Sona MedSpas: An unhappy franchise owner.

Ron Berglund, a Sona medspa owner, left this comment on one of the most widely read articles on this site: What's wrong with medical spa franchises? The article Ron refers to is referenced here: Medspa boom is a bust for some.

"You may want to check out the November 21 issue of the Wall Street Journal. There is a very informative article about mdeical spas (primarily the Sona MedSpa and Radiance franchises).

Having been a franchisee (St. Paul, MN) for almost three years and now facing personal bankruptcy and financial ruin, I can vouch for the accuracy of the article. I have personal knowledge that perhaps 33% (and maybe over 50%) of the Sona franchisees have either already failed or are struggling. The Sona business model-- and I am guessing most of the franchised medspa models-- are replete with flaws, problems and booby traps.

For starters, any business that tells you to spend 25% of gross revenues on marketing and advertising is giving you a recipe for financial disaster down the road. Relying almost entirely on inflated revenues from prepaid multi-treatment packages (allowing you to take in - and spend-- thousands of dollars today without making any provision for the steadily growing future service liabilities) are also a trap for the undercapitalized and unsophisticated. Finally, Sona encouraged us to commit the mortal sin of cosmetic practice-- they coached us to overpromise results to the point of commiting fraud with thousands of clients. When the Sona-required lasers failed enable us to deliver these impossible results we were literally murdered with demands for additional treatments.

I predict a huge "shakeout" in 2007 as other medspa franchisees hit the courthouses with litigation and financial nightmares. The profitable delivery of esthetic medical services is a tricky and demanding challenge for anyone. I believe it takes a unique combination of business and marketing acumen together with great medical skill and emotional intelligence to navigate these tumultuous waters without drowning."

Ron Berglund 

The article Ron refers to is referenced here: Medspa boom is a bust for some.

From the same thread.

JustCurious asks: How does a medspa franchisee handle closing its doors? Aren't there agreements (in years) that must be signed with the franchisor and wouldn't there be penalties for closing shop? I've notice several medspa franchises closing or selling their business within 2 years of opening their doors and I'm wondering (a) what motivates them to close or sell so quickly and (b) what the penalties of closing/selling could be. Also, if a franchisee sells their medspa in this "billion dollar industry" so quickly, is that usually an indication of a failing business?

Dear Just Curious: Thanks for the response to my recent comment. You are asking two additional questions which are very important with regard to the subject at hand. First, you are asking how does a medspa legally close its doors. Closing shop would be no problem if all transactions were handled on a "pay as you go" basis. Unfortunately, most med spas sell primarily multi-treatment "packages". The Sona model encouraged us to do that almost exclusively. We typically sold five-treatment packages for laser hair removal, and often offered BOGO promotions wherein the client would purchase -- and pay cash up front for --five treatments at the "regular" price (full bikini @ $975 for example) and then would receive five FREE treatments for the underarms area. I had an excellent first year of operations since I was taking in thousands of dollars each month for treatments to be performed in the future. After signing up an average of 100 clients per month and pushing the future service obligation forward, you end up "painting yourself into a corner" and facing an insurmountable liability for performing treatments already paid for. Jeff Nebot had the same problem in St. Louis, except that his numbers were typically about triple my numbers. As this isn't enough of a problem, just imaging what happens when you try to sell or close the business!! You have several thousand clients who have prepaid and are legally entitled to the treatments they have already paid you for-- but you cannot afford to keep the Pnonzi scheme going! Believe me-- this makes any medspa almost impossible to sell because any prospective purchaser is scared to death to walk into this huge liability. That is the primary reason Jeff Nebot and I ended giving away our centers for free. Our buildout, furniture and equipment in St. Paul had cost us almost a million dollars and Jeff Nebot's investment was probably twice as much. I know first hand of several former Sona franchisees losing more than a million dollars on the whole mess-- in addition to a million headaches. There was a story posted on the Internet about the former Salt Lake City Sona franchisee closing her doors and failing to provide hundreds of clients with their pre-paid treatments. The article stated that Utah authorities chased the owners down in Texas and instituted some type of legal proceedings against them. I never heard how the matter was resolved, but I heard that the state was trying to impose some stiff penalties against the (Sona) owners.

Your second question asked how can it be that all these problems are occuring when this "med spa boom" is supposed to be happening all around us. The answer-- in my opinion-- is that the so-called med spa "boom" is to a large extent hype. I predict that the majority of the marginal operations will fall by the wayside during the next twelve month and the survivors will be the operatoins that are well funded and operated on sound business principles. Sona and many of the other franchised systems were attempting to offer a "get rich quick" scheme and also a model which-- for the most part-- utilized the physician as essentialy a mere figurehead. My personal belief is that the only truly successful med spa model requires three key components: 1. The physician is the key to the business-- similar to the dentist in the traditional dental office model; 2. The physician needs to be "on site" for a number of reasons-- business, professional and regulatory; and 3. The model requires superb marketing including a ton of cross-promotion and "guerrilla" marketing. Due to competition. typical profit margins and a number of other factors, med spas simply cnnot afford to allow advertising and marketing expenses to exceed over 10% of gross revenues. Whereas most physicians already have from 5000 to 15,000 patients in their data base who can serve as a "warm" client base for a med spa, all of the franchised med spa models start with zero and need to "buy" each client they recruit. Believe me--these outrageous advertising expenses eventually catch up with you! There is a reason the typical fast food franchises absolutely require that advertising expenses remain in the neighborhood of 7% of gross revenues. In order to survive in the low margin marketplace, there is no other way.

Ron Berglund 

Physician Oversight & Scope Of Practice: What's legal in a medical spa?

Physician oversight & scope of practice in medspas.

We receive an ever growing number of questions about physician oversight, scope of practice, and other legal issues surrounding medical spas. What oversight is required? What can I do? What can't I do? Here's our opinion (ie. not a legal one.)

The quick growth of medical spas has led to something of a Wild West mentality. Many spa owners and even some physicians are trying to jump into this market. Unfortunately, this has landed a number of medical spas in hot water. Very hot. Medical spa professionals and many physicians don't understand the legal ramifications of what they're doing. What's legal? What's not?

Here's a sample: "Hello, I am an esthetician currently working in a day spa. My boss has decided to buy and train another esthetician and myself on the Thermage system. Since we are a medical spa, there is no practicing physician on the premises. My question to you is; how legal will our Thermage treatments be without an overseeing physician? By performing these treatments, will my license be on the line?"

Short Answer: Performing Thermage under the above circumstances is practicing medicine without a license.

Longer Answer: There are a couple of problems the question alludes to. First, the 'boss' appears to be someone other than a physician. Non-physicians can not purchase medical devices restricted by the FDA to physicians only. Second, if patients would be treated medically without an examination or being seen by a physician that is absolutely illegal. Third, 'no physician on the premises' is a big red flag. Doctors can not extend their licence to Thermage any more than they can extend it to surgery. It doesn't matter that a physician is directing that the treatment be performed or that your boss thinks it's safe. Fourth, Yes, your licence is at risk. Anyone performing medical treatments without adequate oversight is going to be between a rock and a hard place if anything happens. Thermage (and every other medical treatment) have potentially harmful side effects. Don't think for a moment that you, the doctor, or the business are protected by a physicians medical malpractice if a treatment is performed illegally. (Always check with an experienced lawyer.)

Physician Oversight

Physicians are responsible for every treatment performed under their medical license. If it's a medical treatment, the physician is responsible and liable for the performance of that treatment. The state medical board has jurisdiction as to scope of practice and physicians can't extend the scope of their medical license.

Aestheticians and medical spa technicians performing 'medical treatments' are doing so under the license of a doctor. If the doctor can't extend his license to that particular treatment, it's not covered by his licence and is being performed illegally. Anyone, including the physician, involved with treating patients without legal medical supervision is asking for trouble.

Post your question as a comment on this post and we'll add the answers here.

Question: I really appreciated this article. But I'm wondering, what are the issues involving an registered nurse or nurse practicioner, both of which are entering the esthetics industry? Does a spa offering Botox with a np need a doctor on site? What if that np is working in a state in which np's can operate as an individual business? What options does a spa have with nurses as opposed to a doctor or esthetician?   Spalady

Answer: Nurse Practitioners (NP's) and Physicians Assistants (PA's) in some states have the ability to operate outside of the direct supervision of physicians.

Both must have an arrangement with a physician to supervise them and enter into an agreement with their supervising physician that gives access to the doc. PA's are limited in that they can not open up a business by themselves and have to report more directly. (Which is one reason PA's are more attractive to physicians since they can't just open up in competition with you.)

Registered Nurses (RN's) do not have the ability to operate outside of the direct supervision of a physician in the same way as NP's.

It breaks down as this: NP's and PA's may have the ability to provide medical oversight if a physician is not physically on site, RN's do not. You should always, always, always, have your lawyer check with the state since they're the ones who will decide.

Good advice from a lawyer I know is this: write to the state detailing exactly what you are doing. Do not try to sugar coat it at all. Ask for a written reply from the state saying that they have no problem with you. Keep this as documentation if something goes amiss. That way you have a state regulatory body saying that you were performing within the scope of practice. Excellent advice.

Read the comments since there is some elaboration on scope of practice.  

The 5 Stages of Consumer Decision Making that all your patients use.

When patients buy your services, they all engage in a decision-making process. Research shows that one of the major problems with businesses is that they fail in supporting the customers in this process. By understanding your patients needs and concerns as they progress through the decision-making cycle, you can build better and more successful medical practice.

The consumer decision-making process

Imagine that you need a new cell phone. The first step is recognizing your need. (You can insert 'want' or 'desire' instead of need.) Though you may have an idea of which phone you would like to purchase, you research your options to narrow the possibilities.

If you're a male, you go online and investigate manufacturers, resellers, and independent consumer organisations. You ask friends and colleagues for advice, and you visit a few stores to "kick the tires." You compare you options and finally decide to purchase what seems to be the best alternative, based on criteria like design, features, price. For men, this is a linear process.

If you're female you go through a much different, non-linear, decision making process that takes into account different variables than males typically choose. Men perceive this process as introducing a lot of extraneous noise into what should be a straight forward decision about cost vs.. benefits. Women are actually much harder to please because they're also buying a cell phone based on: What color it is. How it fits in their purse. cute factor, etc. They're deciding how much 'faith or trust' to put in the business. One process is not 'better' than the other, they're just different.

Warning: This is where many men don't get it. Women are using criteria that men don't understand so men tend to disregard this process. While women are harder to please, they are much more loyal consumers if you can satisfy them initially. Men look for features, women look for faith. 

After your purchase, you assess whether it lives up to your expectations. You might find that the phone is able to do what the manufacture promised, but that the navigation is unmanageable. You decide that you will never buy this brand again.

Your decision-making process can be described as five different stages:

 
The customer decision-making process and its five stages

The complexity of this process can range from careful analysis to pure impulse. While an impulse buy, such as adding additional services or products to an existing appointment, can take place instantaneously, complex purchase decisions stretch over a long period of time. This buying process is an iterative process, where patients may collect information from different sources and repeatedly return to re-evaluate and compare the information they have found. Women are particularly adept at this and consider any number of points that you may not be aware of in this decision making process. One of the most important of these could be described as 'feel'. (Men typically descry this type of methodology, often causing them to dismiss what women see as the most important part of their decision making.)

The customer funnel

The Web is a great tool for information research. Studies show that the Internet is now the primary means by which people get key information. This counts for commerce in particular. People expect to be able to find information about products they are considering buying, even if a company doesn't sell its products online.

Considering peoples' high expectations about the information and services available online, it's disturbing to see just how bad commerce web sites are at selling.

Lets look at a study on consumer buying patterns online as an illustration: From their tests of consumer commerce, researchers from the usability consultancy UIE have discovered that the buying process acts as a sieve, where customers are inadvertently filtered out at each stage of their decision-making process. UIE's studies show that out of 100% of purchase-ready customers completely intent on buying, only 34% will actually make the purchase.

 

Studies show that  buying process acts as a sieve, where customers are inadvertently filter out at each stage of their decision-making process.

 

At the information search stage, 9% weren't able to find the products they were looking for because they couldn't identify the right product category or find product options. 8% of the shoppers who succeeded in finding products gave up because the product lists didn't provide enough information to identify purchase options, or because they were confused by going back and forth between product lists and product description pages in order to decide if the products would fit their needs.

UIE's researchers found that the major problems occur when customers want to evaluate alternatives. Only 25% of the shoppers who reached this stage proceeded to the next. Some stopped because they realized none of the products would fit their needs, but most because the product information was so inadequate that they couldn't tell if the products they were interested in satisfied their needs.

At the purchase stage, 13% dropped out because they didn't want to go through the required registration process or because they where disappointed by poor shipping charge policies.

UIE also found a surprisingly high amount of problems in the purchase evaluation stage. 11% percent of the shoppers where either so unhappy with a product that they returned it. Some of the shoppers told UIE that they returned a product because it wasn't what they expected, which suggest a failure in setting up the right expectations in the product evaluation stage.

Knowing the customers' decision-making process

The most interesting thing about the study is that while they observed critical usability problems because of inadequate or poor information:

• Customers couldn't identify purchase options
• Customers couldn't decide if the products would satisfy their needs
• The product presentations and descriptions raised wrong expectations, which made customers unhappy with their purchases

Businesses simply fail in supporting the consumer decision-making process by not taking their customers' information needs into account.

Recommended reading: Marketing to women.

As a Physician, you will have little chance of knowing exactly which information needs patients have when evaluating specific services or treatments. To support the ' decision-making process, you need to understand which needs and concerns they have when making a purchase decision. There will often be patients who unintentionally mislead you by discussing a number of issues that appear to be of equal weight when they really have an overriding concern. You need to recognize how to discern exactly what a patients hierarchy of wants is.

The most effective way of discerning what is motivating your patients is to ask a number of very specific questions during a consultation. Surface physicians are trained, sometimes through trial and error, to ascertain the specific motivations that brought a patient in so that they can support the patients decision-making process.

Information search

The basic prerequisites for patients making their way through the information search stage is that they are able to find services that fit their perceived needs, and that they can easily identify their available options.

In order to support the decision-making process at this stage, you'll need to know:

• How will potential patients be inquiring about purchase options?
• What basic information do patients need in order to identify purchase options?
• What information do patients need in order to decide which product criteria are important to them?
  

Evaluation of alternatives

The problem with the operations in most clinics is that there's systems in place to effectively solicit this information. We saw above how a large number of customers dropped out at this stage simply because the information provided was inadequate. They couldn't decide whether the products they were interested in would fit their needs. All of your staff (especially the physician) should be acting as a skilled educator, and have answers ready to any question or concern that the customer might have.

Some of the critical questions that you need answers to are:

• What information does the patient need when evaluating treatment alternatives?
• Which product evaluation criteria will customers be using and which are most important?
• Which concerns will the customers have and how can we address them proactively?
• How can we encourage patients to maintain contact with the clinic?

Purchase decision

At this stage emphasis should be on providing the easiest possible way for patients to carry their purchase through. In the UIE example, we saw how obstructive policies made the process difficult. Patients want an easy way to find out where and how to buy.

Purchase evaluation

The outcome of the post-purchase evaluation stage is a level of customer satisfaction or dissatisfaction, which is determined by the customer's overall feelings about the effectiveness of the treatment and the experience.

The number on effect on patient satisfaction is the management of patient expectations. Most patient dissatisfaction is a consequence of not encouraging accurate customer expectations at the product evaluation stage. In order to avoid this, we have to make sure that the entire system, from initial contact to treatment, sets up the right expectations.

Designing for customer decision-making

Once we feel confident about customers' needs and concerns, our next challenge is to decide how to present the information to the customers in a way that supports the decision-making process. This is as much science as art. It is common for physicians to inflate their abilities in this regard. It's been my experience that every physician can benefit from constructive criticism and  training in presentation. Patient feedback to physicians is clouded by the patient/physician relationship. The result is that physicians feel that they are perfect communicators when they are not.

Conclusion

The decision making process happens in every instance. When confronted with the poor state of customer service and retention in medical clinics, patient are left to choose between providers. At each step of the decision making process, these clinics lose patients because staff never perfectly addressed their perception of what would be a 'perfect solution'.

Your medical spa staff should  be supporting patients no matter where they are in the decision-making process. They should address their needs and concerns at every point. Understanding the decision-making process, and how specific customers engage with specific needs is a prerequisite for any clinic with an ambition to turn visitors into patients.

What's with the Medical Spa price wars? Cheap is no way to build a medical practice.

Medical Spa physicians always seem to want to offer the lowest price. Why?

I speak with a lot of physicians. One of the first few questions that I'm asked has to do with pricing. (read the MedSpa Business or Med Spa Advertising Q&A here.) Physician and medical spa owners seem to be highly agitated by not offering the lowest price in town. This shows directly a lack of competence and belief in their own abilities. If you can't imagine why anyone would come to you except that you have the lowest prices, you have big trouble.

Anyone who will choose you based on price, will leave you just as quickly. That's OK if you happen to be able to deliver services at substantialy reduced costs compaired to your competiton (think Wal-Mart) but it's certain death if your not the clear low-price leader (think K-Mart). Does your Botox, Restylane, Thermage tips, or staff cost significantly less that your competition? No.

The only sustainable business you can build is a reputation on something other than price. Make a decison about where you want to be and start moving in that direction. No woman ever recomended Surface to her best friend with 'they're the cheapest'.

From Seth Godins Blog:

Cheaper is the last refuge of the person who's not a very good marketer. Cheaper is easy and cheaper is fast and cheaper is linear and cheaper is easy to do properly, at least at first. But cheaper doesn't spread the word (unless you are much cheaper, but to be much cheaper, you need to be organized from the ground up, like Walmart or JetBlue, to be cheaper). They are, you're not.

Cheaper is a short term hit, not a long term advantage. Cheaper doesn't create loyalty, because the other guy can always figure out how to be cheaper still, at least in the short run.

Medical Spa Legal Issues: New Q&A Discussion Area

I added a new discussion area called medical spa legal Q&A

 

In order to address a host of questions that I receive by e-mail and are carried on in discussion threads in other areas about what is legal or illegal, how physicians can structure a business with a non-physician, who can perform treatments, what the scope of practice is, what constitutes direct medical oversight, how you find out what your state regulations are, etc.

I have noticed that there have been a number of postings by non-physicians that are blatantly wrong, and so we are offering the legal area in order to have a little continuity where our physicians can get information that is at least slightly moderated and not full of spam and nonsense. If you have a question about any of the legal aspects of running, owning, operating a medical spa, read the medspa business discussion or the physician to physician threads as well as some of the other postings about opening a medical spa, building a medical spa inside your practice, etc.

None of the comments or posts are offered as legal advice. Consult your attorney before you do anything stupid. 

Top 10 lies of medspa technology salespeople.

These are the lies of salespeople from IPL, laser, and technology companies.

1. "We're committed to helping you grow your business."  This means that the salesperson has attended sales training and memorized a list of popular sales pitches. The information and 'sales growth' kits available from the tech companies are really pitches for building their name recognition. Sales people get paid for selling. Once your sold, you're in.

 2. “This is how (name of competitor medical spa) did it, and it worked.” If a tech salesperson is telling you about your competitors, they're telling your competitors about you too. The only contact sales staffs have are sales related. The information passed around is just what someone told them was the case.

3. “We'll take care of training your staff.” Lasers and IPLs almost always come with training packages. The sales rep will come in and give you a day or so of time. The rest will be up to you so you'd better attend as well since you'll be doing the training from now on.

4. “This is an easy business decision.” This is not an easy business. One of my buddies is one of the largest buyer and seller of used aesthetic equipment. He buys it from docs going out of business and sells it to docs going into business. (The salient part is docs going out of business.) This is a 'retail' medical business, not an easy one.

5. “This is how much this IPL/Laser/whatever costs.” The retail cost of lasers and IPL's is far above the street cost. Check out these listings on Ebay. A Cutera Xeo with a list price of $127,000 has a street value of around $70,000. Unless you need support or this is your first device, you will want to investigate used equipment.

Add your top lies of tech salespeople in the comments and I'll add them to this list. 

Complexity Causes 50% Of All Returns

If your med spa or laser clinc is built around so many options that your brochure looks like the Sears catalogue, you may want to read this article: Complexity causes 50% of product returns, which goes on to say:

Half of all malfunctioning products returned to stores by consumers are in full working order, but customers can't figure out how to operate the devices. Product complaints and returns are often caused by poor design, but companies frequently dismiss them as "nuisance calls.

The average consumer in the United States will struggle for 20 minutes to get a device working, before giving up.

Most of the flaws found their origin in the first phase of the design process.

This last one might be viewed as the most important. During the design of a system program or product, most of the problems with interface or use that are going to crop up are built into the system. Make any system you build adhere to a single, simple rule: Be able to explain the entire offer/system/pricing in one short sentence.

5 Valuable Services Your Medical Spa Doesn't Know About

5 Valuable Services Most Medspas Don't Use.

Iwas involved from the beginning of Medical Spas Online.com. Since we didn't really have any money to waste, I found a number of ultra-valuable resources that very few businesses that I know have ever had the benefit of even trying, let alone using day after day.

I decided today to list and describe the five most valuable services that I absolutely love and use daily. As your business grows, you should plan to invest in some or all of these services in order to improve your efficiency, and maximize your business potential. Used appropriately, these services can and give a company a tremendous competitive advantage over companies that aren't using them. But most of all, these services are just good business.

1 :: GotVMail Communications I have to start with GotVMail. Starting at $10 a month, GotVMail is a virtual PBX phone system designed for small businesses that works perfectly. It can be customized for 1 employee or 30, and can be used anywhere, with any phone, and instantly administered online. There are no long-term contracts to sign, and no hardware or software to purchase. Having purchased a number of PBX systems that start at around $3000 each, GotVMail is a huge bargain and has worked seamlessly. I've even switched one business over to GotVMail that has a perfectly good PBX system to take advantage of some of the features GotVMail provides. I just wish they had an easier name to type.

Features include a unique 800 toll free or local number, voicemail, multiple mailboxes, custom greetings, music-on-hold, live call forwarding, and other professional virtual office features including professional call-on-hold and receiption greetings that sound fantastic.

2 :: Constant Contact If you're not using an email service to contact and inform your existing clients... well, you should be. Constant Contact offers a 60 Day Free Trial I switched to Constant Contact from another provider after hearing rave reviews about them at a networking conference. Constant Contact lets someone without any real programming or HTML skill put together a fairly slick looking email campaign without any hassles. All the hard work is taken care of for you. I regularly have on of the office staff take an hour and send an email to our existing clientiele.

3 :: CallWave I can't really remember life before CallWave. While I use all three of their features the one I think really stands out for businesses is their Fax to Email feature.CallWave Fax to Email is another can't miss feature that lets you receive faxes through your email. (They're converted to PDF's that are sent as an attatchment.) I've found this feature to be invaluable since I never loose or misplace a fax. I have a filter set up on my inbox that forwards all faxes to a "fax" folder so that I never loose them and can email or print them whenever I need. eFax is another service that delivers faxes right to your email inbox that you can try for free. I don't use eFax but have had it recommend to me on a number of occasions so it's worth checking out. RapidFax's Fax to Email service is a third possibility. You can make you're own decision about which you like better but you'll definately want to use one the three.

4 :: GoToMyPC is my favorite service in the world. The ability to log on to a computer remotely changed the way that I and my staff do everything. For business owners, GoToMyPC could be the most valuable tool that I am reviewing today. So make this the first service you plan to become a fanatical user of. Since I'm a business with multiple locations, I can use this service to access any of my locations and work on that computer as if I were sitting in front of it. Our physicians use it to check their appointments for the next day. And it's easy, easy, easy.

5 :: Vonage Voice Over IP If you're running a business and you haven't already switched to VOIP, do it sooner rather than later. With VOIP, you connect your telephone to your high-speed Internet connection using the Vonage phone adapter that we send you. Pick up the phone, and use it just like you do today. You can be up and running within minutes of receiving your Vonage phone adapter. When you pick up the phone, the Vonage phone adapter converts your voice into data and sends it through the Internet like an email. Our network sends the call where you want it and translates it back into voice. When the person you're calling picks up the phone, it sounds just the same as any other call. When someone calls you, they dial your number, your phone rings, and all you have to do is pick up and answer it. The only difference is lower phone bills. So what are you waiting for? Sign up and start saving today.

Saying "I'm Sorry" Can Prevent Angry Patients

While most docs are scared to death to admit any kind of misstep, an apology in the right circumstances can turn the corner and avoid an escalation in unpleasantness. Trying to talk a patient into believing that their eye isn't acctually drooping is just not going to work.

“The majority of people who file medical lawsuits file out of anger, not greed,” says Sorry Works! founder Doug Wojcieszak. “That anger is driven by lack of communication, being abandoned by doctors and no one taking responsibility for his mistakes. Apologizing and offering some up-front compensation reduces this anger.

” Seventeen states have enacted apology laws; some make remorseful words inadmissible in court if uttered soon after mishaps occur. U.S. Sens. Max Baucus, D-Mont., and Michael Enzi, R-Wyo., introduced the Reliable Medical Justice Act on June 29 to provide federal funding for apology projects around the nation. While the need for federal grants here is a mystery, Washington should encourage this concept without reflexively whipping out the checkbook. Implementing it in VA hospitals would be a solid start.

Link to article.
The Sorry Works! Colation

Update on 2005-12-23 16:45 by Medical Spa MD

Comment by Aesthetic M.D.

While I agree that saying "sorry" can go a long way in helping patients heal from medical errors or mistakes, I think there are many other "grey areas" that occur in medicine. Aesthetic medicine is a field where people have high expectations...some of which might even be unreasonable. Here it is imperative to counsel before procedures as to possible outcomes. Explain what may or may not occur as fully as possible in order to manage expectations. So often a mistake or error has not necessarily taken place, but the patient's expectations were not met. What may ensue is a situation that is frustrating for both patients and physicians. I think most people would tend to agree that human nature is to avoid confrontation. Many of these unsatisfied patients are labeled as "complainers" or "problem patients." And many physicians just brush off these patients leaving them even more frustrated and disgruntled.

An apology may not be the appropriate sentiment and saying “I’m sorry you feel unsatisfied” may sound patronizing. The best approach may actually be the one that, at first, feels the most uncomfortable or laborious. But I have found that taking the time to sit down, face to face and to truly listen to what the patient has to say (without interrupting) is often all that is necessary. After they have finished, it might be appropriate to explain why something different from what they had expected did indeed occur. And finally try to rectify or fix their area of dissatisfaction, if it is possible. What I want them to understand is that I do care about whether or not they are happy and that I will try to do everything in my power to make them feel satisfied. As much as most physicians may not want to admit it, we are in a service industry where “the customer is always right.” So much of what we do is judged subjectively and there isn’t always a “right” or “wrong.” And if they are upset then it is the least we can do to offer support and exceptional customer service.

by: Aesthetic M.D.