Brotox...Botox For Men? Don't Bet Your Clinic On It.

Brotox Botox for MenYet more stories about men getting Botox... now it's "Brotox", but don't bet your medical spa on your male clientele.

Plumbers and wall street bankers alike are increasingly turning to Botox to turn back the years? There's more on what's touted as a growing population of men that are turning to cosmetic medicine, Botox in particular.

It Britain, they call it the “Simon Cowell” effect. What do Simon Cowell, Gordon Ramsay and David Hasselhoff have in common? They’ve all confessed to having Botox. Turn out, men care about their appearance just as much as women do, they just haven’t wanted to talk about it.

Once relegated to the female population, Botox has gained popularity among men today – particularly those with what are considered “stressful” careers. Dermatologist Dendy Engleman said that Wall Street men are “the fastest growing segment of my patient population,” because they’re looking to smooth out the stress lines caused by the European crisis abroad and weak economy at home. 

Men feel pressured to maintain a more youthful and attractive appearance to compete in the job market. There’s also less of a stigma now for men to turn to cosmetic procedures. Think of it as a continuation of the metrosexual movement. Guys taking charge of their appearance, and owning it.

And it’s not just Botox. Injectable dermal fillers have now become the second most popular nonsurgical treatment for men. Evidently 29% of men get manicures, 24% have facials, and 13% get eyebrow waxing appointments.

Tom Ford and Marc Jacobs have both launched men’s cosmetic lines. With guyliner and murses out there, it’s no real surprise this is a growing trend. 

Most of the above is complete bullshit. 29% of men get manicures? Bullshit. 13% have eybrow waxing? Bullshit.

Don't listen to what you hear in the press about stuff like this. It's written by a twenty something who's just rewriting a press release that's designed to get attention.

My opinion is that the number of males who look at some form of cosmetic medicine is going to vary somewhere around 5-5% of your clinic, a little more in some areas but that's pretty much it. It's generally a waste of time to try to cater to men in the same way that you cater to your female patients unless you're just doing it for some sort of marketing. There may be some growth, but that just represents the growth of the market in general, and since males make up such a small percentage, it's not hard to see those numbers as skewed. Don't take the bait.

And while we're at it, let's take a moment to share a story about my brother-in-law. Last week he had a business meeting out of town. He packed his bags, han an uneventful flight, checked into his hotel and slept well. In the morning, while dressing for his meeting, he realized that the black pants he had packed to wear with his black suit jacket were actually, his wife's skinny black pants. Ever the problem solver, he decided to give them a quick try on anyway. Surprisingly, they fit... poorly, but still. He even claims they perfectly matched his suit jacket. So, the point I make, perhaps I'm wrong.

Yep, There's An App For That

Allergan Botox App iPadBotox marketing via the iPad?

Allergan has just released an app that markets Botox directly ot patients with an app that digitally modifies what they will look like after Botox. (Who knows if it actually works at all.)

It’s pretty simple. You can either upload your photo to the iVisualizer Tool on the Botox site, or you can use the free iPad app, and watch the results emerge. Voila, a wrinkle-free face.

Those of you who are familiar with photo retouching programs, like photoshop, can see that the “after” effect is pretty much just a bit of softening and blur where the facial lines were, but, perhaps it does give patients a better idea of where the wrinkles will be diminished. 

I'm guessing that you'd have to be a pretty hard core Botox researcher to download an app just to blur your face so I'm guessing that the real driver of apps like this is to extend Allergan's marketing reach to physicians and give the sales reps someting to trot out when they visit your office to show you how much traffic Botox is driving to your clinic. That, and keeping Botox's copetitors (Myosport, Xeomin) chasing them.

Anyone have thoughts on how well this really works?

Why Blackberry Failed, And Why Traditional Medicine (And Your Medical Spa) Will Too

The Globe and Mail has an article on the fall of BlackBerry which actually has three authors and takes a deep-dive into the Canadian phone makers woes.... but there's information in there for physicians.

The overarching explanation of what happened is something that we already know: RIM (Blackberry's maker) failed to iterate/change/evleove at anywhere near the speed that the market demanded in the post-iPhone era, but the article, which includes quotes from an interview with RIM founder Mike Lazaridis really puts touches the main point with the tip of a pin. Here's the quote:

“The problem wasn’t that we stopped listening to customers,” said one former RIM insider. “We believed we knew better what customers needed long term than they did. Consumers would say, ‘I want a faster browser.’ We might say, ‘You might think you want a faster browser, but you don’t want to pay overage on your bill.’ ‘Well, I want a super big very responsive touchscreen.’ ‘Well, you might think you want that, but you don’t want your phone to die at 2 p.m.’ “We would say, ‘We know better, and they’ll eventually figure it out.’ ”

Hubris is the fall of many frontrunners and works on every business scale, including individual small business.

You may know better than your patients, but if you don't listen to them and execute what they want, they'll go somewhere else eventually; just ask the droves of plastic surgeons how have lost patients to the familiy practice guys who aren't constantly pushing their patients into surgical proceedures.

20% Of All Medical Spa Yelp Reviews (Including Yours) Are Fake?

What's this? Fake reviews that you've posted about your own clinic? Say it ain't so...

Now, more than ever, social media plays an integral part of businesses marketing strategies. Savvy consumers turn to Yelp and a host of similar sites to read reviws, and in turn make buying desicions based on what they’ve read. 

The problem is, some businesses (insert medical spas, dermatologists, and plastic surgeons here) are paying freelance writers to create “fake” positive reviews... or they're just writing them themselves.

Writers from Eastern Europe or Asia are paid a few dollars to write glowing reviews... because they work. Businesses are highly motivated to obtain positive reviews, as according to a 2011 study by Michael Luca, assistant professor at Harvard Business School, a one star rating hike on Yelp can mean a 5% to 9% rise in restauraunt revenue.

The number of fraudulent reviews on Yelp rose from 5% in 2006 to 20% in 2013, according to “Fake It Till You Make It: Reputation, Competition, and Yelp Review Fraud,” a report by Luca that was co-written by Georgios Zervas, an assistant professor of marketing at Boston University. Analyzing an additional 316,415 Yelp reviews of Boston restaurants, 16% were filtered and identified as fake, Luca says.

This is a problem that is only beginning to be addressed. Five or six years ago anyone could post phony reviews from their own computer, without ever calling attention to themselves. Things have become a bit more comlicated since then. Now, fake reviewers must submit fake email addresses, and write reviews from multiple locations. Fake reviewers and the companies that hire them are now beginning to face fines. The office of New York’s Attorney General announced this week that it fined businesses (including on physician if I remember correctly) more than $350,000 for publishing fake reviews.

Additionally, false praise online is expected to become more and more widespread. Fake reviews are expected to grow between 10 and 15% by 2014, predicts Gartner, an online research firm.

What’s Yelp’s response? Yelp’s automated software looks at every review published, and ultimately deemphasizes about 20% of the more than 39 million reviews onto a secondary “Filtered reviews” page linked at the bottom of business listings. 

Meanwhile, Google is moving away from anonymous reviews, requiring reviewers to be logged in to Google Plus to write one. Yelp could require a Facebook login to help guarantee identities, but of course options like these may scare off or, just plain annoy potential reviewers.

We all know buying and selling reviews is wrong. And, now, it’s against the law. Yelp’s final word? “But don’t worry, we’ll keep watching out for consumers behind the scenes, too. Just in case.”

Of course we've seen this here, and we've outed a number of equipment vendors and physicians who got caught posting fake reviews here. That's one of the reasons that we don't allow vendors or salespeople into the Medical Spa MD LinkedIn Group.

Has anyone out there got a sneaking suspicion (and an example or two) that the medical spa or clinic down the street is doing this?

The Power Of Single Message Marketing

The first rule of advertising for anyone (including your medical spa): Present one, clear, single minded message.

Your ad will be stronger. Your message will carry more weight. You’ll create breakthrough in a world filled with cluttered, muddled messages, that simply go unseen.

Research suggests that you only have 3 seconds to communicate the message to your audience. Take longer and you could lose potential prospects. 

Think about the bed of nails analogy.

It appears to the spectator that anyone lying on this “bed” would be injured by the nails, but this is not what happens. Assuming the nails are numerous enough, the weight is distributed between them such that the pressure exerted by each nail is not enough to break the person’s skin. 

What if we replace the thousands of nails with just one nail? You know what happens. A person can’t successfully lie on just one nail. The pressure exerted by just one nail is much too strong.

How do you determine your single message? It could be the unique selling point of the product or service or even the biggest benefit gained by using the product or service.

But are times changing? 

We haven’t done studies directly comparing the effects of multiple messages in an ad or commercial vs. single messages, but we’ve studied how people deal with what used to be considered a bombardment of stimuli. They handle it just fine.

The Internet of course has led the way. Watch how even the less skilled with this medium use it – not just skipping from site to site, page to page, item to item at blazing speed. They absorb multiple images and information elements simultaneously. Watch the more adept moving their fingers across their keyboards like the fingers of a virtuoso violinist moving across the strings of their instruments. And the minds of those Internet users are moving even more quickly.

If we move multiple messages into fast forward, will advertisers risk losing their audience? Or will the viewers be less bored and watch or read the advertising. 

Trying to fit 'everything you do' into your advertising is common, but it's also amaturish, and less effective. I understand that you don't want to miss that one patient who's looking for something you offer, but you're tripping over your real purpose which is to drive a single idea home.

Do yourself (and your clinic) a favor and be harsh. If it's not supporting a single point, let it go.

Daniel J. Ladd Jr, DO - Tru-Skin Dermatology In Austin, Texas

Tru-Skin Dermatology, formerly known as Austin Skin, is building a nationwide network based on the "Business Concept Franchise Model".

Austin, Texas Dermatologist Dr. Daniel J. Ladd, Jr.

Name: Dr. Daniel J. Ladd, Jr.
Clinic: Tru-Skin Dermatology
Location: Austin, TX
Website: tru-skin.com

Dr. Ladd is a man of action, an energetic person with various interests and enjoys telling jokes. Aside from founding The Shade Project, Dr. Ladd is a Board Certified Dermatologist and Mohs Surgeon who has seen far too much skin cancer. Committed to help prevent it, he has started a local sun safety dialogue with the Dr. Dan Radio Show. 

The show welcomes guests from all areas of medicine and the non-profit world alike. Listeners can become informed on the many aspects of wellness, healthy skin, skin cancer prevention, and current events on a local, regional and national basis.

Is there anything that is unconventional or uncommon from the average clinic in any way? How do you separate yourself from your competition?

Tru-Skin Dermatology is an industry leading, board certified, state of the art fully integrated dermatology practice; surgical, medical and cosmetic, composed of skin cancer experts and MOHS surgery specialists. Our brand offers patients a dependable, predictable patient centered experience in a clean modern office facility where they will receive expert care. Our affiliation with The Shade Project sets us apart from other clinics. A portion of every service, patient visit and product purchase at Tru-Skin Dermatology is donated to The Shade Project to help skin cancer prevention efforts. The Shade Project is a non-profit organization dedicated to preventing skin cancer through education, community outreach and building shade structures where children and families play.

You’re using video in your waiting room to market to your patients. How effective is that? 

We've begun a concerted effort to promote cosmetic services available at our practice through internal marketing. We're using a customized waiting room video from Frontdesk that has proved effective for awareness of additional services available. Having the videos in our waiting room has allowed patients to feel comfortable bringing up a procedure they saw on the video with the provider during their appointment. The folks at Frontdesk were very easy to work with and responsive to our questions and needs for customization unique to the Tru-Skin Dermatology brand...

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Dr. Naomi McCullum - Personal Botique Cosmetic Medicine In Sydney, Australia

Dr. Naomi McCullum, Sydney Australia Cosmetic Physician

Bridging the gap from old school to new: How Dr. Naomi McCullum embraced social media marketing.

Name: Dr. Naomi McCullum
Clinic: Dr. Naomi
Location: Sydney, Australia
Website: drnaomi.com.au 

Dr. McCullum worked at several of the leading cosmetic/dermatology clinics in Sydney, and after being admitted as an inaugural Fellow of the Faculty of Medicine of the Australian College of Cosmetic Surgery, opened her own botique cosmetic clinic in Paddington in 2002. 

Can you tell us a bit about your career path?

I first had Botox myself as a young resident shortly after graduating from Medicine. On that day, I saw my future in the industry. Being a cosmetic patient and a proceduralist at heart, there was no choice in the matter. I have always been interested in all branches of the aesthetic tree, from design, fashion and architecture to beauty. It is more than a job for me.

I love having just one boutique clinic, as we can really focus on offering the ultimate specialized service to our patients. This attracts a certain type of client, which makes every day fun and interesting.

What is it like practicing cosmetic medicine in Australia in comparison with what you see in other countries?

The practice of cosmetic medicine is quite unregulated in Australia, with many non-doctors like nurses and dentists, involved in the industry. The laser/IPL industry in most states of Australia is also poorly regulated.

Another difference between what we have to deal with in Austrailian and other countries are the legal requirements for online activity in our industry.

In Australia we are not allowed to mention any of the generic or brand names of the injectables that we use on our websites or through social media. For example, we cannot use the words "Botox", "Restylane", "Juvederm" or even "Hyaluronic Acid" or "Botulinum toxin" anywhere online, which as you can imagine, makes it difficult to educate readers / patients. Potential patients have a right to know what products we supply; they also have a right to know comparisons between products that they might be choosing. The regulations also prevent me from having a useful online discussion publicly with colleagues overseas and in Australia about cosmetic treatments. The Australian regulations are paternalistic and harmful to our patients and industry, and need to...

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Botox For Plantar Fasciitis

I've seen Botox used for stress headaches, but until now I was unfamiliar with the fact that Botox can also be used to treat Plantar Fasciitis.

The article below detalis some of the new reasearch, but I'm wondering if anyone is using / has used Botox in this way and what the results were? (Leave a comment.)

Botulinum toxin (BTX)A may be more effective than steroids for the treatment of plantar fasciitis.

The 19 patients given a total of 250 U of BTX-A split between two medial and lateral calf muscle sites and the soleus had significantly faster and greater improvement than the 17 patients treated with intralesional dexamethasone (8 mg) plus 2% lidocaine (2 mL).

Although there was no significant difference between the BTX-A and steroid treatment groups at baseline for the visual analog scale (VAS) for pain (7.1 vs 7.7), patients given BTX-A had a significantly lower average score than steroid-treated patients at the 1-month check up (1.9 vs 3.4 points). Scores were also significantly lower at 2 (1.6 vs 3.6 ), 4 (1.5 vs 3.7 ), and 6 (1.1 vs 3.8) months.

Similarly, despite comparable Maryland Foot and Ankle scores at baseline, the BTX-A-treated patients had significantly greater improvement over the whole study than steroid-treated patients.

Although both patient groups experienced significant improvements of American Orthopaedic Foot and Ankle Society scores and Foot and Ankle Disability Index scores at 15 days after treatment, BTX-A was associated with a faster and more sustained treatment response than steroids.

The researchers note that all patients were shown dorsiflexion and plantarflexion stretching exercises to begin within a week of treatment.

“It is important to note that patients must perform plantar fascia stretching exercises to obtain a rapid and sustained improvement of plantar fasciitis,” say Carlos Acosta-Olivo (Hospital Universitario “Dr Jose E Gonzalez,” Universidad Autonomade Nuevo Leon, Monterrey, Mexico) and co-workers.

Read the entire article here.

Additional articles on the same subject:
http://www.methodistorthopedics.com/plantar-fasciitis-heel-pain
http://www.eurekalert.org/pub_releases/2013-01/sp-bbs011713.php
http://www.sciencedaily.com/releases/2013/01/130117152009.htm
>http://connection.sagepub.com/blog/2013/01/30/botox-beats-steroids-for-painful-foot-condition-plantar-fasciitis/

Dr. Franco Migliori - Plastic Surgery In Genoa, Italy

Italian Board Certified Plastic Surgeon Dr. Franco Migliori

Dr. Franco Migliori: What do successful plastic surgeons have in common?

Name: Prof. Franco Migliori, MD
Location: Genoa, Italy
Website: francomigliori.com

With medical malpractice claims that are 10x the European average and a a growing trend towards unregulated minimally or non-invasive proceedures, plastic surgery in Italy is a competitive market.

Dr Migliori's been an early adopter of new technologies, including the internet, where he's been on the web since 1995, ready for the challenges and opportunities of online marketing.

As a plastic surgeon in Italy, how have you seen the aesthetics market developing? 

Italy has a very competitive cosmetic surgery market due to one of the highest number of board certified plastic surgeons in Europe (more than 1,500) and due to a loosly regulated market, with more than 25,000 so-called "aesthetic surgeons", many of which have much less expertise and skill. Nevertheless, Italian plastic surgery is one of the “top quality” plastic surgery countries, planting its roots back in the centuries with famous names like Branca, Vianeo, Tagliacozzi and Sanvenero-Rosselli, and showing so many contemporary high-level practitioners.

Like most places, the patient types are split into “institutional” (gathering all the pathologies, like traumas, tumors, malformations, burns, etc.) treated mainly in public hospitals and paid by National Health System, and “private practice” (which is mainly aesthetic surgery) performed in private clinics and paid by the patients themselves with no

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Dr. Lawrence Broder - Beleza Medical Spa In Austin Texas

Dr. Broder has a unique combination of primary care experience and surgical training. Now he's has dedicated solely to medical aesthetics and cosmetic surgery. What prompted the move?

Medical Spa Austin TX

Name: Lawrence Broder MD
Clinic: Beleza Medspa
Location: Austin TX
Website:  BelezaMedicalSpa.com

That's interesting: Dr. Lawrence Broder is a decorated veteran. He is a former US Army Major and Flight Surgeon. 

Dr. Broder - Medical Spa Austin TX

Family Medicine is very similar to cosmetic medicine. It's all about customer service. Many of the patients you see as a PCP will get better on their own and your job is to not hurt them and reassure them. As a cosmetic physician, the patients are different and are usually looking for a correction of a specific problem. You have the solution to that problem. Just like a PCP, the cosmetic physician must make sure the patient gets the right treatment without harm and reassure them about the side effects and results. The cosmetic patient who has feels better about their appearance, usually is happier than the patient whose sore throat has resolved. The sore throat probably would have resolved on its own, but I directly helped the cosmetic patient.

The other thing I enjoy about Cosmetic medicine over family medicine is the transparency. My prices, my results, my reviews and my background are all there for every patient to see. As a PCP, the patients did not know what the prices were (insurance), did not know if I had good outcomes with my patients nor knew who I was most of the time. I believe the whole US medical system is designed to extract as much money as possible from the insurance companies and Medicare/Medicaid by upcoding and unnecessary procedures. Cosmetic patients know what they are paying and will even bargain for better prices. Cosmetic physicians have no choice but to be honest about their prices and results, there is no...

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Persuasion Through Repetition


Repeating words out loud to another person boosts memory. Study shows that this technique is better than when they are lip-synched or covertly produced.

According to Professor Victor Boucher, this technique works better if someone, though not listening, is present to hear it.

We knew that repeating aloud was good for memory, but this is the first study to show that if it is done in a context of communication, the effect is greater in terms of information recall. The production of one or more sensory aspects allows for more efficient recall of the verbal element.

The study involved people who were asked to repeat words in four ways: moving their lips, not moving them, speaking aloud to someone, and then to no one in particular. The study further revealed that repeating an information without moving the lips is the least effective recall technique.

But the added effect of talking to someone shows that in addition to the sensorimotor aspects related to verbal expression, the brain refers to the multisensory information associated with the communication episode and the information the result is better memory.

Professor Boucher and his team also found that it this technique also works well with non-words such as ‘snolp’ or ‘snigrit’.

Repetition may be used as a sales tool as it is one of the easiest and most widespread methods of persuasion. In fact, study shows that people rate statements that have been repeated just once as more valid or true than things they’ve heard for the first time.

Familiarity breeds liking. We tend to be more persuaded by something we think as more true. They even rate statements as truer even when the person saying them has been repeatedly lying.

The illusion of truth effect happens when our brains equate familiarity to truth because familiar things require less effort to process. Cognitive fluency is the feeling of ease which unconsciously signals our brain to think them as the truth.

Read more on:

http://www.sciencedirect.com/science/article/pii/S1053810015001518

Groupon Sales Rep Threatens Business With Negative Yelp Reviews?

groupon medspaGroupon and the other daily deals sites don't have the best reputation among medical spas... and threatening businesses that won't listen to your cold call sales pitch won't help.

Here's a Facebook post by a small restaurant and hotel in San Francisco that details an email exchange with a Groupon sales rep. You can read the entire post (and the comments) here.

Here's the email from the Groupon rep and the response:

UNBELIEVABLE CUSTOMER SERVICE EMAIL FROM GROUPON - Threatening me with Bad yelps for not letting him bully me into a sales pitch!!!!! Talk about Abusive business practices (my response is below)

From: Andrew Johnston <ajohnston@groupon.com>
Date: Fri, Aug 16, 2013 at 5:25 PM
Subject: Thanks
To: info@sleepsf.com

Hi Trip!

I sincerely appreciate you hanging up on me. As a resident of San Francisco for over 25 years, I have a huge network of friends (ages 25-40) that all are extremely active on Yelp as well as other social media. I will gladly let them know how you treated me as well as my feelings about the people who run Sauce...

Click to read more...

Here are some more posts on Groupon:

  • Medical Spas & Groupon Group Buys: Group Buying & Medical Spas Social networks and social media (Facebook, Twitter, blogs, etc.) get a lot of attention as marketing vehicles in the cosmetic medical world, and with good reason – your potentail patient are already there and are spending more hours being social online than ever ...
  • Groupon & Medical Spa Offers: Groupon is gaining traction in a number of cities and doing a fair amount of business if their testimonials are a real indication of what's going on. I received an offer last week from one of the local medical spas in the area for 50% off of some general day spa treatments (facials and massage). ...
  • Your Medical Spa + Groupon: Does it make sense to promote your medical spa with Groupon? Groupon is a “daily coupon” website. It’s basically an email list that charges advertisers to send out their “coupons” called Groupons. Many small businesses I’d likely never hear about otherwise sen ...
  • Oregon Chiropractors & Dentists Ban Groupons: The Oregon Board of Dentistry has banned the use of Groupons by the states dentists... and Oregon's chiropractors have followed suit. Groupon seems to be an either love them or hate them marketing tactic as shown in the very strongly worded comments on our post Are Groupon Deals Killing Your Medic ...
  • Are Groupon Deals Killing Your Medical Spa?: There's a deluge of Groupon offers from Medical Spas who are using cheap laser hair removal treatments to gain new patients... Is it working? This Groupon tactic is used by skin clinics who are desperately trying to get new clients and don't know how to market effectively or drive perceived value. ...
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Dr. Yoel Moyal: The Clinique Revolution du Plateau In Montreal

Dr. Yoel Moyal: The Clinique Revolution du Plateau In Montreal

Dr. Moyal is at the cutting edge of new injection techniques to offer a variety of treatment choices for his patients.

Name: Yoel Moyal MD CCFP EM
Clinic: Clinique Revolution du Plateau
Location: Montreal, Quebec, Canada
Website: clinicrevolution.com

Can you tell us more about your career transition from specializing in Family Medicine to Emergency Medicine to Aesthetics?

I have worked in Emergency Medicine and Family Medicine since graduating and recently became interested in esthetics as a means of doing more procedures and fine techniques. I also use my esthetic practice to balance out the often hectic environment of the Emergency Department with the quiet, serene environment of my office.

How do you market yourselves to patients and what do you do that your competitors aren't doing? 

Marketing medical esthetic services to clients is tricky as our ethical code in Quebec does not allow for the solicitation of a client/patient by a physician. We can inform people of the services we offer but can not incite patients to have a procedure done.

This applies to injections of Botox, dermal fillers and other medical-surgical procedures. Treatments such as laser hair removal, IPL and other esthetic services not performed by a doctor can be marketed. Doctors may not sell, endorse or associate any product or brand  to their name in Quebec.

Canadian Cosmetic Medicine Dr. Yoel Moyal

Are there any treatments or technologies that you're especially excited about that haven't hit the market yet? What do you think about new therapies like stem cells or others? 

I am excited about autologous fat transfers for restoration or augmentation and hair cloning for hair transplantation.

As a physician it is wiser to offer services that are exclusive to our profession such as injections or surgical procedures. It is difficult to compete in a market where anyone can offer the same services. For example in Quebec anyone can offer IPL , laser hair removal or tattoo removal but only doctors can inject. A doctor offering laser hair removal in his clinic can not compete with an esthetician doing so in her basement.

That being said, at our clinic we offer Laser hair removal as some people want to go to a clinic where there is medical supervision but the majority do not place much value on that. The majority of our practice revolves around  minimally invasive procedures such as injections of Botox and dermal fillers.

I do not encourage physicians to invest heavily in machinery as the technologies are often overpriced and often underdeliver in terms of results. Many estheticians can obtain similar results (in most cases) with mechanical (low cost) treatments with less risky side effects compared to  new technologies.

Technology has its place but not as much as savvy salespeople would have you believe.

The way to add new technologies is to introduce them into your practice based on the foreseeable demand from your own established clientele and the clienetele that you wish to attract. For example, your current clientele is between 45 to 65 years old doing BOTOX and dermal fillers regularly , the majority of your clients have sun damaged skin or pigmented lesions , they often ask if there is anything to be done. You should consider adding resurfacing technology or IPL at this point.

If you are considering adding a new service then careful market research in the territory you serve is vital- do not take the salesman’s word for it that  there will be people will be breaking down your door to try your newest machine and spend significant amounts of money.

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Renaissance Ideal vs. Niche Market

How broad is your menu of services?

There are arguable benefits to both generalization and specialization. 

Generalists believe that every new trend should be added to their spa offerings for fear of losing a client to a competitor. These polymaths say that customers want one stop shopping. Some like to put everything out there to see what will stick. They offer everything from bioidentical hormone replacement to laser toenail fungus treatments. DaVincians are presented with a marketing challenge as their buyers span the entire spectrum of demographics. 

Specialists insist that expertise cannot be achieved by a jack-of-all-trades. They apply the old proverb, "If you chase two rabbits, they both will get away." They focus their efforts on one or several procedures and hone their skills to levels of proficiency.  They get to know their niche consumer and target them specifically.  Sometimes, they will open a very distinct enitity like a vein clinic or a tattoo removal center. However, those with narrower menus may lose the "largely cast net" benefit of the generalist. 

While there is a happy medium between the two extremes, I have made a choice to offer fewer services over recent years.  I did a profit analysis of each service carefully capturing all associated costs.  Those procedures with lackluster returns and a low promise of improvement were dropped.  All associated equipment was liquidated. In the end, my clients respected fewer offerings rather than trying to be everything to everyone.  I am busier now than I was when I offered more.

The economic downturn combined with increased saturation of the cosmetic market has resulted in a more discerning consumer.  Today's buyer cannot afford to jump from clinic to clinic and wants to get it right the first time. This prudent purchaser may perceive a greater chance for a home run outcome in a niche setting over an "everything under the sun" venue.  The attributes sought in a provider are becoming a  matter of mastery over mediocrity.

Where do you fit in this spectrum?

Francis J. Collini MD, FACS - The Renaissance Center For Plastic Surgery In ShaverTown, PA

Apart from running a medical practice, Dr. Collini is committed to giving back.

Name: Dr. Francis J. Collini
Clinic: Renaissance Center for Plastic Surgery
Location: Shavertown, PA
Website: collini.com

Interesting: Dr. Collini is well-known for his humanitarian and community efforts. He is the co-founder of Community Cares for Kids which donates medical services and training to disadvantaged citizens of Third World countries. Over the past fifteen years, Dr. Collini has performed over three hundred surgeries in Ecuador on children with severe birth deformities and disfigurements caused by accidents and injuries.

What kind of tactices or strategies have you focused on to grow your practice?

I was taught as a resident plastic surgeon that the best way to grow your practice is via the 5 A’s: availability, affability, ability, affordability and attentiveness. In keeping with these principles, I am on call for my patients and the emergency room at Wilkes-Barre General Hospital 24 hours a day 7 days a week. I treat patients with respect and listen to their problems as best as I can. I then provide them with the best and most modern techniques in plastic surgery available.

Television has been the most highly effective marketing medium for my practice. It provides the biggest bang for the buck, so to speak and reaches the most outside people. I also have an LED sign in front of my office that provides up to date information regarding my practice and has proven to be a marketing bonanza.

Which technologies do you see being developed that might impact a plastic surgeon in the next ten years? 

Pills that remove fat or grow hair are on the horizon and I feel that they will negatively impact plastic surgeons...

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5 Powerful Psychological Negotiating Tactics

NegotiationsThere's some interesting psychology that goes into salary negotiation. Here's some new research that shows just how effective certain psychological strategies can be, and some tactics that make them less effective.

Not all of the advice on salary negotiation is worth mentioning here, if it works at all, since much of it is just regurgitated cliches that get passed along endlessly. However, there are some recent psychology studies that do provide scientific insight into how salary negotiations play out, what people do that can result in higher pay, and how those in-the-know might identify and counter those negotiation tactics. Here's five steps that you need to know:

1: Setting A High Anchor Number

When you mention a number, it effectively 'anchors' the conversation as a starting point from which all further discussions proceed. This 'anchoring' is a powerful tactic that has an immediate psychological effect that shouldn't be discounted. In a study from the Journal of Applied Social Psychology that simulated salary negotiations the researches found that when the anchor number is set high, the final agreed upon number is very likely to be higher. In this research, two studies were conducted to examine the effects of implausible anchors on initial salary offers. Participants provided a salary offer to a candidate after receiving a relevant anchor and an implausible anchor. The results of Study 1 indicated that a high implausible anchor influenced salary offers, even in the presence of the relevant anchor. Study 2 examined whether a more extreme implausible anchor would also affect salary offers. The results indicated that both the high anchor and the extremely high anchor led to...

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