Can a per-consult clinician be my medical director?

Not as part of per-consult coverage. Medical direction is an ongoing responsibility that exists whether or not patients are seen that month, which is why it is priced monthly. Some physicians hold both roles for one practice, but they are separate arrangements with separate obligations, and they should be priced and contracted separately.

I have a director already. Why would I need anyone else?

Because a director’s job is oversight, not throughput. If your director is not the one seeing patients, someone still has to complete the evaluations, follow-ups and prescription decisions your program generates. That is the gap consult coverage fills, and it is the pattern behind a good share of the requests StaffMD receives.

Does StaffMD provide collaborating physicians for nurse practitioners?

StaffMD’s core model is completed-consult coverage. Collaborating-physician and supervisory obligations are governed state by state and are a separate arrangement. Tell us on the call: it is either scoped explicitly or you are told it is not something we can supply for your state and structure, rather than a per-consult model being assumed to satisfy it.

Does a good-faith exam count as clinical coverage?

It is a clinical encounter, so it belongs on the throughput side of the line, but it is a distinct workflow with state-specific rules about who may perform it and how. If exams are what you need, describe the services and the states on the call so the fit can be confirmed rather than assumed.

What happens if my state changes its rules?

Coverage that is matched per state can be re-scoped per state. Because StaffMD is paid per completed consult, pausing or shrinking a service line while you sort out a rule change does not leave you paying a retainer for a program that is not running. Oversight arrangements, by contrast, usually run on notice periods; check yours.

Which clinical role do you need?

Medical director or clinical coverage? Which one your program actually needs

Owners describe both with the same word: the doctor. They are different jobs, priced differently, and buying the wrong one leaves you either out of compliance or paying a retainer for patients nobody sees. This page separates the roles and says plainly which of them StaffMD supplies.

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Four roles that get called “the doctor”

Oversight

Medical director

Takes clinical responsibility for the program or facility: standards, protocols, chart review, and in many states the arrangement that lets a non-physician-owned business offer medical services at all.

How it is priced: Monthly retainer, sometimes per location.
When it is missing: You may not be allowed to operate, and any compliance you do have is on paper only.

Collaborating or supervising physician

The physician named in a nurse practitioner’s or physician assistant’s practice agreement where the state requires one. Some states cap how many NPs a single physician may hold.

How it is priced: Monthly, often per NP or per location.
When it is missing: The NP or PA cannot practice in that state, however good they are.

Throughput

Clinician of record for patient encounters

The licensed MD, NP or PA who evaluates the patient, decides whether to prescribe, orders and reviews labs, handles follow-ups and documents the visit.

How it is priced: Per encounter, or hourly, or as salary.
When it is missing: Patients wait, revenue stalls, and whoever holds a license ends up doing consults at night.

Good-faith-exam provider

The clinician who establishes the patient relationship and clears a patient for a service before it is performed, required for many aesthetic and IV services depending on the state.

How it is priced: Per exam, sometimes with a small platform fee.
When it is missing: Services are performed on patients nobody has examined. This is the failure mode inspectors look for.

The first two are oversight. They exist whether or not a patient is seen this month, which is why they are priced by the month. The second two are throughput. They happen one patient at a time, which is why they are priced per encounter. A vendor who quotes you one number for “a doctor” has hidden which of these you are getting.

02

Which gap do you have?

Common situations and the clinical role that closes the gap
Your situation	What you probably need	Where to start
I already have a medical director; consults are backing up	Clinical coverage. Your oversight is in place; you are short of encounters.	How coverage is matched
I am an NP in a restricted-practice state and need a signed agreement	Oversight: a collaborating physician. A per-consult clinician cannot sign it.	Price it as oversight
I am opening a med spa or IV business and need a doctor on paper	Real oversight, plus a good-faith-exam workflow. Paper-only direction is the failure mode owners warn each other about.	The cost guide for the money, then a healthcare attorney for the structure.
My director quit, or stopped answering	Possibly both. Replace the oversight, and check whether the departed physician was also the one doing the consults.	Split the two before you re-buy them as one item.
I run a telehealth GLP-1 or hormone program and want the clinical side handled	Clinical coverage. Oversight is scoped separately if your structure needs it.	GLP-1 or TRT/HRT coverage
I am adding a new state	Clinical coverage licensed in that state, plus a check of that state’s supervision or collaboration rule.	Licensed where you operate

03

What StaffMD supplies, and what it does not

Supplies

Licensed MDs, NPs and PAs who complete patient consults for your program.
Evaluations, follow-ups, lab review and prescription decisions, documented in your EMR.
Providers licensed in the states you name, confirmed per state.
One flat rate per completed consult; no retainer, no minimum, no setup fee.

Does not

Satisfy, by itself, a state’s medical-director, supervising-physician or collaborating-physician requirement.
Operate a pharmacy, a lab or a patient-facing platform.
Promise “hands-off” compliance. Nobody honest can.
Let a per-consult arrangement quietly stand in for oversight you are required to have.

04

Signs you have paper oversight, not real oversight

Owners describe the same warning signs in every forum where this comes up. None of them are fixed by adding consult capacity. They are fixed by replacing the oversight.

The director visits every few months to sign charts and is otherwise absent.
Requests for signatures, orders or prescriptions go unanswered for days.
The director has never read the protocols they are responsible for.
Nobody has confirmed that the collaborative agreement is filed with the board where the state requires it.
The director’s liability coverage does not list the providers they supervise.
The arrangement was found through a listing that said “no daily presence required” and nothing about response times.

05

Questions to ask any vendor before you sign

01What exactly is included in the monthly fee, and what does a patient encounter cost on top of it?
02Who is the clinician of record for each patient visit, and in which states are they licensed?
03Which of my states require a collaborative or supervisory agreement, and is that covered?
04What is the turnaround for prescriptions, orders and signatures, in writing?
05Who carries malpractice for the clinicians, and who carries it for the practice?
06What happens to my patients and my agreement if this physician leaves?

StaffMD answers the same questions on its coverage call, and the ones that do not apply to per-consult coverage are answered with “not us, and here is who”.

06

Questions owners ask

Book a Coverage Strategy Call

Tell us your states, protocols and expected volume. We come back with a coverage plan and your per-consult rate.

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