Unintended Consequences Of Policies Inside Your Medical Spa

How do we keep track of new patient inquires? How do I get my staff to sell more products and services? How can I get my front desk to mention our newest IPL treatment or Botox pricing?

New policies and procedures are usually implemented to try and address a perceived (or real) problem, ut even the most carefully crafted procedures are very seldom realized when you throw human nature into the mix. Take a look at these famous examples from a Quora thread on unintended consequences:

A particularly famous example named the Cobra Effect:

The term cobra effect stems from an anecdote set at the time of British rule of colonial India. The British government was concerned about the number of venomous cobra snakes in Delhi. The government therefore offered a bounty for every dead cobra. Initially this was a successful strategy as large numbers of snakes were killed for the reward. Eventually, however, enterprising persons began to breed cobras for the income. When the government became aware of this, the reward program was scrapped, causing the cobra breeders to set the now-worthless snakes free. As a result, the wild cobra population further increased. The apparent solution for the problem made the situation even worse.

Here's a particularly relevant one around trying to improve service times that results in exactly the opposite:

My first job was as a crew member at a Burger King. To ensure speedy service in the drive thru, a timer was installed and hooked up to a pair of sensors so that it started when the car drove up to the speaker, and stopped when the car left the drive through window. The times were aggregated throughout the day and the times for each restaurant were reported back to the district supervisor.

As a result of this system, on days when we weren't meeting our goal time (generally 3 minutes), the managers would instruct us to have each car pull around to the front of the restaurant immediately after receiving payment if their order wasn't ready yet, causing the timer to stop counting. Then, rather than handing the food out the window, we would have to step out from behind the counter, walk up to the front, deliver the order and then walk back. So the customers ended up waiting longer for their food because we had to travel farther to deliver it, and also reduced the amount of time that we could spend productively handling other customers.

If you're looking to implement a system or procedure to try and deal with a problem or need, make sure that you're not creating more work or building something that will cause unwanted behaviors in your staff. Your perception of what you need might actually be causing you more grief. Here are a couple of thoughts to remember:

  • Nothing you implement exists in a vacuum: If you're asking your staff to spend time talking to patients about your newest Botox or Restylane pricing, there's going to be less time to talk about your IPL or Thermage. If your focused on making sure that patients aren't taking advantage of your time by giving them only 10 minute consultations, your customer service will suffer.
  • Everyone acts in thier own 'perceived' best interest: If you're going to offer a discount for Botox treatments before noon and your nurse injector or front desk staff is bonused on total Botox revenue, don't expect them to be pushing this new program.
  • There's someting at work called Braess's Paradox: It states that "Adding extra capacity to a network when the moving entities selfishly choose their route, can in some cases reduce overall performance. This is because the Nash equilibrium of such a system is not necessarily optimal."

If you have any stories of something that you implemented that had unintended consequences in your clinic or medspa, leave them in the comments below.

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Dr. Lisa Lynn Sowder, A Female Plastic Surgeon In Seattle

Dr. Lisa Lynn Sowder

Dr. Lisa Lynn Sowder manages an accredited surgical facility and plastic surgery practice in Seattle, WA.

Name: Lisa Lynn Sowder MD FACS
Clinic: Seattle Plastic Surgery
Location: Seattle, WA
Website: sowdermd.com

That's interesting: Dr. Lissa Lynn Sowder is past president of the Northwest Society of Plastic Surgeons and the Washington Society of Plastic Surgeons, past chair of the King County Medical Society Grievance Committee and former Trustee of the King County Medical Society.

Your operating room is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF). How much benefit is there for a physician who owns their own surgical suite instead of using other facilities?

The headaches are staffing and supplying the operating room. Equipment needs to be maintained and replaced. Supplies need to be ordered. The floor needs to be mopped, etc. Employees need to be trained. There is a boat load of paperwork necessary for AAAASF certification. Just doing it all right isn’t enough – it all has to be documented and documented and documented. It’s expensive and

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The Desirable Duopoly Of Doctor & Patient

Medical Spa Doctor PatientAsk any corporate tycoon what the toughest business structure to beat is, and surely they'll tell you it's a duopoly - two co-dominant institutions presiding over a market, essentially cutting out all other competitors or outside influences.

Are the two big players friends or foes? One can make a case for both. Republicans and Democrats, Ford and GM, and even Magic and Bird - all dominant duopolies that symbiotically blasted and outlasted their competition. That is, of course, until the third party showed up - the new kid on the block. Traditionally, the third party, or its potential to arise from obscurity into the limelight, has been a great offsetting entity to the status quo of the omnipotent duopoly. Just ask the Tea Party, Chrysler, or Michael Jordan. These entities, the consummate "start-ups", all served to destabilize the ruling double-team, and thus helped democratize whatever industry they were involved in. As it turns out, this destabilization, a requisite force of the free market, serves to wipe up the cobwebs of industry stagnation, and create new avenues and vectors for ingenuity and prosperity. But not all third parties share in this benevolent intention. Some third parties have done the exact opposite.

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