Alabama medical director requirements for med spas

Physician supervision & delegation in Alabama

⛔ ALABAMA HAS A CHAPTER FOR THIS AND IT TIERS THE DELEGATE. 540-X-11 governs lasers and light/energy-based devices — any energy source, chemical or modality affecting living tissue below the stratum corneum, for surgical, therapeutic OR COSMETIC purposes — and says outright that using them is the practice of medicine. A physician may delegate only NON-ABLATIVE treatments, only through written protocols, and only to a properly trained LEVEL 1 OR LEVEL 2 DELEGATE — and Alabama counts the training in hours: THIRTY for a physician, FORTY for a delegate, before either may use a device. The written protocol is a physician’s order kept ON SITE and producible to the Board on request. The delegating physician must formulate or approve the protocol, review and authorize it at least ANNUALLY, and provide on-site or locally remote supervision.

• (1) A physician must complete thirty (30) hours of training. A Level 1 or 2 Delegate must complete forty (40) hours of training.

  Ala. Admin. Code r. 540-X-11-.06(1) (Initial training requirements for physicians and delegates) · verified Sep 4, 2026

• Written protocols for the purpose of this section shall mean physician’s order, standing delegation order, standing medical order, or other written order that is maintained on site. A written protocol must be provided to the Board upon request and must provide, at a minimum, the following: (1) A statement identifying the individual physician authorized to utilize the specified device and responsible for the delegation of the performance of the specified procedure, including proof of the physician’s training in accordance with these rules; (2) A statement of the activities, decision criteria, and plan the Level 1 or 2 Delegate shall follow when performing delegated procedures;

  Ala. Admin. Code r. 540-X-11-.05 (Written protocols) · verified Sep 4, 2026

• (1) The use of lasers/pulsed light devices, or any energy source, chemical, or other modality that affects living tissue (when referring to the skin, anything below the stratum corneum), whether applied for surgical, therapeutic, or cosmetic purposes, is the practice of medicine.

  Ala. Admin. Code r. 540-X-11-.01(1) (Purpose) · verified Sep 4, 2026

• (1) A physician may delegate the performance of non-ablative treatments as defined in these rules through the use of written protocols to a properly trained Level 1 or 2 Delegate. (2) A delegating physician shall supervise the performance of all non-ablative treatments delegated to a Level 1 or 2 Delegate.

  Ala. Admin. Code r. 540-X-11-.04(1)-(2) (Delegation and supervision) · verified Sep 4, 2026

• (b) Responsibility for the formulation or approval of a written protocol that meets the requirements of these rules and responsibility for any patient-specific deviation from the protocol; (c) Substantive review and authorization, at least annually, of the written protocol and any patient-specific deviations from the protocol regarding care provided to a patient under the protocol on a schedule defined in the written protocol;

  Ala. Admin. Code r. 540-X-11-.04(2)(b)-(c) (Delegation and supervision) · verified Sep 4, 2026

• (f) On-site or locally remote supervision for non-ablative treatments performed by Level 1 and 2 Delegates consistent with these rules, the training and experience of the delegate performing the procedure, and the risk of harm to the patient; (g) Personal evaluation and care for complications that arise;

  Ala. Admin. Code r. 540-X-11-.04(2)(f)-(g) (Delegation and supervision) · verified Sep 4, 2026

• (2) Direct Physician Supervision – Direct physician supervision shall mean that the physician is in the physical presence of the patient being treated and is directly observing the use of the modality by a delegate.

  Ala. Admin. Code r. 540-X-11-.02(2) (definition of “Direct Physician Supervision”) · verified Sep 4, 2026

• On-site supervision means continuous supervision in which the supervising physician is physically present in the same building as the properly trained Level 1 or 2 Delegate who is using a laser or light-based device; all treatments and procedures must be performed under the physician's direction and immediate personal supervision, and the physician must be immediately available at all times that the Level 1 or 2 Delegate is on duty.

  Ala. Admin. Code r. 540-X-11-.02(8) (On-Site Supervision) · verified Sep 8, 2026

• Assignment to an unlicensed individual means the assignment of tasks from a licensed nurse to unlicensed assistive personnel, and the licensed nurse making the assignment retains accountability for accurate and timely completion and outcome of the tasks; the individual nurse is responsible and accountable for the delegation of selected nursing activities in selected situations to unlicensed individuals.

  Ala. Admin. Code r. 610-X-6-.01(5); 610-X-6-.03(6) · verified Sep 8, 2026