Telehealth has transformed how Med Spas deliver Good Faith Exams, but every state draws the line differently. Some allow asynchronous (store-and-forward) exams where information is reviewed later. Others require synchronous exams — real-time video encounters between the patient and the provider.
Knowing which one your state allows isn’t just a technical detail. It determines whether your Good Faith Exams are legally valid.
If you haven’t yet read Do Laws Around Good Faith Exams Differ by State, that’s a good starting point.
Understanding Synchronous vs. Asynchronous
Before diving into the laws, it helps to define both.
- Synchronous: A live, two-way video (or audio-video) encounter between the provider and patient. This is the gold standard for most state boards.
- Asynchronous: The patient submits health information electronically — such as photos, forms, or questionnaires — and the provider reviews it later before approving or declining treatment.
While asynchronous models are gaining popularity in broader telehealth, most state boards still require synchronous Good Faith Exams for medical aesthetics.
To see how your state handles telehealth, read What Are the Compliance Laws in My State for a Med Spa.
Why Many States Require Live (Synchronous) Exams
Good Faith Exams are about safety, not speed. State boards favor synchronous exams because they allow the provider to:
- Ask follow-up questions in real time
- Assess tone, hesitation, or physical symptoms
- Ensure the patient fully understands risks and aftercare
- Build rapport and trust before treatment
A live interaction helps the provider form a professional-patient relationship, a key legal requirement for most procedures performed in Med Spas.
States Beginning to Allow Asynchronous Models
A handful of states have begun to loosen restrictions on telehealth. Some allow asynchronous encounters for lower-risk procedures, provided that:
- A provider licensed in that state reviews the full patient record
- The encounter is properly documented
- The provider determines that the information submitted is sufficient to establish a medical judgment
This is why it’s critical to work with a provider network that tracks these distinctions continuously. The rules evolve frequently — and an outdated process can lead to compliance violations overnight.
If you operate in multiple states, see If I Outsource My Good Faith Exams, Do I Still Need a Medical Director for how oversight applies across locations.
The Risk of Getting It Wrong
Conducting an asynchronous exam in a state that requires synchronous evaluation can lead to:
- Invalid treatment authorization, meaning every procedure performed afterward may be deemed noncompliant
- Regulatory fines or disciplinary actions from the state board
- Liability exposure if a patient is harmed and no valid Good Faith Exam was conducted
For more detail on the consequences of missing or invalid exams, read What Happens If I Don’t Perform a Good Faith Exam.
How Spakinect Handles State Variations
Spakinect ensures your Med Spa stays compliant, no matter where you operate.
- We currently serve 40 states and counting
- Patients connect with a licensed provider in an average of 31 seconds
- Every provider is a W-2 employee trained with over 40 hours of compliance and aesthetic-specific education
- Our processes are vetted by Medical Boards and legal experts to meet both synchronous and asynchronous requirements where applicable
- All documentation integrates directly with your EMR and is stored securely in the client portal
This allows single-location and multi-location Med Spas to standardize compliance under one proven system.
To view current coverage, visit States We Service.
FAQs: Synchronous vs. Asynchronous Good Faith Exams
What’s the difference between synchronous and asynchronous exams?
Synchronous exams happen in real time via video. Asynchronous exams involve reviewing information later. Most states require synchronous exams for Med Spa procedures.
Which states allow asynchronous Good Faith Exams?
A few states, such as Washington and Arizona, have begun to accept asynchronous encounters under certain conditions. Always verify your specific state’s telehealth regulations.
Can I choose asynchronous for convenience?
Only if your state explicitly allows it. Otherwise, it may be considered an incomplete or invalid exam.
How can I stay updated on my state’s telehealth laws?
Read Do Laws Around Good Faith Exams Differ by State and What Are the Compliance Laws in My State for a Med Spa.
Does Spakinect handle both types?
Yes. Our system automatically aligns with your state’s telehealth requirements, ensuring every exam — synchronous or asynchronous — meets regulatory standards.
Final Takeaway
The distinction between synchronous and asynchronous exams isn’t academic — it’s a compliance necessity. One wrong step can put your Med Spa at risk of fines, legal exposure, and reputational damage.
With Spakinect, you never have to guess. Our board-vetted processes, licensed W-2 providers, and 31-second average connection time ensure that every Good Faith Exam your practice performs aligns with state law — and protects your business at every step.
