When Growth Backfires: Why Adding Staff, Space, or Services Can Hurt Your Dermatology or Medical Aesthetic Practice

By Connie Kurczewski | September 2, 2025

Growth Isn’t Always Progress

In a dermatology or medical aesthetic practice, adding new services, more staff, or additional space can look like progress.

But growth without systems and structure rarely creates the freedom or stability a practice owner is hoping for. More often, it magnifies inefficiencies, makes the physician even more essential to daily operations, and compromises the elevated experience patients have come to expect.

I was recently quoted in the July/August issue of The Aesthetic Guide in their Reality Check 2025 report on practice growth. I shared that too often practices chase the next device, add new treatments, hire more staff, or move into bigger spaces without first putting the right systems in place to sustain it.

Three Costs When Growth Outpaces Systems

1. Costs climb faster than revenue

Every expansion brings immediate expenses: salaries, space, equipment. Without clear accountability and performance measures, those costs rise faster than revenue, tightening margins instead of improving them.

2. Patients notice what falls through the cracks

When practices take on more without strengthening systems, patient experience is the first to suffer. Follow-ups get missed, communication weakens, and wait times are longer than patients expect. What once felt elevated starts to feel routine.

3. The physician becomes the bottleneck

More decisions, staff issues, and operational questions land back on your desk. Rather than stepping into a true leadership role, you get pulled deeper into the day-to-day, and the practice becomes even more dependent on you.

What Stronger Practices Do Instead

The Aesthetic Guide feature echoed what I see in practices that are advancing in a smart and sustainable way. They aren’t adding simply for appearances. They’re building with strategy and structure.

• Simplifying services. Streamlining offerings to proven treatments, paired with structured maintenance and intentional at-home regimens.

• Tracking the right numbers. Focusing on acquisition cost, retention, productivity, and patient satisfaction instead of vanity metrics.

• Designing consistency. Making sure every visit is purposeful and builds patient trust.

A Reality Check for Practice Owners

The practices setting the pace today aren’t the ones adding the most. They’re the ones growing with systems and structure.

Growth alone isn’t the objective. The real goal is a practice that runs smoothly, delivers consistent results, and doesn’t collapse under the weight of its own expansion.

Ready to Strengthen Your Practice?

If your dermatology or medical aesthetic practice is showing these signs, it’s time to talk.
Schedule your Strategy Call today.