Surviving and thriving in the cut-throat cosmetic industry of South Florida.

Brian Sidella, founder of Forever Young Medspa sat down with us to discuss how a non-physician running a medical spa competes with a host of physician run clinics in South Florida.

Name: Brian K. Sidella
Location: Cooper City, FL
Website: foreveryoungmedspa.us

Brief Bio:  Former “C” level executive with over 20 years experience in sales and marketing who always wanted to own my own business.  Back in 2004, while watching a program called “The Swan” about cosmetic transformations I began to look into a business model centered around the concept of transformations.  This led me to the emerging MediSpa industry.  Within a few weeks I resigned and spent the next 9 months traveling and met with perspective Franchisor and many plastic surgeons across the US & Canada about the industry.  I quickly decided not to go the franchise route and opened up Forever Young MedSpa in 2005.  We began with “zero” patients and have now built a practice of over 3,000 patients.  In the worst economy since The Great Depression and in an extremely competitive market, we’ve been growing double digits the past few years and will do so again this year.

How did you enter the medspa industry?

I’m not a doctor but what attracted me to this business was the opportunity to positively impact people through aesthetics.  My responsibilities are everything outside of performing the treatments. I run the day to day business operations which includes Marketing, HR, Payroll, AP, AR, Staff Trainings and all new technology assessments. 

Hiring is a tough job. What are the qualifications you're looking for?

Coming from a background in sales and marketing, I’ve always believed in performance based compensation and that is the model we have at Forever Young MedSpa.  I’ve always had a philosophy that no matter what you’re official job title, that everyone is a customer advocate and everyone is in sales.  All staff members are also required to perform outside marketing with synergistic businesses.  

Our staff is performance focused with two rules.  If it does not either increase revenue or improve the patient experience, why are you doing this task?

When hiring for any position every perspective staff member is put on the spot and asked to sell me a service.  If they can’t sell and overcome objections during the interview, well, it’s down-hill from there.  Hiring is the single most important decision you will make in this industry yet I find most do a poor job in screening out to find “A” level players.  This is where my background has really helped.  We interview a minimum of 8 people for any available opening.  On more than a few occasions, the 8th applicant was the best and we could have settled for less…

How do you handle new purchases?

Having now been in this business for almost 7 years, I’m still amazed at how this industry operates.  Most of the players have a planned obsolescence strategy of about a 4 year life cycle and then most force you into a fork lift upgrade.  As an example you could have begun 2004 with a Palomar Medilux, bought a Starlux 300 in 2005, a Starlux 500 in 2009 and now an Icon in 2012.  Each of these systems represents a six figure investment.  Whoever brings to market a field upgradable platform that will last a decade is going to dominate…  as for the technology itself we have a pretty extensive suite from Palomar, Cynosure, Syneron, Edge & BTL.  We use Palomar for IPL services and 1540 Fractional, Syneron for the Matrix, Cynosure for laser hair removal, Edge for HydraFacial M.D., Syneron for VelaShape & BTL for the Exilis.

How did you develop and implement you marketing strategy?

We’ve tried everything you can possible think of but the best ROI are Internet based programs.  In addition to a successful patient referral system we utilize a six tier approach for Internet based marketing which includes; Pay per click (ppc), SEO, Google Places, email marketing, outside staff marketing and SMS/MMS marketing.  In fact we have had such success with our model that I created a side business and now help other medical aesthetic centers (outside my area of course) with their marketing programs.  

What treatments or services are most profitable for you?

Our most profitable services continue to be laser based or body contouring treatments.  Back in 2005, we decided to be early adopters of the VelaSmooth and then VelaShape.  Last year we added Zerona and then Exilis.  We’ve now performed over 10,000 body contouring treatments and really know how to maximize results through superior techniques.  Botox & fillers are also very important to our practice as most of those patients will ultimately graduate to additional laser or RF based services. 

 

The laws around who can own any kind of medical services business differ significantly from state to state. What are Floridas laws regarding ownership or operations of medical spas and how are you set up to operate as a legal entity? Does your medical director (a physician) have ownership?

In Florida a non physician is able to directly hire an MD without setting up a management company or separate legal entity..  My MD also has an ownership position in the Medspa.

Since you're competing directly with physician-owners, how do you market yourselves to patients and what do you do that your competitors aren't doing?

This is where I believe we have an advantage.  My background is in business where supreme customer care is critically important for success.  We go the extra mile for our patients day in and day out.   We have an excellent patient focused staff and we cater to their needs. From early morning to late evening to opening up on days off for patients to everything in between, we offer this level of service to our patients. We treat our patients like VIP clients because they have a choice and when they honor us by choosing Forever Young MedSpa it’s our responsibility to WOW them with not just great results but superior customer service as well.  Lastly when it comes to marketing I’d like to see some minimum standards set as well. Price should never be the determining factor for medical services and companies like Groupon and Living Social offer discounts of up to 80% off for medical aesthetics. As any patient to rank in order of most importance; results, safety and price and in most cases, price is last. Why then do so many practices advertise price, price, price.

I’d like to see the medical boards enact laws to forbid the practice of mentioning price in any ad except to existing patients. 

Do you limit your treatments to less invasive or treatments like laser hair removal that are generally not performed by a physician?

This is one of the great myths in this business. We have 9 different laser or energy based systems. We offer laser hair removal, ablative and non-ablative Fractional Lasers & Radio Frequency systems for acne or body scars, stretch marks, body contouring & cellulite reduction systems, IPL’s for PhotoFacials, and skin tightening systems as well. We also have one of South Florida’s best staffs to deliver those services.

Just in the past year we’ve spent almost $400,000 on new next generation technologies to serve our patient base.  When it comes to non-surgical aesthetics, our suite of services are second to none.  For patients that need surgical alternatives we offer them as well through our medical director Dr. Bass but always at a state certified offsite surgical facility.  I’m not a proponent of in office surgery unless the facility is both inspected and state certified and they have the equipment and training for life saving measures should that occur. 

In South Florida last year, 5 patients died at offices that were neither certified nor inspected that were offering “simple” minimally invasive laser lipo procedures.  There is no such thing as “simple surgery” and that brings up another issue this industry faces namely having any doctor with an MD after their name being able to operate without any formal training or certifications. 

IMO if you’re going to offer any type of surgery than you must have had a formal surgical residency.  In a few of the deaths last year the doctors had no surgical training at all and the patients died from lidocaine toxicity.  Patients also need to ask their doctor, where did you do your surgical residency, can I see your diplomas, what types of complications have you seen for the procedure I’m doing and how many of these procedures do you perform a month.  That’s a good start…

How do you compensate your staff now, and what different types of compensation structures have you tried in the past?

Coming from a business background I’ve always believed in performance based compensation system and that’s the type of system we have.  We tried early on to emulate the Spa industry types of commission structure but quickly learned that model does not work in the medical field.  The costs structures are simply far too high.  Most of the MedSpa failures in fact can be directly tied to the ridiculous commission structures of 40-50% and more which resulted in service offerings with zero or negative margins. Our plans all have a base salary range and from 2.5% up to 19% in commissions depending on title and revenue tiers. Our goal is to keep salary & compensation below 32% of gross revenues. That’s really as high as a Medical Spa can go without surgical revenue. Also for all our staff in addition to their formal titles and responsibilities have two additional rules; Everyone is in sales & marketing and everyone is responsible for patient service excellence.  

For several years, you have been in this industry. What are the most significant lessons you've learned?

Not unlike the business world what I’ve learned in this business is that our real bosses are the patients we treat and in this business, they are far more demanding than what I experienced in my career in the technology sector. I mean patients come in pretty knowledgeable about cutting edge procedures and they always want the latest and the greatest. Staffs have to always be one step ahead and know everything possible about “all” the available technology so they can intelligently answer patient questions.  

What’s kind of funny is how incestuous this market is at a professional level. I have been on Webinars with Palomar where a physician luminary is touting Palomar as the best in class system and two weeks later on a Sciton webinar, he’s stating the same for Sciton.   

The truth is that for the most part, especially for the past few years, all the top tier companies are now pretty equal with what the systems can accomplish for patients. The vendors keep trying to sell how much faster a new laser is as if that was really a buying criteria. When we have a double line out the door, speed will then be an issue.

What's the best advice you can impart to anyone who wants to put up a medical spa?

A few things… One is to choose strategic vendors.  What do I mean by this? Choose vendors that provide marketing & clinical support to help you after the sale.  A great example of this is Syneron.  We’ve received hundreds of patients from velashape.com and their other marketing awareness programs. Also choose vendors that provide constant protocol improvements and in the field training and seminars. Many of our best treatment improvements come not from new systems but from advanced protocols and from combining multiple treatments to achieve the best patient outcomes. Also try and pick a few areas to specialize in and build up your patient base from there. The term Medical Spa can actually hurt as most patients still do not know what a MedSpa is.  We still receive calls for massages, physical therapy or pain management. Lastly and I see this mistake most often, is to dedicate 7-10% of your forecasted revenue towards marketing. This is not a buy the technology and they will come market.  Maybe it used to be but not anymore. Now you have to “make it happen”. The answer is yes, the question is how.  Put the action behind the intention and success is sure to follow…

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us