Why Most Medspas Aren’t Scaling, Even When Demand Is High
Cameron Hemphill on the systems problem holding the aesthetics industry back
Welcome to WELL/CONNECTED from FACTEUR PR, where we share a weekly pulse on what’s shaping health, wellness, beauty, and aesthetics, through quick insights from leading physicians, founders, and industry experts.
Today, we’re sitting down with Cameron Hemphill, a nationally recognized growth strategist and key opinion leader in medical aesthetics, as well as the founder of Growth99 and host of the Medical Millionaire Podcast.
Across the medical aesthetics industry, growth is often framed as a marketing problem, but Cameron sees it differently. After working with over 1,000 medspas, his perspective is clear: most practices don’t have a demand issue; they have a systems problem. From missed leads and inconsistent consults to underutilized treatment capacity, the real barrier to scale isn’t visibility. It’s operational discipline.
With a background in building and exiting a CRM-driven patient acquisition platform, Cameron is helping shift the conversation from founder-led hustle to operator-led infrastructure. His work focuses on what actually drives sustainable growth: conversion, retention, and building businesses that function as scalable, transferable assets, not just busy practices.
1. What’s one thing people often misunderstand about growing a business in medical aesthetics today?
The biggest misconception is that growth is driven by marketing alone. Most founders think if they just increase ad spend, post more on social, or hire a better agency, growth will follow. But what I’ve seen across 1,000+ medspas is that marketing only amplifies what’s already happening inside the business. If your front desk isn’t converting, if your consults aren’t structured, if your follow-up is inconsistent, you’re just pouring more leads into a broken system. Growth doesn’t come from more demand. It comes from better conversion, better retention, and better operational discipline.
2. You often say the industry doesn’t have a growth problem. It has a systems problem. What does that actually look like in practice?
In practice, it looks like chaos behind the scenes. You’ve got missed calls going unanswered. Leads sitting for hours without follow-up. Consults happening with no consistent framework.Providers with empty chairs in between treatments. Meanwhile, the owner is asking, “Why aren’t we growing?” The reality is: revenue is leaking everywhere. A systems-driven business fixes that. Speed to lead is under 2 minutes. Every consult follows a proven structure. Every patient is guided into a treatment plan and retention model. Every KPI is tracked daily. When those systems are in place, growth becomes predictable, not accidental.
3. What’s one shift you’re seeing right now in how successful practices are approaching growth and scale?
The biggest shift is moving from founder-led hustle to operator-led infrastructure. The top practices today are no longer relying on the owner to drive everything: marketing, sales, operations, culture. That model breaks at scale. Instead, they’re building real leadership layers: A GM or operator driving KPIs, structured front desk teams focused on conversion, defined systems for consults, retention, and patient experience. They’re also thinking like investors, not just providers. They’re asking: “How do I build this into a $10M+ asset?” Not just, “How do I stay busy?” That shift, from technician to operator, is what separates a lifestyle business from an enterprise.
4. Why do so many medspas plateau around the $1M mark, even when demand is strong?
Because $1M is where hustle stops working, and systems start to matter. At that level, most practices are still: Founder-dependent, lacking clear KPIs, inconsistent in conversion and retention, and not fully utilizing their capacity. They might have 5–6 treatment rooms, but they’re not optimizing revenue per hour. They’re generating leads, but not converting them efficiently. So what happens? They stay busy… but they don’t scale. To break past $1M, you have to start operating like a business: Maximize utilization, increase average ticket, build membership and retention models, and install accountability across the team. That’s the inflection point where discipline replaces effort.
5. When it comes to building a truly scalable business, what’s a question you wish more founders—or even the media—were asking?
I wish more people would ask: “Is this business actually built to scale, or just built to survive?” Because a lot of practices look successful on the surface, great branding, strong revenue, but underneath, there’s no infrastructure. No clear reporting. No consistent conversion systems. No leadership depth. No real understanding of profitability. The real conversation should be about enterprise value. Can this business run without the founder? Are the systems transferable? Is there predictable, repeatable revenue? That’s what buyers care about. That’s what creates wealth. And that’s where this industry is headed, whether people are ready for it or not.
Learn more:
Cameron Hemphill
Media inquiries:
medspaCEO@facteurpr.com
