The real question is "how valuable are you?". If you're not bringing in 4x what you cost to any business then you're not an asset. It's commonplace to find staff asking how they can get paid more. What's less common and more valuable would be for staff to ask how they can build the business. I can't tell from your question if you're a Dr. or employee, but hiring is the single most important decision that owners make IMHO... more than tech or anything else.

I don't think that the question was really answered. Is that compensation too much as it seems that it is affecting their bottom line in a negative way. I would be interested to hear how others in the forums compensate their aestheticians, cme's, and np's. I am located in FL and have heard all kinds of crazy comp plans. Who has a good one that's profitable and effective?

20% is an extremely high service commission with $20/hr. That leaves very little profit. Of course your business model plays a huge role in setting up compensation plans. If you have one aesthetician in a small spa who also serves as your consultant for all cosmetic sales, including those that the doctor does, answers phones, does inventory, marketing, displays, social media, organizes events, etc, you can afford to pay a little higher if they are actually proving themselves and producing, especially if they have experience and are trustworthy. Protecting yourself as a doctor and making sure you have an aesthetician who realizes the liability you are facing if they do not follow safe protocols is worth paying a little more for. However, if you are a large spa with multiple lasers, why tie them up in only one room? Once you market yourself well, and get going, hire more aestheticians at a lower rate and you will do great.