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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here's why:

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

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

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

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

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

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

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

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

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

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

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

So what actions should you take right now?

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

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

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

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

Whatever you do, take action right now and begin.

Powerful Marketing For Your Medical Spa: Social Proofing

Increase conversion rates of cold sales emails through social proofing!

Social proofing is a psychological phenomenon which influences someone to think that you are great after knowing that other people think you are great. It is informational social influence where people assume or conform to other's actions in an attempt to reflect the correct behavior for a given situation.

This is useful especially when you are communicating to your potential customers for the first time, as when you are cold emailing them.

Social proof is also notable on social networking sites such as Facebook, Twitter, and Instagram. The more followers you have, the more trustworthy and reputable you appear to be.

Product reviews and ratings are relevant for American consumers. Statistics says that more than 70% of them look at product's site and its reviews and ratings before deciding to purchase a product.

Several techniques of social proofing can be utilized, including mentioning in your email the patrons of your product, perhaps a famous company which is also your client, a famous investor, or the person you know in common in the mail.

It shows your potential customer that others have also taken the action that your company wanted them to take, whether purchasing or subscribing. Research shows that when a famous customer is mentioned at the bottom of the email, replies in the cold email doubled.

In a study of 10,000 accounts at a German bank, it was shown that customers who came from customer referrals had 16% higher lifetime value than those who came from other acquisition sources. Social media has sparked dozens of different ways to provide this kind of social proof.

Facebook widgets that show other Facebook friends that “like” a brand, Twitter’s display of people you follow that also follow another person, and the various ways that company offer rewards for referring others to the brand are all examples of this. Perhaps you might also want to mention present customers with established positive reputations.

These influencers are seen more positively with association. A shared LinkeIn Connection may also be mentioned. It was found that when you point out a shared connection with someone in common, 25.5% of the people who received the email opted in to have a further conversation about the product compared to the 4 % who received the basic mail.

Testimonials, accompanied with corresponding faces, are one of the most persuasive forms of social proof out there. Compared to statistics, stories and real-life experiences by other people are more trustworthy and persuasive because these examples touch our hearts and mind.

First Implantation of FDA Approved Orbera Gastric Balloon

Following the FDA approval of Orbera's gastric balloon, the very first implantation after its approval has been made by Dr. Shawn Garber.

The gastric balloon has recently gained its FDA approval as an option for patients who are battling obesity but are not qualified to undergo invasive surgery.

According to Dr. Garber, a silicone intragastric balloon is inserted non-surgically in a deflated state into the stomach and then inflated with sterile saline solution through a self-sealing valve once it enters the stomach. The intragastric balloon will remain in place for a maximum of six months. During that six month period the patient will enjoy a feeling of fullness sooner and satiety will last longer after meals, which encourages portion control and helps manage hunger.

The procedure made by Dr. Garber lasted for around 15 minutes and the patient was under light sedation. After the gastric balloon was inserted, the patient stated that she felt full, and the patient was able to leave after 30 minutes. The procedure was performed in the office under light sedation and took approximately 15 minutes. The patient was able to leave the office 30 minutes later.

The patient stated "I feel full" after the procedure. Though this is one of the very first procedure done after its FDA approval, the procedure had already been used internationally for over 20 years.

For more information, you may contact:

Jon Libasci of New York Bariatric Group at 516-616-5500 or jon@nybg.com http://www.orberaweightlosssystem.com.au/

Download Medical Spa Embezzlement & Employee Theft Scams - It's Free

In a recent study, more than 82% of medical clinics reported at least one issue with employee theft or embezzlement... that they were aware of. This free guide to beating embezzlement and employee theft schemes uncovers the hidden tactics behind how these scams work, and how you can find them before they capsize your clinic.


Download Medical Spa Embezzlement & Employee Thef Scams


Embezzlement and employee theft are an unfortunate fact in almost every business, and especially in cosmetic medical practices. If you haven't ever had to deal with this you're extremely lucky since it has taken place in every clinic I've been personally involved with and the stories that are told by physicians and business owners are legion.

If you think it can't happen in your business you';re just whistling past the graveyard. It can. It will.This report is designed to give you a fighting chance to identify how your business is at risk, to understand how these schemes work, and what you can do to minimize your risk and take action when you find a problem.

You're about to read the many stories that have been collected from clinics and physicians; from how a physician-employee put an extra account on a credit card terminal to deposit payments into his own checking account to how a NP would inject patients with straight saline and steal the Botox to use in her own side business. Some of the stories are almost beyond belief in their brazenness and the damage that was caused. In almost every case, the employee was a trusted team member.

Employees that are embezzling or stealing from you are enabled by ignorance and naivety. On the following pages you'll begin to remedy those issues.

I wish a report like this wasn't necessary, but it is.

If you don't read it you're a fool.


Download Medical Spa Embezzlement & Employee Thef Scams


Here's what physicins are saying:

Great report! It should be required reading for 
all doctors — even for those of us who've 
been around!
Marguerite Barnett MD FACS PA, Mandala Medspa
A very eye-opening and sobering report.
This is a must read for everyone!
Windie Hayano, The Skin Inc. Dermatology and Laser Center
Opened my eyes! The information in this report is invaluable! I hadn't even thought of some of the scams mentioned in these testimonials!
Lori Robertson FNP, Skin Perfect Medical Rancho
Great! ...after reading others experiences I realize that you just cannot be too careful when it comes to the financial security of your business.
This report will help other centers avoid going through what we had to endure and overcome.
Brian Sidella, Founder, Forever Young Medspa

Nurse Practitioner Pay In New "Medical" Spas

Nurse Practitioner Medical Spa Pay

What's a good Nurse Practitioner pay in a new 'medical spa' that wants to offer Botox?

I get lots of individual emails looking for information about pay for PAs, NPs and MDs who are being recruited by a local medical spa. Some of these are just entering aesthetics and others are old hands.

Here's an example email that's typical from a NP who's being solicited by a day spa who's wanting to offer Botox and fillers:

Hello, I am a Nurse Practitioner from Wyoming and I am going to start doing some medical aesthetics for an established spa that up to this point has offered everything except medical aesthetics. The owner of the spa and I are having trouble figuring out a fair pay for me. The products are being ordered under my license and I will also be doing all the injections. Right now we are just starting out with Botox and Fillers. She pays her staff an hourly wage plus commission, but I have also talked with other spas that pay straight commission. Both of us are new to this and we are having a hard time finding out what other medical spas pay. Any insight on this would be helpful.



Ok, so here's where we're going to drop some knowledge-bombs on you. (For this post I'm not going to go too deep on whether these types of setups are good ideas on their own.)

First, think about what you're asking and how you're thinking about this new business. You're counting your eggs a little before you've got any eggs.

The fact that you're asking how much you should be paid reveals a number of problems with your understaning of how this is going to work and who's going to be responsible. (This isn't uncommon at all and we're going to disucss business models at lenght in future posts.) Since you're the clinician, you're going to be responsible for everthing to do with this business with the probable exceptions of: #1, paying for stuff and #2 supplying the 'patients'.  So let's look at what you're going to be responsible for:

Since you're going to be practicing medicine, the fulcrum in this relationship is you as the clinician. It's going to be your reputation, medical licence, malpractice insurance, and your ass on the line.

I'm reminded from a line from the science fiction novel Dune in which goes something like, "He who has the ability to destroy a thing, controls that thing." Meaning, that this is effectively going to be your business, not the spas. (Note, I'm not denying that the spa could probably find someone else to do this same deal, just that it's never going to be the spas business.)

The spa will invariably take the tact that this will be an add-on to their existing business and that the 'patients' are their customers etc. This is both wrong in practice and illegal. This will be the practice of medicine and that's pretty cut and dried. You're still going to regulated, HIPPA compliant, etc. and that's it.

You're also going to need to set this up legally in your state. In most states you can't become an employee of or partner directly with a non-physician. (Not sure about how this applies to NPs so if anyone knows, please leave a comment.)

The patients are going to be yours, the responsiblity will be yours, the insurance will be yours etc., and you can't just be paid for performing medical treatments by a non-physician. All that being said, there are ways that this can be done if you're smart, and the spa owner is reasonable.

  1. Set up a legal entity for yourself. (Have a real lawyer do this who has knowledge with clinicians.)
  2. Make sure that the spa has a legal entity. (Different lawyer there.)
  3. The agreement will be between these two entities. (There are different ways to set this up depending on state. In some cases it might be the NP's entity that is 'renting' space from the spa but there are other options. Read through the forum threads on this site for those.) The agreement should also clearly define scopes and responsibilities and what will happen if the business fails. In cases like this, the spa is often 'paid' for rent and/or 'marketing' expenses, not fee splits or referrals. A technicality maybe but an important one.

People always try to overlook the 'business fails' part of the equation but it's a necessity to outline this up front since this business will end at some point in the future, even if both parties are happy.

Since it's illegal in most states to be a clinician who is an employee of a non-physician, that becomes somewhat problematic since you can't be 'paid' in the normal way. I would also suggest that all monies go though your legal entity before being distributed. In effect, you take all payments, not the spa. Headache yes but medicine in the US is the most highly regulated and litigious market there is. Don't sit around on your thumbs with this.

If you look at what you're going to be required to do, the conversation with the spa should be much clearer and should help the negotiations. If the spa owner refuses to understand how this should be set up, don't do any deal. You can't negotiate in good faith with someone who is willing to put you at risk right at the start.

About your Pay?

The real question is, "how much money are you going to make?". 

Business 'partners' always run into personal conflict when; they don't make any money, or.. they make a lot of money. I would suggest that you make sure that you go into this with your eyes open and the spa owner does the same. If you can't resolve the above issues then the money won't matter.

Comments welcome.

Keeping Your Aesthetic Patients Happy Is Good Business

Keeping patients happy makes sense, both to avoid problems and build your reputation and referral base.

Not all patients that state they had a poor experience from another provider are signaling the proverbial red flag. Most of these patients HAVE had an experience of poor treatment outcome.

And to add salt to their wound,the previous treating provider could care less!

We must keep in mind that for most of our patients, coming in for Medical Aesthetic treatments is an exciting and much anticipated experience.

The number one reason patients state they no longer go to their previous provider is, "He was a jerk!" Oddly enough, the number one complaint I hear regarding a female provider is "I had to wait too long." This is not to say there are no female jerks or that patients don’t have to wait too long to see a male provider. These statements are simply the most common that I hear from (from) my patients.

No one is perfect. I don’t care how good you are at fillers, Botox, lasers, and surgery. We’re human, and we have bad days too. Bottom line: If you did achieve a less than desirable outcome, fix it for heaven's sake! With a smile on your face. If you're running more than 15 minutes behind, be prepared to apologize profusely and don't let it happen again. At both our clinics over 50% of our new patients are by referral. The most common reason for these referrals: “They're so nice!” Patients in general have a sense of helplessness when it comes to being treated by a provider. Do not tell a patient what they have to do. This is not life or death nor a dictatorship. Our patients know that we truly love what we do and we care. You don’t have to be all hugs and kisses, but, you'd better have a smile and a few jokes up your sleeve. You must keep in mind that this is the grown up version of a trip to Disneyland. It’s an E ticket ride with a high price tag. This is not an area of medicine of need.

This is completely a "WANT" this treatment situation. We encourage our patients to tell us what they are looking to have done and then offer safe, sane treatment options for them. This gives the patient a greater sense of control, and a decreased sense of possibly being pressured. If they can't afford all of the treatments at one time, what ever you do, never pressure a patient! If they like the one treatment you do and you personally, they’ll be back. And that’s how you keep your patients.

Medical Spa Embezzlement & Employee Theft Scams Report

Download the new, free report for Members: Medical Spa Embezzlement & Employee Theft Scams... Reading it could save your clinic.

It's the guide to beating embezzlement and employee theft schemes in your cosmetic practice or medical spa.

Taking cash payments in the treatment room, stealing Botox and fillers to inject their own patients, ordering fraud, trading extra services for large tips, or stealing your client database to sell or use... In a recent study, more than 82% of medical clinics reported experience with employee theft or embezzlement... that they were aware of. This new 40 page guide to beating embezzlement and employee theft schemes uncovers the hidden tactics behind how these scams work, and how you can find them before they capsize your business.

Embezzlement and employee theft are an unfortunate fact in almost every business, and especially in cosmetic medical practices. If you haven’t ever had to deal with this you’re extremely lucky since it has taken place in every clinic I’ve been personally involved with and the stories that are told by physicians and business owners are legion. If you think it can’t happen in your clinic you’re just whistling past the graveyard. It can. Don’t prepare yourself and it will.

This report is designed to give you a fighting chance to identify how your business is at risk, to understand how these schemes work, and what you can do to minimize your risk and take action when you find a problem.

Here's some of what those who have already read this report are saying:

Great report! It should be required reading for all doctors — even for those of us who've been around!
Marguerite Barnett MD FACS PA, Mandala Medspa
A very eye-opening and sobering report. This is a must read for everyone!
Windie Hayano, The Skin Inc. Dermatology and Laser Center
Opened my eyes! The information in this report is invaluable! I hadn't even thought of some of the scams mentioned in these testimonials!
Lori Robertson FNP, Skin Perfect Medical Rancho
Great! ...after reading others experiences I realize that you just cannot be too careful when it comes to the financial security of your business.
This report will help other centers avoid going through what we had to endure and overcome.
Brian Sidella, Founder, Forever Young Medspa

You’re about to read the many stories that have been collected from clinics and physicians; from how a physician-employee put an extra account on a credit card terminal to deposit payments into his own checking account to how a NP would inject patients with straight saline and steal the Botox to use in her own side business... and a host of others... ordering fraud, trading extra services for large tips, or stealing your client database to sell or use, setting up false bank accounts, switching acocunts on the credit card reader... all of these scams are covered through real life accounts from the physicians and clinic owners who experienced them.

Some of the stories are almost beyond belief in their brazenness and the damage that was caused. In almost every case, the employee was a trusted team member. Do yourself, your family, and your business a favor and read this report. No matter what your experience has been, you're going to learn something important.

Have your own story? Submit it here for the next edition

Submit Embezzlement & Employee Theft Stories From Your Medical Practice Or Clinic

medspa embezzlementUnfortunately, employee embezzlement and theft in cosmetic medical clinics is commonplace. We're going to help you with that.

We've posted about theft and embezzlement before. Read: Embezzlement & Employee Theft: It can, and probably will, happen to you.

We're building a new loss prevention report that will cover this area and provide you with just about every trick in the book including:

  • How common embezzlement schemes are set up and how these criminals cover their tracks.
  • How thieves steal Botox and injectables to supply their side business.
  • Credit card and payment scams at the front desk.
  • Treatment room cash payments.
  • Inventory and product theft in the back room.
  • Everything else...

To do this we're reaching out to you, our Members and readers, and asking for your help. If you have inside knowledge of a situation that involved embezzlement or theft, that you let us know by submitting your story and giving us all the gory details. (No identifiable information is required so you can tell the story anonymously if you wish.)

We're compiling these submissions as well as drawing on our own experiences and contacting embezzlement and loss prevention experts to produce a comprehensive blueprint for protecting your clinic and your business that will give you insight into how these scams work, and how you can prevent them.

If you have any thoughts on this topic or what we should include, please leave them in the comments below.

Embezzlement & Employee Theft Can, And Probably Will, Happen To You.

Medical Spa Employee Embezzlement & TheftEmployee embezzlement and thefts are the most common crimes in any cosmetic practice... in fact, it's pervasive.

Believe me it can and it did happen to us. It’s still hard to believe that I saw the evidence and ignored it because I just could not believe what my eyes were seeing. Instead of going with my gut instinct I listened to a mountain full of lies from my Physician Assistant so the first lesson learned is trust what your eyes are seeing and rely less on distracting noise.

When all was said and done, our P.A. had stolen over the course of just 14 months, more than $200,000 in Botox, Fillers and Laser Treatments. 

How was she able to accomplish this?  The theft occurred in three primary ways.

  1. With Botox/Dysport she would mix the proper dilution of 2.5 and then draw out a full syringe of properly diluted Botox and re-inject another syringe of saline. She would then take the syringe of Botox and put into her mini-cooler posing as a lunch box which she brought every day to keep it cold and then treat patients out of her house. The evidence of this was apparent with patients complaining of poor results. She would cover herself with some inventive lies such as; Botox out too long and I did not want to waste it, the refrigerator was not cooling to proper levels, she put the Botox in the freezer and the solution crystalized and weekend the Botox, I may have accidently put in too much saline and I used Dysport and it does not work as well as Botox.  Looking back I can clearly see the evidence but listened to her lies and excuses.
  2. On fillers her number one excuse was that the product “leaked” while injecting and she was forced to use another syringe. Other excuses were the patient had a bad result so to keep them happy she offered a free syringe, a reaction that forced her to remove and re-inject later and I threw in some free syringes because she bought a package of Fractional Laser Treatments.  Most of the time, she was simply pocketing the syringes to again inject patients of our practice at her house.
  3. Watch you consults and close ratios. We have been in a bad economy so this was hard to gage.  She would “feel” out the patient during the consultation and those who she believed would be players she would offer discounts for Fractional Laser, IPL’s, Matrix etc. if they paid her directly in the room in cash. I was tipped off by this from a competitor who called me and told her one of their patients told them about this. After firing my P.A. within weeks we had identified 36 patients who paid cash in the room.  She told those patients she was the co-owner so it was ok to pay in the room… To add insult to injury we had to complete their treatments as well.

Submit your own story about medical clinic embezzlement or theft here

After having gone through this we put in some practices that I wish we had done all along.  We now perform a Botox and filler audit every Friday. Every unit of Botox is logged onto a log sheet by patient and same for fillers. If we are off by more than 5% I will meet with my NP to go over the discrepancy.  On lasers shot counts are logged for every patient. As an example if Mary comes in for a Fractional Laser Treatment and the beginning shot count was 45,000 and ending shot count was 45,400 then the next patient for the same treatment should begin at 45.401. We also now provide to each patient our policy of ONLY paying for services at the front desk during check out.

I was also amazed to find out that every staff member suspected what was going on but was afraid to say anything because they did not want to cause any problems if they were wrong. Lastly review your insurance policy for theft coverage. I was mortified to find that ours only covered $10,000 which left us loses of about $200,000.00. We were able to absorb the losses but many others might have been forced to lay off staff or worse go out of business. As a non-physician owner I trusted far too much that a professional medical practitioner would not steel. I now understand all too well that the white coat which commands respect could also have hidden prison stripes and to use my eyes and cover my ears…

Where Does Creating The WOW Factor Begin?

Have you ever been put in the bad situation of believing you need to fill an opening out of need? You post and ad and literally the first few people that respond and can walk and chew gum get the job.  How did that ever work out for you...

There is a real skill set to interviewing & selecting the "A" players that will create the WOW factor even without all the tech behind them. The question I'm most often asked is how to find them, interview them and hire them.  Here are a few tips to consider.

1.  Start with ad itself. Don't flour up the position or your establishment to make it seem like a dream job.  Instead, think of what you specifically need for the position you're trying to fill and use language that will weed out anything other than "A" players. In other words don’t talk about your wonderful environment. Talk about the demands of the position.

2.   Weed through the stacks of resumes and make piles of A & B applicants. All others can be put in a rainy day file for a possible another look. Now send an email to each of your A/B possibilities asking them to describe in specific terms what they can do for your organization. Then sit back and evaluate who you want to bring in for a face to face meeting. In order to hire a WOW employee they need to really impress you in this phase.

3.  At this point you're now meeting the applicants. Remember your job is to find the best "A" level player. Now you have to find out if they can think on their feet and react positively to pressure.  For myself I inform each applicant that regardless of what they are being hired for that every position also has three responsibilities.

   A.  Everyone is in Sales

   B.  Everyone is a Customer Advocate

   C.  Everyone is responsible for outside marketing activities and needs to bring in 5 new patient per month through those efforts.  In short they will need Evangelize how we are and what we do.

Now at this point you will begin to weed out the producers from the pretenders but for me, there is still one more test. I call it my pen test but feel free to create your own. I tell the applicant that I need them to role play for me. I tell them that I want you to sell me a pen and not just any pen. I want you to pretend that there are 3 other pen sales people in the waiting room all trying to sell me the exact same pen you're trying to sell me. I then count down from 5 and it's roll play time. 

What you're looking for is the applicant that can take the heat of the moment and find some way to shine. Funny thing is that I'd estimate that 75% of the over 1,000 people I've interviewed in my life fail this test. Some break down and cry, some stammer then shut down, some freeze and walk out and some hit it out of the park. I submit that if a candidate can't handle selling a pen how the hell are they going to sell aesthetic services?  If they can't handle the pressure of a simple role play how will they handle the irate patient we get from time to time. If that can’t sell you a pen that’s the same as 3 others how can they sell Botox & Laser treatments that are same at other practices in your area.   I’m constantly amazed at how few staff members at other organizations I meet can’t give a simple elevator pitch as to why I should buy from them vs. the competition.  If they lead or bring up price in the first sentence or two I can assure you the organization is floundering on failure.

So, seek out the "A" level players.  They exist but you need to attract them, hire them and retain them.  The last one might be another topic to discuss...

Abstraction Is The Kiss Of Death When You Want Someone To Buy

The money in any medical spa or cosmetic practice is made in the consultation room.

There are lots of physicians I know who speak in the abstract.. and abstraction is the kiss of death when you need someone to take an action.

To be quickly understood and remembered, your content must be about real people, objects and events.

For example, proverbs last thousands of years, cross language barriers and the best use real (concrete) things to explain abstract ideas. “A leopard cannot change its spots” can be pictured, easily understood and remembered. “People’s innate nature doesn’t change” requires the reader to understand what “innate” and “nature” mean and there is nothing to picture.

Abstract language is the enemy of clear communication, and you don't want a patient in the consultation room wondering what you're talking about. If a patient doesn’t already understand your abstract idea then it takes them time to follow explanations that are usually ambiguous. With the amount of effort required they would struggle to remember it and have difficulty explaining it to anyone else, and your referrals (and sales) will suffer.

As you are working through your consultation, how much more do the examples “stick” when there are stories about other patients that are shared? They bring the concept to life and make it concrete. The same will be for any concept that you convey to your patients or clients.  Share the stories and testimonials of real people and events that will not just talk about your product or service…but will bring it to life... and that creates sales.

Push Your Medical Spa Overboard With Customer Service

Some of the best marketing for your medical spa is not 'marketing' at all... it's incredible customer service.

(A regular physicians office is probably the very worst customer experience there is... and of course many medical spas are run by physicians who have started a cosmetic practice as an add or or a transition from a regular practice.)

Customer service is probably the easiest way to distance yourself from the competition.

Read the forums and you'll find lots of threads discussing how commoditized the market for Botox or laser hair removal has become, how much to pay your staff, and how Groupon is destroying everyone's margins... but you'll be hard pressed to find discussions about how to deliver service that generates sales.

But delivering great customer service is something that you should think of as driving sales, not lost time and a money-sink.

Our clinic staff operations were designed to provide fantastic customer service to everyone, but to really go above and beyond with selected patients in an effort to wow them, even if it cost us money. In fact, wowing patients had budget set aside from marketing.

 The key is make your customer ecstatic about your business by catering to what they need so they’ll tell their friends about it. In fact the more egregious the demand or the more dramatic the effort needed, the more likely that word about your clinic will spread. As anyone in cosmetic medicine can attest, you don't have to wait long for some stressed out patient who's a candidate. In one case a bride called us in tears on a Saturday morning asking if there was any way that she could get her mother and mother-in-law treated with Botox before her wedding on Wednesday morning... and they weren't arriving until 10PM that night. One of our physicians actually met the wedding party at our clinic on Sunday morning in order to make sure that the effects of the Botox had time to take maximum effect before the wedding. 

Most clinics or physicians would not have done this, they would have scheduled the treatment for Monday if they could fit them in and lost the opportunity to create fanatically loyal clients.

In the above case the physician went above and beyond even what we would ask, but the results were really quite remarkable. Within the following 45 days we had 8 new patient consultations that were directly attributed to that one event. (New patient consultations were something that I tracked carefully since our analytics showed that every new patient consultation was worth approximately $1,300 in revenue within the following 30 days.)

That Sunday treatment drove an extra $10k in revenue at that clinic that month. 

How you deal with your customer service will define your business and your revenues.

Some recommendations for fantastic customer service:

  • If you think that any customer is acting in good faith, don't even question what they're asking. Just do it. If they're unsatisfied, make them happy and take extra time to do it. (This is not a recommendation to deal with those who are clearly just trying to take advantage of you.)
  • The more hoops you have to jump through, the more likely word will spread. Dig out the really extraordinary ways that you can make a splash.
  • Other physicians and clinics aren't likely to offer this level of support. Focus on this and use it to your advantage.  All it takes is a few over the top customer stories, and people will talk, people will post to their Facebook page or Twitter account, and people will tell every friend they have about your clinic.

 Tell me I'm wrong.. or right. Tell your own customer service story in the comments.

The Medical Spa MD Physician Report Out! Download It Here.

The FREE Medical Spa MD Physician Report is now available. Whew.


Our entire report team has been busting their ass collecting answers from physicians and clinics for the last month and compiling them into the only report of it's kind that deep-dives into aesthetic medicine and gives you information you can't find anywhere else. (Thank you Dar, Apple, Marco, and Laurie!)

We've taken on a herculean task in compiling this report and we're pretty happy with the result.

The Medical Spa MD Physician Report researches and tracks all aspects of what's working in cosmetic medicine (and what's not), not only in the U.S. and Canada but across the world.

These reports are published to give our entire physician and clinician community access to the information, statistics, and inspiration to improve their medical (and business) results.

Do you want to know how other clinics are choosing technology, attracting new patients, marketing to their existing clients and compensating their staff? Would you like to discover what's the most effective uses for that new fractional laser, or what other clinicians think of it? Could you use more info about how successful medical spas are expanding their business, saving money, or deciding on what new treatments to add or get rid of?

Answer yes to any of the above you will love, love, love this new report.

Download the report here.



The Medical Spa MD Physician Report

With the power and knowledge of our growing membership, our goal is to bring together all the valuable information, successes and failures; giving you an insider’s point-of-view to improve your business and your bottom line. Which products sell best? Which treatments are most profitable? Which equipment manufacturers are recommended and which are not? Our reports deep-dive into the various areas, such as “Growing your business”, “Advertising and marketing”, and “Staffing and training”.

The reports generally include a survey of cosmetic clinics around the world, an interview or case study, and an area for sponsors or select partners who wish to get in front of our Members and readers with their products and services. To begin, we reached out to not only our member base, but also other prominent doctors in our field. The response was overwhelming. About 80% of our respondents practice in the US, but the other 20% come from all over the world, including South America, Europe, the Middle East and Russia. About 92% are physicians, with the other 8% working as RNs or PAs in cosmetic clinics and medical spas.

Another way to contribute to our Physicians’ Report is to participate in our monthly interview. We choose and office or medical spa each month to get their unique perspective on running their business. The interviews add insight into working medical spas and cosmetic practices, what works, what doesn’t work, successes, failures and anything else you want to share with your peers.

A special thanks to our growing group of physicians and clinics for participating in this month's report. If you would like to join our panel, please sign up to contribute to the next report here. The more participation we get, the greater the value for the group. (Sign up to contribute to the next report here.)

Do you have a suggestion to improve our services or an idea for as research project you think we should be doing? Would you like to be interviewed, or sponsor a report? Please contact us.


Medical Spa MD Report

Founder, Medical Spa MD

P.S. Please feel free to distribute, email, link to, tweet, post or send this report to anyone who may be interested as long as you do not modify or change the report in any way.


Contributing Physicians & Clinics

The following is a partial list of the physicians and clinics that contributed to this report and gave us permission to identify and link to them. Sign up to contribute to the next report here.

Note: We do not identify individual physicians or clinics with specific answers to make sure that all respondents can be completely candid in their answers. (Our surveys are done through our online software and provide confidentiality and anonymity and they take about 10 minutes to complete.)


























Our contributing physician list is growing fast. Thank you to the physicians and clinics who have contributed to this report.

One Medical & The Patient Experience: Dr. Tom Lee

The patient experience: so many people talk about improving it, but very few people have actually done something tangible about it.

Dr. Tom Lee is a rare exception: his company, One Medical provides an excellent patient experience in primary care. Here he describes the challenges and pitfalls in delivering a better experience, despite the torturous constraints in the American medical system.

Relaxed Patients Will Generate More Revenue For Your Medical Spa

Does a relaxing waiting room actually generate revenue for your clinic?

Retailers have known for a long time that happy, relaxed customers leave feeling more satisfied, but new research from Columbia Business School concludes that relaxation does more than just make for a satisfied client. It also produces a client who is willing to pay more.

According to the report, "Relaxed consumers think products are worth more than less-relaxed consumers because relaxed individuals tend to think about the value of products at a more abstract level. For example, when bidding for the camera, relaxed participants focused more on what the camera would enable them to do (e.g., collect memories) and how desirable and advantageous it was to own it, whereas the less-relaxed participants focused more on the concrete features of the camera itself (e.g., the number of megapixels it had, the shutter speed)."

All this being said, you may want to make sure that you're creating a relaxing and comfortable enviroment in your clinic even before the treatment.

Here's one example of how you can use video to create a relaxing atmosphere while also sending a powerful marketing message and communicating about your other offerings.

Watch other waiting room videos.

Managing Patient Expectations Part 2 - Botox Training MD

Read Managing Patient Expectations Part 1

Managing patient expectations is a learned skill but one that you have to master in order to run a competitive and profitable cosmetic practice.

Be aware of is patients who are complaining about previous providers. It's a potential indicator that this client might be a difficult client to deal with.

Clearly if someone is continually bashing another doctor (provided that the didn't do something that caused obvious harm) and they're angry with that doctors and his staff, that's going to put me on guard.

Now, there are situations where a patient's anger is appropriate.

I have a patient right now, that for years, went to another provider, and when she came to me and told me that she's switching providers, I did become a little alarmed right out of the bat. But once I got to know her my misgivings were removed. She had been going to this other physician for years and years and years, and she was upset with him because of the treatment she received for the previous several injections... but she attributed it to the front desk since the clinic had became very busy and impersonal. So I think you have to look at each patient individually. She was legitimate with her complaint and we have a great relationship but there are others.. If a patient is very, very angry, and constantly bashing a former provider and complaining about results you need to be aware, because you could be the next one on their hit list.

I think it's important to take as much time as you can so that you're comfortable and the client's comfortable. To simply make a decision that you're not going to treat that patient and you are now wasting your time, sitting in that room with the patient is the bad approach because then the patient's gonna be angry.

As far as I know, I've never sent anybody out of the office angry because I declined the treatment.

I really make the decision very rapidly as to whether I'm going to treat them or not. I think with time you develop that. I know within the first minute or so if I'm going to treat or won't, but I spend the same amount of time sometimes for both of them - the person I'm going to treat versus the person I'm not going to treat -  because to make that person angry is not what I want to do for a number of obvious reasons.

Often, I can convert them into doing something else that's realistic or telling their friends that's I'm genuine person.  I listen to exactly what they want and I try to understand what they want to have done. Sometimes it's a very small,small correction they're asking for and I don't think I can alleviate it... a very tiny line that I can barely see. So I listen to them, I give them a mirror, I have them point it to me. I try to totally understand what they are pointing up. And most of the time, I can see what it is they want me to correct.

However, if I don't think I can correct it and I think that it's unrealistic, I don't tell them: "That's unrealistic", I explain to them the limitations of the product and the scientific discussion. This product is made for this procedure, not unfortunately for what you want to have done and what you want to have done, I'm unable to correct this in the way that you're asking for.

Some patien'ts don't accept that and will respond with..  "But you're a plastic surgeon or you're an aesthetic physician, this is what you do." So then you have to educate them more with, "Unfortunately we don't have all the tools available". (The 'no magic wand' defense.)

So, even if you've decided that you're not going to treat a specific patient, I think it's really important to spend time with them, see what they want you to do and have them leave happy.


Marc S. Scheiner MD

Dr. Marc S. Scheiner completed his undergraduate studies at the University of Delaware, and received his medical degree at the University of Texas. Following his residency at the University of Florida, he practiced family medicine in the small town of Elkton, Maryland during the 1990’s. During that time, Dr. Scheiner was forced to refer patients from rural Cecil County to Baltimore or Delaware for plastic surgical procedures. His interest in this type of surgery and his desire to provide these services for the local community led him to begin plastic surgery training.

Dr. Scheiner was accepted at the Nassau University Medical Center in 1999, where he entered the General Surgery Program. Following the completion of his general surgery residency, he began training with the oldest and largest plastic surgical group in the United States, the Long Island Plastic Surgical Group in New York.

In June of 2004, Dr. Scheiner completed his plastic surgical training and moved back to Cecil County to open the O’Leigh Aesthetic Surgery Center, LLC, filling a much needed gap in locally provided plastic surgical care.

In 2006, Dr. Scheiner, along with several other local physicians, began construction of a new medical facility in Elkton, Maryland. This building, in addition to being Dr. Scheiner’s new office, houses Cecil County’s first ambulatory surgery center, the Upper Bay Surgery Center. Upper Bay Surgery Center offers ambulatory surgical procedures in a private, comfortable, and safe environment.

Dr. Scheiner has lived in Cecil County since 1984 and currently resides in North East with his wife and three children.