As the aesthetics industry continues to expand, many owners find themselves overwhelmed, not only with day-to-day operations, but also with financial management. Whether you're running a single-location practice or expanding into multiple markets, it's crucial to understand the roles of your financial team. Specifically, what’s the difference between a Bookkeeper, a CPA, and a CFO, and when do you need each?

Below we will break it down in terms of responsibilities, skill sets, and strategic value to your business.

Bookkeeper: The Financial Organizer

What they do:

A bookkeeper is responsible for recording and organizing the day-to-day financial transactions of your medspa. Think of them as the front line of your financial system, they keep your financials accurate and up to date.

Key responsibilities in a medspa:

• Recording sales from your POS system or deposits from your patients.
• Categorizing expenses (e.g., injectables, skincare products, laser equipment)
• Reconciling bank and credit card statements
• Managing accounts payables (i.e. paying your bills), if requested
• Handling payroll, if requested

When you need a bookkeeper:

Right from the start. Even a solo injector benefits from good bookkeeping to track profitability and prepare for tax time.

Tools they often use: They will need an accounting software - we usually recommend Quickbooks Online. They will also need access to your bank accounts, credit card statements, and payroll system.

CPA: The Tax and Compliance Expert

What they do:

A Certified Public Accountant (CPA) is licensed to provide accounting services to the public. CPAs go beyond bookkeeping to help with tax compliance, financial reporting, and audits. They understand the tax code—and how to help your business and you, as the owner, pay as little as possible in taxes.

Key responsibilities include:

• Filing federal and state taxes
• Advising on tax strategies (e.g., depreciation on laser equipment, owner distributions)
• Ensuring compliance with IRS regulations
• Preparing financial statements for banks or investors, if needed
• Assisting with audits, if needed

When you need a CPA:

Annually for taxes—but ideally throughout the year for planning. This becomes especially critical if your practice is growing rapidly or considering franchising, bringing on partners, or buying expensive assets.

Certifications matter: Look for CPAs with experience in healthcare, aesthetics, or small businesses.

CFO: The Strategic Financial Leader

What they do:

A Chief Financial Officer (CFO) is a high-level executive who drives the financial strategy of your business. They interpret your financial data to help guide decisions that affect profitability, growth, and long-term sustainability.

Key responsibilities include:

• Creating and managing budgets and forecasts
• Analyzing profitability by service line (e.g., Botox vs. body contouring)
• Pricing strategy and cost analysis
• Overseeing financial reporting and KPI dashboards
• Managing investor relations or acquisition opportunitie
• Risk management and financial modeling

When you need a CFO:

When you're scaling, adding locations, or planning a high-growth strategy. Many practices benefit from hiring a fractional CFO as a part-time executive who brings expertise without the full-time salary.

A CFO helps answer:

• “Should we lease or buy our next laser?”
• “How much can we spend on marketing this month?”
• “When can we afford to open a second location?”

Who Does What?

• Bookkeeper
  • Focus Area: Daily transactions
  • Primary Value: Accuracy & organization
  • When You Need Them: From day one
• CPA
  • Focus Area: Taxes & compliance
  • Primary Value: Tax savings & compliance
  • When You Need Them: At tax time and for planning
• CFO
  • Focus Area: Strategy & budgeting
  • Primary Value: Growth & profitability
  • When You Need Them: During scaling or expansion

Final Thoughts

In the aesthetics world, precision matters—and that applies to your financial team, too. Understanding who handles what helps you build a support system that ensures you're not just making money, but keeping it, growing it, and preparing for the future. Whether you're injecting filler or building a beauty empire, your financial professionals are key partners in success.

Need help figuring out which financial role to hire first? Start by assessing your biggest challenge—whether it’s messy books, surprise tax bills, or uncertainty about profitability—and build from there. For a free financial consultation, reach out to us at hello@mavenfp.com.