The Medical Director Vetting Checklist.

1 · Verify before you meet

Ten minutes online saves you from the worst outcomes. Do this before the first call.

• Find them on the public register. Physicians: the CPSO "Find a Doctor" register. Nurse Practitioners: the CNO "Find a Nurse" register. If you can't find them, stop here.
• Check status: registration is active and entitled to practise, not suspended, expired, or restricted.
• Read the practice restrictions section. Terms, conditions, or limitations on their certificate can affect whether they can oversee your services.
• Review discipline history and any past findings, both registers show this publicly.
• Confirm prescribing authority covers your menu, e.g., an NP's scope and competence for the specific drugs and treatments you offer.
• Search their name + "medical director", practices they currently or formerly oversaw can tell you a lot.

2 · The 8 questions to ask

Your interview script for the first conversation. Take notes, you'll need them for section 4.

• 01How many practices do you currently oversee, and how much capacity do you genuinely have for mine?
• 02What's your hands-on experience with the specific treatments on my menu?
• 03How do your directives or orders work, and when were they last updated?
• 04What's your expected response time if I need you during clinic hours, and will you put it in writing?
• 05How do you want complications handled, and what's your role when one happens?
• 06What does chart review look like, frequency, format, and the feedback I'll actually get?
• 07How are your fees structured, and what happens when my volume changes?
• 08Why do you do this work? The one almost nobody asks. The best directors treat your practice as part of their practice, not as passive income.

3 · Red flags, walk away

Any one of these is a serious warning. Two or more means keep looking, no matter how convenient the offer.

• ⚑They'll "sign" without ever meeting you or seeing your clinic.
• ⚑No chart review, no protocols, no plan for complications, just paperwork.
• ⚑You're discouraged from contacting them, or they're routinely unreachable.
• ⚑They can't explain how their directives work or when they were last updated.
• ⚑The pitch is about the paperwork, never about the patients.
• ⚑Pressure to sign quickly, or vagueness when you ask anything in section 2.

4 · Fee comparison worksheet

Meet more than one candidate whenever you can. Fill a column per candidate and compare like for like.

5 · Before you sign, get it in writing

A good director won't hesitate to put any of this in the agreement. Hesitation is information.

• Scope: the exact services covered by their oversight, matching your real menu.
• Directives & orders: what exists, who maintains them, and how updates happen when your menu changes.
• Response-time commitment for clinic-hours questions and for emergencies.
• Chart review cadence, frequency, sample size, and how feedback is delivered.
• Complication protocol, escalation steps, reversal agents, and their role in the moment.
• Fees: amount, structure, what triggers changes, and payment terms.
• Exit terms: notice period, and what happens to your directives and records if either of you ends it.
• Independent review: have your own lawyer or advisor read it before you sign. Worth every dollar.