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Portrait of a Medical Spa Owner, Part 4: The Entrepreneur

Posted By Administration, Friday, December 6, 2019

christina imes

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

In the early days of the medical aesthetic business, it was more or less presumed that a medical spa would be owned by a “core doctor”—i.e. a plastic surgeon, facial plastic surgeon, otolaryngologist or cosmetic dermatologist. However, as the field has matured, the group of owners involved has become more and more diverse, ranging from doctors and nurses to entrepreneurs and even estheticians. In fact, it’s somewhat difficult to find a medical spa owned by a core doctor today—according to the American Med Spa Association’s 2019 Medical Spa State of the Industry Report, of all of the medical spas owned by medical professionals, only 20% owned by core doctors.

Today, it’s much more common to find doctors with backgrounds in family practice and emergency medicine owning medical spas—each of those specialties owns 23% of the practices owned by medical professionals, according to the report. Why is this? As you’ll read in this series, there seems to be a certain frustration with the way managed care has caused health care in the United States to evolve, and doctors, nurses and physician assistants are interested in providing more personalized care to their patients without having to deal with insurance and other payment issues.

However, doctors aren’t the only people involved in medical spa ownership—entrepreneurs are making their mark on the industry, as well. According to the report, 12% of medical spas owned by individuals and 24% of medical spas owned by groups are owned by entrepreneurs. It speaks to the broad appeal of the industry—and the amount of money people are making in it—that this many people from outside the traditional boundaries of it are willing to invest their money in medical aesthetics.

In this series, you will be introduced to four people—a doctor, a mid-level practitioner, an RN and an entrepreneur—who came into the medical spa industry from different backgrounds, but managed to find success because of their determination and love for the business. Each one is true success story and an example of how, in this industry, hard work and quality care are a winning combination.

The Entrepreneur

In 2014, shortly after Christina Imes sold the yoga and wellness clinic she owned in Chicago and moved out to the suburbs to be a full-time mom, her neighbor, a nurse, asked her if she’d consider buying a medical spa. Imes said that she hadn’t considered it, but would ask her stepfather, an ER doctor, if he was interested in getting involved in the medical aesthetics business.

“I asked him a couple days later; he said, ‘Absolutely not. I’m happy in the ER, making a lot of money. No,’” Imes says. “Seven months later, he calls me—this is totally how my stepdad is—and he says, ‘Hey, do you want to come with me this weekend to a laser show?’ And I’m like, what? What are you talking about? And he said, ‘You know what? I’ve kind of warmed up to that whole med spa idea. I’ve been thinking about that.’”

Imes’ stepfather ended up buying $350,000 worth of laser equipment that weekend, and in March 2015, he and Imes opened Rejuvenate Med Spa in Oak Brook, Illinois, just west of Chicago. Since it was founded, Rejuvenate has grown to offer a wide variety of treatments—more than enough to stand out from its competition—and features an experienced, talented team of providers that Imes has built through the years.

“I don’t do any of the treatments here,” Imes explains. “I can’t give a facial—I can’t do any of it. But I’m very good at connecting with people. I am incredibly good at forming relationships. My Allergan rep, my Galderma rep, my Alastin rep, they all love me and they would do anything for me. They come in here like once a week, just because we have so much fun here. I create a very fun culture to work for and be in.”

Imes values the freedom that being an entrepreneur in the medical aesthetic industry affords her, but also says that freedom can be a double-edged sword.

“I love that I can do anything I want, whenever I want. I can work wherever,” Imes says. “People are always like, ‘You’re so lucky—you get to go on vacation.’ I’m like, you know what? I am actually always working. I’m constantly worried and checking what’s going on and brainstorming. But that’s also what I love about it as well—the flexibility.”

And despite the financial risk involved in owning a medical spa, Imes believes the money currently being made in the aesthetics industry represents the tip of the iceberg.

“It’s an incredible time to be an entrepreneur in this industry,” she says. “At Allergan’s big meeting this year, someone said that we’re only touching 6% of the population in the aesthetics world. So what does that mean? There’s a ton of money to be made. Get going, people, because hopefully pretty soon the hedge funds will come in and buy us all up and we’ll all be millionaires.”

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:  Business and Financials  Med Spa Ownership  Med Spa Trends  QP 

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How to Build Your Retail Program

Posted By Administration, Wednesday, December 4, 2019

retail products

By Terri Ross, Terri Ross Consulting

Incorporating retail products into your medical aesthetic practice can substantially strengthen your sales program, increase patient satisfaction, boost profitability and increase patient retention—all things that are vital to positive patient outcomes and a healthy practice.

The key to a successful retail program is focusing on products that compliment your treatments and services. Don’t try to be a one-stop-shop—carefully define which products will augment laser skin resurfacing, body contouring or skin tightening; research the options; have the reps come in and do an in-service; and ask to evaluate the products in addition to understanding the numbers and the support the company offers.

Once you’ve selected your vendors and the lines you want to carry (my recommendation is to choose no more than 3-4 SKUs), spend the time and resources necessary to train your staff and integrate the products into your personalized treatment plans and services. ABE—always be educating; if you’re not, or your team is not, stats show your patients will go to a department store or drugstore and buy products, and this obviously does not add value to your practice. After you’ve launched your retail program, follow up on the numbers and make adjustments as necessary to fine-tune and maximize your profitability.

Define Your Niche

Defining your niche is the most important step in building a successful retail program. Just as you seek to define your niche in the world of medical aesthetics through specialized treatments and services, you should seek to define your niche in the products you offer. They should be carefully tailored to your treatment plans. Don’t try to offer every product on the market—this will overwhelm your patients and will negatively impact your retail profitability. Why? Because patients will feel less like they are being offered a product to enhance their specialized treatment and more like they are being sold as many products as possible to increase their overall expenses. When you hone in on a specific retail line, you give patients the impression that you have carefully selected a product that will complement their services, leading to increased patient satisfaction and trust. Also, by focusing on a particular product line, you give your staff the opportunity to really learn the products, applications and relevant technology. Their ability to answer patient questions accurately and thoughtfully is critical and will further enhance the patient experience.

Research the Options

Conduct careful and thorough research of potential retail partners, their products and their current relationships with other offices. Once you’ve honed in on a specific type of product, take note of how many retailers offer that product and what types of products are typically offered in parallel. When choosing a vendor, prioritize product quality and partnership satisfaction. Product quality is crucial—the products you offer patients at your practice will reflect on the overall quality of your services, and your goal is to offer the best patient experience possible. Partnership satisfaction is equally as important. How easy is the vendor to work with? How frequently are they willing to deliver and replenish inventory? What are the potential markups on each product? Is there an opportunity to grow with the vendor and expand as demand increases? What educational support do they offer? Are there minimum quantities? Do they buy back? These are key details to know in advance of making any binding commitments with potential vendors. Read more about how to choose the right vendor in this article from Business.org. The vendor you choose should have a strong record of sales, customer reviews and partner relationships.

Evaluate the Numbers

Once you’ve identified a few vendors, you’ll want to dig deeper into the numbers. What types of products offer the highest profitability in the medical aesthetics market? What products offer patients the best outcomes, both in combination and stand-alone? What are the profit margins for some of the key products in each retail line you’ve targeted? What is a typical quarterly return on investment (ROI)? While some of these numbers are relatively straightforward to calculate, others may be more difficult to pinpoint and will require careful research.

A key part of your investigation should be based on patient satisfaction. After all, even if profitability on a product historically is high, you must first sell the product to make a profit. Research how well customers respond to specific products offered by each vendor and calculate an estimate of overall satisfaction. It also may be beneficial to reach out to other medical aesthetics practices that offer specific products and request a rough estimate of patient satisfaction. What percentage of patients who buy this product review it positively? Would they recommend it to a friend or colleague? How many times have they purchased the product over the last year? How many products does a patient purchase, on average? Some of these numbers may be provided by the vendor themselves, particularly if they are a more established entity. Though careful research takes time, it will be worth your investment to evaluate potential vendors by the numbers before making a commitment.

Manage Your Relationship with Vendors

Once you’ve identified the vendors you want to work with, your next step is to establish and maintain a healthy relationship with this business partner. First, make sure any contractual agreements signed are mutually beneficial. In most cases, they will be, because you have parallel goals—to satisfy patients and sell products. Because product prices can fluctuate with the market, you may want to request written confirmation that the price will not fluctuate more than a maximum allowable percentage, based on your evaluation of profitability. Maintaining transparency is the most important part of managing your relationship with vendors. Pass along feedback on their products from your patients, whether it be positive or negative. They may be able to expand a specific line or improve upon existing products to better satisfy patients in your office. The goal is to grow together. If your sales program is performing exceedingly well, they will be able to learn from you. If your sales have become stagnant, they may be able to offer tips on how to boost your marketing program and may even provide literature or product demonstrations to increase your success with the product. Seek to establish and maintain a positive, honest and mutually beneficial relationship with your vendor.

Integrate Products into Your Treatment Plans

Aside from product quality and vendor relations, how well you integrate product lines into your treatment plans and services is the most important part of a successful retail program. Create in-house literature to support the products you offer, such as pamphlets, posters and quarterly newsletters. Include the expert opinions of physicians, as well as positive feedback from patients who have already tried the products in your office. You want to give your patients the impression that these products will enhance their overall experience and the success of the treatments they receive. If a specific product has been shown to increase the effectiveness of a certain treatment or prolong the effects of a certain service, emphasize that in your marketing plan. In short, the product line you’ve chosen to sell should not stand alone in the back corner of your waiting area. Spotlight the products by featuring them in personalized treatment plans and monthly specials. A successfully integrated retail program will enhance the overall patient experience, resulting in increased patient satisfaction and increased profitability.

Train Your Staff

The success of your retail program is directly proportional to how well your staff is trained. As I discuss in my LAER model of staff training, it is critical that every member of your staff listens to and engages your patient population. They should be intimately familiar with the personalized treatment plans and services you offer. When you launch a retail program, invest in staff training. A well-trained staff will have a thorough understanding of your products, how they will be incorporated into your treatment plans and how they compare to similar products on the market. The goal is to inform your staff so they can inform your patients. When a patient asks about a specific product, they should receive a well-informed, positive response. This will not only help to increase trust in your staff, but also boost sales and lead to increased profitability.

Staff training is critical to almost every aspect of your medical aesthetic office. You invest in a beautiful office, you invest in expense equipment, and you invest in marketing to get new patients, but often internal training is overlooked or neglected. Training your team to convert calls into appointments, convert web leads and conduct an effective patient consultation require skills, confidence, knowledge and effective communication. Investing in training will yield the greatest ROI and build confidence for empowering your staff to help you grow your business and provide five-star customer service. To learn more about the processes and techniques that go into an effective sales program, contact me today and ask about my workshop on staff training.

Keep an Eye on the Numbers

Once you’ve built a retail program, you’ll want to review the numbers at least once per quarter. Calculate your overall ROI on retail sales and determine which products have the highest sales and profitability rates. Also, take note of which products patients purchase more than once. The most expensive products do not always offer the highest profit margins. Use this data to tailor your marketing program and staff training, if needed.

If a particular product isn’t selling well, execute a plan to incorporate it into a monthly special, or feature it in a specific service or treatment plan. Consider sending out a product survey in your quarterly newsletter to learn which products your current and prospective patients are most interested in; use this data to hone your inventory and boost sales. You also can report this data back to your vendors, so they can better plan and tailor their production and inventory delivery. If you want to sustain a successful retail program, you’ll need to keep a regular eye on the numbers and make the necessary adjustments in your protocols, processes, marketing and staff training.

Building and maintaining a successful retail program can substantially increase patient satisfaction and boost profitability. Have you maximized profitability in your office? Contact me to find out how you can implement a successful sales program in your office 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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How to Use Influencers for Medical Spa Advertising

Posted By Administration, Monday, December 2, 2019

influencer

By Sam Pondrom, JD, Associate, ByrdAdatto

Social media is discussed ad nauseam, so it’s always important to begin any discussion of social media by placing it in context. About 3.5 billion (with a “B”) people actively use social media every day, and about 3.46 billion people access it via mobile devices. This amounts to about half of the world’s population. Worldwide, the average person spends around seven hours per day on the internet, and two and a half hours of that seven is spent on social media. This means that roughly one-third of all internet use on a given day is social media-based. Advertisers in the U.S. will spend anywhere from $15 to $30 billion on social media marketing this year alone to reach those users. So, for better or worse, social media is not going anywhere anytime soon.

The engagement of “influencers” is a popular method of advertising on social media. As you likely already know, influencers are social media users who, by virtue of their looks, personality or talent, have developed large follower bases. These follower bases are easily reached by the influencer, and, because follower bases are self-selecting (e.g., the followers choose to follow the influencers), they are particularly susceptible to the influencer’s message. Consequently, influencer advertising is highly valued, since brands borrow the influencer’s reach and credibility to spread their advertising messages, which are often designed to blur the lines between organic user content and paid influencer advertisement.

However, this blurring of the lines often leads to issues with using influencers in medical advertising. So, if you currently use or plan to use social media influencer advertising, here’s what you need to know.

State medical advertising laws. It’s important to remember that no matter how you choose to advertise, you must comply with your state’s medical advertising laws.  While these laws vary from state to state, every state has a standard similar to this: Do not advertise in any manner that is false, deceptive, or misleading. So, what does that mean? You must take care to advertise in such a way that you do not, among other issues, create unjustified expectations about results; advertise or assure a permanent cure for an incurable condition; guarantee results; advertise professional superiority that cannot be verified; provide false, deceptive or misleading testimonials; or fail to identify models and actors used in advertising. Thus, when engaging an influencer for advertising purposes, you must first consider your state’s restrictions to ensure your advertisement is compliant.

FTC advertising requirements. On top of your state’s medical advertising laws, the Federal Trade Commission (FTC) has rules prohibiting “unfair methods of competition and unfair or deceptive acts or practices” in commerce. While this is a broad prohibition, compliance with the FTC can be reduced to three simple concepts: honesty, transparency and disclosure. The FTC is particularly concerned with the fact that the average social media user may have trouble distinguishing between organic user content and paid advertising. To that end, the FTC has determined that anytime an influencer performs marketing services, they are making what the FTC considers an endorsement. Accordingly, the FTC requires that an influencer must disclose any material connections that exist related to the product or service when using social media to make an endorsement. Material connections are connections that might affect the weight or credibility consumers give the endorsement. So, an influencer must disclose a business or family relationship related to the advertisement, a monetary payment connected to the advertisement, or the receipt of free product or services related to the advertisement. The disclosure must be made in plain language that is easy to see or hear, and is clear across all social media platforms and devices.

Use a contract. As made clear in the sections above, using influencers for medical advertising requires careful regulatory consideration. Accordingly, it’s important to use contracts to allocate risk and reduce the potential for unmet expectations.  There are multiple potential pitfalls associated with engaging an influencer for medical advertising. By using a contract, you can address these issues and ensure key items such as content, payment, competition and regulatory compliance are all addressed. For example, you may want to give the influencer creative license in writing the advertisement so their voice comes through (or not). Regardless of who is writing the ad, a physician must have final say over any and all medical claims. You may also want to get creative in compensating the influencer, but you must structure the payment in a manner that is compliant with your state’s anti-kickback laws. By memorializing the important aspects of the influencer-advertiser relationship, you can ensure the advertising meets your standards and expectations and the relationship complies with relevant state and federal law.

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 youngest of three brothers, Sam Pondrom learned early on how to work effectively as part of a team. After graduating from Oklahoma State, an intrinsic sense of curiosity and a keen eye for details led Sam to work as an accountant for two Engineering-News Record top 40 construction firms. It was here where he honed his ability to analyze complex issues and craft clear, concise answers. Sam utilizes these skills to work in partnership with our clients to resolve their complex business and regulatory concerns in the most simple, straightforward way.

Tags:  ByrdAdatto  Med Spa Law  Med Spa Trends 

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Portrait of a Medical Spa Owner, Part 3: The Nurse

Posted By Administration, Monday, November 25, 2019

emily tryon

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

In the early days of the medical aesthetic business, it was more or less presumed that a medical spa would be owned by a “core doctor”—i.e. a plastic surgeon, facial plastic surgeon, otolaryngologist or cosmetic dermatologist. However, as the field has matured, the group of owners involved has become more and more diverse, ranging from doctors and nurses to entrepreneurs and even estheticians. In fact, it’s somewhat difficult to find a medical spa owned by a core doctor today—according to the American Med Spa Association’s 2019 Medical Spa State of the Industry Report, of all of the medical spas owned by medical professionals, only 20% owned by core doctors.

Today, it’s much more common to find doctors with backgrounds in family practice and emergency medicine owning medical spas—each of those specialties owns 23% of the practices owned by medical professionals, according to the report. Why is this? As you’ll read in this series, there seems to be a certain frustration with the way managed care has caused health care in the United States to evolve, and doctors, nurses and physician assistants are interested in providing more personalized care to their patients without having to deal with insurance and other payment issues.

However, doctors aren’t the only people involved in medical spa ownership—entrepreneurs are making their mark on the industry, as well. According to the report, 12% of medical spas owned by individuals and 24% of medical spas owned by groups are owned by entrepreneurs. It speaks to the broad appeal of the industry—and the amount of money people are making in it—that this many people from outside the traditional boundaries of it are willing to invest their money in medical aesthetics.

In this series, you will be introduced to four people—a doctor, a mid-level practitioner, an RN and an entrepreneur—who came into the medical spa industry from different backgrounds, but managed to find success because of their determination and love for the business. Each one is true success story and an example of how, in this industry, hard work and quality care are a winning combination.

The Nurse

Six years ago, Emily Tryon, RN, reached a crossroads in her career. She had spent much of her time in nursing working night shifts at hospitals, but she also had a passion for aesthetics that was causing her to question how badly she wanted to continue working in that setting. So in a moment of what she calls “entrepreneurial insanity,” she decided to strike out on her own.

Her first experience in the industry was a disaster. She began administering cosmetic injections out of a room at a physical therapy center, which she said was “a terrible location, because everyone coming in was just grateful to be alive—they certainly weren’t interested in how they looked from a cosmetic injectable standpoint, that’s for sure.” This arrangement came to an end when the physical therapy practice owner was evicted for failing to pay rent to the building owner; Tryon had to fight tooth and nail to simply get into the building to reclaim her equipment.

Shortly thereafter, she set up her practice, Esthetic Solutions, in a 150-square-foot space in the basement of a hair salon in Scottsdale, Arizona. Against all odds, it was there that she became one of the top injectors in the country, eventually clearing more than $1 million per year in injections alone.

“By year three, I was in the top 7% of cosmetic injectors in the nation, according to Allergan Professional Consulting,” Tryon says. “By year four, I was in the top 3% of injectors in the nation, and as of August 2018, I am now in the top 1% of cosmetic injectors nationwide.”

In December 2018, she moved Esthetic Solutions into a 2,000-square-foot space and expanded its staff to provide a full range of medical aesthetic treatments. She also works as a trainer who specializes in aesthetic medicine and consultation skills.

“That’s where it’s really at for me,” Tryon says. “I finish my training day at 6 p.m., and when I walk out of that clinic and I have hugs and tears of joy from my participants, where they say, ‘Thank you so much—I now have confidence to inject and I know that I can do this. Thank you so much for giving me the tools to do that.’ That’ll get me on a plane at 4 a.m. any day.”

Tryon believes that having a background in nursing has played a critical role in her success in the medical aesthetics business, since the non-medical skills nurses have to develop makes them a natural fit for the retail side of the business.

“Every nurse is in sales,” she says. “When we call a doctor at 2 a.m. because we think a patient needs a blood transfusion, for example. That was my foundation when I became a nurse—I started in sales 20 years ago as an RN in the ICU.”

Ultimately, Tryon’s “entrepreneurial insanity” turned out to be a solid bet on herself and her skills, one that forced her to become a top practitioner and a better businessperson.

“I would say that being an entrepreneur is the biggest, most challenging, most intense game I have ever played in life,” Tryon says. “There are really, really great highs and there are really, really great lows. And being able to see all of it as pieces to a giant puzzle and put those pieces together, for me, it pulls from every one of my strengths and my weaknesses to continue to grow and develop myself and who I can be.”

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 2019 Medical Spa Statistical Survey  Med Spa Ownership  Med Spa Trends  QP 

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Portrait of a Medical Spa Owner, Part 2: The Mid-level

Posted By Administration, Friday, November 22, 2019

maegen kennedy

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

In the early days of the medical aesthetic business, it was more or less presumed that a medical spa would be owned by a “core doctor”—i.e. a plastic surgeon, facial plastic surgeon, otolaryngologist or cosmetic dermatologist. However, as the field has matured, the group of owners involved has become more and more diverse, ranging from doctors and nurses to entrepreneurs and even estheticians. In fact, it’s somewhat difficult to find a medical spa owned by a core doctor today—according to the American Med Spa Association’s 2019 Medical Spa State of the Industry Report, of all of the medical spas owned by medical professionals, only 20% owned by core doctors.

Today, it’s much more common to find doctors with backgrounds in family practice and emergency medicine owning medical spas—each of those specialties owns 23% of the practices owned by medical professionals, according to the report. Why is this? As you’ll read in this series, there seems to be a certain frustration with the way managed care has caused health care in the United States to evolve, and doctors, nurses and physician assistants are interested in providing more personalized care to their patients without having to deal with insurance and other payment issues.

However, doctors aren’t the only people involved in medical spa ownership—entrepreneurs are making their mark on the industry, as well. According to the report, 12% of medical spas owned by individuals and 24% of medical spas owned by groups are owned by entrepreneurs. It speaks to the broad appeal of the industry—and the amount of money people are making in it—that this many people from outside the traditional boundaries of it are willing to invest their money in medical aesthetics.

In this series, you will be introduced to four people—a doctor, a mid-level practitioner, an RN and an entrepreneur—who came into the medical spa industry from different backgrounds, but managed to find success because of their determination and love for the business. Each one is true success story and an example of how, in this industry, hard work and quality care are a winning combination.

The Mid-level

Maegen Kennedy, PA-C, trained in family practice and dermatology, and worked at a busy urgent care where she saw dozens of patients every day. It wasn’t long before she grew frustrated with the grind of practicing medicine in a managed care environment.

“I was tired of seeing 40 patients a day and feeling like a hamster in a wheel,” she says. “I was tired of insurance reimbursements and being told what to do. I was tired of jumping through hoops for patients who weren’t following through with treatment plans, exercising and dieting. You get burnt out.”

Instead of continuing to toil in a job she disliked, however, Kennedy decided to strike out on her own and pursue medical aesthetics.

“It was a big decision that weighed heavily on my conscious—do I want to give up a lot of my training, and will I be happy just doing aesthetics? I decided that it was in my best interest to do that,” Kennedy says.

She didn’t have enough money to open a medical aesthetic practice right away, but her desire to make it on her own sparked her ingenuity. She rented a tiny 250-square-foot studio and began administering microblading treatments; during this time, she built a large client base, became a nationally renowned expert in microblading and, eventually, made enough money to open her medical spa.

“I was just tired of building up somebody else’s practice,” Kennedy says. “I believed in myself enough that I knew if I opened something, I was going to go full force and wholeheartedly into it, and it was going to be successful. I just believed that, even though the med spa space is extremely risky and scary. It’s very hard to break into the industry if you don’t have the capital.”

In September 2017, Maegen and her husband Jordan Kennedy, DMD, opened Windermere Dental & Medical Spa in Orlando, Florida, a full-service medical aesthetic practice combined with a dental practice. Additionally, she operates Fleek Brows Microblading Training, through which she conducts intensive courses that help medical aesthetic practitioners learn how to perform and market microblading treatments.

Kennedy feels that her background as a PA-C has allowed her to become a success in medical aesthetics and, although she is much happier operating her medical spa than she was before, she suggests that people who are undergoing advanced medical training should not begin a career in medical aesthetics right away.

“This is what I tell people all the time: Don’t come out of school and go into aesthetics. It’s just not the right way. I know aesthetics is very attractive because it’s fun and you don’t have to see 40 patients a day—you can see 15 or 20. But the truth is, when it comes to medicine, you’ve got to get your foundation. You need the foundation. I find that without my foundation, there are situations that I may not have recognized or felt as confident in treating patients. But when you have a foundation—whether it’s internal medicine, family medicine or even dermatology—then you’re better equipped in aesthetics. You’re more well-rounded, and I believe you have an appreciation for aesthetics that is so much different than if you just went into it right out of school.”

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:  Business and Financials  Med Spa Trends  QP 

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Launching a Medical Aesthetics Practice: Key Factors to Consider

Posted By Administration, Wednesday, November 20, 2019

medical spa staff

By Terri Ross, Terri Ross Consulting

Launching a medical aesthetics practice can be an incredibly challenging but ultimately rewarding venture. Before opening the doors to your practice, there are several key factors to consider, including, but not limited to, market characteristics, population statistics, competition, potential resources and personal drive.

Market

The status, pace and growth of your niche market is the most critical factor that will directly impact the success and profitability of your medical aesthetics practice. Take a pulse of what’s happening in your target area. Is the market already saturated? How many offices are currently in operation? How many have opened in the last five years? Are they expanding? What specialty treatments and services do they offer?

Identify practices that have demonstrated considerable success and learn from them. Take note of their infrastructure, marketing style, target clientele, etc. Your goal is to create a medical aesthetics practice that excels above the competition. There are a few ways to approach this goal. First, you can strive to meet the needs of your target clientele better than existing practices. This can be achieved by providing a superior patient experience: upscale office and treatment areas, knowledgeable and engaging staff, and personalized treatment plans. Conversely, you can strive to meet a new need in your target population by specializing in a new area or offering unique treatment plans. (Click here to read an article from Forbes about how to find and develop your niche market.). The key is to identify an area of the medical aesthetics market that is under-developed in your region of interest—and capitalize on it.

Population Statistics

Before launching your medical aesthetics practice, you’ll want to carefully and diligently define your target patient population. Where do they live? Where do they shop? Which restaurants do they frequent? Identify this population and research them extensively. Take note of their average household income and their average monthly expenditures on medical aesthetics services, among other expenditures. Consider what types of medical aesthetics services they are currently receiving and what types of services they might be interested in. Identifying and characterizing your target population links back to defining your niche market. If you can identify a need in your target patient population that hasn’t been met by the current market, you’ve accomplished the most important—and perhaps the most difficult—part of launching your new practice.

Competition

Identifying and understanding your competitors is a critical factor that will directly impact the success and profitability of your medical aesthetics practice. What types of services and treatment plans do they offer? Are there any specialty practices already in the market that have a main focus, such as body contouring? Be careful and diligent in your research. Identify three to five of the most successful offices in your area, take notes and visit the competition. How long have they been open? How fast are they growing? How many doctors practice in each? How extensive is their support staff? What is their patient retention rate, according to industry reps? By mapping out these details for each of your top competitors, you will begin to understand key elements you want to implement—or not—in your office.

For example, you might hone in on a particularly successful marketing strategy or identify treatment plans that maximize profitability in your area. By thoroughly examining the competition, you’ll be able to learn from their mistakes, streamline processes and shape a successful marketing strategy before ever opening the doors to your own office.

Potential Resources

Once you’ve identified your niche market and target patient population, you’ll want to make sure that the region you’re considering can support your vision. The area where you choose to launch is critical. It will affect your ability to staff, manage and grow your office. What are the local demographics? Your staff’s ability to listen, engage and communicate with your patients is among the most critical aspects that will shape the success of your office. This begins with hiring the right people and training them well. (Click here to read more about the LAER model I developed for effectively training your front office staff here.)

The accessibility of technical support for your medical equipment is another important resource you’ll want to consider. Your equipment and supplies will need regular and established maintenance and support to ensure optimal performance. Most laser companies offer a maintenance plan; however, while it is vital, it is also very expensive. How quickly can support personnel be onsite? Do they offer a loaner?

The potential for collaboration is one last element to consider before making the final decision on where to open your practice. Are there any practices in the area that offer services that would complement your services or specialty? Would a collaboration or referral system make sense? In some cases, it may be more beneficial to work with key competitors rather than against them. There may be an opportunity to offer patients a bundled promotion or personalized treatment plan that successfully incorporates the expertise of both practices. In this way, you are capitalizing on existing resources and building upon them to maximize your profitability and success.

Personal Drive

Your personal drive is another key element that will impact the launch of your medical aesthetics practice. This factor cannot be easily measured or analyzed, but it plays a pivotal role in the success of your practice, particularly in the launch phase. Undoubtedly, launching a new medical practice in any specialty requires not only expertise and knowledge, but also persistence and drive, in both the medical and business fields.

As the medical expert, you’ll be required to know and stay up-to-date on your clinical knowledge. This includes learning new technology, procedures and treatments as they become available, and implementing them in your space.

As the business leader, you’ll be required to make smart decisions and make changes that will support the growth and success of your office. This includes hiring and training medical and administrative staff, implementing efficient processes and protocols, creating and sustaining a successful marketing plan, and consistently achieving new goals in patient retention and conversion, ROI and room revenue assumptions.

Click here to take a look at some of the critical financial numbers that will affect the growth and profitability of your office. To launch and sustain a successful medical aesthetic office in the current market, you will need diligence, tenacity and a great deal of personal drive.

Launching a successful medical aesthetics practice is a challenging but incredibly rewarding experience. Do you have what it takes? Do you have attainable revenue goals and the infrastructure, protocols and staff in place to get you there? Click here to download the assessment and complete Terri’s 10 Point Checklist.

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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Portrait of a Medical Spa Owner, Part 1: The Doctor

Posted By Administration, Monday, November 18, 2019

nicole norris

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

In the early days of the medical aesthetic business, it was more or less presumed that a medical spa would be owned by a “core doctor”—i.e. a plastic surgeon, facial plastic surgeon, otolaryngologist or cosmetic dermatologist. However, as the field has matured, the group of owners involved has become more and more diverse, ranging from doctors and nurses to entrepreneurs and even estheticians. In fact, it’s somewhat difficult to find a medical spa owned by a core doctor today—according to the American Med Spa Association’s 2019 Medical Spa State of the Industry Report, of all of the medical spas owned by medical professionals, only 20% owned by core doctors.

Today, it’s much more common to find doctors with backgrounds in family practice and emergency medicine owning medical spas—each of those specialties owns 23% of the practices owned by medical professionals, according to the report. Why is this? As you’ll read in this series, there seems to be a certain frustration with the way managed care has caused health care in the United States to evolve, and doctors, nurses and physician assistants are interested in providing more personalized care to their patients without having to deal with insurance and other payment issues.

However, doctors aren’t the only people involved in medical spa ownership—entrepreneurs are making their mark on the industry, as well. According to the report, 12% of medical spas owned by individuals and 24% of medical spas owned by groups are owned by entrepreneurs. It speaks to the broad appeal of the industry—and the amount of money people are making in it—that this many people from outside the traditional boundaries of it are willing to invest their money in medical aesthetics.

In this series, you will be introduced to four people—a doctor, a mid-level practitioner, an RN and an entrepreneur—who came into the medical spa industry from different backgrounds, but managed to find success because of their determination and love for the business. Each one is true success story and an example of how, in this industry, hard work and quality care are a winning combination.

The Doctor

Nicole Norris, MD, spent 12 years working as a family practice physician in Peru, a city of approximately 10,000 in North Central Illinois. During that time, she established a reputation as a caring practitioner who maintained close relationships with her patients. However, after moving from private practice into hospital employment, she discovered that her style of patient care was at odds with what was expected of her.

“Due to the way medicine has gotten mangled by managed care, I made the decision to find another option,” Norris explains. “The hospital was going to drop my salary a third time because I wasn’t seeing 30 patients a day. It’s impossible, with patients with chronic health problems, to see them, get them well and take care of everything. And with the opening of urgent care centers everywhere, the patients who come into the office for acute visits were few and far between. It’s easy to see 30 acute visits—colds, flus, that kind of thing—but not easy to see patients with multiple chronic health problems; that doesn’t happen in 10 minutes. I refused to change the way I practiced, and that was not rewarded. That was when I thought, ‘I have to find a different way to make people healthy.’”

Norris had been administering aesthetic treatments on a very limited basis at her family practice, and she found the experience to be extremely rewarding.

“I could not believe how these patients transformed, both physically and mentally, in just a few visits,” Norris says. “They walked taller and seemed happier and even healthier. I started to believe that my aesthetic procedures were superior to Prozac.”

In 2016, she decided to leave family practice and commit to medical aesthetics full-time. She opened Nicole Norris MD Medical Spa in Peru, and her commitment to attentive patient care has continued to pay dividends.

“Having those relationships basically encourages those patients to come in and see me now, even though I’m not their family doctor anymore,” Norris says. “We already had a relationship—they trusted and respected me. When I opened the medical spa, it helped me to have a good reputation. People already knew me and knew that I was a good doctor, so even though I was doing something really crazy, they still respected it.”

Norris initially approached the practice from a more medical standpoint, but quickly embraced the less traditional aspects of medical aesthetics.

“When I first opened, I was very focused on trying to keep my brand as a medical spa more medical and less spa,” Norris says. “I have since learned that luring patients in the door with spa services, such as facials, eyelash extensions and teeth-whitening, is very lucrative. These are ‘entry drugs.’ Then, by approximation, while in our office, they end up progressing to injectables and laser hair removal. Then they get a little braver and decide to try laser resurfacing, photofacial, SculpSure and even PDO threads. My brand is still very medical, but I am not too proud to emphasize the spa side of my practice, as well.”

Norris’s career move may have seemed risky at the time, but today she is delighted with her decision to leave traditional family practice.

“I love that I can make people mentally happier and, therefore, physically healthier without prescribing one pill,” Norris says. “It’s funny, but even though I work more now, I don’t feel like I go to work anymore.”

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 2019 Medical Spa Statistical Survey  Med Spa Ownership  Med Spa Trends  QP 

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Who Can Do What in a Medical Spa?

Posted By Administration, Friday, November 15, 2019

medical spa team

By Bala Mohan, JD, ByrdAdatto

As the new kid on the block, medical spas are breaking the mold of the traditional medical practice model. The merging of medicine and day spa services has created a new industry with multiple governing authorities to regulate it and the varying roles within it.

Most medical spas provide some combination of medical and aesthetic procedures—lasers, Botox, fillers, Kybella, microneedling, microdermabrasion, dermaplaning, chemical peels, dermabrasion and CoolSculpting. Often, this menu of services blurs the line between medical and spa treatments. While these procedures are considered medical in most states, exemptions exist in others. For example, the cosmetology boards of certain states allow aestheticians and cosmetologists to perform microdermabrasion and dermaplaning, as long as the procedure does not penetrate the dermal layer of the skin. On the other hand, more restrictive state regulating boards limit aesthetic and cosmetology practices to the topmost layer of the skin. This leads to the common question—who can do what in a medical spa?

The authority to administer medical aesthetic treatments follows a basic hierarchy:

  1. Physician;
  2. Nurse practitioner (NP) and physician assistant (PA);
  3. Registered nurse (RN);
  4. Licensed practical nurse (LPN)/licensed vocational nurse (LVN); and
  5. Aesthetician, cosmetologist and unlicensed personnel.

Physicians

Physicians have the broadest authority and often fill the role of owner or medical director in medical spas. The delegation of medical treatments to the rest of the staff falls under the supervision of these physicians, and sometimes NPs and PAs.

NPs and PAs

Certain states grant independent practice authority to NPs, and in those states, physician delegation or supervision is not required. Independent practice NPs can provide medical procedures falling under their scope of practice. Where NPs due not have autonomy, state laws generally indicate the level of physician supervision required for both NPs and PAs. In most cases, NPs practice in collaboration with a physician. Depending on the state’s laws, collaboration commonly follows written protocols (e.g., a list of delegated medical tasks, restrictions or limitations, prescriptive authority and level of supervision). Similarly, PAs usually practice pursuant to a supervision or delegation agreement, addressing their scope of practice and any applicable restrictions.

RNs

The scope of practice of an RN is more limited and subject to stricter delegation and supervision than that of an NP or PA. Unless state law dictates otherwise, a qualified physician or independent practice NP may delegate medical tasks to RNs, as long as the procedure is within their scope of practice and competency has been verified. If required, written protocols are delineated and appropriate supervision provided. If state laws do not define the level of supervision, the delegating practitioner must use their professional judgement to identify and engage in it appropriately.

LPN/LVN

The scope of practice of LPNs/LVNs is more limited and subject to stricter delegation and supervision than an NP, PA or RN. State laws generally dictate the medical tasks that a qualified physician or independent practice NP can delegate to LPNs/LVNs, whether written protocols are required, and the appropriate level of supervision. Similar to RNs, if state laws do not define the level of supervision, the delegating practitioner must use professional judgement to identify and engage in it appropriately.

Aestheticians and Cosmetologists

There is much confusion in the medical spa world about who is considered licensed personnel. While aestheticians and cosmetologists are licensed by cosmetology boards, they are considered unlicensed personnel by medical standards. They generally are permitted to perform spa procedures—e.g., facials and certain types of massages—that fall under their cosmetology licensure, but prohibited from doing anything requiring medical training.

Unlicensed Personnel

In addition to estheticians and cosmetologists, medical assistants (MAs) are considered unlicensed personnel for medical treatments and can perform treatments in medical spas only as state law allows. With limited to no medical training, these staff members generally are not permitted to perform medical or invasive procedures. Even if state law allows delegation, it often requires that the delegating practitioner provide onsite direct supervision during procedures. Delegation of medical treatments to unlicensed personnel must be approached with extreme caution.

From state to state, laws related to medical spa treatments vary from the very detailed to the very sparse, leaving room for legal interpretation.

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

Bala Mohan, JD, knew from a very young age that her choice of career would be related to science because she excelled in her biology and chemistry coursework. With a strong passion for genetics and the desire to find a cure for her mother—who was diagnosed with diabetes at an early age—Mohan obtained a Bachelor of Technology in Pharmaceutical Biotechnology. Having worked as a scientific researcher during her undergraduate studies, Mohan greatly values attention to detail and is a meticulous person. She then pursued a master’s in Entrepreneurial Biotechnology to gain knowledge about business and startups. This landed her a position with Cleveland Clinic Innovations, where she evaluated over 100 innovations and negotiated deals with potential investors. In this role, Mohan had the opportunity to interact with business and health care lawyers from multiple health care organizations, and she quickly realized that her real calling in life was to be a health care attorney. Subsequently Mohan obtained her JD and was able to pursue a career that combined all her interests—science, business, and law.

Tags:  ByrdAdatto  Med Spa Law 

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The Pros and Cons of Becoming a Medical Director for a Medical Spa

Posted By Administration, Wednesday, November 13, 2019

medical director

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

The medical aesthetic industry is booming. According to AmSpa’s 2019 Medical Spa State of the Industry Report, the annual revenue for the industry as a whole is estimated to approach or surpass $10 billion in 2019, which would represent an increase of more than 919% from 2010. The number of medical spas in the United States has more than quadrupled since 2010—from 1,600 to an estimated 6,582 in 2019—and the average medical spa brings in more than $1.5 million in revenue.

Thus, it makes sense that an ambitious dermatologist might be curious about joining or founding a medical spa as a medical director. And although it certainly seems to make sense to join a flourishing industry, there are also a number of reasons why you might not want to take that leap. Here are some pros and cons of becoming a medical director for an aesthetic practice.

Pro: Money

Dermatologists are among the specialists known in the medical spa industry as “core doctors”—doctors whose specialties align with the industry in fundamental ways. Core doctors tend to incorporate their medical spas into their existing practices, which is a less lucrative business model than running them as a business independent of their practices. However, the money still can be exceptionally good, especially if the dermatologist in question allows his or her medical spa to be run as an independent arm of the business by people who understand how to effectively market and promote a more retail-focused business.

Now is the time to earn your money in the medical aesthetics industry. AmSpa’s report suggests that the value of the industry is projected to double in the next five years, and given that it projects a fairly conservative rate of growth compared with those of recent years, the actual rate of growth could be even higher. Dermatologists are in a uniquely advantageous position to benefit from this.

Con: Compliance

When you are the medical director of a medical aesthetic practice, you are responsible for all aspects of the medical side of the business, and that includes compliance. You not only need to be sure that you are properly delegating and supervising the procedures being performed at the practice, but also create protocols for the non-medical employees of the practice in order to make sure they remain compliant with the regulations that govern medical practices in your state.

AmSpa members receive a complimentary 20-minute Introductory Compliance Assessment with a ByrdAdatto attorney. Click here to learn about this and many other benefits of becoming a member.

Pro: Referrals

As stated earlier, dermatologists who operate medical spas typically incorporate them into their existing practices. When this arrangement is properly carried out, a medical spa can create referrals to the dermatology side of the business. However, it is important to understand that creating referrals cannot be the primary reason to add a medical spa to the practice. As previously mentioned, a medical spa must be operated as a separate entity, since a medical spa is significantly different than a dermatology practice in form and function. A medical spa should be able to succeed on its own terms, regardless of what is going on with the dermatology practice.

This might be difficult to come to terms with. I’ve spoken with several core doctors who have had bad experiences with running medical spas, and they can hardly believe that the industry is as successful as it is. Invariably, they went wrong by viewing their medical spas as existing primarily to drive business to their main practices. This can’t be the primary reason you run a medical spa. Any referrals you receive from your medical spa should be viewed as a bonus.

Con: Hands Off

Serving as the medical director of a medical spa is more work than you might imagine, but it may not be the type of work you’re used to or prefer. An effective medical director needs to trust his or her staff to conduct most of the everyday treatments at a medical spa, and this may be difficult for a physician who is used to performing treatments and consultations with his or her patients. Unfortunately for dermatologists who enjoy this aspect of their work, it just doesn’t make sense to be hands-on with the high-volume medical spa side of your business when you could be doing more lucrative work at your dermatology practice. There are only so many hours in the day, after all.

This also speaks to the importance of maintaining a qualified, conscientious staff. You have to be able to trust the people who work under you, and that requires you to pay very close attention to who you hire and how they’re performing. At the end of the day, the medical aspects of the medical spa are the physician’s responsibility, regardless of whether or not he or she is on the premises.

Understanding the Commitment

Owning a medical spa is a great, fun way for dermatologists to supplement their income, but do not underestimate the amount of work you will need to do to make it a success. Serving as a medical director is a major commitment, and it’s best to approach it with realistic expectations.

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:  Business and Financials  Med Spa Ownership  Med Spa Trends 

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Home-grown Success

Posted By Administration, Monday, November 11, 2019

rejuv fargo north dakota

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

According to the U.S. Census Bureau, the population of the Midwest—which includes Ohio, Michigan, Indiana, Illinois, Wisconsin, Minnesota, Iowa, Missouri, Kansas, Nebraska, South Dakota and North Dakota—represented approximately 21% of the U.S. population in 2018 (the most recent year for which this estimation is available). However, according to AmSpa’s 2019 Medical Spa State of the Industry Report, the Midwest is host to approximately 24% of the medical spas in the country, an increase from 22% in the 2017 report. This represents the largest positive discrepancy between the population and the number of medical spas in any of the four census-recognized regions.

So why are there so many med spas in the Midwest, and why is the number growing? Simply put, demand is exploding. Consider the story of Radiant Divine Medical Spa, which opened in Brecksville, Ohio, in suburban Cleveland, in May 2017.

“After the first six months, we were at about $500,000 in sales, so I’m like, this is something—we’ve got something here,” says Ryan DeVault, Radiant Divine’s co-owner. “We had demand from other areas and other markets, so we opened up another medical spa about 25 miles away in Avon, Ohio. I signed that lease in January 2018. Then we had demand from another market that was about 25 miles south of us in Medina, Ohio. I signed that lease for new construction in June of 2018 and we opened up in October of 2018, so we turned one practice into three spas in the first 17 months.”

According to DeVault, Radiant Divine is on pace for $3.5 million in revenue across its three sites in 2019. (Author’s note: Read more about Radiant Divine in the “Cleveland Rocks” a little later in this article.) And although not every medical spa owner has the same ability to open new locations, many in the Midwest have discovered that the path to profitability leads to some far-flung places that one would not necessarily consider to be hotbeds for aesthetic services.

Dakota Dreams

Fargo, North Dakota, is the 222nd-largest city in the United States, with an estimated population of 124,844 in 2018, so it is not exactly a sprawling urban center. Its economy has traditionally been associated with agriculture, and farm families are not generally thought of as traditional medical spa customers. However, Fargo is growing—its population has more than doubled since 1980, and it has increased 18.3% since 2010—its economy is diversifying, and, perhaps surprisingly, it is home to one of the country’s most consistently successful medical spas.

Rejuv Medical Aesthetic Clinic opened in 2005 with 1,500 square feet and three employees. Today, it operates out of a 12,000-square-foot facility, has 40 employees and is on track for approximately $8 million in revenue in 2019.

“We’ve had 15 years consecutive growth at a minimum of 20% every year,” says Melissa Rogne, president and founder of Rejuv. “We really haven’t struggled in finding an audience, and we really have always defied what the typical aesthetic patient is supposed to look like. We’ll tell stories where some of our patients come in and they bring us eggs from their farms. We really feel like Rejuv has broken down the stereotype of what a typical aesthetic patient’s profile is.”

Conventional wisdom suggests that having a large population base is necessary for medical spa success. However, Rogne believes that being part of a smaller, more insular community actually works in the practice’s favor.

“Because of the tight-knit community, the referral network is alive and well, and we’re able to really capitalize on the good nature of the people in this area,” Rogne says. “The Midwest is known for having the friendliest people in the United States, and that’s true. Those people want to tell their friends, they want to see you succeed and they know you really genuinely care about them.”

However, despite its size and success, Rejuv is not the only game in town, which speaks to the medical aesthetic industry’s growth in recent years.

“One of the things that people think is that there’s no competition; it’s actually quite the opposite,” Rogne explains. “I did some research about a year ago, and we have essentially one aesthetic medical spa for every 5,000 people in this community. The competition is extremely stiff—it’s not what people think it is.”

Royal Treatment

To Rogne’s point, according to AmSpa’s 2019 Medical Spa State of the Industry Report, there are an estimated 6,582 medical spas in the United States, up from approximately 1,800 in 2011. Back then, it was possible to find markets in the Midwest that simply were not being served at all, and that is how aNu Aesthetics and Optimal Wellness in Kansas City, Missouri, came to be.

“Where we started, there was a really big void of providers,” says Cristyn Watkins, MD, founder, owner and medical director for aNu. “There was really nobody around us.”

For several years, Watkins and her partners—a nurse practitioner and two other doctors—kept their practice low-key, working evenings and weekends as time permitted and building up a devoted patient base.

“The nice thing was that, since we were all small-business owners and this was kind of our side job, everybody had our cell phone number, we e-mailed every single patient after we saw them, and we were our own schedulers,” Watkins explains. “Our patients really liked the fact that they had access to a physician who cared for them and who they had direct access to.”

During this time, aNu’s reputation grew via word of mouth, and when Watkins decided to dedicate herself to the practice full-time in February 2016, business “went crazy.” The practice moved to a new 6,000-square-foot location in November 2017, and it is projected to bring in $3.5 million in revenue in 2019. Watkins refuses to rest on her laurels, however—she is doing everything she can to spur on aNu’s growth, and that means doing everything she can to give her patients what they want.

“Between medical aesthetics and wellness, you have to be on the cutting edge all the time,” she says. “If there’s something I’m interested in or my staff is interested in, we usually implement it within about 90 days, if it’s got good ROI and I think it’s something we should be doing. You have to always be figuring out what the new thing is in order to make it [to the top], I truly believe. But I also believe that if you care about your patients and you take care of them, that they’ll take care of you.”

Cleveland Rocks

Compared to Rejuv and aNu, Radiant Divine is an overnight sensation; however, although the spa itself has only been open since 2017, its primary provider, Rachel DeVault, RN—Ryan’s wife—has been building a reputation in the Cleveland area for far longer.

“My wife became an RN in 2010,” Ryan says. “She was working just regular hospital jobs, and then a friend of ours opened up a medical spa in the back of his tanning salon. He knew she was an RN and introduced her to aesthetics. She just has a niche for it. She grew his injectable practice from zero to 200 people in about 60 days. She created the following for him.”

Since then, Rachel has become an expert injector. She is currently a Galderma GAIN trainer, and not surprisingly, her loyal clients from those early days formed the foundation of Radiant Divine’s success.

“We didn’t solicit any of her old people—they found us,” Ryan says. “We didn’t do really any forms of advertising. The website was not the strongest. But it just seemed to be that word of mouth and referral was our best source.”

Close to Home

The success of these practices demonstrates the value of establishing a reputation for exceptional service, particularly in places where members of communities are close and inclined to recommend businesses that provide what they promise. However, there are certain disadvantages to working in places that are off the beaten path for aesthetic professionals.

“For us, probably the biggest issue has been hiring,” says Rogne, of Fargo’s Rejuv. “It’s really difficult for us to find people who have experience in this industry in a smaller market like ours. We’ve really had to invest a lot in training people and bringing them up new in this industry. We don’t get to just hire a nurse injector—we have to create a nurse injector. Without a doubt, the biggest challenge for us is the availability of human resources and staffing.”

“It’s always staff,” agrees aNu’s Watkins. “It’s always finding a good front-desk person and a manager.”

However, dealing with issues such as these is a small price to pay for home-grown success.

“I’ve lived here forever, she’s lived here forever,” says Radiant Divine’s Ryan DeVault of his wife, Rachel. “It’s an area I’m familiar with. I know a lot of people here and I know the approach and I know what they’re looking for—the services they’re interested in. I feel we can accommodate our market because we’re familiar with it. Can we do this in different market? I don’t know, but we know this market. Cleveland’s home, you know?

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

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