You spent weeks recruiting. You found someone with a strong resume, they interviewed beautifully, and everyone was excited. Then, six weeks later, they are gone.
Sound familiar?
This is one of the most common and most costly patterns in the med spa industry. And it almost always comes down to one thing: missing structure. Not bad judgment. Not a bad hire. A broken or incomplete process on both ends of the employee journey.
Kristin, a hiring consultant with Diamond Accelerator who specializes in med spa recruitment and interviewing, says it clearly:
"The hardest part of hiring isn't finding the perfect candidate. It's what happens after you and the candidate say yes. And what happens when things don't work out."
This post covers what strong onboarding and offboarding actually looks like in a med spa, why both phases matter more than most owners realize, and what you can do differently starting today.
Why Most Med Spas Struggle With Retention
Before diving into systems, it helps to understand what is actually driving turnover. Many owners assume it comes down to pay. But that is rarely the full picture.
Kristin explains it this way:
"People usually quit because of systems, not people. You can pay them all the money in the world, but if that culture and that connection isn't authentic and genuine, they're going to feel that. These injectors, these practice managers, front desk staff, they're humans behind this work. They want to feel like they're part of something."
When a new hire walks into a disorganized first week with no clear plan, no assigned mentor, and no idea what success looks like at 30 or 60 days, they start questioning their decision. Often within the first few weeks. Knowing what top injectors actually want from a med spa before you even post a job listing can help you build the kind of environment people want to stay in. And having a well-thought-out injector compensation structure in place before they arrive shows them you already take their career seriously.
The good news is that this is fixable. Structure changes everything.
What Strong Med Spa Onboarding Actually Looks Like
It Starts Before Day One
Real onboarding does not begin when someone walks through the door. By the time your new hire arrives, the foundation should already be in place. If it is not, you are already creating confusion before they have even started.
Before a new employee’s first day, you should be able to answer yes to all of the following:
- Are contracts and compensation plans signed?
- Are roles and responsibilities clearly defined and understood by everyone involved?
- Is payroll, benefits, and system access already set up?
- Is their workspace ready, including EMR, email, and any tools they need to do their job?
- Does your existing team know this person is starting, and have they been introduced?
- Is there a clear mentor or leader assigned to guide them through the first few weeks?
These feel like obvious steps. But skipping even one of them creates confusion on day one. And confusion does not motivate people. It frustrates them, and that frustration plants the seed of doubt early.
The numbers tell the story clearly. About one in five new hires quits within the first month and a half when onboarding is incomplete. But when employees are set up properly from the start, they are around 70% more likely to stay for three years or longer. In a field where turnover is expensive and disruptive, that gap is significant.
Common med spa injector hiring mistakes often show up before someone ever starts, so understanding where the cracks appear earliest gives you the best chance to close them.
The First 90 Days Determine Whether They Stay
New hires make up their minds quickly. Most decide within their first few weeks whether this is somewhere they want to build a career or just a stepping stone. The 90-day window is your most important opportunity as a leader to show them which one it is.
A structured first 90 days should include:
- Dedicated and intentional leadership time, not just winging the first week
- Clear training goals so the new hire understands what success looks like and when
- Formal check-ins at 30, 60, and 90 days to course-correct early if needed
- A consistent mentor or point person they can go to with questions
One thing that trips up a lot of owners here is capacity. If you are already stretched thin, carving out consistent time for a new hire can feel impossible. That is where mastering delegation inside your med spa becomes part of your onboarding strategy too. When your leadership bandwidth is freed up, you can actually show up for the people you are bringing in.
Kristin shared a real example of what happens when this is missing:
"I once worked with a med spa that hired a really talented injector. They had no check-ins and no training plan, and she left after six weeks. With a solid 90-day plan, she would have stayed, avoiding lost revenue and team morale issues."
The data supports this. Structured onboarding can increase employee retention by 82%. And employees who feel properly onboarded are 18 times more committed to their employer. That is not a marginal improvement. That is a complete shift in how your team functions and how stable your practice feels day to day.
What Red Flags Look Like on Both Sides of the Interview
Strong onboarding starts even earlier in the hiring process. How you show up during the interview signals everything to a candidate about what it will be like to work for you.
From an employer side, Kristin says red flags candidates notice include:
- Being late or disorganized on day one of training
- Not being upfront about performance expectations or the financial reality of the business
- Failing to show a clear support structure or chain of communication
- Not acknowledging that there is a person behind the role
From a candidate side, the red flags worth paying attention to are:
- Poor presentation or appearance, which matters especially in an aesthetic practice
- Using “I” exclusively with no acknowledgment of teamwork or collaboration
- Not being prepared for a second interview or practical evaluation as though it were a first
Kristin’s advice for the interview itself is to let the candidate talk. A lot of owners get excited and oversell the business, which means they get to know the candidate less. The goal is to understand whether they truly grasp what you need and whether they can deliver it. Some practices are also finding that letting top injectors lead part of the interview reveals far more about fit than a standard question-and-answer session ever could.
What to Do When Onboarding Is the Problem, Not the Person
This is the question most leaders avoid asking. If you are constantly retraining people, losing them inside the first 90 days, or feeling frustrated because a hire that seemed great just is not working out, the honest question to ask is whether your onboarding process is actually set up to help them succeed.
Kristin puts it directly:
"If everyone keeps failing in the same place, look at the system, not the person. Great onboarding removes the guesswork, sets clear expectations, and shows someone how to win fast. When onboarding is weak, even great hires will fail."
This is also why getting your operations in order before you start recruiting matters so much. Hiring into a disorganized system compounds every problem. The right people can only do their best work when the environment they are walking into supports them.
How to Handle Offboarding Without Damaging Your Practice
Offboarding is the part of the employee lifecycle that most practices rush or skip entirely. But how someone leaves your practice has real consequences for your team, your patients, and your business continuity.
Nearly half of organizations report that inconsistent offboarding leads to lost knowledge and costly operational mistakes. When there is no knowledge transfer, no clear communication, and no formal process, the people who remain are left filling in gaps they should not have to fill.
A structured offboarding process should cover:
- Removing system access immediately, including EMR, email, and scheduling tools
- Recovering all company property such as devices, keys, and branded materials
- Protecting patient and team privacy throughout the transition
- Communicating the departure to your team in a calm, clear, and consistent way
- Conducting an exit interview to capture institutional knowledge before it leaves with them
Each of these steps protects the business. Skipping them creates operational gaps that cost time, money, and sometimes client trust. There are also legal and compliance considerations involved in both hiring and separation that many practice owners overlook until a problem surfaces. Understanding the top legal and business mistakes when hiring for your med spa can help you avoid the most common and costly ones before they happen.
How to Communicate a Departure Without Causing Team Panic
When someone leaves, especially if it was not voluntary, the fear of gossip, confusion, or even resignations is real. But the narrative is more within your control than you might think.
Kristin explains:
"You can control the narrative. You don't overshare, you don't vent to anyone on the team, and you don't allow any speculation. You communicate one clear message consistently: this decision was thoughtful, it was aligned with our standards, and we're moving forward. When your team trusts that you hire with intention and fire with fairness, they actually feel safer, not scared."
Silence and avoidance create fear. Calm, clear communication builds trust. Your team does not need every detail. They need confidence in your leadership.
When Is It Too Soon to Let Someone Go?
This question makes most owners uncomfortable, but it deserves a direct answer. Dragging out a bad fit is one of the most expensive mistakes a med spa owner can make, and it is not just about money.
Kristin is straightforward on this:
"It's never too soon to be honest. Dragging it out is what costs you money, morale, and credibility. Onboarding is a two-way evaluation period, not a promise of forever. If someone lacks urgency, doesn't meet expectations, or isn't coachable in the first 30 to 60 days, that's your answer. Keeping someone just to be nice is actually unfair to your team and your entire business."
Kind leadership is clear leadership. A strong leader makes clean, early decisions based on facts and standards rather than emotion. For practices focused on building a high-performing team of injectors, getting the right people in and the wrong people out quickly is part of responsible leadership, not cruelty.
How to Stand Out as a Hiring Practice
In a competitive market for aesthetic talent, your reputation as an employer matters more than most owners realize. Candidates talk to each other. Former employees share their experiences. If your onboarding is chaotic, your communication is inconsistent, or your team feels invisible, that reputation follows you into every future hire.
What actually separates the practices that attract and keep top talent comes down to a few consistent habits. Having a professional, updated digital presence matters because candidates will look you up before they ever respond to a job posting. Being able to speak clearly and confidently to your team’s culture and wins makes a real impression. And showing candidates that you genuinely value and recognize the people already on your team tells them a lot about what it will be like to work there.
Recruiting and retaining top injectors requires more than a good job listing. It requires a practice that people actually want to join and stay at.
Your people are what make you different. Lead with that. And remember that revenue in a med spa is a team effort, not just the result of one or two high performers. When your entire team is well-hired, well-onboarded, and well-led, the practice grows together.
The Hiring and Firing Checklist
Diamond Accelerator has created a free Hiring and Firing Checklist that covers both sides of the employee lifecycle. It is designed to make sure nothing slips through the cracks, whether you are welcoming someone new or navigating a difficult exit.
You can find it on the Diamond Accelerator website under Resources. The checklist is regularly updated because systems and compliance requirements change. It is a practical tool, not a formality.
Ready to Build a Team That Actually Stays?
If any of what Kristin shared resonates with what you are experiencing right now, whether it is high turnover, gaps in your onboarding, or uncertainty around how to handle a difficult exit, you are not alone. These are the exact challenges Diamond Accelerator works through with med spa owners every day.
The team pairs recruitment expertise with operational support to help practices hire with intention, onboard with structure, and lead with confidence at every stage of the employee journey.
The best place to start is a one-on-one strategy session where you can get an honest look at where your gaps are and what a more structured approach could mean for your practice.
Book your strategy session and take the first step toward building a team that is set up to stay.
