South Carolina Practice Structure Guide: The Professional Corporation, Common Law and the Board's 2022 Advisory Opinion

Entity and Ownership

South Carolina's professional corporation supplement requires articles filed with the Secretary of State stating the entity is a professional corporation, limits it to one profession plus ancillary services, and bars other business apart from investing funds. Shares may be issued only to individuals authorized to render the service in South Carolina or another state, to general partnerships of qualified persons with at least one licensed in the state, and to qualified professional corporations. Licensing authorities may restrict or condition issuance by rule. At least half the directors and all officers other than the secretary and treasurer must be qualified persons, and transfers, proxies and voting trusts are limited to qualified persons. An annual report certifies ownership and directors, and the Attorney General may seek dissolution after notice of violation. Names must include a designator such as professional corporation, service corporation, chartered, P.C. or P.A., and P.A. is a naming option for the same corporation and not a separate entity.

The Corporate Practice Position

There is no corporate practice statute. In Baird v. Charleston County (S.C. 1999), a bond case, the Supreme Court said South Carolina has a common law prohibition against the corporate practice of medicine, citing earlier decisions, and described a licensed professional's remedy as an injunction against the violator. The Board of Medical Examiners published an advisory opinion on corporate practice in November 2022. It says the Board does not license or regulate corporations but has expectations about the economic relationships, that the licensee must control the exercise of clinical judgment at all times, that it is unlawful and unprofessional to let an unlicensed person direct, participate in or interfere with a licensee's practice, and that an arrangement that complies and is otherwise authorized by law is authorized under South Carolina physician licensing law.

The practice act makes unlicensed practice a misdemeanor punishable by up to one year and $50,000 per violation and applies to a person or entity aiding and abetting, and it makes it grounds for discipline to assist an unlicensed person to practice. We found no reported prosecution or Board action applying the doctrine to a management structure.

The Management Agreement and Fees

We found no South Carolina statute regulating MSOs or fee splitting in the chapter we searched, and we did not verify the Board's ethics rules on fee division. Control is governed by the 2022 opinion and the aiding-and-abetting provision. South Carolina has no non-compete statute, so the common law governs. A pending 2025 bill would void contract provisions that enable corporate practice or interfere with the physician-patient relationship and ban most physician non-competes, but its page showed no action after committee referral and we could not confirm its fate. We found no transaction notice law.

Med Spa, IV and Prescribing Rules

South Carolina has no med spa statute or facility license. A joint advisory opinion on neuromodulators says physician assistants inject within their supervising physician's scope, advanced practice nurses under a written practice agreement, and registered nurses only with on-site supervision by a physician or APRN for cosmetic use. The Board's May 2024 guidance on lasers and light devices says surgery with those devices is the practice of medicine and requires an exam of each patient before initial treatment or before authorizing a non-physician. The August 2023 joint opinion on retail IV therapy says standing-order, RN-only models are unlawful, that a medical director who does not personally evaluate patients is insufficient, and that a physician issuing standing orders there is aiding and abetting. That opinion matters for wellness, peptide, GLP-1 and hormone telehealth models, which need a proper physician-patient relationship before prescribing.

How We Structure It

As a rule we set up a professional corporation owned by the licensed physician, with no exceptions for what looks like a more flexible state. Patients pay the physician-owned practice. The practice pays the management company a fixed monthly fee under a written management services agreement. The management company pays MedGrid a fixed monthly retainer for consulting. The MSO never practices medicine, and the physician makes every clinical decision. In South Carolina the supervising physician personally evaluates patients and holds clinical control at all times.

Disclaimer

This article is general educational information, not legal advice. Entity and corporate practice rules change, and parts of this summary rest on secondary sources, so have health care counsel in the state confirm the structure before you form or sign anything.