ZDogg MD - TEDMED 2013

Zubin Damania (ZDogg MD) speaking at TEDMED about his life as a physician, and his move to Las Vegas to build a next generation health care clinic. Awesome.

Inbound Marketing For Aesthetic Clinic

There are three things that all doctors running cosmetic clinics want to know; which technology to buy, how to effectively manage staff, and how to get more patients.

If you're looking at the latter, getting more patients, you'll need a decently comprehensive understanding of what your needs and options are. Here's a very good graphic in a recent post from Rand Fishkin  the effectivley shows the split between what's become know as 'interruption' marketing (really more along the lines of advertising), and inbound marketing.

All of the stuff on the left is where you'll find the advertisers who are constantly dropping by your clinic to  "help you grow your business". I'm not a fan for the most part since; once you stop paying the spout is turned off, you can blow through a lot o money to little effect, bigger budgets win.

I tend to stick to the right where; it's never turned off, it's more effective when done well, and it grows organically. 

To be sure, it's a lot more work on the right. You have to actually do things that provide value and that's not easy, but if you do it effectively, there's nothing better.

Client Referral Rewards

Legitimate Marketing Or Unacceptable Practice?

Your client tells you they will send lots of friends your way, if only you will give them a discount for their goodwill. Or you decide that because your neighboring practice offers a $200 incentive for every referral, perhaps you should do this too in order to compete. You want to show your appreciation for the new business that might have otherwise incurred advertising costs, so why shouldn't you offer financial acknowledgement of the referral?

Hair salons and massage practices rely heavily on referral rewards programs. So why not Medical Spas or Cosmetic Centers? Well, if you are a physician and you offer consideration of any kind for referrals, you are in direct conflict with AMA Code of Ethics Opinion 6.021. You may also be violating your state Board of Medicine regulations, many of which simply defer to the AMA Code for ethical compliance. The opinion argues that the reward may incent the referring client to alter the information and expectations to others in an untruthful or unrealistic way. 

Early in my practice, prior to the AMA opinion, I succumbed for a short time to clients requesting rewards. The referred clients never seemed to have the same level of motivation to have a procedure as someone who came on their own accord. Now when a client asks me for a discount or a free service because they will send lots of friends, I simply tell them the following:

"A referral is the greatest compliment you could ever give me. And I appreciate the kind mention of your pleasant experience. I promise to always give you and those you send to me my very best work."

Palomar Icon Aesthetic System

Some information about the Palomar Icon system from the upcoming Comparative Report for Aesthetic Laser Platforms.

We're writing a new report for Members that compares the most used aesthetic laser platforms. One of the most popular platforms, at least in the US, is the Palomar Icon.

There are always discussions around the Palomar Icon and other cosmetic lasers in the forums.

About The Palomar Icon Aesthetic System

The Palomar Icon Aesthetic System builds on Palomar’s 20 year history of creating quality aesthetic technology.  The platform itself is powerful and compact, offering a max power of 1600 VA.  Offering nine applicators, this system is modular and able to perform common treatments such as hair removal, leg vein treatment, wrinkle treatment, and fractional ablative and non-ablative skin resurfacing.  Unfortunately there is no application for lipolysis available.  The us

er interface screen is relatively small but includes treatment tracking software to improve feedback during treatment.

The Palomar System includes the only FDA- cleared melanin reader available.  Known as Skintel, this reader allows quantitative determination of the average melanin density of the skin prior to treatment.  The system also takes advantage of increased surface coverage over its competitors allowing for greater overall effective energy and faster treatment time.   The Palomar system can complete a full face single pass high speed non-ablative fractional resurfacing in less than fifteen minutes.

Overall patient comfort is optimized by adjustable cooling technology.  By maintaining a treatment temperature of five degrees Celsius skin damage is minimized and your patient is more comfortable.  In addition, dual filters minimize excess epidermal exposure and further enhance patient comfort.

Used Palomar Icon Systems are available online, however quantities are limited.  Pricing varies depending upon the age and configuration of the machine.  

Non-American Doctors In The US

While Medical Spa MD has authors, editors, and Members all around the world, I was struck by this article on how physicians from outside the US are treated when they come into the US.

In Southern California alone, there are an estimated 3,000 medically trained Latino immigrant doctors who aren't practicing medicine.

"We had always wondered, where are the (immigrant) doctors from Latin America?" says Dr. Patrick Dowling, chairman of UCLA's Department of Family Medicine. "And we stumbled upon them working in menial jobs."...

That's why Dowling and his colleague, Dr. Michelle Bholat, have developed a program at UCLA that helps fast-track Latino immigrant doctors into the U.S. health care system, the International Medical Graduate program.

The IMG program provides test prep classes and clinical observations with UCLA doctors. It also covers the cost of the U.S. medical board exam and provides a monthly stipend.

Funded by private donors, the program has helped 66 Latino immigrant doctors pass the board exams and get placed into residency programs in California. In return, the doctors commit to working three years in an underserved area.

Of notable success; this story on a migrant worker who became a neurosurgeon at Johns Hopkins.

One of his medical school classmates told him no one could pronounce "Alfredo Quinones," and suggested he change his name to Alfred Quinn. Instead, he lengthened his name to Alfredo Quinones-Hinojosa, honoring his mother's family. It was also in medical school that developed the nickname Dr. Q., which is what his patients still call him today.

It's not just unfortunate that American medicine has become the domain of special interests and protectionist factions, while at the same time disenfranchising main stream American physicians as our friends at Freelance MD can attest. It's a sign of a system that's bouncing along the bottom.

I've had some experience with physicians from outside the US who immegrated and then couldn't get licensed in the US and had to take other work. While there are a lot of countries in which the medical training is not as comprehensive as in the US, the regulation around this leans way to far to the prevention side of the equasion in my opinion.

Is American medicine really the meritocracty that it's held out to be?

The Power Of The Botox Birthday Coupon

For the past 5 years, our plastic surgery office has been offering patients birthday coupons worth $50 off their Botox injections.  

I've been impressed with the power of this Birthday Coupon. Basically this is a letter sent out via a group email with birthdays identified one month at a time. Our EMR is able to identify birthdays which are coming up. Of course we take advantage of the blind cc: email function soin order to protect patient privacy. We also let our patients use it for fillers instead of Botox, and because all patients are getting this email who have a birthday coming up, some patients aren't appropriate for Botox or fillers, and thus we allow them to pass it along as a "regift."

It brings back patients whom I haven't seen in while.  It also brings back patients who have wandered off to other Botox places.  I've also seen new patients who have never received Botox before because they got a the coupon tactfully passed along from one of our existing patients.  And best outcome is when a patient is converted over from an unrelated plastic surgery procedure such as breast augmentation or tummy tuck (already happy and familiar with our office), and now he or she is armed with coupon in hand ready to try Botox!  And in general, our patients seem very grateful for the gift - especially the ones who have already used our services every 3-5 months.  Another benefit of the Birthday Letter is that it makes patients eager to give us their email addresses to stay in touch.

For our office, it's Botox that we use, but I think this concept could be converted to another product or service which helps patients look younger.

The Birthday, itself, of course is a great event, however it does remind all of us that we are getting older, and getting Botox is one of the ways to help us age more gracefully.  I think using a cosmetic injection coupon is a great marketing tool and I've seen a good return on the investment for our own plastic surgical practice.  Best of all, patients seem to really like it and it is a "win-win."

Plastic Surgery & Body Enhancement Infographic

The business of plastic surgery and body enhancement.

How much are people really spending on body enhancing procedures? The infographic below answers these questions in interesting detail.

Push & Pull Marketing Within Your Medical Spa

Push Marketing is any type of marketing that pushes a client through your medical spas door.

It may be a referral from a satisfied client, or possibly a business partner. It may be an article in a publication, a video interview or a promotional video you made. To put it simply, it's marketing that covers everything except ads.

Pull Marketing on the other hand is anything that "pulls" a consumer through your door. These are mainly your marketing materials such as your main website and your advertising, especially those "Specials" ads. Don't forget that these "Specials" are targeting customers that are either unfamiliar to your practice or unfamiliar with your products/services.

It's obvious that higher conversion rate is expected from Push Marketing because people already have a general idea of what you are offering. Before they arrive at your door, they already hold a positive opinion of you. That is unless there's anything unfortunate that comes along the way. These bad marketing bridges may be as simple as poor office behavior, overpricing, etc. Generally speaking, you should be able to convert over 90% of all your push consumers.

In order to increase your conversions in the Pull marketing, it is important to focus on the consumer's trust. If you own an aesthetic practice, adding high quality before/after photos (this needs permission of course!) will definitely increase the consumer's trust as well as adding testimonials to your marketing materials and website from your customers. You can do so by providing testimonials in both writing and videos to your blog, newsletters and auto-responder emails.

If you are able to have access to passers-by that are potentially customers, consider putting banners in your windows showing before/after results. This is great if you're offering aesthetic treatments. But again, make sure you have the patient's permission to use their images, especially if it's in a very public form.

Your Medical Spa's Front Desk

It's easy find sub-par front desk staff in medical spas.

I got this complaint (I'm not sure why it was even sent to me) of someone who ended up leaving a clinic less than impressed...

Here's the comment:

If you're a cosmetic surgeon, a cosmetic dermatologist or even a cosmetic dentist, the gals at the front should somehow represent your practice. Your's have much to be desired.

I recently had an appointment at your clinic I was able to make the following observations.

1. She had blackheads
2. Too little makeup (which made the blackheads visible)
3. Chewing gum
4. Her hair in a ponytail in a way that looks like a rat's nest thingy
5. Wearing some kind of jammy looking top.
6. Could have used a more supportive brassiere.

I left very disappointed...These things should never be seen in any medical spa.

The front desk should be the bus drivers! It means they are the first person you'll see when you enter the bus and the most likely person to cause an accident. Do you understand? If you don't like the sight of the girls you see out front, then there's something wrong about the "Aesthetic" services you're providing.

Now, look at your girls out in front. If they look anything like what I observed, then you should talk to them. Perhaps you need a dress code. Maybe you should provide them the product and treatments that your office is offering. Pamper your staff a little. Besides, it will be easier for them to sell your services since they have first hand experience.

However, one should not be to brash in saying these things since people can be very sensitive, especially women. Consider it from a perspective of a prospective client when they walk through your door. Will they wonder, "why doesn't the front desk person look anything like the product they're offering?" and "what's she doing in a place like this? She doesn't seem to belong".

While the email is obviously not actually for me since I no longer own any clinics, the sentiments represented are spot on. I don't know what clinic gave rise to this email but you'll want to make sure that your medical spa's front desk represents you the way you'd want it to.

Making Your Medical Spas Homepage Succeed

Have you ever found anything similar with the fastest growing companies in the world today? (Hint: It's not overwhelming choice.)

For the fastest growing companies today, there seem to be some common denominators. I'm not sure if they got around together and discussed how they should make their homepages but it seems they stumbled into something important. Perhaps I could share some observations that you may be able to apply to your medical spas site, or pricing, or something.

First, you can't access their content without any signup. There are a lot of startup companies that make a mistake of giving people free access to their site whether it's apartment bookings or making schedules. Often times this is a bad idea. As much as we would like it to be, if your visitor can interact with a lot of things before signing up, then he will most likely not sign up.

Secondly, there is an absence of many links and in many cases just a single option. For many years, many internet marketers developed this "Squeeze Page" with minimal content and a single "call-to-action". They figured out that adding more information could distract a visitor and could cause them to click away to different websites. If you notice in the snapshots of these websites, there are not many links.

Third, focus on a single and clear value proposition. Often times, your products value is drilled down into one clear statement. It's some sort of slogan which clearly states what your product is about. Most people never read past the first sentence and it's important to get your thoughts across with just one statement or sentence. You could also consider this as your testing ground. Just change one sentence and see which one works.

Fourth, people are selfish. Contrary to popular belief, people don't share as much as everyone hopes. Most startups start thinking that people will use their product because it helps them share things more easily. Unfortunately, even people who share don't share things all of the time.

Fifth, they have big images. A picture paints a thousand words. So does a big image.

Lastly, they have embedded signup forms. Make your signup process available from the homepage so people don't have to navigate through a lot of links just to sign up. Generally speaking, the more clicks you have in your signup process, the more likely people will drop off halfway. If you notice, most of them have the signup forms in the upper right hand corner of the homepage, above the fold. Most of them rarely ask more than your name, email and password.

Whenever I tell people about these things, they say, "Everyone's already on facebook or Twitter, so I don't really have to explain what my products are about."

You're wrong.

Maybe everyone we're connected to are already familiar with Twitter and Facebook. However, we're not trying to connect to just me and you. You're trying to market your medspa or clinic to all of people who use the internet (in your area at least) and believe me when I say that not all of them have heard of Twitter or Facebook. Those are the people that these homepages are trying to sign up.

There's a lot that your medical spa can learn as a business and taking to heart what some of the fastest growing businesses in the world are doing will be time well spent. Take a look at your home page and ask yourself what your goals really are.

Dealing With Pain As A Physician

I admit it! I was channel surfing between CSPAN and the Lehrer News Hour...

...and not so accidentally, stumbled upon one of the Kardashian sisters getting some sort of "minimally-invasive" facial rejuvenation procedure in a posh Miami medical office. The procedure was fairly routine, but what really caught my eye was the incredible amount of pain this young lady was willing to endure. I reflected back to my training in Plastic Surgery and General Surgery, and realized how little attention we paid, as a community, to pain.

I often find myself bringing up to my patients a "Postop Pain Plan", only to find them caught in a moment of bewilderment. "I thought I'm not gonna feel anything", I hear sometimes. In recent years, the increasing dumbing down of medicine and plastic surgery in pop culture media, has some people denying the existence of pain after surgery. Furthermore, of the ones that do expect some postop pain, few expect to define a specific plan for managing that pain. Albeit, they come to me with much greater concerns about their appearances, but nonetheless, the change in appearance comes at a price.

As plastic surgeons, we need to address the issue of pain in a more sincere and serious manner. We need to stop painting rosy pictures and admit to our patients that surgery is painful, that what they are asking us to do is, unfortunately and necessarily, inflict pain. We need to implement a Pain Plan. A simple, lay-term, and effective protocol addressing individual patients' postop pain control needs. We also need to document the plan and incorporate it into our informed consent plan.

As patients, we need to inquire within. Ask our surgeons about the nature of the pain, the duration, the severity. We need to request a specific plan, and decide preoperatively how to manage the pain. But most importantly, we need to stop believing everything we see and read in the lay media. We need to realize that elective surgery is surgery nonetheless. It hurts, and we ask for it. So let's treat it like the serious business it is.