I am a RN,EMTP in Texas, have worked in & around the Emergency Room (either as a paramedic on the ambulance or RN in the ER) for the last 19yrs. I have already jumped all in & invested in opening my own med spa (& it being concierge). I’m still in the beginning stages, but I’m basically a couple of steps away from opening shop. Problem is that I thought I already tackled the details and pertinent legalities, but apparently I missed some things. I keep finding conflicting Texas laws on who exactly can own a med spa (according to the AmSpa website, as of 2017, the ONLY people that can are licensed physicians. However, I personally know of medical aesthetic spas in TX that are owned by Aestheticians, PA’s, RNs, and APRNs, but can’t find anything to prove that it’s legal). Also, the TMB laws concerning the medical director & the specific laws concerning their roles (i.e. the how, when, and where, etc) appear to conflict what the AmSpa site says as well. Then there is the concierge part. I can’t find anything that talks about the rules, regs, laws, and codes regarding it - & I have no idea where to look. I’ve been trying, but I’m not finding anything solid that I can trust. If ANYONE can help point me in the right direction or can share with me where to find the resources answering any/all of the above, I would greatly appreciate it. I can also be reached at 806-535-6510. Thank you in advance.

Brooke: The law in Texas is very clear.... the Corporate practice of medicine is illegal. There is not much question about that !! A licensed physician (MD or DO) must own at least a 51% interest in the Medical Clinic be it a medspa or private practice. A NP or PA can be a part owner but the physician must have controlling interest and make the hiring and management final decisions. The physician can employ, if you will, a MSO to manage an advise, and pay the MSO a fee (this allows non physicians to share in the profits without ownership). Having a medical director, whether or not they are on-site does not absolve the spa from the ownership rule.
There are exceptions to the corporate rule of ownership that applies to hospitals and charity organizations.
I am not an attorney so take that with the advise that you consult with attorneys regarding what appears to be an illegal set-up as you describe.
Yes, there are many illegal medspas operating in Texas and many states - see the headlines about the Houston police department arresting those for operating contrary to the laws of the state. the Texas Medical Board moves very slowly and may or may not take an active role in policing these operations. So, let the owner (non MD/DO) beware.

Brooke- I have worked with medical spas in TX for over 30 years. While our TX laws may seem contradictory and at times confusing- there are options that individuals can look at. We have very strong Corporate Practice of Medicine guidelines- and that is why attorneys look at the options of an MSA/MSO option. Yes- there are many illegal med spas in TX- but also some excellent options for working within the guidelines. Please reach out to me for more information.

To expand on Brook’s question; what about concierge services? There are companies that offer nurses/aestheticians who want to offer concierge services, training, insurance, the ability to purchase neurotoxins & other supplies. medical director & Good Faith Exams for a fee. They never mention that we can’t legally practice or open our own practices w/o Md ownership. Any guidance is appreciated!