will want to ensure you and your staff have the appropriate training to provide the services and have proper protocols and patient consents in place.

Other items to consider:

Will you use an electronic medical record system? If so, you will want to ensure that your medical spa is HIPAA compliant.

Will your medical spa be mobile, or will you have a physical location? If mobile, you will want to consider appropriate product storage and make sure your insurance covers travel. If in a physical location, it’s always a good idea to have your lawyer review your lease agreement and help you obtain any necessary business licenses.

Have you developed a logo or other proprietary marks you want to protect? If so, you may want to consult an intellectual property lawyer.

Clearly, there are a lot of options for how to operate a medical spa. The goals of most medical spa entrepreneurs can be accomplished with careful planning, a good understanding of the rules of the road and, of course, good contracts. 

Meghan Riordan is a shareholder in Haynsworth Sinkler Boyd’s Greenville office. Her practice focuses on providing advice to health care providers and assisting clients with general health care-related business and operational issues, including organizational documents, employment and service contracts, and provider policies.