Is your aesthetician your MVP?

Is your aesthetician your MVP? If not, find out how you can grow your business by simply changing your batting lineup.  As most medical spa owners have learned, employing an aesthetician can be a difficult and challenging task.  I, myself, have on several occasions heard and witnessed less than professional personality traits exhibited by my aesthetician colleagues.  Gossiping about coworkers, complaining about pay, and unhappy with scheduled hours these complaints can reverberate loudly from the staff lounge.

You are probably asking yourself, how could that person ever be my MVP and why would I want them to be.  Operating a successful medical spa can be nearly impossible without an aesthetician amongst your team.  If you take a moment and reflect on who an aesthetician really is, you will gain much insight and be able to truly unleash their abilities.  And once engaged, they will become one of your most valuable players.  

Who is the average aesthetician? The average aesthetician is about 24 years old, and other than their aesthetician certification hold no other degrees or licenses. According to ZipRecruiter as of March 2018, aestheticians earn $16.38 an hour and an average of $39,000 per year once commissions and tips are factored in.  So basically, they are young, earn just over minimum wage and have on average 18 months of vocational training.

A large percentage of aestheticians tend to leave the field in their first two years due to dissatisfaction with pay and benefits, difficulty finding consistent employment, and an unrealistic expectation of their roles in the marketplace.  So, they leave the profession they chose within two years.  

Conduct a little research on aesthetician satisfaction in the workplace and you will see most aestheticians are given varying schedules from week to week and oftentimes get same-day notice of shortened or eliminated working hours.  Their job security as well as take home pay is always in question.  Engage in conversation with one or two aestheticians and you will find very common theme of insecurity.

Imagine as physicians the reality that aestheticians live in and you will be able to focus your efforts on actively engaging them within your practice.  Aestheticians have a key role in our arena and should be the backbone of your office.  Who better to be your ambassador for skin care than the person who chose this career and possess the skills, passion and dedication to improving your customer’s skin.

Understanding their background and possible baggage brought over from previous employers is the first step.  The next step is providing security, security in their position, affirmation of their impact on patient retention, and assuring their shifts are as consistent as possible.   

And finally, educate and continue to educate them.  Most aestheticians cannot afford ongoing education and tend to use social media to increase their knowledge base.  As providers, you possess the medical and aesthetic knowledge to grow your team’s ability internally. But, there are many ways to continue educating your team: bring them in during medical services to assist you, have them join you for conferences and conventions, ask them to research new skin care lines and report back to the team.

The concept is simple and applies to all personal and business relationships.  Beyond Maslow’s Hierarchy of Needs, when someone feels valuable their loyalty will bloom as will their desire to help you and your business bloom.  Not only will you find overall sales improving, but you will see many of your customers transition from microdermabrasion to lasers and injectables.  They will become an extension of you, your sales approach, and your practice.
 

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Nancy Miller, RN MBA

Experienced Executive Director Of Operations with a demonstrated history of working in the health wellness and fitness industry. Skilled in Healthcare Information Technology (HIT), Electronic Medical Record (EMR), Health Insurance, Nursing, and Clinical Research. Strong operations professional with a Master of Business Administration (M.B.A.) focused in Health/Health Care Administration/Management.

Dr. Joel Kopelman - Kopelman Aesthetic Surgery, NY & NJ

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Name: Joel E. Kopelman, M.D. FACS
Locations: Park Avenue, NYC & Ridgewood, NJ
Website: https://www.drkopelman.com

Brief Bio:  
I trained in oculoplastic and facial plastic surgery at UCLA in 1983. I subsequently did another fellowship in orbital surgery at Moorfields Eye Hospital, London, England. I have been the director of multiple professional courses on blepharoplasty, endoscopic brow lifting, facelifting, laser resurfacing, and rhinoplasty across the United States. My current laboratory research is on how aging affects the eyelids.   

Can you give us a background of your career in cosmetic medicine?

The training that influenced my entire career really began at U.C.L.A. thirty-plus years ago. Under my fellowship director we performed primary and secondary cosmetic and reconstructive eyelid and eyebrow surgery. Our particular focus was fixing complications from overdone cosmetic eyelid surgery and forehead/brow lifts. Subsequently, my practice evolved into primarily a cosmetic practice. I began to incorporate facelifting techniques, chemical peels ,laser resurfacing techniques, and body contouring into my practice. I never stop learning.I bring new surgical and non-surgical techniques that offer safety and lasting benefits to my patients. I don’t jump on every new product or technique because I have learned from experience that there are fads that are not safe and have precipitated problems. Like everything else in life, experience counts.

What can you tell us about your NY and NJ practices?

I currently practice on Park Avenue in Manhattan in an office I share with three cosmetic dermatologists. I also have a second clinic in Northern N.J. where I have a certified surgical facility. I have four employees who include R.N.s, surgical techs who assist me in surgery as well as a board certified anesthesiologist. My New Jersey and New York practices are similar and consist of primarily women between the ages of thirty to sixty-five and men in their thirties to fifties.  

How do you manage your staff?

I highly value my employees and generally compensate them commensurate with their training and experience. Each employee is intensely vetted prior to hiring them so I don’t usually fire anyone unless they have been dishonest or rude to the patients.

What devices do you regularly use?

I currently use IPL for diffuse skin pigmentation, acne and telangiectasia. I have erbium/YAG, pulsed CO2, and erbium-glass lasers that I use for skin resurfacing. I usually prefer my erbium lasers because there is a very rapid recovery time. I also use a non-invasive ultrasonic body contouring device called UltraShape Power. I like this device because it causes little discomfort compared to CoolSculpt.

What marketing strategies do you employ?

Word of mouth, internal marketing ”awareness”, website and Instagram. The marketing that traditionally has worked is “word of mouth” recommendations. In the past few years internet ratings and ranking has increased traffic but I have found that these patients do not always have realistic expectations.

Which treatments do you consider the most popular in your practices?

Facelifts, blepharoplasties, endoscopic brow lifts. I plan on performing more PRP for hair rejuvenation. I no longer perform rhinoplasty.

In your many years of experience, what have you learned so far?

I tell my staff “If a patient is happy when they come to see me they will be happy when they leave but if they are unhappy when they come to see me they will be unhappy when they leave”- there is nothing that I can do to change their view of the world. 

Lastly, what can you impart to fellow physicians in the field?

Do great work, be passionate, show that you care. Patients will recognize, value and trust your service, see you as their medical guardian, and appreciate you as an outstanding physician and surgeon. You don’t have to wave a flag - your actions will speak louder than words.

Only Work On What Brings Value To Your Customer & Your Medical Practice

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If you're working on solutions without a very clear definition of the problem you're trying to solve, you're doing it wrong.

Is the solution you're working on solving a real problem? Is the problem based on your existing patients needs? If you're successful with the project you're working on, would it change anything for your patients? And in turn, would it change anything for your clinic? These are the fundamental questions you need to answer to make sure that you're investing your time and effort working on worthwhile opportunities.

If you put yourself in a position where your clinic is running on autopilot and give yourself a chance to get off of the constant production treadmill you'll have a chance to work ON your business, not just IN your business.

Process is critical here.

My guess is that you don't have any real way to prioritize what you're working on at any one time. If you're like the vast majority of clinics who are physician-owned, you're not running a business as much as you are running a communal job, where nothing's addressed until there is enough pain that you have to actually do something.

  • We don't have enough patients; so I need to try and figure out how to get some. I guess I'll call that local ___ rep who was in here last week promising that she could help grow my practice. Maybe my nephew can help me out with some Facebook ads.
  • We're getting a lot of returns and some negative reviews online; Oh well, what can you do. Some people will always be unhappy. Nothing really you can do about that. (If this is you, get your ass a Podium account now.)
  • I know that we're over-promising on what the results are with this old IPL that I've had forever but it's still working and it's not worth much so I can't afford to upgrade. (Get a certified quote on your used laser or IPL)

I could go on forever.

Features and solutions are easy to imagine and talk about with other people, and coming up with a 'solution' is rewarding, it makes us feel like we're making progress and are figuring things out.

This is not the way that successful clinics operate.

Successful clinics have systems, and one of those systems is some kind of process to prioritize what to work on, and it's not the low hanging fruit.

It's the hard things that will kill you.

No one cares if you add a Facebook widget to you website so that patients can join up and be ignored in your I-don't-have-time-to-do-it Facebook group.

But if your staff is fighting over commissions your patients will see that and you'll have less word-of-mouth.

Who gives a shit if your using a credit card processor that charges you 5% more than someone else.

But if your consultations aren't perfect you're cutting your own throat.

You need to be working on the hard things; building systems into your business, an obsessive focus on patient satisfaction, a team that is all working in unison, and a real business.

It's the hard things that you have to get right- the foundations of your business- not the bullshit on the surface.

Here's a simple process to identify and prioritize what you should be working on. (Note: I use this but I stole it from Amazon.

Prioritizing What To Work On

Here's a simple method to ensure that you're working on problems that can actually affect your business.

Note: This is a physical process, not a thought exercise. I suggest that you use post-it notes and do this first with yourself, but then with your team. (If you're doing it with your team DO NOT hog the meeting and deliver the answer. Let your team help you with all of it.)

  1. Write down the BIG problems that are facing your clinic. These are the problems that, if they're not fixed immediately, can put you out of business. 
  2. Prioritize those problems according to risk, with the biggest problem at the top and the least risky one at the bottom.
  3. Pick the problem right at the top. The one that poses the biggest risk to your clinic.
  4. Break it apart into smaller constituent parts. For example; "We don't make enough revenue to cover our costs" can be broken down into, "We don't make enough revenue" and "our cost's are too high".
  5. Keep breaking it down into smaller segments.
  6. Pick a segment or a challenge. 
  7. Use this technique of the 5 Why's to uncover the root cause.
  8. Use these root causes to build a plan of action that you can be sure are contributing to drive value and work on your most pressing problems.

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How To Use Jeff Bezos' 5 Whys Technique To Find Root Causes In Your Clinic

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Identifying and addressing the root cause is where you can make changes in outcomes as a business leader.

Pate Abilla is a a process guru, and I've added his post here on how Jeff Bezos uses a simple technique called "5 Why's" to find the root cause of a problem.


What is it that really sets Amazon apart from everyone else. I obviously don't know the definitive answer to that, but I can draw on some experience being an early employee at Amazon. 

I want to especially point to one experience that might, perhaps, demonstrate the way we were taught to think at Amazon.

The Conveyor Belt Accident

Back in 2004, I was part of rotational program at Amazon and at this particular time, I was in one of Amazon's massive fulfillment centers. During Q4, Jeff Bezos takes the time to visit several fulfillment centers to see how things are going and to lend a hand.

In a meeting with the senior team of which I was a part, we discussed metrics for that Q4. One of the metrics is related to safety. It was at this time the safety manager explained one of the accidents during that year at the fulfillment center. 

An associate had damaged his finger on a conveyor belt.

I immediately noticed Jeff Bezos' demeanor change from one of excitement because of the busy-ness of Q4 to one of serious concern.

Then he got up and went to the whiteboard. He then began to facilitate the following discussion:

Demonstration of 5 Whys by Jeff Bezos

Bezos wrote on the whiteboard the following and took us through an exercise right then and there (this is from memory).

  1. Question: Why did the associate damage his thumb?
    Answer: Because his thumb got caught in the conveyor.

  2. Question: Why did his thumb get caught in the conveyor?
    Answer: Because he was chasing his bag, which was on a running conveyor belt.

  3. Question: Why did he chase his bag?
    Answer: Because he placed his bag on the conveyor, but it then turned-on by surprise

  4. Question: Why was his bag on the conveyor?
    Answer: Because he used the conveyor as a table

Conclusion: So, the likely root cause of the associate’s damaged thumb is that he simply needed a table, there wasn’t one around, so he used a conveyor as a table. 

Countermeasure: To eliminate further safety incidences, we need to provide tables at the appropriate stations or provide portable, light tables for the associates to use, or place maintenance bags on the floor.

There are several things amazing about this experience:

  1. Jeff Bezos cared enough about an hourly associate and his family to spend time discussing his situation.

  2. Jeff properly facilitated the 5-why exercise to arrive at a root cause: he did not blame people or groups — no finger pointing.

  3. He involved a large group of stakeholders, demonstrated by example, and arrived at a root cause and he didn’t focus on symptoms of the problem.

  4. He is the founder and CEO of Amazon.com, yet he got involved in the dirt and sweat of his employees’ situation.

  5. In that simple moment, he taught all of us to focus on root causes — quickly. He did not heavily rely on data or over-analysis of the situation, and yet he was spot-on in identifying the root causes of the safety incident.

Conclusion

Remember, this was back in 2004. If the CEO can think this way, then clearly the entire company can. While Amazon isn't perfect in any way and Bezos isn't necessarily the poster boy for effective leadership, this particular situation is a really great example of how leaders can behave and how they can demonstrate clear thinking and quick problem solving.

If I were to point at one thing that sets Amazon apart, it's how their people think. And how they think is heavily influenced by Bezos and his example.

Dr. Ahmad Rabb, Cosmetic Medicine At Medical & Cosmetology Centre In Toronto

Connecting with a Canadian physician practicing cosmetic medicine in Toronto, Dr. Ahmad Rabb.

Name: Ahmad Rabb, MD
Clinic: Medical and Cosmetology Centre
Location: Toronto, Canada

That's interesting: Dr. Rabb leads Bio Ethics Seminars for medical Undergraduates at the University of Toronto School of Medicine. He speaks English, Urdu, Punjabi, Sindhi.

You started out in family medicine but then switched to cosmetic medicine. Why did you switch?

It took me couple of years to transition from family medicine into cosmetic medicine. Over the years I realized that non-invasive and non-ablative skin care techniques were becoming increasingly popular and effective in reasonably reversing the adverse affects of different aging types ex. Photo-aging, Intrinsic aging (age related aging) and environmental aging.

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How To Add Texting To Your Clinic And 6X Your New Patient Inquiries?

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Allowing patients to use text messaging makes them 6 times as likely to reach out and communicate with you.

6X in anything is a MASSIVE increase, but especially in inbound contacts there's simply nothing else that comes even close to that.

Nobody likes to call.

Asking new patient-prospects to call your front desk is a lot to ask. It's an investment of time, it's slow, you have to call during office hours, and you know that there's social pressure that's going to be applied by the person on the other end. It's a big hurdle and has always cost you those patients who you might have had if only it had been a little less difficult.

You're missing those inquiries, patients and those sales.

But texting is easy.

Sending a text is a much lower 'ask', and that's just what you want as a business; a very easy first step. It's asynchronous so you don't have to worry about office hours or connecting, and there's much less social pressure than talking to someone on the phone.

Best of all, your front desk staff can probably handle 5 times the traffic in texting communications than in phone calls.

Here are the numbers*: (reference)

  • New patients are 6 times more likely to text you than call. 
  • Texting is 10X quicker than phone calls
  • 81% of Americans text regularly
  • 85% of people want to be able to not only receive a message from a business but also answer a message from a business.
  • 98% of consumers want to use texting when communicating with a business
  • 95% of texts will be read within 3 minutes of being sent
  • People prefer text for most scheduling, changing appointments, or confirming reservations
  • Response rates from text are 209% higher than phone calls and 200% higher than email

If you can read those stats as a clinic owner and think that you don't need a two-way texting capability to communicate with your patients and field new inquires...  well, I don't really know what I could say that could help you or your business. Please stop reading.

The simple truth is that you need to find a solution using text messages because it's the preferred method of communication for your existing patients, and it's more productive than what you're doing now.

How much time is actually wasted every week on the phone? Here are my guesstimates:


Common Tasks

Calling to confirm appointment

Call patients to fill a cancelation

Staff time wasted: calling, on hold,
calling back, waiting....

Phone

2-5 minutes

5-30 minutes

50-60%?

Text

40 seconds

2 minutes

0  


Texting is clearly a more productive and efficient system and your patients respond better to it. The only question for you is what to do about it.

How do I add texting to my clinic?

Before getting started there are a few things we suggest doing to ensure that you are successful. The first is setting up your Google My Business listing to accept text messages from mobile searchers. Check out this post for instructions on how to set up Google Click-to-Message for your business.

Next, you’ll want to find a solution that can enable your landline to accept text messages. This will help you maintain continuity and consistency with your contact information, which is an important factor in where your business ranks in local search.

Once your landline is set up to accept text messages, you’ll want to publish that number wherever your contact information is displayed with instructions to “call or text us.” Some places to include it are on your website, on all of your business directory listings, and even in your email signature.

Finally, you’ll want to implement a customer interaction platform to help you manage all of your text message conversations.

More help on that a little later.

Best practices: What would I use text messaging for?

I understand your reluctance to start texting your patients and prospects. Its new and you don’t really know where to start or how to do it. but let's identify a few moments during your patient journey where it makes perfect sense to be using text messaging.

1. SET APPOINTMENTS AND SEND APPOINTMENT REMINDERS One of the biggest frustrations is when patients no-show, but you can eliminate a large number of no-shows by texting out appointment reminders and setting appointments with your customers. It's much less intrusive and time-consuming than having your staff call out and remind customers about upcoming appointments.

There are automated systems that you pay for that do this automatically, but that's all they do. You want a a system that does this and the other things on the list too.

2. BE A RESOURCE TO SOLVE PROBLEMS Not all of the questions your customers have will warrant a phone call. Some are simple and can often be answered with a very short text. Because texting is more visual than a phone call, it allows your patients to use testing in ways that phone calls just don't handle well, like sending a photo. This can eliminate a lot of confusion that might arise if they were to try and describe the problem verbally.

3. LOOK FOR OPPORTUNITIES TO UPSELL Having a texting relationship with your customers will also give you the opportunity to upsell them from time-to-time. This will provide your business with incremental increases in revenue that will not only improve customer satisfaction but also boost your bottom line.

4. ASK FOR FEEDBACK A number of our customers have started to replace traditional customer satisfaction surveys with a text message-based survey. These customers see a higher open and response rate because text messaging is more conversational and less intrusive than a survey. A simple "let us know if we can help in any way" as a text is another touch point of care that patients appreciate and cost's you nothing.

5. CLOSE BUSINESS This might sound crazy to you, but it’s not uncommon for people to make a sale in a text message conversation – even for big-ticket purchases. Just send a special offer to your best clients, or followup on a consultation in a non-intrusive way.

7. COLLECT REVIEWS Finally, you should invite all of your customers to review your business via text message. Building up your online reputation is important because it makes it easy for consumers to find your business via online searches, while also helping to influence purchase decisions.

8. LET PATIENTS TEXT YOU AS A FIRST CONTACT This is a big one... make it easier for patients to take the first step towards your clinic by allowing them to text you as a first contact.

What does all of this?

We started looking at providing a solution for our Members that solves these problems. The company that we chose to partner with is a best-in-class software solution called Podium. 

We contacted them and they agreed to partner with us and put together a special offer for Members. You can see that offer here: https://medicalspamd.com/podium

Here's a little info about how it works to make it easier for prospects to connect with you, to communicate and interact with them, and to get them to help you grow you reputation and business.

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Here's a video showing how new patients can use Podium to text you directly from your own website or from other pages like your Google business page. Now, instead of just being able to call, they can now text, connecting them to your front desk and allowing your staff to respond right from their computer.

  1. User finds you on the web, often on a mobile device or smart phone.
  2. They text you.
  3. You text them back.

It's asynchronous so it doesn't impact calls and no one has to wait, you can send images if you want (like a price list or before and after photos), it's efficient so your teams productivity increases, and it's what your patients want.

And here's a video that shows how Podum's new webchat feature works for brick and mortar businesses like your clinic.

"Podium Messenger makes texting with customers a breeze. 90% of consumers want to use messaging to talk to businesses. With Podium Messenger, stay connected with your customers and answer questions in real-time via text message – all from one centralized dashboard"

So that's really it. This is something that you actually need, that your patients want, and that you're never going to get a better deal on since it's only our Members that get it.

To learn more about how you can take advantage of this Members only deal, just find it - along with other deals and offers - in the Marketplace.

Oh.... and in addition to Members getting better pricing forever for this, you'll also get free training for your entire team online.

Done.

The New Member Forums: Cosmetic Lasers, Legal, Marketing + More

The new Medical Spa MD Member Forums are now open.

The old forums were becoming difficult to navigate to the information you might have been looking for. We've simplified them and put them entirely in their own section.

Now, there's one link in the main header above that says "Member Forums" instead of a drop down. That link takes you over to the forums and we've simplified the navigation there as well, removing all of the links above and replacing them with the various categories; clinical exchange, legal, marketing, and cosmetic lasers, IPL, and RF technologies.

There are something like 30,000+ comments. This should make it much easier to use the forums again to find answers and express opinions that both you and others can learn from.

As always:

  • You must be a Member to post a new comment or ask a question
  • You can identify yourself or remain anonymous
  • We regularly (daily) sweep the forums for spam and remove junk links and threads

The forums are an incredibly resource if you use them correctly. For example; ask very specific questions, not general "what should I do" fluff that no one could possibly answer. There are some threads that have more than 400 responses, and others that clinics use to deep-dive into very specific questions.

Take a look and ask your most pressing question. There are thousands of readers and members who just may have the answer to your question.

Take a second and ask the experts.

The New Medical Spa MD Marketplace

We've just launched the new Medical Spa MD Marketplace where you can get special offers and deals from companies.

We've just launched a new, updated marketplace to let Members take advantage of offers and deals from our Select Partners and outside companies who to provide special offers to our Members.

In addition to the publicly available offers which are visible and available to everyone, our Members will also receive additional offers and discounts that are not available publicly. (Yet another great reason to join us.)

You can already find some incredible offers like discounted software, upgraded warranties, and group buy wholesale pricing on fillers and injectables.

And we have a Certified Partner Program to protect all of our Members.

Need a waiting room video to increase your up-sells and educate your patients about your other services? Need a designer to create a kick-ass Facebook page graphic? Want to know that when you buy a used laser that you've got someone who can intervene on your behalf?

Done.

Have a product or service that could benefit our Members? Become a Select Partner.

How To 180 An Unhappy Patient

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No-matter how terrific your clinical outcomes, the occasional unsatisfied patient is an inevitability.

Sometimes it’s warranted and there really was something you did wrong or could’ve done better. But most of the time, you did everything you could and it’s more about managing expectations.

Last week, I had a 42-year-old lady come in to have a mole removed. In passing she mentioned her dissatisfaction with a BBL treatment she had 3 weeks ago.

She's a nurse and a long-time satisfied patient but she seemed agitated and a little upset. She'd paid for a package of 3 BBLS, had 2 of them, wasn’t seeing results, and didn't want to go through with her 3rd treatment.

At this point my first instinct was to say: "What do you mean? BBL is a great treatment and you look amazing!”

She really did look fantastic – wayyy better than when she first came in 2 years ago – but if I’ve learned one thing about dealing with unsatisfied clients (and people in general), it’s that straight-up disagreement will get you nowhere fast.

When you blatantly disagree, the shields go up and you have lost. This is persuasion and sales, not a presidential debate.

So I thought to myself: “what's the best way to turn her around without making her feel like she was proven wrong?”

I said to her: "look, I can see you're not happy with the way things turned out. I wouldn’t be happy either if I didn’t see the results I wanted".

She immediately softened up and I had my nurse bring in her B&A pictures. We went through them together showing her how much clearer her skin was now.

She still thought the recent treatments had done nothing, but I was now in a much better position to guide her in the right direction, since she could see her long-term progress.

I thought and said: “Why don't we just wait then for your third one?”

“Why not wait till the end of the summer? That would be a perfect time to do another one. We’ll fix up your summer skin damage from all the boating and outdoor activities you like to do.”

She agreed.

We then went on to remove her mole, and rebooked her third BBL in the fall.

Everyone was happy and I couldn’t help but think how much of an uphill battle it would’ve been if I didn’t bite my tongue and said the first thing that came to my mind.

Sure, I could’ve convinced her to continue with treatment through sheer force of will, but that would leave a sour taste in both our mouths that would threaten our relationship.

She might stop referring her nurse friends and the patients she sees in the hospital, or could decide to stop coming in all together.

Instead of pushing back against her, I agreed. I acknowledged her feelings and then came up with a solution that worked for both of us, thus preserving our great relationship - the most important thing in a cosmetic practice (or any business for that matter.)

I’m still far from perfect though, and continue to learn every day from situations I know I could’ve handled better.

Here’s the 3 most important points for dealing with unsatisfied patients that I’ve gathered so far:

  1. ALWAYS take standardized before and after photos. Make this part of your protocol that gets done no matter what. These are crucial to showing patients their long-term progress when they’re on preventative treatments and are no longer experiencing the “wow” factor from when they first started.
  2. NEVER blatantly disagree with your patients. This can be extremely tempting, especially if you enjoy getting into heated debates with your friends. In sales, the more tactful thing to do is to absorb the patient’s energy by agreeing with them. You’d be surprised at how much the patient drops their guard and how relaxed the interaction becomes afterwards.
  3. Look for compromises. You don’t want to yield to your patients’ every whim, but also don’t want to be so stubborn that you end up upsetting the patient and ruining the relationship. Compromise allows you to hold your ground without making the patient feel like they were coerced.
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Peter Ursel MD


Dr Peter Ursel has been treating leg vein patients in Lindsay Ontario for over 20 years. He was initially a family and emergency physician and early in his career discovered that there was a need in his area for outpatient vein treatments. At the time, there was no formal training available. After extensive research and over many years, Doctor Ursel assembled the finest treatments available and brought them to Lindsay.

A Free Embezzlement & Employee Theft Scams Course For Members

There are only two types of cosmetic clinics; Those who have have been stolen from, and those that don't know that they've been stolen from yet.

Every cosmetic clinic has this problem.

Every. Single. One.

And it's not hard to see why. Most people aren't bad, but there's always temptation, especially when it's easy or there are outside pressures or gripes that make it easy to justify taking just a little here and there. That little voice that says, "I'm the one doing the work. The patients love me. Everyone else is getting rich. I'm owed more...".

We're doing our part to help protect your clinic by taking our popular embezzlement guide and turning it in to a free course with video explanations and added it to the new Medical Spa MD Training Academy. You'll learn how how these scams work, and how you can protect your clinic from them.

This course is entirely free, and may just save your clinic.

In this course you'll uncover all kinds of creative, never-thought-of-that scams:

  • A physician employee connecting his personal account to the credit card terminal.
  • A PA injecting patients with saline and stealing Botox to run a side business.
  • Laser technicians "up-selling" treatments and pocketing thousands in cash every week.
  • A simple accounting scheme that drove a clinic into bankruptcy.
  • A manager treating patients on weekends.
  • Front desk staff using a simple credit card scam and skimming 3% of sales.
  • And (unfortunately) many, many more...

These physicians and clinic owners weren't stupid. They weren't lax or taking their eye off of the ball. They were just victims of the myriad creative ways that these scams work, and they hadn't taken this course yet.

This course gives you the inside cheats, tricks and scams that people use every day, and the simple ways that you can prevent the vast majority from ever getting started in the first place. This course is for every physician, clinic owner, manager and employee working in cosmetic medicine.

Free Guide: 10 Critical Questions To Answer Before Buying Used Lasers

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We've added a new area to the site to provide Members free reports, information, and resources.

We have a lot of information that needs a better delivery method than a blog post; information that is best delivered as a guide, playbook, blueprint or system that you can download and read, share, or keep around for reference.

For example; 10 Critical Questions To Answer Before Buying A Used Medical Laser by Vin Wells, a Medical Spa MD Author and owner of Rock Bottom Lasers.

Buying used technology can be smart and save you tens or hundreds of thousands of dollars by taking advantage of the massive depreciation that’s triggered when the first pulse is fired. It can make the difference between profit and loss.

But it can also be confusing, distracting, and problematic dealing with sellers, brokers and even manufacturers who have an agenda that may not be in your best interest. 

This guide is designed to walk you through the morass of information and help you make more informed, smarter, decisions about how to take advantage of used technology to help your clinic, your patients, and your profits. It will walk you through the logical, common sense steps to identify ethical sellers and to ensure that you’re not being taken advantage of.

This report is just one of the ways that we're expanding resources and information to benefit our Members.


Selling your cosmetic laser or IPL? Want to know how much your device is worth?
Get multiple, competing blind certified quotes for your cosmetic laser, IPL or RF.

How To Use Your Patients To Grow Your Medical Practice

The best marketing for your clinic is when your patients do it for you.

Word of mouth takes many forms, but it's increasingly being handled online through social networks and search engines. Patients are now researching you online before they call. They look at your reviews. They run searches with your name and "complaints", "malpractice", "lawsuits", "reviews". If you're going to compete, you have to be in the game.

To do that, you're going to need the right tools, which I'm going to show you, but you have to be convinced that they're important to buy and use or you'll just stay with what you know, so I'm going to dive in to why you need them first.

You've got a marketing problem that you didn't have before.

It wasn't long ago when you just needed to be found, and ranking high in searches drove traffic and filled your treatment rooms.

No longer.

Consumers of all types have subtly changed their decision behaviors online and are weighing buying cues much differently than just two years ago. Reviews are seen by prospects as increasingly important in their buying decisions.

That changes the playing field. (Don't believe me? Just keep reading.)

When asked, 90% of people read reviews before visiting a local business. 85% of those people relate that they trust those online reviews as much as they would a family member or trusted friend.

But it goes beyond simply making the first call to your front desk. Consumers spend 31% more money with businesses that have higher reviews than their competitors. It has nothing to do with price, the quality of service, or other metrics. It's the perception in the consumers mind that higher rated businesses are more trustworthy than those with few or negative reviews. There's a simple reason for that I'm sure you're aware of; a review is how the consumer 'felt' about the business after everything else was taken in to consideration; price, value, responsiveness... The star matrix is really a metric of satisfaction at the end result.

Just today I was looking to arrange three business lunches in the coming week. In every case it was the number of reviews and the star totals that made the decision for me.

Here was my thinking:

  • Few reviews? It's too risky; there are safer choices.
  • Lower star rating? Patrons weren't satisfied. Who want's to eat there?
  • Negative reviews by themselves? Tricky... some people are jerks so an occasional bad review is unavoidable, but it's too risky. I'll go somewhere else.
  • Negative reviews with responses? A few negatives is okay. I can trust the positive reviews more and - especially if the business has responded to the reviews - I think they take their reputation seriously. It makes me more confident that they don't want negative reviews and they work harder than others to avoid them.
  • Lot's of reviews (even a few negatives) and a 4+ star rating? That's the place.

And the above is especially true for your clinic.

Think about what you would do if you were deciding between two clinics – both with 4 stars – where one clinic has 5 reviews and the other has 25.

You'll choose the one with 25 every time, and that's costing you patients if you're the clinic with only 5.
 

Do reviews really drive new patients?

Here are the results of a survey we sent out to members showing the importance and value of enlisting patients in your growth strategy. The recipients were selected from a cross-section of members to try and hit all types of clinics; dermatologists, plastic surgeons, medical spas and cosmetic clinics.

Question: What is your most effective marketing?

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Yep. Number 1 and 2 - word of mouth referrals and internet searches - both fit squarely around your online patient reviews. Everything else is a very distant third.

Reviews are a primary traffic driver and trust builder:

  • Reviews are free. Advertising that is completely free of cost is a rare commodity. Reviews let your patients build links to your site and drive new traffic.
  • They're authentic: New prospects want to know what your existing patients think of you. Reviews let them communicate that in an authentic voice that prospects relate to.
  • They build trust: 92% of Americans trust word-of-mouth more than any other form of marketing – even if they don't personally know the person... and online reviews are more trustworthy than testimonials on your site that you have complete control over.
  • Improves your search rankings: Google ranks websites according to their perceived authority and their ability to provide valuable content. Customer reviews can help tell search engines that your brand is established, and when more people online are discussing your firm, Google will rank your site higher in search engine results. It also helps to add links to customer reviews on your site, because Google rewards sites that contain links to other authoritative websites.
  • Lowers your bounce rate: Customer reviews help your business stand out and make visitors to your website more interested in your product or service because of the value others have had. The impact on your site’s bounce rate can be meaningful and can help to trigger higher rankings as bounce rate is arguably one of the ranking factors involved in search results.
  • Previews your star ranking: Many sites that feature star rating systems will show a preview when someone does a search for your brand. This means that a person will not need to click on their page to see that your company was rated favorably, as the star level and the first few sentences will show up on the search results page. Google will sort search engine results based on the number of reviews received, giving you an advantage and an SEO boost. Your good reputation will then precede you, increasing the likelihood that a person will click through and choose you above your competitors.

Reviews are interesting in another way as well; they tell you what's important to your patients and they identify weak spots in your systems that you can address.
 

Do reviews really increase your revenue?

From the same survey, we also asked clinics how much revenue  each new patient added in just the first month. The lifetime value of each patient is dependent upon the clinic type (nonsurgical / surgical) but can be expected to be a multiple of this number.

Question: How much is a new patient worth to your clinic in the first month?

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It's interesting that there's a gap here in the middle, but once I thought about it it made a lot of sense; the clinics we surveyed were fairly well divided between "medical" and "spas"... So if you're a cosmetic medical practice you're far more likely to be on the right of this graph with each new patient spending North of $2000 the first month.

Question: How many new patients does your typical client refer each year?

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Okay, this is were we start to see some hope of shifting the results here to the right if you're getting on board with patient reviews and those reviews are working for you. If you're able to shift that 3 patients a year to just 4, that would equate with roughly a 20% greater delta in your yearly growth and a corresponding increase in revenue and profits. Just a small increase in the coefficient can have a dramatic effect in the end result over time.

That's what we're looking to try and do.
 

What should I do?

The short answer to "what should I do?" is - Do something. Anything. But don't do nothing.

How much less is your clinic worth to someone who wants to buy it if your reviews are negative? How much harder is it to recruit staff? How many patients are you losing that you don't know about.? Simply put, your online reviews are your brand, and an indication of patient trust and satisfaction. Reviews are what people are saying about you to others (which is what your brand is), and you can't just ignore your brand and reputation if you want to have a successful clinic or valuable asset. 

You have 3 options; you can ignore it, you can do it manually, or you can do it automatically.
 

Option 1 - Ignore my online reviews

You can't ignore it... Well, actually I guess you can. After all this is what most clinics do. They bitch and moan about someone leaving a negative review since they know it hurts their reputation, but they take no proactive actions to increase or control those reviews.)They simply float along with the status quo and hope nothing happens.

Here's what ignoring it means:

  • Your competition may not ignore it, which means that they're either taking your existing market share, or they're putting you further behind while you're not even showing up to compete.
  • You're reputation is uninsured: Something really damaging can happen which you won't be able to respond to.
  • You're missing out on every new patient that might have been brought in. You're missing sales, word of mouth, and compounding growth. This is really where you're killing yourself long term.

Pros & Cons: The only pro to this is that it's free, but the cons are legion. If you're ignoring your reputation and new business you're damaging your clinic. Go stub your toe in penance.
 

Option 2 - Do it manaully

Yes, you can do this manually but don't be fooled that it's not a lot of work. It is, but up until now this was the best way that you could address this need and what most clinics have tried to do in some form.

Here's a simple framework of what you should be doing right now at your front desk.

  • Implement operational systems at your front desk check out procedure that is followed for every single patient. (See the Ultimate Clinic Operations Blueprint)
  • Every happy patient should be asked to please leave a testimonial or review on their Facebook page or on your Google Business Listing. You should ask if they would be willing to use their phone to do it right now. (You may want to add a small discount or free product gift if they're willing to do this.)
  • You should contact Tea & Muffins Design to have some postcards made where patients can fill out a testimonial right there that you can use.
  • You should send an email or postcard reminder soon after each appointment. (You'll want to keep track of who has already left reviews or you'll irritate your happy patients with redundant emails.)
  • You should set up a number of Google Alerts to try and monitor when reviews go up so that you can respond to them.

Pros & Cons: We'll, at least you're doing something but this is time intensive and a real pain in the ass to try and manage after the first week. The opportunity cost is huge in the time invested and the "just-one-more-thing-to-try-and-manage" costs.

And there's another problem with this. Even if you're proactive and constantly ask your patients to leave reviews, they don't. 

Have you ever left a review? You have to be really motivated and it's much easier just to do nothing once you're out of the clinic.

But where there's a problem there's also an opportunity.
 

Option 2 - Do it automatically

To be an automated solution you need to have software that is both drop-dead simple to use, and gives you complete control on both Facebook and Google.

It also needs to be easy to incorporate it in to your operations, and use easy workflows; texting review requests, reputation management, notifications, tracking, permissions, and even additional patient interactions.

Here's what this software should do:

  • Needs to be really simple to use: No more than entering a name and phone number. Needs to be used during check-out when patients are most willing to leave you a positive review AND any time thereafter.
  • Needs to be simple for the patient. Needs to work via simple text message, not an app or download.
  • Needs automatic monitoring of my reviews: I want to be notified of every review and be able to respond  in one place, not login to every review site.
  • Needs accounts for each team member: I want track everyone inside the system, and their reviews.
  • Send external texts: I want to be able to send text messages to my patients as followup, reminders, or just to inform them about an offer we have coming up.
  • Let's patients and prospects text me: I want prospects to be able to text me directly from my Google review page or Facebook.
  • Simple... Did I say that already?

Since we're aware that this is a growing need for our Members we took a look at the front-runners in this space. Here are 3 of the top business review software providers to take a look at with their user satisfaction ratings supplied by G2 Crowd.
 

Highest Rated Reputation & Review Management Software

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Highest Rated Ease Of Use Reputation & Review Management Software

 Ratings from  G2 Crowd

Ratings from G2 Crowd


As shown above, Podium is the clear winner among business review management software providers both in total user satisfaction and usability - which is critical.

so we contacted Podium and asked them to help us provide their software at a discount for our Members (you).

They agreed.

So, Podium partnered with Medical Spa MD to provide a special offer exclusively to our members which includes both a full Podium account, discounted fees, and special training for your staff in our Training Academy.

Here's a quick video I made to show you how simple it is to send a review request to your patient while they're checking out!

This is exactly how your front desk staff would use Podium when a patient is checking out, or your staff would use it from their cell phone right in the treatment room.

"Hey, would you mind me texting you a review request to give us some feedback?"

Damn that is nice!
 

Here's Podium explaining more about their software.


And about their messaging feature which allows patients who see you online to text you questions, a much easier action to take than calling and talking to someone.

Because reviews are increasingly critical for every business there are startups that are building solutions to fill the need - including using patient reviews to fill your appointment calendar, increase patient satisfaction and compound your patient referrals and word of mouth marketing.  


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Get this special offer from Podium 

Medical Spa MD Members receive a special, full service Podium account that includes: no setup fee (save $300), a 10% discount forever (save $330/year) and on-demand patient review marketing training for your entire staff ($597 value). 

This offer is not available anywhere else

5 Reasons Why Growing Your Medical Spa Business Is FAR More Powerful Than Cutting Expenses

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Think about it this way; It's much easier to grow your clinic's revenues than it is to cost-cut your way to profitability.

Let's face it. You can't cut your way to long-term wealth or success.

While you'll hear a lot about how to minimize costs and maximize efficiencies and productivity in your clinic (and I'm a big fan of that too), that's only one part of having a successful clinic or medspa that's throwing off mountains of excess cash and expanding multiple revenue streams. Growing your revenue is the most powerful strategy you can use and the only one that will give you the resources to build a business that supports the lifestyle you want, rather than building a soul-crushing hamster-wheel job.

Here are 5 reasons why growing your clinic's business and revenue is more effective than simply cutting costs:

Most businesses, especially clinical physicians, can't simply turn on a switch and earn more. Your medical spa can.

If you're a clinical physician you're trading time for money — a 'job' business model — you can't just start seeing more patients or cram more hours in a work day. (Few physicians ever try to actually earn more money except by working more hours.)

One of the reasons that you opened a cosmetic practice or medical spa is that you're able to leverage technology and secondary providers (physician extenders) to deliver your services. In most palaces you can hire others to perform the actual IPL or laser hair removal treatments under your license and you don't have to push the button on every treatment. That model allows you to extend your license and 'scale yourself' using technology and labor.

There's a catch of course. You have some pretty high fixed costs that are in the tens of thousands of dollars with laser leases, rent, financed equipment and salaries. Those expenses are something that you can mitigate if you're smart (group buy filler injections, used cosmetic lasers, etc. ), but the hard truth is that those costs are part of the business model. Scaling back too far is actually dangerous to your business - cut too deep and you're into the muscle that powers your clinic operations, customer service and employee motivation.

Many docs first thought is to keep monthly costs low and move to commission-based compensation, room rental, or add other low-level services like massage or aroma therapy to try to gain patient flow while not spending anything. While it may look like it's a low risk strategy it's a fools errand because of the distractions and opportunity costs.

Other mistakes like cutting the cost of your Botox treatments as a 'loss leader' (total B.S.) or relying on discounted Groupon traffic... simplistic tactics that waste your time at best, and can cripple you if things go wrong.

The revenue streams I'm talking about may actually involve real business decisions and create an asset that you own - permanent makeup, massage and 'aroma therapy' provided by someone who rents a room in your clinic doesn't.

If you're frugal and want to be sensible, great! Combine earning more with the automation strategy for implementing systems into your clinic, and you have a powerful financial combination. Start by setting sensible short term revenue goals, buy your next IPL or cosmetic laser usedstart implementing systems in your clinic, and cut costs mercilessly on commoditized products like taking advantage of group buy injectibles if you can. Do these things and you’ll be ahead of 99% of other cosmetic physicians.

But that's only the savings and productivity part. To be successful you're also going to have to grow.

When you focus on growing your medical spa and creating a bigger pie, you'll benefit from disproportionate and compounding rewards that most other physicians and clinics can't match.

Here's why:

1: There's a limit to how much you can save, but no limit to how much you can earn. Ok, there may be some theoretical limit somewhere but for how big an profitable a cosmetic clinic can be, but it's far easier to add another $10,000 a month in gross revenues than it is to cut $5,000 from the spend. And it's much more fun.

2: The effects compound. If you're bumping along the bottom and have cut all of the fat from your budget, where do you go? You've starved yourself of the ability to grow.

As your medical spa's business grows you gain access to a larger patient network, and the network works harder for you. It's like compounding interest and gives you scale to reach an ever larger audience that's limited only by your ability to execute and lead. You'll also find it's a better message to patients and staff to be able to tell a growth story. Once you learn how to turn the dials and grow your first $10,000 monthly bonus, it’s relatively easy to turn the dial to make $15,000, or $20,000.

In every market the top 3 or 4 clinics take 90% of the revenue. Everyone else fights for scraps.

3: It improves your teams morale and your patient experience. Have you ever seen a clinic that is just barely getting buy? It's a bummer.

Growing your income let's you provide your patients with a much better experience, and moves your clientele upstream and away from bargain hunters that come with headaches and no profit margins.  Moreover, since payroll is the biggest cost you have it's a target for clinics that are cutting costs and novice business leaders often try to skimp on staff.

Growing revenues means that you can attract and pay for a skilled staff that can be trusted to help build the business, not just see you as a stepping stone to the next gig.

4: It allows you to focus on big wins rather than minutia. As a clinic owner you should be focusing on the big wins instead of trying to save money by eliminating what doesn't matter. Earning more is one of the biggest wins you can have. And by reducing the number of things to focus on — and picking major, important items like increasing revenue — you don’t need to worry about trying to keep your staff working at minimum wage. If you’re handling your major goals, the minor details fall out of that. Whether it’s taking a CME course with polar bears, putting your clinic on autopilot, or building other lifestyle businesses on the side, you can manage your lifestyle the way that you want.

5: It forces you to compete on price, which will kill you. If you're competing on price you're in a losing battle. A patient who comes to you for price will leave you for a lower price just as quickly, and there can be only one lowest price. It's a downward spiral which leads to a miserable existence.

6: It gives you options. Growing your sales lets you move from what you have to do to survive, to what you want to do. It gives you options, and opportunity. Personally, I want to live a rich life, and that means spending money on the things I love. Ask yourself whether you'd rather bump along the edge of going out of business and grinding out another payroll, or spend some time earning money so you could live the lifestyle you want. I'm betting you'll answer earn more 100% of the time.

The way to get started is to quit talking and start doing.
— Walt Disney

So what actions should you take right now?

First, you have to be convinced that it's possible. You need to adjust your mindset from one of scarcity, to one of opportunity. You need to be convinced that you can step forward in a slightly different direction than you're headed, but with dramatically better results. You're going to need to educate yourself.

The good news is that you're in a fantastic market. Most businesses, especially clinical physicians, can't simply turn on a switch and earn more. With a cosmetic practice you can.

There are three main areas where you can take immediate action to begin increasing your sales and income; getting more patients in the front door (marketing), raising your conversion rates (consultations), and streamlining your clinic operations (systems). Increase any of these and your revenue will increase. Ignore them and your opportunities will slowly be throttled, wither and die.

While we don't yet (as of this post) have our training course on marketing available, we can immediately address the other two areas where you can increase your conversions and streamline your operations.

Whatever you do, take action right now and begin.

The 10X Consultation Playbook will be our next course. Here's why.

The 10X Consultation Playbook - The ultimate guide to mastering patient consultations that sell. See it here >

A little while back I wrote a post about the 5 areas that I've found most closely correlated with success in the 17 years that I've been building top performing clinics.

Here's the post: 5 Lessons From 22,362 Clinics About Building A Successful Cosmetic Practice

If you leave any 1 of these 5 areas out you're hamstringing your business and and stunting your growth. If you're good at at least 3 and you'll be competitive, and if you're good at all 5 you'll own your local market... the world is your oyster. 

  1. Mastering patient consultations (sales)
  2. Replacing yourself with systems (operations)
  3. Delivering the remarkable (patient experience)
  4. Aligning your staff's perceived best-interests (leadership)
  5. Waging asymmetrical warfare against the competition (strategy)

You'll notice, and I discuss this in the post, that there's nothing on treatment results (patient outcomes), what IPL or device you're using (technology), or price (money). That's because these three areas, the areas that most clinic owners - especially those starting out - obsess over have no correlation with the success of the clinic. (Now' don't blow a gasket. I'm not saying that they're not important, especially around patient outcomes, but only that they do not contribute to how successful you are going to be in relationship to other clinics. Failure in these areas can destroy you, but success in these areas will not make you successful.)

That post obviously hit a nerve, especially around the top two areas on the list; mastering patient consultations and using systems to automate your clinic operations. And that's understandable. The consultation room is where the money is made, and clinic operations is where the money is lost. 

In fact, we received so many questions and inquires around improving consultations - more than 8 times what we normally receive - that we changed up the training course roadmap.

Our roadmap had been to systematically build a set of comprehensive trainings to teach you (#1) how to implement systems in your clinic (The Ultimate Clinic Operations Blueprint) so that you could make your clinic run more efficiently, then to launch a course (#2) on marketing that taught you how to bring in hundreds or thousands of new patients a year, and then to launch a course (#3) teaching you systems for consultations that convert (selling).

But in seeing the questions coming in we're switching that up a little.

The next Training Academy course we're launching will not be The Ultimate Clinic Marketing Plan, it will be The 10X Consultation Playbook.

Here's why: The single most important determining your sales success is how well you do one thing; consultations

Poor consultations destroy your reputation and waste every dollar you spend on bringing new patients in to your clinic. And they're not uncommon. It's simple math; 49% of clinicians are performing consults that are below average. Poor consultations will put you right on the edge of going out of business, and will force you to try to compete on price. If you're having thoughts around pricing, or if you're using terminology like "loss leader", or if you're just at the lower end of the pricing wars in your local market, it's likely - more than that, it's probable - that your consultations are below average.

Average consultations generate some sales and leave you bumping along and quasi-satisfied with your business - where you can't quite figure out what's missing. You know that you're leaving money on the table but don't exactly know why.

Heads up: The maddening thing about average consultations is that you won't see them as being average. You'll see them as way above average, just like every other person when asked to compare themselves to others. It's called illusory superiority and there are almost endless examples:

  • In Kruger and Dunning's experiments participants were given specific tasks (such as solving logic problems, analyzing grammar questions, and determining whether jokes were funny), and were asked to evaluate their performance on these tasks relative to the rest of the group, enabling a direct comparison of their actual and perceived performance.

    Results were divided into four groups depending on actual performance and it was found that all four groups evaluated their performance as above average, meaning that the lowest-scoring group (the bottom 25%) showed a very large illusory superiority bias. The researchers attributed this to the fact that the individuals who were worst at performing the tasks were also worst at recognizing skill in those tasks. This was supported by the fact that, given training, the worst subjects improved their estimate of their rank as well as getting better at the tasks. The paper, titled "Unskilled and Unaware of It: How Difficulties in Recognizing One's Own Incompetence Lead to Inflated Self-Assessments", won a Nobel Prize in 2000.
     
  • In a survey of faculty at the University of Nebraska–Lincoln, 68% of professors rated themselves in the top 25% for teaching ability, and more than 90% rated themselves as above average.
     
  • In a similar survey, 87% of Master of Business Administration students at Stanford University rated their academic performance as above the median.

Don't think that's you? 

Everyone describes themselves in positive terms compared to other people, and this includes thinking that they're less susceptible to bias than other people. This effect is called the "bias blind spot" and has been demonstrated independently.

We sent a survey to cosmetic clinicians (some of our Members) and asked them to score their consultations against their competitors on a scale of 1 to 10.

The results of that survey fit right in with every other study on how humans perceive themselves. Almost every clinician rated their consultative skills between 5 and 9. So, if you think that you'd rank your consultations as a 7 or 8, you're right at the top of the bell curve of average.

 Consultation Survey Results

Consultation Survey Results

(One interesting note; In speaking with two different clinicians who had rated themselves as a 7 and an 8 in this survey I brought up the fact that their self-rating put them in the 'average' column. Both of them immediately re-calibrated and added another point or two to their rating in order to remain above average.) 

You may have a competitor that is not using technology as good as yours, is not as technical skilled, does not deliver outcomes that are as good as yours, who is charging more (or less) than you do, but is still taking patients away from you. It's maddening, but there's a reason. They're delivering great consults. They're building empathy and trust with their patients. They're guiding along the journey that patient is asking for. There's no way you can compete with that based on having a newer IPL and - if you're going to be competitive - you're going to have to get better at consultations.

But there is good news. Mastering patient consultations is a skill set you can learn.
 

The money is made in the consultation room.

Great consultations are the secret of incredibly profitable clinics. They almost print money. Great consultations fill your schedule and treatment rooms and create fanatically loyal patients and they boost your revenue faster and easier than any other thing you can do as an individual. And great consultations come in all sorts of flavors.

It doesn't matter what your 'shtick' is. You may be rolling old school as a luminary plastic surgeon with a hundred degrees on your wall and a staff of 40, or you may be a family practice doc who's just learning Botox, or you might be setting up a new clinic and going through some sleepless nights wondering how you're going to pay for everything. Your consultations are something that you can improve that makes an immediate difference.

I've seen a lot of clinicians who are fantastic in the consultation room.

  • A plastic surgeon from Brazil who was all air kisses and theatricality. He looked and acted every bit of the Hollywood cliche plastic surgeon from his slicked back hair to his designer suits, but when he walked into the consultation room he stepped off his pedestal and patients knew they could trust him.
  • A Ukrainian physician who was working in the US as an esthetician with movie-star looks and fashion sense who literally sold three times as much as the physician in the clinic.
  • A goof-ball dermatologist who could barely dress himself and looked half the age of his patients open a brand new clinic and destroy the entrenched local competitors by being a boy-next-door.
  • An internist who was completely new to aesthetics pull a clinic out of foreclosure and make it insanely profitable by sitting down with patients and talking girlfriend-to-girlfriend.

All of these clinicians were different, but they all killed it in the consultation room, not because they were consultation savants, but because they understood that consultations are critical to success and they worked hard to improve. Their tactics and personalities varied dramatically and the way they presented to the patient were completely different, but the formula they followed was the same every time.

That structure, that system, that repeatable formula is what the 10x Consultation Playbook delivers.
 

Hope is not a strategy.

It's not going to happen by itself. You weren't trained in sales. In fact, some of the things you were taught are actively hampering you. You're not going to suddenly understand everything you need to know and do to improve your sales and neither is your team.

I can not tell you the number of times when I've asked clinicians how they start a consultation and it's some form of "tell me what you'd like done", or they hand the patient a mirror with something along the lines of "tell me what you see that you don't like". Worse still are the clinicians who actually just launch in to a litany of all the things they can see that they could "fix", oblivious to the frozen smile on the patient sitting their horrified and embarrassed to find out that they're such a wreck. 

The fact is that great businesses aren't built on luck or chance. The're built on repeatable rules and proven processes and reliable frameworks.

It may not sound too exciting, but I'm okay with that.

Because you know what is exciting? Implementing your new systems and finding that your conversion rates, and revenue spike. That is sexy. The best parts of business always are - without fail - the measurable parts. Everything else is just guesswork. And you can't build a business that wins by just relying on your guesses.

Systems help you pre-decide what’s important to you — ONCE — and then force you to stay focused. Instead of your clinic staff wondering what they should do… or making it up on the fly… you’ll have a clear system to follow that is both structured, and flexible, so you’re not working with so many variables that you have no clear idea what's working and what's not.

Once you integrate these systems into your clinic, you’ll feel the freedom of being able to make decisions and see their effects rather than just hoping that you're headed in the right direction.

Think of a simple system you already use — where you put your keys. Maybe it’s by the door, or in the kitchen. Yet it’s become a habit and you never think about it. You don’t have to “try harder” to put the keys where they should be… it just works. It’s mindless. And it does what it needs to do.

Now think about your consultations and the way they work.

You already have a 'system' that you're using. You're beginning the same way, you ask the same questions, and you give the same answers to the same questions each time. That's something of a system, but is it the best you could do? Couldn't it be improved if you actually had a structured system and formula that ensured that every consult was perfect?

That's why we're moving the Playbook up to be the next course we publish; because the money really is made in the consultation room and improving your consultations is the single easiest thing you can do with your existing clientele to bring in more revenue.

You don't have to spend money on advertising, or buy a new fractional laser. You just have to spend some time starting with the basics and building on your existing skill set. you don't have to get a new license or insurance rider.  You don't have to travel or take on inventory. You just have to learn and use some new skills that you can put to use immediately.

That's why I know that when you improve your consultations, you're going to see results.

Small differences in your [system] performance can lead to large differences in your results
— Brian Tracy

 Top performers know how to sell. Average performers don't.

The Playbook is not being built around hard selling or gimmicks or unethical practices. It's not about talking people in to treatments they don't need or being pushy. It's not about pressure. In fact, it's probably not at all what you think of as "sales training".

It's about guiding your patients along the journey they want to take.

The 10X Consultation Playbook is a  system that will take you past the guesswork. You'll get the frameworks, strategy, tactics and repeatable techniques to systematically improve your consultations and conversion rates. You'll learn exactly what to do and how and when to do it, but just as importantly you'll learn WHY you're doing it. In short, 10X Consultation Playbook is a method, a system, and a proven FORMULA... that clinicians have applied successfully over and over to produce high converting consultations, increased patient loyalty, and greater revenue.

It will also come with a 30 day money back guarantee and integrates perfectly with the Ultimate Clinic Operations Blueprint.

And it's not just for you. Every member of your staff will learn these systems too.

So if increasing your conversion rates, sales and income is of interest to you, please take just a second and sign up on our early bird list to be notified when the Playbook launches. Once you're on the email list we'll be sending some early snippets  and lessons and requesting feedback. And you'll also get a one-time special discount for being on the list when we go live.

 

Questions? Please leave a comment or contact us directly.

5 Lessons We've Learned About Building A Successful Cosmetic Practice

 Patient Experience

John D. Rockefeller's quote of "I would rather earn 1% of 100 people's efforts than 100% of my own" is exactly right. So how do you get your patients to help you out just 1% and turn your dribble of patient referrals into a torrent?

The smartest clinic owners know that getting your patients to work for you just that 1% is the path to easy, repeated sales, makes life difficult for your competitors, and isn't forcing you to work 80 hours a week to keep your head above water. Savvy clinicians intuitively work towards each of these goals, but they often don't think of them as part of a whole. In this series of posts we're going to pull these topics apart and detail why and how they all fit together to build a machine that perpetuates and grows your clinic's income. 

I'm going to break down 5 critical areas that you need to spend effort on improving if you're going to move past the average medical practice income and reputation and get into the VIP section of top performers. Leave any one of these out and you're hamstringing your business. 

  1. Mastering patient consultations
  2. Replacing yourself with systems
  3. Delivering the remarkable
  4. Aligning your staff's perceived best-interests
  5. Waging asymmetrical warfare against the competition

Note what's NOT on the list - anything about patient outcomes. (We'll take it for granted that you're not burning patients with your IPL or they're getting ptosis from your Botox.) Outcomes are really what patients "perceive", not the actual clinical result. Improving these 5 areas will readily increase patients perception of the value you're delivering, and their outcomes. What else is not on the list? Price. (More about this below.)

Here's why these 5 areas are of critical importance to your clinic, and what you can do to start improving them.

Mastering Patient Consultations 

Top performers know how to sell. Average performers hope you'll buy.

On a scale of 1 to 10, where would you rank your consultations? How good do you think you are? It's probably that you think that your consults are somewhere above average.  After all, you're getting patients and you're busy so what's the problem? Isn't being busy the goal?

Actually, no. Everyone is busy. That part's easy. Being successful and profitable is the goal. (Having a work/life balance and a 36 hour work week may be part of that too.) and if you're not delivering perfect consultations you're stepping on your own success. 

It's most likely that your consultations - like most - are completely average.

94% of college professors believe that their teaching skills are above average, a statistical impossibility, but there's nothing special in this regard about academics, clinicians also think they're above average in every self-assessment of skills.

We sent a survey to thousands of clinicians and asked them to rank their consults on a scale of 1 to 10. The results of that survey fit right in line with the college professors, every response rated their consultative skills between 5 and 9. So, if you answered the question above and ranked your consultations as a 7 or 8, you're right at the top of the bell curve and you can bet that your consultations are solidly average. Sorry.

Why is that important?

Poor consultations destroy your reputation and waste every dollar you spend on bringing new patients in to your clinic. Poor consults will put you out of business.

Average consultations generate some sales and leave you almost (but not quite) satisfied with your business - where you can't quite figure out what's missing and your clinic is just grinding along. 

Great consultations are the secret of incredibly profitable clinics. They almost print money. Great consultations fill your schedule and treatment rooms and create fanatically loyal patients and they boost your revenue faster and easier than anything else.  Best of all, mastering patient consultations is a skill set you can learn.

What to do: You need to improve your consultations. To that end, we're about to launch the 10X Consultation Playbook in the Training Academy in order to teach you and your entire staff how to master consultations. This masterclass teaches you everything you need to know to put your consultations at the very top of the heap. Oh, and it's 100% satisfaction guaranteed.


Replacing Yourself With Systems

Top performers use systems. Average performers don't.

 Stop working IN your clinic, and start working ON your clinic.

Systems are what every clinic uses in order to stop micro-managing, stop flailing, stop losing patients, and stop losing revenue. They're a way of replacing yourself. Systems help you pre-decide what’s important to you — ONCE — and then force you to stay focused. Instead of your clinic staff wondering what they should do… or making it up on the fly… you’ll have a clear system to follow that is both structured, and flexible, so you’re not constantly “trying harder” to “catch up.”

Once you integrate real systems into your clinic, you’ll feel the freedom of not being crushed by the necessity to be involved in everything (I'm talking to you, micro-manager) because you know that everything is getting done, and it's getting done right.

Think of the simplest system you use — where you put your keys. Maybe it’s by the door, or in the kitchen. Yet it’s become a habit and you never think about it. You don’t have to “try harder” to put the keys where they should be… it just works. It’s mindless. And it does what it needs to do.

You may be thinking that you already have systems. You have a manual, you have some "policies", everyone knows pretty much what to do and when.

Eh... I'm skeptical.

A few weeks ago, I sent a survey to 472 physicians asking about their clinic's efficiency and productivity. Perhaps you're not surprised by some of the results. You might even recognize your own clinic.

  • Over 9/10 of physicians said that their clinic operated at less than 80% efficiency
  • 4 out of 10 said that their clinic efficiency was below 60%!
  • Physicians reported this "productivity gap" costs their clinic between $5k and $40k in lost revenue every month.
  • When I asked them what doesn't work, the most common responses: "lack of systems" (44%), "wasted time and effort" (50%), and "micro-management" (40%).

There's a better way that can pull you out of the micro-managing, hair-on-fire, unproductive daily grind and put you in a position where you're working ON your business, not IN your business.

You're smart. You're tired of sloppy training, loose accountability, and variable patient care and you want some control of your business and your lifestyle. You're tired of putting out fires, answer the same questions, micro-managing everything, and running legal, clinical, and business risks.

Get real systems and put them to work for you.


Being Remarkable

Top performers are remarkable. Average performers are nondescript.

Please don't be beige.

Hard I know, but beige sucks. Beige is mediocre. Beige is completely forgettable. Unfortunately, most clinics aspire to beige... do what everyone else does. It's safe. They're thinking, "I should be able to make go of it... I can do what others are doing...  at least I won't make any costly mistakes that cost me."

Not so.

Working to be average is among the most costly mistakes clinics make, and the most common. Playing it safe leaves stillborn everything you might do that could cause a patient to 'remark' about your clinic. It leaves your patients in limbo and forces you to carry all the water yourself. 

To get your patients to tell others you need to do two things; first, you need to be worthy of being remarked upon and second, you need to make it easy.

Example of being remarkable: One of my clinics was located near a big U.S. Air Force base with about 20,000 military personnel and staff. When operation Iraqi Freedom was launched in 2002 many of those military members were about to be deployed to Turkey for a year. Just before this deployment were some politics going on in the UN and France vetoed a resolution which was unpopular at the base.

I took the opportunity to launch a tongue-in-cheek PR campaign to "Veto French Armpits" and we gave away free underarm laser hair removal treatments to every female military member as well as any wives or girlfriends of military personnel. It was open-ended and completely free series of 7 treatments, a complete package. We didn't tie it to other offers, and yes, we did get some patients who took advantage of it completely but that was what elevated it and made it remarkable. 

The result? We donated more than $40,000 in treatments which made us a lot of friends and brought in a massive surge of new patients, we got national media attention and a deluge of local coverage, and we took a massive chunk of the market that continues to this day. That investment in being remarkable produced about a million dollars in revenue over the years, dwarfing our investment.

If you're open to seizing opportunity, you can do remarkable work with just about any situation. We secured a massive patient population not by doing something that was simple, but by doing something that was remarkable.

Do something, anything, that makes you worth talking about.

Second; you need to make it easy for your patients to help you. If you don't,  you're missing out on all of the goodwill and positive thoughts you're generating.

How many times have you asked patients to share a Like on your Facebook page, or leave a review on Google, or just hoped that they would see how incredible you are and tell everyone?

Hope is not a strategy.

You need to make it easy for them, and that means facilitating the action you're asking them to take - Keep a stack of postcards at the front desk and give them $10 off if they'll write a friends address and a short note when they check out. Give a free package for local business owners or their spouse. Start a corporate program. 

The key is that you want to build these out as part of your standard processes and make it drop-dead easy.

Take a look at the special offer from Podium, the leader in patient review marketing. It's a paid application that allows you to capture reviews from you happy patients right at your front desk when your patients are most likely to take the time to help you out.


Aligning Your Staff's Best-Interests With Your Clinic's Needs

Top performers are leaders. Average performers just pay.

If you think that anyone works for you, well, news flash -  they don't. They all work for themselves, just like you do.

Your job, as a business owner, is to align what they perceive to be in their own best interest with your business goals. This will always include money, but there are other areas where you can have a drastic impact. Workload, environment, professional and personal satisfaction, advancement and training, reputation... your goal is to make your staff believe that making your clinic excel is the most closely aligned with their desired path forward. Do this, and you're going to have a motivated team.

If you can't do this, you're going to have constant turnover and you'll lose income. Your staff may comply with your demands, but they're working for a paycheck, and it only takes a single arched eyebrow or eye-roll to cost you a $4,500 package sale or destroy a reputation with a patient. Multiply that by every patient interaction and you'll see a significant problem.

What's the difference?

Leaders understand that everyone works for themselves. They understand that leadership is given by those willing to follow from the bottom up. Leaders have to live up to very high standards to be worthy of being followed, and they work at it constantly.

Average performers think that their staff works for them. They have 'authority' that flows from the top down, but they're not leaders because they're not worth following. People work simply for a paycheck and will leave as soon as something better comes along. 

What can you do?

  • Work hard to be be someone that others are willing to follow. It's not easy and there are challenges. You'll occasionally be taken advantage of but much less so if you just take the authority route. 
  • Implement systems in your clinic that get your head above the ground and allow you to focus on bigger picture goals.
  • Constantly talk to all of your staff members. Be aware of changing attitudes that may signal a problem. Ask them how aligned they think they are with the clinic. Most people will be very open if they sense that you're interest is genuine.
  • Empower them to make decisions, and use policies to make sure that everyone knows which types of decisions they can make.
  • Get better at interviewing people and asking the right questions.
  • Fire faster. Firing is difficult and most people wait until there's real damage being done.
  • Make sure you understand common embezzlement and employee scams. Forewarned is forearmed

When you've aligned your team you'll feel like you're running downhill. Everything is just easier.


Destroying Competitors With Asymmetrical Competition

Top performers make it happen. Average performers hope, and hope is not a strategy.

Like it or not, cosmetic medicine is a business, and that means that it's going to be increasingly competitive as treatments and services become commoditized and prices drop leading to increased competition.

Asymmetrical Competition is finding and exploiting game-changing opportunities that your competitors can't easily match or compete against. 

When we began opening clinics in new locations we devastated the existing clinics run by clinicians who were taking their patient populations for granted. These physicians (mostly plastic surgeons and dermatologists at the time) expected that they would simply inherit all new cosmetic treatments as part of their current fiefdom of "aesthetics". 

They couldn't respond or adapt to the playing field we created.

Rather than position ourselves as competitors to existing practices we redefined the market and positioned ourselves as the experts in nonsurgical cosmetic technologies. We positioned the existing plastics and derm clinics as experts in surgery and dermatology, and we took everything else. The competition didn't have an easy answer since what we were doing was a fundamental change that they couldn't respond to or reproduce.

We focused with absolute madness on keeping appointments on time, on incredible patient services, and on giving power to our patients. We built systems that put our clinics on autopilot and allowed us to easily scale. We empowered our staff to make any decision, as long as they could explain that it was in the best interests of the clinic. We initiated corporate programs, free educational seminars and consults, incredible comfort and atmosphere, and we took all design and marketing seriously. We trained our staff to perform consultations based on sales and service that crushed our goals while turning our patients into raving zealots. We embraced social media and email. We answered questions and posted our pricing right on our website. In short, we did everything that they couldn't do. 

Of course they adapted and started trying to copy us, but they couldn't actually compete. They didn't have the systems, or the desire.

Asymmetrical Competition is available to you as well. You just need to look at what your capabilities are and match those to the market's need. Most clinics don't have the ability to change. They're essentially locked in place and that always presents you with opportunities to exploit areas that they can't adapt to.

As a Medical Spa MD Member you have assess to a wealth of information and know-how about building your clinic. Special offers from partners when you're buying your next laser or IPL, group-buy wholesale pricing on fillers and injectables, software deals, design & marketing services

Be smart and take advantage of it all.


Note What's Not On This List

The cosmetic medical market has matured in the last 15 years, but 5 areas above are not entirely tied to medicine, they're really business strategies. You won't find "improving patient outcomes" here because those are simply table stakes. 

Patient Outcomes - You can't build a business marketing better patient outcomes.

Outcomes are what the patient says they are. You can have a perfect outcome but if the patient expectations are unrealistic, the 'outcome' from the patients point of view can still be negative. Trying to build your clinic and reputation only through your technical prowess is essentially a dead end because it's beyond your control.

(Now I'm not saying that this is not a priority and shouldn't be your focus, but I am telling you that trying to convince your patient population that you're 'better' than the competition makes you seem small and petty and is only a part of what a successful strategy looks like.)

Technology - Not a determining factor in your success

There are successful clinics using every platform.

Choosing the right technology is important, and can save you money, but the lasers and IPLs that you put in your clinic are all producing the same light waves. There are differences; customer service, cost, consumables, and usability, but none of those will either put your clinic out of business, or make you more money on their own. It's reasonable to let laser companies help pay for some of your marketing, but don't make the mistake that they're going to really help you much. patients don't buy based on which IPL you're using, they buy from someone they know, like, and trust.

If you're looking to save money and find a reputable vendor of used devices, contact anyone in our used cosmetic lasers classifieds who is a member of our Certified Partners program and you'll get a great deal. (And if you have a complaint you can contact us directly as a Member and we'll intercede on your behalf.)

Price - The death spiral of lowest-pricing.

Do not hitch your wagon to being the low-cost provider unless you love being on the verge of bankruptcy at all times. There can only be one lowest price in any market, and everyone who will come to you because of price will leave you just as fast. If you can't justify higher pricing then put the work in to build a clinic that does. 


Conclusion

In future posts we're going to dive into these areas in detail and help you take actions to improve them.

Have some thoughts on this or anything to add? Leave a comment. I read them all.


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