Medical Spa MD is a community of 28,000+ plastic surgeons, dermatologists, & aesthetic physicians practicing cosmetic medicine worldwide. FREE Medical Spa Deals for Clinicians

About   |   Advertise   |   Press   |   Contact

2nd MD - Boarded US physicians work from anywhere.
Medical Justice
Relentlessly protecting physicians from frivolous lawsuits.

More control of your income, career, and lifestyle as a physician.

Medical Spa MD is a world-wide physician community for clinicians in skin clinics, laser centers and medspas with thousands of physician members around the world. By using this site you agree to our terms of service and fine print.

« Is Yellow Page Advertising Worth The Cost To Your Medspa? | Main | Physician Pushes Stupid Regulation In UT Too. »

Aestheticians And The Doctors Who Love/Hate Them.

Aestheticians seem to be one of the primary components for medical spas these days. Almost anywhere you look a medical spa now has a Aesthetician who is posted on their website. Medical spas that are primarily cosmetic, seem to have a bunch, but there are a growing number of physicians who are hiring individual aestheticians to provide skin care consultations, do the microdermabrasions and facials, and give a little fluff to their practice.

Aestheticians on the whole are a difficult bunch to work with, especially those that come out of a day spa setting. Day spa aestheticians are used to working in either a booth rent situation, a commission structure, or some other highly competitive environment.

My own experience with aestheticians is that I try to find aestheticians that are either just coming out of school or aestheticians that were doing something else and have gone back to school and are now coming out with a change in career in mind. Aestheticians that are older and supposedly have their own clientele I have found to be problematic. I don't mean to break balls here, but in a medical practice the physician is the medical care provider. Aestheticians have a hard time kind of understanding this because they come from an environment where they are the care provider and so they consider patients to be their patients.

I cannot tell you the number of times I have had physicians complain to me that their aestheticians gainsay what their opinion is to their own patients. An example here recently was a physician who had prescribed a series of Fotofacials for complexion issues that one of her patients has had, and had sent the patient into an aesthetician in order to have her look at her under the black light and talk to her about products and such. The aesthetician countermanded the prescription by the physician and instead talked the patient into a series of microderm treatments, for which of course she would receive tips. This is not uncommon, but it is no way for a real business to work. Aestheticians in a medical setting have got to conform to physician administered prescriptions and cannot just go run willy nilly deciding what people need.

Reader Comments (20)

I visited a practice in which the aesthetician (under OB/Gyn doc's supervision?) did not discover pertinent medical info. (since not medically trained) -- in this instance possible PCOS/hirsutism causing excess hair growth. The patient was undergoing laser hair removal!
This is in Texas where just about anyone can operate an aesthetic laser or IPL.
07.18 | Unregistered Commenterdermpa
I was under the impression that aestheticians are register nurses that perform Botox, Thermage,hair removal and estheticians are schooled in cosmetology
08.17 | Unregistered Commenteramb

Aestheticians and estheticians are just different spellings. Neither aestheticians (nor estheticians) have any medical licensure and usually have between 600 and 1200 hours of education. They are commonly used because they can perform microderms and facials.

In response to dermpa's comment: I would say that the fact that the aesthetician failed to discover pertinent medical information had more to do with attention to detail and poor training than just being an aesthetician. I've worked in practices where the RNs failed to recognise not only PCOS as a contraindication but blood thinners like Coumadin, or accute use of Accutane....but I'm just an aesthetician (obviously not medically trained) so what do I know?
05.25 | Unregistered Commenternausicaa

I was just wondering you said you like to hire aestheticians right out of school, yet I just graduated got an 85% on my State Boards have a cosmetology license as well, and have had 2and half yrs of nursing. But still can not find a doctor to hire me. Do you have any suggestions! I really love the medical part of aesthetics and want to work for a doctor.I have had my own business for 17yrs in the beauty field,yet nothing.
Thank you.

I am an esthetician, and work in a medical spa practice with five obgyn doctors. I see several patients with PCOS for hair removal, and it has helped there self esteem significantly. I allways explain prior to treatments that they will never be hair free, but that it will help to make the hairs less coarse, thus helping diminish the five o clock shadow they tend to have.

I have seen that some estheticians seem to think they are the doctor, and we definatley have not had enough training to take on that role, but as for myself I just try to get as much training as possible, and be completley aware when I'm with a client. I dont think having a nurse perform the treatments is necesarily better because anyone can make mistakes no matter what there degree is. Also, estheticians do tend to have a more caring energy, and touch which helps clients relax.

06.9 | Unregistered CommenterJBailey

First,this is how to spell... Estheticans. I am an Esthetican that has a medical background. I perform most of all the treatments, including hair removal,ipl,thermage, and so on. All depends on what state you are in. You can still treat PCOS with hair removal. I just have to reassure the client that hair removal is just a reduction. I can kill a hair follicle but a new one can grow right beside it. We dont try to be the doctor. The clients can just relate to us more and we see that. We spend more time with the client than most doctors.

06.9 | Unregistered Commentersusan81

Does anyone have any feedback on lasers or pulse lights from Med-Surge....Prolite II? Mediostar?

06.9 | Unregistered Commentersusan81

First, estheticians may be spelled in either way and still be correct. Here are some links:

Yes, ur right Mr.Barson. In an earlier comment u had mispelled it as Estiticans.

06.10 | Unregistered Commentersusan81

Dear JBailey and Others: You will see that experienced aesthetic physicians and med spa owners have many different opinions about their good and bad experiences about hiring and working with both nurses and estheticians as "mid level" providers or "physician extenders" in this field. For many of us -- regardless of how great, experienced and/or knowledgeable an esthetician may be-- it is simply not LEGAL for a non-medical person to operate prescription devices in MOST states. There are a few exceptions-- and I know that non-medical personnel are being used in this manner all over the place. But just because it is being done does NOT mean it is LEGAL. Check out the penalties for practicing medicine without a license. It can be serious if someone makes a complaint and you are dragged into it.

MedSpa Guy, J.D.

06.10 | Unregistered Commentermedspa guy


Is there anyone who can tell me about hiring a commission base estheticians. how does it work in term of the percentage that they should be paid.

11.18 | Unregistered Commenterannonymous

It depends on where you live. You will need to call local companies and see what they are doing.

11.19 | Unregistered CommenterLH

I think it will probably also depend on what your revenue goals are.
If you are brand new and are expecting an aesthtician to bring in clients to the practice and then sell them services and perform them, it will probably have to be at a higher commission rate than if you are expecting them to up sell new products/services to existing patients.
If you are more established and it's an "easier" sell based on the marketing initiatives you've put into place, that might result in a lowere commission as well.
One of the challenges I faced when I had straight commissioned employees was their feelings that if a task didn't directly make them money that they didn't have to do it. Like cleaning the room, etc. There's also down time that they could be working to bring in revenue (phones, email blasts) and they take off.
Not knowing more of your situation, maybe pay them a small base rate with hefty commissions to motivate?
Are you considering PT or FT?

Then don't hire an Aesthetician! If you don't like them, then don't deal with them! It was obvious that this Aesthetician had poor training.... A lot of doctor's rely on Aestheticians to help them out with their practice and are a great part of the system. While it's true that some Aestheticians think they "know-it-all", the same soes for the doctors! They are just as hard to deal with... maybe you should check YOUR attitude at the door.

03.4 | Unregistered CommenterDee

But, the aesthetician was right and you were wrong. Microdermabrasion is more cost effective and efficacious as compared to a FotoFacial. You should thank your aesthetician for looking out for your patient instead of stroking your ego. Trust builds long term relationships and plastics are used tot he turn and burn mentality.

03.6 | Unregistered CommenterKevin

I have been an esthetician for nearly 20 years and I have worked in all types of every settings. I currently work with 4 plastic surgeons and 1 dermatologist in a cosmetic clinic. I preform all the non-invasive procedures and most definitely spend much more time with the patients than a doctor ever would. I have been instrumental in building the business as patients who have never thought about advanced procedures look to me first for guidance. I resent the fact that you say in your post that estheticians who have worked in a spa/commission setting are trouble. Without my past experiences I would never appreciate the position I have now working in a professional medical setting. I am greatly appreciated by the physicians and most of all the patients for my years of knowledge and experience. Estheticians provide a liaison for physicians who want to offer their patients a broad range of options. We are compassionate, empathetic and true caregivers. Frankly, I would prefer to go to a physician who has hired an esthetician with years of knowledge and truly knows what they are talking about! Hiring someone straight out of school is asking for trouble!!!

04.25 | Unregistered CommenterAmalie

I am currently a Licensed cosmetologist, been in my profession for 13 years. I have always worked more in the cosmetics industry and skincare. How do I get into the medical spa profession? do I have to get an Aesthetician license? my love for dealing with skincare, learning and working in a medical environment would be a dream. Look forward to your response.

05.17 | Unregistered CommenterLeika

This question is for Amalie, how does one work for plastic surgeons? what experience are the dermatologist looking for? Look forward to your response!

Thank you

05.17 | Unregistered CommenterLeika

I'm considering going to school for medical spa aesthetician. I'm 37 and want a change of career. My BS is in biology, and my previous work experience is as a veterinary technician. I'm tired of taking care of dead and dying animals all's quite depressing. My concern is finding a job after finishing school. I live in Bethany Beach, between Rehoboth beach and Ocean City, MD. Is it difficult to find job placement? Even on a part time basis? I'd appreciate any advice.

Thank you.


06.5 | Unregistered CommenterJennifer

PostPost a New Comment

Enter your information below to add a new comment.
Author Email (optional):
Author URL (optional):
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>

Join Medical Spa MD

Medical Spa MD

A community of dermatologists, plastic surgeons, laser clinics, & skin clinics world wide.

Medical Spa MD is a world-wide community of physicians and clinicians practicing cosmetic medicine. Please read our Terms of Service, Advertising Terms and Privacy Policy.

Copyright © 2011. All rights reserved.