A question about American Laser Clinics business model was posted in the tread: American Laser Clinics: Armed guards and threats.

BetterOffNow posted the following in reply:

They actually have two models, one for franchises"licensee clinics" and one for company stores.
When they purchased Advanced Laser Centers they absorbed their franchises and made them buy the rights to use ALC's name.
The licensee clinics have not done well for the company and they stopped licensing new clinics as far as I can tell. They really don't seem to offer them any support.
I'm not really sure on all of the specifics of their business plan, but the doctors are considered by the company to be their employees.
So ALC will go out and recruit or many many MD's and DO's contact them to become a "Medical Director". ALC will rent out a stand alone clinic or rent a space from the medical director.
They do check the licensing requirements of each state that's why you don't see any ALC clinics in NJ which has very tough rules about who can perform laser.
The rent they pay is pretty low,if you notice they don't seem to be in high rent buildings, maybe a few thousand per month.
They pay the MD $4K monthly and the biggest expense after that is equipment, but they have many agreements with Syneron so they aren't paying as much as everyone else does for their lasers. There was an attempt at legal action against them for creating a monopoly about 18 month sago but ALC won the anti trust suit.
If the clinic is a startup, it usually operates with a skeleton crew, 1 manager, 1 FT tech maybe one PT. they expect a new clinic to be producing 60K per month after 3 months,manager's get the axe if their clinic is not producing. No discussion, no negotiation.
They prefer the MD's not to get in the way, I think I talked to my medical director maybe once every 3 months or so.
ALC ia basically a very revenue driven company, and they pretty much try and steamroll over any opposition to their plans.
They operate their clinics in an atmosphere of fear, even my medical director was afraid of them.
Once about 3 years ago, a clinic manager in NY, wasn't feeling well. She was too intimidated to take time off to recover, and didn't want to ask to take an hour off to go see a doctor.
There was a strongly worded manager's conference call about slackers who called in sick because it was the end of the month and big numbers had to be achieved.
Well to make a long story short, that manager called her clinic in the morning and said she was still really sick but she would make it in later that morning. She never showed up and when her assistant manager was able to go to her building and get the key they found her dead. Literally worked to death.she was all of 28. RIP. Like I said - I'm Betteroffnow

For the physicians I've seen this work out extremely poorly. It's the doctors medical license that's at risk and they're always the ones sued first by unhappy patients since they're the ones providing medical oversight. For $3k a month for something you could do yourself it's just not a great deal. The pitch to the physicians is that they'll drive so much traffic into your other clinic that its a great deal. But what I've seen in practice mirrors what's stated above. American Laser tries to distance themselves as much as possible from physician involvement.

I find it interesting that they couldn't make their license agreement work. I guess it's just a lot easier to sell medspa licenses and franchises than it is to support the franchises.