August 30, 2012

Interview: Dr. Mark Mofid, A Plastic Surgeon In San Diego, California

August 30, 2012/ Medical Spa MD

Dr. Mark Mofid's plastic surgery practice includes the La Jolla, Del Mar, and Chula Vista areas of San Diego.

Name: Mark Mofid, M.D., F.A.C.S.
Location: La Jolla, CA
Website: drmofid.com

Dr. Mark Mofid is a board-certified San Diego and La Jolla area plastic surgeon, certified by both the American Board of Plastic Surgery and the American Board of Facial Plastic and Reconstructive Surgery.

Can you tell us how your clinic's set up?

Our office is centrally located in La Jolla/UTC within San Diego County. We have a full time dermatologist (my wife) and plastic surgeon (me) and a nurse. We have a AAAASF/Medicare accredited surgery center attached to the clinic and also provide laser services. The practice has several thousand patient visits per year and we offer medical and cosmetic dermatologic services as well as cosmetic and reconstructive plastic surgery.

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Have you ever paid a commission for Botox and laser treatments? Although it’s very common ... it’s also very illegal.

During the past several years, a very troubling trend has developed in the medical spa industry. Nurses, nurse practitioners, physician assistants and laser technicians are being paid by commission in order to incentivize them to bring new business into the spa. This is very lucrative for both the spa and the individual, but unfortunately, in most states, it is illegal.

However, by accepting commissions for Botox treatments, she was engaging in illegal fee-splitting. Not only could she face significant monetary sanctions if she continued to do so, but both she and her supervising physician risked immediate suspension or revocation of their licenses if the state learned she was taking commissions.Fee-splitting refers to dividing or sharing fees from medical services between a physician and a nonphysician. In most states, all fees generated for medical treatments must be paid directly to a physician or physician-owned corporation. No one other than the physician—including nurses, physician assistants or any nonphysician medical practitioners—may receive any share of a medical fee.

Although the prohibition against fee-splitting has been on the books in most states for years, the practice of paying commissions has become quite prevalent in the medical spa community. This is probably because, in medical spas, most medical directors do not want to spend time firing lasers or injecting since other services can be more lucrative. As a result, injections and laser treatments are delegated to other medical professionals, who, in turn, develop a large client base. An easy way to compensate those professionals is to pay commission.But the consequences for fee-splitting are severe. In most states, the state licensing board has the power to revoke, suspend or refuse to renew licenses in response to fee-splitting allegations. Accordingly, regardless of the monetary incentives, it is always advised to avoid paying or receiving commissions. A safe alternative to fee-splitting is to use a pre-set bonus structure—the nonphysician can still be rewarded for performance, but the bonus is not related to the number of treatments performed.

Recently, a client called me with an urgent concern. This client, a registered nurse in Chicago, worked in a medical spa as an injector and laser technician. She was well-compensated: In addition to an hourly salary, she was also given a commission—a percentage of net revenue—for every Botox and laser treatment she performed. And boy did this nurse perform—during the past 12 months, she personally had generated more than $350,000 in revenue for the spa.

Her concern arose from a conference she had recently attended where she learned that most states have laws prohibiting fee-splitting. She was informed that taking commissions on Botox and laser treatments might land her in hot water with the state nursing board. She explained that this didn’t make sense, given that she had been receiving commissions for years, and that the physicians who paid her surely wouldn’t risk their licenses by doing something illegal.

It is imperative for any medical spa professional to seek legal counsel immediately if being paid a commission for medical treatments. The laws of each state vary and are often difficult to find, but as is often the case, ignorance of the law is never an excuse.

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Over on Freelance MD, I've posted a couple of articles about taking responsibility for yourself and "building your own ship" , and we've also gone through a few common reasons why physicians aren't the best at career modification.

In this post, I'd like to spend a little time introducing you to the idea of "lifestyle design," something that has become a bit of a buzz-phrase in the business world but as far as I can tell hasn't penetrated the world of medicine just yet (for a lot of reasons).

I'll begin with a personal story...

When I jumped off the academic track in 2006, I wasn't exactly sure what I wanted to do as a career but I knew I wanted something unique. My idea was to design a career that was flexible, fun, adventurous, and meaningful, all the while paying my bills and being a responsible spouse and parent. Simple, huh?

I spent months thinking about how to do this as a physician. I searched websites and blogs. I spoke with mentors and colleagues. I read the literature, all to no avail. There seemed to be no conversation about a career like this in medicine. I mean, there were a few articles about volunteer opportunities or non-traditional careers, but nothing really like what I was trying to create.

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The truth remains, however, that most of the time you can spend a lot of time and energy creating and maintaining these various social media outlets without actually realizing much results. And so while we embrace social media in medicine and beyond, we need to be cognizant as to the actual role of each social media outlet is providing for us. I think a better perspective is "what can I do for social media" not "what can social media do for me".

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Medical Spa MD Blog

Dr. Mark Mofid's plastic surgery practice includes the La Jolla, Del Mar, and Chula Vista areas of San Diego.

Medical Spa MD

Authors

Products + Services

Protect your clinic and profits in 24 hours.

The insiders guide to buying used cosmetic lasers.

A Comparative Guide of Aesthetic Laser Platforms

Featured Posts

Guest Posts

Have you ever paid a commission for Botox and laser treatments? Although it’s very common ... it’s also very illegal.

Thoughs on the Ideal silicone / saline breast implant.

There is an element of a gamble inherent in the medical tourism industry as it currently exists.

While hesitant to try yet another Social Media platform, I have left thousands of Facebook fans behind for Google + (and so should you...)!

With the spreading of social media into nearly every aspects of our lives, it is worth pausing and reflecting upon their value.