09/10/2026
I've had versions of the same conversation with several aesthetic doctors, and it usually starts with some variation of, “I know this practice should be doing more than $40K a month.”
They are not brand-new practices. They have patients and a solid team. They are spending money on marketing, showing up online, and doing many of the things they were told they were supposed to do.
From the outside, the practice looks like it should be moving forward, but month after month, the numbers keep landing in roughly the same place.
This is usually where they expect me to start talking about another campaign, another ad strategy, or some new way to generate leads. Instead, I start asking questions that are a little less exciting and sometimes a little more uncomfortable.
Do you actually know where your best patients are coming from?
Can you connect the money you are spending to revenue? What happens when a new lead calls the practice? Is your team helping the patient move forward or quietly making the process harder? Is your content building a brand around the doctor, or does almost everything you post look like another treatment advertisement?
My medical billing background probably has a lot to do with the way I see this. I learned very early that what gets missed on the front end eventually becomes a much more expensive problem on the back end. Patient acquisition works the same way. A practice can keep adding more visibility and more leads, but if the numbers, team, systems, and patient experience underneath it are disconnected, more marketing simply gives the gaps more opportunities to show themselves.
That is why one of the biggest things I tell doctors at this stage is to know their numbers before adding more. Tools like CallRail can help show where calls and leads are actually coming from, but the larger conversation is understanding what those numbers are telling you about the practice.
I wrote about the five things I keep telling aesthetic doctors who are hovering around $40K months and want to move toward $100K months. I did not want to hurt anybody’s feelings, but sometimes the conversation that moves the business forward is not the one you expected to have.
Read the full article on Substack.
https://aestheticpracticeconfidential.substack.com/p/the-tough-conversation-i-keep-having
