What Is a Good Faith Exam? Legal Compliance for Medical Spas and Aesthetic Clinics
Medical spas sit at the intersection of medicine, wellness, and beauty. With treatments ranging from Botox and fillers to IV therapy and laser procedures, med spas offer patients powerful aesthetic results. But behind the luxury lies a dense web of regulation — and one of the most important compliance requirements is the good faith exam.
Whether you operate a brick-and-mortar med spa or offer services via telehealth, understanding and properly implementing the good faith exam is critical to avoid legal trouble, ensure patient safety, and operate ethically.
What Is a Good Faith Exam?
A good faith exam (GFE) is a legally required medical assessment performed by a licensed healthcare provider prior to administering certain treatments. This exam establishes a provider–patient relationship, evaluates a patient’s medical history, and determines whether they are a suitable candidate for the proposed procedure.
The good faith exam is required before performing many aesthetic or medical procedures such as:
- Botox and dermal fillers
- IV hydration therapy
- Hormone replacement therapy (HRT)
- Weight loss injections (e.g., semaglutide)
- Laser or energy-based treatments
Who Can Perform a Good Faith Exam?
The answer depends on your state’s medical regulations. In most states, a good faith exam must be performed by:
- A licensed physician (MD or DO)
- A nurse practitioner (NP)
- A physician assistant (PA)
Some states allow delegation to registered nurses under physician supervision, but not all. In Texas, for example, a GFE must be conducted by a provider authorized to prescribe medication — typically a physician, PA, or NP.
When Is a Good Faith Exam Required?
A good faith exam must occur before a patient receives any medical-grade aesthetic treatment. This includes both initial visits and potentially recurring assessments if treatment plans change or involve risk.
Med spas that skip this step or use pre-filled consent forms without a live evaluation risk violating:
- State medical board rules
- Corporate Practice of Medicine (CPOM) doctrines
- Telehealth regulations
- Patient safety standards
CPOM, Ownership, and the Role of GFEs
In states like Texas, strict CPOM laws prevent non-physicians from directly owning or operating a medical practice, including a med spa. As a result, non-physicians must operate through a Management Services Organization (MSO) and partner with a physician-owned professional entity.
This physician must:
- Oversee medical decisions
- Supervise staff
- Ensure that good faith exams are performed correctly
- Maintain clinical protocols and compliance
Outsourcing the medical director role or relying solely on telehealth providers for GFEs may not satisfy legal requirements — especially if the underlying ownership or supervisory structure is flawed.
Telehealth and the Good Faith Exam
The rise of telemedicine has made it easier to offer good faith exams via video or virtual platforms. While this can be convenient and compliant if handled properly, it is not a loophole for unlicensed or under-regulated operations.
Using a telehealth provider for GFEs still requires:
- A licensed provider with prescribing authority
- HIPAA-compliant technology
- State-specific telehealth consent and documentation
- Medical supervision from a qualified medical director
A good faith exam cannot be treated as a box-checking formality. It must be a real-time, clinically sound, legally compliant evaluation.
Risks of Skipping or Mismanaging Good Faith Exams
Failing to perform a valid good faith exam can result in:
- Investigations by medical, nursing, or pharmacy boards
- Revocation of business or professional licenses
- Substantial fines and civil liability
- Medical malpractice claims
- Criminal penalties in severe cases
State agencies regularly investigate med spas for violations related to GFEs, medical supervision, and patient safety. In some cases, spas have been shut down for failing to follow even basic exam protocols.
Best Practices for Performing Good Faith Exams
To ensure your good faith exam procedures are compliant:
- Always document the exam in the patient’s medical record
- Verify that the provider performing the GFE is properly licensed in your state
- Include detailed medical history and informed consent
- Avoid using cookie-cutter intake forms without direct patient interaction
- Schedule re-evaluations when medically necessary
If you’re a non-physician business owner, work with a healthcare attorney to establish the correct MSO structure and maintain appropriate oversight.
Good Faith Exams in the Context of Compliance
Good faith exams are just one piece of the broader regulatory puzzle for med spa compliance. A compliant med spa must also:
- Have a legally structured ownership model (e.g., MSO/PLLC)
- Hire licensed staff and medical directors
- Follow scope-of-practice laws for each provider
- Maintain HIPAA and OSHA compliance
- Obtain all relevant state and local licenses
A valid good faith exam supports both your clinical quality and legal foundation — but it won’t save an improperly structured med spa from regulatory action.
Summary: Why the Good Faith Exam Matters
The good faith exam is more than a formality — it’s a critical part of delivering safe, ethical, and legal care in the med spa industry. By prioritizing GFEs and working with qualified medical professionals, business owners can protect their patients, comply with state law, and build a trusted, long-lasting aesthetic practice.
In high-regulation states like Texas, where CPOM restrictions are firmly enforced, working with experienced legal counsel is essential. Whether you’re launching a med spa or already running one, ensuring your good faith exam procedures are airtight will strengthen your business for the long haul.
Consider scheduling a free discussion with Dike Law Group for help with opening a compliant medspa and MSO’s. You can do this at dorismeet.com.
