Sep 26, 2026 · 45 min · 13 segments
A packed schedule doesn't always mean a profitable practice. Ashley James, founder of DermAesthetic Consulting, joins Audrey Neff to unpack where med spas leave money on the table — and how to change…
Ashley JamesGuest
Audrey NeffHost
But if we go back to, I think where we'll kind of start today, and this kind of goes hand in hand with what we actually just were talking about around smoke and mirrors, but you have seen so many evolutions of the industry from when it was a very, it was like a little infant to now.
You know, we're still in kind of a very high or consistent years and years and years of growth.
But if we go back to since you've been in the industry for so long and on the topic of smoke and mirrors too, because I feel like this actually ties into this, is...
How have you seen the industry shift over the last few years? Because obviously, if we look at data, there's probably around 13,000 med spas, give or take, in the States today.
Every year, it's usually about 1,000 more, right? So let's say an extra 1,000 medical spas open up every single year.
And obviously, it's becoming a lucrative industry as well if people can do things right.
But with that said, do you think there are – more businesses that know what they're doing open today, or do you think that most practices are still not operating sophisticated businesses?
I would say most of the practices are not running sophisticated businesses, and that's kind of where I come in.
Coming in and evaluating what's happening and what's not happening, where is the business fragmented, and then coming in and fixing those things.
It is crazy to me how many providers or even non-physicians launch practices without a strategy.
I was just talking to a potential client last week that they've already rented their space.
And I said, okay, then what? How much are you going to pay for your staff? What do you know your opening orders are going to be? What devices are you going to purchase? And they don't think about after the doors are open.
They don't give their business the lifeline financially to really get off the ground during those critical moments.
First months which you know usually is around six months to twelve months and they go upside down very quickly or they are single provider Practices that then slowly bring on other providers or other employees, but they just run themselves ragged They're busy, but they're not profitable and they have no idea how much opportunity they're leaving on the table so I think there's more practices that do this the right way and and have a plan and have a strategy and follow that strategy than most.
And I will say those are the practices that are thriving, especially when I think it's like 136 new med spas are opening every single month.
When you have that type of competition, when you have private equity coming in and they have the funding and they have the strategy, that is what you're competing against.
But if we go back to, I think where we'll kind of start today, and this kind of goes hand in hand with what we actually just were talking about around smoke and mirrors, but you have seen so many evolutions of the industry from when it was a very, it was like a little infant to now.
You know, we're still in kind of a very high or consistent years and years and years of growth.
But if we go back to since you've been in the industry for so long and on the topic of smoke and mirrors too, because I feel like this actually ties into this, is...
How have you seen the industry shift over the last few years? Because obviously, if we look at data, there's probably around 13,000 med spas, give or take, in the States today.
Every year, it's usually about 1,000 more, right? So let's say an extra 1,000 medical spas open up every single year.
And obviously, it's becoming a lucrative industry as well if people can do things right.
But with that said, do you think there are – more businesses that know what they're doing open today, or do you think that most practices are still not operating sophisticated businesses?
I would say most of the practices are not running sophisticated businesses, and that's kind of where I come in.
Coming in and evaluating what's happening and what's not happening, where is the business fragmented, and then coming in and fixing those things.
It is crazy to me how many providers or even non-physicians launch practices without a strategy.
I was just talking to a potential client last week that they've already rented their space.
And I said, okay, then what? How much are you going to pay for your staff? What do you know your opening orders are going to be? What devices are you going to purchase? And they don't think about after the doors are open.
They don't give their business the lifeline financially to really get off the ground during those critical moments.
First months which you know usually is around six months to twelve months and they go upside down very quickly or they are single provider Practices that then slowly bring on other providers or other employees, but they just run themselves ragged They're busy, but they're not profitable and they have no idea how much opportunity they're leaving on the table so I think there's more practices that do this the right way and and have a plan and have a strategy and follow that strategy than most.
And I will say those are the practices that are thriving, especially when I think it's like 136 new med spas are opening every single month.
When you have that type of competition, when you have private equity coming in and they have the funding and they have the strategy, that is what you're competing against.
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