Spain has become a key destination for both healthcare and aesthetic treatments, including a fast-growing private and medical-aesthetic market. For foreign brands, this is a real opportunity, especially in major cities and tourist hubs. Yet to open a medical or aesthetic clinic chain in Spain safely, you must respect a complex mix of health, advertising, data protection, employment and corporate rules. Legal planning turns growth ambitions into a sustainable, compliant network.
Is Spain a Good Market for Your Clinic Brand?
Spain combines high demand for aesthetic medicine with a mature healthcare system. Private and semi-private clinics operate alongside public hospitals, serving both local patients and international visitors. The aesthetic medicine segment in particular has seen double-digit growth in recent years and is projected to keep expanding, which is attractive for foreign clinic brands that can offer differentiated services.
Demand is not limited to big cities. Medium-sized cities and some coastal areas host a steady flow of residents and health tourists seeking dermatology, dentistry, plastic surgery and non-surgical aesthetic treatments. However, Spanish patients are increasingly sensitive to safety, qualifications and reputations. New rules around cosmetic surgery and aesthetic medicine focus on patient protection and on limiting unqualified providers.
For your brand, this means that clinical quality and compliance are not optional extras. A clear position on safety, evidence and transparency can become a competitive advantage. The market rewards serious operators, but punishes shortcuts. That is why legal and regulatory mapping should happen before you choose locations or sign franchise deals.
Regulatory Basics: Healthcare vs Aesthetic Services in Spain
One of the first tasks is to identify whether your services fall under healthcare regulation, aesthetic regulation, or both. In Spain, healthcare is heavily regulated at national level and then implemented by each autonomous community. Private healthcare centres, including many aesthetic medicine clinics, must obtain a regional healthcare authorisation and comply with detailed rules on facilities, equipment and staffing.
Aesthetic services form a broad spectrum. Purely cosmetic, non-medical services (for example, basic beauty salons) are subject mainly to consumer, advertising and safety rules. But once you enter medical-aesthetic territory—injectables, lasers with medical risk, surgical procedures—healthcare rules apply. That includes obligations on informed consent, clinical histories, data protection and management of medical waste.
Foreign owners sometimes assume they can replicate their home model without change. That is rarely true. Some treatments allowed in your country may face tighter restrictions, need specific medical specialities or must only be performed in authorised hospital-level facilities in Spain. A careful review of your treatment portfolio against local rules is essential before promising services to partners, landlords or investors.
Premises, Licences and Medical Director Requirements
Every clinic in Spain operates from premises that must match its authorised activity. The building must meet planning, accessibility, fire and technical healthcare standards. In many regions, health authorities require you to submit detailed plans, equipment lists, waste protocols and opening hours as part of the licence application.
On top of general healthcare authorisation, a clinic may also need specific licences for radiology, operating theatres, lasers or certain invasive procedures. Landlords’ generic “health use” clauses in leases are not enough. You must confirm that the premises can legally support your actual services and that any heavy equipment or structural works are compatible with building rules.
In many autonomous communities, a medical director requirement Spain clinic structure is standard for medical and medical-aesthetic centres. The medical director is usually a doctor registered with the local medical college, responsible for ensuring clinical quality and regulatory compliance. Their role, authority and availability should be clearly documented, especially in multi-site chains.
Finding and adapting premises for clinics in Spain involves more than negotiating rent. It includes verifying healthcare compatibility, aligning leases with licensing timelines and ensuring that fit-out works and signage meet both health and planning requirements.
Employment and Professional Liability for Doctors and Therapists
Running a clinic chain means managing a mixed team of doctors, nurses, therapists, administrative staff and sometimes external specialists. Each group has different qualification, registration and liability profiles. Doctors and nurses must have their qualifications recognised in Spain where applicable and be registered with the relevant professional colleges. Therapists who carry out certain treatments may need specific training and certification.
Contracts must reflect the real relationship. Some brands try to engage practitioners as “self-employed” when they work in practice like employees. Spanish labour inspectors and courts look at control, integration and economic dependence, not labels. Misclassification can lead to back payments, sanctions and forced requalification as employees.
Professional liability is another key issue. Even non-surgical aesthetic treatments can lead to complications and claims. You need clear internal protocols on consent, information, documentation and follow-up. Insurance policies must cover the entity, the practitioners and, where needed, the medical director. Cross-border arrangements, where a foreign company tries to cover Spanish operations under a home policy, should be reviewed carefully.
Lawyer’s Tip:
Do not let HR and medical management work in separate silos. Align job descriptions, contracts, insurance and clinical protocols in one review. That way, each practitioner’s legal status, responsibilities and cover match the actual treatments they perform in your clinics.
Expansion Models: Own Clinics, Joint Ventures or Franchises
As with other retail-like chains, you can choose different expansion models for clinics in Spain. Corporate-owned clinics give you maximum control over clinical standards, training and branding. They also require higher capital and deeper involvement in Spanish employment, licensing and tax rules. This model is often preferred for complex medical services where brand reputation is very sensitive.
Joint ventures involve partnering with local investors or practitioners. You might provide the brand, know-how and systems, while the local partner contributes capital, premises or patient networks. These deals rely heavily on clear shareholder agreements, governance and exit rules. They can be powerful when you find a strong local partner, but risky if expectations diverge.
Franchising is possible, especially for aesthetic clinic chains with standardised protocols and strong brand identity. You grant the right to use your brand and system in exchange for fees and royalties. However, you remain exposed to reputational risk if franchisees cut corners on safety or staffing. In healthcare, franchise agreements need rigorous clinical and compliance clauses, regular audits and realistic termination rights.
A lawyer for clinic chain Spain expansion can help you compare these models in light of medical regulation, capital, speed and control. Often, a hybrid path works best: start with a few owned or joint-venture flagship clinics, then add carefully selected franchisees once the model is adapted to Spanish rules.
How Mecan Legal Builds a Compliant Expansion Plan for Clinic Chains
• Mapping your current model and treatment portfolio against Spanish healthcare and aesthetic regulation in the target regions.
• Structuring the clinic group and local operating companies to ringfence risk and support franchising, joint ventures or owned clinics.
• Finding and adapting premises for clinics in Spain, including lease negotiation and coordination of licensing and fit-out processes.
• Designing employment, contractor and medical director arrangements that manage professional liability and meet local standards.
• Managing patient claims and liability risks in Spain and updating protocols when real cases reveal new risk areas.
Opening one clinic is already a complex project. Rolling out a chain multiplies that complexity. You must repeat licensing, leases, staffing and compliance many times, often in several autonomous communities with slightly different rules and procedures. Without a coordinated plan, each new site becomes a separate firefighting exercise.
Mecan Legal helps you build a repeatable, compliant expansion model. We start by analysing your brand, services and target geography. Then we create standard legal “building blocks”: company structures, lease templates, franchise or joint-venture agreements, employment models and consent documentation that can be adapted site by site. This reduces time-to-opening and keeps legal standards coherent across the chain.
Our team also stays involved after launch. We help you monitor regulatory changes, deal with inspections and respond to incidents or claims. Over time, lessons from early clinics can be built into stronger contracts and protocols for later ones. The result is a clinic chain that grows with legal discipline, not just commercial enthusiasm.
Frequently Asked Questions
Do I need a Spanish-licensed medical director for each clinic in Spain?
In many regions, yes, at least for medical and medical-aesthetic clinics. Health authorities often expect an officially appointed medical director who is a doctor registered with the local medical college and responsible for clinical oversight. Exact rules vary by autonomous community and type of clinic, so a regional review is essential before opening each centre.
Can I offer the same treatments as in my home country or are some restricted?
Some treatments can be offered in a similar way, but not all. Certain procedures may require specific medical specialities, particular equipment or hospital-level facilities in Spain. Others might be restricted or subject to stricter conditions. You should map your treatment list against Spanish healthcare and aesthetic regulations before promising services or marketing them to patients.
Are aesthetic clinics regulated like medical clinics in Spain?
It depends on the services. Purely cosmetic, non-medical services have a lighter regulatory framework. However, once you perform medical or medical-aesthetic procedures—injectables, lasers with medical risk, minor surgery—healthcare rules apply. That usually means healthcare authorisation, clinical protocols, informed consent and professional liability cover similar to medical clinics.
Is franchising a viable model for clinic expansion in Spain?
Franchising can work well for standardised medical-aesthetic concepts, but it must be designed carefully. You need robust franchise agreements that cover clinical standards, training, audits, record keeping and brand use. You also remain ultimately responsible for brand reputation and may face scrutiny if franchisees fail to meet legal or ethical standards. For many brands, a mix of owned and franchised clinics is the safest option.