Fractional CFO & strategic finance for med spas
Your practice is busy. Your team is growing. But your own pay still feels unpredictable, and every hire or device purchase raises the same question: can we afford this?
Ward Advisory provides fractional CFO support to help you find where profit and cash are going, understand what’s causing the pressure, and decide what to change.
Built for established health and aesthetics businesses doing roughly $1M–$10M+ a year.
Sound familiar?
You are treating more patients and bringing in more revenue, but the business is not keeping much more. You are working harder without seeing the return you expected.
Why the same revenue can mean very different profitPayroll clears and suppliers get paid, but you hesitate before paying yourself. You need to know what cash the practice can safely distribute after its obligations are covered.
Why a busy practice can still run shortYou hired another provider to create capacity and give yourself breathing room. Now payroll is higher, and you need to know whether the added appointments cover the added cost.
How payroll creep compoundsYour top injector wants a raise. Their revenue looks strong, but after product cost, discounts, and compensation, you cannot tell what the practice actually keeps.
Why your top producer may not be your most profitableThe new device could expand your services, but the monthly payment is certain and the bookings are not. You want a clear break-even case before committing cash.
The break-even math most owners get wrongYou receive the monthly reports, but still cannot answer: can we hire, buy the device, or increase owner pay? You need numbers that help you make the next decision.
What a working financial system looks likeRecognize one of these? That’s where a conversation starts.
Request a Strategy CallThe economics
In a $2M practice, one point of margin is $20,000 a year. A three- or four-point gap is often one of the largest numbers in the business, and one of the least examined.
The gap against a reference point is only where diagnosis starts. What matters is what is causing it, how much of it is controllable, and what change is economically realistic.
$2,000,000
One point of margin
$20,000/ year
45% vs. 41% illustrative reference
Paid provider hours that go unbooked, compensation that pays on revenue, and administrative growth.
How payroll creep compounds4 points gap
≈ $80,000
annual exposure
23% vs. 20% illustrative reference
Product costs rising faster than prices, waste, and over-portioning.
What a unit of neurotoxin really costs3 points gap
≈ $60,000
annual exposure
Benchmark exposure
The dollar size of a gap against a reference point.
Diagnosis
What is actually causing the gap in this practice.
Addressable opportunity
The part of the gap that is controllable.
Measured change
What moves once the cause is addressed.
Illustrative exposure, not an estimate of savings
These figures show where a gap may exist, not what can be recovered. Service mix, geography, staffing model, and accounting classification can explain some or all of it. Driver exposures can overlap and must not be added together. Diagnosis determines what's actually driving it and how much is controllable.
Run your own numbers in the Profitability Gap CalculatorRoot cause
Most owners arrive with a symptom. The work is finding which cause is actually driving it, because each cause has a different fix.
What it could actually be
What it could actually be
What it could actually be
If a few of these are hard to answer with confidence, that is normal. It is also where the money usually is.
We don’t start with the tool. We start with the problem.
The future state
The goal is not a better report. It is a business whose economics improve, and stay predictable, as it grows.
Where many practices are
Better economics
NowRevenue grows while margin stalls.
FutureMargin grows with revenue.
NowLabor and product cost drift upward unnoticed.
FutureLabor and COGS held to targets ownership sets.
NowProviders ranked by what they produce.
FutureEvery provider and service line understood by what it contributes.
NowCash surprises discovered after the fact.
FutureCash forecast before commitments are made.
NowHires, devices, and locations decided on instinct.
FutureGrowth decisions made with a payback case.
NowOwner income that swings month to month.
FutureOwner economics that are predictable.
How we work
We learn how the business runs, what ownership wants to change, and which decisions need better numbers.
We find where performance diverges from what it should be, size the gap in dollars, and trace it to a cause.
Scope follows the problem. There is no predetermined menu of deliverables to choose from.
We build what the fix requires and track whether the targeted economics actually move.
Scope and investment are set after we understand the business and the problem, not before.
How the gains are kept
Fixing a problem once is not the same as keeping it fixed. The Med Spa Financial Operating System is the management rhythm Ward Advisory uses to sustain better economics. It is a way of running the numbers, not software.
Explore the Med Spa Financial Operating SystemLayer 1
Revenue, labor, and margin by service line and provider, so you can see where profit actually comes from.
Layer 2
What the bank account is likely to do before you commit to a hire, a purchase, or a distribution.
Layer 3
A short set of metrics that surface causes early. A rebooking decline shows up months later as a revenue-per-hour problem.
Layer 4
Close, diagnose, decide, measure. Each month ends with an operating decision and a way to check whether it worked.
What we diagnose
Each area below has its own causes, its own metrics, and its own section of the Financial Library, where the math is worked through in detail.
01
Where revenue leaks before it reaches ownership.
From the library
02
Which providers and paid hours actually earn a return.
From the library
03
Which services, prices, and patients actually make money.
From the library
04
Why profit does not turn into cash.
From the library
05
Whether hires, devices, marketing, and locations pay back.
06
Whether your numbers can support the decisions in front of you.
From the library
Why Ward Advisory
Tanner Ward founded Ward Advisory after 10+ years of finance and operating experience. The common thread is the question this site keeps asking: which parts of an operation actually earn a return, and what should change.
Ward Advisory keeps a limited number of hands-on advisory relationships, so the person doing the analysis is the person advising on the decision.
Healthcare finance
Service-line financial analysis inside a hospital system at INTEGRIS Health.
Practice economics are service-line economics: which treatments, providers, and hours actually earn a return.
Amazon finance
Corporate finance in large-scale operations at Amazon.
Capacity, labor productivity, and unit economics measured rigorously enough to run decisions on.
Private lending and fund management
Operating leadership in private lending and fund management.
Capital allocation discipline: a hire, a device, or a location is an investment that should show a payback case.
Fit
Looking for bookkeeping or tax support alongside strategic work? We coordinate with your existing bookkeeper and CPA. How the financial foundation fits in.
A Strategy Call is a working conversation about where the business is today, what ownership is trying to change, and whether there is a financially meaningful problem worth diagnosing.
