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The Pros & Cons of Membership Programs for Medical Spas

Posted By Administration, Monday, April 8, 2019

business growth

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

In 2019, it seems that people have subscriptions to everything. When they shop, they go to Costco or use their Amazon Prime membership. When they eat, they prepare a meal kit that was shipped to them by a Blue Apron or HelloFresh. When they want entertainment, they watch movies or television from Netflix or Hulu.

Now medical spas are getting in on the act by offering patients subscriptions for their services, and while practices are still feeling their way around the specifics of what can make a successful membership program, the experiences of early adopters suggest that the subscription model has legs, as it can build loyalty for your practice and provide the customer with consistent results.

“You want your patients to come back, on average, 3.5 times a year,” said Dr. A. Jay Burns, senior partner at Dallas Plastic Surgery Institute and board member of HintMD, a cloud-based patient engagement and commerce platform. “When we go into every practice, we will pull their data, and the average number of visits per year is 1.44, not 3.5. If they join the subscription model, they come 2.9 times a year, they spend 35% more—so it’s good for a run rate—and they come back more loyal, so it’s good for the doctor.”

There are two major types of membership models: static and dynamic. Static models typically feature the client paying a monthly fee for either a certain number of treatments per month or a percentage off of those treatments. Dynamic models are much more complex and are tailored around a patient’s usage patterns. Companies such as HintMD are working to develop dynamic models for their clients, but early results are extremely encouraging.

Regardless of their type, membership programs provide customers with cost benefits beyond what they experience as a normal patient.

“Something I always stress whenever anyone sets up a membership program is value for the customer,” said Brandon H. Robinson, founder of Skin Body Soul Spa of Ankeny and West Des Moines, Iowa. “If your medical spa sells Botox at $14 per unit, then your membership should give your members Botox at a value far exceeding the monthly fee, based on the average number of units that member would utilize. It needs to be substantial. Another example is a ‘Kiss Club’ for perfect lips. The membership is $19 per month, and the filler is over $200 off. This makes the membership valuable for that client and will make them want to come back for more filler every nine months.”

While this might make it seem that medical aesthetics practices might lose money on these programs, the loyalty these memberships build more than pays for the initial losses over the life of the program.

“We pulled all of our data for the last [American Society of Aesthetic Plastic Surgeons (ASAPS)] meeting, and at that time in April [2018]—I had started in September [2017]—I had 377 members,” Burns said. “The average increase in run rate, or spend, per patient was $1,196. My patients went from coming 1.7 times a year to 3.03 times a year. They spent 35% more per visit. It wasn’t just the run rate, either. I had a 33% increase rate in people using filler who had never used filler, so they get used to their subscription, and then they make an additional purchase because they’re comfortable with that level.”

If you feel your patient base could be more engaged with your practice and you have the logistical infrastructure to handle it, a membership program might prove very beneficial.

Tags:  Business and Financials  Med Spa Trends 

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Legislative Update: PAs & APRNs Gain Ground in First Quarter of 2019

Posted By Administration, Friday, April 5, 2019

legislature

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

As the first quarter of 2019 draw to a close, so does a flurry of new bills being filed in legislative bodies across the country, and a good number of these bills may affect how medical spas operate. Additional bills will continue to trickle in, but in many states, congressional and senate sessions adjourn in late spring or early summer, so this is by far the busiest season of the year for new legislation. Tens of thousands of bills have been filed, and some have the potential to affect the medical aesthetic industry. If you are an AmSpa Plus Member, you may have received updates about legislation of interest in your state. Here is a short recap of the bills we’ve seen so far and some possible trends that may be emerging.

A move towards independent or less restrictive practice for advance practice registered nurses (APRNs) and physician assistants (PAs) is by far the most prominent development we have observed. These bills run the gamut from allowing physicians to oversee more PAs and APRNs to allowing PAs and APRNs to practice without any formal agreement or supervisory relationship at all. If these bills pass, they will change the landscape of medical practice. Once health professionals are able to practice on their own, it will lead to an explosion of independent practices and clinics, and that almost certainly will include practices that focus on aesthetic procedures. We’ll provide a deeper dive into these bills in a future article.

Next, we have not so much a trend, but rather a class of bills that would regulate aspects of medical practice or procedures at medical spas. For example, AB 821 and SB 2834 in New York would provide a regulation and licensing regime for the practice of laser hair removal, a practice that currently is unregulated in the state. Both Colorado and Oregon have introduced bills to regulate smoke that results from laser procedures; these laws currently would only affect hospitals and ambulatory surgical centers, but could easily be expanded to include all laser procedure practices. In Kansas, SB 120 would allow corporations to practice medicine. In Arizona, SB 1287 would allow laser technicians to perform procedures without medical supervision—instead, they only would be overseen by a laser safety officer. And in Florida, SB 732 originally would have brought significantly more regulations to medical spas but has since been amended to be less onerous. Most recently, in Texas, SB 2366—which we have covered in previous articles and a webinar—would greatly restrict who could perform procedures in a medical spa.

Overall, a mix of beneficial, neutral and restrictive bills has been introduced this year. However, the restrictive bills would prove far more damaging than the “good” bills are beneficial if they pass. All new laws will result in a period of compliance and adaptation. Good bills may let medical aesthetic professionals do things they couldn’t do before or streamline processes. Restrictive bills, on the other hand, may impose entirely new requirements or make some of current practices illegal or uneconomical. It could only take a single bill passing to disrupt the whole industry—successful bills often spread to other states, as legislators look to other states for inspiration for their efforts, so a successful push for a restrictive law in the name of “public safety” may continue in other states. That is why it is critical, now more than ever, to come together as an industry to help determine the rules and regulations that affect this industry. The aesthetic medical field is growing larger every year, and every year will bring more notice from lawmakers.

To receive updates whenever new laws are introduced in your state, become an AmSpa Member—click here to learn more. There is no better way to keep track of the legal matters that affect your medical aesthetic practice.

Tags:  Med Spa Employee Types  Med Spa Law  Med Spa Trends 

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Do You Believe Strong Leadership Can Affect Your Medical Spa’s Profitability?

Posted By Administration, Thursday, April 4, 2019

money

By Tim Sawyer, president & co-founder of Crystal Clear Digital Marketing

Does anyone in the med spa industry think strong leadership can affect profitability?

If you had asked me this question a week ago, I would have replied with a resounding, “Yes, of course.” After my experience this past weekend, I’m not so sure. In fact, I am more convinced that the basic concept of leadership in this community is not just undervalued, but almost deemed irrelevant. While I have given many talks on the subject at dozens of shows—including The Medical Spa Show, Vegas Cosmetic Surgery, A4M and The Aesthetic Show, to name a few—my experience this past weekend cemented my belief that now more than ever, we need to keep this topic in the forefront of our discussion through our lectures, blog posts, podcasts and national meetings.

Why? As the co-founder of two separate marketing and software businesses appearing in the Inc. 500 list of fastest-growing privately held companies, I am a firm believer in the very direct link between strong leadership and profitability. As a lifelong entrepreneur, I am constantly bombarded with books, seminars, podcasts and events touting the value and strategies for effective modern leadership. I get it. No leadership equals no sustainable growth. As a former business student, it’s one of those, “Duh, obvious,” things. For surgeons and med spa owners who have spent their lives focused on anatomy, clinical outcomes and patient safety—not so much. And I am not suggesting there is a lack of desire to be stronger leaders; I am suggesting there is diminished value and a lack of understanding.

Back to this past weekend. As I walked onstage to deliver my best 15-minute lecture on leadership, about 40% of the 150 attendees in the room—mostly surgeons—took the opportunity to use this time to take a break, get coffee and mingle. In other words, almost half of the attendees viewed this topic as somewhat irrelevant.

At this point, I know what you’re thinking: “Tim is a sore loser because people walked out of his talk.” Fair enough, and there may be some truth to that. However, it is more concerning to me that these leaders lacked the appreciation of the important role they play in their practices’ success outside of the 12-hour days spent doing treatments and procedures. In fact, I even asked the question, “How many of you want to spend the rest of your lives working 12-hour days with your primary (only) source of revenue coming from your physical labor?” Of course, that drew some intense stares, intentionally. Because this is what is at stake for many of the people in the room.

Entrepreneurs understand that you can’t scale a business if the majority of the revenue comes from the owner’s direct labor. To further explore this concept, I recommend you read The E-Myth; this would be a great investment of your time if this topic is remotely interesting to you. To get scale in your business, surrounding yourself with great people who can also make significant contributions to the business in terms of revenue is the number-one priority. The most successful entrepreneurs know they have done their job well when their businesses can function on its own with little or no direct involvement or supervision from the founders. Many of these strong leaders begin their business with the end in mind. They ask the question, “What do I need to do in this circumstance to create an entity that is either investable by others or saleable to another entity?” More simply put, if I bust my butt for 10 years, how do I exit and get paid? This is every entrepreneur’s dream.

That said, the rules are a little different in elective medicine, as the skills and training of the surgeon or provider essentially represent 100% of the value of the practice. And here’s the billion-dollar question: Is the current state a situation that can never be changed, or is there perhaps another way of looking at the role of the modern entrepreneurial surgeon leader?

I think part of the problem lies in the way we talk about, celebrate and showcase only those practices experiencing hypergrowth (for a variety of reasons, and I include myself in this group). We create this unrealistic expectation that anyone who applies this model or buys that device will immediately ascend to the elective medical elite, which is at best a bunch of B.S. When we do this, we disenfranchise the 90% of practices and med spas that could benefit the most from applying a few basic leadership principles, even if they only have a few employees.

Here are a few principles you can apply right away to increase the value of your practice and set it on a path to realistic sustainable growth. First, ask yourself, “Do I believe there is a correlation between effective leadership and increased profitability?” If the answer is no, sorry about the time you wasted reading this, and hopefully you will find my next article more valuable.

When I pose this question to live audiences, I always get a lukewarm response. But let’s assume we agree that leadership could make a 10% difference in the profit of your clinic. So, step one is to assign a dollar value to the 10%. Now, the next logical step (if we agree) is to first be realistic. Do you spend 10% of your time working on your leadership skills and strategic thinking? If the answer is no, we have already diagnosed a major problem, which is great and free.

Next, how can you put leadership to work in a small elective medical practice?

  • Lead yourself. Be mindful of the words you use, be respectful to employees and manage to your principles. Ask yourself, “What are my most important guiding principles that I will not compromise?” Are you walking that out daily?
  • Share skills. Employee turnover hurts when you have invested time and energy into training. Get over it. Things could be worse, like if you don’t train them and they never leave… yikes. Don’t forget—if you’re not training someone up to replace you, you will never be replaced. (Cue the surgeon-working-in-a-coffin music.)
  • Train and practice together. It’s a team and you’re the leader. Lead. This requires time. If you make it a priority and then a habit, you will improve the culture in your practice.
  • Hold your team accountable.
  • Have a plan, set goals and manage to the plan. You can’t manage what you can’t measure.
  • Share your vision and passion often. People love to feel like they are a part of something special.
  • Incentivize the right behaviors and address the wrong ones.
  • Be inspired. These simple universal truths can apply to any business of any size. You don’t need more consultants, more devices or more marketing. You just need some time to reflect in front of the mirror. Look past the outside and the comparative narrative and focus on the incredible leader inside of you. This is truly one of those scenarios where size doesn’t matter. Crystal Clear started with three employees, and now we have 80. Remember, if we agree that improved leadership skills could make just a 10% difference in the profitability of the business, that’s 10% more time and money you have to do the things that mean the most.

In addition to a world-class digital marketing and software platform, Crystal Clear offers a full-service consulting team to help you get the most out of your people, your processes and the tools you use to grow your clinic in 2019 and beyond. We get it. You can’t do everything by yourself. Fortunately, you don’t have to. Our world-class training team is here to help. They have been in your shoes in real life, long before becoming trainers. To learn more about Crystal Clear, visit www.crystalcleardm.com or call 888.611.8279.

Tags:  Business and Financials  Guest Post  Med Spa Ownership  Med Spa Trends 

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Join AmSpa at the L.A. Medical Spa & Aesthetic Boot Camp

Posted By Administration, Wednesday, April 3, 2019

la boot camp

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

We are just a few days away from AmSpa’s Los Angeles Medical Spa & Aesthetic Boot Camp at the Sofitel Los Angeles at Beverly Hills, and we’re extremely excited for the opportunity to help medical aesthetic professionals develop their practices. There's still time to register for the event—just click here to sign up. Here’s a quick overview of the program:

Friday, April 5

Prior to the Boot Camp, AmSpa will present a special after-hours tour of the Lasky Aesthetics & Laser Center, one of the most successful medical spas in the United States. This event, which is sponsored by BTL Aesthetics, takes place from 5:30 – 7:30 p.m. PST and will show attendees how this well-appointed practice makes its clients comfortable while providing a high standard of service. Space for this exciting event is limited, so click here to register.

Saturday, April 6

The Boot Camp begins at 8 a.m. with a 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.
  • 11 a.m. – 12 p.m.: The Marketing Plan and Social Media, presented by Brandon and Jenny Robinson (Skin Body Soul MedSpa)—This session will help you determine how to most effectively market your medical aesthetic practice using both traditional methods and cutting-edge techniques.
  • 1 – 1:30 p.m.: Medical Aesthetic Hot Topics Panel, featuring Toni Lee Roldan-Ortiz (Environ Skincare) and Tim Sawyer (Crystal Clear Digital Marketing)—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 Michael Byrd (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 (Lasky Aesthetics)—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, April 7

Once again, the Boot Camp begins at 8 a.m. with a 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 MedSpa)—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, the Robinsons 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 (Lasky Aesthetics)—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 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.
  • 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 throughout this event. Attend the L.A. Medical Spa Boot Camp to check out the latest and greatest from the following companies:

We hope you can join us in Los Angeles this weekend. This AmSpa Boot Camp is a tremendous opportunity to get your medical aesthetic business headed in the right direction and learn some tips and tricks that can take it to the next level. Click here to register!

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

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What Texas Senate Bill 2366 Means for the Med Spa Industry

Posted By Administration, Tuesday, April 2, 2019

texas state house

By Courtney P. Cowan, JD, associate attorney, ByrdAdatto

As many in the med spa industry are aware, Texas Senate Bill 2366 (SB 2366) was introduced earlier this month in the current legislative session. Almost instantaneously, it sent shockwaves through the medical community when it was filed by Senator Brian Hughes of District 1 on March 8th.

For context, the 86th Texas legislative session began on January 8, 2019, with almost 9,000 bills being introduced this session. March 8 was the last day to file a bill for the current session, which is notable since that was also the same day SB 2366 was filed. The regular session ends on May 27, 2019.

As the second step in a long legislative process, SB 2366 has been assigned to the Senate Business & Commerce Committee. This Committee will look over SB 2366, deliberate it, recommend it for amendment, and hold public hearing on it. At the end of its review of the bill, the Committee will give a report back to the Senate at large, which will then decide whether SB 2366 should be approved or disapproved. If it is approved, then SB 2366 will go to the Texas House of Representatives for review, repeating the entire process described above again before going to the Governor to be approved as law.

ByrdAdatto and American Med Spa Association (AmSpa) have been in contact with Senator Hughes’s office to gather more insight into the introduction of SB 2366. After speaking with a representative for Senator Hughes, his office commented that SB 2366 as it was introduced was not the intended language of the Senator. Moreover, the representative also stated that the response from the industry and stakeholders had been significantly more than they anticipated.

With all of that being said, it would take a lot of moving pieces, proposing and passing of more bills, as well as various legislative amendments for this bill to ever really take effect against delegated providers in the industry. Another point worth highlighting is that the first iteration of a bill, such as this one, will typically go through many revisions and amendments before ever getting passed (if ever). So even if SB 2366 goes into effect, it likely will look vastly different than the current proposed language.

Due to SB 2366 being such a hot topic within the industry, Patrick O’Brien of AmSpa and Samuel Pondrom of ByrdAdatto gave an in-depth webinar presentation for AmSpa regarding SB 2366. You can listen to Patrick and Sam’s discussion here.

ByrdAdatto understands that SB 2366 could impact Texas and its med spa industry in a big way, and we will continue to monitor the bill as it makes its way through the legislature. While it is uncertain whether SB 2366 will become law, it should be recognized that as the med spa industry continues to expand and grow, there will continue to be legislation implemented to regulate it.

As the daughter of a periodontist, Courtney P. Cowan has been fascinated by the health care field since childhood. Courtney often accompanied her father to his office where she developed an appreciation for physicians and their respective practices. Having absolutely no dexterity that is required to be a surgeon, however, Courtney 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 Courtney discovered her passion for the law. After graduating from SMU Dedman School of Law, Courtney serendipitously connected with ByrdAdatto and now assists our clients by combining her business background with her enthusiasm for health care and the law.

Tags:  Business and Financials  Med Spa Employee Types  Med Spa Law 

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How Do You Open a Med Spa?

Posted By Mike Meyer, Monday, April 1, 2019
Updated: Tuesday, April 2, 2019

open for business

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

Opening any business involves numerous complications that are difficult to predict and prepare for, but opening a medical spa is significantly more complicated than creating most other types of businesses. After all, a medical spa requires high-level business acumen, a thorough understanding of local medical rules and regulations, and dedicated, properly trained employees in order to succeed.

That’s a tall order when you’re just starting out, but help is available. If you find yourself overwhelmed by the obstacles in your way, you may want to attend one of AmSpa’s Medical Aesthetic Boot Camps. Early-bird registration for the Chicago Boot Camp—which takes place at the Chicago Marriott Southwest at Burr Ridge on May 4 – 5—ends at 11:59 p.m. EST on April 4, so if you’re near the Windy City and want to learn more about how to make your medical spa a success from day one, you can do so at a discounted rate until then.

Develop a Business Plan

Creating a detailed business plan is a vital step for any prospective business, and a medical aesthetics practice needs to address an unusual number of issues. Where will the business be located? How will it be designed? What will set it apart from its competition? How will you go about recruiting talented employees? What will you do to attract patients? What types of patients do you wish to attract? All these questions and many more will need to be addressed at the earliest stages of your business’ development.

Learn About Compliance

New medical spa owners might not know much about the rules and regulations they’ll be expected to follow when they enter the medical aesthetic industry, but it is important that they learn as quickly as possible. The “medical” part of the equation makes operating a medical spa much more complex than it would be if it was simply offering aesthetic services such as facials and manicures. The practice’s ownership structure must be developed in accordance with state laws, and that’s just the start—all medical treatments must be performed with proper supervision, and all marketing must be conducted with special attention paid to patient privacy and other factors. Regulations vary from state to state, so there is no one way to approach this, but it is extremely important that you develop an understanding of what is expected of a compliant practice.

Plan for the Future

The medical aesthetic industry is constantly changing, and understanding the metrics that provide the best insight into medical spa success can help keep you ahead of the curve. It is also important to learn how to efficiently operate and maintain the value of your practice. Your practice is about to become your life, so you need to know what you can do to make it as healthy as possible for as long as possible. And while you probably won’t want to think too much about your exit strategy while you’re opening your practice, it’s probably worth having that conversation with your partners, financial consultants and attorneys, as well.

These topics and many more are addressed at AmSpa’s Medical Aesthetics Boot Camps. If you are preparing to open a practice, it’s certainly worth your while to attend one near you. Early-bird pricing for the Chicago Boot Camp can be secured until 11:59 p.m. on April 4, so if you want to attend, click here to register. If you can’t attend the Chicago Boot Camp, keep in mind that subsequent 2019 Boot Camp events are scheduled for Atlanta, Seattle, Dallas, New York and Orlando; early-bird pricing is available for all of these events right now, so sign up today.

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

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Aesthetic Manufacturers Beware: Offering “Marketing Support” and “Practice Management Support” to Practices May Be Illegal

Posted By Administration, Friday, March 29, 2019

justice department

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa), & Patrick O’Brien, JD, legal coordinator for the American Med Spa Association

The U.S. Department of Justice (DOJ) issued a press release that may have a profound impact on the aesthetics industry as we know it. In settling an anti-kickback and False Claims Act claim against medical device manufacturer Covidien, the feds stated that device manufacturers who provide complimentary marketing support, product marketing plans and advertising support as incentives to purchase their products are engaging in an illegal kickback scheme. Even providing complimentary “lunch and learns” to customers may violate anti-kickback laws.

The DOJ enforcing the Anti-Kickback Statute and the False Claims Act is not unusual, and those of you familiar with AmSpa know we often warn practices of federal and state anti-kickback laws. What is unusual about this case, however, is the form the alleged kickbacks took—instead of money, the company offered free or reduced-cost marketing and advertising support, something that occurs all the time in the aesthetics industry.

Let me know if this sounds familiar: As part of its sales strategy, Covidien—which produces and sells a radiofrequency ablation catheter device called “ClosureFast”—would provide free marketing and practice support to physicians who purchased the devices to help them establish and grow their ClosureFast practices. This included providing the physicians with customized marketing plans and hosting “lunch and learn” meetings to educate area physicians about the purchaser’s ClosureFast vein practice in the hope of generating referrals.

Well, guess what? This non-monetary support constitutes an illegal kickback, alleges the DOJ, and can expose offenders to fines and even criminal liability.

The DOJ makes clear in its press release that these types of remuneration are treated the same as monetary kickbacks and will be actively pursued. Although the DOJ’s press release describes the marketing and sales support as being very tailored and specific to the individual practices, it does not indicate that this was a deciding factor in its pursuit of this case. Based on the press release’s rationale, many other types of non-monetary support also could be seen as kickbacks; this may include common industry practices such as providing advertising and marketing materials or services to new device purchasers. As is often the case with high-profile enforcement actions, this may mark the beginning of additional enforcement—not only at the federal level, but also for states acting under their own anti-kickback statutes.

While most medical spas are not directly affected by this new enforcement angle because they don’t bill to Medicare or Medicaid, it is conceivable that state enforcement agencies may take a closer look at these practices in light of the broad language contained in state anti-referral and anti-patient solicitation statutes. These state rules often apply to medical practices regardless of whether they bill to insurance.

This is potentially huge news for manufacturers in the industry. Stay tuned—AmSpa’s lawyers are dissecting the decision to determine its impact on the industry.

Tags:  Business and Financials  Med Spa Law 

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Apply to Join AmSpa’s Mastermind Group Today

Posted By Administration, Thursday, March 28, 2019

mastermind group

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

Shortly before The Medical Spa Show 2019, I posted in this space about the value and utility of mastermind groups—groups of like-minded business leaders who congregate occasionally to share ideas and encourage each other to address their issues with an entrepreneurial mindset. At The Medical Spa Show, AmSpa announced the Aesthetic Mastermind groups, which provide the benefits of a mastermind experience while addressing the specific issues facing medical spa owners and operators.

The Aesthetic Mastermind is not a standard mastermind group—it is custom-designed for medical aesthetic practice owners. Instead of having one large group, the Aesthetic Mastermind will be split into smaller groups of up to five people; the membership is based on factors such as revenue, location and business stage. (Direct competitors will be added to separate groups.) Each group will challenge owners to not only maintain sensible, realistic business plans based on reliable metrics, but also expand their visions in order to become an even more effective entrepreneur.

Each group begins with a three-day, two-night “Vision Quest” retreat. This gathering will feature an experienced business coach and is designed to help group members step back from their day-to-day businesses and create a rapport with their fellow owners, share their business experiences and learn about the industry from a number of different perspectives. After the Vision Quest, the group will meet once a month, 11 times per year, via teleconference; each meeting will include the business coach to keep the group on track and “hot seat” sessions for each member. Before the actual meeting, a guest from the industry will speak about his or her experience and field questions from group members.

Watch business coach Wendy Collier discuss the Aesthetic Mastermind in this brief video.

This package costs $7,995 for the entire year, though AmSpa Members will receive an additional $500 off. Importantly, the Vision Quest’s lodging, meals and program materials are included in this cost; airfare is not included, but AmSpa can provide booking assistance for your flights.

Prospective group members must complete an application so that they are placed in groups that can effectively address their professional needs. Click here to fill out the application.

May 1 is the deadline for registration for the first session of the Aesthetic Mastermind, so fill out your application today and become a part of this exciting project. You won’t find a better opportunity to learn about the medical aesthetic industry from your peers in a format that encourages entrepreneurship, so act now.

Tags:  Business and Financials  Med Spa Trends  The Medical Spa Show 2019 

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Who Can Perform Microneedling?

Posted By Administration, Wednesday, March 27, 2019

microneedling

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

Microneedling is a popular procedure in med spas, but many owners and practitioners do not know if aestheticians can legally perform the treatment. As is the case with many regulatory issues in the medical spa industry, the answer can vary depending on what state you practice in. In much of the United States, however, the answer likely is no.

Also known as collagen induction therapy, microneedling is a minimally invasive treatment that is designed to rejuvenate the skin. A device with fine needles creates tiny punctures in the top layer of the skin, which triggers the body to create new collagen and elastin.

Is It Medicine?

An aesthetician’s license does not permit him or her to perform medical treatments; rather, aestheticians may only perform procedures for the purpose of beautification. Many med spas look at these standards and assume that aestheticians can perform microneedling; however, many state regulatory boards specifically are classifying microneedling as medical treatment, no matter whether the needles actually penetrate the outer layer of the skin.

Illinois and California, for example, specifically listed microneedling as medical treatment in 2016 because they classified the device as medical equipment. At an American Med Spa Association Medical Spa Boot Camp in San Jose, Calif., Kristy Underwood, executive director of the California Board of Barbering and Cosmetology, gave additional details as part of a 30-minute Q&A session.

“This isn’t new—aestheticians cannot penetrate the skin,” Underwood said. “They also can’t use any metal needles, period. [California] aestheticians are prohibited from using metal needles.” She added that they cannot use anything that might be disapproved by the FDA.

For more business and legal med spa best practices, attend an AmSpa Medical Spa & Aesthetic Boot Camp near you.

Supervision & Delegation

In some states, however, people holding aesthetician licenses can perform certain medical procedures. These states differentiate between an aesthetician and a person who is performing medical procedures under the supervision and delegation of a physician.

This means that if the patient is first examined by a physician or a mid-level practitioner—a nurse practitioner or a physician assistant—an individual working in a medical spa may perform microneedling. However, it is very important to note that if aestheticians are going to perform this procedure under this caveat, they cannot represent themselves as aestheticians while doing so. This means aestheticians must flip over their aesthetician name tags and take down any certification they might have hanging on the wall.

The state may allow an aesthetician as a person to perform this procedure under proper medical supervision; however, the regulatory board does not cover this under an aesthetician license.

This sounds onerous, and it is certainly involves more effort than a facial or another aesthetician service, but this does not have to be a deal-breaker for offering microneedling services in your medical spa. The supervising physician does not need to be in the room watching the aesthetician perform the procedure and, in many states, does not need to see the patient before each treatment—just the first one.

The More You Know

Regulations can vary greatly depending on where a business operates, so it is very important to know the laws that govern medical aesthetic businesses in your state. When in doubt, consult an attorney in your state who is familiar with aesthetics.

AmSpa members have access to legal summaries of the laws regulating medical spas in their state, as well as an annual complimentary compliance consultation with the law firm of ByrdAdatto.

See AmSpa’s Treatment Directory for more information on microneedling.

For legal updates and business best practices delivered straight to your inbox, subscribe to AmSpa’s email newsletter. For more information on how AmSpa can help your practice operate legally and profitably, Contact Us online or call us at 312-981-0993.

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Med Spa Law  Microneedling 

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Capturing Your Captive Audience

Posted By Administration, Tuesday, March 26, 2019

computer software

By Tyler Terry, vice president of sales, TouchMD

Medical aesthetic practices spend a lot of their money and resources on marketing to attract patients to their practice, as well as on a savvy website to sell patients on why to choose them over their competition. All this results in a patient scheduling a consult. What happens next is where most practices “strike out looking.”

I've been in more than 400 cosmetic practices spanning more than 40 states across the country, and the problem is always the same: Patients—your captive audience—are either on their smartphones or reading magazines in both the waiting and consultation rooms. They are literally waiting to be sold on whatever product, procedure and/or service that attracted them to your office in the first place. Wouldn't their time be better spent learning about that product, procedure or service? This surely would prepare them to ask better questions and participate in a more efficient and effective consult. Sure, most patients are already sold on Botox, but why wouldn't you give them the opportunity to engage with and learn about the new laser you just purchased or any specials or events that are coming up?

Brag books and brochures were sufficient back in the early 2000s, but it's time to retire them both and invest in technology that will enhance the patient experience and showcase the products, procedures and services that your practice offers. You can start by adding a waiting room solution consisting of either a patient-friendly app for patients to download and watch videos and look at before-and-after pictures, a waiting room loop system to stream educational and promotional content, and/or a tablet with which patients can interact. The same concept applies to your consult room—take advantage of any downtime the patient might have while he or she is waiting.

Here are a few ways to implement captive audience experiences:

  • In-house marketing: Utilize promotional videos and images to educate patients about services you offer.
  • Visual consultation: Everyone is a visual learner—combine videos, images, before-and-after galleries, and educational content into a patient education platform.
  • Patient education: Allow the patients the opportunity to relive the consultation at home using software. Your patients can review drawings, signed consents, operational instructions and custom educational videos.

The captive audience experience is too often forgotten or left out of the equation. It's an easy fix with the right technology.

TouchMD is a visual consultation, marketing and imaging software utilizing touch-screen technology that enhances the patient experience with proven revenue generation. To learn more about TouchMD or request a demo, please email tyler@touchmd.com.

Tags:  Business and Financials  Guest Post  Med Spa Trends 

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