In this week’s Business of Aesthetics episode, host Michael Walker sits down with Dr. Carla Pierson, nurse practitioner and co-founder of Smiley Aesthetics, for a real conversation about something the industry doesn’t talk about enough, how a lack of business know-how is holding providers back. Carla shares her own journey, the common mistakes she sees every day, and practical ways to build a business that actually supports your skills and goals.

Whether you’re just getting started or feeling stuck financially, this episode breaks down why understanding the business side isn’t optional, and what you can do about it.

Key Takeaways

• Clinical excellence isn’t enough Without business understanding, many med spa owners risk burnout, poor decisions, or failure—even with great clinical results.

• You don’t know what you don’t know Many providers lack basic financial knowledge like what a P&L is or how to manage cash flow.

• The dangers of DIY everything Owning and operating without expert guidance or structure leads to chaos—especially when managing taxes, compliance, and partnerships.

• Fight the myth of being the solo CEO The glorified image of being the injector, marketer, owner, and strategist is often unsustainable. Strategic collaboration is key.

• Track cash flow before chasing profit A basic spreadsheet and regular tracking of money in and out can empower even the most non-business-savvy providers.