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...

Sona Medspas: Inside a medial spa franchise.

Medical Spa MD Series: Inside a Sona Medspa Franchise

Q&A from former Sona Franchise owner Ron Berglund.

Ron posted a number of thoughtful comments regarding the problems with medspa franchises.

After exchanging emails, Ron's agreed to answer a number of questions about his experiences with Sona including the good, bad, and ugly. Why he chose Sona? What he was told? What really happended? What went wrong?

As far as I'm aware, Ron is the first medical spa franchisee who's been willing to come forward and tell his side of the story in a comprehensive way.

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

The following article on problems with medical spa franchises ran in the Wall Stree Journal. It's a telling article that points the finger at the current crop of medical spa franchises. I signed up and read it after Ron posted his comments on being an unhappy Sona owner.

Medspa Boom Has Become a Bust for Some

By RHONDA L. RUNDLE: November 21, 2006

Jeff Nebot thought he had struck gold. Two years after opening a laser hair-removal franchise in St. Louis, annual revenue hit $3 million. And over time, the lavish salon added other cosmetic services as Mr. Nebot joined the rush of entrepreneurs into the emerging business of medical spas. Medspas (also called medispas) offer such medical treatments as Botox injections and laser hair removal in a luxurious environment rather than a doctor's office. The field has been rapidly expanding in recent years as entrepreneurs and doctors alike have sought to profit from the dual quests of many affluent consumers: prettification and pampering. For an increasing number of those who entered the business, the boom is proving a bust.

"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.

"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.

You can read the entire article on the Wall Street Journal site here. It does require a subscription. 

Sona MedSpas: An unhappy franchise owner.

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

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

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

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

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

Ron Berglund 

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

From the same thread.

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

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

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

Ron Berglund 

The Angry Physician Syndrome: Hostile MDs entering cosmetic medicine.

Hostile doctors and the clinics they run.

Having consulted with many physicians about incorporating some form of cosmetic practice into their clinic, I've noticed that one of the biggest problems that these physicians have is changing the way they 'think' of medicine. (Noticed is something of a simplification since 'beaten over the heat' is a more accurate description.)

Cosmetic medicine is a new world for doctors who are used to third party reimbursement, nasty collections letters, physician referrals and seeing 30 or more patients a day. Docs today are angry; Irritated by long hours, pissed at malpractice premiums, feeling unappreciated and defensive.

Dr. Charles is Hostile:

There's no justice in Germany either. A German court ordered an OB/GYN doctor to pay $769 a month in CHILD SUPPORT to one of his former patients - a woman who got pregnant despite the IUD (contraceptive device) he inserted. This is horrendous. Sue your doctor if you get pregnant? An unintended yet healthy baby is evidence of bodily harm? No contraceptive is 100% accurate! The article says that "the implant could no longer be found in the woman's body." This does not mean it was the doctor's fault. IUD's fall out in up to 7% of women in the first year of use. That's part of the reason they have a string that dangles out of the cervix into the vagina, meant to be checked on a regular basis by the woman to ensure proper placement. This is totally outrageous, uncivilized, and another reason why it takes serious courage to try to help anyone in this world of blame.
[update - thanks to the correction of a German commenter, it was not an IUD that failed but another device, probably like Implanon but I don't know what's available in Germany. The underlying principle is still unbelievable. Overlawyered has some more links to this, and a decent discussion starting in the commentary.]

The Trial Lawyers Association is changing its name to the American Association for Justice. George Orwell is smiling somewhere, the skies are getting clearer every day, and no child is being left behind.

A doctor acquaintance of mine just got destroyed with a $20,000,000 jury award in a bogus malpractice case. I typed it into google and found this page, which is unrelated. I felt nauseous reading the top guy's credentials. The best thing he's done is apparently winning "the largest medical malpractice verdict ever won in the District of Columbia ($24 Million), (which was) reported by USA Today, Dateline NBC, Jet Magazine, the Washington Post, the Baltimore Sun and affiliates of ABC, CBS and NBC." Way to go! I bet his pockets were full after that one! Those doctors on the other end deserved utter destruction, all those years they spent working 120 hours a week for $30,000 a year, all those hopes they had of helping people, of making a difference. All those efforts pale in comparison to the $24,000,000 he got the jury to cough up.

Dr. Charles is right.

But... cosmetic medicine is a different animal and angry docs fare poorly when the anger they have towards the system spills over into their interaction with patients and staff. (Yes, I know angry docs fare poorly everywhere.)

Whenever I'm interviewing a physician I ask myself if they're an angry doc. If I think they are, it's a non-starter. I can work with a lot but can't change the way that someone fundamentally views the world and their situation. I can't change the way that an angry physician deals with patients, staff, and me. It just doesn't work. It's true that there are lots of angry docs out there and you might know some that you think are successful and that the fact that they're angry doesn't hurt them as a business. I don't.

If you're thinking about entering cosmetic medicine because you're angry and think that someone owes you, get ready for more of the same. In cosmetics as in regular medicine, it's still all about them.

Update on 2006-11-21 00:56 by Medical Spa MD

Follow-up: Dr Charles sent me a very nice email that included the following:

"...Although you said "I'm right", I did find your post kind of annoying, labeling me as an "angry MD."  There is so much more than that unipolarity in defining my approach to medicine, but at times we all get angry."

I did not mean to apply a blanket angry label to Dr. Charles. In fact, he seems to be a well read and thoughtful physician with a respected blog. My apologies to Dr. C. Nothing at all personal intended.

This post, and other I'm sure I will write, are meant to delineate the difference between general and cosmetic medicine for docs looking to make a change or choice. 

Of course anger is not only confined to physicians, pharmacists have it too. 

UnitedHealth: Dr. McGuyire got caught with his thumb on the scale.

"UnitedHealth, one of the nation’s two largest health insurers, also dismissed its general counsel and a member of its board in what amounted to a sweeping overhaul of its governance practices and leadership ranks. The options that Dr. McGuire had been granted over the years have led to criminal and civil investigations and public disapproval.

In a sweeping report released yesterday that was highly critical of management, a law firm hired by UnitedHealth to investigate the timing of stock options concluded that the company was riddled with poor controls and conflicts of interest. The report, which the company posted on its Web site, found that UnitedHealth had backdated options to maximize employees’ compensation."

Read the entire NY Times article here. 

(via Kevin MD)

Update -
The Health Care Blog: "Whether or not it was illegal, his actions suggest staggering greed."

Medspa Business Plan: Get your head examined.

From JerseyMD: a link to your very own Medical Spa Business Plan.

 
While you may well need a business plan for your medical spa, a downloadable, cookie-cutter PDF is not the one to use. Stuff like this makes me shake my head and mutter to myself all night, scaring my wife. 

Dentists & medspas?

MD posted this in the Physician to Physician Q&A discussion area:

Does anybody know if it is legal for a dentist to purchase and run an IPL/Nd:YAG? A local dentist just informed me he was getting into the med spa business to "generate lots of revenue" Humm- good luck with that....

MD makes a point. Dentists, docs, nurses, hair stylists and others who don't have a good business sense and feel that everyone's just making money hand over fist are in for a rude awakening. As I've posted before, one of my friends makes his living (a very, very good one) buying tecnology from doctors going out of business and selling it to doctors rushing into business. I would bet my left kidney against a bag of hammers that there will be a used IPL going cheap in a dentists office.

Follow the medical spa money trail in Florida. A comment worth repeating.

An excellent comment from Denise Curtis (a PA) from a discussion thread on the new regulation governing medical spas in Florida.

Dear MDMan,

All PA's are required to be registered with their state medical boards and by law are required to have continuing education. In NC, the requirements are EXACTLY the same for PA's and MD's, meaning we have to have 100 hours of Category I CME's every 2 years. Furthermore, PA's must pass a national certification exam before practicing and must sit for this exam every 6 years to maintain their certification. Physician Assistant programs now require a BS degree prior to entering PA school and then grant a Masters upon completion. Unlike nurse practitioners, PA's have always maintained their dependence uppon physicians. However, this does not mean that PA's cannot practice independently of their supervising physician.

It is sad that there are many places in this country where a PA is only health care provider willing to work for very low wages to provide basic health care the those rural areas. In those situations, the PA may be the only provider for hundreds of miles. With the passing of these bills not allowing PA's to see patients independently in medical spa settings are they then going to require an MD to be present in all of those health department and rural settings? Think about this for a minute. Basically, they are saying that a PA is not qualified to do laser hair removal but that a PA can provide health care in lower socioeconomic settings. In some of these settings, the PA's run codes, put in A lines, triage critically ill patients, only because there is a lack of MD,s willing to work in those settings.

Do you think this country can afford to put such restrictions on health care? Furthermore, do you think that laser hair removal is more dangerous than running a code?

It is always about the money and control!!!!!

Denise Curtis 

Aestheticians And The Doctors Who Love/Hate Them, Part 2.

I first posted here about Estheticians and the doctors who love + hate them.

Since that first post I've received some negative comments from estheticians who think that they're a pleasure to work with.  You can read a thread of esthetician comments on medical spas and physicians here.  While they blast me as having a bone to pick, you'll notice that twice during the thread doctors are referred to as 'greedy bastards'. 

If anyone's still unaware, embezzlement is the number one problem in medical clinics.

Here are some memorable quotes: 

Well said, Nondy!! I have never worked with a doctor as an esthetician but worked with plenty of them as a nurse for 25 yrs. and yes, they are greedy bastards!  This is why I don't believe anything negative they print about our profession, our products or our equipment not being up to standards.  They just want all the business streamlined to them and will stomp on reputable esties to get it.

I will say not ALL docs fall into this category. It's just precious few, I have found, williing to think outside of the box and give credit where credit is due... Overall though, I found the article to be offensive.

The esty's were paid low hourly wages with no tips... If I go back to the treatment side, I think I'd prefer spa/resort and a percentage of the services/sales over my experience in medical.

Basement lipo proves fatal.

There's a question that's been posted in the discussion threads on what could happen if you get into legal trouble without medical oversight... here's the answer. A couple who performed liposuction in the basement of a home has been charged with practicing medicine without a license.

California Medical Board: Use Of Mid-Level Providers for Lasers, IPLs, Botox, & Other Treatments

The State Medical Board of California has addressed the Use Of Mid-Level Providers for Lasers, IPLs, Botox, & Other Treatments. (Links to PDF) It's a common question that is often brought up over in the discussion areas.

You should read this information carefully. Although it's specific to California, the information is substantially similar to many states.
Read also: Medical Spa Legal: How to...  l  Medspa Legal Discussion Area  l  Building a Medispa inside your practice  l  Medical Spa Franchises

From the Medical Board of California:

Due to an influx of calls to the board regarding who may perform what type of medical / cosmetic procedure and where, the following frequently asked questions and responses are provided for informational purposes and as a reminder. This is a reprint and update to an article published in the October 2002 Action Report.

Who may use Lasers or Intense Pulsed Light devices to remove hair, spider veins, and tatoos?

Physicians may use Lasers or Intense Pulsed Light devices. In addition, Physician Assistants and Registered Nurses (not Licensed Vocational Nurses) may perform these treatments under a physician's supervision. Unlicensed Medical Assistants, Licensed Vocational Nurses, Cosmetologists, Electrologists, or Estheticians may not legally perform these treatments under any circumstance, nor may Registered Nurses or Physician Assistants perform them independently, without supervision.

Who may inject Botox?

Physicians may inject Botox, or they may direct Registered Nurses, Licensed Vocational Nurses, or Physicians Assistants to perform the injection under their supervision. No unlicensed persons, such as Medical Assistants, may inject Botox.

I've been approached by a nurse to be her 'sponsoring physician' for her laser and Botox practice; would that be legal?

No. There is no such thing as a 'sponsoring physician'. Nurses may not, under California law, employ or contract with a physician for supervision. A  nurse may not have a private practice with no actual supervision. While the laws governing nursing recognize "the existence of overlapping functions between physicians and registered nurses" and permit "additional sharing of functions within organized health care systems that provide for collaboration between physicians and registered nurses" (Business and Professions Code section 2725), nurses may only perform medical functions under "standardized procedures." The board does not believe this allows a nurse to have a private medical cosmetic practice without physician supervision.

I've been asked by a layperson to serve as a "Medical Director" for a "medi-spa" that provides laser and other cosmetic medical services; would that be legal?

No. No one who cannot legally practice medicine can offer or provide medical services (Business and Professions Code section 2052). A physician contracting with or acting as an employee of a lay-owned business would be aiding and abetting the unlicensed practice of medicine (Business and Professions Code sections 2264, 2286, and 2400). To offer or provide these services, the business must be a physician-owned medical practice or a professional medical corporation with a physician being the majority shareholder.

I see these ads for "Botox Parties" and think that it has to be illegal. Is it?

The law does not restrict where Botox treatments may be performed, as long as they are performed by a physician or by a registered nurse, licensed vocational nurse, or physicians assistant under a physician's supervision.

Who may perform microdermabrasion?

It depends. If it's a cosmetic treatment, that is to say it only affects the outermost layer of the skin or the stratum corneum, then a licensed cosmetician or esthetician may perform the treatment. If it's a medical treatment, that is to say it penetrates to deeper levels of the epidermis, then it must be performed by a physician, or by a registered nurse or physicians assistant under supervision. Treatments to remove scarring, blemishes, or wrinkles would be considered a medical treatment. Unlicensed personnel, including medical assistants, may not perform any type of microdermabrasion.

I would like to provide non-medical dermabrasion, and hire an esthetician to perform that and also cosmetic facial and skin treatments. What do I need to do?

It is legal for physicians to hire licensed cosmetologists or estheticians to perform cosmetology services, if they have obtained a facility permit from the Bureau of Barbering & Cosmetoloty. All licensed cosmetologists, including estheticians, must perform their services in a facility with a permit.

Why can't I use a medical assistant instead of a nurse?

Medical assistants are not licensed professionals. While doctors have become accustomed to their assistance in medical office practices, medical assistants are not required to have any degree, nor do they have to pass an examination or be licensed. For that reason, the law only allows them to perform technical supportive services as described in sections 2069-2071 of the Business and Professions Code, and Title 16, California Code of Regulations, sections 1366-1366.4.

What is the penalty if I get caught using or helping an unlicensed person to perform medical treatments?

The law provides a number of sanctions, ranging from license discipline to criminal prosecution, for aiding and abetting the unlicensed practice of medicine. Physicians could be charged with aiding and abetting unlicensed practice, and the employee could be charged with the unlicensed practice of medicine. 

I understand that all of these practices may be illegal, but I see advertisements all the time for these kinds of illegal practices. What should I do?

You may file a complaint with the Medical Board. To do so, please send the advertisement, the publication name and date, and your address and telephone number where you may be reached,  to our Central Complaint Unit at 1426 Howe Avenue, Suite 54, Sacramento, CA 95825. The board will contact the business, inform them of the law, and direct them to cease any illegal practice. If it is simply the advertisement that is misleading, they will be directed to change or clarify the ad.

It is impossible to cover all of the relevant legal issues in a short article, and these questions and answers are not a substitute for professional legal advice. Physicians may want to consult with their attorneys of malpractice carriers about the use of their office personnel. In addition, the board has a number of written materials with more thorough information on this subject. There are legal opinions on the use of lasers and dermabrasion, materials outlining the legal limitations on use of medical assistants, as well as the actual statutes and regulations. To request any of these documents, please contact the Medical Board of California, 1426 Howe Ave., Suite 92, Sacramento, CA 95825, or call (916) 263-2389.

What's wrong with 90% of medspa convention presentations?

Everyone's attended useless presentations. My guess is that 90% of all the speakers I've heard have fallen into one or more of the gaffs below.

Which is sad. Hundreds of attendees have paid and given up time to learn something only to be confronted with information that's just not useful. What's up with the speakers? It's really the show organizers fault. The Medical Spa Expo for example is put on by Reed Exhibitions, a business that organizes conventions and expos as a venture. They find a group in the market they're interested in and, voila, instant show. The politics that go into picking speakers are profound. The first presentors are a resouce to the company putting on the expo. They tend to bring in their friends and keep out the competiton.

Now events are often worth going to for the 10% of speakers that are worth listening to. There's often a useful tidbit here and there among the rest as well. But speakers would be better off resisting the most common traps. Here are some tips drawn from my own experience as a speaker and, more importantly, sitting in the audience.

#1. Speakers: No, you can't pitch your lovely company

If you're presentation is really a sales pitch (i.e., your company markets goods or services to the types of people who attend this show), your chances of making it worth sitting on a folding chair for an hour are extremely slim unless you:

• Have your clients speak with you and eliminate all the tricky little references to your company.
• Present new research thats usefull ot the audience and give it away.
  
• Present tactics, jobs, mistakes, etc., anything with numbers. The more, the better.
• Run a workshop at the conference.
• Pitch your physicians or other professionals who are completely and thoroughly unrelated to marketing and sales.

I've seen some absolute horror shows with this one. Please don't regale me with your franchise pitches and tell me how easy it is to make money if only I'd place myself in your caring hands.

#2. Consultants: No tired speeches about your glory days.

Show attendees sit in multiple presentations on the same topic. At medical spa expos it's the marketing baby. Show organizers know this (which is way they often swap postal lists with each other for promotions). They'll pad the schedule with medspa consultants who did lots of stuff in the past but don't own or run a clinic now. If the resume doesn't currently include something other than consulting, it should. This is a lucritive field. Consultants don't make the money or have the info, owners do.

#3. Experts: Avoid overviews

Great -- you've noticed there's a presentation about a topic that promises to pull back the curtin and let you into the good stuff. What you get is not an expert with hands-on experience but a novice with strong opinions about the topic. In either case, the expert and the psuedo-expert, the overview speaches are useless in the daily operations and growth of a business. That's what blogs are for.

#4. Don't ignore format

Most shows tend to focus primarily on one particular type of presentation such as group panels, intensive workshops, case studies, roundtables, etc. Stick with what you're supposed to be there for. Here's a link to Guy Kawasaki's 10/20/30 powerpoint rule. Required reading for anyone presenting anything anywhere.

#5. Copywrite or sell your presentation

The last time I saw this I was at a Thermage presentation by Virginia Stevens M.D.. Doctor Stevens was presenting information for performing Thermage treatments on the body for a packed room of docs. Everyone sat speachless while Dr. Stevens literally flew through her presentation without pause, questions or clairity. The reason became apparent at the end when Dr. Stevens last slide showed the ordering information available for the presentation on her website for a mere $295. The Thermage sales people were horrified and apologized to everyone (out of hearing of Dr. Stevens).

If you're going to accept the invitation to present, then present, don't sell. You just piss people off.

#6. Let go of your ego

Yeah, you're the expert. But the audience is smart too. Prancing around as the man with the plan will get you used and discarded. I sat on a panel with one doctor (remaining nameless here) who bluntly told the audience that he had the ego of any three men. (He was completely believable too.) But that was the end. The audience totally tuned him out an he was forced to elbow his way in to answers. Everybody has an ego. We just don't want to hear about yours.

technorati tags: medspa, expo, medicalspa, consultants, training

Lawyers.

This was an actual courtroom exchange:

* Lawyer: "Doctor, before you performed the autopsy, did you check for a pulse?"
* Witness: "No."
* Lawyer: "Did you check for blood pressure?"
* Witness: "No."
* Lawyer: "Did you check for breathing?"
* Witness: "No."
* Lawyer: "So, then it is possible that the patient was alive when you began the autopsy?"
* Witness: "No."
* Lawyer: "How can you be so sure, Doctor?"
* Witness: "Because his brain was sitting on my desk in a jar."
* Lawyer: "But could the patient have still been alive nevertheless?"
* Witness: "Yes, it is possible that he could have been alive and practicing law somewhere."
(via Medrants)

Lipodisolve: Mesotherapy Horror Posts!

These posts about mesotherapy were taken from discussion threads on this site.

 
The individual comments have been removed from the discussion threads for obvious reasons but are reposted here:

Yono writes: I am a nail salon owner and learned it from a friend. It works great and you do not need a prescription ! Go online for the best prices and instruction. Mesotherapy is great for anyone and you don't have to go to France!

JJlin writes: Anyone can perform mesotherapy. I tell people its cheaper to inject yourself in the comfort of your own home. You can purchase sterile needles and mesotherapy injectables online, compounding pharmacies, just about anywhere. Instructions online as well.

Aestheticianspa writes: I perform manicures, mesotherapy, botox, and laser hair in my garage transformed into a spa like office. I think anyone can do it as long as you have a doctors lisc. Just send em the check every month. :)

And Cosmo: Its pretty safe and effective. You can pick up the solution at any compounding pharmacy or online and inject it yourself. I tried it many times on a friend. Real easy for anyone. Go for it.

JJlin again: I agree w/ Cosmo. Who cares if it works or not? Everyone should get into Mesotherapy. Its cheap, easy and good cash.

Where to begin. It seems hard for me to believe that this kind of activity is actually happening let alone there are those who are posting that injecting yourself or others in the comfort of your home or garage is a good idea. The stupidity is overwhelming.

If you are injecting anyone and are not a licensed medical provider you are practicing medicine without a license, a felony in every state. If you are injecting yourself you are just plain stupid and should be removed from the gene pool as fast as possible. It's no wonder that mesotherapy has a hit-and-miss reputation for being pseudo-garage-science.