Higher music education (HME) institutions and individual teachers are increasingly expected to address the health challenges of music students. In responding to these expectations and meeting students’ needs, institutions and teachers inevitably position themselves as health workers, raising difficult questions of mandates, competences, and purposes of music educational activities.Through theoretical lenses of critical health studies and governmentality, this paper builds on two research projects that examine the intersections between music education, health, and care in HME. These projects look at the interpretative repertoires used in HME to make sense of and address performance difficulties, injuries, and wellbeing, and how instrumental teachers in higher music education negotiate the boundaries of their teaching practice’s mandates, content and activities, and their own roles and responsibilities. This paper draws on two focus groups and 15 in-depth interviews with instrumental teachers predominantly teaching at HME institutions in Norway, in which their work in relation to their students’ health, wellness and development is discussed. The interviews are analysed using critical discursive psychology, and complemented and contextualised by critical document analyses of how musicians’ health is conceptualised in selected HME research literatures and HME institutions’ public statements.While the interviews and document analyses indicate that institutions and the instrumental teachers recognise student health and wellness issues as detrimental to student musical development, these projects highlight several concerns and potential pitfalls as well as possibilities in terms of mandates, competences, and purposes of health work in music educational settings: For one, teachers readily positioned themselves as carers for their students while also lacking health competences to properly assess problems that were brought to them. Next, student disclosures allocate teachers with increased pastoral power and expected health related competences, leading to amplified asymmetrical power relationships and increased pressures on teachers. Finally, teachers displayed widely varying levels of confidence on health topics, but displays of higher confidence invoked more health-related misconceptions, whereas less confident accounts were vaguer but relied less explicitly on interpretations of scientific explanations to justify their understandings and approaches.These combined findings trouble the positioning of instrumental teachers as health workers and as significant figures in relation to students’ health and wellness, while simultaneously highlighting the potential in teachers’ demonstrations of care for their students. Calls for continued institutional support of instrumental teachers as health workers require further discussions regarding mandates, competences, and purposes of music education settings and activities.