Alex Dinovich, Nurse Practitioner and Medical Director at Bradford Skin Clinic and Medical Spa, acts as medical director for Registered Nurses and Registered Practical Nurses injecting in Barrie, Orillia, Innisfil and Alliston. The clinic is about twenty minutes south of Barrie, which makes in person competence assessment and case review practical rather than theoretical.
Written and reviewed by Alex Dinovich, NP, Nurse Practitioner and Medical Director at Bradford Skin Clinic & Medical Spa.
College of Nurses of Ontario registration 13564840, verifiable on the
public Find a Nurse register.
Last reviewed .
At a glance
The short version.
InvestmentQuoted per arrangement. Scope, number of nurses and case review volume all move the figure
What the arrangement includes
Included in the arrangement
Directives authored for your practiceWritten to what you inject, where, and for whom.
Competence assessed in person where that is the right way to do itTwenty minutes makes watching you work a realistic part of the arrangement.
Prescribing for neuromodulatorsWhere that applies to what you do.
Case review, including looking at a client when photographs are not enoughThe option that distance usually removes.
An agreed complications planLocal escalation, agreed before you need it.
Revision as your practice changesA new intervention or a second injector is a change to the documents.
Not included: training. Directorship gives you authority, not technique.
Who you would be working with
A person, not a signature.
Directorship is a professional relationship rather than a
location. You are choosing the person who authors your mechanism, reviews it as
your practice changes, and picks up when a client does not fit it.
Alex Dinovich is Nurse Practitioner and Medical Director here. She is registered with the College
of Nurses of Ontario as 13564840, verifiable on the
public register.
What a directive gives you
Authority to perform the controlled act it names.
A written mechanism you can show.
A named provider accountable for authoring it.
What it does not cover
Anything the directive does not say.
Competence, which comes from training and practice.
Your own accountability to the College for your own decisions.
A directive covers what it says it covers.
Accountability under an authorizing mechanism is specific and bounded.
You remain accountable to the College of Nurses of Ontario for your own practice.
Alex Dinovich, NP. The authorising provider, not a name on a certificate.
The one region where proximity genuinely matters
Everywhere else on this site we argue that directorship is not a local service, because it is not: the documents, the prescribing and most case review are the same whether the authorizing provider is twenty minutes or four hours away.
Simcoe County is where the exception lives. Twenty minutes down Highway 400 means two things become practical that are otherwise theoretical.
Competence can be observed rather than discussed. A director has to be satisfied that you are competent for the interventions a directive covers. The thorough version of that is watching you inject. The remote version is a conversation about your training and your experience, which is reasonable but weaker. If you are close enough to come down for a morning, the better version is available.
A difficult client can be seen. Most case review is a phone call with photographs and that is usually enough. Occasionally it is not: an asymmetry a camera does not capture, something that needs palpating, a client who should be assessed by someone with prescribing authority. Nearby means the answer can be “bring them in”.
The competitor question, straight away
If you inject in Barrie and we treat clients in Bradford, our catchments touch. Pretending otherwise would be silly, so here is how we deal with it.
Directorship is a professional arrangement, not a route into your client list. What should be written down, with us or with any local director, is what is confidential, what happens to the arrangement if either practice changes, and what notice applies on each side. Ask for it. A director who finds the question awkward has told you something useful.
For some nurses the honest answer will be that a director outside their catchment suits them better, and if that is you, directorship across Ontario explains how remote arrangements are structured and what to demand from one.
Building up to independent practice
The most useful thing about a local arrangement is the middle stage.
Training gives you technique. A directive gives you authority to initiate independently. Between those sits supervised practice, and it is the stage the industry is worst at providing. Nurses finish a course, cannot find anywhere safe to practise, and either stall or start independently before they should.
Shadowing in these rooms is that middle stage, and when it is twenty minutes from your house it is a morning rather than an expedition. A directive written after a period of supervised practice is also a better document, because the competence question has a real answer behind it instead of a paper one.
Directives authored for your practice rather than issued from a template. Direct orders where a named client is the better route. Prescribing for neuromodulators where it applies. Case review with a real route to reach the authorizing provider. An agreed position on complications: what you manage, what you escalate, and to where. Revision when your practice or the College’s expectations change.
What it does not cover is the same everywhere: it does not make you competent at something you have not been trained for, and it does not transfer your accountability to the College of Nurses of Ontario. What directorship costs explains the six things that move a quote, and how to choose a medical director is the list of questions to ask us and everybody else.
Who you would be working with
Alex Dinovich, FNP-PHC, Nurse Practitioner and Medical Director at Bradford Skin Clinic and Medical Spa, College of Nurses of Ontario registration 13564840, verifiable on the public register. She assesses, diagnoses, prescribes, issues direct orders and authors directives in her own right, and injects daily in this clinic.
Starting the conversation
Tell us what you inject, where in the county you work, and what you are competent to manage yourself. We will tell you what the documents need to cover, whether supervised practice should come first, and what the arrangement costs.
Call 647-333-6805. Bradford Skin Clinic and Medical Spa, 444 Holland Street West, Unit 2, Bradford, Ontario.
Asked by nurses
Asked and answered.
How close are you to Barrie?
About twenty minutes south on Highway 400. Innisfil is ten to fifteen, Alliston around twenty five, Orillia around forty. For directorship that is close enough to change what the arrangement can realistically include.
Does being local actually change the arrangement?
Yes, in two specific ways. Competence can be established by watching you work rather than by discussing your training, which is a better test. And when a case is genuinely difficult, the honest answer can be to bring the client here rather than to ask for a better photograph. Neither is possible at three hours' distance.
Are you not a competitor if I practise in Barrie?
It is a fair question and worth putting on the table early. We treat clients in Bradford and you would be treating clients in Barrie, which overlaps at the edges. What we will not do is use directorship as a route into your client list, and what you should do with any local director is agree in writing what is confidential and what happens to the arrangement if either practice changes.
I work at a clinic that uses a physician director in Toronto. Is local better?
Not automatically. A good remote arrangement beats a poor local one. Local is better when your practice needs someone physically present, when you are early in building competence, or when the current arrangement makes consultation technically permitted but practically slow. Those are the tests, not the kilometres.
Can you supervise while I build up to independent practice?
That is exactly what being nearby is useful for. Supervised practice sits between training and independent initiation under a directive, and plenty of nurses need it. We offer shadowing in these rooms, and the directive that follows can be written with that experience behind it rather than in place of it.
Do you cover nurses in Orillia, Midland and further north?
Yes. Simcoe County, Muskoka and the near north are all workable, with the usual proviso that the further away you are the more the written route to reach the authorizing provider matters. Our page on directorship across Ontario sets out how arrangements are structured by distance.
Sources
Where this comes from.
Everything on this page is drawn from the regulator, not from a
competitor's marketing. Read the originals rather than taking our word for any of it.
General information about Ontario regulatory requirements. Not
legal or regulatory advice. Nurses remain accountable to the College of Nurses of Ontario
for their own practice decisions.
Talk to us
Ask before you commit to anything.
Leave four details and Alex will come back to you directly. If what
you need is not something we do, we will say so and point you at whoever does.
Written and reviewed by Alex Dinovich, NP, Nurse Practitioner and Medical Director at Bradford Skin Clinic & Medical Spa.
College of Nurses of Ontario registration 13564840, verifiable on the
public Find a Nurse register.
Last reviewed . 
