Medical director agreements are a cornerstone of compliance in med spas and wellness clinics. But just because a contract is signed doesn’t mean it’s set in stone. Changes in services, staffing, regulations, and business growth often require a fresh look at the terms between the physician and the clinic. Knowing when and why to revisit your medical director agreement can help protect your business from legal risk and ensure long-term alignment.
The Agreement Should Reflect Your Current Operations
Many med spa owners sign their first agreement when launching the business, often before they know how their services will evolve. As your service menu grows, especially when introducing advanced procedures like injectables, hormone therapy, or GLP-1 medications, the expectations of your medical director should expand with it. If the contract only covers general oversight but you now require clinical direction or more hands-on support, it’s time to re-evaluate.
Similarly, shifts in ownership structure, such as bringing on partners or forming a management company, should trigger a review of your agreement. The original terms may not address decision-making authority, access to medical records, or how liability is shared among parties. These gaps can lead to disputes or compliance violations if left unaddressed.
Regulatory Changes May Affect Your Obligations
State regulations around scope of practice, physician supervision, and telehealth are constantly evolving. What was compliant two years ago may now expose you to legal risk. For example, a state might change the minimum requirements for chart audits, mandate in-person visits, or revise supervision rules for nurse practitioners. If your contract doesn’t align with these updated requirements, your clinic could be operating out of compliance.
Your agreement should also account for varying regulations across multiple locations if your clinic is expanding. A contract that works for your original state may not be valid in others. Medical director services must be adapted jurisdiction by jurisdiction, and the agreement should outline how these differences are handled, especially if you’re using the same physician across sites.
Performance Concerns and Misalignment
Sometimes the need for review is less about legal changes and more about professional fit. If your medical director is consistently unavailable, missing chart reviews, or not engaging with your clinical staff, you may not be getting the level of support you need. Agreements often specify responsibilities like chart audits, protocol sign-offs, and emergency availability. But unless there’s a mechanism for accountability, such as a review clause, communication standards, or service-level expectations, enforcing those duties can be difficult.
If your director isn’t keeping up with evolving standards of care or doesn’t understand the aesthetic scope of your business, it may create frustration or even compliance risk. Rather than rushing into termination, revisit the agreement. Consider whether the role was clearly defined and if expectations were ever properly aligned.
Adjusting for Business Growth
Growth creates new demands on clinical oversight. A small clinic seeing 20 patients a week might only need monthly oversight. A larger operation or one with multiple nurse injectors may require weekly check-ins, more robust chart reviews, and standardized protocols. The original agreement may have been enough to get started, but it might not scale with your business.
This is especially important when adding new providers. Some medical directors are comfortable supervising a single RN or NP but may not be equipped, or willing, to oversee a larger team. Your agreement should reflect how many clinicians the physician is responsible for and what onboarding, training, and communication processes are in place to support that team.
When Contracts Are Silent on Key Issues
Many early-stage agreements are templates pulled from online sources or copied from a colleague’s setup. They often fail to address essential details like conflict resolution, communication frequency, termination clauses, or protocols for handling adverse events. If you’ve never had to refer to your agreement to settle a dispute or clarify a duty, consider yourself lucky, but don’t assume that luck will last.
As your clinic becomes more sophisticated, your agreement should too. Revisit areas that were vague or never discussed. For example, how will you handle disagreements about new procedures? What happens if your medical director takes leave or moves out of state? Is there clarity about intellectual property, patient records, or medical liability?
Aligning Compensation with Expectations
Another reason to re-evaluate is misalignment between fees and responsibilities. If you’re paying a flat monthly rate but have tripled your service volume, hired more staff, and expanded to a new location, it’s fair to assess whether your director is still being fairly compensated, or whether they’re overpaid for minimal involvement. Either scenario creates tension.
Incentives can also be misaligned. If your director is only paid for time, they may not be motivated to help improve compliance systems, train staff, or address inefficiencies. Revisiting your agreement gives you a chance to clarify expectations, set realistic pricing, and align compensation with the true scope of work.
When to Bring in Support
While Wellness MD Group is not a law firm, we specialize in supporting med spas and wellness clinics through compliant, customized medical director services. Our team helps you evaluate your current agreements, address gaps, and restructure oversight based on your real clinical needs. Whether you’re expanding, updating your service menu, or changing your business structure, we ensure your physician partnership stays legally sound and operationally aligned.
Final Thoughts
Your medical director agreement isn’t just a legal formality, it’s the foundation of clinical oversight in your practice. Re-evaluating that agreement regularly ensures that your business evolves safely, legally, and efficiently. Don’t wait until there’s a dispute, compliance breach, or regulatory audit. Review your contract annually, or any time there’s a major change in your clinic’s structure, services, or scale.Wellness MD Group provides the guidance and physician partnerships to help your clinic grow with confidence and stay compliant every step of the way.
