If you are looking at the aesthetics industry right now and wondering if you missed the boat, the data from AmSpa tells a completely different story. Over the last few years, we have seen this industry explode. We have moved from a 15 billion dollar market to a space that is growing by over a billion dollars every single year. In 2021, there were roughly 7,400 locations across the country, and by the time we hit the start of this year, that number has continued to climb well past the 10,000 mark. For a nurse who is ready to move away from the bedside and into their own practice, 2026 is actually a phenomenal time to start. The demand for non-surgical treatments is still outstripping the supply because people are no longer just looking for a quick injection. They are looking for a long-term relationship with a provider they trust, and as nurses, that clinical connection is exactly what we do best.
The very first thing you have to get right isn’t your menu of services, it is the partnership you build with your medical director. You have to think of this as a professional marriage. It is a part of the corporate practice of medicine structure, but more than that, it has to be a strong fit where you both share the same clinical values. When you go to find a business attorney, you don’t just want a contract. You want an educator. You need someone who will sit down and explain why your MSO and your PC exist as separate entities and how the compensation inside those management agreements actually works. This is your foundation. When the day comes that you need to change your medical directorship or revise your structure, you will be glad you have a legal contact who treated you like a partner rather than just another file on their desk.
Once your legal house is in order, your next major decision is where you are going to put your dream. There is a lot of talk about getting into the most affluent neighborhoods, and while that is great for the bottom line, you have to think about the human element of privacy. High-net-worth clients often value discretion above everything else. They want to be able to walk in and out of your space without feeling like they are on display. When you are looking at a building or a suite, consider how private that entrance really is. If your clients feel like they are entering a sanctuary where their privacy is guarded right down to the physical location of the door, you are going to win their loyalty for life.
That sense of loyalty has to extend to your team as well. We have to be realistic about the fact that when you hire an injector or an esthetician who already has a following, there is a natural leverage there. Everyone in this business knows that is a risk, but the way you assure the success of your company is by treating people fairly from the jump. Your compensation has to be competitive, but your environment has to be even better. If you create a space where your staff feels supported and respected, that leverage becomes a partnership instead of a threat. You want your team to feel like they are building something with you, rather than just using a room to see their own clients.
To make all of this run smoothly, you need a tech stack that doesn’t make your life harder. For many of us, software like Boulevard has become a favorite because it understands the luxury experience we are trying to provide. You want a system that handles the booking and the clinical notes without a hitch so you can focus on the person in the chair. But remember that no matter how good your software is, it is only as useful as the data you put into it. Those numbers eventually have to tell a story about whether your business is actually healthy or just busy.
This leads into the one thing I have seen so many owners put off until it becomes a total surprise at the end of the year. You cannot wait to set up your financial tracking. When you are running a business with an MSO and a PC structure, you are essentially managing two sets of books at the same time. This is why you need a partner who understands med spa bookkeeping specifically. If you start spending money from the wrong entity or mixing your management fees with your clinical revenue, you won’t even know if your improvements are being booked correctly. By the time someone else looks at your accounts, the year might be over and it is often too late to fix the mess.
As Marc Pamatian, founder of Chief Bookkeeping Officer, often says, “The biggest mistake we see in med spa bookkeeping is treating the MSO and PC like one big bank account; without that clear separation and documented flow of funds, you aren’t just risking an audit, you’re flying blind on your actual profitability.”
A bookkeeper who understands intercompany transfers, loans, and medical director fees will make sure that your money is moving exactly where it needs to be. This level of oversight ensures that your clinical entity and your management side stay healthy and distinct.
Ultimately, 2026 is a wide-open year for the nurse entrepreneur who is willing to look past the syringe and focus on the structure. If you respect the legal partnerships, prioritize client privacy, and keep a disciplined eye on your financial entities, you aren’t just starting a business. You are building a clinical legacy that is prepared to thrive in this booming market.
Image by Atikah Akhtar from Unsplash
The editorial staff of Medical News Bulletin had no role in the preparation of this post. The views and opinions expressed in this post are those of the advertiser and do not reflect those of Medical News Bulletin. Medical News Bulletin does not accept liability for any loss or damages caused by the use of any products or services, nor do we endorse any products, services, or links in our Sponsored Articles.
