NEWSDecember 12, 2021

How to Choose a Medical Director for your Aesthetics Practice

By Megan Davies FNP-BC, CANS and Medical Director

“Do you love it?” I get asked this frequently by clients and nurses trying to break into the aesthetics industry. We have glamourized it on social media and let’s be honest, why wouldn’t it sound better than bedside nursing these days? Starting your own business in aesthetics allows you to be the boss, make your own hours and help people look their best…sounds great right? But I’m not here to sell you on starting your own aesthetics practice, in fact if you are reading this blog you probably have already made that decision, or are at least heavily considering it.

This blog is to help you make one of the most important decisions you must consider when opening an aesthetics practice, and that is choosing the right Medical Director for your business. I am a Nurse Practitioner in the state of Arizona, so this blog is written from what I know and found to be true in Arizona. I am also the Medical Director for nurses all over the state of Arizona. I also perform many trainings in my office and have held classes on how to start your own aesthetics practice. This blog is also based on my experiences with my nurses as well as what I have heard from other nurses with other medical directors.

  • Choose a medical director you feel comfortable with that has good communication skills. This may sound like common sense, but I’ve had plenty of people contact me with various stories such as “he/she sent me the contract and didn’t ask me a single question” to “he/she says they will get back to me in 24 hours even in the case of an occlusion”. This is a big decision, and you should meet with the potential medical director or at least talk to them on the phone and feel positive about this relationship.
  • Ask the right questions, but don’t expect them to help you with everything up front. Some questions I would recommend asking:
  1. How long have you worked in aesthetics? Is this a full-time job for you, how often do you perform aesthetic procedures? (If they are an APRN they are required by the nursing board to at least be trained in aesthetics).
  2. How often does the medical director attend industry events and trainings?
  3. Does the medical director offer shadowing opportunities or trainings in their office?
  4. How accessible is the medical director? Do they have front office staff that can get them out of a room if it is urgent? What is the turnaround time to sign needed paperwork?
  5. Do they provide policies/procedures? - If this answer is no this is a red flag, the Arizona board of nursing requires your medical director provide these however many medical directors do not.
  6. Do you have other nurses you are medical director for? How many? May I contact them?
  7. Why are they choosing this? Do they want to be a stay at home mom etc. You should have a sense of what direction they are heading in.

This is a great time to interview them. This is not a time to have all of your business questions answered. I like to have an introductory call and then we can both think further if it is a good fit. I don’t answer a lot of questions up front such as “what accounts do I need to set up” because a good portion of the questions are given in a binder I give all my nurses.

  1. Find a medical director who is reliable and competent. I would ask the medical director what happens in the event they go on a vacation? Is there backup if they are not available? I also believe it is important that they are practicing entirely in Aesthetics. The field of Aesthetics is changing so quickly that it is nearly impossible to be good at it and stay up to date in best practices if you are also working in another specialty. This also may sound a bit odd but they should also be active on social media. This is actually a great way for them to stay up to date on latest trends. I often verify those trends with clinical articles, but a lot of good information is on social media in this arena. I would also find out what kind of trainings they have attended. If they only attended an initial botox and filler certification then I would steer clear. I include my C/V when I meet with someone so they can find out more on why I make a competent medical director.
  2. Strongly consider a Nurse Practitioner. This may sound biased, but here me out! I have seen a rise in offices providing trainings that do not meet the nursing board’s requirements for the initial training in Botox and fillers. As of 2019 the nursing board started requiring nurses to take a course with continuing education credits attached to it. I started noticing many of these trainings were led by Physicians. I do not believe Physicians need continuing education credits attached to their trainings currently to perform these procedures. I began thinking about this…how can a medical director not governed by the same board as a nurse keep someone governed by a different board safe and in compliance? And that is what has changed my view on this. For various reasons over the years, I have actually told people to just use a certain Doctor that is medical director for a lot of nurses in the state, but I think this needs to change. I have had many nurses come to me when their employer is using a Doctor and say “I wish you were our medical director”. And the main reasons they say this is- they aren’t given protocols (even in the event of a vascular occlusion) and they don’t have accessibility to their director or are even made to feel stupid when they call. A Nurse Practitioner who does not provide protocols would be in trouble with the nursing board, but the nursing board can’t do much if a Doctor doesn’t provide them. A good Nurse Practitioner who is active in Aesthetics will keep you more compliant.
  3. Ask what input you can expect from them regarding business questions you may have. Your medical director is normally that, they will help you with the medical side of your business. You should be on the same page about this, as again some directors will be very silent partners, and some will want to be more involved. Some directors will offer business consulting at a fee. This can be a very frustrating time for many nurses, navigating their own business. Many directors do have resources such as attorney contacts etc but again you should expect additional fees for services that are outside of the scope of your medical director.
  4. What services can you perform and are there extra fees for more services as you grow? Most medical directors will include botox and fillers in their general fees, however as you add more services there is more liability and general fees will rise. Performing threadlifts, adding machines or even training in your facility will usually add additional fees. You should also know if lasers are something they are willing to take on if that is something you are interested in. In our state I have been told that the nursing board frowns upon NP medical directors not being on site for laser procedures, so even though I have taken the 3 day course required by the board, I will not sign an off-site medical director agreement for lasers.

A common question that I get is when a nurse lives an hour or more away and they ask if that is too far for me to be their medical director. The answer is no! The state board actually used to require that we be available to assess a client within 4 hours but did away with that clause in 2019 and has since allowed for telehealth conferencing instead. Here is a link with more information about aesthetic procedures and medical directorship in Arizona.

I hope that answered some of your questions! If you are interested in more information about medical directorship, feel free to give us a call our inquire on our contact us form.

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