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Botox injections are considered the practice of medicine in Michigan. Botox may be administered by doctors, PAs whose practice agreements authorize it, and NPs who have been assigned the task by a physician.

Furthermore, except for licensees in a health career subfield, Michigan's general delegation law requires licensees to delegate to both licensed and unlicensed individuals who are otherwise qualified by schooling, training, or experience to perform the delegated mission. The work must be done under the direction of the delegating licensee and must fall within the scope of practice of the licensee delegating the task. A "health profession subfield" tends to be PAs or LPNs.

This means that a physician or nurse practitioner may delegate Botox injections to licensed or unlicensed individuals if (1) the person to whom the task is delegated is eligible to perform the delegated task through education, training, or experience; (2) the task is within the physician or NP's scope of practice; and (3) the Botox injections will be performed under the physician or NP's supervision. Under the general delegation law, supervisions are characterized as the supervising or participating in the work of another person by a supervising physician or nurse practitioner in situations where at least all of the following requirements are met: [i] The supervising physician or nurse practitioner is always available for direct contact with the supervisee, either in person or by radio, telephone, or telecommunication;(ii) On a daily basis, the supervising physician or nurse practitioner is available to monitor the supervised individual's practice, provide consultation, review documents, and further instruct the supervised individual in the execution of the individual's functions; and(iii the supervising physician or nurse practitioner (NP) provides the delegation with predetermined procedures and medication protocols.