Keep What You Earn

Thinking about private equity? Don't wait until you're burned out and ready to hand over the keys. A partner may want you involved for years after the deal.

I sit down with Andrew Goldfein of Alpha Aesthetics Partners to talk about what makes a practice partner-ready, what buyers look at, and why expanding just to get bigger can hurt your numbers.

Another Location Doesn't Automatically Add Value

That second location might grow revenue while draining profit. Before signing another lease, look at your margins, team retention, and whether the first practice can run without you constantly stepping in.

Know Your Numbers Before You Take the Meeting

A potential partner needs more than a healthy top-line revenue number. Get clear on:

• Revenue and margins by service and location

• Memberships and recurring revenue

• Device utilization and profitability

• Provider retention and operating costs

Your P&L should show what's working and where growth is costing you.

(00:07:36) Knowing when to expand or exit (00:12:03) Starting succession planning early (00:15:34) Finding a partner who fits (00:18:30) Understanding the transaction (00:21:00) Stabilizing revenue and retention

Don't Sign Away What Patients Come For

Alpha describes a partnership model that keeps local branding and clinical autonomy while adding business support. But don't assume every deal works that way. Ask what happens to your team, role, and equity. Make sure the actual agreement reflects what you're promised.

Give Yourself Options Before You Need an Exit

Whether you sell, partner, or keep growing independently, clean financials and strong retention put you in a better position.

Start planning while you still have time to improve your medspa. Waiting until you're desperate to leave can limit your choices.

About Andrew Goldfein:

As the head of New Partnerships and M&A at Alpha Aesthetics Partners, the premier platform partnering with the nation's best aesthetics practices, Andrew has spoken with thousands of owners across the country at all stages of growth. Through its 37 partner locations, Alpha has built a community of some of the brightest clinical and business minds in aesthetics who are all now aligned to help each other through shared ownership in Alpha. Thanks to the daily conversations with practice owners, as well as through serving on Alpha's executive team, Andrew has developed deep experience in identifying opportunities and risks in aesthetics practices to help owners grow their top and bottom line.

Prior to Alpha, Andrew spent four years leading M&A and new site growth at the DSO Affordable Care (Affordable Dentures & Implants) and was previously an investment banker at Houlihan Lokey. A Chicagoan at heart, he now lives in Charlotte, NC and spends any free time he can find with his wife and two young kids.

Connect with Andrew:

Website: https://partnerwithalpha.com/

Instagram: https://www.instagram.com/partnerwithalpha/?hl=en

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

Payment processing feels like back-office admin—until fees creep up or your account gets flagged.

In this episode, I sit down with Adam Castillo to talk about merchant services, hidden fees, high-risk rules, and what can put a med spa on the MATCH list. We also cover telehealth, weight loss, website language, and how to protect your ability to get paid.

Know Your Effective Rate

Don't just scan the statement for one fee. Divide total processing fees by total payments processed and track that effective rate over time. Small increases compound fast, and junk fees can eat into margin.

Check the Risk Before You Add the Service

Before launching telehealth, medical weight loss, or a new payment setup:

• Review website and invoice language

• Confirm processor rules for your services

• Ask whether LegitScript or extra underwriting applies

• Audit fees before switching

A cheaper processor isn't a win if the account gets shut down.

(00:05:35) Finding hidden processing costs (00:08:07) Understanding telehealth restrictions (00:16:03) Avoiding risky payment language (00:42:21) How AI scans websites for flagged terms

Your Processor Should Understand Your Business

Med spas don't have the same risk profile as every other business. Work with someone who understands healthcare payments and can help you address issues before they become shutdowns.

Protect How You Get Paid Before You Scale

Expansion gets harder when you can't reliably accept cards. Clean up fees, compliance, and processor relationships now so payment risk doesn't slow your growth later.

About Adam Costilo:

Adam Costilo is a serial entrepreneur who's had a love for business, growth, and the pursuit of the American dream for as long as he can remember. From co-founding a Philly cheesesteak franchise to launching multiple ventures across different industries, Adam has spent his career building things from the ground up — and helping others do the same. Today, as the founder of The Payment Doctor, he and his team process for over 600 clinics to the tune of more than $200 million a year, delivering true payment stability and fully transparent pricing to the medical and medspa space. But payments are just the starting point. With deep expertise in the peptide and GLP-1 landscape and strategic relationships ranging from next-level 503A pharmacy pricing to best-in-class technology partners, Adam has positioned The Payment Doctor as a one-stop shop for clinic growth. His real passion — and his "why" — is helping clinic owners scale their practices and improve their financial lives, and that mission has become the driving force behind everything The Payment Doctor stands for.

Connect with Adam:

Website: www.thepaymentdoctor.com

Meet with The Payment Doctor Team

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

A packed office doesn't automatically mean a successful event. If you're spending on staff, marketing, and extras without a clear revenue goal or follow-up plan, you may be hosting a nice party instead of a profitable campaign.

In this episode, I sit down with Tami Vileta, founder of Pinpoint, to talk about event marketing for aesthetics practices. We cover patient appreciation events, VIP experiences, referral partnerships, and how to measure event ROI beyond RSVPs.

Start With the Goal, Not the Guest List

Decide what the event needs to accomplish before you plan it. Are you reactivating patients, launching a treatment, building membership loyalty, or generating consultations? Set the financial target first, then work backward into attendance, conversion, and budget.

Treat the Event Like a Campaign

A strong event has a before, during, and after:

• Market early enough to build attendance

• Capture contact information at RSVP and check-in

• Make booking or purchasing easy at the event

• Assign follow-up for anyone who showed interest

The event isn't over when people leave. Some of the best revenue can come from follow-up in the days after.

(00:04:27) Planning events with a purpose (00:13:47) Measuring event success and ROI (00:24:51) Building trust without hard selling (00:27:01) Budgeting for events (00:30:25) Turning follow-up into revenue

Patient Experience Comes Before the Pitch

People should leave feeling appreciated, educated, and excited to come back—not like they spent two hours inside a sales funnel. Use education, exclusive invitations, membership perks, and targeted offers to create value without making the event feel transactional.

Events Should Build Lifetime Value

Repeat events, referral partnerships, and thoughtful follow-up can improve retention and lifetime value while showing you what actually converts. As the practice grows, you want a repeatable event strategy that supports revenue, loyalty, and expansion—not another expensive line item you can't measure.

About Tami Vileta:

Tami Vileta is the founder and creative director of Pinpoint Strategic Communications, with more than 30 years of experience in branding, strategic marketing, design, and copywriting for plastic surgery and aesthetic medical practices.

Through Pinpoint, she has worked with more than 400 practices and industry businesses across the U.S. and internationally, including medical device companies, skincare brands, software providers, and consultants. Her work focuses on patient experience and retention through branding, email marketing, patient education, events, launch campaigns, and other nurturing strategies that help practices convert and retain patients—not just generate leads.

LinkedIn: Tami Vileta | LinkedIn

Instagram: https://www.instagram.com/pinpointcreativeagency

Website: Pinpoint Creative - Aesthetic Branding and Marketing Agency

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

Hiring is already expensive. Weak contracts, unclear roles, or the wrong worker classification can make it a lot more expensive later.

In this episode, I sit down with Sarah, a healthcare attorney and former med spa owner, to talk about the legal and financial gaps that show up as practices grow. We cover partnership agreements, W-2 vs. 1099 classification, job descriptions, expansion risk, and how poor documentation can hurt enterprise value.

Put It in Writing Before You Need It

Partnerships and employment relationships are easiest when everyone agrees. That's when you should document pay, responsibilities, expectations, and what happens if things change. Job descriptions should also match the work people are actually doing—not a generic template. If the paperwork says one thing and the practice does another, that's where risk starts.

Fix the Legal Cracks Before You Scale

Before you add another location, provider, or partner, check the foundation:

• Make sure agreements match the real working relationship

• Review W-2 vs. 1099 classification

• Update job descriptions as roles change

• Confirm payroll and scheduling support the classification

If the first location still runs on workarounds, a second one will multiply the risk.

(00:04:35) Starting without the right paperwork

(00:11:39) Risks of expanding too early

(00:20:25) Why documentation matters

(00:23:59) Preparing for a smoother sale

(00:28:10) W-2 versus 1099 classification

"1099 Employee" Is Not a Thing

Worker classification isn't based on preference. Control, scheduling, exclusivity, and the actual relationship matter. Part-time doesn't automatically mean contractor, either. Misclassification can mean penalties, unenforceable agreements, and ugly surprises during due diligence.

Buyers Pay More for Less Risk

Clean financials matter, but buyers also look at contracts, payroll, staff arrangements, and how much cleanup they'll inherit. Tightening those areas now can make the practice easier to scale today and easier to sell later.

About Sara Shikhman:

Sara Shikhman is an experienced healthcare lawyer and entrepreneur with over 16 years of expertise. She and her team have assisted more than a thousand clients in navigating the healthcare industry's complex legal and regulatory landscape, negotiating contracts, protecting intellectual property, and obtaining funding. As CEO and COO, she has also led several multi-million-dollar ventures, including an e-commerce company that generated over $13 million in revenue in two years and a med spa that expanded from one room to 12 locations across multiple states, generating over $13 million in annual revenue.

Connect with Sara:

Website: https://lengealaw.com/

Free Consultation Booking Link: https://lengealaw.cliogrow.com/book/44df0ed4ba012f9e04d8565f2c9c9aa4

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

Per-unit pricing for neuromodulators feels logical because that's how you buy the product. But it can create billing anxiety, invite negotiation, and keep patients focused on units instead of results.

In this solo episode, I break down how per-area pricing can improve the patient experience and make revenue more predictable. We'll look at margins, EMR data, and how to price around outcomes without guessing.

Patients Shouldn't Be Doing Math in the Chair

When patients have to calculate units during a consultation, price becomes part of the treatment decision. They may ask for fewer units to stay on budget, which can compromise the result. Flat upper face, lower face, or full face pricing shifts the conversation back to the outcome and lets the injector recommend what's appropriate.

Build Flat Pricing From Your Own Data

Don't pick a flat rate because it sounds cleaner. Start with your numbers:

• Pull average usage by treatment area from your EMR

• Include product, labor, injector commission, and membership discounts

• Calculate loaded cost and target gross margin

• Keep per-unit pricing where precision treatments need it

Some appointments will run higher and some lower. What matters is that the averages come from real usage and the margin holds.

(00:04:35) Pricing concerns in cosmetic procedures (00:07:36) Managing patient expectations and value (00:13:22) Benefits of flat pricing (00:16:06) Shifting toward outcome-based pricing

Take Negotiation Out of the Treatment Room

Patients should be deciding whether the treatment plan fits their goals and budget—not negotiating units with the injector. Clear pricing gives your team more room to educate and recommend the right treatment.

Predictable Pricing Makes Growth Easier

Price from actual usage and your full cost structure, and you'll get cleaner margins, more predictable revenue, and fewer cash flow surprises. As you scale, a repeatable pricing model is also easier to train and use across providers.

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

People are one of the hardest parts of a practice. Even with careful hiring and a great culture, you'll still deal with turnover, performance issues, and the occasional wrong fit.

In this episode, I sit down with Amy Anderson of ACG Practice Partners to talk about when people problems are actually process problems. We cover retention, compensation, hiring, transparency, and the operational leaks that get more expensive as you grow.

Make It Easier for Good People to Stay

You can't guarantee every great provider will stay, but you can make sure they understand their role, how they're evaluated, and how compensation works. Clear job descriptions, check-ins, and transparency around gross margin and pay can prevent confusion.

Before You Blame the Person, Look at the Process

If a different person stepped into the role tomorrow, would the same problem still happen? If yes, look at the system before replacing the person.

Before you hire again, review:

• Job descriptions and onboarding

• KPIs and compensation plans

• Lead handoffs and manual work

• Hiring criteria

Small inefficiencies add up fast as the team grows.

(00:05:48) Retaining good providers (00:25:56) Diagnosing people versus process problems (00:35:33) Improving hiring decisions (00:40:08) Finding workflow inefficiencies and revenue leaks (00:44:29) Building accountability into operations

Share the Numbers Your Team Can Actually Influence

You don't need to hand everyone your entire P&L. Give your team the metrics tied to their work, like gross margin, booking rates, follow-up, or conversion. Then performance conversations have something concrete to work from.

Small Operational Problems Get Bigger With Growth

A small inefficiency can become wasted payroll, missed revenue, and unnecessary headcount as the practice expands. Start with what's costing the most time or money. Stronger systems help good employees work without the owner constantly stepping in, leading to better accountability, healthier margins, and less stress.

About Amy Anderson:

As a nationally recognized expert and CEO of ACG Practice Partners, she brings over 20 years of hands-on, non-clinical experience in the aesthetics industry. Known for her practical leadership and human-centered approach, Amy has guided practices of all sizes, from startups to multi-specialty groups, on optimizing operations, building strong teams, and achieving sustainable growth. She is especially sought after for her ability to empower leaders and tailor strategies that fit each practice's unique culture. Amy is a frequent national speaker and trusted advisor to surgeons and their teams.

Connect with Amy: ACG Practice Partners: https://acgpracticepartners.com/amy-anderson/

LinkedIn: https://www.linkedin.com/in/amyandersonmba

Instagram: https://www.instagram.com/amyandersonmba/reels/

MedSpa Pro: https://www.medspaproevent.com/expert/amy-anderson.html

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

This week, I'm turning the mic over to Audrey Neff, host of True to Form, and replaying the conversation she originally shared with her audience. Audrey put me in the hot seat with the financial questions medical spa owners need to be asking as they grow.

A full schedule can still produce weak cash flow, a second location can magnify problems that already exist, and a practice that depends on its owner for every decision will be difficult to scale or sell.

Audrey and I connect these issues by following the money from individual treatments through to the long-term value of the business.

The Metrics Behind a Financially Healthy Med Spa

Free cash flow gives an owner choices. It can fund cash reserves, support a new location, reduce debt, or create an exit opportunity. Producing more of it requires a clear understanding of which treatments fill your schedule and which ones contribute meaningful margin.

In this episode, we discuss:

• Why reviewing a P&L without interpreting it leaves owners with more numbers but very little direction

• How revenue per hour, margin per treatment, patient retention, and customer lifetime value influence cash flow

• Why injectables can bring patients through the door while leaving little room for profit when pricing, commissions, and discounts are poorly managed

• How "Bed Bath and Botox" discounting cuts into an already thin injectable margin

• The missed retail sales opportunities hiding inside treatment plans and patient conversations

• Why a med spa should have four to six months of cash reserves before opening a second location

• How to identify and reduce owner dependency by asking, "What breaks first when I leave?"

• What buyers examine when calculating enterprise value, including cash flow, owner dependency, customer concentration, and operational risk

The Five-Part Financial Playbook

Here are the exact steps we use to evaluate a practice's financial health:

1. Core profit: Are your treatments priced to produce healthy margins?

1. Operating profit: Can your budget support the team and infrastructure required to run the practice?

1. Cash flow: What remains after your equipment, debt, taxes, and other obligations are paid?

1. Customer value: Are you retaining patients and increasing the value of those relationships?

1. Enterprise value: Can the practice continue producing reliable cash flow without depending on you?

Following the steps in order helps you identify the financial constraint that deserves your attention now instead of trying to fix everything at once. Get your free Playbook here.

Add "True to Form" to Your Playlist

This conversation originally aired on Audrey Neff's True to Form podcast. Audrey brings candid conversations about leadership, operations, patient experience, growth, and enterprise value to the medical aesthetics industry.

If you own or lead an aesthetics practice, subscribe to both shows:

• Subscribe to Keep What You Earn

• Subscribe to True to Form

• Get the free Financial Scaling Playbook for Aesthetics

Connect with Audrey and Aviva Aesthetics:

Audrey Neff brings more than a decade of experience in the medical aesthetics and wellness industries and currently serves as Chief Marketing Officer at Aviva Aesthetics. A respected marketing strategist and global speaker, she has served as a key opinion leader for several leading aesthetic brands and has taught for more than 30 medical aesthetic associations worldwide. Her thought leadership has been featured in publications such as PRIME Journal, The Aesthetic Guide, and PAN Journal. Audrey is also the host of True to Form, a globally ranked podcast exploring the people and ideas shaping the future of the aesthetics industry.

Website: https://avivaaesthetics.com/

True To Form podcast: https://www.instagram.com/truetoformpodcast/

Instagram: https://www.instagram.com/audreyneff_/

LinkedIn: https://www.linkedin.com/in/audreyneff/

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. She is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

Marketing gets exhausting when every platform, conference, and industry trend comes with the message that your practice should be doing more. More posts, more videos, more channels, more events. But a high volume of marketing activity does not automatically lead to better clients or more profitable growth.

In this episode, I sit down with Robin Dimond, founder and CEO of Fifth & Cor, to talk about building a marketing strategy around the business you actually have. We cover how to choose channels based on your budget, bandwidth, and target demographic; when a personal brand helps or hurts the practice; and why reputation, local partnerships, and consistent patient education can outperform whatever happens to be trending online.

Fix the Patient Journey Before You Generate More Leads

Marketing brings more attention to whatever is already happening inside the practice. If calls go unanswered, the booking process is frustrating, or the team is not prepared to follow up with leads, spending more money will only expose those problems faster.

Look at the full patient experience before adding another campaign. Can someone easily book a consultation? Does the team know how to respond to inquiries? Are you attracting people who are a good fit for the practice? Strong marketing cannot make up for operational gaps that prevent interested patients from becoming long-term clients.

Choose Marketing Channels With a Clear Reason Behind Them

You do not need to be active on every platform simply because another practice is doing it. The right marketing mix depends on who you want to reach, how they make decisions, and what your team can consistently manage. Budget planning also needs to account for time and energy—not just the money spent on ads or content creation.

• Define what the marketing initiative needs to accomplish before choosing a channel

• Identify where your target demographic spends time and what mindset they are in on each platform

• Set a realistic budget for both financial investment and team capacity

• Test one or two strategies on a small scale before expanding into omnichannel marketing

• Batch and repurpose content across Instagram, TikTok, LinkedIn, YouTube Shorts, or Pinterest when those platforms fit the audience

• Consider direct mail, local partnerships, conference attendance, and public relations alongside digital marketing

• Track qualified leads, booked consultations, client acquisition costs, and patient retention instead of relying on views or engagement alone

• Give the team a clear role in content creation and follow-up so the strategy does not depend entirely on the owner

Consistency matters, but it needs to be sustainable. A focused strategy that your team can maintain will usually produce better information and stronger results than constantly switching tactics or chasing the newest trend.

(00:03:42) Navigating an overwhelming number of marketing options (00:05:29) Fixing operational gaps before generating more leads (00:12:31) Understanding client mindsets across different platforms (00:17:27) Standing out with handwritten cards and direct mail (00:26:50) Building a sustainable social media strategy (00:30:16) Balancing personal branding with long-term business goals (00:43:37) Measuring marketing by results instead of effort

Your Practice Reputation Has to Extend Beyond the Owner

A personal brand can help patients connect with the practice, but it becomes a risk when every relationship, referral, and piece of recognition is tied to the owner. Bring providers and team members into the outward-facing side of the business so patients see the depth of expertise across the practice and trust the experience no matter who they see.

Sharing continuing education, patient education, community involvement, and team accomplishments builds a stronger reputation than relying on one personality alone. That matters when you want to add providers, reduce your clinical hours, or eventually sell, because a brand that can stand without the founder is much easier to scale.

The Best Marketing Makes Growth Easier to Manage

When the strategy is focused, the financial reports become easier to interpret. You can see which channels produce qualified consultations, which local partnerships bring in the right patients, and whether your client acquisition costs make sense relative to the value of those relationships. Marketing stops feeling like an open-ended expense because every initiative has a purpose and a way to measure its performance.

As the practice grows, consistency matters more than constant visibility. A team-supported brand, a clear message, and a small group of channels that reliably attract the right clients are easier to manage and repeat across providers or locations. You should not have to spend every spare moment creating content just to keep the business moving. The strategy should support the practice without taking over your life.

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. Shannon is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Connect with Shannon: Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

About Robin Dimond:

Robin Dimond is the founder of Fifth & Cor. With more than 20 years of experience in branding, marketing, and innovation, she has helped businesses move from scattered ideas to clearer strategies across both corporate and entrepreneurial settings.

Her work is rooted in the belief that strong marketing requires more than data—it also requires purpose, courage, and a clear understanding of why people connect with a brand. Through Fifth & Cor, Robin brings people together, removes barriers to collaboration, and helps businesses grow through thoughtful strategy, authentic connection, and consistent execution.

Connect with Robin and Fifth & Cor:

Website: https://www.fifthandcor.com Email: [email protected]

Instagram: https://www.instagram.com/fifthandcor LinkedIn: https://www.linkedin.com/company/fifth-and-cor/

Facebook: https://www.facebook.com/FifthandCor

Being booked feels like proof that the business is working. But if most of that schedule is filled with injectables, the revenue can look much stronger than the profit underneath it. Product costs, provider compensation, commissions, memberships, and discounting can leave very little behind—even when the calendar is full.

In this solo episode, I break down why injectables need to be evaluated as part of your full service mix instead of carrying the entire growth strategy. I also explain how to organize your P&L by treatment category, calculate what patients actually contribute in gross profit, and use comprehensive treatment plans to improve both patient retention and practice profitability.

A Full Injectable Schedule Can Still Produce Weak Profit

Injectables are often one of the largest revenue categories in a medical aesthetics practice. They bring patients through the door, create recurring appointments, and can help establish long-term relationships. But with supply costs, injector compensation, commissions, and discounts factored in, gross margins may only land around 30% to 40%.

That does not leave much room to cover the rest of the business. Rent, administrative payroll, marketing, software, and other operating expenses still have to come out of what remains. When injectables dominate the schedule without enough higher-margin services around them, a busy practice can still struggle to generate healthy cash flow.

Your P&L Should Show Which Services Actually Make Money

A single revenue line labeled "services" does not give you enough information to manage the practice. You need to see how much revenue each treatment category produces and what it costs to deliver those services. Keep the categories simple enough to review consistently, but specific enough to reveal where your profit is coming from.

• Group revenue into four or five core categories, such as injectables, aesthetic services, beauty services, laser treatments, and surgical services

• Match each category with its direct supply costs, provider labor, and commission expenses

• Calculate gross margin by treatment category instead of relying only on the practice-wide average

• Separate package revenue collected from the revenue earned as treatments are delivered

• Compare patient lifetime revenue with the gross profit that patient generates

• Review how memberships and discounts affect margins over time

• Track which services lead to repeat visits and broader treatment plans

You do not need dozens of categories or an overly complicated financial report. You need enough visibility to understand the composition of your revenue. Just as body composition tells you more than weight alone, your service mix tells you far more than total sales.

(00:00:00) Why injectables are difficult to price (00:05:41) Balancing the P&L with service margins (00:08:27) Mapping revenue and profit by treatment (00:10:27) Calculating patient lifetime value (00:14:01) Challenging assumptions about patient budgets (00:17:42) Improving retention through treatment plans

Treatment Plans Create More Value Than One-Off Appointments

Patients may come in asking for Botox or another familiar service, but that does not mean they understand every option available to them. A strong consultation starts with the result they want, then maps out the treatments that can realistically help them get there. Present the full recommendation before making assumptions about what they can afford. Let the patient decide what to pursue, what to postpone, and how quickly to move through the plan. That is consultative selling: educating the patient, setting expectations, and helping them make an informed decision without down selling for them.

A written treatment plan also gives the relationship room to grow. One injectable appointment can become the start of a longer patient journey that includes laser treatments, skincare, and other services that genuinely support their goals.

A Stronger Service Mix Makes Growth More Sustainable

When one treatment category carries too much of the practice, changes in product costs, provider capacity, or local pricing can quickly put pressure on the entire business. A more balanced service mix combines the retention benefits of injectables with treatments that produce stronger margins and make better use of the team, equipment, and space you already have. This gives you a healthier patient lifetime value, more recurring revenue, and a clearer picture of what the practice can support as it grows. It also helps you make better decisions about pricing, inventory, staffing, equipment purchases, and future expansion.

A full schedule should create more than activity. It should generate enough gross profit to fund the next stage of the practice.

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. Shannon is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Connect with Shannon: Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.

Medical aesthetics is one of the few areas of healthcare where practice owners have real control over pricing. Because most services are cash pay, med spas are not waiting on insurance reimbursements or negotiating with carriers. Yet many practices give away that advantage by running constant promotions and training patients to shop for the lowest Botox price.

In this solo episode, I explain how deep discounts create margin erosion, weaken patient loyalty, and push the industry toward commoditization. I also share how stronger consultations, treatment plans, and value-based pricing can improve retention, patient experience, and clinic profitability without turning every appointment into a sales pitch.

Discounts Train Patients to Wait for the Next Offer

Discounts can fill the schedule for a weekend, but they also change how patients see the practice. When every holiday comes with a coupon, patients learn that the listed price is temporary and the service is interchangeable. That is how Botox pricing and injectables start to feel like retail products instead of medical treatments.

Patients who choose a practice based only on price are also difficult to retain. They may come in for the promotion and leave as soon as another clinic advertises a better deal. You pay to acquire them, give up margin on the treatment, and still have no lasting customer relationship to show for it.

Run the Numbers Before You Run the Promotion

A discount should never be approved simply because the calendar is slow or a competitor launched one. Before lowering the price, look at what the offer does to gross profit, cash flow, future capacity, and patient behavior. Promotional revenue can look impressive while the economics underneath it tell a very different story.

• Calculate treatment margin after product cost, provider compensation, payment fees, and promotional spending

• Measure how many discounted patients return and rebook at full price

• Compare customer acquisition cost with patient lifetime value

• Account for prepaid packages as future treatment obligations rather than immediate profit

• Review inventory levels before promoting injectables or retail products

• Determine whether the offer supports a broader treatment plan or only creates a one-time visit

• Give the team clear language to explain value, outcomes, and next steps without relying on aggressive sales techniques

If the numbers only work when patients purchase more later, be honest about how often that actually happens. Upselling cannot carry the strategy when your intake, follow-up, and rebooking systems are not built to support it.

(00:05:43) Building lasting patient relationships (00:09:01) Setting confident pricing for services (00:10:40) Understanding value versus effort (00:15:21) Shifting from retail to patient focus (00:16:31) Improving client intake and planning (00:19:37) Identifying growth barriers for practices

Lead the Consultation With Medical Authority

A patient consultation should feel like clinical guidance, not a review of services and prices. Patients come to you because they want a result and need help understanding which treatments will get them there. When providers lead with patient education, set realistic expectations, and recommend a clear treatment plan, price becomes one part of the decision rather than the entire conversation.

This also creates a better patient experience. People are more likely to follow through, rebook, and trust future recommendations when they understand why the plan was created. Value-based pricing works when the practice can clearly connect its expertise, care, and treatment strategy to the outcome the patient wants.

Patient Loyalty Creates More Predictable Growth

Practices that depend on promotions often see the same pattern: a rush of cash, a crowded schedule, and then another dip. That volatility makes financial management harder because staffing, inventory management, and marketing decisions are being made around short-term spikes instead of reliable demand.

A medicine-first approach creates cleaner practice growth. Strong treatment plans, consistent rebooking, and better customer retention increase patient lifetime value and make cash flow easier to forecast. Over time, that stability gives you room to improve margins, invest in your team, and expand without constantly discounting the work that built your reputation. A med spa with medical authority and loyal patients has far more control over its pricing, profitability, and future.

Follow Shannon & Keep What You Earn:

Shannon Weinstein is the founder of a fractional CFO firm specializing in helping 7-figure aesthetics and wellness practices scale with clarity, cash flow, and confidence. Shannon is committed to helping med spa owners understand, fix, and maximize their business's enterprise value, offering actionable advice and resources, including a popular free video series specifically for aesthetics practice owners.

Connect with Shannon: Fractional CFO Services and Executive Financial Review: https://www.keepwhatyouearn.com/

Connect with Shannon: https://www.linkedin.com/in/shannonweinstein

Watch full episodes: https://www.youtube.com/@KeepWhatYouEarn

Listen on your favorite podcast app: https://pod.link/1580071347

Instagram: https://www.instagram.com/shannonkweinstein/

The information shared is for educational purposes only and is not individualized financial advice. Aesthetics practice owners should consult a qualified professional before implementing financial strategies discussed here.