If you're just starting up your first cosmetic medical practice, you may not know why the graphic designers and advertisers of the world will shortly be clutching you by the short hairs and forcing you to cough.

Well my bespectacled brothers and sisters in white, ward yourself against the beret wearing crowd who constantly rail about 'top of mind awareness', tempt us with subliminal advertising, force us to spend money on the worst shit imaginable, and eventually blame us for not coming up with a good offer. And of course, most of them are communists.

So, in order to do my part to save your medical practice from the charts and smiles crowd, I arm you with this list of things you can do when working with a graphic designer to assure that their experience is much worse than yours.

1. Start with lame embedded graphics
When sending the art department any document, make sure it's made with a program from Microsoft Office. PC version if possible. If you have to send pictures to be used in an ad, you'll have more success in driving them mad if, instead of just sending a jpeg or a raw camera file, you embed the pictures inside a Microsoft Office document like Word or even Excel. Make sure to lower the resolution to 72 dpi so that they'll have to contact you again for a higher quality version. When you send them the "higher" version, make sure the size is at least 50% smaller. And if you're using email to send the pictures, forget the attachment once in a while.

2. Multiple and colored fonts are good.
Now we've got them right where we want them. Ask for at least four different fonts in every ad. Multiple colors are best since they really grab attention and sell, sell, sell. If the designer balks, start asking where he went to school and raise your eyebrow as though you can't believe he actually found a job. Now we're cooking.

3. White space is the fruit of the devil.
Now the first time you have anything designed it's just going to have too much empty space. They'll try to leave white space everywhere. Huge margins, spacing the letters and all kinds of hoy-ploy stuff. They'll also throw that 'clean and professional' jargon at you. Then they'll tell you that they're doing this to make it easier to read. Don't you believe a word of it. They're just trying to get off easy and leave everything half done. Stick to your guns. Ink is money and don't let them get away with more than 4% white space anywhere in the add. The type should actually be smashed into every corner. Remember, graphic designers hate you and want your money. They're also responsible for global warming and the mercury in shellfish.

So make sure you have no margins at all and tiny, tiny text. (Bonus points for multiple colors in the body copy.) They will try to argue and may even cry. Don't worry, they're not really human so you shouldn't feel bad. Remember who's footing the bill.

4. Logos say 'look at me'.
Now of course you're going to need a logo. It's who you are. Make sure you design this yourself and flatly refuse to pay the $4-7k for a real designer, or even the $300 for an online chop-shop. Think about this for at least ten minutes and then dive in. You don't want to make something that's detailed and easy to understand. As always, multiple fonts and rainbow colors are best. Try to work in a scalpel or needle to show you're medical. Above all, be sure to include 'advanced' or 'laser' in the name of your medspa to show the world that you have advanced lasers. (People are stupid and need this.)

Without exception, when you see your logo in print, tell the graphic designer to make it bigger. If the logo doesn't not overlap the edges, you're getting screwed and no one will call and you're spouse will blame you for ruining their life. A good rule of thumb would be to have a five inch logo on a six inch ad. Actually, five and a half inches.

5. Use lots and lots of 'exciting action words'.
When describing what you want in your ad, make sure to use terms that don't really mean anything. Terms like "snazzy it up a bit" or "can't you make it pop more?". "I want this ad to really sell," or "I want an ad that really says who we are." are other options. Don't stop hammering the 'pop' and 'sell' aspects. Don't feel bad about it since the started it when they said they were interested in helping grow your business.

6. Colors make everyone happy.
The best way for you to pick colors (because you don't want to let the graphic designer choose) is to ask your staff what they're favorite colors are and what makes them want to buy. Have your staff write down their favorite colors and make a list to give to the designer to use. This is really a good one. The graphic designer will suggest to stay with 2-3 main colors at the most, but no. Insist that he use at least one color from every staff member because they really know the clientele. If you can, do this whole list thing in front to the designer and smile while you're doing it.

7. Deadlines aren't really meant for you.
When approving a design, take your time. There is no rush. What? Are they going to press without you? Take two days. Take six. You're the only account that matters and that dentist down the street is probably doing it too. If the layout guys want to really know what it's like to go without sleep they would have done residency. Try to incorporate some last minute changes by email.

8. Drive a steak through his heart.
After you've rained down this list on your advertiser or designer, he'll start to get a bit insecure and start second guessing himself. Once he realises that he just can't satisfy your needs, the graphic designer will most likely abandon all hopes of winning an argument and will just do whatever you tell him to do, without question. You want that in purple? Purple it is. Six different fonts? Sure! This is exactly what we're after. The feeling of breaking your designers hopes and dreams over your knee and casting them into the abyss. This is why you became a doctor in the first place.

You would think that at this point you have won, but don't forget the end goal: he has to quit this business entirely. So be ready for the final blow: When making final decisions on colors, shapes, fonts, etc, tell him that you are disappointed by his lack of initiative. Tell him that after all, he is the designer and that he should be the one to put his expertise and talent at work and that you've had to do everything. That you were expecting someone who actually offered insight and useful advice and didn't just sit back while you did all the work. Tell him you've had enough with his lack of creativity and that you would rather do your own layouts from now on instead of paying for his services. This even works with those poor $6 an hour guys they have at the yellowpages.

There you go. Sweet justice for once. Next we'll work on that day spa that has the temerity to use the word medical.