Medspa Advertising: What's the message here.

 

I guess some images just speak for themselves.

Medspa Marketing: Mapping your patient populations.

I really like this idea via Top Lead Generators: Good Idea From My Local Jamba Juice

Up on the wall, there was a giant map of Bakersfield with hundreds of little pins scattered all over the map.  Below the map was the message, "Tell us where you live so that we can put a Jamba Juice in your neighborhood". 

That's smart, on a couple of fronts:

• It's fun, non-intrusive and interesting for patients.
  
• You get valuable feedback on where your patients are coming from. (I'd guess you'll see clusters develop.)
  
• It reinforces your value to the patient. They can see that (hopefully hundreds or thousands) of others have made the choice to come to your medspa.
• It can provide valuable info that could be used for direct mailings or PR stories.
  

Sales leads don't always have to come from a list.  Valuable information is yours for the taking if you give your customers a chance to have a little fun and take a second to provide you with information you can use to grow your business. 

Medispa MD: Questions about your medical spa?

jwrn thinks some of the reactions to questions posed have been rude to which I reply:

It may be rudeness your seeing. It may just as well be an intolerance for those taking positions on medical issues that are clearly wrong and/or illegal. If this is your fist stop in your due diligence and your question is 'how do I open a medical spa' or 'what laser should I buy' it's either answered on other portions of this site, or it's beyond the scope of a 'comment' to answer.

You should take the time and read the relevant  portions of this site.

Those who read and comment on this site are generally physicians who are often running retail medical practices. The fact that completely remedial questions and comments that display a complete ignorance of the moral, ethical, and legal status that comes with the practice of medicine receive short shrift should come as no surprise to anyone. It's frustrating to see the same basic questions posted over and over with the inevitable 'HELP!" thrown in for effect. If you're willing to make important business decisions based on the response you'll get to questions like that, you'll not be around long.

In fact, I've found the community to be remarkable tolerant and almost universally helpful if you're willing to make the slightest effort to ask an intelligent question.

If you'd actually like to take advantage of the considerable communal knowledge stored here... 

Ask an intelligent question that's not in all-caps, run spell-check, show a little respect for the people who you're asking to respond, and you'll receive helpful advice. When your asking for someone to take the time to share information with you, it's the least you can do.

Medspa MD: Subscribe to the comments.

With more than 2600 comments on this blog and 10-15 more every day, the comments are probably more interesting than what I'm putting up. So, now you subscribe to all the comments on Medspa MD from their own RSS feed on the main page. (It's that 'comments' link over on the side.)

For those of you who aren't RSS aware yet.

If you're not using an RSS feed aggregator you should be giving it some serious thought.  

American Laser Clinics: Inside ALC?

A question about American Laser Clinics business model was posted in the tread: American Laser Clinics: Armed guards and threats.

 
BetterOffNow posted the following in reply:

They actually have two models, one for franchises"licensee clinics" and one for company stores.
When they purchased Advanced Laser Centers they absorbed their franchises and made them buy the rights to use ALC's name.

The licensee clinics have not done well for the company and they stopped licensing new clinics as far as I can tell. They really don't seem to offer them any support.

I'm not really sure on all of the specifics of their business plan, but the doctors are considered by the company to be their employees.

So ALC will go out and recruit or many many MD's and DO's contact them to become a "Medical Director". ALC will rent out a stand alone clinic or rent a space from the medical director.

They do check the licensing requirements of each state that's why you don't see any ALC clinics in NJ which has very tough rules about who can perform laser.

The rent they pay is pretty low,if you notice they don't seem to be in high rent buildings, maybe a few thousand per month.

They pay the MD $4K monthly and the biggest expense after that is equipment, but they have many agreements with Syneron so they aren't paying as much as everyone else does for their lasers. There was an attempt at legal action against them for creating a monopoly about 18 month sago but ALC won the anti trust suit.

If the clinic is a startup, it usually operates with a skeleton crew, 1 manager, 1 FT tech maybe one PT. they expect a new clinic to be producing 60K per month after 3 months,manager's get the axe if their clinic is not producing. No discussion, no negotiation.

They prefer the MD's not to get in the way, I think I talked to my medical director maybe once every 3 months or so.
ALC ia basically a very revenue driven company, and they pretty much try and steamroll over any opposition to their plans.

They operate their clinics in an atmosphere of fear, even my medical director was afraid of them.
Once about 3 years ago, a clinic manager in NY, wasn't feeling well. She was too intimidated to take time off to recover, and didn't want to ask to take an hour off to go see a doctor.

There was a strongly worded manager's conference call about slackers who called in sick because it was the end of the month and big numbers had to be achieved.

Well to make a long story short, that manager called her clinic in the morning and said she was still really sick but she would make it in later that morning. She never showed up and when her assistant manager was able to go to her building and get the key they found her dead. Literally worked to death.she was all of 28. RIP. Like I said - I'm Betteroffnow

For the physicians I've seen this work out extremely poorly. It's the doctors medical license that's at risk and they're always the ones sued first by unhappy patients since they're the ones providing medical oversight. For $3k a month for something you could do yourself it's just not a great deal. The pitch to the physicians is that they'll drive so much traffic into your other clinic that its a great deal. But what I've seen in practice mirrors what's stated above. American Laser tries to distance themselves as much as possible from physician involvement. 

I find it interesting that they couldn't make their license agreement work.  I guess it's just a lot easier to sell medspa licenses and franchises than it is to support the franchises.

Plastic Surgeon Study: The aging human face.

Plastic surgeons are tossing out the old-school belief that gravity is the primary culprit for facial aging.

A study in June's Plastic and Reconstructive Surgery(R), the official medical journal of the American Society of Plastic Surgeons (ASPS), reveals the human face is made up of distinct fat compartments that individually change with age and the degree to which our faces age is dependent, in part, on how these compartments change over time.

"Contrary to popular belief, the human face does not age uniformly," said Joel Pessa, MD, ASPS Member Surgeon and study lead author. "We thought facial fat was one confluent mass that eventually got weighed down by gravity, creating sagging skin. However, we were shocked to find not only is the face made up of individual fat compartments but these compartments gain and lose fat at different rates."

According to Dr. Pessa, the face is a three-dimensional puzzle with fat partitioned into discrete units around the forehead, eye, cheek and mouth. A youthful face is characterized by a smooth transition between these compartments, but as we get older abrupt contour changes occur between these regions due to volume loss, volume gains, and repositioning of the compartments. These changes lead to tell-tale signs of facial aging such as sagging or hollowed skin and wrinkles.

With this breakthrough, plastic surgeons will be able to more accurately pinpoint trouble areas and use injectable fillers to add volume to individual sections of the face, creating a more effective way to turn back the clock.

According to the study, this discovery may also benefit cancer and trauma patients who require reconstructive plastic surgery. The authors uncovered that the individual fat compartments have boundaries between them that act like fences. These fences allow the face to maintain its blood supply should it become injured. This anatomical discovery may allow for better results for reconstructive plastic surgery patients. In addition, plastic surgeons can begin to use this new way of thinking to better understand facial deformities, such as cleft lips and vessel tumors.

"Much of facial anatomy remains a mystery," said Dr. Pessa. "This discovery will undoubtedly play a role in how we view aging and how we approach facial reconstructive plastic surgery."

American Society of Plastic Surgeons
http://www.plasticsurgery.org

Medspa License or Medispa Franchise: Where's the difference?

JK posted this question about becoming a medical spa licensee rather than a franchisee:

"So what do you all think of a licence rather than a franchise? You pay money up front and then pay monthly into a marketing co-op? The Licensor doesn't tell you what to do or what to buy? This way you get the marketing benefits of the co-op?"

It's a good question. This could get interesting.

Part 1: What's the difference between a medpa franchise, and a licensing agreement for your medical spa? 

 
There are some fundamental differences.

Franchising is considerably more structured than business opportunities. However, just as with business opportunities there are variations in the definitions used by the Federal Trade Commission (FTC) and some states and there are even variations among the states. The most common definition cited though is the one promulgated by the FTC which makes the distinction between a simple license and a license that has crossed the barrier and become a franchise.

1. The licensee is given the right to distribute goods and services that bear the licensor trademark, service mark, trade name, advertising or other commercial symbols;
2. The licensor exercises significant control over, or provides the licensee with significant assistance and, the licensee's method of operations; and
3. The licensee is required to make a payment of $500.00 or more to the licensor or a person affiliated with the franchiser at any time before or within six months after the licensee commences business operations.

When these three elements are in place, the license is generally considered a franchise and the franchiser must abide by certain rules generally focused on how they offer their opportunity to the public.

Franchising describes the system of delivery, not the specific product or services associated with the delivery as in a business opportunity. The chief differences between Business Opportunities and Franchising is in the degree of the relationship:

So what should you look at with someone calling themselves a medical spa 'license'. 

First, if they fulfill the above criteria, no matter what they call themselves, they are a franchiser and must fallow franchise law with a UFOC and the whole deal. That's exactly why Solana chose that rout. (They sprang from a company called Health West that the State of California closed down for selling medical practices to not physicians.) 

Now I'm no big fan of the current crop of medical spa franchises (I say current because it's possible that could change.) but there's a reason that almost every business chooses franchising over licensing.

So franchisees are supposed to get ongoing support for their operations (The Dermacare guys can comment on this.). Licensees are pretty much S.O.L. in this regard.

Part 2: A deeper look at licensing for medspas.  

Electrologists in Florida can perform laser hair removal?

This kind of underground 'you can do this' stuff pops up regularly regarding laser hair removal. Who can do it? Who can't?

 
Here's a comment that was made that, if you just read it, would lead you to believe that Electrologists in Florida can perform laser hair removal.

Here's the comment and the note I left on it.

From adrisen: "In the State of Florida one needs to be an Electrologist before they can do laser hair removal.  I contacted them becasue I am moving here in 15 months. Thank you for the information on the Harmoney.  There is another unit that I am looking into and might ask about.  Thanks everyone."

(NOTE: I've decided to leave this comment up although it's incorrect. In every state in the US, laser hair removal is considered and regulated as a medical treatment and must be performed under medical supervision at the least. Electrologists on their own, may not perform laser hair removal any more than Jane Doe on the street. There are no exceptions and every state is the same with this basic premise.)

Now if you're an electrologist, don't get out your powered knitting needle and come looking for me. Call us crazy but the US regulates medical treatments.

Medical Spa Legal Discussion Thread

Medspa Legal Category: Blog posts dealing with the legal issues of medical spas.

Lipodissolve, Mesotherapy & Fat Melting Injections.

The plastic surgery community has come out strongly against physician injectable mesotherapy treatments that are often referred to as Lipodissolve and main stream media's taking a look. Is this quackery? Is it medical fraud? Will it effect liposuction incomes?

 
I know a number of plastic surgeons who regularly use Lipodissolve in conduction with their liposuction surgeries. Why? There are inherent problems with liposuction that lipodissolve can address.

The plastic surgeon societies state that it's not 'proven'. True enough. But unlike treatments like featherlift, lipodisolve ends up with happy patients. The market is validating it as 'wanted' and the plastic surgery societies are trying to sweep back the ocean with a broom. Anyone know if there are studies ongoing?

Disclaimer: Surface performs Liposolve.

The Wall Street Journal weighs in on Mesotherapy: Popular Treatment That Aims To Melt Fat Draws Scrutiny

Last month, the American Society for Aesthetic Plastic Surgery warned that the shots are "scientifically unproven, lacking any objective data on safety and efficacy." The surgeons' group, which is sponsoring human tests to evaluate one such treatment, urged the public "to steer clear" until more data come in.

Physicians who offer lipodissolve say the injections can be effective in skilled hands. Diane Duncan, a plastic surgeon in Fort Collins, Colo., cites a 2006 retrospective study that she co-authored in the Aesthetic Surgery Journal, based on data submitted by 75 physicians in 17 countries from 17,376 patients. The study found that roughly 12% of patients expressed disappointment with the aesthetic result. The authors concluded that the treatments have a good safety record; complications included temporary hyperpigmentation, pain and allergic reactions.

Hat tip to PS 101 

It looks as though the Medspa Classified Board is working.

After a few hiccups, It looks like the classified medspa equipment board is now working correctly. (It's geeky beyond my ken.)

 
The last listings have both photos, prices and the rest of the troublesome stuff. There are only a few listings now but with 20,000 unique visitors who are all at least interested in this area (About 70% are docs according to the membership list.) it's prime real estate if you're trying to recycle your Cynosure Laser, Velasmooth, Cynergy PL, Diamond Tome Microderm, Canfield imaging system, Longport Ultrasound, or Skin Typing Spectrophotometer (All current listings.).

I've started a discussion thread for the classified board to discuss used medical equipment, buying and selling, and whatever doesn't fit under a specific IPL or Laser Technology Platform.

Note: Please do not spam advertisements for businesses on the board. I you're a vendor your welcome to post individual listings for equipment you have but not to spam advertisements for your business or services.

Retail Medicine: The Sopranos & the expectation paradox.

Seth Godin (Yeah, I know you don't know who he is) posted about the final episode of the Sopranos and the expectation paradox.

The expectation paradox

So, people are upset because of the non-ending of the Sopranos. People are always upset when a TV show ends with a big finale, because it never meets the hype, never meets the expectations. If HBO had been quiet about it, hadn't done the full page ads and the radio shows and the newspaper articles, it would have been fine. Expanded expectations led to big disappointment.

The paradox: if expectations hadn't been raised, fewer viewers would have tuned in.

...In each case, the paradox is at work. On one hand, you want to raise expectations, because without doing that, you diminish trial. On the other hand, you want to exceed expectations, because that's what generates word of mouth.

As word of mouth becomes an ever more important component of marketing, the scales are tipping. Undersell, overdeliver. It's the strategy that works in the long run.

Every marketer has a choice... to make the first interaction the best of the experience, or the worst (least best).

Managing patient expectations is a constant challenge for many docs. It's easy to oversell and overpromise... don't. It leads to unsatisfied patients who feel 'sold'.

I had a long talk with a doc in FL today about this very subject. He's hired a 'marketing' person who will be incented to close sells and increase patient flow. Here's the potential problem: It's easy to overpromise in this situation leading to an unsatisfied patient and creating a situation where you're constantly having to feed new patients into your clinic. As the wise man said, "That ain't good." 

Read more about paradox in relation to medspas: The paradox of unlimited choice 

Medspa Doc: Greeting your patients by name.

Via Kevin MD: Doctors urged to make good first impression

Almost all patients want to be greeted by name when seeing a doctor for the first time and want to shake hands, a survey of patients found. But while handshakes are common, doctors often never utter the patient's name, the researchers said.

The researchers surveyed 415 U.S. adults in 2004 and 2005 on their preferences and expectations for initial greetings by doctors. They also looked at videotapes of 123 new patient visits with 19 doctors in Chicago and Burlington, Vermont, to see what these doctors were doing in such settings.

Seventy-eight percent of patients surveyed wanted a doctor to shake their hands, while 18 percent did not. In the taped sessions, doctors and patients shook hands 83 percent of the time.

Thermage Lips: Plump yer pucker.

'Thermage Introduces Lips by Thermage, a New Non-Invasive Aesthetic Procedure for Lips  Offering consumers fuller, more defined looking lips without injections'

 

Plasticized says: "This new marketing tool for a now commonly found machine in aesthetic offices uses a small tip to tighten the skin around the lips, minimizing lines. It may also promote fuller lips by stimulating collagen formation.

Still, we are skeptical. The procedure is costly due to the extremely expensive, disposable tips that must be bought from the same company.

This could be an appropiate time to invoke the adage, "To a hammer, the world is a nail". 

Estheticians & Laser Technicians: Want to work at a laser clinic or medical spa?

I get emails and emails from estheticians looking for advice on how to get hired by a laser clinc or medical spa.

 
So here's some advice:

First, read these threads from esthicians who have worked for American Laser Clinics from the thread on American Laser Clinics  & the Armed Guard.  Then read the comments on this post if there are any.

Now take this list to heart: (At least if I'm interviewing you.)

• Don't work for any medspa, doctor, laser clinic, or franchise that looks as thought they may be cutting corners. Why? The esthetician is always named in any trouble and it's common practice to cut the esthetician loose. Let me reiterate... Estheticians will always be the first to get in trouble when a treatment they're performing goes wrong. Poor training and oversight is the most common shortfall and it takes experience before you can recognize potential trouble. Anyone can perform a treatment when everything goes right, but it takes time to learn contraindications and how to handle them. Shoddy business practices will get you in trouble every time.
• Look for a laser clinic / medspa that has a physician that's intimately involved and there all the time. (Surface's protocols specify that every single patient is seen by the supervising physician before any treatment.)
  
• Don't try to tell the physician how many clients you're going to bring with you. (Certainly I'd never believe you.) You may get hired by some doctor who's not experienced either but you won't be able to deliver. Patients make medical decisions on different factors than day spas.
  
• Get off your prima donna pedestal: This is not a day spa where you're on commission. (If it is, it may well be illegal since it could be construed as fee splitting.) You should expect to answer phones and take out the garbage. You may want to think that you're indespensible, make yourself such.
• Work as though you own the clinic. Staff that don't whine and bitch and look out for the clinic as though they owned it are the keepers. If you're not one of these, don't expect to make an impression.

Everyone, and I mean everyone, is paid by how hard they are to replace. Physicians are harder to replace than front desk staff... they make more money. Someone who bitches and moans, is hard on the other staff, is careless... Hey, you're easy to replace. The amount of money you make is a direct correlation between two thins:

1. How hard you are to replace.
2. What the market will bear.

 Thant's it. Make yourself hard to replace and you'll demand a premium.

One last story: I had a master esthetician who sold more product than the next staff member like clockwork. She thought that  that made her indespensible. But she was a prima-donna. She was hard on the other staff. She always whined. In short, the fact that she sold more was offset by other troubles. She felt she was indespensible and acted like it. She was not. The trouble she created inside the system as a whole ment that she was just barely scraping by for quite a while. I tried to remedy the situation and make it work but I couldn't get through. She was more than just a little surprised when she was fired. She gave a long speech about how she sold more of everything than anyone else. So what. The trouble she caused just wasn't worth it. Don't be this person.

Sona Medspa & Spin: Paying $400k is great!

Sona Medspas has big troubles, but evidently Sona's being found guilty of misrepresentation and ordered to pay $400,000 is a good thing, at least according to the Sona Medspa CEO and PR.

From the Medspa Press 'article': Sona Medspa Plans For Growth After Favorable Arbitration Ruling.

"Heather Rose, CEO of Sôna MedSpa stated, “This case was one of a string of cases brought against us. The coordinated attack on our business has utterly failed. We are pleased with the result of this arbitration, and even more pleased that our franchise partners are enjoying prosperity in their Sôna MedSpa businesses.”

 You have to love the cajones of that last sentence about Sona's franchise partners after you read the links at the bottom of this post.

The trouble with sites like Medspa Press and other sites like it is that they have a simple format which takes press releases from RSS feeds and displays them as actual stories or articles. It's not really a bait and switch, but it's not really of great value either. It's just whatever a business in the medspa space want's to put out.

You'll notice that the source at the bottom shows that this is a straight press release from Sona, not a story from the Medspa Press Staff which is what it's supposed to look like. Do I care? Not really. They're making money from the number of 'articles' that they can get up. Read the previous Sona post and then the press release on Medspa Press. I'd be interested to read some feedback on what you think.

Medical Spa MD Series: Inside a Sona medical spa franchise.

• Part 1: Why I bought a Sona medspa franchise
• Part 2: Sona's franchise representations & promises
• Part 3: The medical spa franchise pitch
• Part 4: Sona medspas legal structure & revenue share
• Part 5: Opening a Sona Laser Clinic.
• Part 6: Sona Medspas: Physician & Medical Oversight

AVVO & Rate MD: Ratings for lawyers & doctors.

From Kevin MD Via Overlawyered: Avvo: Stop rating me or else

Raise your hand if you had "two days" in the "How long before Avvo ran into legal difficulties?" pool. According to the Seattle Times' blog, on June 7 -- just two days after Avvo publicly launched as a lawyer rating service -- a local criminal defense lawyer, John Henry Browne, threw the lawyer's equivalent of a temper tantrum. An excerpt from his demand letter to Avvo:

"I wanted to notify you that I have retained counsel and will be exploring a lawsuit against your corporation for the ridiculously low rating you gave my law practice and the practice of other well-known and competent attorneys. We have yet to determine whether it will be a class action lawsuit or not. However, your rating and the attendant publicity has damaged my law practice and will continue to do so. In an effort to limit damages, I request that you remove your profile of me from your website immediately."

You've got to love the claim that his law practice was damaged in a total of two days. It's also questionable as to whether he has a cause of action in any case; Google regularly gets sued by those who want their websites rated higher, and regularly wins these suits (see, e.g., Mar. 1, Mar. 23, Nov. 2002.) These are likely constitutionally protected opinions, although it's obviously early to judge the merits of a lawsuit we haven't even seen about a website whose methods are unclear.

Avvo Lawyer Rating Site.