Customer Service Obsession: Love your patients the Amazon way.

 Is obsessive customer service part of your medical practice?

Amazon is taking a page from Nordstrom's 'heroic customer service' book. Why? Because it's good business. I posted on the oft-induldged stupidity of price wars. One of the differentiators that drives business is customer service. Notice I did not say 'patient care'. Customer service is outside of the medical care you're providing. Customer service is the touchy-feely warm and cozy perceptions that your patients have or don't have.

From my friend Shmula's blog on Amazon's customer obsession:
blockquote.gifpushing 300,000 - 600,000 units of product per day through a fulfillment center is no easy task. gratefully, Amazon’s home-grown software and efficient processes help to deal with the immense volume. sometimes, if there are inventory gliches or poor product flow, an activity known in warehousing as “product chasing” occurs. “chasing” is when a product is ordered, but it is nowhere to be found in the (1MMft^2) facility. in reality, it is somewhere, but according to the inventory software the product is supposed to be in its assigned bin, but it has been moved somehow, drifted to another bin, or stolen. this defect is called Inventory Record Defect Rate and is one of the most important metrics at Amazon, and is highly scrutinized and reviewed by Bezos and his senior team.

customer_lifecycle_experience.gifWhy is it important? because when the front-end Amazon store allows you to order something, the precondition is that the product and the quantity desired is currently in an Amazon facility: the software follows a very complicated algorithm based on network optimization, shortest path techniques, and traveling salesman routing; a check is made against the inventory database — in real time — how many are available, which facility, and how many have been committed already. when the order drops into the assigned facility, the picker goes to the bin where the product is supposed to be, but because IRDR is poor, the item is not there. this situation leads to two following options: (1) go to a local store and buy the item and ship it to the customer or (2) do a “network flip”, where the assigned facility “flips” the order to another facility that has that product. option (2) is ideal, but during the holiday season, it is very difficult to do. during the holidays, option (1) is common.

doing option (1) is heroic and is a true example of customer obsession at work: it’s not about serving all customers as an aggregate, but it’s about serving one really well, several million times. at Amazon, they really believe this and live this.

This kind of take-no-prisoners approach to customer service is absent in most clinics I see. You're asking your patients to spend their money inside of your business. Great customer service is your obligation.

Medspa Physician Consultations: Paid Or Free?

Many, if not most, medical spas are charging for physician consultations. The reasoning is easy to understand. They have time that they consider to be valuable and you feel that there should be a barrier to entry for that time the patient needs to have a little bit of skin in the game in order to take a position away from his paying patients. The flip side of that coin is that consultations are really where the money is made in the medical spa business.
Read More

Aestheticians And The Doctors Who Love/Hate Them.

Aestheticians seem to be one of the primary components for medical spas these days. Almost anywhere you look a medical spa now has a Aesthetician who is posted on their website. Medical spas that are primarily cosmetic, seem to have a bunch, but there are a growing number of physicians who are hiring individual aestheticians to provide skin care consultations, do the microdermabrasions and facials, and give a little fluff to their practice.
Read More

Doctors & Staff Issues: Listen Up

It still surprises me how poor many physicians are when it comes to interacting with staff. I've ended up in the middle of a total non-event in one of my clinics in which the doctor overheard a technician speaking to a patient about a treatment. The tech was informing the patient that the time constraints (the patients) wouldn't allow the treatment to be performed and we would have to reschedule. The physician overheard some of this conversation. But instead of speaking to the technician and finding out why the tech took the action she did, he and the office manager got me involved. From what I gathered the laser tech took the appropriate action, the patient was happy, case closed. But my doc sees it differently even though he never spoke to the tech.

Inside any successful clinic there is a huge amount of staff interaction. Physicians or managers who don't really talk to their staff every day will make poor decisions on partial information. 

Simple Rules For Your Medspa

 Run your medspa as a system.Simple systems are logical, understandable, explainable, and well... easy.

The quicken pace of technology development has led to some new paragigms in the way some businesses are build and are choosing to run. The emergence of 'Agile' software development is an example that has led to a drastic shortening of time to market for developers of new technologies. While you probably won't be implementing Agile in your medspa, there is something to be learned from it.

Read More

Complexity Causes 50% Of All Returns

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

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

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

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

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

Three Great Rules Of Productivity For Your Medical Spa

How can you improve the productivity of your medical spa?

Here is an excerpt from an article in Connect Magazine

Employer Rule No. 1: Give employees ownership of real deliverables. Depending on the kind of manager you are, you’ll either shy away from this because: a) you can do it better, or b) you don’t want to overload your direct reports. Either is a mistake. In my experience, most complaints I’ve had with any of my past employers have related to having too little to do, rather than insufficient salary/title/etc. Give your employees meaningful work, and they will (eventually) love you for it.

Employee Corollary No. 1: Insist on personal accountability. Yes, it’s scary to have people counting on you. It’s much easier to coast along behind the scenes. But admit it: it’s not very satisfying. Sloth never is. It’s much better to be king of an infinitesimal pond than a nobody in a massive ocean. Go for the responsibility, not the title. (I’ve made this mistake on several occasions, and each time I’ve regretted it.)

Read More

5 Valuable Services Your Medical Spa Doesn't Know About

5 Valuable Services Most Medspas Don't Use.

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

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

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

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

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

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

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

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



Saying "I'm Sorry" Can Prevent Angry Patients

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

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

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

 

How much should you charge for your product or service?

One of the most difficult, yet important, issues you must decide as the owner of a medical spa or cosmetic medical practice is how much to charge for your products or services. While there is no one single right way to determine your pricing strategy, fortunately there are some guidelines that will help you with your decision.

Before we get to the actual pricing models, here are some of the factors that you need to consider:

* Positioning - How are you positioning yourself in the market? Is pricing going to be a key part of that positioning? If you're running a business based on price, you're always going to be trying to keep your prices as low as possible (or at least lower than your competitors). On the other hand, if you're positioning your business as an exclusive luxury product, a price that's too low may actually hurt your image.

The pricing has to be consistent with the positioning. People really do hold strongly to the idea that you get what you pay for.

* Demand Curve - How will your pricing affect demand? You're going to have to do some basic market research to find this out, even if it's informal. Get 10 people to answer a simple questionnaire, asking them, "Would you buy this product/service at X price? Y price? Z price?" For a larger venture, you'll want to do something more formal, of course -- perhaps hire a market research firm. But even a sole practitioner can chart a basic curve that says that at X price, X' percentage will buy, at Y price, Y' will buy, and at Z price Z' will buy.

* Cost - Calculate the fixed and variable costs associated with your product or service. How much is the "cost of goods", i.e., a cost associated with each item sold or service delivered, and how much is "fixed overhead", i.e., it doesn't change unless your medical practice changes dramatically in size? Remember that your gross margin (price minus cost of goods) has to amply cover your fixed overhead in order for you to turn a profit. Many physicians under-estimate this and it gets them into trouble.

* Environmental factors - Are there any legal or other constraints on pricing? For example, in some cases, doctors, insurance companies and Medicare will only reimburse a certain price (If you even take third party reimbursement.). Also, what possible actions might your competitors take? Will too low a price from you trigger a price war? Many doctors and medical spas have been burned in a price war with a competitor. Find out what external factors may affect your pricing.

The next step is to determine your pricing objectives. What are you trying to accomplish with your pricing?

* Short-term profit maximization - While this sounds great, it may not actually be the optimal approach for long-term profits. This approach is common in medical spas that are bootstrapping, as cash flow is the overriding consideration. It's also common among smaller businesses hoping to attract venture funding by demonstrating profitability as soon as possible. For this reason you should be very careful about claims of some of the current batch of medical franchises that are only offering minimal services.

* Short-term revenue maximization - This approach seeks to maximize long-term profits by increasing market share and lowering costs through economy of scale. For a well-funded company, or a newly public company, revenues are considered more important than profits in building investor confidence. Higher revenues at a slim profit, or even a loss, show that the company is building market share and will likely reach profitability. Amazon.com, for example, posted record-breaking revenues for several years before ever showing a profit, and its market capitalization reflected the high investor confidence those revenues generated.

* Maximize quantity - There are a couple of possible reasons to choose the strategy. It may be to focus on reducing long-term costs by achieving economies of scale. This approach might be used by a company well-funded by its founders and other "close" investors. Or it may be to maximize market penetration - particularly appropriate when you expect to have a lot repeat customers. The plan may be to increase profits by reducing costs, or to upsell existing customers on higher-profit products down the road. In general, with medical treatments, more patients means more income.

* Maximize profit margin - This strategy is most appropriate when the number of sales is either expected to be very low or sporadic and unpredictable. Many physicians and medical spas are forced to adopt this strategy if they are unable to generate high patient flow for treatments like Thermage, Restylane and other fixed cost treatments. This typically leads to price gouging by physicians and unhappy patients.

* Differentiation - At one extreme, being the low-cost leader is a form of differentiation from the competition. At the other end, a high price signals high quality and/or a high level of service. Some people really do order lobster just because it's the most expensive thing on the menu.

* Survival - In certain situations, such as a price war, market decline or market saturation, you must temporarily set a price that will cover costs and allow you to continue operations.

Now that we have the information we need and are clear about what we're trying to achieve, we're ready to take a look at specific pricing methods to help us arrive at our actual numbers.

As we said earlier, there is no "one right way" to calculate your pricing. Once you've considered the various factors involved and determined your objectives for your pricing strategy, now you need some way to crunch the actual numbers. Here are four ways to calculate prices:

* Cost-plus pricing - Set the price at your production cost, including both cost of goods and fixed costs at your current volume, plus a certain profit margin. For example, your medical treatments cost $20 in raw materials and production costs, and at current sales volume (or anticipated initial sales volume), your fixed costs come to $30 per unit. Your total cost is $50 per unit. You decide that you want to operate at a 100% markup, so you add $50 (50% x $50) to the cost and come up with a price of $100 per unit.

So long as you have your costs calculated correctly and have accurately predicted your sales volume, you will always be operating at a profit.

* Target return pricing - Set your price to achieve a target return-on-investment (ROI). For example, let's use the same situation as above, and assume that you have $10,000 invested in the company. Your expected sales volume is 1,000 units in the first year. You want to recoup all your investment in the first year, so you need to make $10,000 profit on 1,000 units, or $10 profit per unit, giving you again a price of $60 per unit.

* Value-based pricing - Price your product based on the value it creates for the customer. This is usually the most profitable form of pricing, if you can achieve it. The most extreme variation on this is "pay for performance" pricing for services, in which you charge on a variable scale according to the results you achieve. Let's say that your widget above saves the typical customer $1,000 a year in, say, energy costs. In that case, $60 seems like a bargain - maybe even too cheap. If your product reliably produced that kind of cost savings, you could easily charge $200, $300 or more for it, and customers would gladly pay it, since they would get their money back in a matter of months. However, there is one more major factor that must be considered.

* Psychological pricing - Ultimately, you must take into consideration the consumer's perception of your price, figuring things like:

o Positioning - If you want to be the "low-cost leader", you must be priced lower than your competition. If you want to signal high quality, you should probably be priced higher than most of your competition.

o Popular price points - There are certain "price points" (specific prices) at which people become much more willing to buy a certain type of product. For example, "under $100" is a popular price point. "Enough under $20 to be under $20 with sales tax" is another popular price point, because it's "one bill" that people commonly carry. Meals under $5 are still a popular price point, as are entree or snack items under $1 (notice how many fast-food places have a $0.99 "value menu"). Dropping your price to a popular price point might mean a lower margin, but more than enough increase in sales to offset it.

o Fair pricing - Sometimes it simply doesn't matter what the value of the product is, even if you don't have any direct competition. There is simply a limit to what consumers perceive as "fair". If it's obvious that your product only cost $20 to manufacture, even if it delivered $10,000 in value, you'd have a hard time charging two or three thousand dollars for it -- patients would just feel like they were being gouged. A little market testing will help you determine the maximum price patients will perceive as fair.

Now, how do you combine all of these calculations to come up with a price? Here are some basic guidelines:

* Your price must be enough higher than costs to cover reasonable variations in sales volume. If your sales forecast is inaccurate, how far off can you be and still be profitable? Ideally, you want to be able to be off by a factor of two or more (your sales are half of your forecast) and still be profitable.

* You have to make a living. Have you figured salary for yourself in your costs? If not, your profit has to be enough for you to live on and still have money to reinvest in the company.

* Your price should almost never be lower than your costs or higher than what most consumers consider "fair". This may seem obvious, but many entrepreneurs seem to miss this simple concept, either by miscalculating costs or by inadequate market research to determine fair pricing. Simply put, if people won't readily pay enough more than your cost to make you a fair profit, you need to reconsider your business model entirely. How can you cut your costs substantially? Or change your product positioning to justify higher pricing?

Pricing is a tricky business. You're certainly entitled to make a fair profit on your product, and even a substantial one if you create value for your customers. But remember, something is ultimately worth only what someone is willing to pay for it.