Career Advancement for Medical Estheticians

Awhile back I posted an aesthetician position on a local job search website. In my requirements, I had stated that only those aestheticians who have been trained in the proper use of laser technology should apply. I must have received over 100 resumes with barely a few who have ever laid their hands on a laser or even observed any procedures.

I selected a few resumes who I felt had years of experience and; therefore, would know the basic concepts of how skin reacts to laser light, Fitzpatick Skin Typing Scale, etc. I was surprised at how many of them had no idea how to answer what I was asking them.

It's obvious there are many skilled aestheticians out there seeking employment, or desiring to advance their career. I would highly suggest the Advanced IPL & Laser Training Course for Estheticians & Medical Spa Laser Technicians.

Advanced IPL & Laser Training Course is much more than knowing what the difference is between 532nm and 2940nm of light; or how different wavelengths affect blood, pigment and water; or even how laser light affects the stem cells of a hair shaft during the anagen growth phase. It's about broadening your knowledge of the aesthetic field, becoming a more valuable member to a medical aesthetic team, increasing your revenue by commission and upselling with your knowledge, and benefiting your patient by being able to explain various treatment options for them (some performed by you and other treatments by the physician). Even though you may not perform every treatment in a medical spa, such as injectable procedures or laser skin resurfacing, your knowledge of those procedures is very important in the patient advocate and educational process.

Even if you have no hands on training at this point, the Advanced IPL & Laser Training Course for Estheticians & Medical Spa Laser Technicians will lay down the foundation you need to secure a position in a medical spa. If one of the candidates had any understanding of some of the principles of laser technology, I would have brought them in for a personal interview with the physician. Hands on training is the easy part, the hard part is the theory behind laser technology.

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Medical Spa MD: How to operate effectively in turbulent times.

If you’re involved with or own a medical spa, this question is no doubt on your mind.

In this article, I will give you several tips and tools to evaluate your laser centers culture and operations, so you can successfully navigate any economic downturn… And live to sell another day when the inevitable upturn comes around.

What is the Passion and Purpose of Your Medical Spa?

You reap what you sew. When you engage proactively and passionately in your business you will undoubtedly be successful and see your practice expand. It helps to articulate your passion for your medical spa.

At Assara Laser, our passion is to “help clients look and feel great, not fake.”

Why the Recession Drastically Affects Your Laser Clinics Bottom Line

You’ve probably noticed that generating revenue is not as easy as it once was. There are myriad reasons for this; from the decline in disposable income, to unemployment hitting record highs and tanking real estate valuations. As if these facts were not bleak enough, credit markets are virtually frozen so business owners are finding it nearly impossible to obtain small business loans and lines of credit. Refinancing current loans has become difficult for small businesses.

In short, we're operating in the perfect storm.

Accepting Reality and Responsibility Today

The easy way out is to close up shop and blame the recession. This will not help you going forward, it will not pay your devoted employees their wages, and most of all, it will not help your clients “look and feel great, not fake.”

So, accept responsibility. 

The hardships of the recession create a fact-pattern, problem to be solved; not a reason for failure. To paraphrase Michael Jackson, start, first, with the man in the mirror. Think about the following questions. And pay attention - there will be homework at the end of this article!

Finding Your Medspas Winning Competitive Difference?

Let’s be honest. The quality of your laser clinc's treatments are probably not drastically better than that of your competitors. The proprietary equipment and IPL or laser systems (Thermage, Fraxel, Titan) that you use are, for the most part, available to the competitive skin clinic market at large.

You may believe (and tell clients) that your microdermabrasion treatments are better because you use a diamond-tipped wand or aluminum oxide crystals. You may think that your IPLs or laser hair removal treatments are better because you use cryo-cooling or because you use chilled air cooling, or because you use a diode laser or because you use alexandrite lasers . . .

BUT . . .

Step in to your clients' shoes. To them, the bells and whistles of your Thermage or Fraxel device don't matter. Your clients already expect expert advice and cutting edge cosmetic lasers, IPLs and skin tighening equipment, so merely meeting this fundamental requirement is not a winning competitive difference.

What does matter to your clients are presentation, client interaction, customer service, reliability and consistency. Consider this carefully.

What is each of your medspas clients worth? 

At Assara Laser, one of the most popular packages is our $449 per month Unlimited Laser Hair Removal Program. On average, a client that signs up for this program will remain a member of the Program for 7 months, depending on the results they wish to achieve. How much is a single unlimited client worth to us?  A client in the program for 7 months, making a monthly payment of $449 is worth $3,143. For many laser clinic owners, a single laser hair removal client is worth more than a home mortgage payment!

Do you treat every single potential laser treatment client that contacts your laser clinic as if they’re worth $3,000?

What is your time and effort worth?

Before my partners and I built Assara Laser, I was an attorney. I still practice corporate law as a labor of love, when a friend or business contact has an exciting deal. I normally discount my rate to about $400 per hour, as law isn’t my primary source of income. 

Assume an hour of your time is worth $400.  Assume further that, every time your customers complain, you are willing to give a discount, or a free treatment and that, collectively, free and discounted treatments account for a 20% loss in your revenue. To make up for this lost revenue, how much more work do you have to do? 

Well, let’s add 20% to your 10 hour day, which now makes it a 12 hour day. If your annual sales are say $1,000,000 per year, you’ve lost $200,000. This translates into 500 hours more of work you must do to bring your revenue back to status quo!

Is there a big difference between a day that starts at 9:00 a.m. and ends at 7:00 p.m. versus ending at 9:00 p.m.  You betcha there is!  Is there a big difference between a loss of $200,000 and a loss of zero. You betcha there is!  And these differences drastically affect your quality of life.

How Do You Avoid Mistakes?

Mistakes are costly. A happy client is worth more than $3,000, and will likely refer business, the best and cheapest form of marketing. A single angry client will result in you working 2 hours more per day for the following seven work days, and will possibly diminish your reputation by badmouthing your medspa. 

A lot of people think excellent customer service means free treatments. It doesn’t. Excellent customer service means delivering what you promise. You know the limitations and effectiveness of your treatments so promise only what you can deliver and do it consistently, with a smile on your face!

Your Homework

Write an email to one close friend or business partner (or to me, if you would like to engage in this project with me: wshuman@assaralaser.com), in which you answer the following questions.  Cut and paste the text below into your email, and fill in the blanks with no more than three sentences: 

I wanted to pick your brain for a moment. I’m working on a plan to really blast my medical spa practice off the ground, and I wanted you to use your intuition to judge the quality my sentences below.  What do you think? 

The best way to succeed in business while I make clients feel great is:

The recession has made it harder for my medical spa to operate because:

My medical spa’s winning competitive difference is:

Each of my laser center's potential clients is worth:

I will earn every cent paid to me from a client’s hard earned money by:

The biggest recurring (or systemic failure) affecting my customer service is:

Please let me know your thoughts.

Note: The above is a guest post from Will S. of Assara Laser Centers.  You can find Assara on the web at the following links: Assara Homepage and Assara Blog.

If you would like to write or guest post for Medical Spa MD please contact Medical Spa MD here.

Medical Spa MD Training Courses

Finally available! The Medical Spa  MD Training Courses for Laser Clinics, Medical Spas, Plastic Surgery Centers and Cosmetic Dermatology Practices.

Your medical spa staff's knowledge and expertise is a critical componant to your medical spa or cosmetic clinic's success.

From IPL training to skin typing, Botox, Restylane, and Juvederm filler injections, the Medical Esthetician Training Manual & Study Guide, and the Advanced IPL & Laser Training for Non-physicians is required material for smart medial spas, plastic surgeons and cosmetic dermatologists.

Now it's easy to train every new hire on what non-surgical cosmetic proceedures you offer, how they work, and what alternatives there are. Ensure that your front desk, estheticians and laser technicians have the information that they need to answer patient questions with confidence.

For the first time, your laser clinic or medspa staff has the latest information on the newest nonsurgical medical treatments. From Botox, Restylane, and the newest filler injections, to fractional CO2 laser resurfacing, skin tightening and IPL treatments, now you have a uniform and tested training system. This is a must have for any serious cosmetic clinic.

Download Advanced IPL & Laser Training TOC
Download Medical Spa Aesthetics Training Course TOC

Advanced IPL & Laser Training Manual

The Advanced IPL & Laser Training Manual for Non-Physicians is required training material for every new hire working in a medical spa.

From IPL to fractional laser treatments, this manual covers the non-surgical IPL & Laser treatments your staff should know. Give your staff the information that will make you successful.

Advanced IPL & Laser Training - $227

Medical Estheticain Training Manual & Study Guide

 
The Advanced Medical Spa Esthetics Training Course & Study Guide is a two part learning cirriculum for non-physicians.

With 165 pages of quality content, this course is delivered in two parts that include a text book and a study guide. Already being used by leading medical spas and esthetician schools.

Medical Spa Aesthetics Training Manual & Study Guide - $247

Get all three and save: The Medical Spa Aesthetics Training Manual & Study Guide AND The Advanced IPL & Laser Training Manual

Buy the Medical Spa Aesthetics Training Course & Study Guide AND the IPL & Laser Training course and save almost $200!

 
Medical Spa Aesthetics Training, Study Guide, and Advanced IPL & Laser Training - $297

These training manuals are a critical component to the success of any Laser Center, Med Spa, Plastic Surgery or Cosmetic Dermatology practice. Use them to train every new medical spa staff member on what cosmetic proceedures are available, how they work, and what alternatives there are.

Written for non-physicians, both of these advanced training courses are already being used in leading medical spas and laser clinics to provide every new medical estheticians, laser techs, and front desk staff with current information about cosmetic information, and test their knowledge before they're hired.

Written by Paula D. Young, RN, these training manuals are designed to meet the real-world needs of cosmetic practices by those who know how to run a succesful cosmetic practice and how important it is that your staff is trained and has the information they need to become trusted avisors to your patients.

Everyone who has owned or run a med spa or cosmetic practice knows how long it takes to train new staff, and how much damage can be done with the wrong information. These new manuals and study course from Medical Spa MD make it easy to provide consistant, quality information to staff and ensure that everyone is on the same page from day one. Your entire staff now knows what your education expectations are and have the materials to meet them.

From Thermage to IPL to fillers and chemical peels, how they work, who they're for and when to use them. These courses give your laser techs, medical estheticians and front desk staff a deep understanding of the landscape of nonsurgical cosmetic medicine and save you endless hours of repetitive individual trainging. It's the single best investment you'll make in your medspa.

Give your staff the benefits of insider knowledge and make sure they're making the right decisions.

The Medical Spa Aesthics Training Course & Study Guide for medspas & laser clinics.

The Medical Spa Aesthetics Training Course & Study Guide for Medspas, Laser Clinics & Cosmetic Medical Practices.

NOW AVAILABLE!

Written by Paula D. Young, RN, the Advanced Medical Spa Esthetics Training Course & Study Guide is a two part learning cirriculum for non-physicians. The course is delivered in two parts that include a text book and a study guide.

This is an invaluable tool for any Laser Center, Med Spa, Plastic Surgery or Cosmetic Dermatology practice to train every new medical spa staff member on what cosmetic proceedures you offer, how they work, and what alternatives there are.

This study course is being used in medical esthetic schools and leading medical spas and laser clinics to provide every new esthetician and laser tech with a study course, and test their knowledge before they're hired.

For the first time, your laser clinic or medspa staff has the latest information on the newest nonsurgical medical treatments, from Botox, Restylane, and the newest filler injections, to fractional CO2 laser resurfacing and IPL treatments.

Your medical spa staffs knowledge and expertise is a critical componant to your success. Now you can be confident that your front desk, estheticians and laser technicians have the information that they need, and can answer patient questions with confidence.

Memberswill only be available to existing Medical Spa MD Members so be sure that you've signed up for your free membership.

Medical Spa MD: The 6 best ways to earn and use patient testimonials, associations, and third party endorsements.

Patient testimonials, third-party reviews and endorsements, media coverage... these can all differentiate your medical spa, plastic surgery, or cosmetic dermatology practice and convince potential patients to give your clinic a shot.

While search engine marketing (SEO), pay per click (ppc) and direct mail can put your practice in front of potential patients, third party patient testimonials can provide the needed level of ‘trust building’ to initiate a first contact.

The three types of third party validation for medical spas, plastic surgeons, and cosmetic dermatologists:

Direct Patient Testimonials: You’ve seen this if you’re not already doing it. Prominent display of your patients saying nice things about you.

Trust Through Association: The reason that you’ll put your FACS, ASAPS, AAD, or ASDS logo on your site is to build patient trust. It works. Of course, theses associations are completely restricted and very protective of their turf, leading to less restrictive medical associations who want to gain credibility. The reason MAPA was formed was to add some legitimacy to a group of non-core physicians. These associations are always pay to play.

Third Party Endorsements and Validations: Botox ‘premier providers’ is an example of third party endorsement as are others that are run by medical service companies. (If Medical Spa MD links to your medical spa it’s a third party endorsement.) Interestingly, third party endorsements actually have a more favorable impact than association endorsements since the third party is often more ‘relevant’ to the initiation of a financial transaction.

When you receive these kinds of accolades or promotions from prominent third-party players, if validates what you’re doing and provides the potential patient you’re marketing to a level of instant comfort that you’ve already been checked out and are the ‘real deal’.

Subtle changes to the way you’re handling your patient testimonials and third party endorsements can produce dramatic effects, especially online, where the majority of patients are now searching for information.

Medical Spa MD: Quick strategies for piling up and using patient endorsements

Target the places your patients already are: First and most importantly is your existing medical spa or cosmetic practice but you’ll be able to reach far out into the community and gain the endorsements of other prominent businesses and individuals

Identify third-party recognition programs: These are most often paid inclusion but there are ways to get these types of third party endorsements for free, or at reduced cost.

Prepare legal and media write-ups: The media only runs two types of story; we found something good and, we found out something we thought was good, was really bad. Uncover the ways to build this kind of content that you can use on your own site, and share with you local media outlets.

Provide ready-made strong human interest and strong visuals: Patients and the media love photos. If your fractional laser resurfacing before and after pictures suck, you’re losing traffic and paying patients. Learn how to manage your photos and make them more than just snapshots.

Give patient testimonials prominent placement: If you don’t have your patients smiling photo, full name, and a stellar testimonial, you’re less effective that you could be. Learn how to get patient testimonials that are truthful, candid, and really work. Read these testimonials from Medical Spa MD Members touting the benfits of belonging to the best cosmetic medicla commuity on the web.

Look for latent patient traffic, not spikes, from these techniques: The effective use of third party endorsements and patient testimonials work and drive patient flow, but it’s not a technique that provides an instant boost. It’s begins a trend and compounds over time.

If you’re not using patient testimonials and third party endorsements to drive patient flow, start now, your medial spa, cosmetic dermatology clinic, or plastic surgery practice will benefit far into the future.

And of course Medical Spa MD uses testimonials too. Read these testimonials from Medical Spa MD Members:

Mitchell Chasin, MD: Reflections Center for Skin & Body, Livingston NJ

Medical Spa MD helps us to stay focused on the details that make the difference between a thriving practice and one that is languishing in this sagging economy.

Medical Spa MD is an important resource that I recommend to anyone who wants to understand the trends and stay connected to the ever changing aesthetic community.

Paula D. Young RN: Young Medical Spa, Allentown - Lehigh Valley, PA

To really know what's going on in the aesthetic business you MUST join Medical Spa MD! Nowhere else can you find the information crucial to your success in this ever changing arena. From the classified ads section, to the professional community forum discussion threads, to real equipment reviews by aesthetic professionals. I especially value the articles on marketing and the community forum discussions on therapy management like melasma, fillers, laser lipolysis, and skin resurfacing. Medical Spa MD keeps me on my toes as a medical spa owner, marketer, and nurse!

Susan J. DeGuide, MD: Inovamed, Rockford IL

I found Medical Spa MD several months ago and immediately added it to my “Favorites” list. I check the site several times a week to look through the new posts. I enjoy learning about new technology, expanding my knowledge of the technology I already own, and knowing that I’m giving the best available care. I would not buy a new piece of equipment now without first consulting Medical Spa MD.

Ronald Berglund, Former Medical Spa Franchisee. Sybaritic, Inc.

...we no longer feel like we are "all by ourselves" out there. There are a myriad of challenges involved with operating a successful and profitable medical spa, including marketing, sales, operations and procedures, clinical, human resources, regulatory and legal. Another huge issue for everyone is choosing the best equipment for the price. With the help of the "medical spa equipment for sale" feature I have been able to sell several pieces of used equipment. Trying to use E-Bay and other Internet-based options was a nightmare.

Jeffery E. Epstein MD: Founder Medical Aesthetic Practice Association
& Cherry Hill Laser & Skin Care Center

When we look back on the early 21st century with regards to Cosmetic Medicine, we will think of R. Rox Anderson, The Carruthers and we will think of Medical Spa MD. By providing this platform (Medical Spa MD), Jeff Barson has done more to advance Cosmetic Medicine than Anderson and the Carruthers combined. There has been a paradigm change in the cosmetic medical world and it can be directly attributed to Medical Spa MD!

Medical Spa Consultants in NYC

Spa NYC is looking to open a Medical Spa and has talked to some Medical Spa Consultants.

We are looking into opening a medical spa. We are physicians, general practititoners, and have spoken to several consultants who would provide assistance to do the business planning, financial proformas, operating procedures, assist in hiring staff, marketing, equipment recommendations, space planning, info systems recommendations, web site development, etc.

We are located in the greater NY metropolitan area. anyone use a consultant they would recommend, or is it even worthwhile to do so?

And here's my response:

Beware. The vast majority of medical spa consultants are less than worthless in my opinion. Thre are only two that I've ever recommended and they both specialize in a specific niche.

Physicians are, as a rule, intelligent, but they think that because they're intelligent that they'll be able to 'think their way through' a problem. That's not generally the rule. Physicians have a reputation for being poor at business and there's reason enough for that.

The real cost of poor medical spa consultants is that they waste your time and distract you with irrelevant things like proformas statements and excel worksheets that project your earnings. Useless. Of the dozens of clinics I've been involved in and the millions of dollars spent and made, I've yet to see one single medical spa business plan that was worth a piss in the wind.

My advice is this. Go slow. The market isn't going to be kind to those who make mistakes and you can easily spend a couple of hundred thousand dollars in a bloodbath education. Just ask the myriad of physicians who regularly frequent this site. Go slow. Go slow. Go slow. Spreadsheets are worse than useless as are business plans. I've written dozens and they're used to give a sense of security where there is none.

Choosing technology? Note this sentence from Susan DeGuide MDs testimonial on joining Medical Spa MD: "I would not buy a new piece of equipment now without first consulting Medical Spa MD".

Post a question about the technology you're investigating and you'll receive responses and possibly an offer to talk by the physicians who are using it. If you don't take advantage of this resource you're too stupid to be practicing medicine. (Getting off on a little bit of a rant there... sorry.)

If you're looking for someone to build your medical spa for you so you can just step in, work 40 hours a week, and own everything, you've already lost. Cosmetic medicine is an entirely new area for most non-core docs and there's a learning curve. Don't get ahead of it. The greatest thing about Medical Spa MD is that you're able to find and network with physicians who are not your direct competition and are willing to help. Take advantage of it.

If you have some advice for a physician group in NYC that's opening a Medical Spa, help them out here or in the forums.

Should I open a medical spa?

Below is an example of the many emails I receive from doctors in residency. Many of these types of questions are from doctors in Family Practice but there are also quite a few from Plastic Surgery and Dermatology residents who don't want to be a lacky forever.

I've removed the name from the email but the questions are common so I thought I'd post this and see what sort of collective wisdom you more experienced doctors have for an about-to-be-graduate.

I am currently in my first year of Residency in Family Medicine. I am very interested in Aesthetic Medicine and in opening up a Cosmetic Spa when I am finished with my residency training. What are your suggestions in terms of how feasible this will be for me? Do I need to work for a few years as a general practioner before being able to proceed in this direction, or do I have the opportunity to dive straight into a cosmetic spa when I finish my training. I am hoping to use my elective time to learn cosmetic procedures. Any advice would be greatly appreciated.

Thank you,
VJ, MD
University of Oklahoma

Medspa MD: 9 Rules for Setting Your Prices

 

 

Setting prices for your medical spa or laser center?

 
Part guesswork, part experience, part number crunching - how ever you look at it, determining how much you're going to charge is a difficult task. Here are nine factors to take into consideration:

1. Your Costs
If your prices don't include enough just to break-even, you’re heading for trouble. Medical businesses are expensive to run. The best thing to do is add up all your costs so that you absolutely know how much you need to make each month. If you've made the mistake of paying your staff on commission, you'll need to figure all of this out as well.

Also make sure you factor in all the hidden costs of your business like insurance, services that never get paid for one reason or another, and everyone’s favourite - taxes.

2. Your Profit
Somewhat related to your costs, you should always consider how much money you are trying to make above breaking even. This is business after all. You will actually need to decide how much money you want to make.

3. Market Demand
Cosmetic medicine is in high demand, but the markets getting more and more competitive as well. You should be aiming to make your services more expensive. Conversely if there’s hardly any work around, you’ll need to cheapen up if you hope to compete. You're fortunate here in some respects. There are ways of maximizing physician time for where it's most needed, physician treatments and consultations.

4. Market Standards
It’s hard to know what others are charging, but try asking around. Find out what all the spas, medical spas, plastic surgeons, and dermatologists charge. The more you know about what others are charging and what services they provide for the money, the better you’ll know how you fit in to the market.

5. Demand level
If you're a plastic surgeon to the stars, you're going to be able to charge more. If you're a GP that's offering Botox twice a month, you're going to be charging less. You need to be realistic, not about what you think, but about what the marketing thinks. We all know that injecting Botox is not that hard, but the truth is that the market doesn't know that. You'll need to come to grips with what demand you can expect.

6. Experience
Although often bundled with skill, experience is a different factor altogether. You may have two very talented doctors, but one with more experience might have better client skills, be able to foresee problems (and thus save the client time and money), intuitively know what’s going to work for a certain audience and so on. Experience doesn't mean medical experience but a combination of medical and business experience. The markets acceptance of how much experience you have should affect how much you charge.

7. Your Business Strategy
Your strategy or your angle will make a huge difference to how you price yourself. Think about the difference between Revlon and Chanel, the two could make the same perfume but you would never expect to pay the same for both. Figure out how you are pitching yourself and use that to help determine if you are cheap’n'cheerful, high end or somewhere in between. (More on this in future posts.)

8. Your Services
What you provide for your clients will also make a big difference to your price tag. For example you might be a touchy-feely doc who will do whatever it takes to get a job just right, or perhaps you are on call 24-7, or perhaps you provide the minimum amount of communication to cut costs. Whatever the case, adjusting your pricing to the type and level of service you provide is a must. Surface charges a premium since we specialize. Generalists tend to have less pricing pull.

9. Who is Your Client
Your price will often vary for different clients. This happens for a few reasons. Some clients require more effort, some are riskier, some are repeat clients, some you'd do for free since they know everyone, some you wouldn’t want to go near with a stick. You should vary your price to account for these sorts of factors. While it's often assumed that only the rich are cosmetic patients, we all know that's not true. We have patients arrive in both limos and busses.

Give it lots of thought
Your pricing needs to be carefully thought out. I see a lot of physicians who set their prices on what the doc down the street is charging. There are a lot of docs who continually try to undercut the prices of everyone, exactly where you don't want to be. There can always be only one lowest price and the patient who will come to you based on price, will leave you just as fast.

Pricing isn't simple. You should keep an open mind about your ability to charge a premium. If you're charging too much or to little the market will tell you. Be receptive. 

Med Spa vs Laser Clinic: Analyzing your medical spa competiton.

Get to know the laser clinic and med spa competition.

Contrary to what some may say, growing your clinic or medical spa isn't a single event.

Successful clinics and medspas look for 'incremental wins' that compound over time. The key to winning market share is to differentiate your company by providing products, services or solutions that your best prospects will find more desirable than what's offered by your competitors.

Experienced marketers know it's easier to fill an existing need than to create one. Someone who is already using the type of product or service you offer is a great prospect because he or she has a clearly defined need and is looking for a solution.

The job of convincing qualified prospects to buy from you instead of your competitors' is where the real work begins. One of the first steps is knowing what the other clinics, day spas, medical spas, and others who might be competing are up to in your market.

1. Do some detective work. Ok, this is a little spy like, but don't think all of your competitors aren't doing it to you and it's just good business sense. Start by gathering your competitors' marketing tools and advertising materials. Read their web site, print and broadcast advertising, and articles in which they've been featured. Request their brochures, price lists and any collateral materials. You may also be able to do some mystery shopping, which will allow you to experience what these medical spas are offering and how their positioning themselves. You'll want to send your staff rather than visiting yourself if you want to avoid embarrassing situations. (Surface has had more than 45 plastic surgeons, dermatologists and other physicians attend our seminars over the last five years in this type of sneaky capacity. They're not hard to spot and often they're 'outed' by women in the audience. They're the guys (mostly) who are sitting in the back scribbling furiously while their estheticians sit up front and ask telling questions like, "Now types of sutures do you use?".)

2. Evaluate your "slant" competitors. Chances are, you have a lot more competitors than you think. In addition to real competitors, evaluate the marketing tools and materials of any businesses your prospects perceive as offering a similar set of products or services. It's very common for day spas to attempt to compete with medical practices by offering a few medical services from a NP or PA. Microderm is often touted as some sort of medical type treatment. OBGYN's, FP's, pretty much whoever is in the market or wanting to get in. Know who's saying what about you.

3. Focus on the message. Once you've gathered the materials, the next step is to analyze what's being communicated and how. Identify the key promises made by your broad field of competitors. And don't be surprised if you see a lot of "me too" marketing. There's so much out there that's mediocre or worse, you may find the majority of your competitors have similar messaging, with only a few front-runners showing anything approaching real positioning. (This probably refers to you but we'll work on that.)

After assessing the most effective messaging, look at the actual tools and materials themselves. What formats seem to work best overall? At this point, your competitive analysis will reveal whether your company is lacking any standard tools that prospects expect everyone in your industry to offer.

4. Find a unique spin. So now comes the 'look in the mirror' moment. You've gathered all the materials and have learned the key message points of your real and perceived competitors. It all boils down to this: How does your clinic meet its patients' needs in a way that is both unique and compelling?

To find the answer, consider not only the products or services you sell, but also how you operate, including any company-specific characteristics, such as a higher level of customer service or uniquely specific positioning. If you can't find a selling point based on your current service offering that will help you stand out from your competitors, use what you've learned in this competitive analysis to retool what you sell and how you sell it.

If you can't see any difference between yourself and your competitors, why should you think any patient would choose you? 

Medical Spa Classified Ads: IPLs, lasers & spa stuff.

New classified section for cosmetic medical & spa equipment.

 
Here's the new classified section for Medical Spa MD: Medical Spa Equipment

Here's where you can add a new listing.

If you've got something you're trying to move, now you've got the place to do it. There are currently four listing areas: IPLs, Lasers, Medical Equipment, and Spa Equipment. I'll add others if needed.

If  you've got something listed elsewhere or on consignment, I'd encourage you to list it here as well. Medical Spa MD has more than 18,000 unique monthly visitors and a large contingent of physicians. Better yet, the listings are free and there's no 'percentage of sale' so you've got no complaints there. The site is up and fully functional although there will be improvements as we go along.

I'm anxious to find out if this is a need that many have. Another middle-man gone.

Note: The classifieds will also be monitored and spam or solicitations will be removed. Equipment only for now. 

Seth Godin & Your Med Spa or Skin Clinic

In sitting down to write this post I was struck with the width of the topic. Not Seth Godin, but cosmetic medicine (laser clinics, med spas, skin clinics) and how successful medical practices are built and run. It's no easy task. Which brings up Seth Godin.

Seth has a job. He describes it as being Seth Godin, noticing things that don't have an existing vocabulary and giving words to people so that they can talk about concepts that didn't have words before. Seth's quite good at this as, since there's a scarcity of Seth Godin's in the world and he's the only one.

Scarcity. Superstars. Best in the world. Remarkability. Mantra.

All things I've blogged about but not really focused on in a coherent pattern.

In effect, I've missed the forest for the trees. I'm going to try to talk about a few of those trees. They're the ones you're using to build your business.

There are now many smart docs reading this site. Some comment, most do not. It's a statistical fact that only about 1% of any interaction you have (including blogging) elicits a response from the people you're interacting with. I'll guess that many come and scan the list of recent comments along the left side of the page rather than read what I'm writing about. That's good, fine, and by design. Decentralized but organized systems win every time.

Seth is used to talking about markets and retail. This site is for physicians in retail medicine (It say's so right at the top.) so I'm going to use some of Seth's words and some of my own. I think they're good ones.

Doctors in retail medicine have been operating at a disadvantage. Due to certain idiosyncrasies of the medical marketplace they've not had access to the resources that other retailers take for granted. The medical spa franchises are a first studdering step to bring systems to the marketplace. My own feelings are that the current crop are doomed to fail because they don't fulfill what is needed to succeed. Scarcity? Remarkability? Best in the world? No. If you've sat through any of the medspa franchise discovery days what you hear is this: Turn key operations. Low hanging fruit. Uniformity. Those are not the words that build successful businesses. These are the words that build commiditzed, mediocre, average, and struggling businesses.

The good news? There's also a scarcity of superstars. There's room at the top. Medicore's where the crowd is.

New Medspa? First; Write your press release.

My friend Pete loves to spread the word about customer obsession. Change the word 'customer' to 'patient' and Pete's blog is entirely applicable to your medical spa operations, even if it's distilled to equations.

One of Shmulas posts has to do with his experiance working at Amazon and the customer obsession that was practiced there. Here's an excerpt from Petes post on starting at the end and working back for clarity. Write the press release that announces where you're going to be first.

From Pete's blog at Shmula: Here’s another example: the product development process at Amazon is centered on the customer.  Amazon follows a process called "Working Backwards", which means that the first deliverables created are the documents at  launch, then work backwards towards the items closer to the implementation.  Defining a product this way adds clarity and simplicity — you know at the front-end what the customer can expect, and working backwards allows the team to build it.  Here are the general steps followed in this process, and I take it directly from Werner Vogels:

1. Start by writing the Press Release.  Nail it. The press release describes in a simple way what the product does and why it exists - what are the features and benefits. It needs to be very clear and to the point. Writing a press release up front clarifies how the world will see the product - not just how we think about it internally.
2. Write a Frequently Asked Questions document. Here’s where we add meat to the skeleton provided by the press release. It includes questions that came up when we wrote the press release. You would include questions that other folks asked when you shared the press release and you include questions that define what the product is good for. You put yourself in the shoes of someone using the product and consider all the questions you would have.
3. Define the customer experience. Describe in precise detail the customer experience for the different things a customer might do with the product. For products with a user interface, we would build mock ups of each screen that the customer uses. For web services, we write use cases, including code snippets, which describe ways you can imagine people using the product. The goal here is to tell stories of how a customer is solving their problems using the product.
4. Write the User Manual. The user manual is what a customer will use to really find out about what the product is and how they will use it. The user manual typically has three sections, concepts, how-to, and reference, which between them tell the customer everything they need to know to use the product. For products with more than one kind of user, we write more than one user manual.

Medspa Q&A: Legal: Can a non-physician employ a physician?

 This question pops up regularly so I'll bring it over here and answer it.

Question: Is it illegal for a non-physician owned medspa franchisee to employ a medical director? Can a non-physician owned medspa franchisee (physician owned franchisor) legally employ its own medical director? - ELH

ELH, Thanks for the question. Here's the answer. 

Answer: A non-physician can not employ a physician OR own a medical practice that employs a physician OR partner in a medical practice with a physician. Only physicians can employ or partner directly with other physicians.

Most of the generally accepted principals of business do not apply for one simple reason; You, as a non-physician, man not be involved in the practice of medicine in any way. 

Sure, hospitals and HMO's employ physicians but they have lobbyists in Washington, you do not. This is an absolute so I'll state it again, non-physicians can not employ physicians as employees. There are no exceptions (no matter what a medspa franchise might say.) Read the WSJ article on unhappy medspa owners here.

Clarification: That non-physicians can not employ physicians is an absolute rule. However, there are ways in which non-physicians can do business with physicians but they require a careful legal setup that doesn't violate the law.

• Example 1: You have a spa with a visiting physician who comes in and performs Botox and Restylane. You 1099 them at the end of the year as an independent contractor. WRONG: You can not do this as you would be employing a physician.
  
• Example 2: You have a spa and a physician solicits you to allow them to come in and treat your clients. The physician and you plan to split the revenue. WRONG: This would put you in a partnership with the physician as well as potential trouble for splitting fees. Big, big, trouble.

 Additional: In situations where a medical spa is set up incorrectly, the physician will be at risk. Every malpractice policy will be voided if a physician is practicing outside of the law, which this is. A physician who gets in trouble in a situation like this will be completely on her own and my best guess is that the prosecuting party will be happily pointing this out in court... not a good place to be.

The non-physician will be at risk as well. A physician can shut down your business at any time by refusing to extend their oversight to any medical treatments. The state could also be a problem since if it's found that you own a 'medical' business, you'll be shut down by the state tute suite.

You should be very wary about how you state what you own. While I've used examples of what you may not do, I've stayed away purposefully from exactly how you can legally set this up since I don't want to give advice that someone might follow and get themselves in trouble. Consult a lawyer who specializes in this area of medicine.

Medspa Q&A: Planning ahead for your medical spa.

This post is part of Medspa Q&A, questions that I receive from physicians. If you have a question you'd like me to answer, you can email it to me here.

Hello Jeff,
Thank you for your reply.

I graduated medical school in the summer of 2003, in Denmark, Copenhagen, and have since completed my internship (11/2 years) and worked temporarily in a general practice in Norway. I am currently on maternity leave and will be starting a PhD program in the summer of 2007.

I’ve always wanted to be a plastic surgeon. Plastic surgery seemed like the natural choice for me as I’ve always been very creative and love the combination of aesthetics and surgery. I love the challenge of correcting disfigurements and doing cosmetic enhancements.

I’ve had several opportunities to shadow other plastic surgeons and found their work exciting, but also somewhat crude and that’s why I really like the idea of non-surgical cosmetic medicine.

I have had plans for a long time of running my own clinic someday. My sister is a cosmetologist/spa manager and she introduced me to your website. We have often talked about working together and incorporating our different, but very complementary skills into a health enhancing, cosmetic business.

Until I read your website, I had no idea that medical spas existed. It seems like the perfect model for us. We have already committed to opening a medical spa.

I was hoping that I could get some information from you on how to start up such a practice, what I’d need and where I could be taught how to use fillers (e.g. Restylane, Botox, Liposolve, laser, point lift and other anti-aging techniques. I plan to learn as many techniques as possible at the same time as I’m doing my PhD. A bit of a mouthful, I know. I hope to start up the medical spa shortly after the end of my PhD program, which is roughly going to last 3 years. It will probably take longer than I anticipate and I’m also ready for that.

I’d be happy for any advice or information you could provide.
Sincerely,
Dr. E B...

Ask a question, get an answer. Here goes...

It’s certain that I know a lot about my own company Surface. I’ve opened a few clinics myself and consulted more than a few doctors opening medical spas. You’ll have to decide if what I’m about to write makes any sense for your situation.

Decide how much money you’ll need to make: Since you’re at the beginning of your career, you’re in a much different situation than the many physicians I deal with who are looking to change their practice or add to an existing clinic. One of the benefits is that your overhead is probably as low as it’s going to be for a while. (Existing practices offer different challenges.) So ask yourself; How much money do you need to make.

Many doctors make the mistake of opening a new medical spa and only after they’re in business do they figure out that they’re not able to make the money they need to take home and keep the business afloat. When you’re thinking about your startup and recurring costs, keep in mind that you’re going to have to eat. Can you live on the cheap for a while? There’s a distinct possibility with any business. Don’t think that you’re going to be taking home 20k the first month, or any month during the first year.

Decide what kind of medical spa you want to start: Perhaps the most common problem that doctors get into is the leaping before you look strategy of business. Here’s a tip: Day spas do not make any money. As a rule, the average margins for day spas in the US is 6%. Medical practices generally lie in the 50-60% margins. Physicians hear day spa and start thinking this is great. The day spa will bring in all these patients and my hard working staff will kick them upstairs for face lifts and boob jobs. Sorry. It doesn’t work that way.

So, decide very carefully about the medical spa you’re starting. The answer to this question will largely depend on what your own background is and where you have connections. What is your current situation? How is it structured? What’s the legal and liability issues? Who owns what? What’s the offering and pricing? Who’s responsible for the advertising? Who’s running the operations? Get the picture? Not easy to know in advance but there it is. This is Retail Medicine and it’s significantly different from the mainstream.

Find someone who knows more than you: This is not a recommendation buy a medspa franchise or hire a spa consultant. The truth is; The only people I recommend that you really talk to are already running successful medical spas of the type you’d like to emulate. Salesmen, professional trainers and spa consultants are in the business of retailing their services to you. (Read: Inside a Sona medspa franchise series.)

You’re probably going to research training, seminars, and conventions on the net. You’ll find lots of people telling you that they know the secret. I once actually sat in a training session at the NY Medspa Expo with the title: Make $200,000 per treatment room. Right Now! The expert advice to turn each room into a gold mine? Never let a patient leave without rescheduling a future appointment and buying at least $100 in retail. Utter tripe and a good way to kill your own reputation. I could go on ad nauseam but you get the idea. Find someone who’s in the business of running medical spas. Not a doctor who already does Botox, they can’t teach you what you need to know.

OK, so that said, what does it take to start a medical spa? Well, here are a few principal ways I’ve seen physicians start cosmetic practices.

Start with a lot of money: Get $500,000, hire the best people you can find, and then count on not making much money for the first 6-12 months until you’re able to build a client base and some sort of reputation. Of course you might make any number of mistakes in hiring, advertising, or choosing the wrong technology.

Medical Spa as a sideline: Build your aesthetic practice alongside your existing one. This is probably the most common route. It seems the easiest and probably has the least risk. But it still has challenges. When you hire full time employees your burn rate can skyrocket quickly.

(There’s often the esthetician who has ‘hundreds of clients’ that they’re willing to bring in exchange for a regular paycheck. Sorry. Any aesthetician who has hundreds of clients is not looking for a job. I can’t tell you the number of time I’ve heard variations on the ‘the aesthetician was supposed to bring the clients in’ theme.)

The advice here would be to start slowly and learn fast. If you’re going it alone, spend as little as possible until you have to. Never buy redundant technologies. Get professional help from a reputable advertising agency with medial spa experience.

Get lucky: I know a few good luck stories when it comes to starting a medical spa but not many and It’s not the kind of odds you’d like to bet on.

Hope this helps.

Wall Stree Journal Article on Medical Spa Franchises: Medspa boom is a bust for some

Via Wall Stree Journal. Read the entire article here.

Read the Medical Spa MD series: Inside a medical spa franchise.

Medspa Boom Has Become a Bust for Some

By RHONDA L. RUNDLE
November 21, 2006

...Medspa ownership turnover generally reflects business stumbles rather than safety issues. Ms. Leavy says many of the troubled spas are affiliated with franchise chains with flawed business models, such as those requiring too much of a franchisee's revenue to go for marketing. (She estimates that about 10% of medspas are franchises, although other industry experts put the percentage at 30% or higher.)

Several Sona franchisees, though not Mr. Nebot, are in private arbitration over problems that include misrepresenting a complicated business as a turnkey operation and failing to provide needed support. Sona officials declined to comment.

Several franchisees of Radiance MedSpa Franchise Group PLLC, a franchiser in Scottsdale, Ariz., say the company's financial projections overestimated revenue and underestimated initial start-up costs, including working capital.

The president of Radiance, Charles L. Engelmann, recently said: "There are currently 32 open stores and we will have 47 or 49 open by the end of the year. None of the stores have closed." He also acknowledged that some franchisees are attempting to get their money back.

One common pitfall for medspa operators is the failure to properly account for prepaid services, such as discounted packages of laser or light-based facial treatments. At Mr. Nebot's shop, for instance, clients would routinely pay $1,000 in advance for a package of laser hair-removal treatments to be delivered over a year or more. The shop's rooms were then filled with nurses treating customers who had paid months earlier. Finding new customers with fresh cash was a constant struggle.

Mr. Nebot says he felt like a cartoon character, "running faster all the time but falling further behind." He used radio advertising to draw more clients, moved to a larger space and extended his operating hours. To avoid alienating customers, he gave away free treatments to those who complained that their hair kept growing back after they finished the five-treatment regimen they purchased.

In the wake of the recent legal changes in Florida, some medical-spa owners there must shell out an extra $60,000 a year or so to a dermatologist or plastic surgeon to oversee operations.

"I can't be my own medical director any more, which is an added expense I can't afford," says one Florida physician who is not a dermatologist. He says he is "facing personal bankruptcy and trying my best to get out while there is something left for my family" after miscalculating what it would take to market, advertise and build his business. Indeed, many medspa owners are doctors who hope to make easy cash at a time when income is shrinking from their traditional medical practices.

Some franchisers have run afoul of state regulators by violating laws against the corporate practice of medicine. In February 2005, California denied a franchise application from HealthWest Inc., a Los Angeles firm that had more than a score of Inaara MedSpas around the country. California ruled that HealthWest had "falsely represented" to owners that they could legally own a medspa without a medical background. HealthWest has gone out of business, but some Inaara shops broke away from the founders and still are operating as independent, stand-alone shops. (Note: The former owners of HeathWest are now 'licensing' medspas under the name Solana.)

Another bust was Skin Nuvo International LLC, which filed for bankruptcy and sold its 37 stores to a private equity firm that in turn sold them to Pure MedSpa, a Toronto company.

Sleek MedSpa, a closely held chain in Boca Raton, Fla., recently acquired SkinKlinic's Fifth Avenue flagship in Manhattan, but SkinKlinic's two other stores, one in Las Vegas and the other in Greenwich, Conn., have closed. SkinKlinic's founder, Kathy Dwyer, is a former senior executive of cosmetics giant Revlon Inc. Attempts to reach her for comment were unsuccessful...

Medspa Training: The Paradox of Choice.

Too many options create unsatisfied patients.

While the comments below were made regarding web site development, they are equally applicable to any offering. Novice businesses often want to include the 'we do it all' statements in their advertising  and consultations, in effect, putting the decision making problems back in the lap of the patient.

The patient wants and needs to feel secure in their decision. Creating a menu of too many choices creates a petrie dish of patient dissatisfaction. 

From the patients point of view, too many choices puts them at risk of choosing something other that the optimal. While you may not want to extend yourself to 'telling a patient what to choose', that's exactly what the patient wants you to do. Great salesmen know this and often employ a 'shark fin' approach by narrowing the offering to three choices; an exceptionally expensive choice, a minimal baseline choice, and the one they're really selling, the 'as good as premium but without the bells and whistles choice'.

The patient wants to be sold. That does not mean the the patient wants to be pressured, it means that they want you to lay out their options, risks, and rewards, and make a recommendation in their best interest.

Luke Wroblewski - The Paradox of Choice:

When people have no choice, life is miserable. As you start adding options, you increase wellbeing. However, you reach a point where the curve flattens out and there are diminishing marginal effects. At a point in the curve, satisfaction drops and you are worse off than when you were neutral.

Are all these choices a good thing? Yes. Having choices is good but we have always thought it was only good. There is a dark side as well:

• Paralysis: so many options that you end up not making a choice. A grocery store alternated allowing customers to sample 24 different flavors of jam & 6 different flavors of jam. With 24, more people came to the table but 1/10th as many people bought jam. In Speed dating, you are more likely to select a match with 6 dates vs. 10. For every 10 mutual funds made available, rate of participation in 401(k) investing goes down 2%
• Decision Quality: when presented with too many options, we do not use difficult criteria to decide but choose on the basis of what is most simple. For 401(k)’s the simplest choice is the worst choice: putting money in a money market account. In retail brand and price are the simplest choices.
• Decision Satisfaction: Even when people have chosen well, they are dissatisfied with their results. When you give people lots of options, they will get a better result. But they will feel worse due to regret and anticipated regret. If you did not examine ALL options, you assume one or more might have been better. This reflects opportunity costs: the reduction of value through comparison to other options.
• Escalation of expectations: the availability of many choices increases expectations. When things were worse (less choices): it was easier to exceed expectations (now as high as possible). There are no pleasant surprises left.
• Maximizer Impact: too many choices is an issue for people whose aim in life is to get the best (maximizers). How do you know if you got the best? You actually need to look at every possibility by making an exhaustive search. There is virtually no area where maximizing makes sense.
• Leakage: the conditions present when people are making a choice do not stop exerting influence after a choice has been made. People are less satisfied due to regret or missed opportunities and this dissatisfaction extends after the choice to the actual experience.