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You Can’t Pay for Patients and Call it “Marketing”

Posted By Administration, Friday, March 15, 2019

money changing hands

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

Finding customers is the biggest challenge for any business. You can offer the finest product or the best service, but none of it will matter unless you can find people willing to walk in the door and buy from you. Therefore, marketing and advertising are critical to a business’s success. This is especially true for medical spas and others in the aesthetic health industry. There are many effective marketing strategies to use, each with its own legal issues. We’ve previously written about issues with email marketing and text message marketing.

The referral is one of the most effective marketing tools. Satisfied customers can be your best advocates and salespeople by simply going out into the world and telling their friends about how great you are. A recommendation from a friend or trusted acquaintance can be hugely credible, so incentivizing people to make more of these referrals for you might seem like a great idea. However, since medical spas offer medical procedures, they are subject to a slew of laws that make rewarding referrals very difficult to do.  Many states prohibit physicians or licensed healthcare providers from paying or accepting money or other types of value for referring a patient.

Consider the ongoing saga of Forest Park Medical Center in Dallas, where doctors (allegedly) enacted an elaborate plan of paying other physicians for referrals to the center for elective surgeries and ran afoul of anti-bribery laws. Forest Park apparently was paying hundreds of thousands dollars per month to physicians for referrals and calling it “marketing.” Obviously, most medical spas are not able to pay millions a month in “marketing,” and very few seek reimbursement from insurance. So what do they have to worry about? Texas’ patient solicitation law prohibits paying “any remuneration in cash or in kind” for “securing or soliciting” a patient. (Confusingly, this particular law is not the one at play in the Forest Park case, but it does apply to other Texas medical practices). So while it might seem nice to give a gift card to someone for bringing a patient to you, it very likely is an offense under this section.

Texas isn’t the only state to look unkindly at paying for patient referrals. Many other states have similar “anti-kickback” laws or general prohibitions on physicians “fee-splitting” with others. New York, for example, clearly prohibits a licensee from offering, giving or receiving any fee or consideration to a third party for the referral of a patient. If you think this seems broadly written, you would be correct—and New York and Texas are far from the only states that have laws such as these on the books; most traditionally have viewed paying for referrals as subverting a patient’s interests. After all, the patient is relying on the person to provide a recommendation that is in his or her best interest, and the introduction of a financial motive may influence that recommendation.

You also may notice that payments for more traditional advertising could fall into this broad definition if the fee is based on results. Depending on the specific facts of the case and the state in which it occurs, this could be the case. California has accounted for this possibility by providing an exemption for certain advertising relationships in its anti-kickback statute. The California Business and Professions Code § 650 prohibits a licensee from offering or accepting any payment as compensation or to induce the referral of patients. However, it does allow for the payment of services (but not payment for referrals) based on gross revenue or a similar arrangement if it is consistent with the fair market value of those services. But even in states like California that explicitly carve out advertising from the anti-kickback rules, not all advertising relationships are permitted. Paying for advertising based on results or consumer response always will appear to be a paid referral and is certainly a risky arrangement. Before implementing any marketing strategy, it is always a good idea to review your state’s fee-splitting and anti-kickback laws, as well as your licensing board’s guidance on professional conduct.

If you would like to learn more about marketing that won’t land you in the same hot water as the physicians at Forest Park Medical Center, consider attending one of our Boot Camps this year. We also have a number of webinars that cover various issues and aspects of marketing that you may find helpful.

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

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In Just 15 Minutes, You Can Help the Medical Aesthetics Industry

Posted By Administration, Friday, March 15, 2019

taking a surveyBy: Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

From now until March 28, AmSpa is conducting the 2019 Medical Spa State of the Industry survey, and if you’re the owner or managing business director of a medial aesthetics practice, your participation is vital to helping us gain a better understanding of what’s going on throughout the industry. The survey takes approximately 15 minutes to complete, and once you finish, you’ll be entered in a drawing for valuable prizes. Click here to take the survey now.

This survey is extremely important to AmSpa and its members, and the information you provide can help us determine emerging trends and topics of concern that affect everyone in the industry. The more data we can gather, the better—it allows us to determine what is happening with a greater degree of certainty, and it helps bring to light perspectives that might not have been considered before. In other words, your opinion is incredibly valuable to us and to everyone else in the industry.

If you complete the survey, you’ll receive a free executive summary of the results when the survey is completed, as well as a promo code for $100 off a ticket to any 2019 AmSpa Medical Spa & Aesthetic Boot Camp, so if you’re a qualified respondent and you’re considering attending any of these events, it’s certainly worth your while to participate. Additionally, you will be entered in a drawing to win one of two $500 Visa gift cards.

Participation in the survey is limited to owners and managing business directors of medical aesthetics practices, and we ask that only one person per practice respond; however, if you don’t personally have access to the information you need to answer a particular question, we encourage you to solicit that information from others in your organization.

The more information you have, the better decisions you’ll make. By participating in AmSpa’s 2019 Medical Spa State of the Industry survey, you’ll help yourself and others to become better informed about the trends and topics that are currently driving the medical aesthetics industry, which can, in turn, help the industry can become even healthier as a whole.

Tags:  AmSpa's 2019 Medical Spa Statistical Survey  AmSpa's Med Spa & Aesthetic Boot Camps 

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Medical Spas Face the Challenges of Private Equity-Backed Health Care

Posted By Administration, Thursday, March 14, 2019

By James M. Stanford, JD, Partner, ByrdAdatto

Over the last several years, private equity activity progressively made its entrance into the market of dental support and management service organizations. Now, the trend has made its way into the practice of dermatology, and the field is divided over the rise of private equity—not only in dermatology, but in other areas of medicine as well, including plastic surgery, aesthetics, and the medical spa space. The competing schools of thought on private equity in medicine are highlighted in an article recently published by The New York Times entitled, “Why Private Equity is Furious Over a Paper in a Dermatology Journal.”

The article details the backlash a medical research paper received after its data supported a conclusion that private equity firms tend to acquire practices “that perform an unusually high number of well-reimbursed procedures and bill high amounts to Medicare.” The article also highlights the criticisms over the paper’s factual accuracy, its sudden removal from the medical journal’s website, and the questions raised about private equity firms’ growing presence and influence in the practice of dermatology at the expense of patient care.

While the corporatization of healthcare is not a new debate, the research paper’s conclusion is the most recent example to illustrate the challenges that arise in maximizing profits without diminishing patient care. This is because the ability of a practice to effectively align its healthcare and business issues can be the differentiating factor between the success and failure of the practice. On one side of the equation, you have the traditional healthcare practice structure where business innovation and creativity is extremely limited, and the primary focuses are patient care, efficiency in billing and operations, and payer reimbursements. On the other side, you have the retail business structure where there is a limited understanding with healthcare laws and regulations and the correlated risks of excessive monetary penalties and lawsuits, but its experts are skilled in innovative marketing and branding.

Like it or not, private equity has made its way into the dermatology market and other health care spaces. If you have a management service organization and need help navigating the challenges of raising private funds, or if you are currently operating with private equity backers and need guidance, consider attending one of AmSpa's upcoming Boot Camps, where industry leaders can answer your questions and show you how to move your business forward.

James M. Stanford is an attorney and partner at the ByrdAdatto law firm. From transitions, mergers, and acquisitions to structuring complex ownership arrangements, James enjoys the personal reward that comes from bringing parties together and making deals happen. James practices primarily in the areas of health care and corporate law with a focus on intellectual property. A proud father, Jim served in the U.S. Army and is fluent in Russian. In his spare time, he enjoys hunting, fishing, and spending time outdoors.

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

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Fibroblast Plasma Therapy, Who Can Do It?

Posted By Administration, Tuesday, March 5, 2019

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

Fibroblast Plasma Therapy is a new skin tightening procedure that is generating a lot of buzz in the medical aesthetics industry. It delivers tiny arcs of plasma created by an electrical discharge via a “plasma pen” to the skin, singeing the surface and tightening the underlying tissue. Unlike a typical light or other energy based skin tightening treatment where a large area of skin is treated with each firing, a Fibroblast Plasma Therapy treatment only effects a tiny pin-point of tissue with each firing. The whole treatment is then performed by repeatedly applying the pen in grid pattern over the treatment area. It appears that, in general, there are few risks of complications with this treatment. However, there is risk of burning through part of the skin if the plasma is applied for too long or too deep.
 
As is typically the case when such a product emerges, we at AmSpa are getting a number of questions about who can actually perform Fibroblast Plasma Therapy procedures. The treatment appears to be very straightforward—a provider applies the device in a grid pattern to the area of the skin to the skin. Its simplicity raises an obvious question: can an esthetician or licensed vocational nurse (LVN) perform this procedure?
 
It’s great that we get these questions because it shows that medical spa owners and operators care about remaining compliant, but because innovation moves faster than the regulation, it’s sometimes difficult to determine what the answers are when new treatment emerges. However, we can use what we know about similar treatments and technologies to determine the most prudent course of action until government agencies make their rulings.


Find answers to your med spa law questions with AmSpa's State Legal Summaries.
Click Here


Simply put, the Fibroblast Plasma Therapy is essentially an energy device similar to other IPL, electricity, and radio frequency devices. A lot of the issues we’ve addressed in recent years regarding other energy skin tightening devices are likely also going to apply to it. Every state that has looked into these other energy devices that tighten the skin has found it to be a medical treatment, so a good-faith exam must be performed before the procedure, and if a doctor is not administering the treatment him- or herself, it must be properly delegated. Unfortunately, for practices that would like to use unlicensed practitioners to perform Fibroblast Plasma Therapy procedures, this takes them out of the scopes of practice for estheticians and most LVNs.
 
The only conjecture we can make is that Fibroblast Plasma Therapy will likely be regulated in much the same way as other energy based skin tightening, both in terms of medical board rulings and FDA approval.
 
Unfortunately, since it is so new, we don’t have all the answers yet, however we will stay on top of this as more states weigh in on the procedure and news develops. Look to AmSpa for more about Fibroblast Plasma Therapy treatments. Thus far, it has been safe and well received, but the industry needs to have a firmer grasp on the regulatory issues surrounding it.

 

To learn 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 be the next med spa success story.

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

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

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Texas Nursing Board Reiterates That Nurses May Only Use Non-Ablative Lasers

Posted By Administration, Monday, March 4, 2019

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

Unlike many other professional licensing boards, the Texas Nursing Board provides a volume of guidance and answers on their website for nurses wanting to practice in a medical spa. In general, this guidance recognizes that that registered nurses (RNs) and licensed vocational nurses (LVNs) have a scope of practice that is defined partially by their educational background, level of competence, and knowledge. This flexibility seems to carry over to the Board’s position statement 15.9 on Laser Therapy.
 
Position statement 15.9 (available here), begins by acknowledging that the “use of laser therapy and the technology of laser use have changed rapidly” over the years. It goes further on to state that nurses play many important roles in laser therapy and that it may be within their scope of practice to administer such treatments. The statement lays out the basic requirements that the nurse needs to have the education, experience, and knowledge to perform the treatment and must perform it subject to a valid medical order and under appropriate supervision. All through this section references are made to lasers, laser therapy, or laser energy. However, the seeming broadness of this position is quickly undermined by the single use of one term: non-ablative. Non-ablative is used only once in the statement and by its inclusion it excludes many laser skin resurfacing treatments from RNs and LVN’s potential scope of practice.
 
Recently, Sam Pondrom an attorney with the law firm ByrdAdatto, spoke with the Board of Nursing regarding this language in 15.9 he says “The Nursing Board was very clear: that there are no plans to remove the (non-ablative) language from the statement and that they don’t feel a (RN or LVN)’s educational background prepares them to accept these assignments.”
 
This limitation to non-ablative lasers in the position statement appears to be in response to an older practice guideline from the Texas Medical Board (TMB). This TMB guideline was adopted in 2003 but has since been withdrawn and at the time it prohibited physicians from delegating any ablative laser procedures to others. However, the Nursing Board’s statement retains the restriction and in 2013 only removed reference to the withdrawn TMB rules (see here for a discussion of the 2013 amendments). Currently, no other rule or law prohibits a physician from delegating an ablative laser procedure to a nurse.  However, position statement 15.9 makes it clear that it is not within the scope of practice for an RN or LVN to accept such a delegation. It remains to be seen when The Board of Nursing will again recognize that “the use of laser therapy and the technology of laser use have changed rapidly” as they had previously stated in the opening line of 15.9. 

To learn 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 be the next med spa success story.

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

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Medical Spa Bad Press: Coming to Terms with Compliance

Posted By Administration, Thursday, November 1, 2018

By Alex Thiersch, CEO of the American Med Spa Association

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

View the full segment.

See AmSpa’s full statement on the segment here

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

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

The Truth

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

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

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

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

Creating Compliance

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

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

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

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

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

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

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Self-Regulation: Equipment Manufacturers and Training Centers Need to Get on Board

Posted By Administration, Tuesday, October 30, 2018

By Alex Thiersch, CEO of the American Med Spa Association

In this space a couple of weeks ago, I wrote about the need for self-regulation in the medical aesthetic industry. In that piece, I mostly focused on how medical spa owners and operators can help the industry by observing certain standards that AmSpa is helping to develop. However, the need for self-regulation is not limited to practitioners—it extends to equipment and device manufacturers, as well as clinical training facilities.

After an AmSpa Boot Camp or a consultation where I detail the legalities of laser use, for example, I’m often approached by attendees who say, “I was trained by a laser manufacturer, and they didn’t tell me any of this stuff.” What I’ve found is that there are a lot of people out there who give a lot of disparate information and, oftentimes, it’s not accurate and it leads people to believe that they can do things that legally they cannot do.

We at AmSpa have been working very hard since the organization’s inception to educate not only medical spa owners and practitioners, but also the industry as a whole. If everyone knows the laws under which they operate, everyone can be on the same page.

AmSpa works with many laser manufacturers that have listened to us and acted in very responsible ways. However, I’ve also heard countless stories from people who were told by manufacturers or training facilities that they can do something that they plainly cannot, and they feel like that is unfair.

This is not just an AmSpa problem or a medical aesthetic practitioner problem—it is an industry problem. The entire industry need to be on the same page. Every member of the industry needs to buy into the same set of standards, and we all need to be teaching the people who work in the industry the same thing. It makes no sense and does nobody any good to, say, take a long laser course and learn to perform treatments if a practitioner cannot legally administer them.

Therefore, AmSpa is calling on the entire industry—not just medical spa owners and practitioners, but also device manufacturers, drug manufacturers, and training facilities—to start taking compliance seriously, because it’s the only way for the industry to evolve in a positive direction. Everyone wants to succeed and make money, but if the industry is overly regulated due to negative outcomes and people acting in bad faith, it will be extremely difficult for the industry to become better and larger than it already is.

I’m looking forward to discussing self-regulation with everyone at forthcoming AmSpa Boot Camps. We will be in Orlando next week for our final Boot Camp of 2018, and our just-announced 2019 itinerary includes stops in Los Angeles, Chicago, Atlanta, Seattle, Dallas, New York and Orlando. Click here for more information and to sign up for a Boot Camp near you. We’ll also be discussing this matter at the Medical Spa Show in Las Vegas in February 2019. Click here to learn more about this year’s agenda and event … it shouldn’t be missed!

 

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

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Patient Privacy in Your Medical Spa Marketing

Posted By Administration, Thursday, October 25, 2018

By Alex Thiersch, CEO of the American Med Spa Association

Medical spas must use marketing best-practices to succeed, but must also be aware of common patient privacy issues that could leave the practice in hot water. All of a medical spa’s operations must be overseen by both an innovative business eye and a careful, meticulous medical eye. When it comes to marketing, these two perspectives can clash and, if this clash breaches patient privacy, the business can be hit with severe penalties.

Fines for violating the Health Insurance Portability and Accountability Act of 1996 (HIPAA) can be huge, and most states have patient privacy laws that are even stricter than the federal standard. Patient information can include—but is not limited to—email addresses, birth dates, social security numbers, and treatment information. Even the fact that a patient is being treated at your facility can be considered private information.

This is not to say that you shouldn’t engage in marketing; you absolutely should. Digital marketing and social media in particular are cost-effective ways to increase the reach of your business. Problems arise when the drive to grow your client base mixes with the unfamiliarity of or neglect of laws and regulations. 

Common Patient Privacy Mistakes
  1. Publicly reaching out to a patient. Engaging with clients is a central tenet of social media marketing. You want to create a sense of connection and community. You must remember, however, that in a medical spa your customers are also patients. Commenting publicly to a client on social media in order to thank them for coming in, or reminding them of a future appointment, or discussing their treatment in any way are all potential breaches of that patient’s privacy.
  2. Responding to comments whether positive or negative. This is risky for the same reasons as listed previously. If patients comment about an experience they had at your business, responding to them can be seen as breaching their privacy, and responding to negative reviews can be especially risky. If, in your response, you inadvertently reveal any private information, then not only do you have a customer who is angry with you, but you also have a customer that can report you for a privacy breach in an industry where investigations from regulators are largely driven by customer complaints. The Washington Post looked into this issue earlier in 2016 and made note of several situations where responses landed businesses in regulatory hot water.  “The consumer complained to the Office for Civil Rights within the U.S. Department of Health and Human Services, which enforces HIPAA. The office warned the dentist about posting personal information in response to Yelp reviews.” The Post further notes that the Office for Civil Rights, “is currently investigating a New York dentist for divulging personal information about a patient who complained about her care, according to a letter reviewed by ProPublica.” Do yourself a favor and don’t respond to negative reviews.
  3. Publishing photos without proper consent. Before-and-after photos are a powerful method of attracting new patients. Without the proper signed consent forms, however, you cannot publish patient photos to your website, blog, social media, or any other platform. Additionally, if you post photos of your facility or an event at which you’re offering treatments, you should be very careful to ensure you are not publishing a photo showing any patient in the background who has not signed a consent form.
What Can You Do?

The No. 1 rule when mixing marketing with medicine is you must be informed. The defense, “I didn’t know what the law was,” never works. Medical spas are governed by several different licensing boards and a slew of individual laws that vary from state to state, so be sure to consult a health care attorney (preferably with experience with aesthetics) that is familiar with the laws in your state. Know the regulations that apply to your business, and err on the side of caution.

As far as concrete things you can do, keep the following in mind. 

  1. For treatment reminders and thank-yous, a personal email or phone call should be used in place of reaching out via social media. 
  2. Consent forms are a necessity when displaying any photography of patients or of medical procedures on any platform, and be sure to note that traditional consent forms for before-and-after photos are not necessarily sufficient for using photos on your social media channels.
  3. The best ways to fight bad reviews are providing superior patient care and encouraging your happy customers to post positive reviews.

Also, keep in mind that once you understand what you need to do to protect your patients’ privacy in your marketing, you must train your staff to do the same. Your staff must know the regulations as well as you do, since you will be on the hook for any breach. Establish marketing procedures and guidelines, have them in writing, and make sure your staff knows them backward and forward.

For more ideas on how to build a profitable and legally compliant medical spa attend an AmSpa Medical Spa & Aesthetic Boot Camp and be the next med spa success story.

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

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Medical Spa VIP Programs Increase Loyalty and Retention

Posted By Administration, Wednesday, October 24, 2018

By Bryan Durocher, Founder and President of Durocher Enterprises

Retaining patients is one of the keys to medical spa success, and VIP programs can be a huge driver for repeat visits. Loyalty rewards programs are used by some of the most successful businesses including GNC, American Airlines, and most of the credit cards we carry these days. We do not have to reinvent the wheel when it comes to these programs. Offer clients acknowledgement and value added incentives for being your best clients and they are more likely to keep doing business with you on a more consistent basis.

At your med spa everyone’s a VIP (Very Important Partisan, that is). That’s why it’s important to have a Very Important Partisan (VIP) program to create loyalty among your most frequent patients. According to the 2017 Medical Spa State of the Industry Report, only 39% of medical spa practices have VIP programs in place to retain their most loyal clients. 

 

Data collection will begin soon for the 2019 Report and we want to hear from you, so keep an eye out and help us define data in the medical spa industry!

With the Internet and competition it’s more important than ever to keep your hard-won clients shopping with you, since it can cost three to five times MORE to win new patients than to retain your existing ones.

Have them earn points for each service they enjoy and each product they purchase. For every 50,000 points they earn, clients receive a “store” credit worth $50 to spend on services, products, or gift cards.

Be careful, however, of offering rewards for referrals for med spa procedures because of laws regarding fee splitting.

Earning VIP Points – Omni-Channel Earning Clients who interact with you on more than one channel such as receive your newsletter, come to the practice, and follow you on social media typically will spend 18-36% more than clients who just visit for services.

Here’s how your clients can earn points:

Activity Points Earned

Spend $1 at the med spa on gift cards, in store or online – 10 points earned

Spend $1 at the med spa on services, products, series, and memberships, in store or online – 100 points earned

Like and or follow on each of your social media pages Facebook, Instagram, Twitter, Pinterest – 500 points earned for each page.

Sign up for the newsletter – 1,000 points earned

Pre-book their next appointment at time of checkout – 2,500 points earned.

Your system needs to automatically track the points they’ve earned. They can check their balance by asking your concierge, looking at the top of their receipt at checkout, or logging in to their online account (if available).

Redeeming VIP Points

Once they’ve earned 50,000 VIP Points, you automatically send them an email alerting that they have earned a points reward. This requires that they have a valid email address in your system and that they have not opted out to email communication. When they check out of their appointment at the clinic, just alert the concierge to offer if they would like to spend their points and then credit the transaction $50.

Enrolling in the VIP Program

Your clients are automatically enrolled in your VIP program from the first time they make a purchase at the Med/Spa.

The Fine Print

There has to be a catch, right? Not really, but here are a couple of details about how the VIP Program works:

VIP points expire two years from the day that they were issued. So, if they haven’t reached the 50,000-point threshold within those two years, the points may expire.

Points will be awarded at the time of check out. For example, if they refer a friend they will get their points when he/she checks out at the clinic. If they pre-book an appointment, they will earn those points when they check out of that appointment, not when they schedule it, etc.

VIP points may not be redeemed for cash.

No double dipping! Some purchases may not earn points. For example, they won’t earn double points if they buy themselves a gift card and use it on their own purchase. If the spa suspects abuse or other behavior, it can reserve the right to terminate the enrollment in the program.

VIP points are non-transferrable, but they may purchase a gift card with their VIP points to give to a friend.

Consider these other restrictions in your program terms:

  • May not be valid with some special offers, sale items or special purchases.
  • The med/spa reserves the right to terminate or modify the program at any time.
  • Clients may not earn points on purchases or services made using third party gift cards or tender.
  • Card is only valid for cardholder.
  • Card must be present to accumulate points.
  • Points cannot be earned from previous purchases.
  • Only the cardholder’s purchases are valid towards point accumulation.
  • Points are not awarded on shipping charges or sales tax. Product returns and other financial adjustments will be deducted from their total points.

Because there is a savings don’t offer VIP points for gift cards purchases that result in earning a bonus gift.

Enjoying treatments at the med spa may be habit forming, resulting in lower levels of stress, increased wellness, and moments of extreme contentment.

VIP Program Example

The Med/Spa has created valuable benefits to reward our most loyal guests and thank you for your patronage, support and trust.

The Med/Spa VIP program provides you with additional opportunities to make your experiences at our Med/Spa more valuable. View your additional opportunities for saving below.

  • 10% off retail purchases
  • Full Privilege points on product purchases when you spend $300 on product enjoy a $15 product credit in the retail store
  • Insider savings on new services
  • ABC Med/Spa gifts for special occasions
  • 5% discount on series purchases all year (VIP use only)
  • Complimentary Delivery of Gift Cards and Gift Boxes
  • 10% discount on gift card purchases during the months of Jan., Apr., Jul. and Oct.
  • Ask a concierge or your service provider about additional discounts

ABC Med/Spa VIP program cost for annual membership:

$500 for an individual (saving) or $50 per month

Membership can be paid up front or automatically deducted from your account each month.

The ABC Med/Spa VIP program provides savings based on anticipated use. Memberships will expire 1 year after the date of purchase. There are no refunds, credits, or cash given for “unused memberships.”

The VIP program renews annually upon each client’s enrollment date.

You will need to create signage and information about your program to create awareness among your team and client base.

Marketing

Signage can involve large posters throughout the business, station and treatment room signage, POP displays, and flyers for the retail bags when purchases are made. A banner across your website promoting the program is a good idea!

Other marketing tools to promote the program are business newsletters and e-mail marketing to your data base.

Additionally, you can offer your team member incentives for each VIP membership they sell. For the Front desk, you can offer an override to the team based on total sales.

For more ideas on how to build a profitable and legally compliant medical spa attend an AmSpa Medical Spa & Aesthetic Boot Camp and be the next med spa success story.

Bryan Durocher is the author of Wakeup Live the Life You Love in Beauty, and is the founder of Essentials Spa Consulting and Durocher Enterprises. Durocher was named one of the “Top 20 People to Know in the Beauty Industry” by Global Cosmetic Industry magazine, and provides coaching, consulting, global industry trends, and marketing solutions for medical spa, spa and industry professionals internationally. He has published many articles and has provided business education internationally at a variety of national and international industry events including AmSpa’s Medical Spa & Aesthetic Boot Camps and The Medical Spa Show.

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

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OSHA: What You Don’t Know Can Hurt You

Posted By Administration, Thursday, October 11, 2018

By Alex R. Thiersch, Founder and Director of the American Med Spa Association

Med spa ownership, delegation requirements, HIPAA, and fee-splitting are common issues to consider when coming up with your medical spa’s compliance plan, however it is vital that you do not overlook Occupational Safety and Health Administration (OSHA) standards in your medical aesthetic practice. You may not even know what OSHA is, what it does and why it does it. It’s time to change that. In fact, it’s mandatory that medical spas follow OSHA standards—your business depends on it.

When Lori Marshall, a physician's assistant at the West Side Medical Spa, reported to management that she had been stuck by a contaminated needle during a procedure, nobody knew what to do. When she tried to convey to management the need for procedures, she was told to wash the puncture site and get back to work. Lori felt betrayed and angry. At her husband’s suggestion, Lori called the Occupational Safety and Health Administration (OSHA) and reported the incident. Within hours, Lori was contacted by an OSHA compliance safety and health officer (CSHO), who took a detailed statement from Lori, and advised her that they would schedule an immediate site visit.

Two days later, an OSHA CSHO walked in to the West Side Medical Spa and identified herself to management, and advised that they were there in response to a complaint. Throughout the next three days, all employees were interviewed, and all documents and records were reviewed.  Within a matter of weeks, West Side Medical Spa received a letter containing the following citations and penalties.

No written bloodborne pathogens/exposure control plan                             $4,500 
Failure to train employees in BBP within 10 days of hire                               $2,500
Failure to provide medical follow-up after an exposure                                $2,500
Failure to maintain required needle stick logs                                                  $1,500
Failure to include employees in selection of safe medical devices             $2,500
Total penalties                                                                                                    $13,500

 
This scenario is based on an actual event, and all names have been change to avoid actual identification of the employee or the employer. 

What is OSHA?

The Occupational Safety and Health Administration (OSHA) is part of the United States Department of Labor. It was created by the Occupational Safety and Health Act of 1970, and its mission, according to the act itself, is “to assure safe and healthful working conditions for working men and women.” OSHA protects most private-sector workers in the United States, though its standards are typically associated in the public consciousness with industries such as construction and agriculture—fields in which physical labor is a major part of jobs, and workers may easily suffer injuries—or worse—if improperly trained.

However, medical spas and medical aesthetic facilities also must follow a number of OSHA standards, which may come as a surprise to their owners and operators. Often, unless these are followed, a business can be fined tremendously and ultimately, it can be shut down.

“Sadly, many medical spas may not even be aware that OSHA standards apply to them,” says Steve Wilder, president of Sorensen, Wilder & Associates, a safety and security risk management consulting group specializing in health care. “Medical spas are considered health care entities; therefore, they are subject to the health care requirements of OSHA.”

OSHA standards for medical spas

According to Wilder, medical spa owners and operators must comply with seven particular OSHA standards.
• Bloodborne pathogens—exposure control plan;
• Hazard communication;
• Recordkeeping;
• Slips, trips and falls;
• Tuberculosis;
• Workplace violence; and
• Laser safety.

The specific requirements for each standard can be found on OSHA’s website (www.osha.gov). In general, compliance for each standard requires commitment from management and employees; workplace analysis; detailed hazard prevention and control procedures; the completion of training programs; and detailed recordkeeping utilizing OSHA’s Form 300 log and Form 300A summary.

“If you’ve got the proper programs in place in those seven areas, including the written programs, the training programs and everything that’s required, you’re going to be in pretty good shape,” says Wilder. “It can be expensive, but there are a lot of alternate ways around it. You can find different ways to be creative—such as online training—and still meet the intent of the requirement.” 

What Happens If I Do Not Comply?

If OSHA conducts an audit on your medical spa and finds that it is in violation of workplace standards, you will be fined a considerable amount.

“OSHA has enforcement authority under the federal government,” says Wilder. “The standards that they develop can be enforced under penalty of law. What that means is that if they come in and audit a health-care provider—whether it’s a spa, hospital, nursing home, an ambulance or whatever—and they identify places in which the health-care provider is not compliant with the standards, they then have the authority to issue monetary fines.”

And those fines can be severe. OSHA can issue a fine of up to $7,500 for a first offense, though it is more likely that such a fine will be in the range of $1,500 to $5,000, depending on the severity of the deficiency. It is also important to keep in mind that each additional violation will result in an additional fine, and these fines can quickly add up. What’s more, you cannot be insured against such fines, so they will come directly off of your bottom line.

“I looked at [a case] for a nursing home client a couple of months ago and, when OSHA got done with them, their total penalties were more than $45,000,” explains Wilder. “And with no insurance to cover it, that’s a heck of a bite.”

And if a violation for which you have already been cited is found during a subsequent visit, or if said violation is found at a different location that is owned by the same person or company, OSHA has the authority to fine you up to $75,000 for that violation.

“You need to take it seriously,” cautions Wilder. “OSHA is not getting any gentler; they’re not getting any more workplace-friendly. Expect them to be really aggressive in infection control in all areas of medical care. Their focus is protecting employees, so anywhere that employees can get exposed to an injury risk or to an illness risk, they’re aggressive about it.”

Knowledge is Power

Bringing your medical practice up to OSHA code is not an option. It’s a necessity and OSHA does not accept ignorance as an excuse. Now that you know what is expected of your business, you must take the necessary steps and move forward in order to avoid major financial penalties that very easily could result in the closing of your business. Click here to read more articles about med spa law topics and how they could affect your business.

Attend an AmSpa Medical Spa & Aesthetic Boot Camp to learn ways to build and run your medical spa practice profitably, and within the bounds of the law.

 

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

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