New-patient acquisition over-spend.
Most Ormond med spas spend the bulk of their marketing budget on cold acquisition because that is the only lever they know how to pull. In a market where the existing patient list is the highest-value asset on the books, that allocation is upside-down. We see practices spend $8,000 a month chasing new patients while a 3,000-person dormant list sits idle. The Boomerang™ program reactivates that list at 15 to 25%. The math is not subtle.