Clinic & Practice · 12 min read · April 28, 2025
Two practice models have captured the attention of entrepreneurial nurse practitioners more than any others in recent years: concierge medicine and aesthetic med spas. Both offer higher revenue per patient, reduced administrative burden, and greater autonomy than traditional employment. But they are fundamentally different businesses with different clinical skill requirements, regulatory frameworks, and patient populations.
Concierge Medicine: The Premium Primary Care Model
Concierge medicine is essentially DPC with a higher price point and an expanded service menu. Where DPC practices typically charge $50–$150/month and focus on accessible, relationship-based primary care, concierge practices charge $150–$500/month (or more) and offer additional services: executive physicals, advanced lab panels, genetic testing, longevity medicine, same-day house calls, and direct physician/NP cell access.
The patient population skews toward higher-income individuals who are willing to pay out of pocket for a fundamentally different healthcare experience. These patients are not looking for cheaper care — they are looking for better care, faster access, and a provider who knows them as a person.
For NPs, concierge medicine requires full practice authority (or a collaborative agreement) and a strong foundation in primary care. The clinical bar is high because your patients will ask sophisticated questions, expect detailed explanations, and often arrive having already researched their conditions extensively.
The Med Spa Model: Aesthetics as a Clinical Business
Medical spas (med spas) are healthcare facilities that offer cosmetic and aesthetic procedures under medical supervision. Common services include:
The med spa industry has grown at approximately 8–10% annually and is projected to reach $47 billion globally by 2030. NPs are uniquely positioned in this space because they can both own and operate med spas (in full-practice-authority states) and perform the clinical procedures.
Regulatory Considerations
Med spa regulation varies significantly by state. In most states, a med spa must be owned or co-owned by a licensed healthcare provider. The procedures performed must be within the scope of practice of the performing provider. Laser procedures in particular are regulated differently across states — in some, only physicians can operate certain laser devices; in others, NPs and even aestheticians can perform them under medical supervision.
Before launching a med spa, you need: