Different Roles for Different Goals in Medical Aesthetics
A deep dive into staffing structures across different types of practices.
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Who works on what and what types of specialized experience is needed can differ across the Medical Aesthetics industry. While some practices may offer niche treatments or minimally invasive procedures, others provide a comprehensive suite of services that require surgical facilities, aftercare, and more. Here, we take a look at three different types of practices and how they are staffed to best meet the needs of their patients and clients. This overview may help you understand the type of role and practice that may be a good fit for you, whether you’re just starting out or looking to make a career change with a new job.
The Med Spa
We spoke with Houston-based med spa Managing Director Anthony Moschitto, who has helped grow his staff from two part-time employees to over 15 full-time employees in two offices in Houston and San Antonio.
Today, they have a medical director, a director of nursing, four nurse injectors, two laser technicians, two body contouring specialists, a director of operations, a director of marketing, a remote sales consultant, a front desk manager, and four front desk associates.
Some of the key employees are meeting needs that only came up as the practice grew. Let’s take a closer look at some of these key roles:
Medical staff:
- Medical Directors: Renee Moschitto, Anthony’s mother and also the owner and founder of the practice, hand-picked the current Medical Director in Houston. For the San Antonio practice, it was Anthony Moschitto who found the Medical Director: a doctor, building a large practice with eight other doctors in downtown San Antonio, who was looking to put a med spa on the first floor.
- Nursing Director: Renee Moschitto, RN, BSN, who’s been injecting for over 12 years, does all the initial training on injectables as well as the ongoing training when there are new products or techniques to learn. She secures training resources for the laser technicians. If there are ever escalations of any kind, she’s the one to manage them. She also works as a provider, seeing patients about four days a week.
- Nurse Injectors: At this practice, Nurse Injectors focus solely on injecting neurotoxins and fillers. When hiring a Nurse Injector, Anthony Moschitto is seeking “somebody who understands the journey to becoming an injector,” even if they’re new to the industry. “It can be hard for people coming from traditional healthcare because they’re used to going to medical training, practicing a handful of times, and then being good to go. Here, you have to get comfortable with not being an expert in one day, and you have to have the patience to work through that.” Moschitto also values team players who will be able to refer patients to other providers in the practice, such as aestheticians or laser technicians, to fulfill their other needs.
- Laser Technician–Aesthetician: These practitioners do less assessing and devising of treatment plans and more relationship building, in addition to having the necessary qualifications to operate a laser, which depends on the state. “You’ve got to be fairly chatty and friendly to get somebody through an hour-long laser hair removal session,” Moschitto says. He looks for outgoing people who are skilled at making people feel comfortable and at home through their treatments.
Marketing and administrative staff:
- Remote Sales Consultant: She was hired to help manage appointments for body contouring. “We get 150 to 200 of these leads a month, and those leads are pretty important to follow up on quickly,” Moschitto says. “I did have our specialists doing that role, but the challenge is that when we’re getting the most inquiries, we’re obviously doing the most treatments, so they had the least amount of time to follow up.” The Remote Sales Consultant also picks up overflow calls for the front desk of the practice, which is especially important as the business expands.
- Director of Marketing: The role collaborates with Moschitto on developing marketing pieces, emails, fliers, and brochures for the office and oversees the contractor handling social media and blog writing, offering direction on topics and tone, and maintaining a social media calendar. She also works closely with the Digital Marketing Consultant to advance various goals, “whether it be improving SEO performance or deciding the type of hashtags we should be using on our posts.”
- Front Desk Associates: These employees handle all inbound and outbound phone calls, checking patients in and out, taking initial photos before new neurotoxin and filler injections, and doing skin analysis using a new imaging tool that the practice incorporated. The best front desk associates are experienced with aesthetics, have worked in a medical environment (so they understand patient privacy), can keep up with the fast pace, can manage a complex checkout process with multiple forms of payment, have good basic computer skills, and can be flexible with change.
In the new San Antonio practice, both the front desk associate and one of the two nurse injectors speak Spanish, which is essential for their patients. This practice is also smaller, so everyone wears many hats. Because there’s only one front desk associate, nurse injectors will pitch in at the phones when needed. Likewise, the front desk associate knows EMR (electronic medical records) because she often needs to solve problems on her own.
Med spas need to have a cohesive, collaborative team that is willing to refer their clients to other specialists within the practice.
The Medical and Aesthetic Dermatology Practice
Dr. Lori Stetler, MD, is a board-certified Aesthetic Dermatologist who has been in the industry for over two decades. Today, her Dallas-based practice has 23 employees and a wide range of treatment offerings that include medical and aesthetic dermatology as well as surgical procedures and skincare consultations. She has been named one of the “Best Doctors in Dallas” by D Magazine every year since 2001.
Dr. Stetler works every day to create a warm, safe working environment where patients feel welcome and at home. To help her accomplish that, she’s assembled a staff that can handle the full range of roles and responsibilities.
In her office, Dr. Stetler has the following staff:
Medical staff:
- Doctors: She’s brought in two board-certified dermatologists as partners. Dr. Stetler does mostly aesthetic dermatology; one partner does about 70/30, aesthetic to medical, and the second partner is the reverse—about 30% aesthetic and 70% medical.
- Physician Assistant: A physician assistant in Dr. Stetler’s office specializes in injectable dermal fillers, neurotoxins, fractional laser resurfacing, radiofrequency tightening, tattoo removal, and sclerotherapy.
- Aestheticians: Two certified aestheticians specialize in laser hair removal, microneedling, dermaplaning, and facial treatments.
- Body Contouring Specialists: Two practitioners in the office have been brought in to handle body contouring treatments as demand for the procedure has risen.
Administrative staff:
- Front Office Manager: She oversees all staffers working in the front, according to Dr. Stetler, so she’s looking at everybody’s schedule and handling a lot of the human resources duties. She’ll manage questions from patients “so the receptionists at the phones don’t have to get bogged down by one patient—they always need backup,” Dr. Stetler explains.
- Receptionists: All front office staffers handle basic duties, such as checking patients in and out and answering phones, but most of them also have a specialty. For example, one person is devoted to resolving insurance claims. Then there is a front desk assistant at a separate aesthetic center who fulfills online orders for skincare products. “They all have their primary roles, but then they all have unique things that they’re responsible for,” Dr. Stetler notes.
Dr. Stetler also engages the services of an external marketing coordinator who helps manage the website, highlighting before-and-after pictures to help educate future patients. The marketing coordinator also hosts patient events, such as Patient Appreciation Day, executing all the event advertising and scheduling, and creation of goodie bags. She manages her own personal social media.
The warm family environment she strives to create in the practice starts at the top. “It’s how we invest in our employees, how we handle ourselves in the office, and how we treat patients,” Dr. Stetler states. “Your employees will model after you, so if they see you being kind and listening to patients, they’re more likely to do that.”
Because the dermatology practice offers more surgical procedures than at a med spa, there is more weight placed on proper medical training and surgical expertise to ensure patient safety and care.
The Plastic Surgery Practice
Dr. Paul Ruff IV, MD-FACS owns a busy private plastic surgery practice with five plastic surgeons, 14 physician assistants, and registered nurses, 12 aestheticians and other providers, and 11 administrative employees, offering a full range of surgical and non-surgical aesthetic treatments to patients in the Washington, D.C. area.
Dr. Ruff makes sure to clearly define the roles and relationships for everyone in his practice.
Medical staff:
- Plastic Surgeons: They are the primary providers. One surgeon specializes in gender confirmation work, which is a unique specialty area. A facial plastic surgeon specializes “from the clavicle up,” which means he does rhinoplasty, facelifts, eyelids, and some injectables. Two other plastic surgeons offer plastic surgery treatments for both the face and body including breast augmentation and fat grafting.
- Medical Aesthetic Treatment Team: A team of registered nurses (RN), physician assistants (PA), aestheticians, and certain medical assistants (MA), work with patients on a variety of Medical Aesthetics treatments.
- Body Contouring Specialist Team: There are two nurse practitioners (NP) and a PA who work independently and a certified body contouring specialist who does most of the non-invasive body contouring. Dr. Ruff appreciates her background in the hospitality industry. “It gives her a tremendous amount of training as far as how to deal with patients, manage patients, take care of patients, and care for patients in ways that doctors typically don't,” he says.
- Provider Teams: There are aestheticians, medical assistants, and other providers, including the operating room staff. “Our OR team consists of our surgical techs and RN’s who manage that side individually, and they don't tend to connect specifically with the clinical side, other than caring for the patients in the OR and working with our Patient Care Coordinators (PCCs) for scheduling, and our perioperative team for all of the pre-op work that ensures the patients’ safety throughout the process.”
Administrative staff:
- Practice Administrator: One of the first people Dr. Ruff hired is his practice administrator, who manages “all the things that happen on a day-to-day basis.” The practice administrator handles the financial side of the practice and oversees marketing business development.
Also on the administrative staff is a head administrator, a manager, two concierges who assist with patient services, three patient care coordinators, and an insurance specialist. Patients who come to Dr. Ruff’s practice through self-referral will be greeted by the concierge providers at the front desk. Then they’ll see one of the patient care coordinators, who will dive further into the patient's interests and needs, and schedule them accordingly.
In addition, the administrative team includes a clinical research coordinator and two marketing coordinators, who work with satisfied patients to share their success stories and attract new business.
To give patients the best possible care, Dr. Ruff has set up groups that specialize in different treatment offerings. His nurse providers do most of the injectables and laser services; the aestheticians work closely with the nurse providers and the surgical team from the facial rejuvenation standpoint; the patient care coordinators set the consultations, schedule surgery, and work very closely with the front desk concierge staff; and the OR staff works cohesively with a perioperative group that sees patients pre- and postoperatively. “I've put these systems in place to help each patient flow seamlessly through the entire process, all the while, optimizing all the staffing needs, so each team member can do their job appropriately, but also allowing an ease of transition in information communication, so the patient is always cared for,” Dr. Ruff says.
For Dr. Ruff’s plastic surgery practice, there are a lot of moving parts, so emphasizing the importance of a Practice Administrator to oversee the business end and coordinate across the five different teams helps keep things running smoothly. Approaching his staff structure from a team-building perspective helps ensure that his patients and clients have the proper service and resources at every step of their experience.
When you’re starting out on your journey into Medical Aesthetics, it may be helpful to ask yourself where you see yourself fitting into these very different types of practices. For every aspiring Medical Aesthetics professional, a great role may be waiting just for you.
About The Professionals
Anthony Moschitto
is a managing director for a leading med spa in Houston, overseeing operations including marketing, finance, and EMR/POS Systems. He has a bachelor’s degree in Nutrition and Exercise Science and previously led a technology sales team, selling to Fortune 500, healthcare, and public sector accounts. Read more about his career in Medical Aesthetics in his feature article Learning and Applying Along the Way.Lori Stetler, MD,
is a board-certified dermatologist who served as the chief resident at the UT Southwestern Medical School during her residency. In the 1990s, with advances in technology, she decided to expand her knowledge and become a leader in the aesthetic dermatology industry. Since then, Dr. Stetler has founded her own dermatology practice. Discover more about her passion for helping women, and her emphasis in the best business practices here.Paul G. Ruff IV, MD, FACS
is a board-certified plastic surgeon who was first exposed to patient care during his studies at Georgetown University. Deciding to become a surgeon, he went on to receive his MD at Eastern Virginia Medical School and performed his general surgery residency and surgical critical care residency at Washington Hospital Center and his plastic surgery residency at the University of California, San Diego Medical Center. Since then, Dr. Ruff founded his own plastic surgery practice in Washington, D.C. Get inspired by his patient-centric approach and learn more about his journey in Medical Aesthetics from San Diego to D.C.Like this article? Share it now!
