Measuring Data in Plastic Surgery vs Medical Spas

We talk all the time about people struggling with data:

  • What Key Performance Indicators (KPIs) do you need to know? 
  • What do they actually mean? 
  • How do you manage and measure your data? 
  • How do you interpret it? 
  • Finally, how can you use it to make business decisions?

What we don’t always dive deeper into is the difference between measuring data in plastic surgery practices vs. medical spas. That’s why I’m so excited to share some valuable insights from my conversation with long-time friend and colleague, Izhak Musli.

Izhak is an expert in business processes, operational excellence, and using technology as a tool to improve business efficiencies. He has a deep understanding of practice management having worked with aesthetic practices since 2015. He founded and developed two software solutions for the aesthetic industry, both of which have since been acquired: AtlasKPI, the industry’s first business intelligence dashboard, and MedicalPRM, a digital lead management tool.

Izhak was gracious enough to share his industry knowledge and wealth of expertise on the fundamental difference in business models between a plastic surgery practice and a medical spa as well as the critical KPIs that should be monitored for each. Below is a summary of key insights Izhak shared with me.


When you think about the aesthetic industry, there are two main categories: plastic surgery and medical spas. Many times there is overlap, but the core businesses are very different. A lot of plastic surgeons we work with decide to open a medical spa, but they don’t realize that it is really a whole separate business.

Sometimes, practice owners assume that opening a medical spa is as easy as buying equipment, finding a brick-and-mortar space, hiring staff, and then boom–people will come through the doors. That kind of thought process is a recipe for failure in terms of the differentials and data analytics required for each model.

Here are some of the differentiators between both models:

  • Profit Margin: The number one differentiator is profit margin. When you look at a plastic surgery practice, they typically have a few staff members and may have more than a 70% profit margin on their services (if surgery is the only service they provide). Conversely, when you look at a medical spa, if they break the 20% profit margin benchmark, they are considered rock stars. What you need to take into account and realize is that if you start to monitor every penny you are spending and focus on your conversion rate, it will make a huge difference–no matter which practice type you have.
  • KPIs: The KPIs that need to be measured are different as both business models are fundamentally separate. Most people don’t love numbers, and most aesthetic providers have not gotten an MBA in business. So, knowing which KPIs to measure for each model is critical. If you are a plastic surgeon who is considering opening a medical spa in addition to your practice, you must run Profit and Loss (P&L) reports for each business unit separately. Even if they share some expenses, they have to be analyzed completely separate from one another because each has its own parameters of success and important KPIs that must be measured and monitored (see more on this below).
  • Scalability: A question we get asked often is how do you decide whether or not to open a medical spa or a plastic surgery practice or a blend of the two? First off, let’s start with the realization that each one has pros and cons–even with respect to profit margin. Plastic surgery is typically not a scalable model because usually there is one plastic surgeon or, sometimes, an additional 1-2 doctors in the practice. It’s very rare to see a large plastic surgery practice with multiple doctors. If you do find one, it normally gets acquired by different groups that know how to run large practices. As a result, the providers become more like employees inside of the business. Again, most plastic surgery business owners run solo practices or have a maximum of 1-2 additional surgeons. When it comes to a medical spa, the scalability factor is limitless. That’s why it’s so attractive to so many. If it’s run well and efficiently, a medical spa can easily turn into a passive income stream. There is no dependency on one provider to generate the majority of the revenue. There is typically a lower volume of patients with higher cost services in a surgical practice. In a medical spa, there is a much higher volume of people coming through the door, yet smaller transactions.
  • Lead Acquisition Costs: Let’s take that even one layer deeper. If you think about marketing, the cost per lead might be $200-$300 for a medical spa, and it will take, perhaps, a year to make a profit from that customer. With plastic surgery, the lead acquisition cost is typically $1,000, but if you sell one face lift, then you already are going to realize a nice profit margin.
  • Need for a Dedicated Practice Manager: Many times with plastic surgery businesses, the doctor can run the business alongside 2-3 staff members, and often doesn’t require a dedicated practice manager. Sometimes a patient care coordinator can take some of the management role. However, when it comes to medical spas, they really need a professional manager who is there on a day-to-day basis and really knows their numbers. This is much more efficient than relying on a doctor who is in surgery three days a week and trying to manage a practice the other two.


Industry benchmarks are a tool to help you see how your practice stacks up to others in your area or specialty. Some benchmarking tools are only for plastic surgery, and others compare apples to oranges—for example, comparing facial plastic surgery to reconstructive plastic surgery. Benchmarking data needs to be tied to specific KPIs, not just something like total revenue because the potential is completely different based on multiple factors. A surgeon in New York City, for example, is going to have a different revenue potential than a plastic surgeon in Alaska.

Profitability is based on how much you pay for your goods and how much you are charging. To figure out how to keep enough money in your pocket for those services, a good KPI to look for benchmarking data on is:  How many staff or providers a practice has in order to measure capacity. This type of KPI is good because it is operational.  Whether your practice is in Alaska or New York, the potential can be very different, but operationally they run in the same manner, making the benchmark much more applicable.

APX’s GAUGE component helps you access and understand the latest industry benchmarks and competitive trends as well as provides insights into patient buying patterns and behaviors. The data is statistically relevant and standardized with regularly updated production metrics from a nationwide network of aesthetic practices. By using GAUGE, providers can evaluate important metrics, such as revenue generated across surgical and non-surgical services, procedure counts, and average charges by filtering by different user groups, products or services, location, time periods, and more.  To book an APX demo to see how you can use GAUGE in your practice to make informed business decisions, click here.


If you want to be profitable, the cost of labor should be under 20%. A lot of providers open their Profit & Loss Report and just see a bunch of numbers. When you start to add in the percentage of your total revenue minus your operating expenses and compare it over time, you start to understand things like the importance of structuring your bonus plans for your staff correctly based on a percentage of what you make. So, whether your practice makes 2 million a year or 10 million a year, you are paying the same percentage out of that in bonuses.

We see so many practices either paying bonuses out illegally, or completely out of whack with revenue. When labor costs are too high and the provider is not generating enough revenue to cover them, you end up in a deficit situation. That is critical information to know, so you can course correct. So again, P&L Reports need to be set up correctly, but being able to extrapolate and measure your labor costs accurately is critical.


Determining which KPIs to monitor depends on the stage of the business you are in, your business goals, and growth strategies. To start, keep it very simple and focused on what your business goals are.

For plastic surgery, one of the key KPIs to monitor (no matter what stage a practice is in, how long you’ve been in business, or the size of the practice) would be the Revenue per Employee or revenue divided by the number of full-time employees. That’s because it’s really important to know how many employees it takes you to generate the number that you’re trying to reach.

Revenue per Hour is also a critical KPI for plastic surgeons because their time is so valuable. Many don’t realize it, but their time can be worth more than $1,000 per hour. So, if you spend one hour sitting and waiting for a patient or multiple patients throughout the day, that is $1,000 per day of lost revenue. Multiply that by 30 and they have $30K in potential lost revenue over the course of a month. That adds up to $360K per year.

Finally, the Net Promoter Scores (NPS) KPI, which measures how happy your customers are, is key as it directly influences whether or not patients will refer you to their friends. This KPI doesn’t get enough attention, and they actually have NPS scores for both plastic surgery and medical spas. It is SO important to know your patient satisfaction levels. One customer with a bad experience can spread the word, and you can end up losing another 20 potential patients.

There are multiple tools out there to measure satisfaction levels. One of the easiest is Survey Monkey. You can also use MailChimp to create a small survey. Ask questions like, “Would you recommend us to your friends, family or colleagues?” You can be the best doctor in the world, but if your front desk staff is giving people a bad vibe or your office is dirty or has very long wait times, it will affect the rating number they will give you.

By reviewing survey results, you can quickly identify red flags and areas in need of improvement. If you are confident enough in business, you won’t fear soliciting feedback. If they put their name on the survey, pick up the phone, call those people, and ask, “What can we do better?” Trust me, they will be happy to tell you and will appreciate that you took the time to ask. This is the key for any business—excellent customer service.

Data shows that 35% of patients will come back in or rebook with you just because somebody actually took a minute to call them. Automation is great, but we are all still human. Human touch/high touch customer service truly makes the difference.


When it comes to KPIs for medical spas, Profit Margin is very important. Medical spas should focus more on the upsell of retail products because retail has a large profit margin. 50% of people who get injections are also going to buy recommended products. That tremendously increases the profitability of the injectable service.

Cost per Lead and Lead Source is also critical for medical spas because marketing is a lot more competitive, and they use a lot more channels. It is important to ensure their marketing strategy works the right way with minimal costs per lead. Marketing costs should be about 10% of overall revenue as a rule of thumb; 15-20% if you are a startup.

NPS scores, again, are important for both plastic surgery and medical spas. So make sure you are conducting those surveys.

Finally, Average Spend per Customer is key to know. Looking in your Practice Management Software to see who your top spenders are and how often they come in is vital. You can reach out to them when you have a new product or service, or if you are offering a special promotion.


Analyzing and understanding data is the SINGLE MOST IMPORTANT thing you can do in your practice in order to make strategic, data-driven decisions. There are no emotions involved with data. It is factual. Oftentimes when contemplating a business decision, emotions get involved when you remember the last thing an employee said or a patient complained about.

Data gives you the honest truth, not opinions. Without data to back things up, you are relying on an opinion to make critical business decisions. You shouldn’t make a decision based on how you feel today or what you perceive to be a cycle of demand this week. Data gives you an honest picture of what is the right thing for your business. Data tells you what is working and what is not.


Let’s be honest. Not everybody is great with numbers, and there are not a lot of resources to go to learn about KPIs and what reports you should be running. Even if you do have that information, knowing what to do with it can be challenging. As a consultant, this is my passion–to help practices become more profitable, and educate them on this topic. That is why I created APX, so we could reach more people and provide them with the tools they need to learn how to make smarter, data-driven decisions.

Izhak agrees that, “Any provider who doesn’t really understand how to analyze their data should subscribe to APX. The cost is a fraction of the true educational value. The sales, finance and operational training as well as the financial calculators within APX will increase your bottom line and help you run a more profitable and efficient practice.” He continued, “Education is something that goes across the board, so everybody needs to know how to run the portion of the practice that they’re responsible for and know how to monitor themselves. Whether it’s your front desk staff, your Patient Care Coordinator, or the physician, at the end of the day your team needs to be able to look at a scorecard and be able to say, ‘I’m doing a good job,’ or ‘I need to step it up the rest of the month’ because they know the data and what is expected of them.”

If you want to have a high-performance practice, you’ve gotta train like a high-performance athlete. Buckle down, roll up your sleeves, put in the work, and get it done! No matter where you are right now or how much revenue you are generating today, you have the potential to double that if you hire the right people, train them the right way, and don’t settle for mediocrity. Even if you are kicking ass, why not maximize your business and potential by working smarter not harder?

We have clients who have literally grown 2800% in one year because they put in the work; trained their teams; reviewed and understood their data; and stopped doing procedures that were not making them money. They also reallocated their marketing spend; hired the right way; and created a viable compensation structure. All those ingredients put together created a beautiful recipe for success.  Remember, my team and I are here to support your growth every step of the way!