Podium: 5 Questions To Ask Patients For More Powerful Testimonials

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Most cosmetic clinics, and now almost every medical practice, asks for patient reviews and testimonials. Make sure they're powerful by asking the right questions.

You're asking for testimonials, and if you follow up and pester your patients you're getting them.

However, there's a problem that most clinics have. The testimonials you're getting are powerless.

Testimonials are really just very short stories, and that's how you should be treating them. But if you look at your testimonials they come across as just pablum. These milquetoast testimonials are what you're left with if you don't understand how to ask the questions that allow your patients to give you memorable and powerful endorsements, and that start's with how you ask.

We're going to pump up your testimonials but helping you ask the right questions, in the right way.

5 questions to get a powerful patient testimonial:

1. What was your main concern about buying this treatment?
2. What was the result of buying this treatment?
3. What specific result did you like most about this treatment?
4. What are 3 other benefits of this treatment?
5. Would you recommend this treatment to your friends? If so, why?

You'll also want to follow up with : Is there anything you'd like to add?

Note: you'll change "treatment" to a specific service: Botox, Restylane, liposuction, etc. Specific is good. There's no need to shy away from saying "buy" or "bought" or "purchased". Many of the concerns that your testimonials will directly address will be about "buying", 

Also, make sure that you're ask about the objections and concerns that the patient overcame to buy. It's critical information that both elevates your testimonial and helps you identify concerns that you can address with your marketing and consultations.

Why these 5 questions work

Let's take a look at why we want to ask each of these 5 questions.

1. What was your main concern about buying this treatment.

You're going to ask this question because no matter how popular or safe a treatment ins, in the patient's mind there's always a concern. It could be money, time, pain, outcome, or almost anything. It could be all of those.

When you ask this question it brings out those concerns, and it goes further. When the patient searches her memory to think through what may have been a deal-breaker, they'll come up with a number of things that you may not have considered to be relevant before.

There is always a concern. So, when the patient brings up this concern it presents an angle that's unique, personal, and dramatic. A concern that other patients will relate to directly.

2. What was the result of buying this treatment?

You want to ask this question to show how the obstacle or concern was overcome. When a patient answers this question, she talks about why the treatment was worth it despite the concerns.

3. What specific result did you like most about this treatment?

Here's where we start digging deeper. "Specific" is the key word. If you ask a patient to focus on the benefits of the treatment they'll provide a vague 'overview' type of answer that may be nice, but it won't move anyone. That's why you want to focus on a single result that the patient liked most. This brings out the one feature and the patient will be much more explicit

4. What are 3 other benefits of this treatment?

Since you already asked about the primary benefit from the treatment, now you can go a little wider, adding color to whatever else the patient liked about her results. 

Depending upon the treatment you can substitute any number, 2 or 1, or even eliminate the number completely, but the number does make it easier for your patient to try and address the question. It let's her focus on a limited number of factors and ranks them for you in what the patient found most useful.

5. Would you recommend this treatment? If so, why?

Psychologically this question is important. When a patient makes a recommendation an they are personally tied to it, there's more at stake for them. This ties to the way that they think about their own integrity. Unless the patient feels strongly they won't be forward about recommending it, and when she does recommend it, she communicates clearly to perspective patients, "Hey! I recommend this and here are the reasons why!"

Bonus: Is there anything you'd like to add?

Most of the testimonial has already been addressed but here's where you may catch something that the patient overlooked or thought differently about. There's never any harm in picking up a few last tidbits after the first questions have got the patient thinking. Occasionally you'll find that this last answer is where you really illicit something great.

Using testimonials to discover and address patients objections

The way that we're looking at constructing testimonials brings us to the reason behind the methodology; the testimonial actually answers the buying objections. When we ask the patient, "What was the obstacle that would have prevented you from buying this treatment?",  the "obstacle" the customer brings up is going to be the concerns that we'll address in our marketing and consultations.

We should plan our testimonials to directly defuse each objection

Let's just take filler injections; Restylane, Juvederm, etc. If you talk to the average potential patient you'll hear any number of objections:

• It's too expensive. / I'll get stuck on an expensive treatment program forever.
• I'm afraid of needles and pain.
• I can get it cheaper somewhere else.

Let's assume that these are the three main objections. If you're asking the questions above, what are the testimonials that you capture going to say?

• I thought it was too expensive, but (here's why it was worth it).
• I'm afraid of needles, but (here's what happened and why I'm not afraid now).
• I thought about getting it cheaper somewhere else, but (here's what I found).

Each testimonial is a mirror image of each objection

You may know it's coming. You may have heard it often before and addressed it early in your marketing materials and sales copy, but new patients get a third-party perspective when they see your current patients defusing their objections in your testimonials.

A third party is always far more believable to your potential customers, and because each of these testimonials is linked directly to an objection, it systematically reduces the risk. 

How do I control the testimonial?

You may want to try and exercise control of your testimonials or give guidance to drive patients towards specific outcomes. You may want to talk about your length of time performing fillers, you education, or awards, but your patient may want to talk about price. So how do you control what your patient says?

Er... you don't.

You're part is constructing the questions. If you're doing this correctly you don't need to control the responses or the process. But that doesn't mean that you can't exert some influence on the direction that those responses take.

Start with the key objections you know you need to address

When you reach out to the patient. Ask her if cost, pain, or results were one of her big objections. If she says yes, follow up to find out the specifics. But if she says no, and mentions a completely different issue, follow up and run that objection to ground.

For example, a patient may say, "A friend had it done and it didn't look natural."

That feedback reveals an objection you hadn't considered, and it may be an objection that you haven't been addressing yet.

Examine it carefully, but you many decide that the new objection isn't worth pursuing and you can't use it. No problem. If that's your decision there will always be more patients who get the angle you're going for.

This process will extract the exact buying objections and testimonials that will help you defuse key objections. The result is that the testimonial is going to do some real grunt work for you in overcoming the fears and objections of the patients you're marketing to.

Get believable testimonials that are complex and detailed

Testimonials are among your most powerful sales and marketing tools simply because they come from patients, not you. They're told from the patients view point, about their concerns, and the results that they achieved. When a patient produces a testimonial that is rich in detail and emotion, and is believable it's done it's job.

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Here's what other clinics are saying about Podium:

“First and foremost, Podium has helped generate more reviews for our practice. That increase in reviews has steadily translated into more patients.”

— Dr. Josh Wyatt

“Within about 20 seconds we can get a review invite out to them. It couldn’t be simpler.”

— Dr. Chad Ellis

Stop Losing Patients - The New Ultimate Clinic Operations Blueprint (Free Preview)

There are a few known truths in cosmetic medicine. The first is; the money is made in the consultation room. But there's another on which is just as critical to your success; the money is lost in operations.

For the last two months I've been working on building a new course for the Medical Spa MD Training Academy to fix that last problem - the one about money being lost in clinic operations.

As of the time of posting this it hasn't been launched, but you can see the course description and even see a few lessons for free here: The Ultimate Clinic Operations Blueprint

Winners use systems. Loser have goals.

The Ultimate Clinic Operations Blueprint is all about implementing and then using systems in your clinic to hit some very specific goals. 

• Stop losing patients – You may not know how bad this really is but patient churn is killing your clinic's future revenue and value.
• Less micro-management – Yeah. Get out of the minutia of every decision and put your staff on track to handle things themselves. It's empowering as an owner and a team member.
• Work on your business, no in it. – If you feel like you have a job... enough said.
• Lifestyle – When you have great systems that are used it really does feel like your clinic is running on autopilot.
• Building value – If your clinic depends upon you being there, it's not a business, and the value of your clinic is determined solely by the estimated patient retention when you leave. Hint: Systems build much more valuable clinics.

This course is just one of many that we're going to be adding to the Training Academy. Clinical training, business training, staff training... we've got a lot of work to do.

Note: If you're not already a Training Academy Member join now. You'll get first shot at all new courses and discounts for members.

Publish your own course. We'll help. Learn about building a course for the training academy.

Survey: How Efficient & Productive Is Your Medical Clinic?

The New Clinic Efficiency & Productivity Survey

As part of a new course we're building for the new Training Academy, we're looking into how clinics and medical practices operate, and how efficient and productive they are.

The new course? The Ultimate Clinic Operations Blueprint.

Please take a moment and answer 9 quick questions on your clinic's productivity and efficiency. It should take just 2 minutes and we'll send the results to all participants.

Take the survey right here.

Contribute to Medical Spa MD

The New Medical Spa MD Academy: Clinical + Business Training For Physicians

A few months ago we started thinking about how we could add more value for Members - and we came to the conclusion that there was a lot more we could do to help you. So we decided to bite the bullet, roll up our sleeves, and build it.

This is kinda a big deal... so cut us a little slack if we sound a little giddy.

Until now, we've focused on building what is essentially a somewhat 'soft information' community built around the blog and the forums. It's worked incredibly well. We've gown into a vibrant community with thousands of members, millions of page views and unique visitors, there have been millions dollars exchanged through the classified ads (lots of 'millions' in this post), and we've helped many Members find info or answers that have grown their practice or save them from making mistakes. (Just read some of the testimonials on the Join Us page.)

We're going to keep all of that. 

But we're adding something new: An incredibly powerful training platform.  : )

Over the last few months we've been heads-down building out an entirely new technology stack and some amazing new capabilities. We've been polishing code and tweaking copy. Our testers have run through more than 100 usability trials and security tests.

The result: We're launching the Medical Spa MD Training Academy — real-world courses for Members will provide clinical and business training for our Members.

(The first course: A Botox and filler injection course taught by Marc Scheiner MD, a Certified Allergan Trainer who has already trained hundreds of clinicians.)

Now, a physician who has spent years training clinicians a few at a time, can take that training and make it available to any clinician, anywhere, at any time. And it all happens auto-magically.

It's as easy to train a doc in Mali or Singapore or Toronto as it is to train them in your clinic.

And online clinical training works — something we learned from our friends at http://MedMastery.com who teach online clinical courses on Cardiac MRI, ECG, Epidemiology, Coronary Angiography and Transesophageal Echocardiograpy... all of which will earn you CME.

For clinicians, there are real benefits for learning online.

It used to be that you'd pay Dr. Scheiner $2,000 for a two day training. You'd have to pay for your travel. You'd have to pay for a hotel. You'd have to bring your own patient. You'd miss a couple of days of income and you'd spend those two days looking over the instructors shoulder trying not to miss anything and remember everything that you were seeing. (The old see one, do one, teach one.)

And it was still worth it.

But now it's easier.

Now, you spend a couple of hundred dollars for an online course. You can watch the trainings over and over and refer to them at any time. You don't have to worry that you'e missing something. You get every file, video and lesson in one place.

And there's a 30 day money back guarantee so there's zero risk.

What's not to like?

But there's much more to this than publishing a single course.

The 'light bulb' moment was when we realized that all of the expertise we would ever need was already here on the site. You. Thousands of Members with - we're guessing here -  hundreds of thousands of years of experience. You guys - in aggregate - know pretty much everything there is to know about clinical cosmetic practice.

If only there was a way that we could help you extract those skills and knowledge, design a beautiful course that would be available to anyone, and supply you with a massive audience of potential buyers.

So that's what we built: A new training platform and perfect target audience that's going to allow you to take your clinical expertise or business savvy, and create an awesome course that will be seen world-wide.

It's the best deal we could possibly think of.

It removes all of the risk that has stopped you from doing this on your own. You'll build your credibility, personal brand, visibility and influence, and you'll make money every time your course sells.  : )

And there are no preconditions other than they provide massive value for our Members.

If you're a clinical trainer. If you've given a clinical presentation. If you're a consultant that can teach clinicians something of value. If you're a clinician who's discovered a new technique. If you're a savvy operations manager who can improve a clinics consultations. If you already have a course that you're teaching offline, or if you think you might be able to build a course that will benefit our Members, we want to chat.

So here's what we'd like you to do: Take a look at the new Training Academy and read the "Become and Author" page. (links below) Then contact us and tell us about your new course. If we like it, we'll help you build it, market it, and put it in front of  hundreds of thousands of potential buyers who want to know what you can teach them.

Let's get started.

The Physicians path To Effective Leadership: Humility and Will

Most physicians think that they're effective leaders but there are plenty of clinics that rely more on authority than leadership.

So what do you need to be an effective leader? Personal humility and the will to be a great leader.

Studies shows that CEO humility is positively associated with empowering leadership behaviors. They tend to connect more effectively with both top and middle management, creating a collective empowerment for the organization.

This was the result of the study examining the concept of humility among CEOs in 63 companies from China. A More than 300 top management team members and 600 middle managers were surveyed in the study.

In 2001, the research done by Jim Collins about how a CEO's humility can impact a company has been shown in his book, From Good to Great. Here, Collins shattered the concept of a supposed CEO image: charismatic, authoritative, convincing, and larger-than-life.

Collins described leaders who have both personal humility and intense will to be "Level 5 Leaders".

According to our five-year research study, executives who possess this paradoxical combination of traits are catalysts for the statistically rare event of transforming a good company into a great one.

The other types of leaders, according to Collins, possess skills to transform companies but not sustain the level of excellence. This type is not the only one that can effectively lead a company, but it is essential. An interesting question would be: Can this type of leadership be learned? In an answer, Collins shares his hypothesis about two categories of people: those who don’t have the Level 5 seed within them and those who do.

My best advice, based on the research, is to practice the other good-to-great disciplines that we discovered. Since we found a tight symbiotic relationship between each of the other findings and Level 5, we suspect that conscientiously trying to lead using the other disciplines can help you move in the right direction. There is no guarantee that doing so will turn executives into full-fledged Level 5 leaders, but it gives them a tangible place to begin, especially if they have the seed within.

Read more:

• https://hbr.org/2005/07/level-5-leadership-the-triumph-of-humility-and-fierce-resolve
• http://asq.sagepub.com/content/59/1/34

Can A Dentist Own A Medical Spa?

There's been a fair amount of angst around dentists performing Botox treatments and whether it's legal or not.

This is from a press release that was emailed to me from a thread on a LinkedIn forum:

In Illinois, for instance, only a licensed physician may own a medical spa. Under the Illinois Medical Corporation Act, a medical spa, or any entity that provides medical treatment, must be owned and operated only by persons licensed under the Medical Practice Act of 1987 (the Medical Practice Act governs the medical licensing of physicians).

In Florida, for example, anyone, including a dentist, can own a medical spa. And in Washington and Oregon, non-physicians are not completely precluded from med spa ownership if they structure the business in a particular way.

Similarly, the laws vary widely from state to state as to whether dentists can even perform medical procedures like Botox and laser hair removal, which are commonly offered in med spas. In most states, dentists are limited to injecting Botox or other injectables in certain areas around the mouth. In Kentucky and Illinois, the use of Botox and other injectables falls within the scope of dentistry as long as it involves conditions surrounding the mouth but in other states like Missouri, the law does not provide express guidance on whether dentists may administer Botox or other injectables."

Does anyone know any cases where a state has come down on a dentist who owns a laser clinic or medical spa?

RockBottomLasers.com Joins Medical Spa MD Classifieds Ads

We're happy to announce that RockBottomLasers.com is joining Medical Spa MD as a Select Partner and listing their entire inventory in the classifieds. 

Buying and selling used devices is something of a headache. There are a lot of resellers but you never really know if you're getting the best price, and there's not really anyone to ensure that you're treated fairly if there's a problem. We wanted to do something about that.

We had launched a previous iteration of a classified ads area but it came with some problems. The previous ads were free. These are not. While we moved millions of dollars in cosmetic equipment, the fact that the previous listings were free invited spammers and ne're-do-wells that were always a pain in the ass to try and keep out. We didn't want to deal with that any more so we've added a payment system to keep out the riff-raff.

This time we wanted to do it better. We wanted to benefit Members by building a system that promoted:

1. Transparency in the pricing of cosmetic lasers and aesthetic equipment.
2. Active competition and pricing between resellers.
3. Easier selling of your own equipment, either by listing it yourself or contacting resellers.

Vin Wells, the founder and CEO of RockBottomLasers.com has been around the Medical Spa MD community for more than a decade, answering comments in the forums and generally being helpful to members who are looking for inside info. So, when we started looking around for used cosmetic laser vendors to have some preliminary discussions with, Vin was first on the list of people we talked to and he readily agreed to post his entire inventory to the site.

Check out Vin's inventory of pre-owned cosmetic lasers and IPLs in the classifieds area.

We're not done. We're looking for other reputable cosmetic laser resellers who want to be part of this new program and list their inventory too. We think that by aggregating multiple resellers we'll meet our goals of more transparent pricing, more active competition, and easier buying and selling for everyone. Vendors get exposure, leads and sales. 

To list an add for your laser or IPL it will cost you a measly $10 a month. Making the ad 'featured' will add another $10. That's not bad to sell a $40k laser.

There are some other things we'e working on as well. There's a category for buying and selling cosmetic medical practices and even the ability to promote and list services or products that you're trying to get in front of cosmetic clinics.

Cosmetic laser reseller? Learn more about becoming a Select Partner.

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Gastric Bypass Balloon Pills: Allurion vs Obalon

Swallow a pill. It inflates into a balloon. You're full for four months. (Eat less = lose weight). Balloon deflates and you excrete it.

It's not available (yet) in the US but Allurion, a Boston-based startup had just gained an additional $27 million in funding to pursue FDA approval. If you're in France, Spain, Belgium,  and some other European or Middle East countries it's already available.

There's a lot of competition around gastric bypass using implantable devices, but they're most often surgical. This one's not. You swallow the pill portion, it's filled with up to 550ml over the next ten minutes, then the catheter's detached and pulled out. (Might be fighting a gag reflex here.) that's pretty much it. The "Elipse Balloon" persists in the stomach for the next four months before it deflates and is passed.

Allurion has a rival in the US with a similar balloon-in-a-pill company Obalon which has already met FDA approval. (The main difference seems to be that Obalon requires endoscopic removal of the balloon which will greatly reduce market acceptance.)

Here's a video of the Obalon Ballon in action

If Allurion is successful in the US of obtaining FDA approval as simply a weight loss device they could be adopted by cosmetic practices as a vanity treatment. (If they're only approved for the very obese the aesthetics market probably won't have nearly the penetration.

• The Allurion website
• The Obalon website

13 Things Successful Cosmetic Clinics Don't Do

Strong cosmetic practices have leadership and teams that are able to manage their behaviors, patient interactions and ways that set them up for business success. Much of what's written is about what to do, but what you don't do is just as important. H

ere's a list of things that strong and profitable cosmetic clinics (and their teams) don't do.

1. They Don't Waste Time Focusing On The Competition.

Successful clinics don't sit around worried about the medical spa that's offering lower prices or spending more on advertising. Instead, they focus on delivering on what's critical for their success; delivering perceived and real value to their patients. They understand that competitors are part of every business environment.

2. They Don't Avoid Change

Great clinics don't coast. They actively look - continually - for the changes they can make that improve their business operations and the value they're delivering to patients. Successful clinics embrace change as a continual business need and an opportunity to improve.

3. They Don't Waste Time & Energy On Things They Can't Control

Successful clinics are all about what they are doing, not bitching and moaning about why they can't win and how the competition down the street isn't fair. Instead, they focus on what they do control and recognize that their success is in their own hands - always.

4. They Don't Try To Please Everyone

Great clinics focus on a few things that they do exceptionally well. They don't try to flail away and capture every patient. They realize that you can only be the best at one or two things, and they focus on delivering exceptional value in those areas.

5. They Don't Fear Taking Calculated Risks

Success isn't given and it doesn't ever follow your business plan. It's survival of the fittest and successful practices embrace the fact that they're going to have to make smart decisions and take some risks. In fact, they know that the biggest risk is not taking any risks.

6. They Don't Dwell On The Past

Successful clinics are forward looking. They're not talking about their past successes or grievances. They're looking forward to what they can improve in the future and they embrace continual improvement.

7. They Don't Make The Same Mistakes Over And Over

Successful cosmetic clinics make (a lot of) mistakes, but they only make those mistakes once. They learn fast and are voracious in rooting out why the mistakes were made and how they can avoid them next time.

8. They Don't Resent Other People's Success

Successful clinics can appreciate other clinic's successes. They know when the're being beaten and are intellectually honest enough to know that there are reasons that the market is rewarding someone else, most often because they're doing something right.

9. They Don't Give Up After Failure

Along with mistakes come failures; a terrible Groupon, a bad hire,  a cosmetic laser that is a lemon... Every successful clinic has a long list of failures that they can point to. They can also point to what they did, and kept doing, after every one.

10. They Don't Feel The World Owes Them Anything

Successful clinics don't think that they're owed success, and they certainly don't think that patients owe them anything. Instead, they look for opportunities based on their own work and merits and work to serve patients first.

11. They Don't Expect Immediate Results

Successful clinics know that success is a journey, not a destination, and like every journey it takes time. They don't expect immediate results. Instead, they apply their skills and effort to build the clinic.

12. They Say No More Than They Say Yes

Sales reps, patients, vendors... everyone is asking for yes. Successful clinics learn to say 'no' more than they say yes. It's harder, but it keeps your head in the game and your clinic pointed in the right direction.

13. They Don't Resent Their Patients

Successful clinics don't resent patients who don't want to be upsold or balk at a price. They know that all of their patients contribute to success and that their reputation is not what they want it to be, but what their patients actually think and say about them.

How Good Are Your Patient Consultations? ... About Average.

A while ago we surveyed some of our members to tell us a little about how they perform cosmetic patient consults.

If you were surveyed and responded. Thank you. (We're still collecting responses so if you haven't taken the survey you can do so through the button below.)

We had a pretty good response, and we're looking on putting together a report to present all of the findings, but there were a few surprises. One of them was the results we received about how clinics thought that were already performing. 

How well do you think that your clinic performs patient consultations?

As you can see the bulk of the answers registered were between 5 and 9 with a few 4's thrown in. There were no 10's and nothing bleow 4.

Part of that is that we used 0 as "our consults are usless". Our bad. A consult that bad is pretty hard to actually perform, so let's look at this as though 4 - the very bottom answers- are actually the lowest. If we do that then we're left with a couple of impressions:

• If you ask yourself how well you perform patient consults and your anything less than a 9, you're probably about average. That's not great since we know that consult training can increase a clinic's profitability anywhere between 25 - 100%. You're leaving money on the table, or in the consult room.
• If you answered 9, you're probably pretty good at consults.
• If you answered 6 or below. You're going to need some help.

We're going to publish all of the results once we stop collecting them. If you'd still like to contribute and add your thoughts, you can still take the survey below.

Why Don't (Most) Used Cosmetic Laser Sellers List Their Prices?

You might have noticed that a lot of used ("pre-owned") cosmetic laser sellers don't list the price of their units on their site. They demand that you call them up and talk to them.

Since we relaunched the classified ads for buying and selling used cosmetic lasers, I've noticed that a lot (most) cosmetic laser resellers don't publish the price of the equipment they're selling.

I understand. They want to have the chance to find out what you're looking for, steer you towards their inventory, and convince you that they offer superior service in addition to value pricing.

That's fine as a sales tactic and it certainly works if you have a pretty good sales team, but it does become opaque and prevents you from doing much research to determine if a specific vendor is above market, or offering a really good deal. (The very same reasons that most cosmetic practices don't post pricing.)

So, why don't cosmetic laser resellers post their prices?

1. They don't actually offer competitive pricing. 
   The internet makes for a very efficient pricing market for products. The difference you will pay for a hard drive from Amazon or Tiger Direct is mere pennies since they're 'commodities'. Cosmetic lasers and IPLs are not quite in that category but there is a know market for these devices and all of the resellers know it. After all, they have to buy their inventory as part of their business. If you're not offering really competitive pricing, buyers will see that almost immediately and you'll loose them for others who are looking for the lowest price.
   
   Recommendation: Avoid. You're going to want to determine if their pricing is high because they actually a primer offering (below), or they're just overpriced. If you get the feeling that they're not being completely above-board, avoid them and move on. There are lots of vendors and you're going to be relying on building a real relationship that's transparent.
    
2. They consider themselves a premier offering.
   The sellers position is that they offer much more than just the machine. There's the quality of the information, the expertise and detail of the refurbishment and quality check, the guarantee and service after the sell. Every physician buyer is going to be on the phone and want to feel reassured that they're getting all of that and publishing the price just means that they're not got to get the chance to talk to that doc and build a relationship. They're trying to keep the 'tire kickers' out of their sales cycle since they probably won't win those deals anyway and they suck up a lot of time.
   
   Recommendation: Worth considering. This one might not be bad for you if you're looking for a lot of hand-holding and support. Just be clear about what they're providing. Everyone (almost) says they're a premium service. They should be very clear about what they're going to do and what you can expect. It will be up to you to discern if they are, or if they're just masquerading as one.
    
3. They don't have the specific laser they're advertising and that you're calling about.
   Sellers just want the call. They can get pretty much anything but keeping inventory is expensive. It makes a lot of sense to advertise that you have everything and if a potential buyer calls, you have plenty of options to kick the can down the road just a little until you can either buy the laser they're asking about, or switch them to something you have in stock. 
   
   Recommendation: Avoid. They're injecting themselves into your search and transaction and you won't be able to count on their recommendations. 
    
4. They're profiling you before quoting a price.
   Sellers have the internet too and they use it, sometimes while you're on the phone. They're looking you up and making a guesstimate of your practice, income and needs. This isn't necessarily a bad thing, but since you're a consumer facing business they can find out a lot of information in a very short period of time.
   
   Recommendation: Be careful and ask questions. You're going to get a vibe based on where the conversation goes. If you think that they're not being honest or forthcoming in any way.. probably best to end the conversation and find someone else.
    
5. They're just being lazy.
   Keeping pricing up to date is something of a headache, especially if you have a lot of inventory. Just throwing up a few stock photos of a XEO or Starlux with a "call for pricing" message is easy.
   
   Recommendation: Avoid. Something's not right here if they can't get their act together enough to actually manage their own inventory. Probably not someone you can rely on to go the extra mile.
    
6. They're running a link farm.
   Some of the larger resellers have many sites for the same business. They do this to try and generate a lot of leads by dominating the search engine rankings with multiple listings. In some cases they have separate phone numbers so that you may not know that you're looking at the same company. In most cases they're not really trying to hide this but it does cloud the waters since you can't really find everyone in the space who might have the device you're looking for. They're not posting prices since it's just too much work to make sure they're synced across all of these sites.
   
   Recommendation: This isn't really unethical but it is confusing, and it can be expensive. These companies are usually larger which means that they are more difficult to negotiate with and it's more of a transactional relationship.

Should you look for cosmetic laser resellers who post their prices?

In general I would say yes. While there are a lot of resellers and your experience will depend largely on the individuals you're dealing with, there are worthwhile reasons to feel more confident with the increased transparency that being able to see the actual price before you contact them. Here are two examples of cosmetic laser resellers who show their prices:

• Rock Bottom Lasers in Phoenix Arizona - Owner: Vin Wells - A smaller hands-on reseller with a great reputation but not the sexiest website. Vin has run clinics in the past and is extremely knowledgeable about running a clinic in addition to cosmetic lasers.
• Sentient Lasers in Kamas Utah - CEO: Chris Cella  - Sentient is a somewhat larger vendor that also has a great reputation.

Note: Medical Spa MD has no financial relationship with Rock Bottom Lasers or Sentient Lasers. We just like these guys and they have good reputations.

Do you have a cosmetic laser, IPL, or other equipment that you want to sell? You can contact a laser reseller or you can sell it yourself on the classified ads site for members at http://ad.medicalspamd.com

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Revance: New Botulinum Toxin Moving on to Phase 3 of Clinical Trials

Just what we need. Another Botox competitor and the sales reps that go along with them.

There's a reasons that all of these companies are launching botox competitors... As a collective, Botox is the biggest money-maker in the injection market by a long ways. 

Here comes another one: Revanace, who promises longer duration than Botox. You can take a look a the company website here

Revance Therapeutics, Inc. (NASDAQ:RVNC), a biotechnology company developing botulinum toxin products for use in aesthetic and therapeutic indications, today announced the completion of its Type B / pre-IND / pre-Phase 3 meeting with the U.S. Food and Drug Administration (FDA) regarding DaxibotulinumtoxinA for Injection (RT002) for the treatment of glabellar (frown) lines. 

In this trial there were five different groups for testing for 268 subjects. There were subjects for 20U, 40U, and 60U of daxibotulinumtoxinA, participants for 20U, and some more subjects for placebo.

In Week 4, daxibotulinumtoxinA was still at 100% efficacy rate among the participants. The determinant was the Investigator Global Assessment - Facial Wrinkle Severity (IGA-FWS) scoring, in which most participants from all groups gave a 1-point improvement. In the end, the daxibotulinumtoxinA shows greater efficacy with 40U as compared to onabotulinumtoxin 20U treatment 8 to 20 weeks post-injection, even attaining 2 more points on the scale. It was well tolerated and showed longer duration.

daxibotulinumtoxinA seems to show more its efficacy and shows potential a competitor of the big three botulinum toxins. Revance might give the current competitors a run for their money, however Botox Cosmetic, Dysport, and Xeomin are trusted brands. Revance’s product is at Phase 3 trials and the trial is estimated to finish December 2018.

There's another competitor in the same state: Daewoong’s NABOTA currently undergoing clinical trials to receive FDA Approval. The daxibotulinumtoxinA aims to treat such as wrinkles, cervical dystonia, and plantar fasciitis. Clinical trials for the latter two treatment areas are also undergoing.

What 2016 Cosmetic Medicine Stats Mean For Your Clinic

Stats from 2016 are trailing indicators of the market but they should give you a clear view of where cosmetic medicine is headed.

When you're looking at where cosmetic medicine is headed, you'd do well to keep up with the latest stats showing that nonsurgical treatments are on a path to overtake cosmetic surgery in total dollars spent. 

If you look at some of these stats you'll sees some obvious trends, and that should make you think about what kinds of treatments you might look to ad or promote. Nonsurgical is where the growth is.

Nonsurgical cosmetic medicine's growth is accelerating according to the International Society for Aesthetic Plastic Surgery's (ISAPS) annual statistics.

Take a look at this chart of nonsurgical treatment's growth in the US, and compare that with the growth in surgical treatments. IPLs, cosmetic lasers, Botox and injectables.

Download and read the ASAPS report here.

The International Society of Aesthetic Plastic Surgery (ISAPS) 2016 Stats

Read the ISAPS report here

If you're not practicing cosmetic medicine in the US, you might want to think about starting a clinic in Brazil.

In the report, Brazil and the US trade top spots depending upon the proceedure. They're neck and neck, except when the treatment is further South. Brazil is almost double the total number of treatments in both Labiaplasty and Vaginal Rejuvenation than the US. (Interstingly, Labiaplasty worldwide had the greatest increase in treatments year over year at a massive 45% increase.)

The US has far more nonsugical treatments due to greater market penetration of cosmetic lasers and IPLs.

Here's a breakdown of nonsurgical treatments wich shows wider spread than if all cosmetic treatments (including surgical) are included.

Total Nonsurgical Procedures by Country

Here's another chart that gives a little insight into the macro trends around injectables worldwide.

Year-to-Year Comparison of Injectable Change

Winners? Juvederm, Restylane, Belotero Balance and Sculptra Aesthetic. Loser? Radiesse.

Implications and takeaways for your clinic

Non-surgical procedures continue to grow at a steady. No surprise there, but there are some areas of interest if you're looking at adding to your treatment menu. You really want to ride a wave that's growing and a careful reading of these types of reports can show you where that wave is headed.

The fastest growing cosmetic procedure of all? Labiaplasty, at 45% year over year growth. That's a pretty damn good indication that there's a lot of demand. 

The non-surgical options using RF and fillers for vaginal rejuvenation has just started to trend, but it's dramatic. You might want to take a hard look at adding vaginal rejuvenation to your treatment lineup.

More non-surgical procedures may continue to progress and develop, as dermal fillers and Botox are not limited to the use of the face. Lasers and IPL also contribute to the increase as they are considered non-surgical alternatives for fat reduction or skin rejuvenation. It is expected that in the coming years, there may be a spike of numbers coming in from the younger and middle age demographic.

Dr. Sarah Cenac Jackson - Audubon Dermatology, New Orleans

Part 1 of our interview with Audubon Dermatology in New Orleans: Dr. Jackson tackles the medical technologies used in their practice and her experiences as a Dermatologist.

Name: Dr. Sarah Cenac Jackson
Location: New Orleans, LA
Website: http://audubondermatology.com/

Of Interest: Dr. Jackson is a member of the Annenberg Circle of the Dermatology Foundation, the largest foundation of dermatologic research in the country. She lives in New Orleans, LA with her husband Konrad and their 3 children Adelaide, Henry, and Charles.

What sparked your interest in offering cosmetic medicine?

Botox and Restylane were FDA approved for cosmetic use when we were in training at a program that had an established cosmetic training clinic and education in place. It was a natural fit for us to continue using and perfecting our techniques with injections.

We have several leaders and mentors within the cosmetic field in New Orleans and we were inspired to stay at the cutting edge of this exciting time in dermatology. What keeps us in cosmetics is the high level of patient satisfaction with these procedures. People love looking better and it translates positively to other areas of their lives. The constant positive feedback stimulates a desire to continue training and offering our patients the best services possible.

What are the IPL and lasers you use? And how do you select the medical devices in your practice?

We use many lasers and energy devices. We started out by renting a hair removal, vascular, and resurfacing devices. As we became more booked up on the days we rented the lasers, we made business decisions to purchase devices. IPL and laser hair removal were our first purchases and remain very profitable.

We determine devices to purchase based on 1) demand 2) data on the device's success 3) profitability.

Consumables and warranties can become very expensive so we are sure to factor that in as we make purchase decisions. We calculate ROI per hour on devices including the time required for one of the doctors or aestheticians to operate it, including numbing and consents. More complicated and painful procedures have a cost to us in time!

Our Palomar IPL, Exilis radio frequency, and Cutera Hair Removal systems are fantastic because they require no numbing and have no consumable. Cool Sculpting is very popular as well. We do research to see how much competition we have locally with a particular technology, but we have found that our patients are very loyal and respect our expertise, so it has not been a big problem for us to compete with med spas or group-on type pricing.

Clear and Brilliant and Fraxel Dual are also very popular, but difficult to use in New Orleans in the summer as we have so many tanned and skin of color patients. We are starting to use Cutera's picosecond laser for pigment as it is more color-blind.

Our tattoo removal business has not been as busy as we had initially thought, but it is growing and we love having the picosecond technology as indications for that device grow.

Over the years we have become savvier about negotiating. We usually decide what technology we want (skin tightening, resurfacing, etc.) and then research which device by talking to other KOLs and peers. At meetings, we try to have meetings with laser companies and get to know their personality. We always, always demo the devices before purchasing. Prices are negotiable and we discuss extra warranty years, extra consumables, and what to do if the device is upgraded before ever signing.

What anecdotes can you share about your patients?

I think some of the worst patient situations that happened involved syncope secondary to patient anxiety about needles. As a physician injecting all day long, we need to be skilled in recognizing syncope and pre-syncope and be able to best treat our patients. We have had several episodes in the office of seizure-like activity as part of syncope. We have had patients jerk with these convulsions while a needle is near the globe and even fall off the exam table. One patient even had lateral nystagmus. After consulting with our Neurology colleagues, we learned these symptoms can be seen with syncope. We have found it very helpful to know the proper recovery for syncope. Most importantly to lay the patient flat and let the blood flow back to the brain. We keep juice and ice on hand and everyone in the office is ready and prepared in case it happens. People are not allowed to leave until fully recovered. We have had a young male patient try to leave to early and face plant the copy machine on his way out! So, we triage for this as part of the patient intake. “Have you ever passed out with needles?” We are always prepared with guarding the needle and stabilizing our hand in case the patient jerks. We have our staff prepared so the patient recovers fully and can have confidence in our care.

Bio: Dr. Jackson received her medical degree from Louisiana State University School of Medicine, where she was a member of AOA honor Medical Society. She also fulfilled her residency training at Louisiana State University Health Science Center where she served as Chief Resident in Dermatology. She received her undergraduate degree in Zoology from Louisiana State University, where she graduated cum laude. She is a board-certified Dermatologist with special interest and training in medical dermatology, dermatologic surgery, cosmetic dermatology and laser surgery. Dr. Jackson is a former President of the Louisiana Dermatological Society. Additionally, she served for several years as the Louisiana State Chair of the Dermatology Foundation. Dr. Jackson is a member of the American Academy of Dermatology, the American Society for Dermatologic Surgery and the Women’s Dermatologic Society.