I recently joined Robbie Antosi of MyAdvice and Brooks Locker of BSL Consulting for a webinar called “Fill, Thrill & Bill”—a conversation about patient acquisition, retention, and profitability for med spas. It was a well-rounded discussion, and while Robbie and Brooks brought incredible insight on the marketing and patient experience side, I want to dig deeper into the financial themes we covered—because in my experience, those are the areas where med spa owners have the most questions and the fewest clear answers.
Whether you’re a new practice trying to find your footing or an established med spa looking to scale, the financial decisions you make around marketing spend, growth strategy, patient retention, and cash flow management will ultimately determine whether your practice thrives or just survives.
Your Marketing Budget Needs a Financial Framework
One of the first topics we tackled was marketing spend. The standard benchmark you’ll hear across the industry is 8% to 10% of gross revenue for practices in active growth mode—and that’s a solid guideline. But here’s what I always tell clients: that number can’t exist in a vacuum. It has to live inside a bigger financial picture.
Before you commit to any marketing budget, you need a business plan and a budget that accounts for your total expenses, revenue targets, and profit goals. If you’re spending 10% on marketing but your payroll is already running above 35% of revenue, you have a math problem—not a marketing problem.
The other piece people miss is capacity. If your providers are already operating at or near full capacity, pouring money into patient acquisition doesn’t make sense. In that scenario, you’re better off pulling your marketing spend down to 2% to 5% and focusing on retention and maximizing revenue per visit from the patients you already have. Marketing spend should always reflect where you are operationally—not just what a benchmark says you should spend.
Financing, Memberships, and Consistent Cash Flow
Something I brought up during the webinar that I think deserves more attention is the role of financing options, packages, and membership programs in med spa financial health. These aren’t just patient convenience tools—they’re cash flow strategies.
When you offer patient financing, you remove one of the biggest barriers to higher-ticket treatments. The patient gets the outcome they want, and you collect revenue that might have otherwise walked out the door. Packages and memberships take it a step further by creating predictable, recurring revenue—which is the foundation of financial stability for any service-based business.
If your revenue graph looks like a roller coaster—great months followed by slow months with no predictability—memberships and procedure plans are one of the fastest ways to smooth that out. Predictable revenue means you can plan payroll, inventory purchases, and growth investments with confidence rather than reacting month to month. For a deeper look at how to set and track financial goals using these tools, check out our recent guide.
Hiring a Provider vs. Buying a New Device: A Financial Decision
This is one of the most common questions I get from growing practices, and we spent some time on it during the webinar: should you hire another provider or invest in a new piece of equipment?
My answer always starts with utilization data. When your current providers are operating at 75% to 80% capacity, that’s your signal to start the hiring conversation. Below that threshold, adding another provider just means you’re spreading existing patient volume thinner and diluting productivity across your team.
For equipment purchases, the calculation is different but equally important. Before you sign a lease or write a check, break down the monthly cost of the device and compare it against the realistic revenue it will generate. And here’s the key: gauge demand from your existing patient base first. Survey them. Ask what treatments they’ve been curious about. Your current patients are the lowest-hanging fruit for any new service offering—if there’s no demand from the people who already trust you, that device may collect more dust than revenue.
One more note on equipment: if you’re purchasing before the end of the year, there are significant tax advantages through Section 179 and bonus depreciation that can allow you to write off the full cost in the year of purchase. That’s a real financial benefit—but it shouldn’t be the reason you buy. I’ve seen practices get trapped in a cycle of purchasing devices primarily for the tax write-off, only to realize they’ve front-loaded all their depreciation and have no deductions left in future years. Buy because the business case makes sense, and let the tax benefit be the bonus—not the driver.
The Rebooking Problem Is a Financial Problem
Patient retention came up heavily in the “Thrill” portion of the webinar, and there’s a financial dimension that often gets overlooked. Brooks shared a stat that stuck with me: dentists successfully rebook nearly 90% of their patients before they leave the office, while the medical aesthetics industry averages somewhere between 40% and 50%. From my experience with med spa clients, 50% is the high end of what I see.
Think about what that gap means financially. Every patient who walks out without a next appointment is a patient you’ll need to spend marketing dollars to re-engage. It’s the most expensive way to fill your schedule—acquiring the same patient twice. If you can close the rebooking gap even partially, you reduce your dependency on marketing spend, improve return visit rate, and create more predictable revenue.
This is why I encourage every practice to track rebooking rate as a weekly KPI. It’s one of the fastest indicators of practice health, and when it dips, it’s almost always connected to either a patient experience issue or a front desk process breakdown. Either way, the financial impact is immediate.
Employee Incentives Must Align with Financial Goals
We spent some time discussing team culture and employee retention during the webinar—and Brooks made an excellent point about staff wanting money, to feel valued, and to see a growth path. I agree completely, and I’d add a critical financial layer: whatever incentive structure you build must align with the practice’s overall financial goals.
I’ve seen incentive programs that reward top-line revenue without accounting for margins, which can actually encourage behaviors that hurt profitability—like excessive discounting to hit volume targets. The better approach is to tie incentives to metrics that drive healthy financial outcomes: rebooking rates, average revenue per visit, and utilization percentage are all solid starting points.
Being transparent about financial goals with your team also matters. You don’t need to open every line of your P&L, but sharing top-line revenue targets and letting your team understand how their daily efforts contribute to those goals creates buy-in. A team that understands the financial picture performs differently than a team operating in the dark.
Cash Flow Monitoring: The Non-Negotiable Habit
I closed our webinar discussion by talking about early warning signs of a cash flow crunch, and I want to reiterate the point here because it’s foundational: if you don’t have a budget, and you aren’t reviewing your financials on at least a monthly basis, you’re flying blind.
My recommendation is to review your P&L monthly to spot trends—my favorite report is the P&L by month comparison, which lets you see exactly where things are heading. On top of that, check billing and patient reports weekly to make sure you’re tracking toward your targets. If you’re relying on gut feeling to assess your financial health, you’re going to get caught off guard eventually.
This is what we do with our Virtual CFO clients—we build the financial systems and review cadences that turn your numbers from a source of anxiety into a decision-making tool. Because at the end of the day, the med spas that win aren’t just the ones with the best treatments or the most followers. They’re the ones that understand their numbers, make data-driven decisions, and have the financial infrastructure to support sustainable growth.
Build a Financially Healthier Practice
If any of this resonated—or if you’re reading it and realizing you don’t have clear answers to these questions for your own practice—that’s exactly the kind of conversation we have with med spa owners every day. At Liguori Accounting, we specialize in outsourced accounting, tax planning, and fractional CFO services built specifically for the medical aesthetics industry. Reach out to our team to start a conversation about your practice’s financial health.
