Medical director requirement
Required; physician must directly supervise all aesthetic procedures
Corporate Practice of Medicine
Strict; physician ownership or MSO with physician control required This is the doctrine that decides whether a non-physician can own or control the practice, and it usually travels hand-in-hand with the medical-director question.
Who can supervise or delegate
NP/PA may not independently practice or inject; physician collaboration required but injectables restricted to MDs/DOs
How the exam ties in
Required; in-person exam before treatment
What to verify in Hawaii
Verify that your medical spa is physician-owned or physician-controlled, and ensure only MDs or DOs perform all injections; do not delegate injectables to RNs, NPs, or PAs.
Primary source: Hawaii Medical Board
General business information for Hawaii medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Hawaii board (and your own counsel) before you act.