Map the med-spa compliance structure — scope of practice, good-faith exam / medical supervision, consent and adverse-event protocols, product handling — as operational structure, flagging every state-specific rule [verify-at-use] and routing the actual determination to the medical director and a licensed professional. Flag, never decide.
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---
name: scope-of-practice-and-supervision
description: "Map the med-spa compliance structure — scope of practice, good-faith exam / medical supervision, consent and adverse-event protocols, product handling — as operational structure, flagging every state-specific rule [verify-at-use] and routing the actual determination to the medical director and a licensed professional. Flag, never decide."
---
# Scope of Practice & Supervision
Aesthetic medicine sits under a compliance structure that is easy to blur into an ops convenience — who may inject, what a good-faith exam requires, what supervision a mid-level needs, what consent must capture. This skill maps that structure so the medical director and a licensed professional can make the determinations. It **flags**; it does not decide.
## The loop
1. **Separate structure from determination.** Describe the *shape* of the question — there is a delegating physician, a supervision level, a good-faith-exam requirement, a consent capture — without asserting what the rule *is*. The rule is state-specific and belongs to a professional.
2. **Map the service to its structure.** For each service: who performs it, who delegates/supervises, what exam precedes it, what consent it needs. Traverse the **scope & supervision structure** tree in [`../../knowledge/med-spa-decision-trees.md`](../../knowledge/med-spa-decision-trees.md).
3. **Flag every specific.** Scope, supervision ratios, good-faith-exam rules, corporate-practice-of-medicine, and MSO structure are `[verify-at-use]` and state-specific — route each to the medical director and a licensed attorney/regulator.
4. **Enumerate the consent + adverse-event elements.** Informed consent captured, complication escalation path, documentation, follow-up — as structure to have in place. The *language and legal sufficiency* is a professional's call.
5. **Vet marketing claims.** Copy reading as a medical/efficacy claim or implying scope beyond the license is a flag; route it.
## What this skill does NOT do
- It does not state the scope-of-practice rule for any state.
- It does not decide who may inject, what supervision is sufficient, or whether a consent form is legally adequate.
- It does not render a corporate-practice-of-medicine / MSO determination.
- It does not handle patient PHI/PII.
Those are **determinations** — they route to the medical director and a licensed professional. This skill makes the map; they make the call.
## Anti-patterns
- Answering "can this person inject in our state?" with a rule instead of a routed flag.
- Treating scope as an ops convenience to keep the schedule full.
- Scaling a service before the consent and adverse-event protocol exists.
- Shipping marketing copy with an unreviewed medical claim.
## See also
- Best practices: [`../../best-practices/scope-of-practice-is-a-medical-director-call.md`](../../best-practices/scope-of-practice-is-a-medical-director-call.md).
- Knowledge: [`../../knowledge/med-spa-reference-2026.md`](../../knowledge/med-spa-reference-2026.md) (every scope/supervision row is `[verify-at-use]` + route-to-professional).
