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What Medical Spa Owners Need to Know About LLC Taxation

Posted By Administration, Monday, November 4, 2019

tax forms

By James M. Stanford, JD, Partner, ByrdAdatto

Fake or Real: My company is taxed as an LLC—Fake!

There is no such thing as being taxed as a limited liability company (LLC).

Clients, as well as tax and legal professionals, routinely confuse entity structure with tax classification. Quite commonly, we hear clients state that an entity is taxed as an LLC when, in fact, no such tax classification exists.

Many people do not realize that when forming an entity—such as a medical spa—typically there are two principle filings. Understanding the difference can alleviate a lot of confusion.

  1. The first filing is at the state level, which incorporates the company as a legal entity (i.e., filing as a limited liability company).
  2. The second filing—or filings—are with the Internal Revenue Service to obtain an employer identification number. This filing determines how the new entity will be treated from a federal tax perspective.

An LLC is purely a state-level entity structure. In turn, the LLC elects how it will be taxed: either as a partnership, an S corporation, a C corporation or a disregarded entity. Generally, when someone says they are taxed as an LLC, what they really mean is that they are taxed as a partnership.

AmSpa members receive a complimentary 20-minute Introductory Compliance Assessment with a ByrdAdatto attorney. Click here to learn how to join AmSpa today!

James M. Stanford is an attorney and partner at the ByrdAdatto law firm. From transitions, mergers, and acquisitions to structuring complex ownership arrangements, James enjoys the personal reward that comes from bringing parties together and making deals happen. James practices primarily in the areas of health care and corporate law with a focus on intellectual property. A proud father, Jim served in the U.S. Army and is fluent in Russian. In his spare time, he enjoys hunting, fishing, and spending time outdoors.

Tags:  Business and Financials  ByrdAdatto  Med Spa Law 

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California Continues History of Limiting LVNs and MAs in Medical Spas

Posted By Administration, Friday, November 1, 2019


By Patrick O’Brien, JD, legal coordinator, American Med Spa Association

Every state has differing rules about what types of tasks and procedures may be delegated to licensed vocational nurses (LVNs) or unlicensed medical assistants (MAs). Usually, LVNs and MAs have a more restricted scope of practice when compared to that of a registered nurse (RN). California, in particular, greatly restricts what MAs and LVNs may do, and it has a history of publishing information confirming this. Recently, it appears that the state’s licensing boards have been increasing enforcement of these restrictions through the use of undercover investigators visiting medical spas. So, in the interest of compliance, now is an excellent time to review what MAs and LVNs can and can’t do.

California defines the specific tasks that MAs may perform in statutes and rules; this leaves very little room for differing interpretations. This differs from the norm in that it the majority of other states only provide general rules or guidance. An MA in California is authorized to perform “basic administrative, clerical and technical supportive services.” Technical support services include listed tasks such as administering medication, performing skin tests and non-invasive specimen collection. The Medical Board of California (MBC) offers a number of resources to help determine what qualifies and what doesn’t. For general questions, it has provided a lengthy FAQ that provides very helpful guidance. You will note that MAs may inject medication in some circumstances; however, that does not include the injection of Botox, as the MBC makes clear elsewhere. MAs also are strictly prohibited from administering any type of laser, intense pulsed light, radio frequency, microneedling, microdermabrasion or chemical peel procedure. As such, MAs would be extremely restricted in a medical spa setting and unable to perform nearly any of the common procedures.

LVNs in California, by the nature of being licensed professionals, do enjoy a much broader and varied scope of practice. LVNs are licensed to perform “services requiring those technical, manual skills acquired” in approved vocational nursing courses. This permits LVNs to perform tasks such as injecting medication, withdrawing blood and starting IV fluids, when directed by a physician. Once again, however, LVNs are very limited in a medical spa setting in California. Like MAs, LVNs are not able to inject Botox, use lasers or light-based devices, or provide microdermabrasion services.

AmSpa also has become aware that the TMB is increasing its enforcement for these types of procedures by using undercover investigators who pose as potential customers. From the limited information available, it is not entirely clear if the investigators are acting based solely on the procedures offered or if they also are looking for insufficient or improper physician oversight. Regardless, LVNs who offer Botox and filler injections are subject to disciplinary hearings for practicing outside of their scope. If you want to learn more about the Board of Vocational Nursing’s Enforcement Division, you can read more here.

In the past, we have discussed the importance of remaining compliant and operating within each license’s scope of practice (here and here, for example). A board investigation such as those mentioned above can be a much greater problem than it appears. The LVN can be disciplined for acting outside of their scope of practice and may have their license suspended or revoked. The physician may also be subject to discipline from the MBC for aiding in the unlicensed practice of medicine or providing inappropriate supervision. They also can be subject to penalty, including suspension or revocation. If that were to happen, every other nurse or physician assistant at that medical spa would be out of a job unless there was another physician in the practice who could supervise.

If you would like to learn more about the practice and structure of medical spas, plus all of the latest trends and best practices, attend The Medical Spa Show 2020 in Las Vegas from January 31 – February 2, 2020.

Tags:  Med Spa Law  The Medical Spa Show 2020 

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How Forming an LLC Can Help Your Medical Spa

Posted By Administration, Wednesday, October 30, 2019


By Courtney P. Cowan, JD, ByrdAdatto

Beginning Labor Day Weekend through the first few weeks of 2020, you will find ByrdAdatto attorney Robert Fisher proudly wearing the same red fishing shirt imprinted with the distinctive University of Georgia “G” logo. That garish shirt signals to everyone in the office that college football is upon us. We take football seriously at ByrdAdatto—and in the state of Texas, generally—so it seemed fitting to compare the similarities of our two loves of college football and limited liability companies (LLCs). “What could these two things possibly have in common?” you ask. The answer is simple: absolutely nothing.

But that hasn’t seemed to stop people, particularly college football coaches, from using LLCs as a means of conducting business. Originally used as a way to circumvent the optics of making more money than prominent state officials, collegiate head coaches formed LLCs to function as depositories for the large amount of supplemental income they received in addition to their base salaries. A recent Dallas Morning News article detailed some of the reasons for doing this, including tax relief and liability protection.

While we appreciate the publicity the head football coaches bring to the LLC, these reasons are not novel to those familiar with this business structure. Many business owners, accountants and attorneys have long been proponents of the LLC due to the advantages offered by it, including:

  • Tax flexibility: The LLC can elect to be taxed as a disregarded entity, partnership or corporation (s-corporation or c-corporation). By default, an LLC is taxed as a “pass-through entity” (i.e., a disregarded entity or partnership, depending on the number of members), meaning all of the profits and losses of the LLC “pass through” the LLC to the members, who then report the profits and losses on their personal tax returns. The LLC itself does not pay federal income taxes, unless it elects to be taxed as a c-corporation.
  • Limited personal liability: The owners (members) of an LLC are protected from the liabilities and creditors of the LLC as long as the LLC is formed and operated properly. Moreover, LLCs provide protection against outside liabilities (i.e., the liabilities of the other members).
  • Perpetual existence: The LLC can survive the death of its owners. This means the business will survive even if its owners do not.

Whether you are a Power Five coach making millions or a small medical spa, virtually anyone can form and take advantage of the benefits of an LLC.

AmSpa members receive a complimentary 20-minute Introductory Compliance Assessment with a ByrdAdatto attorney. Click here to learn how to join AmSpa today!

As the daughter of a periodontist, Courtney P. Cowan has been fascinated by the health care field since childhood. She often accompanied her father to his office, where she developed an appreciation for physicians and their respective practices. Having absolutely none of the dexterity that is required to be a surgeon, however, Cowan instead decided to pursue a degree in business while attending Baylor University. It wasn’t until she was required to take a business law course that she discovered her passion for the law. After graduating from Southern Methodist University Dedman School of Law, Cowan serendipitously connected with ByrdAdatto and now assists clients by combining her business background with her enthusiasm for health care and the law.

Tags:  Business and Financials  ByrdAdatto 

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What to Look for When Purchasing a Laser

Posted By Administration, Monday, October 28, 2019

laser treatment

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

Laser treatments are a staple of the medical aesthetic industry. According to the American Medical Spa Association’s (AmSpa’s) 2019 Medical Spa State of the Industry Report, laser hair removal is offered by 59% of medical spas, and it is the second-most common procedure for a first-time patient, so it actively brings patients into practices. Additionally, the report found that 29% of medical spas offer full-field ablative laser skin resurfacing. What’s more, 8% of medical spas that don’t offer laser hair removal and 5% of medical spas that don’t offer laser skin resurfacing are considering adding them.

In order to perform any of these laser treatments, however, the proper equipment must be acquired. And that can be more expensive and complicated than one might imagine.

Laser Overview

In recent years, a number of new companies have begun offering laser equipment designed for use by medical aesthetic practices, which has resulted in unprecedented competition. This equipment can be very expensive, costing as much as $250,000, so the stakes in the market are very high.

The representatives who sell this laser equipment typically are compensated, at least partially, on commission, and the commissions they can make are substantial. As is typically the result of commission-based compensation plans, the reps are very motivated to close the deal. Potential clients often forget this fact when they are shopping for a new machine, but savvy consumers always will remember that the sales reps, even at the most reputable companies, make most of their money when they actually sell a machine. Because of this, some reps can be very aggressive.

Although there are many reputable laser companies with very knowledgeable, considerate reps, some other companies employ laser sales reps who act in an unscrupulous manner because of the potential for lucrative commissions. This is the primary reason why you should work with reputable companies with established track records.

Unscrupulous reps often pressure potential customers to make a decision immediately, before they have a chance to truly evaluate their options. These reps will tell customers that they are on a tight timeframe or that they have limited-time discounts that expire soon. However, prospective clients should take a step back and evaluate their options. These are major investments and should be treated with a great deal of care. Good sales reps from trustworthy companies will understand the gravity of the decision and provide customers with the time, information and references they need to make an informed decision.

Prospective customers also should keep in mind that the only time they have leverage in this situation is before the contract is signed—when you can still walk away. This is the time in the process when they must do everything they can to negotiate the deal in their best interest. Therefore, when a representative offers a prospective customer a contract to purchase a laser, that customer must fully understand that contract, because this likely will be the only time that contract can be negotiated.

Preventing Problems

Taking the time to read and understand the contracts offered by the salesperson is the best way for laser customers to protect themselves. If provisions you don’t understand are in the contract, ask the sales representative to thoroughly explain them to you. A good rep will always make sure you understand the contract. But it is always a good idea to get an independent explanation. If your lawyer is familiar with negotiating laser contracts, you should consult him or her; if not, you should consider hiring an attorney with knowledge in this area. Laser contracts can be much more complex than contracts for other types of medical aesthetic equipment—they may include convoluted provisions on warranties, maintenance, technical support or authorized use, so enlisting the aid of someone who has experience with them can be tremendously helpful.

The amount of marketing support the manufacturer is offering is an aspect of a laser contract that should be carefully considered. Some laser companies offer excellent support; others say they will but offer nothing in writing to guarantee it. The inclusion of a well-developed marketing assistance program often will increase the price of the laser, but it can add substantial value to the deal. The customer must make sure that the contract he or she signs includes language that guarantees sufficient manufacturer support. With a purchase of this size, it is crucial to the customer to have as much support as possible.

It also is important to ask the representative to provide references from people who own the laser model you are considering purchasing. These should not be clients who just bought the laser and are still in the “honeymoon” period—these should be experienced users who know the highs and lows of owning the laser long term. Or, better yet, ask a group of medical aesthetics professionals you know to ensure you get an honest answer. For example, AmSpa offers a private Facebook group to its members, which acts as a forum for these and any other professional questions that come up in the course of your medical aesthetics business. A prospective buyer should ask about how the laser performs, its service record, its return-on-investment, manufacturer support and any additional relevant information. Good reps will have a large number of references from people they have dealt with throughout the years; if they don’t, that should be seen as a red flag.

Deciphering Laser Provisions

Some provisions that prospective customers need to carefully consider are often found in laser contracts. It can take hours to review and analyze all elements of contracts, but there are three provisions that I often focus on when representing clients in laser purchases.

Recertification fees. The most controversial provision deals with recertification fees. It dictates that the manufacturer must inspect a used laser device to “certify” that it is in working order and operating to the manufacturer’s standards before it can be resold on the open market. The fee that the manufacturer charges for this service can be quite high—$50,000 or more—and it must be paid before the machine can be supported at a new customer site, which not only cuts into the resale value, but also makes it difficult to resell on the open market. However, some manufacturers provide a warranty and clinical training as part of the recertification fee, which may actually enhance the machine’s resale value.

There are valid reasons for having this fee in place—ideally, it helps ensure safety for both patient and provider—but it still is a very significant cost that should be understood before the laser is purchased. This is one reason why it’s very important to make sure that the laser you’re purchasing can be supported by your market. If, after a few months, you decide that the equipment is not ideal, you might be stuck with an extremely expensive piece of equipment you don’t use and can’t easily sell— since the secondary market for lasers can be extremely volatile and tends to favor buyers.

Prospective laser buyers should know that they can, in some instances, negotiate recertification fees, and some laser manufacturers are sometimes even willing to waive them altogether, typically when a practice is introducing laser treatments in markets where they have not yet proven to be successful. In fact, some manufacturers will even offer to repurchase the machine after a period of time if customers can show that their market is not responding to the product offerings. However, these are all things that must be negotiated into the contract before the sale is finalized. If the contract is signed and these elements aren’t included, you are out of luck.

Resale restriction. A resale restriction dictates that the customer cannot resell a laser without the manufacturer’s approval, or that the laser must be sold back to the manufacturer at a discounted price. As with recertification fees, there are valid reasons for these provisions; however, they can limit a practice’s options when it purchases new technology. Horror stories abound of medical spas with functional laser technology that they don’t use anymore because newer models were released. I’ve seen practices that have more than $1 million worth of technology sitting in a room gathering dust because they simply can’t do anything with them due to contractual restrictions and a weak secondary market.

However, as is the case with recertification fees, a resale restriction can be negotiated. Again, it is extremely important that the customer recognizes these provisions prior to signing the contract in order to maintain leverage. Reputable laser companies stand behind their products and typically have no issues working with new clients to make sure they are satisfied. If nothing else, a good sales rep should explain this provision so that the customer understands why it is there and how it is designed to help the customer.

Service clauses and warranties. Although they are commonly found in medical spas and aesthetic practices, let’s not forget that these machines actually fire lasers. This technology was science fiction in the relatively recent past. These are very sophisticated, sensitive pieces of machinery, and no matter how reputable the manufacturer, the machine will need to be serviced at some point. Good companies ensure that the customer endures little downtime and expense in these situations, but it’s up to the customer to make sure that everything that needs to be covered is covered for a reasonable amount of time, and that service is guaranteed to occur in a timely manner. After all, every day that the machine is offline is a day it is not generating revenue.

Prospective customers need to learn about exactly what happens if the machine breaks, what is covered—and what is not—under the warranty, and what the included customer support entails. Moreover, they must get as much as possible in writing so that they are guaranteed to have efficient, cost-effective service.

Know What You Don’t Know

For a medical aesthetic practice, offering laser treatments can be extremely lucrative, but buying a laser is much more complicated than simply going down to the neighborhood laser store and picking one out. If you know of a lawyer who has experience negotiating laser contracts, it is in your best interest to hire him or her to help negotiate this transaction.

Tags:  AmSpa's 2019 Medical Spa Statistical Survey  Business and Financials  Med Spa Trends 

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Join AmSpa at the Orlando Medical Spa & Aesthetic Boot Camp

Posted By Administration, Friday, October 25, 2019

caribe royale orlando

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

Starting next Saturday, November 2, AmSpa will host its Orlando Medical Spa & Aesthetic Boot Camp at Caribe Royale Orlando. This is the last AmSpa Boot Camp until April 2020, so if you are a medical aesthetic professional who wants to learn how to improve your practice, make your plans to join us next weekend. There’s still time to register for the event—just click here to sign up.

Here is a quick overview of the program:

Saturday, November 2

The Boot Camp begins at 8 a.m. with a continental breakfast, followed at 8:30 a.m. with my opening keynote. From there, we will move into the main program:

  • 9 – 10:30 a.m.: The Plan, presented by Bryan Durocher (Durocher Enterprises)—What are the most effective ways to develop a business plan for your medical spa? Medical Spa Consultant Bryan Durocher discusses the ins and outs of the planning process and helps determine how long it realistically takes to open a practice.
  • 10:45 – 11:45 a.m.: The Lessons, presented by Louis Frisina—Every medical spa is different, but the successful ones share several common traits. In this session, Business Strategy Consultant Louis Frisina discusses the qualities that are typically found in practices that bring in a significant amount of revenue.
  • 12:45 – 1:30 p.m.: Medical Aesthetic Hot Topics Panel, featuring Tim Sawyer (Crystal Clear Digital Marketing), Candace Noonan (Environ Skincare) and Gail Winneshiek (Galderma)—This panel, moderated by yours truly, will feature a spirited discussion of the current issues and events that concern medical spa owners and operators.
  • 1:30 – 3:30 p.m.: The Law, presented by Alex Thiersch (AmSpa) and Bradford Adatto (ByrdAdatto)—In this presentation, we’ll discuss the long-standing and emerging legal issues that every medical spa owner needs to know about. As you can imagine, there is a lot to cover here, since new concerns seem to be arising daily lately.
  • 4:15 – 5 p.m.: The Treatments, presented by Terri Ross (Terri Ross Consulting)—Learn about the most profitable and popular treatments available to your practice, and find out how to best determine which treatments are right for you based on the state of your practice.
  • 5 – 6 p.m.: The Digital Marketing Ecosystem, presented by Tim Sawyer (Crystal Clear Digital Marketing)—Find out how to effectively spread the word about your medical aesthetic practice and how best to determine what’s working and what’s not. Your practice’s digital presence is more important than ever before, and curating it should be a top priority.

Saturday will wrap up with a cocktail reception from 6 – 7:30 p.m.

Sunday, November 3

Once again, the Boot Camp begins at 8 a.m. with a continental breakfast.

  • 8:30 – 9 a.m.: Anatomy of a $5-Million Med Spa, presented by Alex Thiersch (AmSpa)—Have you ever wondered what the difference is between your medical spa and one that’s mega-successful? It might be less significant than you think. This presentation will show what a $5-million med spa is doing right—and what you might be doing wrong.
  • 9 – 10 a.m.: The Financials, presented by Bryan Durocher (Durocher Enterprises)—At the end of the day, the money you’re bringing in is the most important measure of your practice’s success. This presentation will, among other things, demonstrate how to properly develop a budget and use metrics to determine your med spa’s strengths and weaknesses.
  • 10:30 – 11:30 a.m.: The Long-term Revenue, presented by Brandon and Jenny Robinson (Skin Body Soul)—Simply being successful isn’t enough for a medical aesthetic practice; you have to know how to maintain and grow your success. In this session, Bryan will show you how to build patient loyalty and move your business forward.
  • 11:30 a.m. – 12:15 p.m.: The Consultation, presented by Terri Ross (Terri Ross Consulting)—As the old saying goes, you never get a second chance to make a first impression. Learn how to put your best foot forward with effective patient consultations—and how to turn them into consistent business.
  • 1 – 2 p.m.: The Marketing Plan and Social Media, presented by Brandon and Jenny Robinson (Skin Body Soul)—This session will help you determine how to most effectively market your medical aesthetic practice using both traditional methods and cutting-edge techniques.
  • 2 – 3 p.m.: The Team, presented by Bryan Durocher (Durocher Enterprises)—A medical spa is only as good as its personnel, so it’s important to make sure that you hire a staff that can do everything you want it to—and more. In this session, you’ll learn about recruiting, hiring and retaining employees who can make your medical spa dreams come true.

Also, you’ll have the chance to visit with a number of exceptional vendors during this event. Attend the Orlando Medical Spa & Aesthetic Boot Camp to check out the latest and greatest from the following companies:

We hope you can join us in Orlando next weekend. This Boot Camp is a tremendous opportunity to get a medical aesthetic business started off on the right foot, and learn how to take an already successful business to the next level. Click here to register!

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Business and Financials  Med Spa Law  Med Spa Trends 

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Email Marketing Strategies: Targeted Newsletters

Posted By Administration, Wednesday, October 23, 2019

email marketing

By Terri Ross, Terri Ross Consulting

Once you have identified and attracted the attention of your patient population, it is essential to stay in touch. One of the easiest and most direct ways to do this is to send out targeted newsletters that inform prospective and current patients alike about new treatments, new technology in the field of medical aesthetics and special rates your office is offering. As I discussed in my blog on building an effective marketing program, once you have identified your target population, developing personalized marketing tools to guide them toward a consultation appointment is the next step.

Identify Your Patient Population

Identifying your patient population is the most critical aspect of a successful marketing program. Your patient population consists of current patients, new patients and prospective patients. To market to each of these groups effectively, you will need to first establish communication—collect basic contact information, including their email addresses.

Current/new patients: For current and new patients, the process of establishing a connection and recording patient information has likely already taken place. From the very first appointment, your front office staff should be engaging, be knowledgeable and work to establish a personal connection with each patient. (Click here to learn about the LAER model I developed for training front office staff here.) This includes collecting basic patient history and recording current contact information. If some patients are hesitant to relay their email or physical addresses, assure them that their information is protected and will not be shared with external parties.

Prospective patients: Establishing communication with prospective patients is a more challenging but equally important task. Consider what types of clientele you want to attract to your office and what types of treatments and technology might appeal to them. Find your patient niche and commit to it. From there, you can market specifically to this niche.

First, configure your website so it’s searchable to this population and create a page specifically for prospective patients. On this page, include concise and key information about your medical aesthetic office and what sets it above the rest. Offer information about a few key procedures and treatments you offer. Most importantly, include a well-defined banner that allows prospective patients to join your newsletter list by providing basic contact information, including their email address.

Attending and setting up booths at local, regional and national medical aesthetic conferences and shows is another way to secure and market to your prospective patient audience. This gives you a chance to market your office to a wider audience. Feature a sign-up sheet that promises attendees personalized treatment plans and special rates. Be sure to also assure prospective patients that their information will be protected.

To help organize your marketing materials and define strategies to market to current, new and prospective patients, divide patients into different groups based on their specific treatment/procedure interests, age and how many years they’ve been a patient with you (if relevant). This will allow you to personalize your marketing materials and send targeted newsletters to the right populations.

Select a Secure Email Marketing System

Practice-purchased: The best option—if you can allocate resources towards it—is to purchase a secure email marketing software for your medical aesthetic office. There are many solutions on the market to choose from, from simple platforms to sophisticated systems. Companies such as Campaign Enterprise offer business-level software for purchase that allow you to create your own database, tailor your own system and personalize your marketing materials. Click here to read more about this software. One of the advantages of this option is that you can keep all your patient information—including contact information—secure. No third party will have access to this information, making it protected and fully yours. This approach will take a greater investment of time and resources to fully set up, so you will need to budget for this expense upfront. You may also want to invest in training for key members of your office staff, to get the system up and running at full capacity. Once established, however, having a practice-purchased email marketing solution is the best option for the long-term.

Vendor-supplied: If you’re looking for a similar email marketing solution but for a fraction of the cost, purchasing a vendor-supplied system is the best option. There are countless options to choose from, so be diligent in your selection. Consider the size of your office, your budget, your desired materials and the types of patients you’ll want to target. Click here to read about some of the top vendor solutions. The advantages of this option include a lower cost, easier setup and, often, a lower startup burden compared to a practice-purchased system. Key features of many of these services include mass email capability, email scheduling and management, and formatted templates. You’ll be able to get this system up and running quickly, which means you’ll be able to reach your target audience faster. However, you may be limited with regards to the variety of materials you’re able to send, and you’ll have to pay per user, which can add up quickly. The main disadvantage to this option is that you’ll have to enter patient information into a third-party system. While many of these vendor solutions attempt to ensure reliability and security, your risk for patient data corruption and/or theft is increased. If you choose this option, be sure to review relevant HIPAA requirements to make sure patient data is as secure as possible.

In-house: You may be able to use in-house tools to manually create email lists, compile patient information and send out personalized marketing materials. This option will work in the short-term. Although it may seem like the most cost-effective solution, remember that this option will take more of your staff’s time and effort, and it requires constant attention, compared to practice-purchase and vendor-supplied software. As soon as your budget will allow, you’ll want to research and find the best professional marketing tool for your office.

Personalize Your Marketing Materials

Once you’ve identified your target patient population, organized their contact information and selected an email marketing solution, creating personalized marketing materials is your next step. The goal here is to make a connection with each patient. To prospective patients, create newsletters that emphasize what sets your office apart: medical expertise, educated staff and state-of-the-art technology. The key here is to make clear how your office stands above the competition. This will help you begin to establish a connection and guide prospective patients to come in for a consultation appointment. For new patients, you’ll want to send out monthly newsletters detailing new technology or services your office offers. Be sure to include special rates and information about personalized plans that would be available to them. For current patients, you want to maintain a personal connection. Tailor emails and newsletters to specific subsets of your patients. For example, you might send out information on the newest facial technology to patients who have expressed interest in these services in previous office visits or patient surveys. Through personalized marketing materials, you can establish and maintain a connection with your patients.

Follow Up

After sending out materials to your patients, you’ll want to strategically follow up. Reach out to new and prospective patients and make sure they’ve received all the information they need to make an informed decision about their medical aesthetic care. Invite them in for a free or reduced consultation appointment to get the ball rolling. Also, reach out to current patients and make sure they’re aware of new technology and/or treatments in the office, and answer any questions they may have. This also gives you a chance to record and address any concerns your patients may have, so you can be proactive in your service and offer top-of-the-line, personalized care.

Targeted email marketing is an essential component of a successful marketing program. To choose the right solution for you, schedule a strategy call with Terri today and take the first steps towards making and maintaining a connection with your patients today.

Terri Ross brings more than 20 years of sales and management experience to the field, having worked with leading-edge medical device companies such as Zeltiq, Medicis, EMD Serono, Merck Schering Plough and Indigo Medical, a surgical division of Johnson.

Ross’ vast knowledge and experience as a sales director managing upwards of $20M in revenue and successful teams has allowed her to become a renowned plastic surgery management consultant helping aesthetic practices thrive.

To optimize revenues and business performance, Ross’ practice management consulting services help physicians evaluate practice processes including, but not limited to, overall-operating efficiencies, staff skill assessment, customer service and operating efficiency strategies. The goal is to develop a comprehensive plan of action to improve productivity, quality, efficiency and return on investment.

Tags:  Business and Financials  Med Spa Trends  Terri Ross Consulting 

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Retail Rakes It In

Posted By Administration, Monday, October 21, 2019


By Michael Meyer, Content Writer/Editor, American Med Spa Association

Not every medical spa offers retail products, but according to the findings of the 2019 Medical Spa State of the Industry Report, those that don’t are missing out. The report reveals that 92% of medical spas sell skin care products as retail and that, each time patients decide to buy these products—an average of 81 times per month—they spend an average of $134 on them.

“High-volume retail sales are absolutely imperative for the profitability and long-term success of a medical spa,” says Bryan Durocher, a medical spa consultant and business development expert who is president of Durocher Enterprises. “In today’s competitive market, owners must invest not only in the products and merchandise stocked on the shelves, but also in properly ensuring their staff is adequately trained in how to sell retail, so that the products move off the shelves and into their patients’ hands. Developing a staff into the ultimate retailing dream team is the best, most underexposed and underutilized investment one can make.”

If someone comes into a medical spa from a medical background, it might seem somewhat gauche to him or her to place such an emphasis on retail sales. However, selling is a key part of what sets the medical aesthetic industry apart from more traditional medical services, and it is important that all providers understand that they are part of the sales process.

“Having meetings and educating the staff takes up a lot of time, and it can be annoying and make the week a little hectic and frantic, but it’s really important,” says Tanya McDevitt, practice manager for NeoSkin Center Medical Spa and Acne Clinic, a multi-million-dollar medical aesthetic practice located in Hudson, Ohio, a suburb of Cleveland. “Everyone in our facility is trained, from front desk to Dr. [Tricia] Bedrick [the practice’s owner]. Everyone gets the same amount of product training.”

McDevitt estimates that approximately 20-30% of NeoSkin’s revenue comes from retail sales. Maintaining or improving upon this is a top priority, and communicating with sales representatives from suppliers and manufacturers helps her and her staff understand how to best sell these items.

“I’ve really learned to utilize the sales reps for the products that we carry here,” McDevitt explains. “I really had to change my mind-set on that. I feel like setting aside the time with the rep—whether it’s a one-on-one with me to give me updated product information or to give Dr. Bedrick a one-on-one with updated product information or a team training—is just vitally important. They’re the experts on that line. I think a couple of my product reps are in here probably every two weeks. I love having them here. We learn something new every single time they come in, and I just think the presence of those reps is really important. And I can’t believe I’m saying that, because, at first, it really irritated me. But I find that they’re very helpful.”

A provider with excellent product knowledge can confidently tell a client about the benefits of a particular product, and a happy, well-informed client will very likely recommend the product to others.

“Your existing patients are the best and most cost-effective advertisement opportunities your medical spa has,” says Durocher. “When your staff properly educates their clients, they are able to maintain their service results at home. This ensures their satisfaction and return to your medical spa, while creating enthusiasm to spread the word about  their experiences.”

Given this, medical spa owners and operators should try to sell products that are not widely available or easily obtained from other outlets.

“Most of the product lines that we carry are not available to purchase online,” says McDevitt. “I feel like that makes us a destination, and our patients know that they can’t just log on to Amazon or somewhere else and purchase them. I think that makes us unique.”

Branded merchandise is another growing aspect of medical spa retail. According the 2019 Medical Spa State of the Industry Report, 19% of medical spas offer products such as t-shirts and jewelry, and while these products don’t sell in as great quantities as the skin care products—the average spend per patient is $45, and med spas report 38 purchases per month—but because they are so cheap to manufacture, they represent a relatively low-risk way to add to a practice’s bottom line.

But even if you feel that selling t-shirts is a step too far, embracing the retail side of the industry in a meaningful way can lead to higher profit margins and greater awareness of your business.

“We’re in a very small suburb outside Cleveland that’s a high-income area, and our lobby looks just like a storefront would if you were on the street and you could walk in,” says McDevitt. “It is so exciting and fun when people walk into our new space—they’re like, ‘Oh my gosh, I can’t believe how beautiful it is.’ And it looks like you’re in a retail store.”

Tags:  AmSpa's 2019 Medical Spa Statistical Survey  Business and Financials  Med Spa Trends  QP 

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Texas Medical Board Approves for Publication Changes to §193.17

Posted By Administration, Friday, October 18, 2019


By Patrick O’Brien, JD, legal coordinator, American Med Spa Association

The Texas Medical Board (TMB) Disciplinary Process Review Committee met in a public hearing on October 17 to consider its posted agenda. At the hearing, the board unanimously approved a motion to publish the TMB’s proposed changes to its Administrative Rule Chapter 193, Standing Delegation Orders, including Section 193.17 – Nonsurgical Medical Cosmetic Procedures, in the Texas Register. We covered some of the proposed changes discussed at last week’s meeting here. The TMB indicated that the version approved had been revised based on the feedback it received. However, the version of the rules approved at this week’s meeting won’t be available to review until they are published in the Texas Register. This publication will trigger a 30-day public comment period, after which the proposed rules will be eligible for adoption and approval at a hearing of the full medical board. AmSpa Members can click here to view additional analysis on the meeting from our lobbyist. We will keep you updated on developments once these rules are published.

Tags:  Med Spa Law  Med Spa Trends 

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AmSpa Member Spotlight: Amachi MedSpa

Posted By Administration, Tuesday, October 15, 2019

Watch this video to take a tour of Amachi MedSpa and learn about its most popular treatments. Located in Marietta, Georgia, Amachi MedSpa is led by Stanley Okoro, MD—a double board-certified plastic surgeon—and is a center of excellence for Thermi and BTL.

Spa Director Majeedah Deen attended AmSpa's 2019 Atlanta Boot Camp, and Dr. Okoro has been invited to speak at The Medical Spa Show 2020—he will be presenting “How to Incoporate Safe Injectables into Your Medical Spa” as part of the Clinical Practice and Technique: Today's Clinical Landscape track, from 5 – 5:25 pm on Friday, January 31.

To learn more about Amachi MedSpa, click here to visit its website.

The Medical Spa Show 2020 presented by AmSpa, is the only trade show in the United States focused solely on medical spas and non-invasive medical aesthetics. It will be held at The Aria Resort & Casino from January 31 – February 2, 2020. For more information, call 312-981-0993 or click here to visit the website.

Tags:  Member Spotlight  The Medical Spa Show 2020 

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A Booming Industry with Compliance Concerns

Posted By Administration, Monday, October 14, 2019

medical spa

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

Anyone involved in medical aesthetics can tell you that the industry has been absolutely booming for some time now. Whether you own a large medical spa, operate a small aesthetic practice, or sell devices to providers, chances are you’re making money. Good money.

And the industry has shown incredible resiliency and staying power, having remodeled itself after the 2008 recession into a larger, more profitable enterprise.

The numbers don’t lie. AmSpa recently released its 2019 Medical Spa State of the Industry Report, which details business, financial and treatment data relating to United States medical spas. The numbers are pretty impressive.

The report showed that the industry grew a whopping 50% in 2017 alone, with 2018 following close behind with 30% growth. Since 2011, when the industry really started to take off in its current form, it has grown an average of 28% every year. And it shows no signs of stopping. AmSpa forecasts nearly 20% growth every year for the next five years, projecting the industry will double in size from 5,400 medical spas in 2018 to more than 10,000 in 2023.

The medical spa industry is currently a $10-billion business that employs more than 53,000 people by itself (excluding other aesthetic practices such as plastic surgery and cosmetic dermatology). It is on pace to become a $20-billion industry in short order. This places it among the fastest-growing industries in America.

So what’s not to like? Strong growth, better technology, increased appetite for non-invasive techniques that make customers look younger—it all looks good, right?

Although all signs point to continued robust growth, one issue lurks beneath the surface that continues to nag at the industry as a whole. It is the one problem that the industry can’t seem to get its hands around and, until it does, it risks not only never reaching its full potential, but also causing the industry to crumble under its own weight.

I’m talking about compliance. AmSpa’s report also took a high-level snapshot of how the medical spa industry functions from a legal and regulatory standpoint. It’s critical to remember that this industry is made up of medical spas—businesses that are medical facilities governed by the same regulations that orthopedic surgeons, family practice doctors and cardiologists, for example, must follow. These rules are enforced by state medical and nursing boards, the U.S. Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA), as well as state attorneys general. These are mandatory regulations that, when broken—even if just a little bit—can result in loss of license, hefty fines and even imprisonment.

All of these outcomes have occurred at an increasing rate during the past five years, and enforcement efforts are clearly increasing. Don’t believe me? Try typing “Botox arrest” or “med spa arrest” into Google and see what pops up.

It’s understandable, I suppose, that this industry would be slow to get on track legally. After all, with entrepreneurs and pharmaceutical companies raking in billions of dollars, it stands to reason that some shady characters would operate on the fringes. And there is no question that the applicable laws can be difficult to find, are sometimes fuzzy, and almost always are antiquated relics designed to apply to a different era of medicine. With so much new technology and so many new opportunities coming together in one industry, it is not surprising that many providers have struggled to determine what rules apply, and when. Don’t believe me? Just try calling your state medical board or nursing board.

But it’s time to get serious—and fast­—because as the industry innovates, creates and adds zeros to its bottom line, more and more opportunists take notice. Turf wars are developing between medical providers and societies. Industry executives are carving out pieces of the pie exclusively for themselves. Scammers are emerging, as are get-rich-quick schemes. And state and federal authorities are opening their eyes and actually paying attention.

Here’s the bottom line: If the medical spa industry doesn’t get its act together and focus on becoming safe, compliant and trustworthy, a reckoning will come in the form of over-regulation, truly bad publicity and public distrust—none of which are good for consistent growth.

And let’s be honest with ourselves here: Many of the rules that are being broken are not terribly difficult to wrap our heads around. Should an aesthetician with zero medical training, no oversight or supervision, and no hospital privileges be performing lip injections that can cause a patient to go blind if side effects aren’t handled properly? Should lasers that can quite literally burn a patient’s skin off their faces be administered without oversight or medical supervision?

AmSpa’s 2019 Medical Spa State of the Industry Report found that 13% of medical spas don’t perform any medical consultation prior to treatment, and that 15% of medical spas have someone other than a registered nurse, nurse practitioner, physician assistant or doctor performing injectable procedures. Five percent of medical spas admit that they have employees with no medical training whatsoever performing injections.

Take a step back and really think about those statistics. There are close to 1,000 medical spas in this country where a patient can be injected with toxin or fillers—treatments with potential outcomes that, if untreated, have been scientifically proven to cause serious side effects—without ever seeing a qualified medical professional. Or where a technician can fire a laser capable of causing third-degree burns and permanent disfigurement without any medical supervision whatsoever. Now imagine the news coverage and subsequent legal and legislative action that would result from even one individual going blind from a filler injection from an unqualified provider, or one high-profile individual being permanently scarred from laser burns. The results won’t be pretty.

Physician oversight is crucial, as are minimum training standards. Basic requirements must be universally adopted and self-enforced. The public must be convinced beyond any doubt that all medical spas are just as safe—if not safer—than plastic surgery offices or dermatology practices. AmSpa, with its partners at the law firm of ByrdAdatto, has been working tirelessly for more than six years to educate the industry on the basic requirements needed to make it safe and allow it to grow to its full potential.

Tags:  AmSpa's 2019 Medical Spa Statistical Survey  Med Spa Law  Med Spa Trends  QP 

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