Not always. While a doctor doesn’t always have to be on-site for every medical spa procedure; however, you should have a face-to-face consultation with a doctor, physician assistant or nurse practitioner prior to each medical spa treatment. Once that happens, a doctor doesn’t necessarily have to be on-site. However, most states require, and AmSpa recommends, that a medical professional always be on-site to ensure proper treatment and supervision. Note that if you are ever offered a medical treatment without first seeing a doctor, nurse practitioner or physician assistant, that medical spa is likely operating illegally.