Medical direction is the first thing a med spa needs and the last thing anyone explains. We connect your clinic with a licensed physician in your state, paper the relationship the way your board expects, write the protocols your staff will actually follow, and keep all of it current. Then the catalog, the member pricing and the back office sit on top.
MedGrid is a management services and consulting organization built for med spas, IV lounges, hormone and weight-loss clinics, and wellness practices. We stand up the legal and operational structure a medical practice is required to have, then run the consulting, compliance and back-office work that sits around it. We never practice medicine and never direct a clinical decision — the clinical practice stays a licensed medical entity, the business stays yours, and MedGrid sits between them as the management and consulting company, holding the administrative work under a management services agreement so that ownership, control and clinical decision-making land exactly where the law says they must.
A verified medical director licensed in your state, connected to your clinic and contracted properly — chart signing and prescription management, with scope of oversight, standing orders and Good Faith Exam protocol documented.
For nurse practitioners and PAs in states that require a collaborating or supervising physician, we connect that physician and document the collaboration agreement, chart-review cadence and the prescribing authority your license actually depends on.
Offer and pricing strategy, patient acquisition and marketing review — built so growth campaigns stay inside advertising, scope-of-practice and platform rules instead of creating exposure later.
The professional entity and the management company formed, joined by a management services agreement, with operating agreements, transfer and succession documents where the state requires them, plus EIN, registered agent and state filings.
Two ideas explain almost everything about how a med spa or wellness clinic has to be built. Here they are, without the jargon.
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States Enforce CPOM
In some form — strict or moderate.
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Strict-Enforcement States
Actively litigated and audited — the friendly-PC structure is not optional.
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Moderate-Enforcement States
The rule is on the books and rarely tested — until it is.
The other 18 states and DC do not enforce a corporate-practice-of-medicine doctrine the same way — a non-physician can generally own the entity that delivers treatment there. That does not remove the requirement for a licensed medical director; it changes what the ownership paperwork has to look like. See your state's tier.
In a strict-enforcement state, the PC is not a formality: the physician who owns it is the one whose license is actually on the line, which is why the standing orders, the protocols and the chart-review cadence run through them directly rather than through a name on a wall certificate. The MSO structure holds up because the two entities stay genuinely separate — separate bank accounts, a real management fee rather than a revenue split, and clinical decisions that are never made or reviewed by anyone on the MSO side. We connect you with a physician licensed in your state to sit inside that PC — not a name rented for a signature, but the person actually signing your standing orders and running your chart-review cadence.
The PC and the MSO are connected by a Management Services Agreement (MSA), the contract that defines what each side owes the other and how money actually moves between them.
Cash pay at the point of care. No insurance claims.
Physician-owned. Receives the revenue, pays clinicians, malpractice and clinical supplies first.
The MSO. Holds the administrative infrastructure for everything non-clinical.
Consulting agency to the LLC. Non-clinical services only.
The medical director: in a corporate-practice state the PC pays the director as its own clinician, before any transfer to the LLC. In a state without a corporate-practice bar, the director may instead invoice MedGrid for non-clinical advisory time. Clinical work is always paid by the PC.
All clinical revenue is cash pay, earned and received by the PC in its own account, never by the MSO. The PC covers clinician compensation, malpractice and clinical supplies first. Separate accounts, books and payroll keep the physician’s license and your investment protected if either side is ever questioned.
On the schedule set in the management services agreement, normally monthly, the PC transfers a fixed, fair-market amount to the management company (the LLC) for the non-clinical services it provides, never a percentage of medical revenue. That percentage is what turns a fee into fee-splitting.
The LLC pays MedGrid a fixed monthly retainer, invoiced against a written scope of consulting, accounting, marketing, membership and certification work. MedGrid charges for no medical service and never touches a patient payment.
The physician signs medical decisions, you sign business decisions, and the MSA keeps that line clean. The medical director is paid by the PC for clinical work, or by invoice to MedGrid for non-clinical advisory time in states where the law allows it.
A written list of the non-clinical services the MSO delivers: brand and marketing, lease and equipment, non-clinical staff and payroll, systems, purchasing and vendor accounts, billing operations and back-office administration.
One fixed monthly amount from the PC to the management company, set to fair market value for the services actually provided, followed by a fixed monthly retainer from the LLC to MedGrid. Neither is ever a percentage of medical revenue or a payment per patient or per referral, which is what keeps it from becoming fee-splitting.
Diagnosis, treatment, protocols, prescribing, clinical hiring and discipline stay with the physician-owned entity, in writing. The MSO runs the business around the medicine and does not direct it.
A defined term, renewal terms and termination rights for both sides, plus what happens to records, staff, equipment and patient continuity if the relationship ends, so neither side is trapped and patients are never stranded.
The medical record belongs to the PC. The MSO touches patient information only as a business associate under a HIPAA business associate agreement, with access limited to what its functions need.
Both sides agree to cooperate with board inquiries, insurer audits and buyer diligence, and the compliance file that supports the arrangement is kept current by the MSO and reviewed by the physician.
Most clinics arrive with a version of one of these. They are fixable without closing the doors, and they are the first things a board, insurer or buyer notices.
General structure, not a legal opinion for your clinic. Your director and counsel confirm the specifics before you treat.
How money actually moves through a PC/MSO structure — patient revenue landing in the PC, the fixed management transfer to the MSO, MedGrid's retainer, and physician compensation — the same CPOM flow of funds covered on this page, walked through step by step.
This isn't just how we recommend running the accounts. In a state that enforces corporate practice of medicine, this exact flow is required to keep a PC structure compliant: revenue lands in the PC first, the MSO is paid a fixed, fair-market amount rather than a share of medical revenue, MedGrid is paid a fixed retainer by the MSO, and the accounts stay separate.
It's also why MedGrid only builds on a PC — never a PLLC — in every state we work in. A PLLC lets revenue flow straight into a member's account with no equivalent separation, which is exactly the structure this flow of funds is built to avoid. Why that distinction matters.
Written authorization for what your staff may perform, on whom, and under what conditions — the document a board asks for first.
Every treatment you offer reviewed and signed off, with contraindications and escalation paths spelled out.
Who performs the initial examination, in person or by telehealth, defined the way your state allows.
A real cadence of chart review — the director signs off on at least 10% of charts each month, scheduled and recorded, rather than a signature applied in arrears.
Reachable when a treatment goes sideways — with a documented escalation route your injectors know by heart.
Training sign-off for each provider and each device, kept on file and refreshed as your team changes.
Many states let a nurse practitioner or physician assistant run day-to-day care under a formal collaborative or supervisory agreement with a physician, rather than a full-time on-site medical director. If that is how your practice is structured, the paperwork is different — and it still has to be right.
Your state, treatments, hours and how much physician involvement your services actually require.
We connect you with a licensed physician matched to the specific services you offer — not a shortlist you have to vet and choose from yourself.
A kickoff call to confirm scope, availability and the review cadence. The match is already made — this sets the working relationship up, it is not a tryout.
Agreement signed, delegation and standing orders filed, protocols loaded, review cadence scheduled.
Read the full guide: How to find a medical director for your med spa →
Ownership, brand, pricing, staffing and hours. We are a service provider, not a partner on your cap table.
Your clinic, your chart, your patients. Nothing gets rerouted through a call center.
Member pricing is an offer, not an obligation. Keep the vendors you like and use us where we are cheaper.
Month to month after the first quarter. Your protocols and compliance files leave with you.
Most owners meet this list one missing document at a time, usually under pressure. We work through it in order and hand over the whole file at the end.
Scope varies with your state and whether the entity already exists — we tell you which items you can skip on the first call rather than billing for all of them.
A flat monthly stipend for their time, set by state and scope — never billed by the hour, per patient, or by headcount, since a fee that moves with volume is a kickback exposure for both sides — and paid transparently, so you see the figure, not a bundled fee with a margin hidden in it.
We connect you with someone else. You are not locked into a physician relationship that is not working, and the compliance file transfers.
They direct clinical care, which is the point. Business decisions — pricing, marketing, staffing, hours — stay with you, and the agreement says so plainly.
Each state needs a physician licensed in it. We handle per-state coverage for multi-location groups as part of Group membership.
No. We maintain templates and tell you what your state requires; your director and your counsel make the calls. Nothing here is legal advice.
Same company, same login. The MSO builds the clinical and compliance structure; the marketplace supplies it. You can use either alone.
Three questions, then a twenty-minute call. If we can't help, we'll say so on that call.
