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Medical Spa Business Forum > MD spa director salary

I am in internist in CA with a small, new (open 4 months) med spa which I own with a nurse (51%/49%). So good so far. We have been approached by a couple who would like me to be the medical director of their spa which they plan to open in Dec. They have offered me a small salary and 15% profit for about 10hrs/wk hands on and, of course, all of the medical liability. I am curious what other md's would consider fair compensation in this scenario. I would not have to financially contribute to the opening of the new spa.

08.19 | Unregistered CommenterDr.Kelly

I am not sure that I would want to work for my competition. I would only think about it if they were not in your market.As you have read on this site before, watch the contracts. You do not want to get yourself in a legal bind.

If you do it, make sure that they give you all medical oversite. Most likely they will not care about the medical side of things but only the financial. Read what has happened to others in the situation. You will find it in other areas of this site.

08.19 | Unregistered CommenterLH

Thank you for your response. Yes, I will have all the medical oversite and I will be very careful with contracts. Fortunately since I have my own spa I have done a lot of research about the legal aspects of spa ownership and management. What I don't know is the typical payment structure for my senario. Perhaps there is not one, but I don't want to go into final negotiations and later find out I was financially taken advantage of.

08.20 | Unregistered CommenterDr.Kelly

As I understand it, you cannot partner with a non-physician in the practice of medicine. Even cosmetic medicine would be allowing the partner to profit from medical procedures and therfore be practicing medicine without a license. Am I wrong? You also mey be in the realm of fee splitting.

11.2 | Unregistered CommenterMedSpaMD

As long as your cosmetic spa isn't taking govt insurance you can arrange the fees anyway you want. As a partner in the medspa you should get a "technical fee" (or hourly rate) when you perform a procedure. The "ownership" portion of the profit should be split after expenses. As MedSpaMD states in many areas you cannot partner w/ non physicians, though many states will allow this as long as there is no "corporate practice of medicine". This basically means that your non-physician partner can't tell you how to practice ( ie: telling you "Everyone gets sold Thermage when they walk through our door".)

I Don't know if this is helpful to your situation, but American Laser pays their medical directors a flat 4K per month- no commissions.

i know of someone getting 3000/month and no commisions

12.22 | Unregistered Commenterark

The Medical Spa Director that I used to work with at another medspa would get $5K monthly without commission. As far as "partnering", here in California, the physician has to own the medical spa and the non-medical financial partners can only own the management company affiliated with the medspa. Physicians who are thinking of partnering with laypeople in a medspa should make sure they know who are they dealing with and that the laypeople do not participate in the corporate practice of medicine.

03.12 | Unregistered Commenterpacmvk

I am a M.D. being approached by a med spa owner to be the medical director of his spa and am looking for details on things to look out for and resources to educate myself on the legalities of the position. The spa is a franchase owned branch of a national chain, the location is in CA which I know comes with certian legalities can someone please advise?

09.10 | Unregistered Commenterpg

There is no split fee as long as each involved performs a professional service. Compensation can be what you make it. An MD can even take a percentage, more money = more complexity = more liability = higher fee for "supervision".

I would say MD is better with %. Spa is better with flat fee as long as revenue is high.

09.10 | Unregistered CommenterFlorida PA

PG: I know of a lawyer in California who specializes in this. If you provide an e-mail I will send you his contact information. California is probably the top enforcer of the "corporate practice of medicine" prohibition in the nation.

I have been approached by an aesthetician going on her own to be the medical director at her spa. My question is for the monthly salary mentioned (3/4/5K/month), what liability are they assuming, what procedures are being performed. Are the physicians doing any of their own work?

05.18 | Unregistered CommenterDr. PAH

I am a nurse that runs a satalite office for a plastic surgeon,I get an hourly plus commision, I am interested in having the buisness and having a Medical Director that I pay I will still want a Plastic Surgeon he is with in ten miles but many times I send patients to him, what is a fair rate and what are the steps that should be taken. Do I legally have to have a plastic or Derm as my Director in Texas

04.23 | Unregistered Commenterdnurse

Im sorry I didntt include I do the Botox and Dermal Fillers, he still has his practice that he runs and does offer many services and he does do some of the Botox

04.23 | Unregistered Commenterdnurse

I am an RN with extensive aesthetic education and have owned and operated my own business for several years. I believe the medical director fee is directly related to the number of patients treated per month. Of course the greater number of patients, the greater the risk for the medical director. I believe it is also related to the risk of the procedures performed. for basic medspa services, botox, filler, peels, product, acne care, basic laser, all which are not high risk treatments, I think the fee should not be as high as medspas performing high risk treatments. I carry my own malpractice insururance, I have clinic insurance, and the medical director has her own insurance. I tried a 10% of all profits, but it ended up a bookkeeping nightmare. In the rural areas where the patient load is not high, monthly fees range from $800 to $1500 per month. this is typical for rural Minnesota and North Dakota. I would be really interested in seeing what others medical director agreements look like as well as treatment protocols..

01.5 | Unregistered Commenternancy

Hi Nancy-
Do you operate independantly with an off-site Med Director? Those of us in Virginia (RNs) have recently taken a beating in the manner of repeated visitis by the boards of Pharm, Med, and Nsg- all instigated by a few local plastics here.
I would really appreciate any input you have regarding your state regs.

Julie Trask

01.6 | Unregistered CommenterJulie

I'm an RN(20+yrs) in Memphis, TN area. i would love to speak with the last two RNs that posted on here. I'm opening a weight loss spa. bringing in an NP for the medically supervised weight loss portion. I'm going to be leasing space from an adjoining MD. I'm interested in presenting her an offer to be Medical Director. as I'm in the financial planning stages, any input would be helpful. or 901-340-9726.

01.6 | Unregistered CommenterPaulaRN

Hi Paula,

Interestingly, I recently left a weight loss combination aesthetic clinic. The physician for the weight loss side of the business was the medical director for the aesthetic side of things. The owner thought bringing in aesthetics would be a good investment because as people lose weight and start feeling better about themselves, they would utilize aesthetic services. In addition, the weight loss traffic would support the aesthetic end by giving visibility to the aesthetics.

The owner hired me to start the aesthetic piece. It was in place for about 18 months and it did not turn out at all like we thought it would. What happened is the weight loss clients did not want to or have the money to spend on both weight loss and aesthetic. Even if the weight loss person met their goals, they felt so good about themselves they didn’t have interest in aesthetics. We also thought the traffic of weight loss people would be enough to fuel the aesthetics, it was not.

In the 18 months, the aesthetic piece lost the business money. In the area of Minneapolis the clinic was located, there was quite a bit of aesthetic competition. We lowered our prices, but still… that did not help the business grow. It’s been a tough economy here though.

I am now with a natural path physician. In the Twin Cities, medical directors have different motives and their motives is what drives what they charge for a fee. For example, if you have a medical director who is a plastic surgeon and is looking for plastic surgery referrals and you give him a fair share of referrals, his fee is going to be much less than a physician taking on a medical director position for income. The fee also depends upon what it will cost a physician to add being a medical director to their malpractice policy. If you have a plastic surgeon for a medical director, their malpractice insurance is second highest to obstetricians so for them to add medical directorship to their malpractice policy it is not going to cost them any more than the high rates they pay already. For a general family practice doc, it will cost anywhere from $4000-$6000 per year to take you on. Most medical directors will expect that you will pay that as well as their monthly fee. In the beginning, getting an aesthetic practice up and running, with the product so darned expensive and the medical director fees, not to mention the equipment and advertising, your pockets have to be pretty deep. I am NOT gloom and doom, I LOVE aesthetics. However, I have opened 3 clinics from the ground up without an established client base that existed and in all 3 clinics it was a tough go.

I hope this helps a little. I would be curious how your endeavor all turns out for you. Keep me posted 

01.7 | Unregistered Commenternancy

Hi Julie,
Yes, my medical director is off site. And yes, the derms more so than the plastics are beginning to be rebellious. I know in a couple of states they are mandating RN's be certified so that is my next step in October 2011. I have very specific protocols I follow leaving no room for question. My defense is that this is no different than the RN's out in the field doing home hospice care working with IV's, morphine, pic lines, trachs, etc.. or other home care, and no different than the paramedics in the field providing much more intense treatment out in terrible situations, ditches, accidents, etc. than an RN injector is providing in an aesthetic environment. I too have had visits with the board of nursing and the key is to have all of the paperwork perfect. I follow the state standards of practice to the T and document according to them. Let me know if you want more details! Good luck!

01.7 | Unregistered Commenternancy

I am a family physician in Canada and have an aesthetic practice on the side. I also am wondering what the salary/consultant fee would be for a medical directorship. I am a little hesitant to take on this role because my impression of this type of situation is that the medical director is barely present but has medicolegal responsibility the entire time. i was thinking that a monthly salary with commission would be the best bet as your rate would be guaranteed to increase as the clientele numbers increase (as does the medical liability). Does anyone know of the numbers in that situation?
Hi Julie!
thanks, mb

02.20 | Unregistered Commentermb

Commission basis is easier to calculate when you first start out however as you get busier it becomes more difficult and tedious for the one doing the calculations. I pay our medical director a straight salary.
Whatever our total bank deposits are on our monthly statement I give 10% of that.
You can do it that way, or give 5 % off the top.
Commission is more accurate but also keep in mind you would have to take into account cost of overhead and products.
Good Luck.

02.20 | Unregistered CommenterD NP

Hello all, I have been approached by an RN who has worked for a prominent plastic surgeon for years, to be her medical director for her. She is going to travel to her high end clients office and/or home to provide their fillers and botox. What should I ask for compensation?



06.7 | Unregistered Commenterkdoc

Hi I live in Texas and have a salon day Spa. I have many clients that are asking me for Botox and fillers, I would like to know how or where do I go to find a Medical Director. I beleave in Integraty and honesty, always do things wrigh from the start.
Thank you

07.5 | Unregistered CommenterMarilyn

Where do you reside in Texas? Are you looking for a remote or on-site medical director??

07.10 | Unregistered Commenterbdoc

I'm looking for a remote Medical Director, my business partner is an RN with 10 years of experience Injecting Botox, Fillers etc.
I need some one ASAP. I would send any required information or references. My contact

Thank you

07.14 | Unregistered CommenterMarilyn

Can a Clinical MA with injectables experience after working under a physician open a MedSpa if they have a Medical Director in TX

09.9 | Unregistered Commenteraesti/ma

@ aesti/ma
Very simple answer: No.
Please go ahead and any of the medical / legal discussions and threads. As an MD you can not practice medicine or own a medical practice.

I am constantly amazed by the questions asked by so called "experienced" operators. Ask yourself if you would go to yourself for treatments or treat your daughter's face. If the answer is "NO" than do not try to do anything. To do so is taking an extraordinary risk. I can not wish you good luck because you are stupid if you do it anyway.

09.10 | Registered Commenterlefty2g

I have read all the blogs above and am always amazed at the level of diversity; as in the topics mention. My background, massage therapist for 18 years-both medical and wellness, currently own a vocational school for massage therapy and currently am enrolled in a estethics program. I am considering leaving all behind and moving into the Med Spa area. I would like to use my experience and knowledge in this field while continuing to be open for new education. I absolutely love product, marketing, education, treatment and teamwork. My degree is in Business Administration. So, my question is," Would I be employable and what would type of income could be expected?" 36 yrs, old.

11.17 | Unregistered CommenterKimberly

Where are you located?
Owning your own vocational massage school sounds nice. Great massage schools with reasonable pricing are actually needed in Southern California; Specifically east of Los Angeles; Montebello, Whittier, and Diamond Bar, Brea area. If you are going to be an Esthetician, you can make approximately 40% of facials, Microdermabrasions, Chemical Peels or greater. I pay our Esthetician $35 on a $85 Microdermabrasion treatment, $26 on a $65 European Facial and $150 on a $350 Vi Peel after costs... 10% of Products Sold; You would need to work in a high end region to make money; there has to be a high turn around of clients to generate the income you are aiming for.
Having both Massage and Esthetic background is definitely an asset. A skillful individual in marketing is especially needed in this industry. Combining all your traits into the Medspa industry would be the best thing to do because med spas are not always busy with facials or massages ... Some more days than others and with expenses there is so much marketing that can be done so a balance of traits will keep you with a steady income. The Medspa industry is a growing industry but also very competitive. Too Many spas try to sell Botox so inexpensively that in the end those trying to lure clients with their low prices end up suffering in the end.
Good Luck in the Medspa Industry. Remember...everyone wants to look young and feel good... We all need to relax...

11.17 | Unregistered CommenterD NP

I would like the Nurse Practitioner that works full-time in my Aesthetic Practice to also be the spa director. We are a successful medi spa in California. What would be an average salary to pay the NP?

01.26 | Unregistered CommenterCindy

to clarify we have a MD that is our medical director that is owner of the spa the NP would manage the day to day operations.

01.26 | Unregistered CommenterCindy

Nancy, I would like to hear more about your protocols you have set in place

05.5 | Unregistered CommenterCindy

I"m a medical aesthetician in the state of GA, currently in the process of opening a medical day spa searching for an off site medical director for my practice. The services performed will be laser aesthetic services performed with a class 4 laser, such as: hair removal, spider veins, skin tightening, radio frequency, ipl, treatments etc... I will also have a nurse practitcioner performing botox services and other injectables. If anyone has an example of a medical director proposal they can share, I really would appreciate your help and guidance.

Please email to

Best Regards,


09.29 | Unregistered CommenterK Wheeler

Hi- my friend and I are in the planning phase of opening a medical spa and needing some guidance in writing a contract between us (we're both RNs) and the medical director. Thank you

01.4 | Unregistered CommenterAMC

Hi- my friend and I are in the planning phase of opening a medical spa and needing some guidance in writing a contract between us (we're both RNs) and the medical director. Thank you

01.4 | Unregistered CommenterAMC

@Medical Spa MD

Per Your "As MedSpaMD states in many areas you cannot partner w/ non physicians, though many states will allow this as long as there is no "corporate practice of medicine". Is Texas a State where this is allowed if meeting the stated criteria? Thank you.

01.6 | Unregistered CommenterER

I would have to planning financially contribute to the opening of the new spa.So I hope you will contract us.

Hi ,
I am an internist and I am interested in opening in medical spa . I have read multiple postings saying that they have experience in opening one. . Please contact me if anyone is interested in building a medical spa

02.4 | Unregistered Commenterjo

I am an NP (certified in botox/filler) looking for medical director. Want to start side business. Any tips would be helpful in establishing protocols. Already have a full time job, but aesthetics are my passion! thanks.

I'm a Crna that's adv practice in the state of fla. My husband is a doc, and I'd like to find an atty in the state of Florida who knows the laws of opening a medispa. I'll b in the pan handle area. Does anyone have suggestions?

05.28 | Unregistered CommenterMellab

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