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Entries by Medical Spa MD (1203)

Sunday
Jan012017

8 Rules in Finding Patients (and Saying No!) in 2017

With 2017 coming up, more and new challenges are afoot in managing practice and performing cosmetic procedures. You may encounter new patients who have no idea about cosmetic procedures or get quirky ones who have jumped from one physician to another.

Before all that, here are three things to evaluate in the upcoming year.

Practice ways you can market

Marketing will always stay a crucial factor in getting patients. Whether you are marketing through word-of-mouth or social media (SEO), strengthen that further.

Not getting your desired results? Try a different approach. There are other marketing approaches other than basic marketing in social media. You could mix it up in other social media platforms. Read more about our Marketing Strategies in 2017 here.

Set your current policies and rules

This one deals with mostly updating your current guidelines to staff and patients; this is in dealing with new patients and caring for them. It could act as a refresher to old staff or new information for your new staff as well.

Organize a list

For what, you ask. Everything you do and will do in your practice, and now that you have probably figured out which services you want to keep, it’s best to know which new procedures you could do with existing ones. That includes updating your menu of services.

Promote services that keep your practice alive. Don’t let your old devices collect dust in the corner. Sell them while you still can or probably re-use them.

Considering having your staff undergo training? Enumerate it there. Do not only expand your experience, give them opportunities to make them grow.

Now that you have set-up, what about the new patients that would come in your office come 2017. The holidays are finally over, and they would need a new look over the new year. Some would come with the weirdest requests while others would come in without knowing anything. This is where you come in and educate them about what you offer and how you manage your practice.

Have a sit down with the patient and assess the situation objectively

Allow them to come to your office and listen to them. Ask them where they got the idea to get the new treatment. Once you have heard their story, discuss what options they have or recommend what other alternatives for their desired treatment.

Explain the expected outcomes (for their preference and of your assessment)

Many patients come in the clinic without expecting risk at all; most would think it would only enhance them. As their physician, it’s your responsibility to inform them of everything involved around their favored procedure.

For example, if their desired procedure or treatment is attainable in another way, offer that one instead. Spare no details of the risks and costs involved. This way, your patient knows the effects of undergoing the procedure, rather than leaving you with a bad review. Yikes!

Stand your ground

This comes hand-in-hand with the policies and rules you have prepared, and later we will briefly elaborate on saying no to your patient. Don’t be a pushover to your patient, and approach them as to how you will be performing the procedure without being aggressive either.

Remember to ask about their history

Patients may forget to disclose their past surgeries or physicians they have gone to, and from there you can determine how you could work out your process in treating them.

Get insight from past patients

Learn from your past and apply it in your present. You might think that this one patient was similar to someone you have encountered before, tell a background about how some patients reacted to the treatment.

Saying no can be a daunting task. Most aim to please their patients, which could be a factor to getting good reviews, but not all procedures and treatments are plausible or doable, as they pose risks to your patient and to your practice. In order to avoid that, politely apologize to avoid any misunderstanding from the patient; the prospective patient may not appreciate your initial turning down. Thus, elaborate why you will not perform the procedure, and how risky and costly it could be.

In doing so (and saying no), remember three things in mind.

Empathize first

Many patients would undergo a procedure just to enhance a specific area of concern, and this could be a valid reason. Some others would do it for other people, and not for themselves. Let them know that surgery would not be the immediate answer to their concerns. Instead, offer them an alternative.

Offer other options

Their procedure may not be attainable, offer alternatives as to how to achieve similar results or that would greatly benefit them. Another scenario is after you have assessed them, and recommend the treatment that would suit them best.

Stay firm

In the case where the patient is insistent on getting their wanted procedure, assert and assure that the options you laid out would be the safest. Emphasize how the treatment won’t be achievable. Remind them as a physician all you want to offer your patient is better care and services.

Sunday
Jan012017

Fillers in Men; Reshaping the Face of Masculinity

Fillers in Men

Guest Post by Dr. Ebtisam Elghblawi, an aesthetic dermatologist in Libya.

Dr. Elghblawi's interview.

Nowadays it is vital to feel confident, self assured and self content about the general look. Face and beauty is always appealing and pursuing beauty is one of the most deeply ingrained human drives as always and as ever.

It has been found that beauty is innate preference as they have noticed a three- months babies were staring for long on beautiful faces.

Over the recent years, demands for medical cosmetic procedures have growing by leaps and bounds, with an immense potential. It has been noticed that the number of patients who is receiving cosmetic has risen. Cosmetic procedures have dramatically increased in popularity over the past two decades in the USA and men newly represent a growing percentage of all consumers, beside women who still make up the main bulk of the filler market.

More than ever, males nowadays are seeking cosmetic procedures for various reasoning. They become more self-concerned and self-conscious to look their best in the impossible quest with the possible available non invasive ways.

This surge could be attributed to the pressure of the media, glamorous lifestyle magazines, and tempting television adverts and offers with movies promoting men’s trendy styles, baby “boomer” male, grooming appealing utilities, and fitness merchandise. This new trend is contributing to the rise of male aesthetic procedures in dermatology.

Men nowadays are much more open and proactive about their appearance and it’s not considered a taboo as it used to. And this can be explained to the reason of quick fix at lunch time with no downtime.

Some men will recognize particular areas of concern to combat, while others point out only the overall aging appearance.

Men generally are less price sensitive comparing to their counterpart women, and are difficult in making follow up appointment and more pain sensitive comparing to women. They want a less bruise work and pain free fix with easier administration.

Men differ from women when it comes to inject their faces, as different methods can be adopted due to the biological, anatomical and behavioural variation aspects.

Men have a squarer face, strong horizontal brow, a more angled and larger jaw, strong chin, and equally balanced upper and lower facial proportions. Thus feminizing men facial features will lead to patient’s dissatisfaction.

Any person per se is considered a piece of art, a sculpture, and herein we are creating an appealing exquisiteness. The face has divine measures. We have to look for an artist for each client faces to achieve what is desired. Also addressing patients’ main expectations and checking out realistic outcomes are the main goal in any successful aesthetic practice.

We have to hand men a large hand held mirror to appreciate and compare the treated and untreated areas.

In many instances some patients do have body ‘dysmorphia’ whereby they never appreciate nor see any positive outcomes even if it was merely subtle. It’s after all, patients own perception of their body and they could just make unnecessary troubles which we should ensure before any procedure to save the hurdles incurred after then.

The general joking says ‘the more fit men are, the worse they look, they look close to death’. As in fact heavy exercise causes fat to exhaust from a destitute area and build up in parts of the face where it conveys an ugly look for men. Many men want that quick subtle make over for their face to be probably ready for action.

In defining unique male characteristics we need to consider certain aspects in order not to feminize men. We have to emphasis on the masculine athletic look. For instance, the projected chin, chiseled jaw, and sculptured men jaw line, and the ‘alpha men’ are the preferable one. After all, men with wide angle, strong face and chin is the picture domain for most men.

There are different ways to approach men face with injectable fillers. In fact injectables are meant to shape the face subtly and not grossly without going under the knife.

Strong chin give the confidence look and adding 1-2 cm projection to the chin would imply as adding few inches to the actual height. In fact it gives the alpha men appearance. Also under eye darkness, bags, puffiness and hollowness would imply a tired look and adding little filler will give the rested and the super refreshed look and more youthful outlook.

Full face filler - subtle augmenting facial features treatment can be the right choice to approach after full face assessment. In fact small changes will give big impact and boost the self confidence and body image. Even nose hump correction, with the under eye, cheek, and chin augmentation would all reflect in one way or another with a positive attitude.

The ultimate aim is not to overuse and just aim to have a subtle favorable improved look. It’s in fact a combination between aesthetic and cosmetic reasoning to stay proactive and trendy.

It’s not favorable to augment men lips though some demand that in the western society in copying some celebrities. After all it’s everyone choice and should consider it from all aspects. However, pouty lips are considered to be sexually attractive by both men and women and certainly a feminine attribute. When augmenting lips in the male patient, under-correction is the rule to be undertaken.

Looking good is important to most people and everyone wish. Facial beauty can be defined by an amalgamation of factors that involve symmetry, visually pleasing and aesthetically pleasing geometrical proportion. After all, men are still only a small portion of most clinician’s total patient population.

The good about cosmetic injections that it offers immediate results with no downtime and thus a quick return to work after the procedure

Cosmetic dermatology continues to offer refined, improved, and new patient aesthetic treatments and desired therapies. Dermatology is a continuous, open-ended practice, and I always strive to perform the greatest procedures to my patients with the wish to enhance and improve the appearance of their skin. In many occasions, a new product and procedure doesn’t always live up to manufacturer’s promotion, expectations or advance reviews. My patient’s consulate me for advice about safety, effectiveness, and the painless performance of desired procedure, to keep them in the look they yearn for.

My greatest reward is when my patients are happy, and exceeded their expectations and improved their self esteem.

My patients in general, want to look younger, natural, refreshed, and vibrant, simply a better version of them and without any downtime.

My current driving passion is detection of skin cancer by the dermatoscope and applying my own skillful knowledge on cosmetic dermatology.

To come to an end, men who desire fillers have their own needs and anticipations. It’s important to optimize men satisfaction with the yielded outcomes. After all cosmetics are utilised to beautify, enhance attractiveness, and sometimes altering one’s look without affecting the underneath structure or functionality. And in order to optimize outcomes - cosmetic approach must be tailored for each patient individually and it’s important to have a proper understanding and a mutual communication to achieve the desired results.

Hyaluronic acids will keep on growing in both male and female patients, and the sole principles of the male face must be well-known as treatment goals in order not to feminize men. Furthermore, symmetry, steadiness, and an harmonious mix are the crucial objectives for delivering perfect treatment.

About the Author

Dr. Ebtisam Elghblawi is a Libyan-based Aesthetic Dermatologist. She is very much passionate in learning more about aesthetic medicine as she progresses in her career.

Submitting a guest post.

Thursday
Dec222016

Dr. Dore Gilbert - Newport Dermatology and Laser Associates, California

Dr. Gilbert is an Associate Professor of Dermatology at the University of California, Irvine. In this interview he shares experiences from his 30 years in medicine.

Dr. Dore Gilbert - Newport Dermatology and Laser Associates, California

Name: Dore J. Gilbert, M.D.
Clinic: Newport Dermatology and Laser Associates
Location: Newport Beach, California
Website: drdoregilbert.com

Brief Bio:

Dr. Dore Gilbert, former Chief of Dermatology at Hoag Hospital, is an Associate Professor of Dermatology at the University of California, Irvine. In practice for 30 years, Dr. Gilbert is the Medical Director of Newport Dermatology & Laser Associates, in Newport Beach, California where he specializes in Anti-Aging and Acne solutions through combination treatments of topicals, Lasers, Intense Pulsed Light (Fotofacial), Blue Light (Acne), Therma-Cool® (incision less face-lifts), Radiofrequency microneedling, and fillers such as Radiesse, Juvederm and Restylane®. In addition to cosmetic dermatology, he also practices general dermatology with an emphasis on skin cancer.

As a member of the International Society of Cosmetic Laser Surgeons, American Academy of Dermatology, American Society of Laser Medicine and Surgery and the American Society of Dermatologic Surgery, Dr. Gilbert lectures regularly and has published numerous clinical papers.

My practice is in Fashion Island, Newport Beach, Ca. We have 2 full time Dermatologist and a PA. I have 2 estheticians, 3 laser nurses along with front and back office staff. I have an office manager who oversees all the employees (18) and the office runs like clockwork. We offer both general dermatology and cosmetic dermatology. Approximately half the patients I see are general dermatology (which generates cosmetic patients) and the other half is made up of Botox, fillers, rf microneedling and lasers (CO2, IPL, 532 for telangiectasias, laser hair removal). We do over 100 laser procedures a month...

Click to read more ...

Wednesday
Dec212016

Dr. Jennifer Dunlop - The Capital Cosmetic & Laser Clinic in Austrailia

Dr Dunlop trained in medicine and surgery at the University of Sydney and undertook international post-graduate training in Practical Dermatology through the University of Wales, UK.

Dr. Jennifer Dunlop - The Capital Cosmetic & Laser Clinic, ACT

Name: Dr Jennifer Dunlop
Clinic: The Capital Cosmetic & Laser Clinic
Location: Australian Capital Territory
Website: www.capitalcosmeticlaser.com.au

Interesting: I pursue a variety of extracurricular interests that aide my technical skills of fine finger-eye coordination. I am a Friend of the National Gallery of Art, the National Portrait Gallery, the National Library, the Byzantine Art School, and subscribe to concerts performed by the Australian Chamber Orchestra, the Australian Opera, and The Brandenburg Orchestra. Amongst many charitable interests there are Medecin San Frontiers, Royal Australian Flying Doctor Service, Blind Dogs NSW, and Caritas Australia.

What can you tell us about your clinic and the demographic?

I established the first female led cosmetic medicine practice in Canberra, Australia in 1998. I am the Medical Director and directly treat all the patients whilst my excellent receptionist keeps the office running smoothly. Services offered include vascular, pigment and tissue laser, sclerotherapy, radiofrequency surgery for excisions and for skin tightening, CIT skin needling, microdermabrasion, chemical peels, muscle relaxation treatment, scar reduction treatments, dermal fillers, facial rejuvenation topical treatments, skin cancer checks and minor surgical procedures...

Click to read more ...

Wednesday
Dec142016

Dr. Kavita Beri - Beri Esthetique, New Jersey

Dr. Kavita Beri of Beri Esthetique shares her experiences and her way of managing her practice and staff in our interview with the physician.

Dr. Kavita Beri - Beri EsthetiqueName: Kavita Beri MD
Clinic: Beri Esthetique
Location: New Jersey
Website: www.beriesthetique.com

Brief Bio: 

Dr Beri is the Medical Director and founder of Beri Esthetique Skin and Laser Medspa ( BE Skin & Laser) Dr. Beri is a board certified physician. She is the Medical Director and owner of Beri Esthetique Skin& Laser Med Spa. She also holds the position of Adjunct Professor of Biomedical & Tissue Engineering At Rutgers State University. She is also a Visiting Scientist at the Center for Dermal Research At Rutgers University. Dr. Beri is an Editorial Advisor to the Future Science OA Journals a leading group of journals in the field of regenerative medicine.

Her area of focus in research is with plant stem cells and their influence on epidermal stem cells leading to skin wound healing, anti-aging, and hair regeneration. She has contributed to extensively to scientific literature, publications, and presentations nationally as well as internationally. She is an avid practitioner of yoga and holds a keen interest in how Yogic and Vedic philosophy may guide scientific.

How did you consider aesthetic medicine in your practice?

Anti-aging physiology has always interested me since I was in medical school. Body healing mechanisms and its innate regenerative capacity fascinated me. My vision for Anti- Aging was always having a more holistic approach and facilitating the skin's regenerative capacity for healing. A more mind body and spirit approach to skincare and anti-aging. With this vision in mind I opened a medical practice that geared towards cosmetics but having a very regenerative and holistic approach to it. Aesthetic medicine has a very “feel good approach” and “instant gratification” aspect to it. But it is always important that this effect is not temporary when the service is provided and the client goes home with a feel good chance that they are proud and feel more satisfied with the results.

Click to read more ...

Wednesday
Dec072016

Dr. Glynis Ablon - Ablon Skin Institute, California

The Ablon Skin Institute in Manhattan Beach is a single physician clinic where dermatologist Dr. Glynis Ablon provides a wide range of cosmetic care and research.

Dr. Glynis Ablon - Ablon Skin Institute, California

Name: Glynis Ablon
Clinic: Ablon Skin Institute
Location: Manhattan Beach, California
Website: http://abloninstitute.com/

Brief Bio:

Glynis Ablon, M.D., F.A.A.D., is a board certified dermatologist and cosmetic surgeon, who completed her training at Baylor School of Medicine in Houston, Texas. Dr. Ablon is an Associate Clinical Professor at UCLA, practicing at both UCLA and LCMH. She is active in clinical research and the first published author in the United States in mesotherapy. Dr. Ablon is an on-camera medical consultant for The Doctors Show, E! Entertainment, Extra, ABC, CBS, KCAL and Lifetime. She is a Fellow of the American Academy of Dermatology, American Academy of Liposuction Surgery, American Society for Laser Medicine and Surgery, and American Society for Dermatologic Surgery. Dr. Ablon also received the IMCAS Research Award 2010 for innovative research on Botulinum Toxins.

We got together with Dr. Ablon to ask her a few questons about her career and clinic.

Ablon Skin Institute, California

How did your background influence your journey to cosmetic dermatology?

I always wanted to be a doctor. My parents called me a “Red Cross Nurse” because I always wanted to help people. I loved the diversity found in dermatology from medical, pediatric and surgical dermatology, to cosmetic dermatology. It is nice to follow entire families through their lives. We can offer our patients a more full service clinic and lifestyle.

I really started in the cosmetic dermatology realm in my residency at Baylor with mentors like Ted Rosen and Leonard Goldberg, and lasers with Dr Moise Levy. I liked the challenge of difficult cases, but also making people look and feel their best, starting with my very first and most difficult cosmetic client, my mom.

You're in a LA which has to be a hyper-competitive market. What can you tell us about Ablon Skin Institute?

My clinic is located on the Manhattan Beach Studio Lot in Manhattan Beach, California, offering full service medical, pediatric, surgical and cosmetic dermatology.

I am still a very type A solo practitioner with a staff of 8 and an office that includes a research center of almost 5000 square feet. I oversee everything, but am good at delegating tasks. I think it is critical if you run a small solo practice to have good checks and balances. A good office manager can really lighten your load, but finding one that will do diligence evaluating office expenses to keep your overhead as low as possible can be challenging, so I do it myself.

Staffing is always and issue. How have you made that work?

Staff is probably the second most critical issue in a medical office (first being your talent as a physician). My staff is paid well; I give bonuses every year (and sometimes during the year, if they are performing exceptionally). I also offer 401K and profit sharing. If you have good staff you want them to stay, so you must be a great boss and offer competitive monetary compensation. I don’t like commissions because I don’t want my staff promoting things they don’t believe in just to make extra money. If my patients are happy, which means the office is doing well, then my staff is rewarded. I have individuals that have been with me for 5-15 years. If you have a problem employee, move on it quickly. Give them written warning, and then say goodbye; they can be a cancer in your office if you don’t.

You also have a lot of technology. What are your considerations before buying laser or IPL technologies?

I have 20 lasers in my office. I love new technology but it has to fit into your practice and patient population. Don’t just buy to buy. I test all technology before purchasing. I have only one laser purchase regret and it’s the one laser I didn’t test out before buying. I went along with a colleague’s recommendation and It sits in my storage closet. I love radiofrequency with microneedling. I still love my IPL and versapulse. Always look at the revenue you can generate from a laser against the purchase price. Always negotiate prices! I don’t like machines that are extremely painful even if results are decent.

Your thoughts on marketing?

I have been lucky to have some free media exposure early on in my career, so I have never advertised. I have recently started social media, as it appears to be the wave of the future and not going away anytime soon. I do charge for all cosmetic consultations. I don’t want looky-loos. If patients are willing to pay for consult they are more likely to do the procedure. We do apply our consult fees to future treatments, so it is not lost or wasted. I do believe word of mouth is still the best way to get new patients.

Are you looking to add any new treatments in the near future? Is anything on your radar?

I am always on the look out for new treatments, but I am extremely picky. It is important to try out new technology in your office to know how it works, how it feels, what’s the pain level, and who needs to run the machine. You don’t really want to buy just to have “the newest” technology but rather the best. And you must look at your specific patient population and what they need (you wouldn’t spend money on a new hair removal laser if you are treating the majority of light haired individuals). I think radiofrequency with microneedling is an amazing advancement. We can treat all skin types and don’t have the complications like lasers with pigmentary alteration.

What are things you've learned that you'd like to share?

You can’t please all of the patients all of the time! It is so important in this time of social media that you stay true to yourself. Do your best, and if you get a bad feeling from a patient before you start performing cosmetic procedures on them, don’t do it. If a patient comes in complaining about another good doctor you know, don’t treat the patient. And if your staff has a really bad feeling about the patient, don’t treat that patient. It will make your life less stressful, and I really believe less stress is the key to longevity both in life and the profession. This business can be life altering (I treated a patient with fillers status post brain surgery with a skull depression that hadn’t looked or felt normal in 6 years since her surgery, making her skull now a normal shape leaving her ecstatic), but it can also drain you if you don’t stay true to your self. Going to work doesn’t feel like a job because I love it so much, but I think that’s because I have found a great balance in work, home life and playtime.

It took my mom’s meningitis and near death experience and my own attack of facial paralysis to realize 5 years ago that I needed to be more serious about reducing stress. I wrote a book called What’s Stressing Your Face to teach others what I learned and how to better manage the environment we live in. My best advice is to find balance in your life. Work on lowering stress in every aspect of your life. Spend time with those you love, doing what you love. Surround yourself with great people, great staff and great friends who bring you up, and envelop you with love. Life is short, don’t waste a day not being happy!

About Dr. Ablon and the Institute

ASI Research Center is an independent clinical research site specializing in cosmetic and medical dermatology clinical trials. The Center was founded by Glynis Ablon, MD, FAAD in 2008. Dr. Ablon began her interest in research at Pomona College in the Genetics Department in 1990, and has expanded her research experience over the past 20 years culminating in the opening of ASI Research Center. The center has its own full-time staff and dedicated office within Ablon Skin Institute. Our research center is equipped with more than 20 laser systems and state of the art photography systems including Visia, Janus, FotoFinder Mediscope and Nikon Dermalite Macrophotography. ASI provides a full range of medical, surgical, and cosmetic dermatology services.

Wednesday
Dec072016

Millennials Are Starting To Hit Cosmetic Medicine

Millennials are now hitting the age where they're looking for cosmetic medical care... but reaching them requires a change in the way you're getting your message out.

Reaching Out to Millennials

Social media is a key factor in engagement. It has opened doors for physicians to update patients with the latest offers in the clinic or with the newest in the health world or by simply educating them about your specialty or practice. The power of social media would help you become an influencer, allowing you to be known across different channels and even through different generations.

Moz, an SEO company, released a series of infographics about generational use and reach of social media.

See them here: https://moz.com/blog/the-generational-content-gap-three-ways-to-reach-multiple-generations

According to some experts, physicians have difficulty reaching Generation Y (millennials). While many millennials are active in social media, physicians may have to step up their game in order to reach this demographic to garner more patients in their practice. Millennials have trust issues, and as physicians who want to reach Gen Y, you may need to build up your online reputation and website. After all, they're looking at everyting online via their smart phone.

If you're a single physician, make your name a brand. According to Forbes, Millennials are able to connect with companies better as a brand, so try to condense your popular procedures into 140 characters on Twitter. Another alternative to wordiness is visuals. So, put your name out there and differentiate yourself from the others.

If you're running a larger clinic, you can do the same thing with your clinic's name.

Reviews will remain important. Forbes also reports that Millennials trust reviews before getting into anything. It helps them discern if the cosmetic procedure is right for them or is too expensive and the risks that follow. Ask returning patients to give you reviews so that Millennials will be able to read about your treatments and the way you and your staff handle patients as well.

Lessen advertising. Advertisements sound the alarms on a Millennial’s head. This causes their trust issues to rise, and they . Don’t target their insecurities, target their possible needs. In addition to what they would need, elaborate further as to how this procedure could be beneificial and risky it could be. In that sense, you could have them consider getting the procedure and look more into it.

So physicians, what should be your 2017 strategy?

Change it up. Don’t stay on Twitter or on Facebook all the time. Try Instagram and Snapchat. According to most SEO experts, Expired Content—posts that last for only a few hours—would keep them curious or wanting more. If you are already established on Twitter or Facebook, go on live video to introduce products and services, show your whole practice, and flaunt your practice or clinic. It allows your audience to see how the clinic looks like and your staff also runs the practice.

Content is always essential. No updates could hinder your conversion strategy. Always have relevant content on your blog and your social media channels. Churn out significant content. Remember, there is a difference between spamming your followers and posting regularly.

Ask returning patients to follow and mention you. This is important, because in this regard you can retweet or like their posts and some of your followers will be able to see that.

Educate and inform. To establish yourself further on the social media front, you will need to post educational content about cosmetic procedures. This way, your patients know what to expect and at the same time see you as their reliable sources.

Tuesday
Dec062016

Dr. Michael Gold - Gold Skin Care Center, Nashville

With 30 years of cosmetic dermatology experience Dr. Gold shows no signs of slowing down as he continues to grow his Nashville practice.

Dr. Michael Gold is a cosmetic dermatologist in Nashville Tennessee who was kind enough to sit down for an interview and give us his insights into how he runs his clinics, what technologies he uses, and what he's learned.

Dr. Michael Gold - Gold Skin Care, Nashville

Name: Michael H. Gold, MD
Clinic: Gold Skin Care Center
Location: Nashville, Tennessee
Website: www.goldskincare.com

You've been working in this area for quite a while. What made you pursue cosmetic dermatology and aesthetic medicine?

I actually got started thinking about dermatology and aesthetics when I was 16 years old due to a bad case of acne, that I had when I was a young man. My dermatologist was Dr. Albert Kligman who invented Retin A and I was one of his first patients he placed on this medication. It was a strong formulation and within a week I had peeled the equivalent of today’s medium depth chemical peels. My skin was really smooth after that, and I thought - derm is the route I want to pursue in medicine. In my residency - actually my first day, I did a hair transplant with Dr. JB Pinski and the second day I did a liposuction procedure with my chairman Dr. Henry Roenigk. Dr. Roenigk was keen on cosmetic dermatology and instilled this love for aesthetics and surgery into me. I learned much from him and my other professors at Northwestern during my time there - especially from Drs. Jerry Garden, Ruth Frankel, and June Robinson. When I finished my residency I moved to Nashville, TN where I began seeing lots of patients interested in cosmetic concerns. This, along with my love of dermatology in general, helped propel my career in this field.

I was very fortunate to have played a role in the use of topical silicone gel sheets for hypertrophic scars and keloids and was part of the team that helped bring topical ALA into the US for not only AK use but for rejuvenation of the skin as well. I have been involved in lasers and light sources for years and had the first dedicated IPL for hair removal, which became a popular method around the world for hair removal. And I have played a role in absorbable suture technology for skin lifting.

Cosmetic dermatology has been very good to me - and with hard work and determination it can be for anyone who so desires.

You must have learned a little something about what you want as a work-life balance overseeing what is really quite a large clinic. What can you tell us about how you run your clinic and how it's organized?

Our clinic is very efficient - at least we like to think so. We have about 25,000 square feet of space all under one roof. We have many facets of our business and we have proven leaders who help oversee the various parts of our puzzle. We have a general dermatology area with 22 exam rooms that is staffed with 3 mid-level providers and myself. We have a medical spa with a dedicated aesthetician staff who perform services and sell skin products - which number about 500. We have a dedicated laser and rejuvenation center with their own dedicated staff where cutting edge treatments occur with either energy based devices (n=43) or with one of the injectable products we use. And we have a separate, dedicated research center, staffed with trained and outstanding nurses - all certified research professionals under my guidance. We have recently just added one of the most respected plastic surgeons in the US, he is now focusing his attention on hair transplants.

We have a staff of almost 50 employees and they are coordinated by our COO and CFO, Ms. Amy Anderson and for the research department we have Ms. Julie Biron. Amy uses department managers to assist her in the daily operations of the practice, which has been estimated by some to be one of the busiest practices anywhere in the nation. Our patient population varies from day to day but on average between 200 and 250 people pass through our doors daily. Patients come to us from all over the region and from most states in the US as well. Because of my international travel, we have visitors train with us on a regular basis and teaching these young and eager students has been some of the most rewarding work we have done.

A clinic that large, with that number of patients every day, is some serious work... It had to take some time to build out. How do you manage your team?

At the beginning it was easy - find the best of the best and pay them more than anyone else. But most importantly, treat them with respect and allow them to do the work that you hired them to do. Do not micromanage your senior staff - trust them to have your best interests at heart, and have the proper checks and balances in place to make sure that things run smoothly and efficiently.

We do use commission for our spa staff - shared amongst them so not to have a competition for each and every patient who comes to our spa. This has worked for me and therefore we have used this plan the longest.

Which technologies - IPL, lasers -  are you using in your practice and how do you decide what to buy?

I may be a little different when it comes to IPLs and how we use them and how we decide to get them into the clinic. I had the second dedicated IPL for vascular lesions way back when and had the first dedicated IPL for hair removal after that. Which means that we have been working with IPLs for over 23 years now. Our clinic, along with a few others, studied and worked through the parameters to make what we now have - safe and effective and reproducible IPLs. When you decide to purchase an IPL make sure that it has a squared pulse, contact cooling, and sophisticated software parameters. The major device companies all have great IPLs - we usually stick with Lumenis, Syneron, Alma, Venus, and Sciton - where we have devices from. These are well made, well studied IPLs that one can surely trust.

Technology purchases are run through the committee in my office - I want everything so we have my office COO and CFO who must sign off on anything I want, which means we only get what we need. You don’t need devices sitting around and collecting dust - you need them to be productive and used on a regular basis. If we buy a new device today, we try to set a time line as to when that device needs to be paid off for us to be successful. It works most every time, and makes us concentrate on the task at hand.

What can you tell us about your marketing strategies?

Marketing has changed over time and I do things a lot different than I did when I first started in practice 30 years ago. Now things like social media are key to getting the message out there and we do use social media to spread the word and advertise what we are doing in our clinic. I think intrinsic advertising - using your own data base for advertising is the way to go today and having means of getting referrals from patients and colleagues as well. This is where we are today, plus newsletters and e-mail blasts and signs in the office.

In the past we used a lot of print advertising which at the time made sense - it really does not any more.

The other thing that we did 30 years ago was to be very involved in the community and we attended almost every charity event in town which was a great way to meet people and to determine which charities and causes would shape our giving’s over time. We still participate as often as we can and our community has been incredible kind to us over these 30 years.

Where do you see the aesthetic market going? Which treatments are the most popular?

Everything we do hopefully is profitable. As I said, we value our purchases and try to have them paid off in a specific period of time to make sure that profit starts at an appropriate time. If you buy a 100K machine and use it once a year, it is not going to be profitable. If you use that same device 5 times a day, then it is a different story.

My most profitable device at this time is the Aerolase Neo - I have a large acne population - as you can tell from question one - and we use the Neo to treat acne painlessly and successfully. It can be used for many indications but for us acne is number one.

But every procedure needs to be profitable and I am happy to say that almost everyone is in our clinic.

You've undoubtedly seen a lot running a large clinic with thousands of patients. What have you learned, and what advice would you give to other physicians?

I have learned much over these past 30 years. I have learned that my best friends do the same things that I do - David Goldberg, Mark Nestor, and Mitch Goldman. All of my mentors and friends taught me to be ethical and honest, to work harder than anyone else, and to give back to my specialty whenever I could. And hopefully the examples I have set for some of my mentees over the year have shown that drive, determination, compassion, and skill make for the best cosmetic practitioner and dermatologist.

My advice to others is real simple - learn your craft well, treat it with respect, and always put the interests of your patients above your interests.

We are blessed in what we do and we need to remember this each and every day.

Gold Skin Care Center Nashville - Staff

About Dr. Gold

Dr. Michael H. Gold is the founder of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center, and Tennessee Clinical Research Center located in Nashville, Tennessee. Dr. Gold is also a Clinical Assistant Professor at Vanderbilt University School of Nursing and an Adjunct Assistant Professor at Meharry Medical College, School of Medicine, which is also in Nashville. He is a Visiting Professor of Dermatology for Huashan Hospital, Fudan University in Shanghai, China (11/2006), Guangdong Provincial People’s Hospital, Guangzhou, China, as well as a Visiting Professor of Dermatology at Number One Hospital of China Medical University (11/2008) in Shenyang, China.

Dr. Gold is a board-certified dermatologist and cosmetic surgeon who oversees the various facets of the Center’s operations: a combination of medical and surgical dermatology, cosmetic dermatology, aesthetic services, and research endeavors. Dr. Gold has earned a national and international reputation for providing patients with leading-edge technological advances and has expertise in all facets of dermatology and aesthetic care. The Tennessee Clinical Research Center is now one of the leading dermatologic research institutions in the U.S.

Dr. Gold speaks on national and international fronts, focusing on dermatology issues related to the use of lasers and energy-based devices, as well as the use of fillers and toxins in aesthetic and cosmetic dermatology. He lectures in venues around the world and is a sought-after contributor to educational meetings globally.

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