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Can an Esthetician Do It?

Posted By Administration, Tuesday, November 20, 2018

By Patrick O’Brien, J.D., Legal Coordinator for the American Med Spa Association

The services that medical spas offer can range between traditional spa beauty treatments to cosmetic medical procedures. Just as medical practitioners have developed less invasive procedures to offer in their practices, so too have cosmetologists and estheticians adopted more invasive procedures. As discussed previously (and here), this can create issues when these procedures fall into the practice of medicine without a license or without proper delegation an oversight. 

The traditional scope of esthetician practice is usually limited to beautifying procedures and applications that do not invade the living tissue. Typically, living tissue ends up being defined as the stratum corneum, the very top most layer of skin. This is the case in South Dakota, where estheticians are limited to only “non-invasive” procedures that are confined to the non-living cells of the stratum corneum. Similarly, North Dakota forbids estheticians from performing any invasive procedures. This limitation to the stratum corneum allows estheticians to perform many of the services offered in traditional spas, but many of the services a medical spa offers will be outside of their scope of practice. (For individual states, AmSpa Members can refer to your state’s summary here.)

The North Dakota Cosmetology Board mentioned above offers a guidance document you can access here which specifically prohibits their practitioners from performing laser use, CoolSculpting, any sort of injecting, microneedling that invades the live tissue, and chemical peels over a certain strength. These cover many of the most popular procedures that medical spas offer. And since estheticians are the most commonly employed licensee in many medical spas, this can create a temptation to practice beyond their scope. In response to this, many states have passed rules and regulations that provide a legal way for estheticians to extend the scope of their services. This process has taken multiple forms which broadly fall into two categories: 1) expanding their scope or practice or 2) providing rules allowing estheticians to perform medical procedures under physician guidance. However these changes can bring their own risks.

In Minnesota, the legislature passed a law creating an “advanced practice esthetics” license that allows licensees to perform procedures that effect the epidermis. This seems like a minor change, as the epidermis is made of primarily of the stratum corneum. The other two layers of the epidermis are significantly thinner. However, it is enough of a change that many formerly prohibited dermatologic procedures would be permitted within this new scope of practice. In this case, the adopted rules for Minnesota’s advanced practice esthetic license allow practitioners to perform dermaplaning, microdermabrasion, and to use electrical- and light-based skin care treatments. These advanced practice licensees are still prohibited from using lasers, but the other procedures encompass a significant percentage of medical spa offerings. Oregon also has an advanced practice esthetician license that allows license holders to perform “advanced non-ablative esthetic procedures” including, among others, laser-based skin rejuvenation and cellulite reduction. After earning this license the advanced practice esthetician is able to perform services without physician oversight. However, they do need to maintain a collaborative agreement with a medical professional if patients need to be referred. Although both the Oregon and Minnesota advanced licenses prohibit injections, they would still be a versatile licensee to have as part of a medical spa’s team. 

Other states have recognized that, although estheticians may have skills that complement more invasive medical procedures, they still need guidance and oversight of a medical licensee. States such as Wisconsin provide detailed rules for estheticians performing services that are medical procedures under physician supervision. A person licensed by the Wisconsin Board of Cosmetology may provide laser hair removal, microdermabrasion, and certain chemical exfoliation procedures; however, this can only take place in a licensed salon and under the delegation, supervision, and written protocols from a licensed physician. Similarly, Kentucky forbids estheticians from performing common medical spa procedures, such as Botox injections, laser treatments and microblading unless under the direct supervision of a physician. Here, direct supervision means within immediate distance to be able to respond to the patient if needed. These states and others like them attempt to strike a balance between expanding esthetician and cosmetologist’s scope of services and providing sufficient medical oversight.

Many states do not have the formalized rules or roles that allow estheticians expand their scope or perform more invasive procedures offered Minnesota, Wisconsin, or Kentucky. In some of these states, physicians may still be able to delegate procedures to other unlicensed individuals known as medical assistants. This may include people who hold esthetician licenses, but usually requires that they not hold themselves out as practicing under their license. Texas is one such state: Estheticians and cosmetologists may only provide their services in a licensed salon. Furthermore, physicians are unable to delegate cosmetology procedures to those licensees. However Texas law and its medical board do allow physicians to delegate certain procedures to others, including medical assistants. Since these procedures are not within an esthetician’s scope of practice, they could only perform them as an unlicensed medical assistant under the supervision of a physician.

Estheticians can be very valuable and versatile employees to a medical spa. They offer a wide variety of services that complement and enhance the other cosmetic medical procedures offered by licensed health care professionals. And in the states that offer expanded scopes of practice or advanced practice licenses, estheticians can even perform some of the more invasive procedures offered. It is, however, critical that medical spas operate well within the rules for delegation and licensees’ scope of practice. Even where the laws and rules are seemingly clear in allowing a procedure to be done by an esthetician, caution should still be exercised. When a physician’s supervision is required, there is always a requirement that the physician confirm that, in their professional judgment, the person has the appropriate training, skills, and experience to perform the procedures. Clearly this is a subjective standard, and the physician’s judgement in regard to what constituted sufficient training and skill would come under close scrutiny by the medical board if there were ever a complaint or adverse patient outcome reported. The physician’s license would depend on the board agreeing with the physician’s prior assessment and, when a patient has been harmed, the board may be less inclined to agree. On the other end of the relationship, if the physician is not providing sufficient oversight or is allowing the esthetician too much free reign, the esthetician could be made vulnerable to discipline from their own board for exceeding their scope of practice or subject to charges of practicing medicine without a license.

It is critical to every medical spa’s success and to the continued success of our industry as a whole that medical procedures are performed by properly trained and licensed people under appropriate supervision well within the rules and regulations of each state. If you would like to learn more about the legal issues surrounding your medical spa you may want to consider attending The Medical Spa Show this coming February in Las Vegas, NV. 

Tags:  Med Spa Law  Med Spa Trends 

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Understanding CoolSculpting and Your Med Spa

Posted By Administration, Monday, November 19, 2018

By Brad Adatto, JD, Partner, ByrdAdatto

Whether you’re an entrepreneur or a veteran business owner of a med spa, you know that business tends to run hot and cold. But does it really matter that business is hot when lifestyle preferences are cooling down? Literally. CoolSculpting is the growing phenomenon that is shifting a culture that was once obsessed with burning fat to freezing it.

CoolSculpting offers a fat reduction alternative to liposuction and a lifestyle alternative to diet and exercise by freezing and eliminating targeted fat cells using a process called cryolipolysis. The process is noninvasive, nonsurgical, and FDA approved. But make no mistake, there are still plenty of legal considerations to navigate before entering into one of the fastest growing practices in the country.

While the procedure is commonly referred to as a “cosmetic” treatment, CoolSculpting, or cryolipolysis, is considered the practice of medicine and a medical treatment in many states. Therefore, businesses must be extremely careful when navigating state laws regulating the practice of medicine, including the ownership and staffing of a CoolSculpting business.

Here’s what you need to know:

Ownership. You should develop your business and ownership model according to the laws of the state(s) in which you plan to practice. Because these laws vary from state to state, you need to know how to legally structure your CoolSculpting business and the type of liability that may be associated with the structure you choose.

You also need to know if there are any licensing restrictions on owning a business that renders medical services in the state(s). California, for example, limits the ownership of businesses that provide medical treatments to California-licensed physicians, but also allows partial ownership by a list of other non-physician health care providers, subject to strict and narrow business and ownership structure requirements.

The Practice of Medicine. What constitutes the practice of medicine or medical treatment varies from state to state, and these laws can be specific and nuanced to varying degrees. Therefore, you need to know whether CoolSculpting is considered the practice of medicine, and consequently a medical treatment, in your state. For example, Texas considers diagnosing a person as an appropriate candidate for a cosmetic medical procedure and giving orders for their treatment to be the practice of medicine.

Staffing. Medical professional scopes of practice not only vary from state to state, but also vary depending on the training, experience, and skill of a medical professional. Therefore, you need to know who can legally perform the treatment in your facility. It critical that state laws governing who can legally perform medical treatments, such as cryolipolysis, are not confused since many states only permit state-licensed physicians, physician assistants, nurse practitioners, and certain other licensed healthcare professionals to perform cryolipolysis, subject to state laws governing delegation and supervision.

Brad Adatto, JD, is a partner at ByrdAdatto, a business, healthcare, and aesthetic law firm that practices across the country. He has worked with physicians, physician groups, and other medical service providers in developing ambulatory surgical centers, in-office and freestanding ancillary service facilities, and other medical joint ventures. He regularly counsels clients with respect to federal and state health care regulations that impact investments, transactions, and contract terms, including Medicare fraud and abuse, anti-trust, anti-kickback, anti-referral, and private securities laws.

Tags:  Business and Financials  Med Spa Law  Med Spa Trends 

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Critical Financial Numbers You Must Know

Posted By Administration, Friday, November 16, 2018

By Terri Ross, Managing Partner of Lasky Aesthetics

In order to maximize the profitability and success of your office, you need to take an accurate and realistic snapshot of where you are by the numbers.

  • Do you know your return-on-investment (ROI) for every procedure and treatment you offer?
  • What percent of patient leads do you retain?

Patient retention is directly linked to how well your front office staff listens, engages and responds.

In order to become a top-performing practice, every working part of your office or medical spa—the staff, systems, processes and protocols—must be performing at optimal speed. Be diligent and organized in your record-keeping. Take a quarterly snapshot of your office. If you know where you are, you can make a sustainable plan for future optimization and growth.

HERE ARE THE KEY NUMBERS YOU NEED TO KNOW:

Budget
  • Start-up costs – Property, building, equipment, technology, staff and marketing all go into start-up costs.
  • Payroll – When your business is off the ground, payroll makes up a large part of your bottom line. Know how much you pay your personnel, in wages, taxes/insurance and bonuses throughout the year.
  • Equipment – This includes initial cost, maintenance and materials required to run, update and optimize equipment.
  • Marketing – Any expense targeted toward attracting new patients falls into this category, from pamphlets, to website development and networking events.
ROI = (Gain – Cost) / Cost
  • Procedures – Know how much every procedure costs you to perform, including supplies, time and personnel involved. Your potential gain-per-procedure is based on these expenses.
  • Technology – Know how much a piece of new equipment costs to acquire and maintain. You’ll need to include maintenance and supply costs in your calculations of ROI for every piece of equipment in your office.
  • Marketing – Knowing your ROI on marketing strategies allows you to quantitatively measure how successful a specific marketing tactic is. Know how your patients found your office and why they return—online marketing, networking at the right events, etc. Read more about how to calculate your marketing ROI in this article from Forbes.
  • Website position – Know the numbers behind your website—how many people visit the site per day, what page they go to and stay on, what your bounce rate is, and modify from there.
Rates
  • Conversion/close rate – How many prospective patients do you “land?” How many are retained as long-term patients?
  • No show/cancellation rate – On average, how many patients make an appointment and don’t show? Or cancel in advance?
  • New patient rate – The number of new patients you bring in per month, year.
Room Revenue Assumptions
  • Number of rooms – Total number of procedure rooms.
  • Hours of operation – How many days are you open?
  • Average treatment price – Taking an average of all procedures offered, what is your average price?
  • Average length of procedure – On average, how long do your procedures take? This includes operating preparation.
  • Treatments per day – How many treatments do you complete per day? Are any days busier than others?
  • Revenue/hour – Based on the numbers above, what is your average revenue per hour?
Goals
  • New patients – Set a goal for number of new patients retained per quarter. Using the LAER model I developed, you can train your staff to engage, respond to and retain patients.
  • Revenue - Based on where you are, what is your projected revenue? Set your revenue goals and make the necessary changes (processes, protocols, staff) to get there.
  • Revenue/hour – To reach your revenue goals, how much do you need to generate per hour? Avg room should do between $600-$1000 per hour.
  • Price strategy (vs. competitors) – Based on your current and desired revenue, and keeping competitor pricing in mind, develop an informed and realistic price strategy.

How Does Your Office Look By The Numbers?

Do You Have Attainable Revenue Goals And The Infrastructure, Protocols And Staff In Place To Get You There?

CLICK HERE TO DOWNLOAD THE ASSESSMENT BELOW & COMPLETE TERRI'S 10 POINT CHECK LIST.

Terri Ross is managing partner of Lasky Aesthetics & Laser Center, which she transformed from a $500,000 to a $3.5 million business in the span of three years. She is also the CEO of Terri Ross Consulting, providing high-level practice management consulting services and sales training to a number of high-profile physicians, including world-renowned plastic surgeon, Garth Fisher, MD, who started Extreme Makeover, and world-renowned facial plastic surgeon and host of the TV show Botched, Dr. Paul Nassif. Ross is an advisor for Revance Therapeutics, speaks for many companies, and works with venture capital firms to help start up medical spas. Her experience also spans the corporate world, with more than 16 years working as a sales director for several leading medical device companies, such as Zeltiq, launching Coolsculpting in the United States and Canada; Medicis (now Galderma); EMD Serono; and Johnson & Johnson.

Tags:  Guest Post 

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What Does the Recent Texas Botox Arrest Mean to You?

Posted By Administration, Thursday, November 15, 2018

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

As many have seen in the news recently, a Texas LVN named Michelle Bogle from Savvy Chic Medical Spa was arrested under the claim that she was practicing medicine without a license.; specifically, she was offering Botox injections. Although all of the facts about the case are not known, AmSpa wanted to take this time to review the rules in relation to delegating cosmetic medical procedures in Texas. The state of Texas is fairly liberal in who it allows to physically perform Botox and other injectable procedures. Anyone with proper training may inject Botox and other cosmetic injectable as long as it is under the protocols, supervision, and delegation of a physician. The Texas Medical Board has adopted Rule §193.17 (available here) to provide guidance to physicians who delegate these nonsurgical cosmetic procedures. The rule applies to nonsurgical cosmetic procedures, including injecting or using a prescription medical device performed by someone who is not otherwise licensed to perform the procedure and not a physician, PA, or NP.  The rule includes 13 points that physicians must adhere to in properly supervising and delegating such a procedure to anyone other than a physician assistant or a nurse practitioner. These include the following.

  1. A physician is responsible for being properly and appropriately trained in the specific procedure, and keep records documenting their training.  
  2. Before the procedure is performed, the physician or a PA or NP acting under their delegation must perform an initial examination. This examination must include: taking a history, performing a physical exam, making a diagnosis, recommending treatment, developing a treatment plan, obtaining a patient’s informed consent, and providing emergency and follow-up care instructions. They must also maintain medical records, and have signed and dated written protocols and standing orders for the procedure
  3. Following the above examination and diagnosis, the procedure can be delegated to another person as long as a PA, NP, or physician is on-site, or the delegating physician is available for emergency consultation and able to conduct an emergency appointment if necessary.
  4. The physician, regardless of who they delegate to, maintains ultimate responsibility for patient safety. 
  5. The physician is also responsible for documenting and maintaining the patient records. 
  6. The facility must have a quality assurance program in place, including mechanisms to identify complications, adhere to protocols, monitor the quality of treatments, a review and improvement mechanism for protocols, and ongoing training.
  7. Physicians can delegate procedures only at a facility where they have either approved of that facility’s written protocols for the procedure or they have developed their own protocols.
  8. The physician must also make sure that the delegated person has appropriate training in several areas related to performing procedures (see the rule for details).
  9. The physician must have in place a written office protocol for the delegated person to follow in performing the procedure.  his protocol must identify the delegating physician, criteria for the physician, PA, or NP to screen the patients, and description of appropriate follow-up care including for complications, injury, and emergencies.
  10. The physician must make sure that the delegated person follows that written office protocol.
  11. Patients must sign consent forms before receiving any treatment. The form must identify potential side effects, complications, and identity of who will perform the procedure.
  12. The delegated person who performs the procedure must have a name tag which discloses their name and their credentials. 
  13. The facility must have at least one person on-site who is trained in basic life support whenever a procedure is performed.

Each of these above points are necessary to be in compliance with the rule. However, this article is not meant to be an exhaustive compliance check rather to give more of an overview. So, if you are a physician planning on delegating such procedures to anyone other than a PA or NP, please carefully review the rule in total or consult with an attorney to ensure that you develop policies and procedures that are compliant with its requirements.   

The implications of this story are far-reaching. This is the second instance of an LVN being charged with the unauthorized practice of medicine in recent months as a result of an undercover sting operation (the other occurred in California). AmSpa encourages all of its members—particularly those in Texas—to ensure that they strictly comply with every step of the Texas delegation and supervision rules governing cosmetic procedures. Following each step specifically is critical, and practitioners must take care to pay very close attention to the specifics of the rule and follow it exactly. As now has been seen, failure to do so may result in criminal prosecution, not to mention action by the medical and/or nursing boards.

Tags:  Med Spa Law 

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Three Reasons Why Offering Payment Options helps to Strengthen Client Relationships

Posted By Administration, Tuesday, November 13, 2018

Sponsored by CareCredit

Spa and med spa businesses are always looking to strengthen relationships with clients. How you connect with clients, solidifies credibility and trust that translates into continued financial success. However, a major challenge many businesses face is identifying the right strategies to help build long lasting relationships and overall reputation. One effective action plan can be to offer your clients payment options, like the CareCredit credit card. 

1. Provide transparency and build trust with your clients 

Offer your clients payment options that include special financing options like the CareCredit credit card, with no interest if paid in full within the promotional period*. This helps them identify how to pay, with a selected option that best fits their needs. With budget-friendly monthly payments, spa owners can also help clients choose service enhancements and add-ons without cutting the price of the service to show value. With a dedicated way to pay, clients will understand the pricing for their treatments, and trust their spa or med spa providers. This may also entice clients to elevate or increase services and return for follow up treatments. 

2. Offer payment options that help clients get the treatments and services they want, when they want them

Most spa clients may not have a fixed budget for covering the costs of the beauty, spa and wellness treatments that they want or need. The CareCredit credit card offers spa clients a convenient payment option so they can fit more spa services into their budget. Promotional financing options are available for purchases of $200 or more. CareCredit offers cardholders access to a calculator tool so they can easily review average monthly costs. In turn, clients will feel valued knowing their spa and med spa provider has their best interest in mind. 

3. Leverage payment options to promote your spa or med spa specials and exclusive offers 

Give your marketing materials an overhaul. Update exclusive offers and eblasts touting the latest and greatest offerings or promotional specials; and make them even more exciting by noting that the CareCredit credit card is a payment option for them. By offering value and information about a payment option with promotional financing options, clients will feel like they are receiving a special offer. As a result, they may schedule services and return visits.  

CareCredit works with more than 210,000 providers across a broad range of specialties including medical care, beauty, dental, optometry, hearing and veterinary services. With CareCredit’s 11 million cardholders, spa and med spa businesses can get connected to a new client base, while providing optimal service for current clients. 

Visit Carecredit.com/providercenter now to learn more and enroll so you too can offer your clients CareCredit as a preferred payment option.

*Subject to approval. Minimum monthly payments required.  See carecredit.com for details. 

**No interest will be charged on the promotional purchase if you pay the promotional purchase amount in full within the 6, 12, 18, or 24 month promotional period. If you do not, interest will be charged on the promotional purchase from the purchase date. If your purchase qualifies for a 24-month promotional offer, fixed monthly payments are required equal to 4.1667% of initial promotional purchase amount until promotion is paid in full. The fixed monthly payment will be rounded up to the next highest whole dollar and may be higher than the minimum payment that would be required if the purchase was a non-promotional purchase. For all other promotional offers, the regular minimum monthly payment terms of the account will apply. Regular account terms apply to non-promotional purchases and, after promotion ends, to promotional balance, except the fixed monthly payment will apply until the promotion is paid in full. For new accounts, Purchase APR (interest rate) is 26.99%. Minimum Interest Charge is $2. Existing cardholders should see their credit card agreements for their applicable terms. Subject to credit approval.

Tags:  Sponsored Content 

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How Skin Care Products Benefit Medical Spa Patients

Posted By Administration, Thursday, November 8, 2018

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

The most effective and marketable services offered by a medical spa will almost always be the treatments provided, running the gamut from microneedling, to laser skin resurfacing, to anti-aging treatments, such as Botox. Although these procedures draw patients in, offering skin care products can put your patients on the path to the best long-term results.

Skin Care Supporting Treatments

It should be no surprise that medical spa treatments designed to revitalize the skin can benefit from proper after-care.

“You’re doing your practice an injustice if you’re not sending the clients home with a product that’s going augment the results of the treatments they just came in for,” said Candace Noonan of Environ Skin Care.

After laser skin resurfacing, for example, doctors on RealSelf.com universally recommend emollients for the days immediately following treatment, with some also suggesting home-care treatments containing retinoids to aid in skin healing. After microneedling, RealSelf.com doctors recommend topicals that include a growth factor for improved results and faster healing.

Do your research and ask your skin care sales representatives what home care products will work best with your menu of services.

Skin Care as an Anti-Aging Treatment

Medical spa-based skin care is not limited to after-care. For patients concerned with procedures relating to skin health and/or anti-aging, medical-grade skin care products can be a treatment on their own. Although moisturizers and other skin products are widely available from drug stores and retail boutiques, these products are often very different than what medical spas are able to offer.

According to the FDA, with retail products, patients should be able to select and safely use the product using only the information available on the label. This means that off-the-shelf products need to be safe enough for a customer to self-diagnose and administer without the advice of a trained professional. As a result—although retail products may say they include similar ingredients the concentration of active ingredients—the ingredient concentration is often far lower, in order to ensure it can serve the widest population of people.

“Generally, brands that are sold in drugstores and department stores contain lower amounts of active ingredients so they’re irritation-free for a broad consumer base,” said Lucy Papa, executive vice-president of Canderm Pharma Inc., which sells both medical-grade and retail-grade skin care products.

Since a medical spa will select products specifically based on a patient’s unique needs and train the patient on proper use, these products will contain a higher concentration of active ingredients with clinically tested formulations that can deliver faster and better results.

“We have to look at things like bioavailability, how is it delivered to the skin, is the skin even able to absorb these ingredients,” said Noonan. “When choosing a skin care line … you have to be able to back it up with science as far as what’s actually going to work.”

The onus is on medical spa professionals to educate patients on the benefits of medical-grade skin care, not only with respect to supplementing procedures, but also as a treatment in itself. Selling skin care in your medical spa will not only lead to better results for your patients, but also for your business, as well.

Tags:  Med Spa Ownership  Med Spa Trends 

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AmSpa Member Spotlight with Alexa Nicholls Costa and Alexandra Rogers, NPs and Co-Founders of LexRx

Posted By Aly Boeckh, Wednesday, November 7, 2018

 

Take a tour through one of Boston's top med spas, LexRx, located in the Beacon Hill neighborhood of Boston. 

Co-Founders and Nurse Practitioners, Alexa Nicholls Costa and Alexandra Rogers share the success of running an injectables-only business in this member spotlight feature.

LexRx is a hyper-focused dermatology practice offering only injectable services, botox and dermal fillers. They are breaking the myth that you can't make money on injectables.

Check out the video playlist on Youtube to get the full walk through tour of their practice and learn about their secrets to success!

Alexa and Alex attended the Boston AmSpa Boot Camp in September 2018 to speak on the social media panel. They will also be speaking at The Medical Spa Show February 8-10, 2019 at the Aria Resort & Casino. Visit LexRx's Instagram account to view the available promo codes for attendance to The Medical Spa Show 2019 and AmSpa memberships.

Visit LexRx's website here.

Tags:  Member Spotlight 

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Build Loyal Med Spa Clients with a Loyalty Program

Posted By Administration, Wednesday, November 7, 2018

By Dori Soukup, CEO and Founder of InSPAration Management

In the early 1980s, American Airlines’ goal was to increase retention and provide their clients with something extra special. The airline created the first frequent flyer program that allowed travelers to accrue miles and gain benefits when they flew with American. 

American Airlines was one of the first companies in the country to offer a customer loyalty program. It set the standards for the entire industry. Since then, loyalty programs have gained significant popularity. According to a recent study, companies spend more than $2 billion on loyalty programs every year. Statistics show that the average American household belongs to about 14 different rewards programs. 

If you want to increase your retention rate, it is a great idea to offer your clients a loyalty program that will keep them coming back. 

What type of loyalty program should you offer? 

There are several types of programs to offer consumers, and no matter which one you choose, it is important to keep it simple. Below are two of the most effective loyalty programs: 

A. Charge a fee to join the loyalty program. 

For example, Barnes & Noble charges its clients $25 to join their loyalty program. Then, its members can save 10 percent on their purchases for an entire year. For a person who frequents Barnes & Noble weekly, this type of program provides great benefits. The end-of-year savings are significant. This program keeps me loyal to Barnes & Noble, and the $25 fee to join is well worth it. You can do the same, but I recommend you charge more. For example, you can charge a fee of $150 to join and offer them the following:

  • Two $25 gift cards—to be utilized one at a time 
  • A complimentary consultation valued at $50 
  • A complimentary makeover valued at $50 
  • A loyalty program welcome kit 
  • A discount of five to ten percent on every spa visit or retail purchase 

You are giving them the $150 enrollment back in value. This allows you to raise cash flow, and encourages the new member to visit the spa on a regular basis. As part of the loyalty program, the client will benefit by receiving a small discount with each spa visit. 

B. The second plan offers clients a chance to join for free and earn points with every visit. You can reward them by letting them earn one point for every dollar they spend. Once they reach a certain number of points, they can use them toward gifts, services or products. 

You will need to determine the amount of rewards you are willing to offer. For example, if someone spends $500, they will earn 500 points. If you wish to offer them a 10 percent reward, you will need to select a $50 prize that they can have once they reach 500 points. This represents a 10 percent reward. If you are offering this type of loyalty program, I recommend you offer merchandise as a reward because your cost will be $25, but the client will receive a value of $50. This practice allows you to decrease your loyalty cost to a five percent reward instead of 10 percent.

Select gift items that you can brand with your logo. This includes robes, T-shirts, hats and water bottles, all displaying your logo. This method has many benefits: 

  1. Provides your loyal clients with desirable, quality gifts 
  2. Gifts are a great way to promote your business 
  3. Shows a higher perceived retail value while reducing your loyalty cost 
  4. Saves money and increases retention 

The point system can also be used as a marketing tool. If you have some slow slots within your schedule, you can reward your clients with double points on slow days or hours. Instead of offering discounts, offer double points for promotions. You can ask your clients to write reviews to earn points. Or, let them earn points when they “like” your page on Facebook, and so on. 

Keep in mind that no matter which program you offer, you have to market it, track it and deliver a great guest experience. 

Offering a loyalty program is a great opportunity to promote your business and recognize your VIP clients with special value while motivating your clients to keep doing business with you. Implement a loyalty program and increase your retention! 

Dori Soukup is the Founder and CEO of InSPAration Management, a firm specializing in medical spa and salon business development, advanced education, and business tools. Throughout the past 15 years, Soukup has contributed to the success of spa companies worldwide. Her passion is developing innovative, effective educational programs and business strategies leading to exponential growth and profits. She is the recipient of the American Spa Preferred Educator award and is a sought-after global speaker within the spa and medical spa industries.

Tags:  Business and Financials  Guest Post  Med Spa Ownership 

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California Passes Amendement to New Law That Could Affect Your Med Spa

Posted By Administration, Friday, November 2, 2018

By Brad Adatto, JD, Partner, ByrdAdatto

Do you own or work for a med spa in California? If so, this is important news. Just two months after California passed their new sweeping consumer privacy law, the California Legislature has passed an amendment to the act that was submitted to the Governor on September 12th for signature. The original bill, the California Consumer Privacy Act of 2018 (“Privacy Act”), was signed into law on June the 28, 2018, creating the strongest protections in the nation on collecting and using consumer’s information (please see our previous article here for more details on the Privacy Act). As written, the Privacy Act would require substantial compliance efforts for businesses working with California residents. The amendment makes many changes and clarifications to the Privacy Act, and several will be beneficial to medical practices.

The most beneficial change for medical practices is the Privacy Act now does not apply to health care providers to whom the rules of HIPAA or California’s Confidentiality of Medical Information Act apply, so long as the practices maintain patient information in the same manner as they are required to maintain protected health and medical information. Protected health information and medical information covered under those laws were already exempted in the original law.

A second helpful change for medical practices is that the disclosure to consumers of their rights of deletion no longer needs to be on the website or in the privacy policies. Rather, it now only needs to be “reasonably accessible to consumers.” Previously, this would have necessitated medical practices making major updates to their websites to be compliant.

The amendment also narrows the broad definition of personal information covered by the law. Previously “personal information” included a laundry list of types of information, ranging from biometric data to employment information. Unfortunately, the laundry list still remains, but is limited only to data that is capable of being associated or linked with a particular consumer or household. This is helpful as it exempts aggregated demographic and trend data.

While the Amendment may have eased the burden of compliance for medical practices, it has not removed it. We are hopeful that most of the nuts and bolts compliance concerns will be fully addressed in the Attorney General’s forthcoming rule interpretation. Consistent with the amendment, the AG must release its rule interpretation by July 1, 2020. However, since the Privacy Act itself becomes effective January 1, 2019, medical practices will need to be mindful of how they are treating consumer information before the Privacy Act takes effect. Substantial processes and changes may still needed by medical practices to be compliant.

Brad Adatto, JD, is a partner at ByrdAdatto, a business, healthcare, and aesthetic law firm that practices across the country. He has worked with physicians, physician groups, and other medical service providers in developing ambulatory surgical centers, in-office and freestanding ancillary service facilities, and other medical joint ventures. He regularly counsels clients with respect to federal and state health care regulations that impact investments, transactions, and contract terms, including Medicare fraud and abuse, anti-trust, anti-kickback, anti-referral, and private securities laws.

Tags:  Med Spa Law 

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Medical Spa Bad Press: Coming to Terms with Compliance

Posted By Administration, Thursday, November 1, 2018

By Alex Thiersch, CEO of the American Med Spa Association

Bad outcomes and patient injuries in medical spas are appearing in more and more headlines across the country. It is evident to many who work in the medical spa industry that there are a number of grey areas in the rules and regulations that govern it, and that certain unscrupulous medical spa owners and operators exploit these inconsistencies while sacrificing quality patient care to make money. Media pieces highlighting these bad actors in the industry are appearing with increasing regularity, and even the Doctor Oz show recently highlighted “Rogue Med Spas” that endanger patient safety. These reports express the industry’s problems to the public and, when the public catches wind of a health issue, you can bet that local, state and federal regulators will need to address it sooner or later.

View the full segment.

See AmSpa’s full statement on the segment here

The days of the medical spa industry being the “wild west” are likely coming to an end. So if your practice is not entirely compliant with your state’s medical statutes, it is certainly in your best interest to identify the ways in which it falls short and address them as soon as possible.

AmSpa members can check their state’s medical aesthetic legal summary to find the laws governing their practice.

The Truth

Stories such as the Doctor Oz report are not positive for the medical spa industry, but they’re not necessarily hatchet jobs, either—many medical spas are, in fact, operating illegally, and untrained, unqualified employees are burning patients with lasers, among other potentially serious violations.

Medical spas and laser centers have become so popular—and so profitable—that some owners and operators rush to open them and, as a result, they are often not properly formed and not compliant with state and local statutes. Traditionally, there has not been a great deal of enforcement of these violations, but this is changing.

Medical spas have become so prevalent that state regulatory agencies simply cannot ignore them anymore. As is seen in the rise of media coverage of these issues, patients who suffer unforeseen outcomes will not hesitate to complain to the media. Personal injury attorneys have also picked up on the trend—you may have noticed television commercials and print ads calling for clients to sue medical spas and laser centers. The story is out there, and it only takes one aggrieved patient to cause a medical spa’s world to come crashing down.

Although it is undeniable that there is a certain level of non-compliance that exists in the medical spa industry, medical spa owners and operators need to be asking themselves how they can start becoming an industry that regulates itself, so that they don’t have these types of continuing issues with state regulators.

Creating Compliance

To start on the road to compliance, medical spa owners and operators should take the following steps.

  1. Know the law. While there are grey areas, many answers can be found in state’s practice acts with just a little bit of searching.
  2. Reach out to local health care attorneys for evaluation. Most medical spas only contact a lawyer when they’re already in trouble, not at the front end where the lawyer can help prevent trouble down the road.
  3. Work toward understanding. You goal should be to understand the basic core principles regarding medical practice and realize that, while this is a lucrative industry that is often quite safe, there is still some level of danger.

AmSpa pledges to continue its efforts to educate medical spa owners and operators to make sure that they are operating in compliance with the law. It also aspires to educate the public in order for them to understand the difference between a medical spa that is compliant and one that is not, as well as inform them about what the treatments offered by medical spas actually entail. AmSpa is also pushing for standardization of laser training across the industry—in some states, there are no training requirements, and a lack of proper training can lead to outcomes such as the ones that Doctor Oz aired to the general public.

The industry needs to come together to discuss how it should be regulated, as it is clearly growing and is not going away. There is some guidance in the laws as they are written, but the states do not do a particularly good job in educating the public about what they say and mean. Still, enforcement is ramping up, and medical spa owners and operators must be properly prepared in order to comply and avoid more negative media coverage in the future.

Attend an AmSpa Medical Spa & Aesthetic Boot Camp to learn how to build and run your medical spa to be profitable and compliant with all of the laws in your state.

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

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