Most states leave you to infer what an unacceptable medical directorship looks like. North Carolina’s medical board publishes it.
The NCMB maintains a position statement on the Corporate Practice of Medicine (10.1.2), and its disciplinary committee has written up the pattern in its own newsletter: a physician agreeing to be “medical director” of a med spa for a flat monthly fee, assured he would not need to be on site, with the business owned and operated by a non-licensee. The board’s framing for that is aiding the unlicensed practice of medicine.
What North Carolina actually requires
- A business practising medicine owned in its entirety by holders of active North Carolina licences — physicians, or physicians together with nurse practitioners or physician assistants.
- A licensed physician as medical director who is genuinely involved in operations and supervises clinical staff and procedures.
- A management services organisation for the non-clinical side, owned separately.
- Compliance with the North Carolina Professional Corporation Act, including the exemptions the board’s position statement discusses.
- An arrangement you would be comfortable describing to the board in the same words you used to sell it internally.
Who may do what in North Carolina
| Licence | What they may do |
|---|---|
| MD or DO | Independent; may own the professional entity and hold the director role |
| Nurse practitioner | May co-own alongside a physician; practises under the applicable arrangement |
| Physician assistant | May co-own alongside a physician; practises under supervision |
| Registered nurse | May not own the professional entity; delivers care within RN scope under an order |
| Non-licensee | May own the MSO only |
The specific detail worth sitting with: the physician in the board’s example was paid $2,000 a month and told he did not need to attend. That is not an exotic arrangement — it is the standard offer in this market, described by a regulator as a problem.
What MDside provides in North Carolina
- A North Carolina-licensed MD or DO as medical director, doing the work rather than lending a name.
- The professional entity and management agreement built to North Carolina rather than to a national template.
- Licensed physicians for the good faith exams behind prescriptions and injectables.
- Protocols and delegation written against your live service list, and revised when it changes.
- 503A and 503B pharmacy relationships and lab draws.
See what is included, or book a call and tell us which states you operate in.
Read the detail on North Carolina
Frequently asked questions
Can a non-physician own a med spa in North Carolina?
Not the entity practising medicine — it must be owned entirely by active North Carolina licensees. A non-licensee may own a management services organisation providing non-clinical services.
Can a nurse practitioner co-own a med spa in North Carolina?
North Carolina permits ownership by physicians, or by physicians together with nurse practitioners or physician assistants. An NP alone is not the model.
What does the NC Medical Board say about paid medical directorships?
Its position statement on corporate practice, and published disciplinary commentary, treat a paid but absentee directorship over a non-licensee-owned business as aiding the unlicensed practice of medicine.
General information about North Carolina practice structure and med spa regulation, not legal advice. Statutes, board rules and scope-of-practice requirements change. Confirm your obligations with healthcare counsel licensed in North Carolina.