Growth

There is no honest single number, because the law makes you buy a different thing in each state. Here is what you are paying for in six of them, and the five things that move the fee everywhere.

Georgia caps a delegating physician at eight protocols and job descriptions combined. Your physician assistants count against the same ceiling, and that decides your hiring plan.

Texas rewrote the med spa delegation rules in January 2025 and added an elective IV therapy statute in September. Most directorship agreements in circulation predate both.

SB 351 took effect 1 January 2026 and names what a private equity group or hedge fund may not control. If your MSO is founder-owned, it is not the entity the statute is aimed at.

Arizona nurse practitioners practice without physician supervision, so the director’s job here is narrower than operators assume. That changes what you should be paying for.

A peptide brand is five different businesses wearing the same word. They are not equally lawful, not equally expensive, and not equally survivable.

Injectables are episodic; weight management and hormone therapy are programs. What Texas requires structurally, and where the margin actually comes from.

California is where adding a prescribing service line badly creates the most exposure. How to grow revenue without compromising the structure SB 351 now polices.

What medical directorship actually costs in Florida, what belongs in the agreement, why percentage-of-revenue pay is a problem, and how to spot a rubber stamp.

Gyms and fitness studios can offer GLP-1 and medical weight-loss programs, but not directly. Here is the entity structure that separates the fitness business from the clinical one.