I spent my clinical years in an emergency department before I opened a med spa in Knoxville, and the habits I brought with me shape how a two-person business runs.
By Sarah Hitchcox, RN, BSN
The treatment room is kept simple so the provider can see what she is doing.
Table of Contents
The habit I kept from the ER
My clinical background is the emergency department of a teaching hospital, and before I was an RN I worked nights there as a nursing assistant while I was in school. People assume that kind of work teaches you to read faces. It doesn’t. In the ER I read the chief complaint, I looked at the vital signs, and I asked the patient where it hurt and what the pain felt like. Then I checked again, because the first answer was rarely the whole answer.
That habit came with me. A consultation at my practice starts with what the client wrote on the intake form, and then I ask the same questions out loud. I look at the facial anatomy in front of me, I listen to what actually bothers them, and I make a recommendation that fits their goals. Before I draw anything up, I confirm the product and the areas one more time. It takes a minute. In the ER that minute mattered, and I don’t see a reason to drop it now because the stakes look smaller.
Why the team is still two people
The practice is Sarah Hitchcox Aesthetics, and it’s nurse-owned, self-funded, and 100% woman-owned, with no investors. The first office opened in Bearden on March 28, 2024, as a single room. Today there are two West Knoxville offices, Bearden and Farragut, and every service is available at both.
The full-time team is still two people. I do the clinical work, and my husband runs operations and marketing. We have a physician medical director, and I’m the provider in the room. The Botox page on my site says every treatment is performed by Sarah Hitchcox, RN, and that’s a plain statement of how the business is set up, not a slogan.
A small team is a choice with a cost. I move between the two offices, so a room sits empty whenever I’m at the other one. That’s why I’m hiring a second provider, along with a licensed medical aesthetician and a part-time assistant for marketing and patient experience. I’d rather take the time to find the right people.
Supplies are laid out and confirmed before anything is drawn up.
The ER taught me to stay calm and act fast. Owning a practice feels different, because everything is on me. There’s no hospital behind me. When something goes wrong, the person who fixes it is the same person who did the work. That’s uncomfortable in a way the ER never was, and it’s also why I check twice.
What that looks like from the chair
The treatment room is simple. A white reclining chair, a gold rolling tray, white walls, and the device I need for that visit. I keep it that way so I can see what I’m doing.
Clients don’t usually come in because of a big life moment. They come in because they saw a line in the mirror while doing their makeup or washing their face, and it bothered them. I don’t ask whether there’s an event behind the visit, and I don’t screen anyone psychologically. The job is to solve the problem they came in with.
Being honest about that problem is most of the consultation. Many women want facelift results for very little money, and part of my job is to bring the plan back down to earth. If it’s a neurotoxin visit, I say up front that the product takes about two weeks to kick in, so nobody leaves expecting to see a change in the parking lot. My goal is a result that looks rested and still looks like you.
Botox Knox Med Spa is my other business at the same offices. It’s the Botox-focused practice for wrinkle relaxers and lip work, and the same person does the injecting there, with the same intake and the same second check.
What I’d tell another owner
If you’re building a service business, decide early who holds the clinical standard, and make sure that person is close enough to the work to see when it slips. In my case that’s me, every day, in both offices. My careers page describes the practice as nurse-owned. What that means in practice is that the person who answers for the result is the one who did it, and I checked it twice.
