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How the Update to the Texas Privacy Breach Notification Law Could Affect Your Medical Spa

Posted By Administration, Friday, October 11, 2019

data breach

By Jay Reyero, JD, Partner, ByrdAdatto

Target. Equifax. Facebook. Capital One. For us, a data breach is a reminder that the sensitive information we routinely entrust to organizations has inherent value and can be subject to nefarious attacks. For organizations, it is a reminder of the great responsibility accepted because of the great power received from valuable information. For states across the country, it is a reminder that more needs to be done in the fight for privacy and protection of sensitive information. With the passage of House Bill 4390 (HB 4390), Texas has showed how it plans to address the privacy of personal identifying information.

Signed into law on June 14, 2019, HB 4390 amends Texas’s privacy breach notification law—Texas Business and Commerce Code Chapter 521, Identity Theft Enforcement and Protection Act—by specifying a time frame for when notice of a breach is required and creating a notification requirement to state regulators. Beginning January 1, 2020, if a breach occurs and disclosure is required, the disclosure must be made “without unreasonable delay and in each case not later than the 60th day after the date on which the person determines that the breach occurred.” Previously, the disclosure only needed to be made “as quickly as possible.”

It is important to understand that the 60-day time frame doesn’t create a window for compliance, so organizations should not feel comfortable simply getting disclosures out by the 60th day to comply. Instead, organizations are first responsible to provide disclosure “without unreasonable delay,” which, depending on the circumstances, could be well short of the 60 days. If the circumstances support a reasonable delay approaching 60 days, an organization will then need to ensure that disclosure is provided before the deadline.

Also, beginning January 1, 2020, HB 4390 requires notification to the attorney general for breaches involving at least 250 Texas residents. The notice will need to include:

  1. A detailed description of the breach;
  2. The number of residents affected;
  3. The current and planned mitigation efforts; and
  4. Any law enforcement involvement.

All organizations subject to Texas’s breach notification law should begin reviewing and updating their breach notification policies in preparation for the new rules in 2020.

In addition to the current changes to the Texas privacy breach notification law, HB 4390 signals that Texas is not done addressing privacy with the creation of the Texas Privacy Protection Advisory Council. The purpose of the council will be to study various privacy laws and make recommendations to the Texas legislature on specific changes regarding privacy and protection of sensitive information.

To learn more about legal and business best practices to keep your med spa compliant and profitable, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and become the next med spa success story.

Jay Reyero, JD, is a partner at the business, healthcare, and aesthetic law firm of ByrdAdatto. He has a background as both a litigator and transactional attorney, bringing a unique and balanced perspective to the firm’s clients. His health care and regulatory expertise involves the counseling and advising of physicians, physician groups, other medical service providers and non-professionals. Specific areas of expertise include federal and state health care regulations and how they impact investments, transactions and various contractual arrangements, particularly in the areas of federal and state anti-referral, anti-kickback and HIPAA compliance.

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

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Texas Medical Board Holds New Stakeholder Meeting on Proposed Changes to Rule 193.17

Posted By Administration, Thursday, October 10, 2019

texas capitol

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

On October 8, the Texas Medical Board (TMB) held a stakeholder meeting to discuss Rule 193.17—a rule in development that would bring changes to the cosmetic medical delegation rule, known as Rule 193.17. You may recall that the TMB held a similar meeting earlier this year, which we discussed here. In that prior meeting, two versions of possible changes were offered. Ultimately, only a new signage requirement moved forward and was adopted (see here). The more sweeping proposed changes were tabled for additional work and future consideration. This week’s meeting was to solicit feedback on the most recent version of these developmental rules. Representatives from AmSpa attended this meeting as well.

In addition to a number of small changes to the current version of 193.17, these new developmental rules would make large changes in three areas: delegation, supervision and ownership. These developmental rules would change the definition of who is qualified to perform medical spa procedures. The proposed version would allow only licensed or certified health care providers to perform the procedures under supervision; the current version of the rules allows unlicensed persons to perform the procedures. The proposed rules also would necessitate that a physician, or a physician assistant (PA) or advanced practice registered nurse (APRN) under their delegation, to provide onsite supervision of the qualified personnel while procedures are being performed; the current rules require either onsite supervision by the physician, PA or APRN, or offsite physician supervision as long as they are available for emergency consultation and appointment if necessary. As part of the required supervision, the physician will need to cosign procedures performed under supervision within 72 hours; the current rule requires “timely” cosigning of procedures performed by unlicensed people, but does not specify a definite time limit.

The third major area of change is the inclusion of an ownership statement. Two versions of this section have been suggested. The primary version would require that facilities offering these procedures be owned by a Texas licensed physician; the owner, in turn, may employ a medical director to supervise and delegate. This version makes it clear that all physicians delegating and supervising in the facility are responsible for complying with all rules and laws for the supervision and delegation of medical procedures. The alternate proposal would require that any physician who accepts a medical director position first notify the board of the facility location and provide owner information, a list of all people to which procedures can be delegated, and the names and license numbers of the supervising physicians; any changes to this information would need to be updated within 30 days. The supervising physician also would need to provide an alternate supervising physician to step in if they are unavailable.

The TMB stressed that these rules are still in development and do not reflect the final version. It is accepting comments and feedback, and has stated it may have a version ready in the coming weeks for formal proposal. If a final version is proposed, this amendment would then be voted on by the full TMB at its upcoming December meeting. If the TMB approves that version, it will be published in the Texas Register and begin a 30-day public comment period before the amendment becomes official. That would be the quickest timeline for official adoption—it is possible that comments and feedback will require additional time before presentation to the full board. AmSpa will continue to closely monitor these changes and will report developments.

Tags:  Med Spa Law  Med Spa Ownership 

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How to Structure New Employee Orientation

Posted By Administration, Wednesday, October 9, 2019

medical spa employee

By Terri Ross, Terri Ross Consulting

Your team is one of the most important assets of your medical aesthetics practice. Each member of your team—from the front office to the clinical team, medical providers and consultants (if you have them)—should be well-trained, be knowledgeable and have a passion for the industry and their position. Building a top-notch team of employees begins with planning and executing an informative, comprehensive and well-conceived new employee orientation. Here are the elements of how to structure a successful new employee orientation—from preparation to on-the-job training—and some key points that will ensure your team is well-trained, informed and prepared.


Ahead of time, make personalized packets of information for every new employee. Make sure all key information is included, from tax information, employee benefits, the employee handbook and all legal documents to the basics of how your office operates. Include system login information, a layout of the office, and detailed job descriptions. It also is a good time to relay etiquette and dress code expectations, so any questions or concerns can be addressed before the new employee’s first full day. You may also choose to include job-specific e-training, so employees can get a head start on preparing for their role before their first day. Preparing personalized folders of information for new employees is the first step to a successful orientation. Not only does it help you build a more productive staff, but it also makes new employees feel welcomed and informed.

Assign a “Peer” or Work Buddy

To help each employee adjust to the systems and protocols of your office, it’s a good idea to assign them a “work buddy.” Preferably, this person will work closely with the new employee in their role. The duties of the work buddy include:

  • Making introductions to other employees in the office (front office staff, doctors, clinical personnel and supporting staff);
  • Making sure the new employee feels comfortable in their work space; and
  • Providing necessary resources and information about their job duties and general office protocols (system logins, meeting schedules, patient care, etc.).

Joining a new office dynamic can be intimidating and overwhelming. By assigning each new employee a go-to person within the office, you will ensure they feel welcome and integrate seamlessly into your team.

Give a Comprehensive Tour

Give each new employee a complete tour of your office, from the front office to the waiting rooms, procedure rooms and consultation rooms. Every employee in your office should know where to direct patients if needed and where to find necessary information, whether administratively or clinically. In order to offer top-notch service, each employee should be an integrated member of your team. This means knowing what types of procedures your office offers, the technology available, and a comprehensive view of the industry and how your office compares to your competition. You want each employee to know their niche in the office so they can excel in their role. The first step is offering a complete narrated tour.

Provide Access to Important Systems

In addition to offering introductory packets and a guided tour, you will want to make sure every new employee has access to your systems. If the employee will need to access patient information in their role, provide information about the patient management software and scheduling system used. Not providing this can negatively affect their productivity. If they can begin familiarizing themselves with the protocols and systems in your office during orientation, they will become productive members of the team much faster. You may also want to provide detailed information on new technology and services your office offers and make sure the employee can log onto vendor websites as needed. This way, they can take the initiative to really learn the technology your office offers, after hours if needed.

Plan a Group Lunch

New employee orientation can be overwhelming. To help make the employee feel relaxed and welcome, plan a group lunch on their first day. Order food from a nearby café or restaurant and gather in a neutral location, such as a staff conference room. Make sure a few people from each part of your office are included—front office staff, supporting staff, nurses and doctors. Not only can the new employee interact with and get to know other members of the team on a personal level, but they will also establish key connections that will help them in their role. The most important part of answering any question is knowing who to ask. This introductory lunch will assist in establishing those connections and help the employee feel more integrated before they begin their first full day on the job.

Offer On-the-job Training

As part of new employee orientation, you will want to introduce the new employee to the general structure of a normal working day. Beginning after lunch on the first day, make sure the employee is settled at their desk or office location and provide a few simple tasks to complete. The “work buddy” will need to be available and ready to assist in the coming days and weeks, if needed. Make sure the employee feels encouraged and supported to ask questions. (Read more about the importance of on-the-job training in this article.) Now is the time to make sure the new employee feels comfortable with the expectations of their role, is equipped with all the necessary tools, and can begin working as a valuable member of the team.

Follow Up

Following up is one of the most critical aspects of new employee orientation. Don’t expect the new employee to know their role completely before they have some experience. Generally, you should have the “work buddy” check in with the employee weekly. After one month, arrange a meeting between the employee and the front office manager or relevant supervisor. This is a dedicated time for the employee to ask unanswered questions. You also can use this time to gather feedback and ask the employee questions about the office, services you offer and technology you use. At this point, the employee should be familiar with their role and responsibilities, know the basics of your services and treatment plans, and have some background knowledge of the industry. Use this opportunity to give an informal quiz and make sure they are up to speed.

Having a knowledgeable staff is absolutely key to the success of your office. This starts with an effective and well-thought-out new employee orientation. Schedule a strategy call with me or download my 10 Point Assessment to learn about how to structure your new employee orientation 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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What’s New in Microblading

Posted By Administration, Monday, October 7, 2019


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

Microblading is a semi-permanent beautification technique that typically is used to improve the perceived thickness of eyebrows. When performing microblading, providers create superficial cuts near the surface of the skin and fill them with pigment, creating the illusion of fuller hair. It is an increasingly popular treatment—in fact, according to the American Medical Spa Association (AmSpa) 2019 Medical Spa State of the Industry Report, 27% of medical spas offer microblading services, up 2% from the 2017 study, and a further 8% are considering adding microblading to their menus.

The growing success of this treatment suggests that the market has yet to reach saturation, so enterprising practices stand to make a great deal of money with this technique. Here’s what medical spa owners and operators need to know about offering microblading services.

The Treatment

Microblading is extremely inexpensive to practice owners—it only requires a disposable device that costs around $5. Also, a practice typically does not need a doctor or a health care provider to perform these treatments, which helps keep its practical costs low. However, medical spas typically charge up to $500 for microblading services, so they are realizing very high profit margins when these procedures are administered.

Patients like microblading because it is semi-permanent, which is much more palatable than the lifetime commitment that comes with tattooing, which has been used in the past to add body to eyebrows. In addition, microblading tends to look more natural than tattooing.

“It's becoming a much more popular procedure—it just keeps growing and growing,” says Maegen Kennedy, PA-C, of Fleek Brows Microblading and Training in Orlando. “There’s a lot of good that comes from microblading, but it just needs to be done the right way and with the right safety protocols.”

Unfortunately, the rapid growth of microblading has created some issues surrounding the procedure and its practitioners.

“I'm finding that microblading is becoming more of a commodity—it's becoming less about the artwork and more about the price,” Kennedy says. “There's such a high amount of potential revenue that it is extremely attractive to people who feel that they have artistic abilities or would be able to develop the artistic ability. When you have a $100,000 potential salary [that can become] up to a $500,000 potential salary or more from doing this procedure, it's like a gold mine.”

As the demand for the procedure has skyrocketed, so has the demand for trained practitioners. Since there are relatively few qualified trainers available to meet that demand, the void is being filled by some potentially bad actors.

“There are so many places that are now offering training, and there is no requirement to be a trainer at all in any capacity, and so anybody could call themselves a trainer,” Kennedy says. “A lot of these training academies are just popping up literally overnight. I find that there's a lack of medical-based training, and people are getting trained by various companies that really aren't good, truthfully, or aren't providing the type of training that they should be receiving to be able to actually do this procedure.”

The Wild West… for Now

Since the microblading process is so similar to that of tattooing, most states that have issued rulings on the matter of who can legally perform these treatments have stated that a tattooing or body art license is required. If your practice is located in one of these states, your aestheticians or unlicensed practitioners would need to get these licenses, if they don’t already have them, in order to perform microblading treatments in a medical aesthetic practice. This might sound like a bit of a hassle, but obtaining a tattooing license tends to be simpler than you might imagine—and therein lies the problem.

“The laws are way too lenient,” Kennedy says. “The procedure hides under the umbrella of a tattoo artist and, unfortunately, that means it just doesn't have a lot of requirements or regulations associated with it. There just needs to be much more oversight for safety because there's no medical degree required to do this procedure. You can be a banker one day and a microblader cutting on someone's face the next day.”

In recent years, several states have introduced legislation designed to more clearly define microblading and recommend registration and licensure procedures, but none have been signed into law. In Missouri, for example, House Bill 877 (2017) and House Bill 71 (2018) sought to modify the state’s existing definition of tattooing to include “new cosmetic procedures performed with the aid of needles or blades … .” Both bills died in committee. Similar measures were introduced in Massachusetts, Nebraska and New Mexico legislatures, but none were signed into law.

However, according to Kennedy, simply categorizing microblading as tattooing across the board might represent a step in the wrong direction.

“People don't realize that it's actually a real procedure—that you're cutting on someone's face,” she says. “They assume when they go to these places that they're using sterile techniques and they're in good hands, but it's a real procedure—they’re cutting their skin open, essentially.”

And although action has not been spurred by any high-profile bad outcomes, Kennedy believes that it’s only a matter of time before underqualified practitioners cause real problems for those who practice compliantly.

“Even when the procedure goes wrong and it looks bad, patients typically aren't taking any action against anybody,” Kennedy says. “I find that they just kind of hide out and they're depressed and they're sad and they're frustrated and they're angry. But I haven't seen or heard of many people who are taking legal steps with any of the artists when they have a bad outcome. But I don't think that's going to be the case for long, because as it becomes more widely available and people are getting it done left and right, there are definitely going to be some problems with managing infection, allergic reactions or much worse things that can happen.”

Kennedy says that she spends a lot of her time fixing problems created by unqualified practitioners.

“There's a lot of work I'm trying to correct from people who are putting brows too close together, too high, too low, or using the wrong color,” she says. “I probably get one phone call a day from a person who got microblading done, and they're very dissatisfied with their face. They feel ruined. It's a very serious procedure, and I think there's just a lot of people doing it that aren't qualified to do it or aren't doing a good job.”

Consult a local health care attorney to learn how microblading is regulated in your state. He or she also can tell you what is required to get a tattooing license where you live, if you or your employees need one, and may be able to recommend reputable trainers.

An Evolving Art Form

Thankfully, the popularity of microblading is also leading it to greater legitimacy in some circles.

“Medical spas are offering a lot more microblading than they ever have before,” Kennedy says. “Instead of solo artists going and doing their own thing, I'm seeing a lot more of incorporation into medical spas, which is a good thing. The environment is typically much more regulated. I'm also seeing people who open up solo microblading places and are doing really well start to include injectables, so they bring in injectors, and now that they have this patient base. They are opening med spas because they were successful in brows and they're now moving into opening actual, real med spas.”

Microblading is not going away any time in the near future. Even though it is likely going to face legal tests and evolve into different forms—"combo brows,” for example, are growing in popularity and combine semi-permanent microblading with actual tattooing—conscientious medical spa owners should consider offering this treatment.

To learn more about legal and business best practices to keep your med spa compliant and profitable, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and become the next med spa success story.

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

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Medical Spa Buzzwords

Posted By Administration, Friday, October 4, 2019


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

The medical aesthetic industry is all about buzz. A treatment that’s hot one day can be passé the next, and keeping tuned into the buzz around the industry is the only way to keep track of what’s what. There are a few terms that you’re likely to come across again and again, however, and understanding why people are talking about them is a key to maintaining a successful practice. Here are a handful of the buzzwords we’re encountering regularly, what you need to know about them, and how you can harness their power.


Historically, medical aesthetics have been associated with fast, easy solutions rather than lasting change, but, in recent years, the mantra of wellness has become a key part of the industry. Today, it’s not enough to simply look good; you must also be healthy, so a holistic approach to self-care has become a part of many aesthetic regimens.

Wellness is a concept that informs many of the other terms we’re going to cover here. Generally speaking, there is a bit of a stigma attached to “quick-fix” solutions for aesthetic issues, so many practices have begun offering more natural, organic solutions and encouraging more comprehensive views of patients’ overall health. After all, no medical spa wants to be featured as part of an exposé on botched aesthetic procedures, and the chances of that increase if your practice uses a lot of harsh chemicals and complicated treatments.

What’s more, a healthy body helps contribute to a healthy mind, and those with healthy minds are less likely to cause problems for your medical spa with unfair expectations and difficult-to-address social media reviews.


The concept of rejuvenation is a powerful one for medical aesthetic practices, as it suggests that those who partake of aesthetic treatments can recapture aspects of their youth they thought were gone forever. This is a powerful impression, and successful medical spas are able to leverage it to attract customers who are not entirely happy with their appearance or physical health.

Of course, this term is also now commonly associated with vaginal rejuvenation, a very popular treatment that has attracted a lot of attention to the medical aesthetic industry in recent years, particularly after the commissioner of the U.S. Food and Drug Administration (FDA) issued a statement in October 2018 addressing the use of unapproved laser equipment for the procedure. Despite this warning, the market for this treatment continues to be robust.


This is a loaded term. Obviously, everyone is subject to aging—after all, we all do it every minute of every day. However, medical aesthetic practices, drug manufacturers and device manufacturers use this term to insinuate that their offerings can be used to combat this process, and the suggestion that such a thing is possible is an extremely attractive proposition for those who don’t like what they see in the mirror.

Realistically, though, this term only covers the signs of aging, so it’s a bit misleading when employed as it commonly is. It remains a powerful buzzword in the medical aesthetic industry, however, and as the wealthy Boomer population continues to age, it’s going to keep bringing business through medical spas’ doors.


As the old saying goes, an ounce of prevention is worth a pound of cure. This buzzword suggests to prospective customers that the medical aesthetic treatment being advertised can help thwart future problems. Again, this is an attractive concept, both for patients who are conscientious about their appearance and for practices that stand to make money from said patients for treatments they don’t immediately need. That’s not to say that these treatments aren’t useful—to the contrary, they provide tangible benefits over time and a are part of a well-rounded aesthetic care regimen. Over time, it’s more beneficial and cheaper for patients to engage in preventive care instead of waiting for problems to emerge.

Along the same lines, prevention is a key concept when it comes to medical spa legal compliance. It is significantly less expensive to implement proper protocols and procedures at the beginning of a medical aesthetic practice’s existence than it is to correct issues after they are uncovered by a regulatory agency. It’s also a good idea to get into the habit of compliance as soon as possible, since it is a significant part of a practice’s existence.


The term “non-invasive” gets to the heart of the appeal of the medical aesthetic industry. The treatments provided to medical spa patients produce visible, often lasting results without the need for painful, expensive surgeries that require prolonged periods of recovery. The term also suggests a certain convenience—medical aesthetic treatments are non-invasive in terms of the amount of time spent at the practice, as well. A patient can typically pop into a med spa, receive a treatment, and continue on with his or her day.

Although plastic surgeons have historically been key parts of the medical aesthetic industry, the non-invasive nature of medical spa treatments typically makes them much more appealing than surgery to the average consumer. As such, practices likely will benefit from using this term in their marketing materials.


Nobody wants toxic things on or inside them, obviously, so the promise of removing these harmful elements is extremely appealing. As a result, the term “detoxify” is widely used in the medical aesthetic industry, and is effective at convincing people to undergo treatments provided by medical spas. Along the same lines, the term “cleanse” helps patients see that these treatments can help them become healthier and remove detrimental influences on their bodies. From a psychological standpoint, these are extremely powerful suggestions, and they can (and should) also be reflected in a medical spa’s design and layout—a practice should always be clean and inviting, so as to reinforce that it is a place where such things are valued. In maintaining your practice properly, you tell your clients that you are serious about all aspects of wellness.


If you tell a patient that you’re going to restore their appearance, you’re telling them that you can bring back something they thought they’d lost. Again, this is a powerful idea, and that’s why the term is so widely used in the industry. If you can restore the way a person looked in the past, perhaps you can restore the way they felt back then, as well—or at least that’s the implication. It speaks to the power of medical aesthetic treatments and helps to attract new customers to medical spas.


Again, the use of terms such as “youth,” “young” and “younger” reflects a desire on the part of medical spa patients to recover some of the vitality they’ve lost over the years. This is particularly true for Baby Boomers, who have the money to spend on procedures such as these and the time to become active again, since many are nearing or entering their retirement years. During this time in their lives, people encounter numerous milestones that suggest to them that their best years are behind them, and many are taking steps to combat that sentiment. Because of this, boomers are helping to drive the medical aesthetic industry revenues, and tapping into their desire to feel young again can help your practice develop new customers.


People want to believe that damage can be repaired. If you wreck your car, you keep telling yourself that it’s not that bad and that it can be fixed—at least until the mechanic tells you that it’s totaled. That sort of optimism can also be leveraged in medical aesthetics, even if the “damage” isn’t particularly severe. (Severe damage will probably require the skills of a plastic surgeon.) This term can be used to promote procedures such as tattoo removal and microdermabrasion, as well as a number of more conventional aesthetic treatments.

Market the Buzz

Language is a powerful tool in marketing, and learning how to leverage buzzwords such as these will help you maximize your medical aesthetic practice’s business. As you can see, a lot of this amounts to offering clients idealized versions of themselves, and as long as you can provide them a means to do that once you get them in the door, your practice stands to benefit from their patronage. Using these terms taps into people’s desires to recapture—or prolong—their glory days and to look as good as they feel, and this is something that medical spas can provide quickly, conveniently, and generally without complications. Understand who you are marketing to and what they want, and you’ll find yourself with a thriving medical aesthetic practice.

To learn more about legal and business best practices to keep your med spa compliant and profitable, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and become the next med spa success story.

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Med Spa Trends  QP 

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Join AmSpa at the New York Medical Spa & Aesthetic Boot Camp

Posted By Administration, Wednesday, October 2, 2019

new yorker hotel

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

Starting next Saturday, October 12, AmSpa will host its New York Medical Spa & Aesthetic Boot Camp at The New Yorker Hotel (A Wyndham Hotel). We’re extremely excited for the opportunity to help medical aesthetic professionals in the Big Apple improve their practices, and we’re looking forward to visiting New York once again. There’s still time to register for the event—just click here to sign up.

Here is a quick overview of the program:

Saturday, October 12

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

  • 9 – 10:00 a.m.: The Plan, presented by Bryan Durocher (Durocher Enterprises)—What are the most effective ways to develop a business plan for your medical spa? Medical Spa Consultant Bryan Durocher discusses the ins and outs of the planning process and helps determine how long it realistically takes to open a practice.
  • 10:15 – 11:15 a.m.: The Financials, presented by Bryan Durocher (Durocher Enterprises)—At the end of the day, the money you’re bringing in is the most important measure of your practice’s success. This presentation will, among other things, demonstrate how to properly develop a budget and use metrics to determine your med spa’s strengths and weaknesses.
  • 11:15 a.m. – 12:15 p.m.: The Lessons, presented by Louis Frisina—Every medical spa is different, but the successful ones share several common traits. In this session, Business Strategy Consultant Louis Frisina discusses the qualities that are typically found in practices that bring in a significant amount of revenue.
  • 1 – 1:45 p.m.: Medical Aesthetic Hot Topics Panel, featuring Tim Sawyer (Crystal Clear Digital Marketing), Toni Lee Roldan-Ortiz (Environ Skincare), and a representative from Galderma—This panel, moderated by yours truly, will feature a spirited discussion of the current issues and events that concern medical spa owners and operators.
  • 1:45 – 3:30 p.m.: The Law, presented by Alex Thiersch (AmSpa) and Renee Coover (ByrdAdatto)—In this presentation, we’ll discuss the long-standing and emerging legal issues that every medical spa owner needs to know about. As you can imagine, there is a lot to cover here, since new concerns seem to be arising daily lately.
  • 4:15 – 5 p.m.: The Treatments, presented by Terri Ross (Terri Ross Consulting)—Learn about the most profitable and popular treatments available to your practice, and find out how to best determine which treatments are right for you based on the state of your practice.
  • 5 – 6 p.m.: The Digital Marketing Ecosystem, presented by Tim Sawyer (Crystal Clear Digital Marketing)—Find out how to effectively spread the word about your medical aesthetic practice and how best to determine what’s working and what’s not. Your practice’s digital presence is more important than ever before, and curating it should be a top priority.

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

Sunday, October 13

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

  • 8:30 – 9 a.m.: Anatomy of a $5-Million Med Spa, presented by Alex Thiersch (AmSpa)—Have you ever wondered what the difference is between your medical spa and one that’s mega-successful? It might be less significant than you think. This presentation will show what a $5-million med spa is doing right—and what you might be doing wrong.
  • 9 – 9:45 a.m.: The Long-term Revenue, presented by Bryan Durocher (Durocher Enterprises)—Simply being successful isn’t enough for a medical aesthetic practice; you have to know how to maintain and grow your success. In this session, Bryan will show you how to build patient loyalty and move your business forward.
  • 10:30 a.m. – 11:30 p.m.: The Medical Spa Success Panel, featuring Alexander L. Blinski, MD, (Plump), Marria Pooya (Greenwich Medical Spa), and Alexa Nicholls Costa, NP, and Alexandra Rogers, NP (LexRx)—This exclusive panel features four of the most successful aesthetics professionals in the Northeast. I will ask them how about the innovative business strategies and techniques they used to rise to the top of the medical aesthetic industry.
  • 11:30 a.m. – 12:15 p.m.: The Consultation, presented by Terri Ross (Terri Ross Consulting)—As the old saying goes, you never get a second chance to make a first impression. Learn how to put your best foot forward with effective patient consultations—and how to turn them into consistent business.
  • 1 – 2 p.m.: The Marketing Plan and Social Media, presented by Alexa Nicholls Costa, NP, and Alexandra Rogers, NP (LexRx)—This session will help you determine how to most effectively market your medical aesthetic practice using both traditional methods and cutting-edge techniques.
  • 2 – 3 p.m.: The Team, presented by Bryan Durocher (Durocher Enterprises)—A medical spa is only as good as its personnel, so it’s important to make sure that you hire a staff that can do everything you want it to—and more. In this session, you’ll learn about recruiting, hiring and retaining employees who can make your medical spa dreams come true.

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

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

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

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How Your Medical Spa Can Address Negative Patient Reviews

Posted By Administration, Monday, September 30, 2019

one star

By Kita McCray, JD, ByrdAdatto

Benjamin Franklin said, “It takes many good deeds to build a good reputation, and only one bad one to lose it.” It’s been a couple of centuries since Franklin made this statement, yet the same remains true today. It is especially true in health care, where patient dissatisfaction can be amplified with just a few keystrokes and the click of a mouse.

On one hand, the internet has expanded our accessibility to one another and information; on the other hand, it provides a medium for bad reviews and feedback to travel further and faster than our reputations can keep up with. As a result, many patients think they “know” their providers before they ever meet them. So, what’s the solution when that one dissatisfied patient tries to start a fire by posting a negative review of you or your practice? The answer is simple: Dilute the fire—the solution to pollution is dilution.

Jeff Segal, MD, JD, a ByrdAdatto partner and CEO of Medical Justice, has built a simple strategy for dealing with negative patient reviews. Specifically, when writing a response to a negative patient review, you must remember these five golden rules:

  1. A model response shows the practice is reasonable and isn’t engaged in a debate;
  2. A model response educates the public;
  3. A model response addresses the concerns raised in the review;
  4. A model response takes the conversation offline; and
  5. A model response does not address the author directly.

Segal further advises that the person or employee who is responsible for locating and responding to negative reviews should commit to these rules in order to dilute or drown out the dissatisfied voices in the crowd. These rules also will help you to avoid potential violations of HIPAA or professional licensing board regulations that may cause regulators to perceive the filtering of negative reviews as false and deceptive advertising.

Remember that it takes two flints to make a fire. Engaging in a debate with a dissatisfied patient in a public way is a bottomless pit. Once you fall in, it can be difficult to pull your reputation out.

To learn more about legal and business best practices to keep your med spa compliant and profitable, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and become the next med spa success story.

Kita McCray’s decision to become a lawyer was solidified in fourth grade after job shadowing a local lawyer in her hometown of Ferriday, Louisiana. In college, Kita dedicated all her enthusiasm and energy to becoming well-read in classic English literature before attending law school. But while working as a public health graduate researcher, she developed an interest in health law and policy, and decided to focus her legal studies toward health care law.  Today, Kita brings the full scope of her multidisciplinary background to assist clients with their business and health care needs.

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

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Building Your Exit Plan

Posted By Administration, Friday, September 27, 2019

doctors speaking

By Bradford E. Adatto, partner, ByrdAdatto

My father is a retired orthopedic surgeon. I’ve witnessed his personal retirement journey and know that closing the book on a successful practice can feel both daunting and exciting. But before you begin that last chapter, you must first define your goals and set yourself up to meet them.

There are several steps a physician should consider in building an exit plan: practice assessment and valuation; pinpointing late-career and retirement goals; and, finally, customizing your plan. More than anything, you need to make a plan. The most common struggle among our physician clients is taking action, because they become paralyzed by the complicated question of “when” to retire.

Practice assessment and valuation means realistically evaluating the current state of your practice and understanding your practice’s financial value. The valuation process requires you to recognize and identify your revenue streams, how they differ (professional services vs. ancillary services) and how they contribute to your bottom line. Additionally, during the practice assessment process, it’s important to assess your practice’s legal health. Even financially successful practices can be impacted by compliance issues. Recognize ahead of time if your legal model is helping or hurting your practice and make changes accordingly. You will also want to evaluate your practice from a cultural perspective. If a prospective buyer will inherit your team, it is important to be realistic as to whether there are dysfunction issues or overpaid staff that commonly result from long-term employment with a practice.

Ultimately, a successful valuation of your practice results from years of fostering goodwill with your patients. Practice goodwill relates to your practice’s ability to continue to generate earnings without the presence of any particular physician. If you want to eventually be in a position to sell, you must brand and run your practice as an enterprise. Patients must be seen as transferrable to the buying physician, and creating practice goodwill helps ensure that.

Next, it’s time to determine your retirement goals and late-career objectives. Think about your legacy and the impact you’d like to leave. Think about if you’d like to retire in stages (surgery first, cutting hours, etc.). Based on those intentions, we at ByrdAdatto can help customize a plan that sets you up for success.

While there are many exit strategies, the four most common plans we see at our firm are:

  • The Fixer-Upper Plan: This plan is all about repurposing your practice to fit your late-career goals and retirement timeline. Basically, it requires some legal restructuring. For example, under this plan, we’ve had clients develop separate entities as cost centers under a single legal model. This remodeling allows each entity to operate more independently, but still develop value under a single legal model.
  • The Sensei Plan: You, the sensei, will teach him or her, the student. This plan follows the standard concept of bringing on an associate, training him or her as a partner, and prepping him or her to take the reins in a buyout. Under this model, it is extremely important that the sensei and student develop the four Cs: cost, control, contingencies and compensation. Without mapping these elements, expectations from both parties are often unmet.
  • The Old School Plan: For many clients, the retirement timeline is compressed. Once they decide it’s time, the process of stopping practicing moves forward in months, as opposed to years. Historically, these late practice sales have ended in less value, but that is not always the case. We have worked with clients on creative solutions to retire on a shorter horizon, while still capturing full and fair value for their practice.
  • The Drop the Mic Plan: This is your show, and you draw the curtains the way you want, when you want. This exit requires you to position the practice—financially, legally and operationally—in a way that allows you to walk away on your own terms. Here, we help leverage offers to optimize your endgame.

The last bit of advice I offer is from my father: Once you retire, keep yourself busy—no matter your exit plan.

To learn more about legal and business best practices to keep your med spa compliant and profitable, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and become the next med spa success story.

Bradford E. Adatto is a partner at ByrdAdatto, a national business and health care boutique law firm with offices in Dallas and Chicago. His background is in regulatory, transactional and securities law. Having worked in health care law his entire career, he has an in-depth knowledge of the “dos and don’ts” of this heavily regulated industry. Brad has worked with physicians, physician groups, and other medical service providers in developing ambulatory surgical centers, in-office and freestanding ancillary service facilities, and other medical joint ventures. He regularly counsels clients with respect to federal and state health care regulations that impact investments, transactions and contract terms, including Medicare fraud and abuse, antitrust, anti-kickback, anti-referral, and private securities laws. Adatto has been recognized as Top Rated Lawyer by the Dallas Morning News (2016) and a Best Lawyer in Dallas in health care by D Magazine (2016 & 2018-2019), selected as a Best Lawyer in America in health care (2017-2019), and was recently named a Best Lawyer in Texas (2019) and Texas Super Lawyer, published by Thompson Reuters (2019).

Tags:  Business and Financials  ByrdAdatto  Med Spa Trends 

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Building Customer Loyalty Through Promotional Financing

Posted By Administration, Thursday, September 26, 2019

speaking with a patient

By Karen Zupko, on behalf of CareCredit 

Cultivating loyalty with existing clients is less expensive and more effective than constantly trying to bring in new customers. Existing clients already have relationships with you. Nurturing them to become loyal followers can turn that $2,000 they spent on CoolSculpting and peels this year into $10,000 or more over five years. Plus, loyal clients refer their friends, who will add even more revenue to the bottom line. All told, the lifetime value of a loyal client can be tens of thousands of dollars or more.

Here are three ways to keep your spa on the minds of current clients, inspire them to schedule additional treatments and build loyal relationships that last a lifetime.

  1. Reactivate clients you haven’t seen in the last 12 months. Depending on your relationship with them, call, text or email with a special “We want you back!” promotion. Perhaps that’s a limited-time discount on the last service they received or a special rate on a “day of beauty” package. It may be a limited-time offer for scheduling one of your new oxygen treatments. When you reach out, let your clients know that you offer financing options that can be used to pay for all these services. If you accept CareCredit as a payment option, include the promotional financing options that are accepted at your practice, and include your custom apply link in emails or text messages to those who may not already have the CareCredit credit card.*
  2. Contact those who didn’t book a treatment due to “cost concerns.” Start by generating the unconverted quote report from the last six months. If your staff members are taking good notes, you’ll quickly zero in on those who didn’t schedule because of cost. Send them a personalized email or note with limited-time special pricing on the service they had considered. If you prefer not to offer special pricing, remind them of the budget-friendly ways they can pay with CareCredit promotional financing options—including no interest if paid in full during the promotional period.**
  3. Reward your top 25 clients on the “lifetime value” report. Generate this report from your spa management software and create a very special promotion for this VIP group. For example, mail them handwritten invitations to a posh private dinner event with a “celebrity” speaker, such as a local fashion designer. In the goodie bag, include a special offer for one of your high-end services and information on ways to pay for this service, including promotional financing options such as CareCredit. Make sure to allow each of your top 25 to invite a friend.

To learn more about CareCredit, click here. AmSpa Members receive 20% off promotional financing merchant fees on purchases of more than $200.

These patient financing tips have been provided by Karen Zupko, on behalf of CareCredit. Zupko is president of Karen Zupko & Associates, Inc. She has been advising aesthetic practices about marketing and management for more than 30 years.

* Subject to approval.
** Subject to approval. Minimum monthly payments required.

Tags:  Business and Financials  Guest Post  Med Spa Trends 

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Consulting from the Patient’s Point of View

Posted By Administration, Wednesday, September 25, 2019


By Terri Ross, Terri Ross Consulting

The first consultation with a prospective patient is undoubtedly the most important. Patients will form most of their opinions regarding your office during their first visit. From the aesthetic quality of the waiting area to the expertise and relatability of your front office staff and the provider, it is critical that every element of the patients’ consultation experience is impeccable. Much of their experience will be directly related to how well your front office staff listens, engages and responds. (To read more about how to successfully train your front office staff, read my article on the LAER model.) Equally as important is how you, as the medical expert and professional, are able to connect with the patient. Here are the elements of the patient consultation and the key points you will need to consider to successfully consult from the patient’s point of view.

Perfect the First Impression

The aesthetic quality of your office—the décor, ambience and overall tone—will make a significant impression on prospective patients. When they first enter the front door of your office, you want them to feel at ease. Your front office staff should acknowledge them immediately using their names, offer them refreshments and give an introduction to the office. They also should provide a pamphlet of relevant literature: the services, equipment and individualized plans available in your medical aesthetic office. This way, the prospective patients will be more informed and prepared for the consultation appointment. Further, they likely will form additional questions based on this information, which will incite conversation and give you an opportunity to connect with them during the consultation appointment.


Making a connection with the patient is critical. Research has shown that making a genuine connection matters more than any other factor, including expertise and pricing. (Read this article from the NY times about the patient-doctor relationship and how this shapes medical care.) Establishing a connection begins with your front office staff. They should strive to connect with patients even before the formal consultation begins. By making conversation and finding common ground—similar interests or having kids that are close in age, for example—the front office staff members begin forming that personal connection.

During the formal consultation, it is important that the medical expert continues making that connection. This can be done by first listening to the patient: their needs, desires, reservations and questions. (This will be discussed further in the next section.) Make sure you devote enough time for the first consultation, but don’t overdo it—evidence has shown that if you spend too long with patients, they may assume you aren’t busy enough, and this can reflect negatively on their overall impression. The takeaway here is that you only have a defined amount of time to make a genuine, lasting connection with a patient. This often is what the patient will remember most when they leave your office.


While your natural inclination may be to provide prospective patients with as much information as possible during their first appointment, it is critical to listen first. Ask questions that will allow you to really get to know the patient: why they seek treatment, what types of treatment they’re interested in, etc. This begins with their interactions with the front office staff and continues during the consultation. The consultation should be a two-way conversation. This will help the patient feel more at ease, and they will feel like they are receiving personalized care. The patient’s input should guide your treatment plan: the services, technology and timeline. The goal is not to throw every treatment option at them, but rather to develop and fully taper an individualized treatment plan.

Relay Your Expertise

Every member of your staff—from the front office to the nurses—should be well versed in the treatments, technology and services your office provides. While your front office staff members may not know the science behind the technology, they should be able to relay key information about your services, how they compare to your competitor’s, etc. A patient wants to feel like they are in the hands of the experts. When you meet with prospective patients, explain the services to them with enough detail that they feel confident in you as the expert. Be careful to not oversell them or over-explain the technology. Relate the technology to their personalized treatment plan and explain how it will benefit them specifically. This goes back to making a genuine connection. If patients feel a connection with you and feel confident in your expertise, it is likely that they will choose your medical aesthetic office.

Follow Through

At the end of the consultation, a prospective patient may want to consider his or her options before fully committing to your office. If you have successfully consulted from the patient’s point of view, it is likely that he or she will feel confident moving forward and will follow through with a second appointment. After the initial consultation, move forward by developing an individualized, comprehensive treatment plan based on that first appointment. Make sure the plan is professional, clean and personalized. Meet with him or her in person to discuss all of the options, financing, timeline, etc., or send it via email and discuss it by phone. This will get the conversation rolling and encourage him or her to make a final commitment to your office.

It is essential to consult from the patient’s point of view. First impressions are critical. Make a genuine connection and carefully tailor your expertise to meet the patient’s needs and desires.

Click here to 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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AmSpa provides legal, compliance, and business resources for medical spas and medical aesthetic practices.

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