How to choosea medical director in Ontario

Most pages about choosing a medical director are written by somebody selling one. So is this one, and you should read it with that in mind. What makes it worth reading anyway is that every check below is something you can verify yourself, without taking our word for any of it, including about us.

Check the registration yourself, before anything else

Ask for the registration number, then look it up on the College of Nurses of Ontario public register. It is free and it takes under a minute. You will see the class of registration, whether it is current, and whether there are findings.

Do the same for a physician on the College of Physicians and Surgeons of Ontario register. A director who hesitates when you ask for a number has already answered the question, and it is the one check that costs you nothing and eliminates the worst outcomes.

Establish who is accountable for what, in writing

This is where most arrangements are vague, and vagueness only ever hurts the nurse. An authorising mechanism transfers authority for specific acts under specific conditions. It does not transfer responsibility for your competence, your assessment or your decisions, and anybody implying otherwise is misunderstanding the accountability structure or hoping you will not look closely.

You remain accountable to the College for your own practice. Your director is accountable for the mechanism they authored and for the oversight they agreed to provide. Both halves should be written down.

Read the actual directive before you sign anything

Ask to see a sample directive, or better, ask what yours would say. The document is the product. A directive that covers routine treatment and says nothing about adverse event management leaves you trained to act and not authorised to act, which is the worst position to be in at the exact moment it matters.

Check that it names the interventions you genuinely perform, not a generic list. Check what it excludes. A directive covers what it says it covers.

Ask what happens at two in the morning

Complications do not keep office hours. Ask, plainly: if a client rings me tonight with sudden severe pain and blanching, what do I do, who do I call, and how fast will they answer?

A good answer is specific. It names a route, a timeframe and a fallback. A bad answer is that it is very unlikely to happen. It is unlikely. That is not the question.

Find out how often the documents get reviewed

Your scope changes. The products change. The College’s expectations change, and they are changing right now: the Aesthetic Services practice guideline was published in July 2026 and the regulator is actively reviewing how directives and delegation are used in this area of practice.

A directive written once and never revisited will eventually describe a practice you no longer have. Ask what the review interval is and what triggers an out-of-cycle review.

Ask what the fee includes, not just what it is

Price on its own tells you very little. Two arrangements at the same monthly figure can differ completely: one buys document authorship and a name, the other buys authorship, revision, case review, a reachable person and agreed handling of complications.

Get the inclusions in writing. Then the number means something, and you can compare it with another quote honestly.

Ask how they keep up with the clinics they cover

There is no regulated maximum number of clinics one director may cover, and anybody quoting you a limit is inventing it. The useful question is how they manage the load: what the review cadence is, what the response time is, and what happens when two clinics need them in the same afternoon.

You are listening for a system, not a number.

Check they will say no to you

This sounds like an odd thing to want. It is the most reliable signal there is.

A director whose entire commercial interest lies in you injecting more will not be the person who tells you that a client should not be treated, or that an intervention sits outside what you should be doing yet. Ask directly what they have declined to authorise, and why. Somebody who has never declined anything is either very new or not really looking.

Understand what they will not do

Nobody can take blanket responsibility for your practice. Anyone offering to is either misunderstanding the accountability structure or hoping you will not look closely, and that is worth knowing before money changes hands rather than after.

A clear statement of the limits is a better sign than an expansive promise.

Decide whether you need training, oversight, or both

These are different purchases and they get conflated constantly. Training gives you competence. A medical director gives you authority. Neither substitutes for the other, and a course certificate does not authorise you to inject any more than a directive teaches you where the facial artery runs.

If you are newly trained, you probably need both, and it is reasonable to buy them from different people. If a provider will only sell you the pair, ask why.

What we would say about ourselves, factually

We provide medical direction, so treat this as interested. Here are the facts you can check rather than the claims you cannot.

Alex Dinovich is a Nurse Practitioner registered with the College of Nurses of Ontario, registration number 13564840, verifiable on the public register linked at the foot of this page. She authors the directives and direct orders, reviews them as practice changes, is reachable for case review, and states in writing what she will not take responsibility for. She also declines things, which is the point of check eight.

Whether that suits you is your call, and running these ten checks on somebody else is a perfectly good outcome from reading this page.