What EMR Does Everyone Use? Nobody Audits That Number

The short version

• No analyst-audited market-share data exists for specialty EMRs. KLAS and Black Book measure user satisfaction, not installed base, and the detailed panels (IQVIA-class) are paywalled.
• Every share number you’ve heard is vendor-published: ModMed’s 35-40% of dermatology traces to its own 2012-2018 press releases, Symplast’s “10% of plastic surgery” counts users including staff with no denominator, and Nextech publishes one total across five specialties.
• The denominators are public: about 12,120 practicing US dermatologists, roughly 7,000 active board-certified plastic surgeons, and 11,500+ medspas. Check any claim against them and watch the units: providers, physicians, users, locations, and accounts are five different things.
• The only independent survey ever run (2020, ASPS-distributed) found Epic on top, because academics answered it. The sample decides the answer.
• Generally speaking, share barely matters to your decision anyway. Fit does. Use the numbers to test how a rep handles being asked for sources.

Specialty EMR market share: the data nobody publishes

Somewhere in your next EMR demo, a number will come up. Forty percent of dermatologists. Ten percent of plastic surgery. The most practices in aesthetics. Confident numbers, delivered confidently. Here’s the thing I wish more buyers knew: nobody audits those numbers. Not KLAS, not Black Book, not anyone you can read for free.

Before we go further, the standing disclaimer: we use these platforms every day, we like these companies, and none of what follows is a knock on the software. The products are good. The statistics are marketing. Those are two different sentences, and this article is about the second one.

What actually exists: satisfaction awards (real, but they count smiles), vendor press releases (real, but they grade their own homework), and paywalled panels like IQVIA’s office-based EHR data (real, audited, and priced for pharma budgets, not practices). What doesn’t exist: a public, independent count of which specialty EMR sits in how many plastics and derm practices. So let’s read the claims the way a biller reads an EOB… line by line, units first. (Yes, we read EOBs for fun. We’ve made peace with what that says about us.)

Best in KLAS and Black Book #1: what the awards measure (and what they don’t)

KLAS and Black Book survey the people who actually use the software, score the vendors, and hand out rankings. That’s genuinely valuable. When Symplast wins Best in KLAS for ambulatory plastic surgery, or ModMed sweeps Black Book across eleven specialties for the umpteenth year, real users voted for that. We cited both in our shortlist guide, happily.

But read the fine print on what got measured: satisfaction. Support quality, usability, whether the practice would buy again. Not how many practices bought in the first place. A vendor with 400 delighted practices can outrank a vendor with 4,000 mixed ones, and the award tells you nothing about which is which. Neither number is on the trophy. Happiness rankings and headcount are different currencies.

So when a rep says “number one in dermatology,” the right follow-up is four words: number one at what? Satisfaction is a great answer. Just file it in the right drawer.

Where EMR share claims actually come from: ModMed’s 40%, Symplast’s 10%, Nextech’s 16,000

Let’s trace the big ones. This took some archaeology, and honestly, it was fun in the way cleaning up an AR aging report is fun. We’re aware of what that says about us too.

1. ModMed: “35-40% of US dermatologists.” Follow it back and you find ModMed’s own press releases: over 35% by 2017, north of 10% in 2012, 26% in 2014, 30% in 2015, 40% on the company blog by 2018. A tidy growth story, self-reported at every step, and repeated by third parties ever since without anyone re-counting. Is it plausible? Honestly, yes… EMA is everywhere in derm. Audited? Never. Both things are true.
2. Nextech: 16,000+ physicians. Real company-published scale, and here’s the unit trap: that total spans five specialties, including ophthalmology and orthopedics. Nextech has never published the plastics or derm slice. Whatever share of your specialty it holds, that number won’t tell you.
3. Symplast: “trusted by over 10% of the plastic surgery industry.” The same site says 4,400+ users. Users includes front desk, medical assistants, and billers, and “the plastic surgery industry” comes with no denominator attached. Ten percent of what, counted how? The claim might be fair. It’s also unfalsifiable as written.
4. PatientNow: 5,000+ practices and businesses worldwide. The worldwide does work in that sentence, and so does businesses, which sweeps in medspas. Fine number, wrong shape for a US-practice comparison.
5. The medspa platforms. Aesthetic Record’s 9,000+ accounts includes solo injectors and international clinics. Boulevard’s “15% of the US medspa market” comes from its own funding announcement, and Boulevard is a front-of-house platform, not an EMR. Different race, different lane.

None of these companies is doing anything unusual. Marketing publishes the best defensible version of every number, in every industry, forever. Your accountant’s software does it. Your car did it. Your job at the demo isn’t to catch anyone… it’s to ask for units, denominators, and dates, and see what happens next.

The denominators: how many dermatologists, plastic surgeons, and medspas there actually are

Here’s what makes share claims checkable at all: the denominators are public, even when the numerators aren’t.

1. Dermatology: about 12,120 practicing US dermatologists. (We know. Fewer than you thought. Everyone says that.) So ModMed’s 35-40% claim, if true, means roughly 4,200 to 4,900 derms on EMA. Plausible against a 40,000-provider company total? Sure. Confirmed anywhere? No.
2. Plastic surgery: roughly 7,000 active board-certified plastic surgeons in the US (ASPS counts 11,000+ members worldwide). Symplast’s “10%” would be about 700 surgeons, which is at least the right order of magnitude for its 4,400 total users once you count staff seats. See how fast the math either hangs together or doesn’t?
3. Medspas: 11,500+ US medspas and climbing, the fastest-growing denominator in the group, which is exactly why every platform’s medspa percentage ages so quickly.
4. ENT: about 13,000 otolaryngologists, a bit over half in private practice, and here’s the fun fact: no vendor publishes any ENT installed-base number at all. Zero. The specialty with the least data is also the one with the fewest platform choices, which is not a coincidence.

The move to steal, and say it with me: NUMERATOR. DENOMINATOR. YEAR. Any percentage, every time. Three asks, ten seconds, and you’ll know more than the rep expected you to.

The only independent EMR survey in plastic surgery found Epic on top. Here’s why that’s wrong and useful.

Exactly one independent, peer-reviewed EMR usage survey exists in this space: a 2020 study distributed through ASPS. Its finding? Epic was the most common EHR among responding plastic surgeons.

Epic. In plastic surgery. If that sounds off, your instincts are right and the study is still telling the truth: academic and hospital-employed surgeons answered the survey, and they chart in whatever the health system bought. Private-practice surgeons, the people actually shopping this market, mostly didn’t respond. The sample decided the answer before a single question was asked.

That’s not a reason to dismiss the study. It’s the cleanest demonstration you’ll ever get of why this article exists: even honest, independent, peer-reviewed data answers only the question its sample can hear. Generally speaking, when someone hands you a market statistic, the first thing to ask isn’t whether the math is right. It’s who got asked.

How to use EMR market share claims when you buy: three questions and one honest confession

Does share even matter? A little. Let’s be honest about how little. A big installed base in your specialty means easier staff hires who already know the system, more third-party integrations, and a vendor less likely to sunset the product. Those are real. But none of them outweigh fit… the most-installed platform in your specialty can still be wrong for your cosmetic split, and we wrote a whole guide on picking by modules instead of by crowd.

So use the numbers as a probe, not a criterion. Three questions:

1. “Share of what, counted how, as of when?” Units, denominator, date. A good rep answers or finds out. A great rep says “honestly, that’s our marketing number” and you’ve just learned you can trust them with harder questions.
2. “How many practices like mine, in my specialty, at my size?” This is the only share number that affects you, and vendors do have it, because it’s how their sales territories work.
3. “Can I talk to three of them?” References are the audited market data of this industry. Your billing operation should sit in on those calls too, because reference practices tell billers things they don’t tell buyers.

And the confession we owe you: we could quote you our own numbers here. Auctus bills inside these platforms across a book of plastics and derm practices, and we know exactly which EMRs we see most. We’re not publishing that as market share, because a billing company’s client base is a biased sample too… practices that outsource billing, found through our channels, weighted to our corners of the country. If we quoted it as a market number, you should trust us less. Same rules for everyone, including us. What we will do is put that pattern-knowledge to work on your shortlist, one practice at a time.

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This article is for general informational purposes and is not coding, billing, or legal advice. Verify current rules and your contractor policies before making operational decisions.