Medical Center and Medspa Bookkeeping

If you are looking for a medical director, you are not just thinking about it anymore. You are about to spool up a real operation. You are talking about state rules, CPOM and MSO structures, good-faith exams, injectables, lasers, and real clinical oversight.

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Finding the right supervising physician is usually one of the hardest parts of starting or scaling a med spa. You want someone whose license, standards, and expectations match what you are trying to build. At the same time, you are trying to stay inside your state’s rules and still run a profitable business.

The good news is you do not have to cold message random physicians on LinkedIn. There is a small industry of services that exist just to help med spas find medical directors and collaborating physicians. Below are several of the main options owners use, plus how bookkeeping fits into that relationship once you have a doctor on board.

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Moxie – Launch Help and Medical Director Matching

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Moxie is known in the med spa world for helping owners launch and scale, not only with marketing and business coaching, but also with medical director matching. Their positioning is simple. They help you understand what you actually need in your state, what a medical director does, and then introduce you to physicians who fit your model and geography. They also lean into launch strategy, offers, and operations, which is attractive if you want a more guided path and not just a name on a license.

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For a new med spa owner, the advantage is that you get the structure and the physician at the same time. Policies, protocols, pricing, and oversight are built together rather than bolted on later. Once that relationship is set up, bookkeeping becomes part of the same foundation. If your medical director compensation is tied to revenue, profit sharing, or specific service lines, you need financial reports that both of you trust, not just whatever the point of sale system says.

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Medical Director Co – Flat Fee and Fast Placement

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Medical Director Co is a nurse owned service that focuses on placing collaborating physicians and medical directors for med spas, wellness clinics, and advanced practice providers. Their selling points are usually speed, a clear flat monthly fee, and the fact that they handle the vetting and licensing checks on their side. You tell them your state, scope of services, and what you are trying to build. They match you with a physician who fits that profile and structure.

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For med spa owners, the biggest benefit is predictability. You get a straightforward monthly cost instead of a vague percentage deal that no one really understands. From a bookkeeping standpoint, that predictability is huge. Your medical director cost becomes a clean line item on your profit and loss that you can track over time and measure against revenue and growth.

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Doctors For Providers – Nationwide Footprint and CPOM Awareness

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Doctors For Providers operates nationally and connects practices with medical directors and collaborating physicians in all 50 states. They also spend a lot of time educating owners on what they actually need. In some cases you need a medical director. In others you only need a collaborating physician. In CPOM restricted states, they help structure relationships between a physician owned professional corporation and a management company.

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That is important if you are planning to grow beyond one location or one state. A structure that barely works in State A may not work at all in State B. If you already think in terms of MSO and PC entities, physician contracts, and multi state growth, this kind of service helps keep you from painting yourself into a legal corner. Good bookkeeping then mirrors those entities. Revenue and expenses sit in the right entities, management fees are tracked properly, and you can actually read your numbers without a law degree.

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GuardianMD – Compliance Heavy Medical Direction

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GuardianMD is positioned very clearly around compliance, medical direction, and collaborating physicians for med spas, clinics, and telehealth models. Their message is about starting smart, scaling safely, and staying compliant. They talk directly about CPOM rules, MSO and PC structures, good-faith exams, and state specific oversight requirements. They also market fast matching times, often within a matter of days.

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If you are already nervous about doing this the wrong way, or you know your state is strict, this kind of partner can be reassuring. You get help designing the structure and then finding a doctor who fits inside it. Once that is in place, your bookkeeping has to respect the same lines. The professional corporation is not the same thing as the management company. Management fees are not random transfers. When the books line up with the legal structure, your medical director and your attorney both sleep better.

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We Treat – Med Spa Launch Plus Medical Director Matching

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We Treat is a broader launch and consulting partner for med spas that also offers medical director matching across the country. Owners work with them for a more full service approach. That can include branding, marketing, patient acquisition, technology stack selection, and finding a medical director who fits the clinic’s plan and state rules.

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For a first time owner, the appeal is obvious. You get the playbook and the physician relationships at the same time. The trade off is that you are often dealing with setup fees, recurring retainers, and sometimes bundled services. Without clean books, you have no idea if the model they helped you design is actually profitable. With clean books, you can see what your launch really cost, how fast the clinic is ramping up, and what your ongoing overhead looks like once the dust settles.

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Why Your Medical Director Cares About Your Books

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It is easy to think of a medical director as a box to check. Find the doctor, sign the contract, get the license, start injecting. In reality, a good medical director is putting more than a signature on a page. They are putting their license, reputation, and sometimes their ownership into your business.

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Most serious physicians want to know a few basic things:

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• Is this business being run like a real clinic or like a side hustle

• Can I see clear numbers if my compensation is tied to revenue or profit

• If something goes wrong and the board starts asking questions, will the paper trail make sense

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If your answer to all three is “I am not sure, but I can pull some numbers from Stripe,” that is not going to inspire confidence. Clean bookkeeping changes that dynamic.

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How Third Party Bookkeeping Supports the Medical Director Relationship

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Here is where the angle gets very simple. Medical directors need books too.

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Proving How Their Compensation Is Calculated

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Many medical director agreements are tied to financial metrics. Some are a flat monthly fee. Others are a percentage of revenue, net income, or a specific service line. A few structures include bonuses tied to clinic performance over time.

If you cannot produce a proper profit and loss and supporting reports, you are asking your medical director to just trust you. A third party bookkeeper gives you reconciled financials that match what actually hit the bank. It gives your physician an objective reference point instead of a spreadsheet you edited the night before.

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Showing the Business Is Managed Like a Real Clinic

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Accurate books are a signal. They tell your physician that you care about the same things they care about: order, documentation, timelines. If your bank accounts reconcile every month, your expenses are categorized properly, and your financial reports go out on a schedule, it suggests you probably treat protocols and charting with the same level of discipline.

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On the flip side, if your financials are a mess, it raises questions. If you are loose with money, are you also loose with consent, documentation, and scope of practice.

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Keeping MSO and PC Money Flows Clear

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In an MSO and PC structure, money moves between entities. The PC collects clinical revenue. The MSO provides management services and charges a fee. The physician is paid at one level. Owners may be paid at another level.

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Someone has to track that correctly. If those flows are not documented, your numbers stop meaning anything. A dedicated bookkeeper makes sure management fees, physician compensation, and owner distributions are recorded clearly so that owners, doctors, and advisors all see the same picture.

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Making Growth Conversations Easier

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Once a med spa is running, the real questions start:

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1. Can we afford a second location?

2. Should we add a new provider or a new device?

3. Do we change the medical director compensation model?

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Those conversations are much easier when everyone involved has a clear view of historical revenue, margins by service line, and what happens to profit when you add overhead. Without that, decisions are just educated guesses. With proper books, you can sit down with your medical director and your advisors and talk in numbers instead of feelings.

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What To Do Now

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If you are currently:

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• Interviewing medical director services

• Reviewing contracts and talking about compensation

• Finalizing your MSO and PC structure

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...then you are at the perfect point to bring in a bookkeeping partner too.

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You do not need a twelve person finance department. You need a third party that understands med spa revenue, memberships, packages, injectables, retail, management fees, and physician compensation. Someone who can plug into whatever tools you are already using and turn your activity into clear reports.

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Your medical director handles clinical oversight and keeps you inside the lines. Your bookkeeper proves that the business itself is healthy and worth their time.

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If you want help on that side of the house, Chief Bookkeeping Officer works directly with med spas and medical directors to keep the financial picture clean, simple, and transparent. When you are ready to put a physician’s name on your door, that is the right time to put a proper set of books behind it.