Who Does Not Qualify to Perform a Good Faith Exam?

Several members of the med spa team contribute to patient care but are not legally authorized to independently perform a good faith exam. Their responsibilities typically support the evaluating provider rather than replace the medical evaluation required before treatment.

Registered Nurses

Registered nurses (RNs) are generally not authorized to independently perform a good faith exam. Their responsibilities support the evaluating provider rather than replace the medical evaluation required before treatment.

RNs commonly assist with:

• Collecting patient history: Gather information about the patient’s medical history, current concerns, medications, and allergies before the provider’s evaluation.
• Recording vital signs: Measure and document clinical information such as blood pressure, heart rate, temperature, and other relevant observations.
• Completing intake documentation: Record patient information, obtain required forms, and prepare the medical record for the provider’s review.
• Preparing patients for evaluation: Help patients understand the examination process and ensure they are ready for the provider’s assessment.

However, RNs generally cannot independently:

• Diagnose medical conditions: They cannot determine a medical diagnosis or identify whether a patient has conditions that affect treatment eligibility.
• Determine treatment candidacy: They cannot independently decide whether a patient is an appropriate candidate for a medical aesthetic procedure.
• Prescribe medications: They do not have independent prescriptive authority for medications used as part of aesthetic treatment.
• Establish the patient-provider relationship required for delegated medical procedures: They cannot independently perform the medical evaluation required before delegated treatments begin.

Medical Assistants

Medical assistants are not licensed to perform medical evaluations or good faith exams. Their responsibilities focus on administrative and clinical support rather than making medical decisions.

Medical assistants typically assist with:

• Scheduling appointments: Coordinate patient visits, follow-up appointments, and treatment schedules.
• Collecting basic patient information: Gather demographic information, medical history forms, and other details before the provider’s evaluation.
• Preparing examination rooms: Set up treatment rooms, equipment, and supplies needed for the patient’s visit.
• Assisting providers during patient visits: Support physicians and other qualified providers with non-diagnostic clinical and administrative tasks during the examination.

Medical assistants cannot independently diagnose medical conditions, determine whether a patient is an appropriate candidate for treatment, prescribe medications, or establish the patient-provider relationship required before delegated medical procedures.

Estheticians

Licensed estheticians are not authorized to perform good faith exams. Their role focuses on non-medical aesthetic services rather than evaluating whether a patient is medically appropriate for treatment.

Estheticians can:

• Educate patients about skincare: Provide guidance on skincare routines, products, and post-treatment care within the scope of their license.
• Perform non-medical treatments permitted under state law: Deliver cosmetic services that do not require medical evaluation, diagnosis, or physician oversight.

Estheticians cannot independently:

• Perform a medical evaluation: They are not licensed to assess a patient’s medical condition or determine treatment eligibility.
• Diagnose medical conditions: They cannot identify or diagnose conditions that could affect patient safety or treatment outcomes.
• Approve patients for delegated medical procedures: They cannot determine whether a patient is an appropriate candidate for medical aesthetic treatments.
• Establish the patient-provider relationship required before medical treatment: They cannot independently perform the medical evaluation required before delegated procedures begin.

Experience in aesthetics does not replace the legal authority required to perform a good faith exam. Practices should ensure that all medical evaluations are performed by providers authorized under state law.

Delegation Requirements

Provider licensure alone does not determine whether someone can perform a good faith exam. State delegation laws also establish when nurse practitioners and physician assistants may evaluate patients before treatment.

Delegation requirements commonly address:

• Physician supervision: Some states require supervising physicians to remain available for consultation during delegated medical services.
• Collaborative agreements: Reduced and restricted practice states often require written agreements that define the NP’s authority.
• Delegation protocols: Physicians may need written protocols identifying which medical services may be delegated.
• Prescriptive authority: State law determines whether the provider can prescribe medications and authorize treatment independently.

For example, states such as California, Texas, Florida, Arkansas, Louisiana, Kentucky, and Arizona each regulate physician delegation differently. A provider who is authorized to perform a good faith exam in one state may not have the same authority elsewhere.

Practices should verify both provider licensure and state delegation requirements before assigning responsibility for good faith exams.

What Happens When the Wrong Person Performs the Exam?

A good faith exam performed by an unauthorized provider can create significant compliance, legal, and patient safety risks. The consequences can extend beyond the individual provider to the supervising physician and the practice itself.

Potential risks include:

• Board investigations and disciplinary action: State licensing boards can investigate providers and practices that fail to comply with physician oversight or delegation requirements.
• Invalid treatment orders: Treatments authorized after an invalid good faith exam may not satisfy state requirements, placing the underlying medical services at risk.
• Violations of physician delegation requirements: Allowing an unauthorized provider to perform the examination can violate state laws governing physician supervision, collaboration, or delegation.
• Increased malpractice exposure: An improperly performed good faith exam can increase liability if a patient experiences complications that should have been identified during the evaluation.
• Insurance reimbursement disputes: Claims associated with services that do not meet applicable regulatory requirements may be denied or challenged when coverage applies.
• Patient safety concerns: Incomplete or unauthorized medical evaluations can overlook contraindications, underlying medical conditions, or other factors that affect treatment decisions.

Establishing clear provider responsibilities and verifying who is authorized to perform a good faith exam helps practices reduce compliance risks while supporting safe patient care.

How Medical Director Co. Makes Sure the Right Person Is Always in the Chair

Provider qualifications vary by state, making physician oversight an essential part of good faith exam compliance. Medical Director Co. helps med spas establish compliant provider relationships through:

• Qualified physician matching: Match practices with physicians licensed in the appropriate state who understand physician oversight requirements.
• State-specific compliance support: Support physician oversight that reflects applicable delegation laws and board guidance.
• Attorney-reviewed agreements: Provide attorney-reviewed agreements that support compliant provider relationships.
• Ongoing compliance assistance: Help practices maintain physician oversight as regulations evolve.

Medical Director Co. combines qualified physician placement, compliant documentation, and ongoing compliance support to help med spas establish physician oversight programs that support long-term compliance.