Can a Georgia med spa employ its own medical director?
The ownership question and the supervision question have different answers in Georgia, and a great many structures were built by people who only read the first one.
The short answer
It depends who owns it. If the med spa is owned by a physician, or by a lay owner who is not the clinician being supervised, Georgia's employment prohibitions do not apply.
If the practice is owned by the APRN or PA under supervision, putting the supervising physician on payroll is unlawful under O.C.G.A. § 43-34-25(n) and § 43-34-103(k).
The two statutes
O.C.G.A. § 43-34-25(n): except for the practice settings in subsection (g)(7), it is unlawful for a physician to be an employee of an APRN, alone or in combination with others, if the physician is required to supervise the employing APRN. Rule 360-32-.04(5) restates it as a Board rule.
O.C.G.A. § 43-34-103(k) does the same on the PA side, grandfathering only arrangements the Board approved on or before July 1, 2009. The (g)(7) exception reaches 501(c)(3) entities primarily serving uninsured or indigent patients and federally funded health centers — not med spas.
Does an MSO fix it?
No, and in Georgia an MSO is usually solving a different problem than owners think. A management services organization — holding the lease, equipment, brand, non-clinical staff and back office, and contracting with a separate clinical entity — exists in strict corporate-practice states because lay ownership of the clinical entity is barred there. Georgia does not bar it, so an MSO here is a financing, multi-site and investor-readiness decision.
If the entity that employs the supervising physician is itself owned by the APRN being supervised, that arrangement belongs in front of counsel. The Board has not published guidance on whether interposing an entity, or engaging the physician as an independent contractor rather than an employee, changes the analysis. It is genuinely unsettled.
The question an auditor will ask
What the statute is reaching for is plain: a supervising physician whose income is controlled by the clinician they supervise is a physician who cannot easily say no. However the entity chart is drawn, that is what an auditor, a plaintiff's attorney or a malpractice carrier will put to it — could this physician have refused?
How Local Medical Directors helps
Our physicians work under agreements we are prepared to defend on substance, and we will tell you plainly if a proposed structure is one we will not sign.
Can a lay (non-clinician) owner employ the med spa's medical director in Georgia?
Georgia's employment prohibitions in O.C.G.A. § 43-34-25(n) and § 43-34-103(k) apply when the employer is the APRN or PA the physician supervises. A lay owner who is not the supervised clinician is not covered by those sections.
Is an independent-contractor medical director agreement safer for an NP-owned med spa?
The Georgia Composite Medical Board has not published guidance on whether engaging the physician as an independent contractor, or through an intervening entity, changes the analysis under O.C.G.A. § 43-34-25(n). It is unsettled and should be reviewed by Georgia healthcare counsel.