Supervision standards across the states we cover run from readily available to in the same room. Louisiana sits at the demanding end, and it adds an examination requirement on top.
Louisiana requires a pre-treatment physical examination by the physician, and the prescriber must be physically present on the premises. For registered nurses performing permitted cosmetic procedures, a physician or nurse practitioner must be physically present and immediately available at all times the RN is providing patient care.
What that does to the operating model
It converts medical direction from a retainer into a rota. Your clinic can only deliver the services requiring presence during the hours when the prescriber is actually in the building, and every additional opening hour is a staffing cost rather than a marginal one.
Two consequences follow immediately:
- Extended hours and weekend trading need cover, or those slots cannot carry the services that require presence.
- A second location does not share the first location’s prescriber. Presence is per premises.
The pre-treatment examination is separate
Presence and examination are two requirements, not one. A prescriber standing in the building does not satisfy an examination requirement, and an examination performed last quarter does not satisfy a presence requirement today.
Build both into the workflow: the examination gated before the first treatment and recorded, and the presence evidenced by something better than memory — a rota, a sign-in, a note in the chart identifying who was on site.
The structure behind it
On the corporate side, the Louisiana State Board of Medical Examiners has published a Statement of Position on the corporate practice of medicine. A corporation may not engage in the practice of medicine except a Professional Medical Corporation, owned and governed exclusively by physicians.
That is a narrow entity rule. Non-licensee participation runs through a separate management company, and the position statement is the document to read before deciding how far that management role may extend.
What to confirm before you sign a Louisiana lease
- Which services on your menu require the prescriber on site?
- What are your intended opening hours, and who covers them?
- Who performs the pre-treatment examination, and where is it recorded?
- Do you have written protocols and staff competency records under LSBME Rule § 7911?
- Is the entity a Professional Medical Corporation, and is it owned and governed exclusively by physicians?
Related reading
Frequently asked questions
Does the prescriber have to be on site in Louisiana?
Yes. The prescriber must be physically present on the premises, and a physician or nurse practitioner must be physically present and immediately available whenever an RN is providing patient care.
Is a pre-treatment examination required?
Yes, a pre-treatment physical examination by the physician.
Who may own a Louisiana medical practice?
A corporation may not practise medicine except a Professional Medical Corporation owned and governed exclusively by physicians.
Does presence transfer between locations?
No. Presence is a requirement at the premises where care is being delivered.
General information about Louisiana practice requirements, not legal advice. Confirm your obligations with healthcare counsel licensed in Louisiana.