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Entries by Medical Spa MD (1210)


Laura Carlsen, RN - Colorado Skin & Vein Center

Vice President and Clinical Director of the Colorado Skin & Vein Center, RN Laura Carlsen proves to be an all-around cosmetic provider.

Colorado Skin & Vein Center provides a wide range of services from clinical dermatology (provided by a physician) to cosmetic care (provided by an RN), a common strategy. In this interview Laura Carlsen RN discusses her work and path to a successful career and business.

Colorado Skin & Vein Center

Name: Laura Carlsen, RN
Clinic: Colorado Skin and Vein Center
Location: Englewood, CO

Brief Bio:

I graduated from Northern Illinois University in 1989 with a marketing degree. After graduation, I sold IBM electric typewriters, computer maintenance contracts and Aveda skin care. In 1990, I started a home-based business performing facials, microdermabrasion and waxing treatments. I ran that business for 13 years, before graduating from the University of Colorado Denver with a nursing degree in 2009. As a Registered Nurse, I went to work for Colorado Skin & Vein (which was previously known as Colorado Center for Photomedicine) where I have proudly worked for eight years.

What sparked your interest in cosmetic medicine?

When I went to school to become an RN, it was with the intention to stay in the cosmetic industry. I loved doing facials and skincare but wanted to expand on that knowledge. I was doing a lot of acne facials and had several patients ask me about blue light. I knew then that I had to know more about what was available and how I could be involved.

What can you tell us about the clinic?

For eight out of the 11 years that Colorado Skin & Vein has been in practice, we operated with one doctor, one nurse (myself), and one to two support staff. Sometimes we had an esthetician, yet oftentimes we did not. We went from a 2500 square feet space in Highlands Ranch to our current building at I-25 and County Line with over 20,000 square feet. We occupy the top floor and rent out the bottom floor. Our staff has grown to 10 full-time and a few part-time employees. We have three main areas of focus: Dr. David Verebelyi, who does vascular treatments (leg veins, facial veins, port wine stains, etc.), Smartlipo and CO2 resurfacing.

Dr. Kimberly Neyman is our dermatologist and dermatopathologist, and I am the clinical nurse manager who oversees all the aesthetic treatments in our office. The areas that I manage include: Botox, filler, Kybella, cosmetic sclerotherapy, tattoo removal, hair removal, Genesis, IPL, PDL, CO2 for stretch marks, and chemical peels. Our patient population is diverse due to the multitude of services we provide. The cosmetic side is dominated by females in the 30-60-year range, but veins and dermatology attract a more equally mixed ratio of male to female clientele.

As a hiring manager, how do you manage staff?

I am personally involved in most of the hiring. The one thing we found that has worked very well in our favor is doing working interviews. We begin by doing phone interviews, progress to face-to-face interviews and then take our top 2-3 candidates and have them spend a day with us. This allows us to see how they interact with our clients and staff, to see what type of questions they ask and to see if they offer any insight into our current way of doing things. This has dramatically changed who we extend offers to and the culture of our practice. We currently have a staff that we truly love and that are passionate about being here.

The cosmetic providers receive compensation in the form of a base salary and commission based on profit. We used to do it based on revenue, but found that it made sense to the office and provider to focus on profit. When the business makes money, the provider makes money. The front office staff also receives a base or hourly wage, plus commission. Each employee’s commission may be based on increasing production totals, or collection levels, and each year we review their commission structure and decide what to focus on for the coming year.

Which technologies do you usually use in the clinic?

We have a lot of technology in our office which includes: Cellfina, Ulthera, Smartlipo, and CoolSculpting. We use the Lumenis FX for our CO2 procedures and for IPL, Nd:Yag and Genesis, we use the Cutera Xeo. For laser hair removal, we use the Cynosure Apogee Elite and the Lumenis LightSheer Duet and we can treat all skin types. The Lumenis Fotona is used to perform tattoo removal and for superficial vessels, we use the Candela Pulsed Dye Laser.

We are very cautious with how we buy equipment. Years ago, you would buy a machine and own the right to use it. Today, companies like Ulthera and CoolSculpting require disposables or cards to operate. When CoolSculpting came out with the Cool Mini, we had to evaluate whether the $10,000 new hand piece would generate enough business to justify its cost. Since we offer multiple modalities, we had to ask ourselves “could we treat those same areas with Kybella or liposuction” and “could we offer better results than the Mini?”

We never want to be put in a position that we must sell something because we are trying to recoup our investment. We currently do not have the Mini hand piece, but we will constantly revisit this decision as demand grows.

What ways do you get the word out for new patients?

Converting a new patient is always more expensive and time consuming than obtaining more business from a current patient. We try to focus on what our patients want and what they are asking for and we enjoy offering two annual parties per year. One focuses more specifically on new equipment or offerings, while the other is more of a patient appreciation party. Our patients look forward to these parties and enjoy the education, specials and goody bags they receive at them.

As for advertising, we often test the waters. We will try an avenue such as print media and track how many calls came based off the ad. If we don’t see our money back, we don’t continue our business with them. Over the years, we have tried billboards, radio advertising, local print media and community events. While advertising a procedure, like CoolSculpting, can generate some interest, we found that when other practices advertise, it helps drive business to our practice also. Often patients will hear about a procedure they are interested in and then Google to see who offers it at the most convenient location.

Which equipment do you think would be helpful in the practice?

We are currently excited about Cellfina and are planning to see a good return on investment. The research is very good and the patient satisfaction is very high, even after 4 years. We also do very well with CoolSculpting and sclerotherapy. We used to offer facials and microdermabrasion treatments, however, we have dropped those offerings as the profit margin was low. We are considering adding miraDry to our practice.

Can you tell us about any encounters in your eight years of working in the clinic?

I always try to meet or exceed expectations, and I often turn patients away if I don’t feel we are a good fit for each other. Even with that said, you cannot hit a homerun 100% of the time. For instance, I just finished a follow-up appointment with a patient who had recently visited a plastic surgeon for a facelift, but ultimately decided she did not want to have surgery. She wants lift in the cheek area but is cautious. We did Botox and one vial of Juvederm UltraPlus split between both cheeks. Normally, I would have done Voluma, but the patient wanted a natural lift that would perk her up a little and money was tight. I was concerned that doing such a small amount of filler would leave her unhappy as it would not be enough product to lift her cheeks significantly, yet she assured me she would be happy with trying anything.

Now, two weeks later, patient feels she is too full in the cheek area. The photos are beautiful. One half vial of Juvederm in the cheek of a 54-year old woman cannot possibly be too much filler. At the end of the follow-up she asked me to do filler on her jawline, but also stated that she didn’t want it to look any fuller. I told her I could not meet that expectation. I had her take a picture of her before and after on her phone so she can remember what the service did for her and perhaps also get advice from family and friends. As hard as I tried with conversation and showing before and after photos, somewhere the communication was not clear enough that filler will provide a more volumized look. It reminds me to keep attempting to be as clear as possible.

What advice can you impart to physicians or to any provider that is in the aesthetic business?

The best advice I could give is to take great before and after photos and to listen intently to what the patient wants. In the above story, if I had not taken photos, I may have believed that I made the client look worse than before they came in.

About Laura Carlsen, RN

Armed with a Nursing degree and a certificate of Registered Nurse, Laura went to work for Dr. Verebelyi in 2009. Laura has been able to contribute to Colorado Skin and Vein by writing protocol and assisting in surgery, learning laser safety and parameters, taking over the injectable practice, training and overseeing estheticians, and being responsible for all clinic supplies. The number of Botox patients has tripled in the last few years and her filler numbers put her practice in the top 6% in the nation.

Laura’s passion is in helping people to look younger and better, but not “done”. She prefers a conservative, natural approach. Because of her dedication to the long-term care of her patient’s skin, she still retains many of her original clientele from Secret World Day Spa. If you have an interest in perking up your looks but are not sure what to do, meet with Laura for a complimentary consultation. Her expert eye combined with incredible training from some of the top injectors in the world, will have you smiling in no time.


Help us decide what to build into Medical Spa MD!

Take the 1 minute survey below and let us know what you want most. Then we'll build it.

From time to time we reach out to the community to help set the agenda and uncover what is uppermost in everyone's mind. This is one of those times. The button below launches a quick, multiple choice survey to get your opoinion and thoughts on what you're most interested in so that we can focus on providing that information. Take a moment and share.

This survey should take you about 1 minute to complete.


Marketing Strategies to Retain in 2017

Here's where you might look to focus your marketing and advertising efforts from the experts at

Like with any other retail, direct-to-consumer business, cosmetic medical practices need to be exposed in the digital world as there is a shift with marketing online. After all, 90%+ of your potential patients will start their search for a provider solution online, even if you're local and well known.

So, what do you do?

The first step is understanding that you have two different types of marketing; farming and hunting.

Hunting-marketing is what you're doing when you're buying advertising. It can work, but once your ad run is over, you're pretty much done.

Farming-marketing is somewhat different. Farming demands some work up front, but there are benefits that accrue long after that work is completed. Things like SEO, patient referral programs, customer service, front desk videos and other areas touch more of farming than of hunting. The main difference with farming is that you often own the distribution platform rather than just renting someone elses expensive space. The challenge with farming is that it's often not a quick-win but performs more like compounding interest.

There's need and a place for both.

Social media is [STILL] one of the best areas to get in front of potential patients

Social media is going nowhere. Almost everyone is hooked on their phones, stuck on their social media accounts finding something new or posting updates. Twitter, Facebook, Pinterest, and among others can be used as an avenue to get new patients. With the right hashtag and relevant content, you can access new patients. Make sure that your content is new and up-to-date with the current technologies and procedures available to patients.

As for your present pool of patients, you can always show them your newest procedures or convince them you are still their go-to physician. New technologies and procedures are created and developed every year, and you could show your patients that you offer those that would help you in your practice. Not only that, people would see you as an expert of new methods in cosmetic medicine and you are constantly learning to improve your practice.

The goal here is to add value so that you're not muted. If the only thing you ever do is hard-sell your services or blather on about how great you are, well, you're stuck in first gear. Get your head out of your ass and figure out how you can serve your patients by teaching them something that they didn't already know, and that they value in some way.

It's not about you. It's always about the buyer.

Keep your website updated

This is crucial with any business since search and your rankings are critical to the top of your marketing funnel. If you keep your site the way it went live the first time a few years ago, it may not look good, and the search engines can see the tumbleweeds blowing across the page. (They don't like that.)

Internet users want to look at a modernized site that has a quick loading time and is easy to use and navigate... AND it's critical that it works on mobile devices, especially phones. Do not forget to update not only the look of your site, but also the information housed in the website. You do not want an old telephone number or a defunct email address on your CONTACT US page that may cost you your new patients.

Update your site regularly... meaning that you should have some content that changes every week or so (which is why blogging is so effective).

Positive reviews

This is the lifeblood of every doctor. Reviews help new patients discern if the physician would be the right fit for them. Teresa Iafolla of eVisit says that you may need to urge and encourage your patients to write reviews about you, your clinic, your staff, the procedure and anything else. Put them up on your website or broadcast it over your social media accounts, chances are patients will find them.

Beware of posting fake reviews or 'buying' reviews online. If you get caught the search penalties can be pretty severe.

These are simple tips that you may have to apply on your website or social media accounts to build your online presence further. You don’t even have to pay for these strategies either. While these are simple, it could go a long way. Do not forget these tips and it may help boost your revenue and sales.

If you have any questons, visit us at and fire off a question. We've been growing cosmetic medicial clincs and medspas for more than a decade and will be hapy to help.


Dr Elias Tam - EHA Clinic Shaw Centre in Singapore

Dr Elias Tam's interest in cosmetic medicine sparked because of his patients needs and is guided by a simple philosophy.

Name: Dr Elias Tam Dr Elias Tam - EHA Clinic Shaw Centre Singapore
Clinic: EHA Clinic
Location: Shaw Centre, Jurong West, and Toa Payoh

Brief Bio:

I am involved in several medical societies. This includes being a committee member of the Society of Men’s Health of Singapore, and in the International college of Surgeons(ICS). I am very humbled to be accepted as a Fellow of ICS being a non-surgeon, and even more overwhelmed to be elected the President for the Singapore Section. At the international level of ICS, I am also the Honorary Secretary of the Pacific Federation, Honorary Secretary of the Cosmetic-Aesthetic Specialty and member of the International Executive Committee. I have also started a Cadaveric workshop since 2010 and invite the best from different disciplines to teach our fellow doctors. The unique opportunity to refresh our anatomy through dissection and confirm that we are injecting into the correct depth/compartment cannot be over emphasized.

What made you interested in branching out to cosmetic medicine?

After starting my first clinic in 1998, there was constant request for treatment of skin problems such as acne, wrinkles, hair loss, pigmentation and tattoo. To take better care of my patients, I went to attend various trainings in laser treatment, filler injection, or surgical techniques such as hair transplant. The term Cosmetic Medicine or Aesthetic Medicine was unknown then. Legally speaking in Singapore today, we are classified as General Practitioners with a special interest in Aesthetic Medicine. Cosmetic/aesthetic medicine does not belong exclusively to...

Click to read more ...


Dr. Steven Ang - Steven Aesthetic and Laser Clinic, Orchard Road

From injecting earlobes for good luck to training other physicians, Singaporean Physician, Dr. Ang has a number of interesting stories to share.

Dr Steven Aesthetic and Laser Clinic, Orchard RoadName: Dr Steven Ang
Clinic: Dr. Steven Aesthetics and Laser Clinic
Location: Orchard Road, Singapore


Dr Steven Ang started his private cosmetic medicine practice in Singapore in 1998. The same year, he became a member of the International Union of Esthetic Medicine, and in the process, introduced the term and concept of esthetic medicine (cosmetic medicine) locally. He was one of the pioneer cosmetic doctors in laser medicine and surgery, intense pulsed light, botulinum toxin and dermal filler injections in Singapore. In the past, he had been a trainer in botulinum toxin injections. He had developed the course syllabus at a local beauty school. He was a member of the Beauty Task Force, a committee set up by the Consumers Association of Singapore to look into objectionable practices by beauty salons and consumer complaints in Singapore in 2002.

Which factors played in your journey to cosmetic medicine?

I was exposed to using lasers for skin treatment in 1991 while working at a clinic. In the process, I saw a big market potential for cosmetic medicine.

As a teenager, I suffered from severe acne. One of the nasty remarks made by a former classmate that stuck in my mind was: “Your face looked like excreta.” Later, I managed to treat myself and regain confidence. This motivated me to want to help others. My favorite tagline is “Sculpting Beauty, Creating Happiness”.

I graduated with Bachelor of Medicine and Surgery degrees from the National University of Singapore in 1987. I sought further training at the renowned St John’s Institute of Dermatology in London and obtained my Master of Science degree in Clinical Dermatology from the University of London in 1994.

In the early days, there was no formal training for cosmetic medicine. I enrolled at a local beauty college that offered diplomas from the United Kingdom and Switzerland. I learnt the practices of an esthetician. In 1998, I became a member of the International Union of Esthetic Medicine (IUEM), which was based in Europe.

I started my private cosmetic medicine practice in Singapore in 1998, and through my membership with IUEM, introduced the term and concept of esthetic medicine locally.

Slimming and body contouring are another aspect to cosmetic medicine. To learn more, I undertook the clinical and oral examinations conducted by the American Board of Barriatric Medicine (now renamed as the American Board of Obesity Medicine) in 2002.

I now practiced at two locations, in Orchard Road and Redhill. We offer a full range of esthetic services. Our staff strength is 13 personnel. We serve thousands of patients each year.

Every cosmetic physicians has stories. What stories can you share with us?

One thing I learnt about practicing cosmetic medicine is unpredictable situations can arise and you must learn to respond. Once, I have a Chinese patient who consulted about getting dermal filler in his earlobes. According to him, a bigger earlobe will attract fortune and ensure a long life. Being Chinese myself, I know that these ethnic physiognomy beliefs are real. Therefore I proceeded to treat him.

As an experienced physician, what can you advise your fellow doctors in cosmetic medicine?

Over the years, I have learned that there are several critical factors that can contribute to the success of a practice...

Click to read more ...


Dr. Mohiba Tareen - Tareen Dermatology, Minnesota

Dr. Mohiba Tareen - Tareen Dermatology, Minnesota

In our interview with Dr. Mohiba Tareen, she shares her views about staffing and running a successful dermatology and cosmetic practice.

Name: Dr. Mohiba Tareen
Clinic: Tareen Dermatology
Location: Minneapolis, Minnesota

Dr. Mohiba K. Tareen is a board certified dermatologist and dermatologic surgeon. She serves as medical director for Tareen Dermatology, a full service medical, surgical, and cosmetic dermatology practice located in Roseville, Minnesota. Dr. Tareen is proud to be the mother of 4 young and active sons.

About Tareen Dermatology:

Since its inception in 2011, Tareen Dermatology has provided high quality dermatologic care to thousands of patients in the Twin Cities and suburbs of Minneapolis and St. Paul. Dr Tareen trained at University of Michigan in Ann Arbor and Columbia University and also worked at a number of high profile New York City Dermatology practices prior to relocating to Minnesota. The Tareen Dermatology aesthetic practice began as a natural extension of the dermatology practice. It has now grown to employing 5 aestheticians in 2 different locations as well as a total of 4 physician assistants and 40 support staff members (clinic administrator, receptionists, clinical assistants, pharmacy staff, etc).

As a dermatologist, what sparked your interest in cosmetic medicine?

Dermatology and aesthetic medicine are complementary. I trained and worked in New York City for several years before moving to Minnesota. Patients in the midwest were surprised by the minimal and natural approach that I brought to toxins, fillers, lasers and skin care. The practice has grown tremendously as patients know that I will recommend simple and cost effective interventions that will enhance their youthfulness and beauty, while keeping them natural.

Tareen Dermatology prides itself as a comprehensive practice that cares for all aspects and ages of skin and health. I am proud to care for 3 and 4 generations of patients. From a cosmetic perspective, this may translate to chemical peels for a teenager with acne, filler/botox for a middle aged parent, and full face laser resurfacing for the grandmother to rejuvenate the skin. I also care for all of their medical needs.

As the physician, I form the center of the wheel. My four physician assistants work with me to provide excellent medical care. Our aestheticans perform procedures and consults. Our medical assistants make sure patients are comfortable and all their needs are taken care of. I surround myself with the best- a patient recently remarked that Tareen Dermatology is like "Dermatology Disneyland" as we really have such a happy office!

Can you tell us more about you think of and use your staff?

My rule is to always over-staff. My job is much less stressful if we have enough staff. When I enjoy my job, everything always runs more smoothly! Also, I have learned that, these days, most staff only work at any given place for a few years. I used to take it personally when staff left, but now I have changed my perspective and try to feel fortunate that I was able to have a skilled individual for a few years. Most of my staff keep in great touch and it is exciting to see the great things that they go on to do.

You've got a number of lasers, and in some cases more than one of the same kind. Can you give us a run-down of the technology you're using?

We have three Excimer lasers for Psoriasis, three vascular specific lasers, 2 Candela Gentlemax units for hair removal and deep vascular lesions, a fractional and non fractional CO2, 2 coolsculpting machines, and we just purchased an Enlighten laser for tattoo removal!

In general, I prefer specific lasers, not IPL modaliies, as I feel they deliver safer and more predictable results

Most of your marketing is word-of-mouth and based on your exisiting dermatology patients. Is that so?

Our marketing is almost completely internal. We are fortunate to have an audience of 150- 200 dermatology patients who trust us who come into our office every day as well as patients who spread the great work that we do.

My time is money- so the services that I do not have to perform directly- coolsculpting, vascular laser, laser skin tightening, and laser resurfacing- are the most profitable. I still do filler and toxin personally so I always struggle as I likely could make more money seeing medical patients during the time it takes me to do these procedures. However, I do enjoy the artistry and patients love my natural approach!

As a dermatologist whose practice is not entirely cosmetic, what have you learned about practicing cosmetic medicine?

In a medical and cosmetic dermatology office, often the lines can be blurred. Several years ago, we did a full face CO2 on a wonderful patient who had many medical and cosmetic procedures in the past. As she was checking out my assistant presented her with the $2,500 charge. She was confused and said, "Oh, I thought this was medical and we were doing it for my pre-cancer spots!" This taught me that I need to always draw a line between medical and cosmetic. Now, PRIOR to procedures, patients sign a form delineating their charges.

What advice can you impart to your fellow dermatologists or physicians?

Ironically, I was against the significant growth of my aesthetic practice. I thought that it would take away from the legitimacy of my very successful medical and surgical dermatology practice. I resisted the growth and purchase of expensive lasers. My husband, a urologist and my business manager, encouraged me. He said "Mohiba, people know you do good work. They are going to other places now and not getting the results they desire." My husband was correct, and our practice has grown exponentially. I think that if people know you do great work medically, aesthetics is a natural extension. I wish I would have grown my aesthetic practice sooner!

About Dr. Tareen

Dr. Tareen completed her dermatology residency at Columbia Presbyterian Medical Center in New York, New York. During this time, she also lectured extensively and had her work published in a number of prestigious medical journals, including The New England Journal of Medicine. In addition, she was awarded the Conrad Stritzler Award of the New York Dermatological Society while a second year resident.


Dr. Renier van Aardt - NS MediSpa and Vitality MediSpa in Truro and Halifax

Opening a medi-spa was a natural extension of Dr. Renier van Aardt’s passion for medicine, beauty and helping people. He began practicing family medicine in Canada in 1993, and now spends much of his time in the practice of cosmetic medicine.

Dr. Renier van Aardt - NS MediSpa and Vitality MediSpa Canada

Name: Dr Renier van Aardt MB,ChB,CCFP
Clinics: NS MediSpa, Vitality Medi-Spa
Locations: Truro and Halifax Nova Scotia Canada

Brief Bio:

Graduated with degrees in medicine and surgery in 1991 from the University of Stellenbosch, South Africa. Practiced Family Medicine and ER medicine in Canada from 1993 to 2004, Canadian Board Certified in FM. Started doing laser and cosmetic medical procedures in 2000 & transitioning full time in 2004. Now the Medical Director of 5 clinics in NS, NB & ON, President of the Canadian Association of Aesthetic Medicine and a fellow of the ASLMS, teaching and speaking nationally & internationally, authored 2 chapters for Elsevier and contributing to journal articles for Aesthetic Medicine, many TV and radio interviews.

When you were in South Africa you were a surgeon. What led to your switch to cosmetic medicine when you moved to Canada?

After leaving South Africa for Canada I was forced to abandon surgery and the many hands on procedures that I loved to do, so I was itching to specialize in a surgical area of practice. In 2000 I happened attended a presentation in Toronto on laser tattoo removal and laser skin treatments. Early that morning I met Dr Mark Lupin at the venue and he encouraged me to take the leap to offer cosmetic medical treatments in my practice. The rest is history.

You've got two clinics, one in Truro and one in Halifax. Could you tell us about your practice and where your focus is?

My practice is definitely unique and unlike most others. I have two main locations in Nova Scotia and three satellite clinics between NS, NB & Ontario. I have an amazing team that manage and operate these locations, while I focus on patient care and travel between them along with my nurse.

My focus is on injectables and minimally invasive medical cosmetic treatments with minimal to no downtime. The patient demographic ranges from teens to patients in their 80's, some medical, most with cosmetic concerns and we have noticed a shift from middle aged, to more patients in their 20's and 30's in the past 8 years. According to industry partners, my practice size ranks amongst the top 25 in Canada.

What have you learned about managing and motivating your staff? Do you work on commissions?

It has taken me many years to distill many employees into a cohesive and focusing team with a common goal of success. It is an ever evolving and constantly growing effort. Staff have to have initiative, be self motivated and have a spark of entrepreneurship in order to be a good fit for my practice. It requires a good sense of reading character and intuition to identify the individuals who will make up a winning team.

All of my staff work on some type of commission structure. I'm a firm believer in capitalism, the harder you work, the better you do. There is no one perfect compensating plan & I use at leasts 3 different types across my clinics and they all seem to work fine. All staff are subject to a 3 month trial period & If any red flags arise, we make a clean break right away.

Technology is always a critical decison for a clinic. Could you tell us more about the technologies you use and what you think of the tech you're familiar with?

I've learnt a lot of hard lessons with technology purchases over the years. The best approach that I can advise is to start your practice with low overhead procedures, build up equity to where you can make an outright purchase, or at least be in a very comfortable financial position in order to make an equipment purchase. It should never be a burden on you or your practice. Never make an emotional purchase!

In my practice, I have laser and IPL platforms that I have purchased outright that perform many functions, as well as niche treatments that we have identified as good additions for revenue and practice growth like CoolSculpting and the ThermiRF suite of treatments. These niche treatments are definitely for the more mature practice that is established and financially sound.

Most of our energy device treatments are delegated to well trained staff. As Medical Director, along with my board of directors, any device purchase is very carefully considered and the advantage vs cost and marketing efforts are considered. I'm no longer influenced by sales representative pressure and glamour and glitz presentations, but rather consider my practice goals, practicality and feasibility of an additional procedure at any given point in time. Some companies will actually partner with a physicians in a non threatening way to assess their needs and make realistic suggestions for optimizing the practice portfolio - be alert and take the time to think it over.

I don't believe that there is any "bad" technology in our industry, however I'm careful to select the best bang for the buck options that have at least some track record of performing well and providing patients with impressive results before I'd continue make a purchase. I'd also always discuss it with a colleague that has used it for a while before taking the plunge.

Any marketing strategies or tips you can share?

Marketing is challenging as we have to abide by College rules, but within the restrictions that apply, I tend to stick to the lowest cost options. My advice is to avoid costly advertising and rather spend your marketing dollars on a great website and gradually develop a solid social media following. Open houses and patient focused in-house events are also very beneficial. At the end of the day, word of mouth is the best way to build a practice. Slow but sure and consistent efforts will pay big dividends.

Botox and fillers are often cited as amont the most popular treatments in most medspas or clinics. What are the most popular treatments in your practice?

It is imperative to track every treatment's profitability and monitor what's working and what's not. We market the treatments that do best and axe those that don't perform, if possible. Injectables are our top earners, followed by body contouring, skin care and lastly laser treatments. Minor surgeries like resections, sclerotherapy and scar treatment have fallen by the wayside in my practice. One of the newest trends is vaginal rejuvenation and we have just begun promoting that treatment in our practice.

Could you tell us some stories in your career in cosmetic medicine?

There are so many anecdotes! My nurse and I have started filming little video clips of funny situations that we reenact to show at the next annual meeting of CAAM in Toronto next November. We definitely have fun and enjoy our work tremendously. Of course, like any area medicine, complications and side effects occur and we need to be ever vigilant. We've also come across scam artists that complain about their outcomes for the sole purpose of obtaining a refund and one woman wrote 2 horrible reviews of me on RateMD's because I refused to reimburse her. It's par for the course and I think if we practice ethically and honestly, then we should stand up for what we do and believe in. This particular woman screamed at the top of her lungs how we've ripper her off and stormed out of the office to the shock and dismay of all the other patients waiting. I called a few colleagues in the area and they all new her and had blacklisted her for the same reason.

Any advice for fellow physicians who are just starting out in cosmetic medicine?

Dream big. Believe in yourself. Be patient. Set goals and write them down. Have passion for what you do. Have a "no matter what" attitude. Learn from others, do preceptorships with physicians that are successful. Be open to teach and share ideas with your colleagues so that we can all grow together. Attend conferences regularly. Be a member of CAAM to network with peers and obtain good CME and have access to the complications hotline. Don't make big debts when you're just getting started. Never give up.

Believe in yourself!

About Dr. van Aardt

Dr. van Aardt has studied medical aesthetics extensively, and approaches his patients with a thorough understanding of the person as a whole. He appreciates the medical, psychological and aesthetic considerations that go into making someone feel better – even more beautiful.

Through years of experience, Dr van Aardt has perfected the art of providing medical cosmetic treatments with remarkable patient comfort. The results speak to his attention to detail and ability to reveal or enhance a patient’s natural beauty.


Cosmetic Clinic Embezzlement: Bank Deposits

The following is a story from the Medical Spa Embezzlement & Employee Theft Scams Report which contains information for physicians and medspa owners to understand these scams and find out how to protect your cosmetic clinic.

The complete report is available for free to all Medical Spa MD members.

Beware anyone taking complete control of the books and the bank deposits.

Our embezzlement story has some classic elements: a break down in financial control procedures, an employee (bookkeeper) showing behavior changes and a drug problem, and a manager and a boss not paying close enough attention.

I have a solo private practice of plastic surgery with skin care services. At the time, we readily accepted cash payments, even for surgical procedures.

My practice manager was responsible to review the daily close, checking the work of the full-time bookkeeper. The manager was to make the bank deposit daily and attach the deposit receipt to the daily close. I would normally check our financial statements at my meeting with the manager every other week. It turns out that we missed one of our meetings, (because of schedule conflicts, being “too busy,” or the usual excuses/reasons that we end up skipping an administrative meeting) and I didn’t ask to see all the reports, anyway.

I became concerned when I noticed some behavioral changes in my bookkeeper, including erratic hours, late for work, leaving the office during the day.

When I discussed this with my manager, she noted that some of the daily reports were coming inconsistently.  I asked if the manager was getting the daily close and making the bank deposit;  my manager (now “buddies” with the bookkeeper) explained that the bookkeeper had taken this over “to help, since she saw I was so busy.”

The short story: the bookkeeper was pocketing all the cash and depositing/ recording only the credit card and check deposits, “cooking the books” to try to hide the missing cash. Fortunately, we discovered the ploy within a short time; our audit showed a loss of less than $11,000.

I brought in an HR attorney for the termination of the bookkeeper and the manager and filed a report with the Sheriff.

We subsequently learned the bookkeeper had developed a Vicodin/codeine habit from a fairly recent injury.

When the bookkeeper left the state, without forwarding address, and “could not be found,” we did not invest in prosecuting, on the advice of the attorney.


  • Have secure financial/bookkeeping controls: Have a daily close. Make sure that the person who collects is different from the person who checks/records. Use a third person to make the deposit.
  • Verify compliance with these procedures (“Trust, but verify!”).
  •  No matter how “busy” you get, check the daily deposit.
  • Hold yourself accountable,as well!

Erratic behavior is a warning sign of something worse. Trust your gut. If something “doesn’t seem right,” check it out, sooner rather than later.

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