A fair question, asked everywhere.
Aesthetic medicine is medicine. Who performs it, what they are licensed to do and who is supervising are reasonable things to ask, and a good practice answers without getting defensive.
Delegation is legal, normal, and where the variation lives.
Michigan’s Public Health Code lets a licensee delegate acts, tasks or functions to somebody else — and notably, to a licensed or unlicensed individual who is qualified by education, training or experience, performed under the licensee’s supervision.
That is not a loophole. It is how almost all of medicine works, and it is why a nurse can do a great many things a physician has delegated.
The statute puts one hard limit on it: you cannot delegate something that, by prevailing standards, needs the judgment of the licensee themselves. Everything interesting about a practice lives in where it draws that line — so ask where they draw it.
Michigan Public Health Code
Act 368 of 1978, on delegation. The emphasis below is ours.
“[A] licensee … may delegate to a licensed or unlicensed individual who is otherwise qualified by education, training, or experience the performance of selected acts, tasks, or functions where the acts, tasks, or functions fall within the scope of practice of the licensee’s profession and will be performed under the licensee’s supervision. A licensee shall not delegate an act, task, or function under this section if the act, task, or function, under standards of acceptable and prevailing practice, requires the level of education, skill, and judgment required of the licensee…”Michigan Compiled Laws 333.16215(1). Read the section →
They take a minute and they sort out most of it.
None of them is hostile and none of them should produce a flustered answer.
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“Who is actually going to do this, and what is their license?”
Physician, physician assistant, nurse practitioner, registered nurse — each is a real credential with a real scope. “Certified injector” is not a Michigan license; it usually describes a training course, which may be excellent but is a different kind of thing.
HereDr. Nadia Aldridge, MD performs all injectable treatments personally. -
“Is the supervising physician in the building?”
Supervision is a spectrum. In some practices the physician is in the next room; in others they are a name on a contract, reachable by phone, and have never seen the inside of the place. Both can be lawful. They are not the same thing to be a patient of.
HereMedical director, on site during all injectable appointments. -
“What happens if something goes wrong at eight in the evening?”
The genuine risks of filler are rare and time-critical — the one that matters most is a vascular occlusion, where the answer is dissolving the filler quickly. A practice should be able to tell you, without hesitating, who you reach and how fast, and that the reversal agent is in the building.
HereA direct number on your after-care card, answered by the clinician who treated you.
Every Michigan license is public.
The state runs a register of licensed professionals. It costs nothing, needs no account, and is not something a practice can edit.
Look us up. Then look up whoever gave you the other quote, which is the part most people never do.
One thing this page is not
It is not a suggestion that other practices are unsafe. Most are careful and many are excellent, and plenty of superb injectors are nurses working under supervision that is genuinely present.
It is a page about what to ask, published by somebody who would rather you asked it of everybody, including us. A practice that finds these questions annoying has told you something either way.