A New York medical director carries more personal exposure than a director in most other states, and the agreement has to reflect that. It also has to pay them in a way New York permits — which rules out the structure many operators expect to use.
Start with the compensation constraint
New York prohibits fee splitting between a professional entity and a non-licensee. That shapes directorship compensation before anything else is negotiated.
A medical director should be paid a fixed fee reflecting fair market value for defined services. Not a percentage of treatment revenue. Not a per-patient amount. Not a bonus that scales with injectable volume.
If a prospective director proposes a revenue share, that is a signal about how carefully they work — not a bargain.
What drives the number
- Service menu. Neurotoxins and fillers are one oversight load. Weight management, hormones, and IV therapy each add protocol and monitoring burden.
- Staffing model. An NP-led practice needs different oversight than one relying on RN administration under delegation.
- Volume. Chart review scales with throughput.
- Locations. Genuine supervision across multiple sites is harder and costs more.
- Scope of the engagement. Supervision alone is less work than supervision plus performing evaluations and prescribing.
A flat quote given before anyone asked what you offer is a price for a signature.
What the agreement must actually do
| Provision | Why |
|---|---|
| Named procedures | Oversight is service-specific; a category is not a menu |
| Protocol authorship and review | Who writes standing orders, and how often they are revisited |
| Availability standard | What reachable means, and the path during an adverse event |
| Chart review | Frequency, sampling, and documentation of the review itself |
| Credentialing | Who verifies licensure and scope before someone treats |
| Evaluation responsibility | Who performs the good faith exam and what happens on a decline |
| Fixed fee, stated in advance | New York’s fee-splitting rules |
| Insurance | Whose policy responds, and whether it covers this work |
| Termination and records | Notice period, and what happens to protocols and records on exit |
The physician’s exposure is personal
Physician conduct in New York is overseen by the Office of Professional Medical Conduct, and that oversight attaches to the individual. A director who supervises in name only is exposed personally — their license, not the operator’s LLC.
This changes the negotiation. A physician who asks hard questions about your protocols, your staffing, and your evaluation process is not being difficult. They are the one who will be answering for it.
Red flags on both sides
Warning signs in a prospective director: they never ask about your service menu; they will not write or review protocols; they hold directorships at a large number of sites and cannot say how many; they have no answer for what happens during an adverse event on a weekend.
Warning signs in an operator, from the physician’s perspective: pressure to approve every patient; resistance to declining candidates; a request to backdate protocols; an expectation that the director’s name appears in marketing while their involvement is minimal.
Directorship alone often is not the answer
In a strict corporate practice state, a directorship agreement does not by itself create the professional corporation, employ the clinicians, or resolve who evaluates patients and issues prescriptions.
Operators frequently buy a directorship and assume the structure is handled. It is not. Directorship is one component of a compliant operation, and the smallest one.
What MDside provides in New York
MDside holds New York licensure and provides medical direction as part of a working clinical operation: the professional corporation, the physician of record, licensed providers performing evaluations and prescribing, protocols maintained against your actual menu, and a fee structured as New York requires.
See what is included, or read the New York ownership and scope rules.
Frequently asked questions
How much does a medical director cost in New York?
It depends on the menu, staffing model, volume, number of sites, and whether evaluations are included. What it cannot be is a percentage of treatment revenue.
Can I pay a percentage of revenue?
No. New York treats that as prohibited fee splitting between a professional entity and a non-licensee.
Does the director have to be physically present?
Requirements turn on the services and the supervision arrangement, but genuine availability is the substance of the role. A director who cannot be reached is not supervising.
Can an NP serve as medical director in New York?
The supervising role for a medical practice contemplates a physician. Confirm the specific arrangement for your services with New York counsel.
Can one physician direct several New York locations?
Only if genuine supervision across all of them is realistic. Because OPMC exposure attaches to the physician personally, careful New York physicians limit how many sites they take — a director who accepts an unlimited number is telling you how closely they intend to look.
General information about New York medical directorship, not legal advice. Compensation, supervision, and oversight requirements depend on your facts. Confirm with healthcare counsel licensed in New York.