How much can a Medical Spa make?

 Dermadoc got me thinking with a comment he left on this Dermacare Franchise post:

"I will say that Dermacare offered no help whatsoever with suggestions in setting up the business or tax structure, HR for the folks we hired ( other than to force them to sign a non-disclosure agreement), or even how to address the competition locally (apparently 'We are Dermacare, tremble before our might!' was supposed to send the competition scurrying.)

'MedSpas' can be a fun business - I have a great time with the patients. It can also cost a fortune to get up and running if you don't do your homework, and franchisors truly only have some of the answers. I don't think I will ever make a million dollars with my little slice of heaven here, but it's mine and that's the important thing for me."

In general I don't like to comment on how much Surface makes. Certainly it depends on the clinic and other conditions, but I'm supprised a bit by DermaDocs comment that he feels that he won't every make a million dollars. Now while you may not take home a million dollars, a million in gross sales is very possible... if you know what you're doing.

Dermadocs comment that Dermacare offered no help or suggestions with business structure, taxes, HR leaves me absolutly dumbfounded. What the hell are you paying for DermaDoc?

We need to talk. 

I talk to somewhere between 5 and 10 physicians a week. Most are looking to try to enter or start a 'medical spa' but a fair number are already open or looking for training.  For many if not most physicians in this area, they're making a few thousand extra dollars a month and they're good with that. Of course if you're running an actual business, that just won't cut it. I'm curious about what everyone thinks is attainable or what you're goals are?

Comments

[SM]

I'm one of those struggling docs. I gross about 8k a month in my medical spa which means I make 2-3 of that. I have one IPL, do fillers and Botox and use my existing staff. I'd think I'd died and gone to heaven if I could make 20k a month but I'm not a great marketer or businessman. I'd really like to learn. Kudos to this site.

[LH]

In order to pull in the 20k per month you will likely need to increase your internal marketing. This is the cheapeast route to go. Make sure that all of your current patient base know about your medspa and what you can do there.

As your business grows you will likely need to increase the procedures you perform. Start with the least expensive procedures and advance from there as income allows.

[DermaDoc]

Jeff-

I am always amazed that my little rantings generate interest in something besides whether I forgot my medication that day.

Just for clarity though, I can foresee having revenue of $1 million at some point, but I know growing a stable business of that size from scratch takes time and lots of homework. I originally saw a much different vision with Dermacare, starting one clinic and expanding through our area like those in Phoenix. After seeing the general ethics of the people I am dealing with, and recognizing that I may very well lose everything if I try to get out of the whole mess, I am content at this point to hang on to my clinic and make it an exceptional single rather than part of a mediocre whole.

For the record, I did ask for some advice on legalities and structure when this all started. And I was told there was an HR manual being developed in early 2006 which would be distributed to all of us. Never happened, and no one knows anything about it. If I got any suggestion besides 'call an attorney in your area', it was wrapped in so many layers of disclaimers as to be essentially useless. Thankfully with a very good attorney and an MBA in my back pocket, we were able ( I think at least) to negotiate the obstacles without too much damage done.

As far as what we are paying for....I think Corporate describes it as 'The System' (trumpets in the background). We are paying for slow response time from Corporate, broken promises as every turn, a website that most clients complain about, and last but not least, the priviledge of making all the mistakes ourselves and having the feeling DC is circling overhead, waiting to try to sell the carcass to a different pack of hyenas.

Geez, I must have had a worse day than I thought.

And in a fascinating turn of denial at Corporate, the web-based lead program, which was touted as one of the most efficient ways of getting leads, has been dysfunctional for months, giving up only a couple of leads occasionally when it is working intermittently. Several franchisees have complained about it, seeing their leads drop from 30-40/month by one account, to 1 or 2. Corporate is upholding that it is working adequately and the potential clients must not be looking at it. That makes me feel so much better to know that our website is poorly viewed. So all the clients that say it doesn't work must be too stupid to point and click. (that was facetious by the way).

Well, April is a new month, let's see what Spring will bring!

Good night all.

[MichMD]

Dermadoc,

How can you then defend your franchisor in any way, shape, or form? If it were me, writing that franchise check every month would raise my blood pressure 100 points systolic. I'd be using 4-letter words with every number I wrote. With your MBA, why didn't you just consider plopping a machine or two in your office and doing it that way? I'm just curious why some risk so much to 'go for it' with huge buildouts, franchise fees, office managers (I've never used an office manager yet), etc, etc when they could probably make a very decent monthly just by buying a machine and setting up one room in their office to do the procedures. I'm just asking to see how one decides to choose the franchise model which seems to not work well at all.

[DermaDoc]

MichMD-
Good questions. I suppose I mostly wanted to avoid being the businessman and just be the doctor which is what I truly enjoy. The MBA was what told me that I need a good office manager. Spending hours tracking charges and data every day in addition to seeing patients really didn't sound like a good idea to me. As to why I went with the franchise model, I plead guilty to looking for an easy solution. Having what was presented as essentially a turn-key operation seemed like the best plan rather than doing all the research on my own. And you can see from other posts througout the site that ten different providers have ten different protocols for a procedure and preferences for machines. I wanted to pick the best machines with the best results and get the best training on them to minimize the learning curve. Oops.

As for defending DermaCare, you're right, it does stick in my throat (or fingers) every time I post something positive, but then again, I can give some credit where credit is due. I still think that they are trying to make it work, if only for their own selfish reasons, and that can be beneficial to the franchisees. The marketing team is turning around. I am trying not to confuse growing pains with incompetence and I am sure there is a good bit of each, but this is what I have to work with right now, and being consistently negative about it starts to wear me out as well.

[Midwest]

I hesitate to sling a leg over onto the 'Dermacare Drama' bandwagon, but even though I'm in the Midwest it has gotten personal! I have a good girlfriend who recently moved to the 'Arizona Area' (I am intentionally being vague) and is now employed at a Dermacare Franchise. She does not have good things to say at this point in her training. I will not go into detail because it's not my place to judge, but she is being asked to do and say things she is morally and ehtically opposed to. She's a smart girl with little gray area when it comes to right and wrong and has been practicing laser hair reduction for six years. What is the deal with this franchise? It seems to be gobbling up all of these good smart people and spitting them out with half empty pockets, slandered reputations, and a bitter taste in their mouths.

This is bringing out the vigilante in Midwest! Can we start a Medspa Union or something?! lol....

[LH]

I think that dermacare has it all wrong. They are a business trying to practice medicine. Jeff is right, Dermacare must have a very poor business model.

Yes, this is a business but it is still medicine. That is why many of these franchises are not going to survive. Most of the people that are nurses, midlevels and physicians are not followers they are leaders(not to mention a higher IQ). They do not automatically jump on the bandwagon just because corporate tells them to do so.

Medical staff will always look at clients/patients from that perspective not just a dollar sign. From what I have been reading on this site, everyone here is of that mindset. You want to do what is best for the client not just "upsell" them.

[Medspabuzz]

We are a franchise medspa in the midwest. The post by LH is correct. If I listen to our corporate office and my staff upsell's everything then we are not building a long term medical business. Each and every patient is different and there will be a natural progression for our services once they are exposed to them. The upsell will unfold in it's own time and pattern, that is of course if we earn a patients trust, respect and they enjoy our staff, facility and prices. My biggest turnoff in any environment is an overbearing salesperson who is programmed not to accept no. It is the used car salesman or yellow pages mentality and it has no business in a medical environment. It may take longer to produce numbers but in the long run I believe we will have a sustainable business with loyal customers who trust and respect or medical advice. We will also have ethical and happy staff with little turnover. I have already seen this. Quite different from many postings about franchise medical spas, but as a business owner sometimes you go with your gut. The franchise got me in business but what they have does not work for me and they are not in the business of keeping me in business. All this is well exposed and documented on this site. I'll bash any franchise medical spa and there models, that's why I am following my own and building a respectable practice. Hope my pockets are deep enough.

[LH]

To bad we can't all go with the same name but maintain independent practices. We could all market together and become a national brand.

[DermaDoc]

Bless you MedSpaBuzz-

I was starting to think sales ethics were inconsistent with an even reasonably successful practice. I agree 100% that the upsell will come on its own. Return patients (I just can't call them customers) and referrals have surpassed most of my advertising vehicles as a source of revenue. That wouldn't happen if they think they are getting the hard-sell. I always take a few minutes with the patient at the end of the procedure to make sure they are comfortable and go over the expectations, side effects and after-care, sometimes for the 4th or 5th time. I have started keeping a price list in the rooms because I had so many inquiries on subsequent procedures and I know people don't want to go to the front desk and ask about specific procedures in front of the lobby.

Nothing against a good ethical salesperson, I just find the loyalty of the patients is enhanced when they feel they are leading the process. And as I have stated before, an upsell only has value when it is a procedure THEY can benefit from. Upselling to get the money for something they don't need is a sure-fire way to lose clients and get the rep as a used car salesman, saying anything to get the 80 year old granny in that 'Vette.

Good Luck to you!