Average Salary For Physicians

Here's what the U.S. Bureau of Labor Services (BLS) report as the average salary of a physician in the US.

In 2008, physicians practicing primary care had total median annual compensation of $186,044, and physicians practicing in medical specialties earned total median annual compensation of $339,738."

Let's look at a few specific specialties, in ascending order:

General Pediatricians $161,410
Psychiatrists $163,660
Family and General Practitioners $168,550
General Internists $183,990
Obstetricians and Gynecologists $204,470
Anesthesiologists $211,750
Surgeons $219,770

Physicians and Surgeons, All Other $173,860.

Oh, and nursing jobs are going to grow over the next decade.

The number of registered nurses is expected to swell to 3.2 million by 2018, accounting for approximately 581,500 new jobs, according to the Bureau of Labor Statistics. That's up from 2.6 million today, and it represents the largest overall growth projection out of all occupations in the U.S. economy, for good reason.

Americans aged 65 and older will make up 19% of the population in 2030, up from 12.4% in 2000. As the population ages and the growth of the working-age population slows down, there will be an increased demand for health care services in general, and home health care services in particular. In the past year, the home health care services industry has experienced sales growth of 11.2%, making it the fastest growing industry in the U.S., according to Sageworks, a financial analysis company.

Along with registered nurses, Sageworks projects that home care aids, physician assistants, pharmacists, and other medical professions will be in high demand for the foreseeable future.

Medical Tourism: $100B and growing

Smartlipo in Mexico, a nose job in the Philippines or a kidney transplant in India.....

Medical tourism is generally defined as leaving home for care. It can be inbound, (someone from Mexico coming to the US), outbound (leaving the home country to go to another country) or domestic. There are local, regional, national and international medical tourism clusters developing throughout the United States and around the world.

It is estimated that global medical tourism is a $100B global industry expected to grow significantly over the next few years. While no one can know for certain the effects of the recent US healthcare reform bill, rising costs, lack of supply of physicians and the demand for technologies and treatments continue to expand and fuel the growth of the industry.

There are several ways for physicians to get involved in medical tourism. The first is as a provider, either in their home location or in a remote site doing surgery. Second, physician entrepreneurs are creating service companies like medical tourism facilitators or aggregators. Other potential business opportunities exist in supporting the medical tourism supply chain by providing insurance products, healthIT infrastructure, real estate projects, quality ratings agencies, accreditation and marketing arms and other consultation services. In addition, more and more payors and employers are offering voluntary medical tourism benefits to their employees and insureds, driving the demand for talent who can do medical tourism quality improvement and utilization review.

The most common procedures sought by patients considering medical tourism are cosmetic surgery and dentistry, bariatric surgery, IVF and short stay procedures in urology, orthopedics, ENT and ophthalmology. That said, because of the onerous costs of some procedures in the US, patients are seeking life saving cardiac surgery in India, proton beam irradiation in South Korea and living donor liver transplants in Asia.

A recent report from the Center for Medical Tourism Research in San Antonio, Texas called medical tourism "arguably one of the fastest growing industries in the US"  Maybe it's time for you to take a look.

Arlen Meyers, MD, MBA is Cofounder, President and Chief Medical Officer for www.medvoy.com.  He will be a speaker at the Medical Fusion Conference in November.

Medical Fusion Conference: Guest Speaker Medical Justice

Dr. Jeffrey Segal, founder of Medical Justice, will be speaking at the Medical Fusion conference in November.  He also happens to be a Medical Spa MD Select Partner to boot.

Turning A Negative Into A Positive, The Medical Justice Story

I am a board-certified neurosurgeon who was sued one time for what I perceived to be a frivolous reason. The single expert who testified against me had been expelled from our professional society for delivering frivolous testimony. This expert had never performed or even observed the specific technique in question.

At the time I was practicing in Indiana, a state that embraced substantive tort reform years earlier. Nonetheless, I was in the crosshairs.  After two years, the case was dismissed a few weeks before trial. But, I never felt as if I won anything. I just felt as if I lost less.  I learned I was in good company. Many have been sued. Few talk about it.

Beyond the age of 40, I quit my day job and started Medical Justice, a physician-based organization focused on keeping doctors from being sued for frivolous reasons. The organization now addresses an array of medico-legal threats and serves thousands of physicians nationwide.  The single goal is to make it easier for doctors to practice medicine.

Migrating from a comfortable living as a neurosurgeon to the calculated risk inherent in the entrepreneurial world was not easy.  Many lessons were learned.  My session at the Medical Fusion Conference, "Physicians and the Legal System, the Story of Medical Justice", will focus on the story and these lessons --the good, the bad, and the ugly.

Take in some more information from Dr. Segal at the Medical Fusion Conference, November 5th throught the 7th at the Wynn confernce center in Las Vegas.

Botox From China. It Play Good.

Get your Botox from China.
Then get yourself a good lawyer.

Look, I'm not in the habit of bashing anyones' second language skills considering my own inadiquacies with Japanese, French and German, but if you're going to be soliciting business in a country and promoting illegal activities, you'd better have a slicker pitch that this one for 'Botox from China'.

I get these pretty regularly now; pitches from China for Botox substitutes or cosmetic lasers and IPLs. It's interesting that they're using Gmail for their 'corporate correspondence'.

Here's the Botox from China email I just received:

Christina
christina.biochem@gmail.com
Subject: Anti- Aging and skin care products based on HA ( Dermal filler,Botox,HA cream,etc)
Message: Dear friend,

I get your information on your website and find that you are engaged in non-surgical cosmetic and aesthetic medicals.

I would like to introduce our company and products with hope to get a chance to establish business relationship with you in the future.

We can supply the botox in 150iu. It play good in contouring facial lift.

Besides,we are also the manufacturer of hyaluronic acid filler. I have fillers in 10.000, 100.000, 200.000 particle in 1ml for deep,medium and fineline wrinkles. It also play good in nose augmentation, chin enhancement. We do not only have 20mg/ml fillers. We also have 25mg/ml one. And it do better for nose augmentation and chin enhancement.

We adopt BDDE cross-linked technology from Germany,the quality and lasting period is long and good. And our three plants are up to GMP standard.

So at first time we do not have minimum order limit in order to let you know my products.

We will delivery the products  immediatly by DHL express after we received the payment of the goods.

Should you have any questions or problems,pls let me konw freely.

We look forward to building up very good business ships based on mutual benefits.

Best quality, competitive prices & pleasant reputation are our Aim.

Have a wonderful day.

Thanks and best regards,
Christina
Qufu Haitao International Trading Co.,Ltd
Add:No.1 Guangming Road QuFu Tour & Economic Development Zone, QuFu
ShanDong, China

I don't know anyone that's ever used this kind of product... scratch that. I do know one physician who 'ordered' some of that cheap lab-animal botulism product that some doctors got in trouble with a few years ago. Of course he claims that he never used it on a patient.

Injecting with fake Botox substitutes from China is usually reserved for the wacko 'I learned to inject myself with fake Botox on YouTube' crowd, not medical practices, but It's obviously working at least a little bit if the frequency that I'm being contacted is any indication.

Is anyone else receiving these kinds of pitches?

Medical Spa MD: Change In Federal Gift Certificate Law

On Sunday, August 22nd, the new federal gift certificate law went into effect. What does this mean to your medical spa?

In essence, the new law sets a 5-year minimum term for most gift certificates sold in the U.S. and it doesn't shorten any minimum terms required by your State law. Period.

The new law is just extending the terms of expiration if they previously were less than 5 years. If your State had a minimum term of more than 5 years, such as MA (7 years), your term will not change.

In addition, if your State does not permit you to apply an expiration date, such as the Stets of CA, CT, FL, ME, MN, MT, NH, RI and WA, of course those terms would still apply to any gift certificates you sell.

Gift certificates sold prior to August 22nd will be grandfathered in. If you have questions you can always visit the National Conference of State Legislatures.

If you have any questions about whether this new federal law pertains to you, you should check your state laws regarding gift certificate expiration, or consult with your legal representative or accountant.

Your Medical Spa & Laser Clinic Advertising Sucks

I hate to tell you this, but your advertising sucks.

That's alright. Your competitors advertising sucks too.

In the last ten years that I've been around medical spas, laser clincs, dermatologist practices and plastic surgery centers, I've seen a lot of sucky advertising.

In the kingdom of the blind, the one-eyed man is king. It's more than just a little appropriate if you apply it to the marketing and advertisng of cosmetic practices. After all, the're generally small businesses in which the owner is in there working all day making the payments. It's no wonder that with; no training, no resources, no access, and no working knowlegde of how to really market and advertise... the typical medspa or plastic surgeon relies mostly on the 'vendors' to try to get some littel bit of name recognition.

And the vendors love to help you (if you're producing for them) by giving you a hundred brochures or postcards that tout 'their' product.

And docs are tripping all over themselves to try to get this stuff.

So, we're going to be doing something about that. We're going to to offer some actual advertising and marketing umph that a few of the smarter docs on the site will be able to take advantage of.

We're going to be launching a marketing and advertising portal for plastic surgeons, dermatologists, medical spa and laser clinics.

We've been working on it for the last six months already.

It's still about a month away but I've been pretty excited about it and thought it about time to show a little leg.

This new portal will be designed specifically around providing the highest quality marketing and advertising for cosmetic medical practices. The idea will be to provide entire, integrated campaigns that will give you the ability to have the same look and feel across your entire presence; business cards, postcards, brochures, flyers, posters, emails... all of it.

Sure, there might be another clinic somewhere that's using the same theme, but what will you care? You'll be paying pennies on the dollar for what you'd pay to have this work done exclusively for you and you'll be able to look a lot bigger than you are.

I may be jumping the gun just a little in this but, damn, I've seen the stuff and it rocks!

Oh, and by the way, this stuff wasn't put together by some teenagers or housewives with photoshop. We've scored some fantastic talent, from art directors to writers who have worked on huge accounts.

So, there are a few things left to do, but it's all coming together. Stay tuned.

---

Medical Spa MD Members get a Podium patient review marketing account and save $1,257

Protect your reputation. Get new patients. Medical Spa MD Members receive a special, full service Podium account that includes: no setup fee (save $300), a 10% discount forever (save $330/year) and on-demand patient review marketing training for your entire staff ($597 value).  This offer is not available anywhere else.

The Medical Spa MD Micro-loan Fund

Join Medical Spa MD and our Members to do some good around the world.

If you've never heard of Kiva, it's a micro-lending organization that provides working capital in amounts as small as $25 or $100 to entrepreneurs in third world countries.

My daughter has had a tiny, $100 'micro-lending' fund that we started when she was ten. So far, that single $100 investment has helped 24 small businesses around the world. (It's a loan so they pay it back and it can be re-lent to others.)

We've been doing this for a few years as a family and it's been a real learning experience for my daughter. After all, this is real money and these are real people. If you lend to one person, it means that you're not lending to another. Who is more deserving? Who's riskier? We've had some very deep discussions and it's been great.

Which brings me to the Medical Spa MD Micro-lending Team.

I want to recruit you to join the Medical Spa MD Micro-lending Team on Kiva.

Kiva is a non-profit website that allows you to lend as little as $25 to a specific low-income entrepreneur across the globe. You choose who to lend to - whether a baker in Afghanistan, a goat herder in Uganda, a farmer in Peru, a restaurateur in Cambodia, or a tailor in Iraq - and as they repay the loan, you get your money back.

If you join Medspa MD's team, we can work together to alleviate poverty. Once you're a part of the team, you can choose to have a future loan on Kiva "count" towards our team's impact. The loan is still yours, and repayments still come to you - but you can also choose to have the loan show up in our team's collective portfolio, so our team's overall impact will grow!

If you're part of a medical spa, laser clinic, plastic surgery center or dermatologists office and you're willing to put in $100 or more to Kiva loans and join our lending team, I'll publish your clinic or medspa on a special page that I'll build (Hey, I just thought of this. It's not done yet.) and give you a badge to display on your website. You'll also be doing some good in the world.

Please take a look at Kiva. It's a fantastically run organization. I've been lending through them for the last six years and I have never had a momemets regret. It's easily the best $100 that I every put to use.

Let me know what you think about this in the comments. (As soon as we have a couple of members I'll build a lenders page that will link directly to supporting clinics and sites.)

Create an account and join the Medical Spa MD Lending Team!

Botox News: Allergans Profits Jump 36%

Botox continues to be a golden child for Allergan, but there are a number of other products that are bolstering the drug giant's sales.

Allergan, and most especially Botox, is always on my radar... Since we opened the first medical spa back in 2000, I'm sure that we've put more than one of Allergan's sales reps into a new house. (Perhaps not, I'm not really sure what Alergan's sales reps make.)

While there Medial Spa MD's physician members who are in a position to take advantage of our Select Partners have less expensive ways to get Botox than paying sales commissions, Allergan certainly still takes the lion's share of the profits from most Botox treatments that are performed. Botox has become something of a commodity, with almost every medical spa and laser clinic (and a few day spas) offering it.

For those of you who are interested in the Botox Behemeth's contnued rise, I give you the following compiled from their latest earnings report.

Allergans second-quarter earnings soared 36% with accelerating sales spurred on by their cosmetic products. There have also been recent developments that mark progress toward FDA approval to sell Botox injections to treat migraine headaches.

Allergan said the FDA has asked the company for certain material, such as a modified Botox "risk evaluation and mitigation strategy" that includes information about thepreventive treatment of migraines. Allergan has 3 months to provide the information. Allergan says it continues to expect an FDA answer this year.

Evidently wall street liked the news... especially the rising Botox sales since shares of Allergan traded up 5.4%. The company also raised its 2010 sales estimate for Botox. (Allergan posted total Botox sales of $1.31 billion last year, split evenly between cosmetic usage and various medical treatments.)

Allergan's total revenue rose 10% to $1.25 billion with double-digit gains in both its specialty pharmaceutical and medical device businesses. (Facial aesthetic products wer up 32% and skin-care products up 40%.)

Allergan's second quarter "benefited from a continued recovery in our cash-pay aesthetics business around the world," said Pyott said in a company press release.

Botox sales rose 7% in the quarter to $360.5 million. Looking ahead, Allergan said it now believes the drug will post sales of $1.36 billion to $1.39 billion this year, which compares with a forecast in February for $1.33 billion to $1.37 billion.

It dropped its forecast for the eyelash-enhancing drug Latisse, however, to a range of $90 million to $100 million, down from February's $140 million target. A big issue is that consumers have learned to stretch their supplies, which means Allergan has to figure out how to broaden the market to offset that effect.

Allergans Outlook For the full year of 2010

Total product net sales between $4,620 million and $4,750 million.

Total specialty pharmaceuticals net sales between $3,835 million and $3,930 million.

Total medical devices net sales between $785 million and $820 million.

• ALPHAGAN  franchise product net sales between $370 million and $390 million.
• LUMIGAN  franchise product net sales between $490 million and $510 million.
• RESTASIS  product net sales between $580 million and $600 million.
• SANCTURA  franchise product net sales between $70 million and $80 million.
• BOTOX  product net sales between $1,360 million and $1,390 million.
• LATISSE  product net sales between $90 million and $100 million.
• Breast aesthetics product net sales between $290 million and $300 million.
• Obesity intervention product net sales between $235 million and $250 million.
• Facial aesthetics product net sales between $260 million and $270 million.
• Non-GAAP cost of sales to product net sales ratio between 15.5% and 16.0%.
• Other revenue at approximately $50 million.
• Non-GAAP selling, general and administrative expenses to product net sales ratio between 39% and 40%.
• Non-GAAP research and development expenses to product net sales ratio between 15% and 16%.
• Non-GAAP amortization of acquired intangible assets at approximately $20 million. This expectation excludes the amortization of acquired intangible assets associated with the Inamed, Cornéal, EndoArt, Esprit, Samil and Serica acquisitions and the ACZONE(R) asset purchase.
• Non-GAAP diluted earnings per share attributable to stockholders between $3.11 and $3.15.
• Diluted shares outstanding between approximately 307 million and 308 million.
• Effective tax rate on non-GAAP earnings at approximately 28%.

For the third quarter of 2010, Allergan expects:

Total product net sales between $1.13 billion and $1.18 billion.

Study Shows Disturbing Medical Lawsuit Numbers

Frivolous or not, harsh statistics show lawsuits are running rampant against physicians...

There are about 95 medical liability claims filed for every 100 physicians—or almost one per doctor—and nearly 61% of physicians age 55 and older have been sued, according to a report released by the American Medical Association  and based on a survey of 5,825 “non-federal patient care physicians” conducted in 2007 and 2008.
The survey, which included doctors practicing across 42 specialties, found that 42.2% of the respondents had a claim filed against them at some point, with more than 20% of physicians sued at least twice.

As physicians age, it is more likely they will get sued, according to the survey, which found that only 15.3% of doctors under age 40 had been sued and only 4.2% had been sued twice; 45.3% doctors between 40 and 54 had been sued, with 22.3% having been sued twice; and 60.5% of doctors 55 and older had been sued, with 39.2% having been sued at least twice.

The study also found that 47.5% of male physicians had been sued, with 26.3% having been sued twice; and that 23.9% of female doctors had been sued and only 9.4% had been sued twice.

The most-sued specialties were obstetricians/gynecologists and general surgeons, with 69.2% of them being sued; while psychiatrists were the least sued at 22.2%.

In another study, the Illinois State Medical Society and the ISMIE Mutual Insurance Co. malpractice insurer surveyed some 1,100 Illinois physicians between June 21 and July 2, and 66% said they have personally reduced or eliminated high-risk services or procedures because of the threat of being sued, 82% said they viewed each patient as a liability risk, and 89% said that liability concerns caused them to “order more tests than are medically needed.” 

Guest post by Joy Tu of Medical Justice.

Submit a guest post and be heard.

Medical Spas & Cosmetic Crimes

From our friends over at Healthy Aging Magazine, an article that may or may not surprise you......

Depending on what statistics you read, tight economic times can either produce crime increases or decreases. However, a particularly peculiar variety of crime seems to be increasing these days—vanity crimes.

No, I’m not talking about the crime of going too big on your lip plumper or stripping 20 years off your skin when 10 would look more natural. I’m talking about people ripping off the dermatologists and plastic surgeons they’ve gone to for aesthetic procedures. 

A newspaper in Florida reported recently on several cosmetic crime cases:

• A woman came in for Botox and fillers totaling $3,300 then pulled a dine and dash. When she walked out of the office to visit an ATM to get the money, she bolted and never returned. Although she declined the before and after pictures, the office captured her on security video.

• A women received a $9,000 breast augmentation and tried to pay for it with a stolen credit card.

• A Fort Lauderdale women was charged with using a stolen credit card to pay for a tummy tuck.

• In a similar case, a Des Moines woman was accused of identity theft when she used a credit card to pay for over $6,000 in cosmetic surgery. She took out the credit card in her estranged husband’s name—probably not a good way to win him back.

An article on MSNBC cites Botox bandits Newport Beach, CA; Port St. Lucie, FL; Tampa, FL; Brisbane, Australia and Kenton, England. Jeff Karzman from the American Academy of Cosmetic Surgery states that it's a problem happening "coast to coast."

Dallas plastic surgeon Rod Rohrich, MD, says he's having patients pre-pay for procedures to prevent what he calls "runners." Many medical spas have turned to an up-front payment system. 

Is smoother skin or a slimmer figure really worth a crime? How many months or years in the slammer would you do for a breast job or Brazilian butt lift? What should practice owners do to protect themselves against this kind of thing? Post security guards? Perform preemptive credit and background checks? Charge for procedures up front? If charge up front, should that apply to all patients or just new or suspicious ones? 

Guest post by Grant Clauser, Editor of Healthy Aging Magazine.

Submit a guest post and be heard.

New Medical Spa Regulations for Arizona & Texas

Arizona Medical Spa Regulation Update: Esthetician & IPL Laser Technicians

Arizona requires all training providers be registered with the state to provide training to comply with their requirements. The program shall provide a provisional certificate to the applicant verifying the successful completion of the didactic training.

An esthetician who has been using laser and IPL devices before the effective date of this amendment to this section may continue to do so if the esthetician applies for and receives a certificate pursuant to this section before October 1, 2010. Arizona state legislature requires a laser technician who wishes to perform cosmetic laser procedures and procedures using IPL devices to successfully complete 40 hours of didactic training as required by agency rules at a certified training program.
More Information From State Website

Texas IPL & Cosmetic Laser Regulations Update

The Texas Legislature has passed legislation in House Bill 449that establishes a regulatory program for laser hair removal. The Department of State Health Services is charged with implementing that program. The legislation requires every laser hair removal facility to be licensed by the department. It also requires that each individual who performs laser hair removal procedures, except physicians, be certified by the department. By September 1, 2010, every laser hair removal facility must be licensed and each individual who performs laser hair removal must be certified.

However, the adoption of the laser hair removal rules and implementation of the laser hair removal program has been delayed for a number of reasons, including the request from state leadership for each state agency to submit a plan to reduce budgets by 5%, as well as implementing an agency hiring freeze to help address the state's budget situation. Work on implementation, however, does continue forward.
More Information From State Website

Information adapted from Aesthetic Trends & Technologies

Guest post by Paula D. Young RN, author of Advanced IPL & Laser Training and the Medical Esthetician Training Manual & Study Guide and head of operations at Young Medical Spa.

Submit a guest post and be heard.

Is Taiwan Asia's Next One-Stop Plastic Surgery Shop?

Tourists who frequently return to Taiwan might recommend savoring succulent street food or exploring Taipei's boisterous night markets. Or they may pass along the business card of a favorite plastic surgeon or dermatologist....

And why not? Taiwan has long been popular with its expatriate population as a medical-travel destination. At Taipei's abundant health care facilities, the equipment is modern and sophisticated, and most importantly, prices are considered a steal. Some of the biggest savings are in liver-transplant surgery, which runs to around $91,000, compared with some $300,000 in the U.S.

Price tags like that have built a small but devoted following for Taiwan's niche medical-tourism market, and it's about to get a lot more customers. Taiwan's neighbors across the strait have been making their way to the island for a nip or a tuck since travel restrictions for Chinese tourists were lifted in mid-2008. Now, in the latest of a series of agreements and concessions between China and Taiwan, Taipei announced last week that Chinese tourists will soon be allowed to travel individually to the island — a development that many medical-tourism proponents are hoping will be a boon to their industry - especially the plastic surgeons.

Taiwan's current policy only permits controlled tour groups from the mainland, which limits options for Chinese who seek varied medical services.

Under group-travel restrictions, tourists are told where they can go and when. They can't deviate from the set itinerary," says David Wang, a plastic surgeon and chairman of the Taiwan Medical Tourism Development Association. "I've heard of a few people who will secretly come [for plastic surgery], perhaps under a fake name or by claiming they are here on business."

Now, Chinese patients seeking operations can plan ahead and book Botox treatments and eye-bag or double-eyelid surgery at Wang's offices on their own schedule.

Mainland tourists could be a huge boost. According to Taiwan government statistics, just over 972,000 tourists from China journeyed to the tear-shaped island in 2009 — a 195% jump from the figure in the previous year, when the two sides made transit and tourism agreements. Further encouraging cross-strait exchanges, last month Chinese aviation officials announced a 10% to 15% reduction in airfares for flights between the two sides. With over a million projected to visit this year, even more mainlanders will be emptying their wallets into Taiwan's service sector.

Wang, the plastic surgeon, already travels to China about once a month to promote his practice, and he isn't the only one. Many enterprising proponents of Taiwan's medical tourism have been making the cross-strait journey in the hopes that they, too, might entice more mainlanders to seek medical care on the island.

Not many people know about the quality of Taiwan's health care system," says Richard Wu, CEO of Taiwan Task Force for Medical Travel. "It's our priority to first put out Taiwan as a brand name and then promote individual hospitals for services."

The fact that these customers will now be able to travel to Taiwan solo will only help. "No one would join a group tour that lets everyone else know they are going for plastic surgery or other medical reasons," Yen says. "With individual travel, you can just tell your neighbor you are going to Taiwan for vacation."

Medical Spa Horror Stories: Woman Dies From Silicone Butt Injections

Illegal medical spas and filler injection services are up and running, and actually killing people.

If it weren't bad enough that there are websites marketing "do it yourself Botox injections" and "filler injection kits" for home use, there are still people out there who are willing to go to a motel room and have non-physicians inject them will industrial silicon.

Two sisters who were selling Botox, filler injections, and butt augmentation in motel rooms are now on the run. Police say they performed illegal cosmetic surgery from inside their residential home and are the cause of one woman’s death.

Some of their patients (victims) went to police after experiencing infections and hardened body parts after receiving silicon injections. One woman, 22-year-old Mayra Lissette Contreras, would die from respiratory failure a day after getting some silicone shots in her buttocks. The sisters were arrested and charged with practicing medicine without a license but were released on bond and have probably fled to Mexico (see below). 

There's always plenty of  smartass advice to give to anyone who may ever contemplate injecting themselves with fake botox or getting cosmetic surgery while bent over someone’s kitchen counter, but I just couldn’t do better than the advice given by by Deputy Chief Kirk Albanese. “If you are receiving an injection at a home in a residential area, that should be the first warning sign that you shouldn’t be there.” But I will add that whether or not a facility is residential or not,  it’s normally not a good idea to receive cosmetic treatment from a 50-year-old woman who looks like a creature commonly seen in movies being chased around by villagers with pitchforks.

Sisters sought after woman dies from silicone butt injections

Sisters Guadalupe Viveros, left, and Alejandra Viveros, above, allegedly ran an illegal cosmetic filler injection service and squirted silicon into anyone with a check book.

Guadalupe Viveros, 53, and Alejandra Viveros, 50, may have fled the country after Mayra Lissette Contreras, 22, of Pacoima died Friday after receiving the injection, police said. An autopsy was pending Wednesday, said Ed Winter of the Los Angeles County coroner's office. Initial reports indicated that Contreras died from respiratory distress.

The Viveros sisters were investigated last month by the Los Angeles Police Department after other patients complained that the fillers, typically injected in the face or the buttocks, made them ill. The sisters were taken into custody June 21 for practicing medicine without a license, police said. They were held on $20,000 bail before being released.

They were supposed to be arraigned on Monday, but they skipped their arraignment. Police realized that they are probably on the run, and since the two women have connections in Mexico, authorities suspect they have fled south.

Police say the Viveros sisters are not doctors. Neither is licensed to perform medical procedures in the United States.

They have been allegedly operating an illegal cosmetic surgery business and performing expensive procedures in their home rather than in a licensed operating room, cosmetic clinic or doctor`s office. Patients told police they developed infections and said the silicone used by the sisters turned to hard plastic once inside their body.

LA police are searching for these two women and believe they could be in Mexico. People with information on their whereabouts as well as victims are asked to come forward and contact the Los Angeles Police Department.

LA Times article

And if you thought this was a one-of-a-kind event...

San Diego transgender woman dies after illegal silicone injections.

A 45-year-old transgender woman who received illegal silicone injections at a party in a private home in San Diego has died after nearly a month on life support, the county medical examiner said on Monday.

Patricio Gonzalez, who police said received silicone injections to her hips, buttocks, cheeks and lips, died on Sunday. Gonzalez and at least nine other people were injected at a so-called "pumping party" on June 19, police said.

"Pumping parties," where people seeking a more feminine appearance have silicone injected into their bodies, have been on the upswing in the last few years, experts say. The silicone used at the parties is often industrial-grade material like floor sealant.

The Food and Drug Administration banned direct injections of silicone in 1992 and the substance has been known to migrate within the body and cause chronic, degenerative illnesses.

Gonzalez and another transgender woman received more silicone than the other party guests and suffered immediate respiratory problems, prompting the Los Angeles-area woman who was administering the silicone to flee, police said.

Police have issued an arrest warrant for Sammia "Angelica" Gonzalez, 39, who was injecting the party guests with silicone, is believed to have fled to Mexico.

Transgender women often have humiliating experiences with traditional surgery clinics, and surgeons often require a psychological exam before they will consider treatment.

Article

Frontdesk SEO: Medical Spa Marketing & Keyword Selection

Frontdesk has a growing number of full-service website SEO accounts from Medical Spa MD Members and additional do-it-yourself accounts popping in all the time.

Read this review of our SEO software by a Medical Spa MD Member.

Since we've had so many Medical Spa MD Members sign up and begin using our SEO software or outsourcing their SEO to us, I though I'd comment on one of the most common questions that we get from plastic surgeons and medical spas that are just starting; keyword selection.

What are keywords?

Keywords (or key phrases) are what someone who is looking for your clinic types in to the search engine. For many, selecting the right keywords can be of the utmost importance. If you select the right keywords your marketing efforts should see some pretty significant results after just a short time, but select the wrong keywords and you're going to be banging your head against the wall with little to show for it. So, let's talk keywords that are going to be most useful for Medical Spa MD Members.

Most Medspa MD Members are individual physicians who have a single clinic location. As such, you're targeting potential clients based on geographical location; a certain 'radius' around your practice that you typically pull new patients from.

This one single piece of info gives you the ability to be especially effective by using your geography in your SEO efforts. And since 85%+ of your potential clients are now using the web to find local businesses it's more than just a 'nice to have', it's imperative for success if you're looking to grow.

Selecting Your Medical Spas Best Keywords

There's some good news here. If you're offering Botox, Dysport, laser hair removal, or photofacials, or you're using technology that clients might be searching for like Fraxel, Thermage, or IPL treatments, you can just stick your area code or location on the end (which is how people commonly search) and you're set; so 'Fraxel' now becomes 'Fraxel Manhattan', 'Thermage' becomes 'Thermage NYC', and 'laser hair removal' is now 'laser hair removal 90210'.

Of course there's a hitch. Just because you're being ranked for 'Fraxel NYC' doesn't mean that you'll rank for anything else. So, you'll need to keep up your marketing efforts on all the keywords that you're targeting at the same time. (This can be pretty difficult if you don't have a system in place.)

If you've got any website SEO efforts in place, you'll do better with just adding your local city or zip code to your normal process.

Where to start

OK, here's the plug; you should run a free SEO website report on your domain name. We offer this service (and it's a valuable one) so that you can see exactly how your site's performing at any given time.

Twilight Craze Brings The 'Vampire Facelift'; Selphyl

A new cosmetic procedure may just "eclipse" its competition. They're calling it the "Vampire Facelift", and it's increasingly available at medical spas.

It's not really a facelift, though, it's an injectable filler called Selphyl (get it? Sounds like cell-fill). It's generating lots of buzz.

It works by temporarily plumping up lines, much like its older cousins Juvederm and Restylane. But unlike the competition, Selphyl uses the patient's own blood to do the plumping.

Twilight enough for ya?

First, an amount of the patient's blood is extracted. Then, according to the maker, the platelets are separated from the red blood cells. The platelets are blended with a proprietary synthetic mixture and injected into your frown line.

This happens to coincide with all this fascination people have right now with blood - the whole vampire craze," says Dr. Tabasum Mir, who specializes in cosmetic dermatology and cosmetic laser surgery in Manhattan. Her patients are not requesting it, she ads, but inquiring out of curiosity. "I don't think my patients are interested in a two-step procedure when there are a lot of other fillers around that have been tried and tested."

Besides, one can't help but thinking that a real vampire wouldn't need Sephyl or any other wrinkle filler, because the undead stay out of the sun and never age. Anyway, is it safe for humans?

We certainly looked into it, but I think there probably isn't much of a problem when it comes to safety," says Dr. David Bank, President of the New York State Society for Dermatology and Dermatologic Surgery. "And by now, if any of our members were coming in with problems or complaints they would be reported to the society and those reports would be then shuttled to me. I haven't heard anything bad. But that's not a guarantee. The jury is still out."

Is Suing Your Medical Spas Patients Ever A Good Business Strategy?

Your medical spa or laser clinic is going to be the target of negative reviews at some point. How are you going to deal with unhappy patients who have a forum?

In the aesthetic medicine business, reputation management is a big deal. First, of course, you want to do good work for your patients. You want them to be happy with the results, and then you want them to tell all of their friends how happy they are. Good reputations take time to build, but bad ones can be made very quickly. A California plastic surgeon is now dealing with the fallout of some bad online reviews by taking legal action against the people who posted them.

Unhappy patients aren't anything new, but the Internet, with it's assortment of social media and consumer review sites give grudge-holding patients a significant amount of power. A few of those patients recently vented their opinions of Greenbrae, CA, plastic surgeon Kimberly Henry, MD, on consumer rating sites Yelp.com and DoctorScorecard.com. The doctor, in return, sued the patients.

What may have begun as a consumer rant--the sort that goes on every day about restaurants, car dealerships and plumbers-just got serious. According to an article in the Contra Costa Times, Dr. Henry is currently seeking injunctions against 12 reviewers, allegedly former patients, for libel, defamation, invasion of privacy and interference with prospective economic advantage. The doctor is seeking $2 million in damages plus other unspecified costs.

Earl Thurston, the proprietor of DoctorScorecard, confirmed that he provided Nordskog e-mail and IP addresses of Henry critics in January, but has not done so since. Nordskog's subpoena was the first he had ever received.

"I was inexperienced with the law and the way the court system works," Thurston said. "I assumed that if a judge ordered that I provide the information, that I was required to do so by law."

Since then, another lawyer sent him a subpoena for user information for a similar lawsuit in Texas. Thurston said he is fighting the subpoena with the help of Public Citizen, a nonprofit consumer advocacy organization in Washington D.C.

"I spent many hours reading online about the legal process and came to the conclusion that I could fight to keep our users anonymous, even if a judge orders us to reveal their identities," Thurston said.

Stephanie Ichinose, a spokeswoman for www.Yelp.com, a site that posts user reviews on numerous subjects, noted that a similar case played out last year in San Francisco. In that case, dentist Gelareh Rahbar filed a defamation suit against Jennifer Batoon, a patient who wrote a negative review about the dentist on Yelp.com.

"The judge threw out the defamation counts and ordered Rahbar to pay $43,000 for Batoon's legal fees," Ichinose said.

The claim was dismissed because of California's law against so-called SLAPPs - strategic lawsuits against public participation - which are lawsuits aimed to squelch free speech. Batoon was represented by the California Anti-SLAPP Project, a public interest law firm in Berkeley.

John Diamond, a professor at University of California, Hastings College of the Law, in San Francisco, said forum providers such as Yelp.com are immune from defamation suits, and that anti-SLAPP laws provide some protection for online commentators.

But Diamond, who has no knowledge of Henry's case, said reviewers can be held liable if they assert "false facts, not just opinions."

"They actually have to commit defamations, and that is something that is false and damaging to reputation," said Diamond, a Tiburon resident. "I think what's happened is many more people have a forum now to make comments and have a impact. Previously there haven't been that many opportunities."

This guest post is written by Grant Clauser, Editor of Healthy Aging Magazine. Read Grant's post: Plastic Surgeon Strikes Back At Online Reviews on the Healthy Aging blog.

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