Does a med spa in Delaware need a medical director?

Short answer
The cited rules do not settle this — no medical director title is named, but aestheticians may not prescribe or provide medical treatment, and any physician who delegates medical acts to a non-physician must actively supervise, not be involved in name only.

Delaware writes two supervision regimes and a med spa can sit under either. The one that reaches a non-physician directly is 24 DAC 1700 § 11: the delegating physician is responsible for that individual’s medical activities, may not delegate a function the delegate is barred from performing, and may not be involved in patient care in name only — with direct supervision meaning physically on the premises, and indirect supervision meaning present or reachable electronically and able to be physically present within 30 minutes. The regime Delaware writes for physician associates is the more detailed of the two: the collaborating physician may not be involved in patient care in name only, must be involved in active patient care on a regular basis, and may not assign medical acts exceeding the physician’s own license. Unless a Board regulation changes the number — and except where both work in the same physical office or facility building — that physician may collaborate with no more than 4 physician associates at a time, with the PA’s scope identified in a written collaborative agreement kept on file where care is given; a physician associate above 6,000 postgraduate clinical practice hours may be released from the regime on application. Two disciplinary grounds reach supervision directly: failing to supervise a person working under a physician’s supervision, and knowingly assisting unauthorized practice. A physician practice with multiple offices must have a physician member visit each at least monthly. The Act’s own exceptions section states that its practice-of-medicine provisions do not apply to the business of cosmetology, and the cosmetology chapter states that an aesthetician is not authorized to prescribe medication or provide medical treatment in the same manner as a dermatologist.