Guide · For clinics
Does a nurse-led clinic need a doctor?
What the prescriber rules mean for your hiring
Michelle Mexted
Founder and Recruitment Specialist, Aesthetics Recruitment Australia
I get asked this a lot, usually by a nurse-led clinic that is growing and wondering whether the next hire has to be a doctor. The honest answer is that there isn't a point where a nurse-led clinic is required to bring on a doctor. That isn't how the rules work, and anyone who gives you one clean answer to that question is oversimplifying it.
What a clinic offering prescription cosmetic injectables does need is an authorised prescriber. That can be a doctor or a nurse practitioner. So the real hiring question is not "when do I need a doctor", it is "who is my prescriber, and is that arrangement going to hold up as I grow".
Why clinics actually bring a doctor in
In my experience, when a clinic brings on a doctor it is rarely about compliance. It is almost always one of three commercial decisions.
The first is treatments. Some clinics want to offer more advanced work than their current team can, and that is where a cosmetic doctor earns their place.
The second is price. Doctor-led treatments sit at a higher price point, and some clinics are deliberately moving up the market.
The third is the patient. Some patients specifically want to be seen by a doctor, and a clinic going after that demographic needs one on the floor, not just on paper.
That is the real decision, and it is a business one. If none of those three apply to you, a doctor may not be the hire you need right now.
The rule that changed, and what it means day to day
For a long time many nurse-led clinics ran on a prescriber who never spoke to the patient: a doctor, often interstate, signing off a list. That is what has gone. A prescriber consulting your patients in real time, by video, is still fine.
Doctors have had to consult the patient in person or by video each time they prescribe a cosmetic injectable since the Medical Board's guidelines took effect on 1 July 2023. From 2 September 2025, Ahpra's guidelines applied the same rule to every other registered practitioner who is authorised to prescribe, which includes nurse practitioners. No scripts by text, email or online form, and no batch prescribing across a list of patients.
For a clinic, that means your prescriber has to be genuinely available to see patients in real time. It also has to be clear who looks after a patient if something goes wrong after treatment and the prescriber or treating nurse isn't around. That is a staffing question as much as a compliance one.
Doctor or nurse practitioner: what it means for the hire
A nurse practitioner can prescribe cosmetic injectables within their scope, subject to your state's rules, and costs considerably less. As a rough guide, nurse practitioners sit around $100 to $150 an hour, against $250 to $400 an hour for a doctor.
But cheaper on paper doesn't mean easier to fill. Good nurse practitioners with real aesthetics experience are genuinely scarce, and the ones who are good are rarely looking. Budget for the search taking longer than you expect, and be ready to move quickly when the right person is available.
Whichever way you go, brief it properly. Say which treatments the prescriber will cover, how many patients and clinics they will be consulting for, whether that is in person or by video, and who handles aftercare. A vague prescriber role attracts the wrong people, and the right people ask about exactly these things before they ask about pay.
The nurses you hire are covered by the same guidelines
The 2025 guidelines also set experience requirements for nurses. A registered nurse needs at least a year of full-time equivalent practice in general or specialist nursing before moving into cosmetic work, and enrolled nurses work under a registered nurse's supervision with limits on higher-risk areas. It is worth knowing when you are weighing up a newer candidate, and it's part of what we check before you see a shortlist.
What this means for your next hire
The hiring side is my end: who you need, when, and what it will take to get them. Anything about how your clinic is structured, how medicines are ordered and stored, or what your insurance covers belongs with your indemnity insurer, your pharmacy and your state's health department, because the answer depends on where you are.
We work exclusively, one search at a time for one clinic, with a commitment on both sides. It's the only way to run a proper search rather than a race against three other agencies, and it's worth knowing before you get in touch.
Common questions
Does a nurse-led cosmetic clinic have to employ a doctor?
Not as such. A clinic offering prescription cosmetic injectables needs an authorised prescriber, which can be a doctor or a nurse practitioner. The rules on prescribing and supply differ between states, so check your own state's drugs and poisons rules and speak to your indemnity insurer and pharmacy.
Can a prescriber still approve patients remotely?
Only through a real-time consultation, in person or by video, each time they prescribe. Doctors have been under that rule since 1 July 2023, and since 2 September 2025 it applies to nurse practitioners and other authorised prescribers too. Prescribing by text, email or online form is not acceptable practice.
Why would a clinic hire a cosmetic doctor if it doesn't have to?
Usually for commercial reasons: to offer more advanced treatments, to move to the higher price point that doctor-led treatments carry, or to serve patients who specifically want to be seen by a doctor.
Is a nurse practitioner cheaper than a doctor?
Usually, yes. As a rough guide nurse practitioners sit around $100 to $150 an hour against $250 to $400 an hour for a doctor. Good nurse practitioners with aesthetics experience are scarce, though, so the search can take longer.
How much experience does a nurse need before doing cosmetic work?
Under the 2025 guidelines, a registered nurse needs at least a year of full-time equivalent practice in general or specialist nursing before moving into non-surgical cosmetic procedures. Enrolled nurses work under a registered nurse's supervision, with limits on higher-risk areas.
This guide is about staffing, not regulatory or legal advice. The rules differ by state and change over time, so check your own state's drugs and poisons rules.