The medical spa or "medspa" industry has been growing in popularity for a number of years. Consumers are increasingly interested in receiving the latest and greatest aesthetic and cosmetic procedures and entrepreneurs are interested in profiting off of the growing consumer demand for these services.
We receive a lot of inquiries from both licensed health care providers and unlicensed people wanting to learn how to open a medical spa. They are often surprised to learn that the process for opening a medspa is more complicated than they hoped and that a number of state laws regulate their operations. This article will review some of the larger regulatory issues affecting ownership and operations of medical spas in Illinois, and the most frequently asked questions we receive on this topic including "who can own a medical spa?" and "what license do you need to open a medical spa?".
Legal Requirements by Type
Medical spa requirements in Illinois are multifaceted. They include restrictions on ownership, restrictions on choice of business entity, as well as licensing and scope of practice considerations. In addition, because a medical spa involves the practice of medicine, compliance with state laws governing medical practice operations is required.
Arguably the most important issue is determining who can own a medical spa. Illinois recognizes the corporate practice of medicine doctrine, which generally prohibits lay corporations from practicing medicine or employing a physician to provide medical services. A medical spa is considered a medical practice even though the services it offers are different from your typical doctor's office. This means that lay persons (i.e., non-physicians) cannot own a medical spa; though, they may be able to provide services to, or assist in operations of the medical spa. It also means that the form of business entity selected to own the medspa must permit the practice of medicine. Illinois recognizes a number of professional business entities that permit the practice of medicine including medical corporations, professional service corporations, and professional limited liability companies. These business entities are also licensed and regulated by the Illinois Department of Financial and Professional Regulation (IDFPR).
Medical Practice Requirements
A medspa is considered a medical practice, which means it is regulated under state laws governing the practice of medicine. In Illinois, state laws impose requirements on many aspects of the practice of medicine including advertising, prohibitions against fee splitting, and supervision/delegation of medical services. Many of the services offered at medspas must be performed or supervised by a physician, which means that a physician-patient relationship may need to be established before certain services can be delivered. Moreover, because medspa services have potential risks and adverse reactions, policies and procedures should be in place to assure that services are offered in a safe manner and informed consent should be obtained prior to performing service. It is essential that physicians and non-physicians interested in operating a medical spa be familiar with applicable state laws to assure compliance.
Most medical spas offer an array of services and treatments designed to improve a customer's "aesthetic" or appearance. Therefore, it is often assumed that licensed individuals, like cosmetologists or estheticians, are able to perform those services. However, that is not the case.
Most medspa services and treatments must be performed or supervised by a physician or a full-practice authority advanced practice registered nurse. While physicians may delegate performance of certain services or treatments in Illinois, they must do so in the context of a physician-patient relationship. In addition, they must ensure that they are delegating (1) to a licensed person who is acting within the scope of his/her license, or (2) to an unlicensed person who has appropriate training and experience and the physician is on site to provide assistance.
It’s also important that the services and treatments ordered and supervised by the physician are within the physician's scope of practice, education, training and experience. This means that a physician who has no training, education or experience in aesthetic medicine should not be ordering or supervising delivery of medspa services.
Illinois Medical Spa Frequently Asked Questions
What license do you need to open a medical spa in Illinois?
A medical spa must be owned by a physician licensed pursuant to the Illinois Medical Practice Act. In addition, any professional business entity formed to operate a medspa must undergo IDFPR licensing.
Can nurse practitioners own a medical spa?
Illinois now allows advanced practice registered nurses (i.e., nurse practitioner or APRN) to obtain a full practice authority license, which enables them to practice without a collaborative agreement. A full practice authority APRN may be able to form and own their own professional business. However, they cannot practice medicine. Moreover, they cannot advertise their business as a medical spa or "medspa" as only physicians are allowed to engage in the practice of medicine. Careful thought should be given into the type of services offered and how services are advertised.
Can physician assistants own a medical spa?
No, a physician assistant is not able to own a medical spa in Illinois. Physician assistants do not hold a license to practice medicine and may only practice under a collaborative relationship with a physician. Moreover, physician assistants are legally prohibited from personally billing patients or charging for their services. Only a physician assistant's employer may receive payment for services provided by the physician assistant. For these reasons, it is not legally possible for a physician assistant to own a medical spa.
Can registered nurses own a medical spa?
While registered nurses cannot own a medical spa, they may be able to deliver services as an employee of the medical spa.
What are the requirements for an esthetician or cosmetologist?
Estheticians and cosmetologists are prohibited from engaging in any technique, product or practice intended to affect the living layers of the skin. Many of the services offered in a medical spa are specifically intended to affect the living layers of the skin. Accordingly such services would not be able to be performed by an esthetician or cosmetologist absent physician supervision or delegation. Moreover, an esthetician or cosmetologist working at a medical spa would not be able to hold themself out as holding such a license.
Can non-physicians own a medical spa?
In Illinois, it is not possible for non-physicians to own a medical spa. However, they may be able to assist in operations of the medical spa by providing certain administrative services.
If you are interested in opening a medical spa or have questions about medical spa operations, contact us for a free initial consultation.