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The Aesthetic Platinum Rule

Posted By Administration, Thursday, August 1, 2019

By Tyler Terry, vice president of sales, TouchMD

In life, it's said that living by the Platinum Rule will ensure that you're optimally treating your fellow man the way that he or she wants to be treated. For those who have never heard of the Platinum Rule, it means you should treat others the way that they want to be treated. We've all heard of the Golden Rule, which states you should treat people the way that you want to be treated. The Golden Rule has good intentions, but it's not attending to the core of what really matters, which is how the person with whom you’re interacting wants to be treated.

When it comes to consulting your patients, the Platinum Rule couldn't be more valuable. This simple guideline will help you maximize each and every consult by treating and consulting your patients the way that they want to be treated and consulted. One key to bringing this rule to life is to take a picture of your patient and give him or her access to that picture to look at and draw on while he or she is waiting in your consult room. This can simply mean printing off their picture or having that picture pulled up on an iPad or computer and allowing the patient to circle any areas of concern. The talk track would go something like this: “Ashley, while you're waiting, the doctor would like you to circle any areas that you would like to enhance. This will help us provide the very best consult, leading to excellent care and satisfaction of your treatment plan.” At this point, Ashley would have the opportunity to look at her picture subjectively and point out what she feels is most important for her overall satisfaction.

After implementing the Platinum Rule in your consultations, you will be amazed at what your patients point out and share with you. They are essentially telling you how they would like to be treated—telling you how to sell to them—and giving you the opportunity to consult them as the expert. By doing this, you are providing them with the treatment plan that they specifically want and need to feel good about their treatment and experience with your practice.

The Platinum Rule allows your patients to be the “compass” of their aesthetic journey with your practice and allows you to be the “captain” of the consult, as you feel confident navigating through the various stages of the patient's journey. This rule can be applied to so many aspects of our lives. The key is to be willing to genuinely ask and listen.

TouchMD is a visual consultation, marketing and imaging software utilizing touch-screen technology that enhances the patient experience with proven revenue generation.

Tags:  Business and Financials  Guest Post 

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Front Office Training: 7 Steps to a Positive First Impression

Posted By Administration, Wednesday, July 31, 2019

By Terri Ross, Terri Ross Consulting

When you first walk into a medical office for an appointment, what are your expectations? How do you want the staff to greet you, and what are some of the things that make you say, “I’m never coming back here again”? As a business owner, do you meet those expectations? The front office is often a patient’s first glimpse into the workings of a practice, and if a patient has a positive experience with your front office staff, it sets the stage for a positive experience overall.

As with any business, effective communication in the medical aesthetic office is key. The first interaction you have with potential patients is often a phone call. Office staff should be trained on how to begin and execute a productive and engaging phone call. In their interactions with patients, front office staff should strive to be enthusiastic, knowledgeable and engaging.

1. Be enthusiastic, engaging and confident: A positive attitude is infectious and an important element of success in any business. This article from the Huffington Post explains the importance of a positive attitude in business. Convey a positive attitude, speak and articulate information with confidence, and engage the patient in dialogue to ensure you have gathered all of the facts about them and what they are requesting. This will set you apart significantly from others practices that don’t invest in training their staff. 

2. Listen first: Listen to prospective patients—assess their needs and desires before pitching a service or treatment. Strive to make a genuine connection with each patient. You want to “land the patient.” See TSIA’s explanation of the Land, Adopt, Renew, Expand (LAER) model here. The LAER model I teach is Listen, Acknowledge, Explore, Respond. Most often, people tend to listen and respond without really understanding  patient needs. Explore more details, show empathy and acknowledge that you fully understand what the patient is telling you.

3. Ask questions: Your ability to connect, ask questions, and engage with potential patients is critical. The medical aesthetics space is very competitive, and the consumers are very educated and have numerous resources to explore. They also have many choices, so your ability to articulate with conviction by credentialing the business and providers, as well as knowing the products and treatments you offer over the competition is paramount to a prospective patient wanting to schedule with you over another office.  

4. Never say no: If a patient asks if you offer Ulthera and you don’t, do not say no, or you’ve lost them. Instead, say, “May I ask who is calling? Hi [patient name]—so you are interested in skin tightening, is that correct?” This means you must know your technology and your competition and be able to effectively convince them that what you offer is equally as good if not better than another option. More importantly, your knowledge and skill set will make them want to schedule with you. If that doesn’t work, ask if you can follow up with them.

5. Respond to patient needs in a timely fashion: If a patient calls or emails with a question or need, make it a point to respond immediately—usually within 1 ¬– 3 hours, or 24 hours at the very latest. There are several different types of patient inquiries, and one of them is new leads. This is critical, as they are shopping but haven’t yet decided on your practice. Current patients are the ones who know you, trust you, and already have a relationship with you. However, communication with current patients is equally as important, as this helps to establish patient retention. If a patient asks a question to which you don’t immediately know the answer, say that you are searching for the answer and will respond as soon as possible. This lets them know that they are important.

6. Be the expert: It is essential for you to know every product and service offered in your office. Do your homework. You need to know every treatment: What it does, what it’s used for and how it can be incorporated into a personalized treatment plan. By knowing your services and how they compare to your competitors’, you engage patients and make them feel they have landed at the right office.

7. Go beyond what is expected: In attitude, knowledge and service, go beyond the patient’s general expectations. Make sure the patient has a positive experience from start to finish. Are you the Four Seasons or the Marriott?

Now that you’ve read these seven steps, picture yourself as a patient walking into your office, and ask yourself if you’d return for a next visit. Even if you’ve answered yes, there might be some room for improvement in certain aspects, and I want to make sure you have reached the point of a perfect first impression. Please download the complimentary checklist to evaluate where the holes in your staff training might be.

Is your office running at maximum capacity? Have you invested in staff training or sales consulting? Click here to download 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  Compliance is Cool  Med Spa Ownership  Med Spa Trends 

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Alabama Board of Medical Examiners Publishes Statement on Use of Lasers and Other Devices

Posted By Administration, Tuesday, July 30, 2019

coolsculpting blog

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

The most recent issue of the Alabama Medical Digest (published July 24, 2019) contains an interesting article that clarifies the Alabama Board of Medical Examiners’ stance on the use of lasers, intense pulsed light (IPL) and other energy devices that affect living tissue. According to the article, it was motivated by the number of questions the board gets about what devices a non-physician can use and how new technologies, such as CoolSculpting, are treated. (A portion of these questions were very likely mine!) To provide answers, the article relies heavily on the board rules under Chapter 540-X-11 of the board’s administrative code, titled Guidelines for the Use of Lasers and Other Modalities Affecting Living Tissue.

On new devices and technologies, the board’s position is that any device that is capable of affecting the tissue below the stratum corneum is a medical device regardless of the particular energy or technology used. Such devices must be used only by a physician or someone under a physician’s delegation and supervision. In this case, cryolipolysis devices such as CoolSculpting and radio frequency heating devices such as Exilis would be considered medical devices and would fall under the board’s rules—specifically the 540-X-11 guidelines. 

These guidelines divide energy- and chemical-based treatments into two broad categories: ablative and non-ablative. Ablative treatments are those that are expected or intended to remove, burn or vaporize tissue. These procedures and treatments may not be delegated to non-physicians and can only be performed personally by physicians. Non-ablative treatments include all other uses of lasers, energy or chemicals, as well as laser hair removal. Under the rules, non-ablative treatments may be delegated to non-physicians in some circumstances—the physician must examine the patient, establish the patient’s treatment plan and sign the patient’s chart, after which the treatment can be delegated to a person who meets the education requirements under chapters 540-X-11.07 or 540-X-11.08. When delegating these treatments, the physician must provide onsite supervision, meaning he or she is physically present in the facility and available to immediately respond if needed. However, when this treatment is delegated to a physician assistant (PA) or a nurse practitioner (NP) who practices at a remote site, the physician is not required to by physically onsite, but still must complete the initial patient examination, treatment plan and chart signing steps.   

The article also touches on the use of telemedicine when the physician performs the patient assessment and examination. The board states that the physician is able to utilize telemedicine for these exams, provided it meets the same standard of care as if the physician were seeing the patient in person.  However, as the article notes, using telemedicine in these cases make little practical sense when the physician must be onsite anyway to supervise the treatments, although telemedicine could be used for PAs and NPs at remote practice sites where the physician’s physical presence is not required.

In all, this article does not drastically change the practice landscape in Alabama. In fact, Alabama AmSpa members familiar with their State Legal Summary will not be surprised by the positions of this article. It does, however, give additional insight to how the Alabama Board of Medical Examiners views its duties, as well as serves as an important reminder that medical and nursing boards across the country are increasingly aware of and taking action in the medical aesthetic industry.

Tags:  Med Spa Law 

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Microneedling Joins Toxins and Fillers as a Leading Medical Spa Treatment

Posted By Administration, Monday, July 29, 2019

procedures

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

It should come as no surprise that injections of botulinum toxin and hyaluronic acid fillers are the treatments most commonly offered by medical aesthetic practices. After all, they provide good return-on-investment (ROI) and are constantly in demand. According to the 2019 Medical Spa State of the Industry Report, 88% of respondents’ medical spas offer botulinum toxin. Furthermore, 73% of respondents’ medical spas cite it as being among their top three most frequently performed treatments, and 56% state that it is the most common treatment for first-time patients.

Hyaluronic acid filler injections are similarly widely available—they are offered by 88% of medical spas—but are not quite as widely administered, appearing in 58% of med spas’ top three most frequently performed treatments.

In the 2017 version of this report, botulinum toxin and fillers were combined as one option, and they were found to be available at 82% of medical aesthetic practices, so their availability is still growing.

And while it finished fourth in terms of availability, microneedling’s ascent into the pantheon of medical aesthetic treatments is perhaps the biggest story of this report. In the 2017 survey, microneedling was mentioned on only a handful of responses; today, it is available at 84% of responding medical spas and is among the top three most popular treatments at 20% of them. 

AmSpa Basic Members receive an executive summary of the 2019 Medical Spa State of the Industry Report, while AmSpa Plus Members receive the entire report. Click here to learn about this and all the other great benefits of becoming an AmSpa Member, and sign up today.

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

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QP Extra: Q&A with Vic Owoc of Ageless Medical

Posted By Administration, Friday, July 26, 2019

ageless medical

“You can't manage what you can't measure,” says Vic Owoc, MBA, co-owner of Ageless Medical in suburban Fort Lauderdale, Florida. Since the practice opened in 2006, he has used his expertise in metrics to make it exceptionally successful. Owoc recently spoke with AmSpa Content Writer/Editor Michael Meyer about his history in the medical aesthetics industry and how he maintains his practice’s success.

Michael Meyer: What inspired you to open your practice?

Vic Owoc: Before opening up this business, I was involved in a health and supplementation business called Vital Pharmaceuticals. The business has really grown quite a bit now. I don't know if you've ever heard of a product called Bang energy drink or Redline—they just surpassed Rockstar as the number-three energy drink. So prior to this I was involved in that business, and we had some anti-aging products, as well as a lot of health and fitness-related products. So when I met Erin (Owoc, ARNP)—she's my partner in this and she's a nurse practitioner—it was a very natural progression, once I sold off that business, to the whole idea of health and making people look their very best. Moving over to a medical aesthetics practice was fairly logical for us. Erin had been doing procedures—Botox and hair removal and tattoo removal and all that—for a dermatologist for quite some years, and me being more the entrepreneur, I had several small businesses before we opened up this. We thought it was such a great fit. I had the business background and the entrepreneurial risk, and she doesn't have a lot of that, but she had a great following and a lot of knowledge in this area. So together we thought it just was a wonderful fit for this type of business.

MM: What would you say is different about your practice now versus when you opened it?

VO: The size of the business, certainly the number of patients and our location. We ended up buying our building, as well—one thing that I think is very important in this business is to own the real estate. Part of it was moving out of an area that was a smaller strip mall area to something that was bigger and had much more of a professional look and feel to it.

MM: What is your most popular treatment?

VO: We've got eight areas of business here, and I run this almost like eight different businesses. We've got our medical-grade products business. We've got a Botox, Dysport and Xeomin business. We've got our dermal filler Sculptra business. We've got a laser hair removal business. We’ve got a tattoo removal business. We've got a fat reduction business. We've got an aesthetics business, which is your facials, Hydroderm and SkinPen. And then we've got a medical aesthetics business, and that's where we have the more advanced stuff, including CO2 and Vivace and IPL and laser resurfacing—things typically an aesthetician can't do. I've always run this business as multiple businesses, so I can tell how this particular business is doing, what kind of marketing we're doing for this particular business, etc. I always say that our business is doing the best when all eight cylinders are running. 

But to answer your question, as far as revenue, it's fairly well balanced. The top three would be, the injectable businesses—your Botox, Dysport and all that, and then your dermal fillers. That is probably 30 – 40% of our business. And then from there, it's pretty much all balanced out. Our aesthetics business, 15%; hair removal, 15%; medical aesthetics, 15%; fat reduction, 15%. I've tried to get everything balanced together because you don't want a business—at least I don't want a business—where you've got all your eggs in one basket. Then, all of a sudden, a product comes out—for example, it could be topical Botox, which a lot of people are talking about. If you had 70% of your money in injectables, you're like, “Wow, I'm taking a big hit.”

So I believe in running a balanced business, like all eight cylinders in a car. But today, the injectable business is still the most profitable, if you had to break that out.

MM: What do you think makes your spa different from others?

VO: If I look at the competition, the biggest thing that I see is the discounting—trying to get patients by lowering price. It's a different type of patient. Yes, we'll have promotions here and there—not that often—but we're not going to discount lower than the next guy to get business. We don't want that type of patient. I hear it from some from some of the patients when I do a survey—your prices are a teeny bit higher, but I go there because of Lisa. I go there because of Erin. I go there because of how great the front desk makes me feel. When you start discounting, you train people to look for that. When I look at other practices that are continually having promotions and trying to bring people in through pricing, that's not what we do.

MM: What specific metrics do you use to determine success?

VO: I'm kind of a metric maniac. I start with daily metrics—how many leads have come in and how much revenue is coming in. Those are metrics that we manage by. And then how many of those leads that have come in—and this starts going on more of a monthly basis—come in for consults? How many of those leads as consults come for business? That's a very important metric for me because it allows me to say I'm spending this amount of money on this particular type of marketing, and who's coming in, how many are coming in, the percentage that is coming in for consults and how many who are coming in for consults are coming in for procedures. So that's a big metric area that I look at.

As far as other financial metrics, at the end of each month, we look at every single service that we do compared to how that service did last year and the percentage of business—like I said, the injectables being around 35%—that particular service brings in. I have this sheet that we look at during our team meetings and say, okay, our medical aesthetics business is down 2%, and within that business you notice that a laser, IPL or something else is what’s that's dragging that along. I always say, you can't manage what you can't measure.

It's very clear every month where our money's coming in, what services are bringing people in, and what is growing year over year. Knowing that is very important for each business. And then I jump into that in a little bit more detail, and that is, what's the profitability? I run the metrics on the profitability of each of those services so I can get a gross margin so I can say, okay, this particular service I'm emphasizing a lot, it's not growing, but here's what it's really doing to my bottom line. And then I do the same thing for the providers. What is the profitability of each provider that I have?

To really understand your business, and it's real clear, you have to know which services you’re making money on. Here's where I'm going with them, here are the providers I have, here's how much I'm paying them, here's the gross margin on each of them. When you do that, you really understand the health of your business. You understand where your marketing dollars are going and what's bringing you the most return, and for the providers you have, which ones are doing the best and bring in most of the bottom line, and the same thing with services.

There's one that I do on a daily basis looking at the revenue coming into leads. There's a monthly-basis one that's profitability on each of the services and how the services grew year over year. And then there's more that I run every quarter to six months. But there's a lot of them, and I do run this business on a metric base, because I just can't say this money I'm spending here on marketing, I think it's doing well; it looks like I'm a little busier. Or I want to get into vaginal rejuvenation but I'm not really sure. You have to measure it, and you have to be ready to drop a service or change out a provider, because once you have this data, what do you do with it? You can try to change the costs associated with those services, and the same thing with the providers. You have to be ready to make changes.

vic owoc

MM: What do you love most about the aesthetics business?

VO: I love that we're helping people. Our slogan is, ‘We make people look as young as they feel.’ Especially here in South Florida, people don't want to look like they've aged. When people come in here, they feel good. I can't tell you how many times my wife has told me, and I've seen it on occasion, that the patients cry. They've done dermal fillers on their face because that's something immediately you can see, and they look at themselves and they cry, and that's how much this bothered them. It's just amazing what you can do with some treatments of IPL to take the pigmentation off their face, some fillers for if they have folds on their face, and treating wrinkles around the forehead with Botox, you can make them look 10 years younger. It's just beautiful.

MM: What do you love about being an entrepreneur?

VO: Being able to call my own shots. I worked for large corporations for years. Reporting to someone else and being responsible—if you're a real mover and shaker and you want to change things, it’s very difficult to do in a corporation. But as an entrepreneur, if you can handle the risk, and you may make some mistakes and you may have some issues with that, but the ability to create your own success, to manifest your own destiny to me is exciting. I really love being able to take an educated risk, and of course the benefits from that. All the positives of being your own boss and running a successful business that helps people. I couldn't see it any other way.

MM: Who inspires you?

VO: My wife. She's the lead provider at Ageless Medical. She's just a very smart person. The patients come in so often to see Erin, it's almost a problem for the other nurse practitioners that have to go against her. Not only is she well credentialed, being a national trainer, she's just awesome.

MM: What advice would you give to other medical spa owners?

VO: Create a high-end brand. If you start your medical spa business and your brand is just okay, it's hard to go up, so start off with a great customer-centric brand. Also, you need to have the right people. When we bring someone on board and they know that we pay more than the other medical spas, they know we expect more. The people are so important. Hire the very best people. Pay them more. Because I will tell you, this is a business about people. A lot of people have the same technology that we have, but not everybody has our people. Attracting, training and retaining the right people are, by far, the most important things.

MM: What would you say is one word to describe your med spa journey?

VO: It's been exciting. You have to love this business. When I say exciting, it's all the changes that go on—you have to be excited about them. There are changes in technology, sometimes changes in policy, changes in your types of patients—now it’s becoming more and more millennial-based, for example. I'm excited about the changes. The business itself has been changing, but my feeling about the whole thing has just been excitement.

AmSpa members receive QP every quarter. Click here to learn how to become a member and make your med spa the next aesthetic success story.

Tags:  Business and Financials  Med Spa Trends  QP 

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5 Tips for Managing Patient Photos to Keep Your Medical Spa HIPAA Compliant

Posted By Administration, Thursday, July 25, 2019

doctor photographer

By Emily Alten, on behalf of RxPhoto

Before-and-after photos and photos used to document patient procedures are considered protected health information (PHI) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), regardless of whether or not clients are using health insurance to pay for their services. Therefore, it is essential that your practice properly secures patient photos to avoid potential fees for improper PHI handling. Here are five things to keep in mind to ensure that your patient photos remain HIPAA compliant.

Storage

Do not leave photos stored on devices indefinitely, and no photography equipment should ever leave the practice unless it has been wiped of photos. Remote-wipe technologies exist, but if you have set up this capability, make sure you are up to date on the most recent Health Information Technology for Economic and Clinical Health Act (HITECH) regulations. (Click here to learn more.) If using a DSLR camera, photos must be uploaded to a computer regularly and the SD card must be wiped clean so that photos cannot be accessed outside the practice or by anyone other than a trained staff member. If using a mobile device, the simplest way to remain HIPAA compliant is to use a service that stores photos in a HIPAA-compliant cloud server for you. That way, when photos are taken, they are automatically stored on the cloud and never stored on the device itself.

Communication

Sending or receiving photos of clients is an easy way to fall into HIPAA non-compliance. Emails are a big no-no. HIPAA requires that electronic communications with any PHI—including photos, names, any medical information or anything that can be used to identify a patient—be properly encrypted to ensure privacy. Also, be aware that sharing information with another party requires a consent form from the client to acknowledge that he or she is aware of what information being shared and with whom. HIPAA also states that communication between two parties should only include the minimum necessary information to properly care for the patient; however, if the client is a mutual patient of the two parties sharing health information, it can be freely shared.

Marketing

It may be obvious that consent forms are required to use any client’s information or likeness in order to market your product, but you should be aware that blacking out a subject’s eyes or even face is not enough to remove all possible identifying features or information. Getting consent forms and being transparent with clients about how their information might be used by the practice is the most prudent move.

Social Media

Social media is an excellent way to market to and communicate with present and potential clients. However, it is easy to slip into HIPAA-violating familiarities online. Even confirmation that an online persona is a client violates HIPAA rules. Make sure that any online communication from the practice does not include any of the following information:

  • Recognition that someone is a client—“It was nice to see you the other day,” or, “Glad you enjoyed your visit”;
  • Discussion or comment on a treatment—“We’re glad you’re happy with your Botox”; or
  • Recommendations for treatments, which could be considered medical advice from a non-MD source—or, worse, public medical advice violating patient confidentiality.

Educate Your Staff

Your staff should be educated on HIPAA and HIPAA compliance to ensure that your practice is doing everything it can to remain above-board. There are numerous resources, including online courses, that offer HIPAA training for medical staff; pricing averages approximately $25 per employee. (HHS.gov, HIPAAExams.com and MyHIPAATraining.com are among the sites that offer these training opportunities). This will not only keep your practice HIPAA compliant, but also help keep any staff/client communication professional and courteous.

Writing enthusiast and biology nerd, Emily Alten specializes in educational health care and medicine content. She is a Magna Cum Laude graduate from Columbia University with a degree in biological sciences/pre-medical studies.

Tags:  Guest Post  Med Spa Law  Med Spa Trends 

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Crackdown on Fraud and Abuse Serves as Warning to Medical Practices

Posted By Administration, Wednesday, July 24, 2019

doctor in handcuffs

Jay Reyero, JD, Partner, ByrdAdatto

In addition to the bright sun being so prevalent during these warm summer months, the fraud and abuse enforcement spotlight shines bright on Oklahoma and Florida.

In Oklahoma, two cases were filed involving a total of three physicians and five marketers, who all were charged with anti-kickback violations involving compounded prescription drugs. In one case, the fallout continues from the compounding pharmacy prescription scheme involving OK Compounding, where three physicians and a marketer were charged with anti-kickback violations and other criminal offenses. The allegations involve kickback payments disguised through medical director and consulting arrangements with the pharmacies. In a second case, a Texas marketer was charged with conspiracy to pay health care kickbacks for recruiting physicians to prescribe compounded drugs in exchange for a commission based upon reimbursed prescriptions. In a final case, three marketers were charged with kickback violations for a direct payment to a prescribing physician.

These cases offer a reminder that medical director, consulting and marketing arrangements are heavily scrutinized and will not disguise any intent to pay for referrals. Parties must carefully analyze their arrangements and ensure the intent and substance behind the arrangement matches the form of the contract.

In Florida, an owner of a substance abuse facility pled guilty in a massive $57-million money laundering conspiracy involving hospital pass-through billing. In the scheme, the owner arranged for his facility to send patient urine samples to a laboratory for testing in exchange for 40% of the insurance reimbursement. The laboratory, in turn, entered into arrangements with rural hospitals to have the testing billed under the hospital’s provider number using hospital in-network contracts. The owner also arranged for other substance abuse facilities to participate and receive 30% of the insurance reimbursement while he received the other 10%.

Hospital pass-through billing arrangements have become problematic as hospitals, clinical laboratories, and other parties seek arrangements to maximize both operations and profits.  Arrangements between hospitals and laboratories must be closely scrutinized and regulatory compliance carefully analyzed.

If you want to keep your medical spa compliant with state regulations and move your business forward without engaging in illegal activities, click here to learn how to join AmSpa.

Tags:  ByrdAdatto  Med Spa Law 

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The Legalities Behind HIPAA and Social Media

Posted By Administration, Monday, July 22, 2019

social media

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

A well-executed social media campaign can be extremely beneficial to a medical aesthetics practice. Millions of businesses use social media channels—such as Twitter, Facebook and Instagram—to increase their brand awareness, and successful social media campaigns can help build strong bonds between practices and their patients.

Unfortunately, medical aesthetic practices and medical spas are particularly susceptible to certain types of social media violations that can attract the attention of the federal government, and investigators will not care whether or not you were aware of these transgressions. You must educate yourself about what you can and can’t post on social media channels to stay on the right side of health care privacy laws.

Understanding Your Identity

It’s important that medical aesthetic and medical spa physicians, owners and operators understand that these practices are, in fact, medical institutions—unorthodox medical institutions, certainly, but medical institutions nonetheless. However, they exist in an unusual market. The services they offer are elective, so they typically market themselves in ways that traditional health care outlets do not. They often present their services as commodities, in much the same way as outlets such as traditional spas and salons do. And because the medical aesthetics market is expanding, there is a great deal of competition for a prospective client’s attention, so marketing campaigns need to be cost-efficient and effective.

This is why many medical aesthetic practices and medical spas turn to social media to help publicize their businesses. However, it is shockingly easy for such a practice to expose itself to patient privacy issues with even the most harmless-seeming social media activity.

An Introduction to HIPAA

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a piece of legislation that regulates the many ways in which the business of health care is conducted in the United States. Since its adoption, however, it has become virtually synonymous with the issue of patient privacy. HIPAA’s Privacy Rule prohibits medical institutions from sharing protected health information, which it defines as anything that can be used to identify a patient. This includes any information at all that could possibly reveal the identity of the patient—his or her e-mail address, street address, name, birth date, Social Security number, etc. All this must be kept completely confidential.

If a medical institution is found to have violated HIPAA, it may be subject to very substantial fines—sometimes hundreds of thousands of dollars per violation. Additionally, many states enforce even stricter patient privacy statutes, so medical institutions must go to great lengths to ensure that absolute patient privacy is observed at all times.

See No Evil

There are three major ways that medical aesthetic facilities and medical spas often violate patient privacy laws on social media without even being aware of it.

1. Publicly reaching out to a patient. If you are connected with clients via a social media channel, such as Facebook or Twitter, it might seem like a good idea to reach out to them after a visit to publicly thank them for coming in. Ideally, this could build a relationship with these clients and entice their friends to follow suit. Unfortunately, this seemingly innocuous act may constitute a violation of HIPAA (and possibly a gaggle of state laws), because you’re revealing that person is one of your patients.

You can still thank your patients via social media; however, you just need to be very careful about how you go about doing it. Consider reaching out to your patients using the private messaging feature of whichever social media platform you are using. You will not be able to reach your client’s friends, but you’ll still strengthen your relationship with your client. However, as any number of disgraced celebrities will tell you, it’s very easy to post something to the public that you intended to keep private. Use extreme caution if you decide you want to attempt this.

Also, if you’re starting a Facebook campaign, establish a fan page rather than a standard user page. That way, your facility’s followers won’t be visible to users.

2. Publicly responding to a positive comment from a patient. Let’s say that one of your clients posts the following on your practice’s Facebook wall: “Had a great Botox treatment here today!” You may be inclined to post a response, such as: “Thanks! We hope to see you again soon!” However, it is important to understand that even this can represent a breach of a patient’s privacy, since you’re confirming that your practice provided the customer with treatment.

This is an emerging legal issue that has yet to be put to the test by litigation, and it could be argued that, by publicly posting that message, the patient is tacitly waiving his or her HIPAA protection. Unfortunately, HIPAA and other state-based privacy laws are very strict, so it’s probably not a good idea to test them.

You can attempt to avoid falling into this trap by stating on your social media channels that, although you appreciate all comments, the best way to deliver them is via e-mail or to call the practice directly. If you do this, you can avoid appearing unappreciative and reduce your potential exposure to patient privacy violations. Alternatively, you can try to draft a form that acknowledges that a patient who signs it wishes to waive his or her HIPAA protection for social media; however, this form would need to be very complex in order to stand up to legal scrutiny.

3. Responding to negative reviews. Yelp is a social media service that allows users to rate the experiences they have with businesses. As of the fourth quarter of 2015, more than 86 million unique visitors per month use mobile devices and 75 million unique visitors per month use desktop computers to refer to Yelp’s more than 95 million user-generated reviews, so make no mistake: This service is immensely powerful. The success or failure of businesses can be determined by their Yelp reviews alone.

This can empower ordinary people and, ideally, lead businesses to provide exceptional service to everyone. Yelp even encourages the businesses that are critiqued to become part of conversation, allowing owners and operators to respond to reviews and engage with users.

Unfortunately, Yelp’s enforcement of its user content guidelines is spotty, so it can have a dark side for businesses. Some reviews are unfair, made by people who have ridiculous expectations or axes to grind. Additionally, some Yelp users post negative reviews if they aren’t allowed to pay the prices they want to pay for products and services, regardless of whether those prices are reasonable. And those negative reviews can impact prospective customers—even if a business has a preponderance of four- and five-star reviews, readers are often compelled to peruse the handful of one-star reviews for entertainment purposes or to familiarize themselves with the worst-case scenarios.

Most businesses have recourse for dealing with problematic Yelp reviews—they can openly engage critical users using the service and attempt to demonstrate that they’ve done nothing wrong. The owners and operators of medical aesthetic practices, however, absolutely cannot respond to these posts, because if they do, they could identify unhappy users as patients, thereby violating patient privacy statutes.

The best way for medical spas to combat bad Yelp reviews—the only way, really—is to encourage satisfied customers to post positive reviews. Unfortunately, this means that you’re essentially asking customers to work to promote your business for free, but there is little else that can be done to address the situation without violating patient privacy laws.

Given the importance of Yelp and the lack of a level playing field regarding its reviews, the owners and operators of medical aesthetic facilities may be tempted to engage in what is known as “astroturfing”—using employees or associates to post fake positive reviews in order to bolster ratings. However, they must resist that urge, as astroturfing can be interpreted as consumer fraud. New York state regulators recently issued enormous fines to several facilities for astroturfing.

The Final Word

Social media can be a valuable tool in the promotion of a medical aesthetic practice, but its use can also be fraught with peril. Owners and operators of these practices should make sure that everyone involved in their social media campaigns—as few people as possible, ideally—understands that it is critically important that patient privacy be respected at all times. Few practices can survive the penalties associated with these violations, so they must be avoided at all costs.

Tags:  Business and Financials  Med Spa Law  Med Spa Trends 

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QP Extra: Q&A with Matt & Kathy Taranto of AesthetiCare Medspa

Posted By Administration, Friday, July 19, 2019

matt kathy taranto

AesthetiCare Medspa is among the more successful medical aesthetic practices in the Midwest—it is so successful, in fact, that owners Matt and Kathy Taranto also operate an aesthetic medicine consulting business, MINT Aesthetics. The Tarantos their staff have been providing a wide variety of aesthetic treatments to the residents of eastern Kansas for over 18 years, and they recently spoke about their history in the industry and keys to success with AmSpa Content Writer/Editor Michael Meyer for the inaugural issue of QP.

Michael Meyer: What inspired you to open your practice?

Matt Taranto: I had been in the industry for about six years, starting in the mid '90s, and back then, all the equipment companies used independent reps—they didn't use employees. I was an independent rep, and I sold a variety of lasers, microdermabraders and skin-care products in a six-state region in the Midwest. After doing that for a while, in 2001, I decided to open AesthetiCare. At that time, the main reason was I realized that every equipment company sells the best of everything and all the reps base their sales pitches on what the company tells them. And I thought, man, I'd have a lot more credibility I actually used if the things I was selling every day in a clinic and I could tell my equipment clients, “I'm not just telling you what the company tells me to say. I'm telling you what we see in our clinic every day.” So I really opened it up to be a model for my equipment. But what ended up happening was I really liked the clinic a lot and started focusing more and more time on it. So instead of just turning out to be a small little model where we used equipment, I decided to really focus on it and make it something special.

MM: What is different about your practice now versus when you opened it?

MT: Everything. I opened at 1,000 square feet and we now have 11,000 square feet. I opened with three treatment rooms and we now have 18 treatment rooms. I opened with two employees and we now have 26 employees. What happened is once we saw that we were able to make it grow, we decided to kind of pivot from what we were doing with the equipment sales and really focus more on utilizing our experience in growing a successful clinic to helping clinics all over North America realize their potential, and so we started doing a lot more business consulting using AesthetiCare as a model. We are now on our fourth physical location—we started in 1,000 square feet, we expanded to 2,200, then we expanded to 4,000, then we expanded to 6,000, and now in the same 6,000-square-foot space, we've added another 5,000, so we're up to 11,000 square feet. It's been 18 years now, and we've actually never had a year where we have not grown by at least double digits. The thing we're most proud of is we've always had this steady increase, and hopefully we'll continue to do that.

MM: What's one word you would use to describe your medical spa journey?

MT: I would say “educational.” I've learned a ton.

Kathy Taranto: I would say “passion.” It's something that I've found joy in every single day. It's one of those things where you continue to love it. Why wouldn't you continue to grow and enjoy it?

MM: What is your most popular treatment? Which is the one that brings in the most revenue?

MT: There are basically three treatments that we look at that make up about 65% of the revenue, and they're all pretty equal. CoolSculpting is one of them. Forever Young BBL and Halo, which we do a lot in combination, is another one. And then neurotoxins and fillers. Each one of those three brings in $1 million or so a year in revenue. The other 40% of revenue is made up from a ton of different things that we do. We have a very large menu. But those three are pretty equal as far as revenue goes.

MM: What do you think is the most important factor in your success?

KT: I really feel like it's the culture. I feel like when you create an environment that your team wants to thrive in, they want to build their own careers within your practice. Matt started the clinic before we were together, and so that was already created when I came on board. It's something that we really strive to continue with every single day, having a space that our team loves, and then that just feeds out into our patients or our client base.

MT: Right. Without a doubt, it's your team and staff. Like Kathy said, we want our staff to love their job. And the way that we do that is we pay them more than anybody else pays them. We spend more money on advanced training than any clinic I've ever seen. And we try to remind ourselves, you know, we're not curing cancer here. This is not a life-or-death situation. We should have fun. We laugh a lot and hug each other a lot and just create this environment where we just don't have turnover. Turnover is so expensive, and so many clinics don't realize that. When you lose a good provider, you don't replace that provider the next day. It takes probably a good two years to replace a really good provider. So Kathy and I both just focused on making sure that we treat our staff incredibly well. We treat them like family—like we would want to be treated. And the result is they just don't leave. We create these wonderful long-term relationships with them, and them with our clients.

KT: Because we not only have our clinic, but also have an aesthetic consulting business, we're exposed to so many other clinics and their culture, or lack thereof. One of the things that I can instantly tell is when they're afraid of the owner or afraid of the doctor or they're really not friends. It's like they just go to work. It's just this constant reminder of how important that is—this fun culture that you create at work.

MM: What makes your medical spa different from others?

MT: We have 55 aesthetic centers in a 15-mile radius of us, and we have a staff meeting every other week and we talk about that—how can we be different? What can we do? Because we're not going to be different because we offer Botox or CoolSculpting. Everyone and their sister offer that. So what makes us different? I think it's the focus that we put on customer service. We want people bragging about AesthetiCare they way they brag about Nordstrom or Disney or Ritz Carlton. But the biggest thing, as she said, is that we've trained and consulted with over 1,200 clinics, and we invest more money into advanced training for our staff than any clinic we've ever seen, because to us, it's common sense. The more we invest in them, the better they get at their treatments; the better treatments they give, the happier clients they have and the more referrals they get. I really think that focusing on an extraordinary level of customer service and making sure our staff is better trained than any of our competitors are so important to us.

aestheticare

MM: What specific metrics do you use to determine success?

MT: We can look at our financial statements and see what percentage of every dollar goes to payroll, cost of goods sold, marketing, benefits, insurance, things like that, and really making sure those things stay in the zone that makes us profitable. But the other thing is really measuring your staff. For each of your providers, you should look, at every month, how much revenue are they producing, how much revenue they're producing per hour, and where that revenue coming from. It's a combination of treatments and products, and what is that ratio? We really strive to do 15 to 20% of our gross revenue in retail products.

We also look at price integrity. We work with a lot of clinics who say, “We charge $13 per unit for Botox.” Then, when we do the math of what they've actually taken, we realize they charge $13, but they're only getting $10.50 because they put it on sale all the time or they're giving freebies. We really try to make sure that we have price integrity. Every month, we give all our providers a sheet showing what they produced, how that compares to the year before during the same time period, and how that stacks up against their peers. Why is the top nurse doing better than the bottom nurse? Why is the top aesthetician doing better than the bottom aesthetician? What can we learn from that?

KT: I think too, it comes down to not just the money side, but back to the fulfillment side, in terms of success—what fulfills each one of our providers? What kind of personality do they have? What fulfills us on a regular basis? It's looking at that joy you find at work—is our team happy? Do they stay with us? And looking at our turnover, or the lack thereof, I think really helps to speak to that as well.

MM: What do you love most about aesthetics?

MT: I think it's so amazing to have a career where, when you tell people what you do, they want to talk about it in detail. If I sold life insurance, nobody's going to really want to talk to me about my career that much. And nothing's wrong with that job—it's just not the most fascinating job. When I tell somebody I'm in aesthetics, man, they want to talk about it. And I love the fact that I work in a field that people find intriguing.

KT: I think for me, it is the interaction with our clients. I understand we're not curing diseases, and you don't need the treatments we offer, but these improvements you make in their skin build their confidence, and you get to know them over months and years, and you get to know their families. The connection with people is something that I've always loved within the industry. Whether it's with our patients at AesthetiCare or our clients at MINT, having that personal relationship with them is always something that I've loved.

MM: What advice would you give to other medical spa owners?

MT: The best book I ever read about business is The Customer Comes Second [by Hal F. Rosenbluth and Diane McFerrin Peters], and that book is all about how you make your staff your number-one priority. If you're going to own a business, with the financial risk and time commitment, your goal is to develop something that isn't dependent on you. The whole idea of creating a great team is that this place can run when Kathy and I are gone. And so I would say my number-one tip is make your staff your number-one priority. Number two sounds silly, but it is do everything you can to make it fun. Enjoy it. We spend too much time at work to look at it as a chore. We have a choice every day when we walk through the door—what type of attitude are we going to bring to the workplace? And if we're going to put in our 40, 50, 60, 70 hours a week, man, let's laugh a lot. Let's joke around a lot. Let's have some fun. I think when you combine those two things, it's a good recipe for business.

KT: I definitely agree. I think the other thing that I commonly see that I feel like we're always helping our consulting clients with is just looking at their numbers. For me personally, the team and the fun and all that comes more naturally. The numbers, for me personally, don't come as naturally, which is great because it does for Matt. But most people don't have a Matt and Kat—they have just one person who owns the clinic, and maybe they have a manager and maybe they don't. And so they just tend not to really look at their numbers. They don't have anybody to help them with their numbers. And then they come in here and they're shocked to see they're not making money. Take a look at your numbers. Find somebody that can help you or pay somebody to do it for you, but really take a close look and understand where you are with that.

MT: I think Kathy has a good point—understand your business. I think one thing we see, to that point, is that so many of these clinics are owned by a doctor who also has a medical practice. It might be a derm or plastic or whatever, and their medical practice may be doing very well. They lump all those numbers together and say, “Oh yeah—we're doing pretty well.” Then, when you break out the aesthetic number that the medical practice is supporting, your aesthetic practice is actually losing money, and it's eye-opening.

Also, one thing we get a lot in this day and age is people saying, “Oh man, there's so much competition. So many people are doing it, I don't know if I should do it. Is there enough business?” Never worry about competition. We've worked with over 1,200 clinics; I would tell you 80% are never going to get the right way to do this business. It'd be great to have a goal to be the greatest med spa in the world, but be the greatest one in your geographic area—maybe a 10- to 15-mile radius of you—and that's doable. When the number one procedure in the United States is Botox and only 3% of Americans have ever tried Botox, there's a lot of room for growth.

AmSpa members receive QP every quarter. Click here to learn how to become a member and make your med spa the next aesthetic success story.

Tags:  Business and Financials  Med Spa Trends  QP 

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Critical Financial Numbers You Must Know

Posted By Administration, Thursday, July 18, 2019

financial meeting

By Terri Ross, Terri Ross Consulting

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 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—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

  • Startup costs: Property, building, equipment, technology, staff and marketing all go into startup 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 towards attracting new patients falls into this category, from pamphlets to website development and networking events.

Return on Investment (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 pages they go to and stay on, and 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 and year.

Room Revenue Assumptions

  • Number of rooms: The 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 per hour: Based on the numbers above, what is your average revenue per hour?

Goals

  • New patients: Set a goal for the 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 per hour: To reach your revenue goals, how much do you need to generate per hour? An average room should do between $600 and $1,000 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 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  Guest Post 

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