Posted By Administration,
Thursday, September 13, 2018
By Renee E. Coover, JD, ByrdAdatto
Medical spa laws regarding physician supervision can be critical to a practice’s compliance plan, particularly if the practice utilizes nurse practitioners, physician assistants, nurse injectors, laser techs, or other non-physician providers to administer treatments.
Given the current economic landscape for medical practices, an increasing number of physicians are seeking alternative sources of revenue outside the traditional practice of medicine. Many physicians are turning to medical spas as an additional or alternative source of income, not wrought with the same Medicare/Medicaid and insurance issues currently plaguing the healthcare industry. But as physicians flock to medical spas in the hopes of making an easy income, many overlook the fact that a certain level of supervision is still required for all medical treatment. At the end of the day, the physician is responsible for every patient and if something goes awry, the physician’s license is on the line.
Recently, our law firm has exploded with calls from physicians and med spa employees asking questions about physician supervision like:
Does the doctor need to be present at all times?
Does the doctor need to see every patient?
What if the doctor consults with the patient over Skype- is that allowable?
First and foremost, it is crucial to know what med spa services require physician supervision in your particular state and what constitutes an adequate amount of supervision. In California, for example, all medical treatments – including Botox and laser hair removal – require physician supervision. Although a physician may delegate medical treatments and initial patient consults to nurse practitioners (NPs) and physician assistants (PAs), the physician must be involved and available to patients in the event of an emergency.
Ultimately, the physician is responsible for each patient that walks through the door of a med spa. Some states have additional oversight requirements as well. In Illinois, a medical professional must be onsite at the med spa at all times when medical procedures are performed. This means that if a physician owner only has one other employee and that individual is a non-medical professional, the physician must be onsite at all times to supervise the medical procedures.
Many physicians don’t realize, at least not right away, that treating patients in a med spa is just like any other practice. Most medical spa treatments by and large are still considered the practice of medicine, and the physician must assume ultimate responsibility for all of the patients that are seen and treated at the med spa. The physician must ensure that proper protocols are in place, oversee treatment plans, and safeguard patient confidentiality. While many of these tasks can be delegated, it is the physician, not the med spa owner or the employees, who is going to be held responsible if something goes wrong.
Experience and Training
One pitfall is the physicians’ notion that they can supervise medical tasks outside of their specialty practice, but in most states a physician in a med spa must specialize in, or at least have experience and training in, aesthetic medicine. In other words, the physician overseeing the medical spa and whose license is ultimately on the line, must actually practice aesthetic medicine.
Frequently, general practitioners, OB/GYN’s and emergency room physicians are quick to sign on as “medical directors” of med spas even though they have no experience or training in injectables, laser treatments, or any other aesthetic procedures, but this can get them in trouble fast. Even dermatologists and plastic surgeons should seek out training in these types of medical treatments in order to properly supervise the aesthetic treatments being offered at the med spa.
With the advent of telemedicine, physicians frequently want to know if they can use real-time interactive communication on programs like Skype or Facetime to consult with and examine patients instead of meeting each new patient in-person, but this remains a gray area in the law. There is a fine line between giving generic health information over a smartphone and actually diagnosing or treating a patient. Telemedicine is viewed as a cost-effective alternative to the more traditional face-to-face method of providing medical care and in some states it is being cautiously embraced. In Oklahoma, for instance, the state medical board recently passed telemedicine rules exempting physicians from face-to-face meetings with patients if certain criteria are met. Not every state is on board with this and only time will tell if telemedicine will be the future of medicine. Read more on telemedicine in medical spas here.
The bottom line is that physician supervision in the medical setting is a key component to running a successful and legally compliant med spa business. If you are unclear about the level of physician supervision required in your state, you should seek legal guidance from an experienced attorney immediately. AmSpa members can take advantage of their 20-30 minute annual compliance consultation with an attorney from ByrdAdatto.
For more ways to build and run your medical spa practice legally and profitably attend an AmSpa Medical Spa & Aesthetic Boot Camp and be the next med spa success story.
Renee E. Coover, JD, is an associate with ByrdAdatto, a law firm focusing on business, healthcare, and aesthetics. She has a unique background, blending litigation with healthcare law. A former litigator in high-stakes employment cases, Renee has extensive experience with counseling and representing businesses in employment matters, policies, and contract disputes, and defending business owners in state and federal trials. She has also served as General Counsel for the American Med Spa Association, advising health care professionals on regulatory and legal issues governing the medical spa industry.
Posted By Administration,
Tuesday, September 11, 2018
By Alex Thiersch, JD, Founder and Director of the American Med Spa Association
An employment contract between a medical practice and a physician must benefit both the employer and employee; otherwise, it likely will be unsatisfactory for one or both sides. If one or both sides don’t take the time to read the contract, they could find themselves disappointed with the outcome. Here are a few things that physicians and practices should find within a mutually beneficial contract.
For more information on medical spa employment contracts, view AmSpa’s webinar on the topic (free to AmSpa Plus members.)
A Clearly Articulated Goal
Before a contract with a physician is finalized, the practice should consider what it wants to accomplish. Does it want to fill a need? Does it want to service more patients? Does it want to transition ownership to this individual? The answer to this can affect the way an employment agreement is designed and the type of person the practice wants to recruit (i.e., a younger doctor versus a more experienced one). If a practice hires a physician who has entrepreneurial aspirations to simply tend to patients, for example, neither side is likely to be particularly happy, and the relationship likely will not last very long.
The practice must clearly communicate its intentions during the recruitment process and make sure that the contract is built around that philosophy.
From the other perspective, a physician must honestly evaluate his or her goals when negotiating a contract. Physician contracts typically last for one to two years, but both sides typically expect that the relationship between the practice and the physician will continue thereafter, so a physician must consider his or her long-term plan. Is this where he or she wants to build a career? This can influence how the contract is negotiated.
The physician also needs to consider his or her “plan B”—if this arrangement does not work out, what’s next? The answer to this question heavily influences how he or she evaluates the contract. For example, if the physician wants to live in the city where the practice is located but the contract has a restrictive non-compete clause, that clause will need to be negotiated, as it severely restricts his or her options if it the relationship with the medical spa does not work out. Click here to read more on non-compete and non-solicitation clauses.
A Fair Wage
A medical spa should balance the economics of the practice, the risk tolerance of the owners, and the realities of the market in terms of salary when negotiating a contract. A competitive guaranteed base salary with some form of incentive-based bonus system can make a difference when it comes to obtaining top talent who might be considering other options. There are multiple ways this can be arranged depending on what suits the physician.
The prospective employee, on the other hand, must come to terms with his or her risk tolerance. While a high base/low bonus structure might appeal to some, others might want to bet on themselves with a low base/high bonus structure. It is up to the physician to determine his or her comfort level with the contract’s salary structure and negotiate if it is not optimal.
The physician also must be sensible when determining his or her actual earning power. If there is not enough potential business in the market to justify taking a low base/high bonus salary, the physician should negotiate a different deal.
The practice must determine what it wants to accomplish in terms of ownership with the hire, since it will affect everything from scheduling and coordination to top-level decision-making. The owner(s) of the practice also must consider if this transaction constitutes part of their exit strategy; if so, the contract must be structured with that in mind.
The physician, meanwhile, must determine his or her goals in building the practice and figure out how the ancillary revenue streams offered by the practice compare to those offered by others. Ownership has different appearances for different entities, so the physician must think about what he or wants and what the practice can provide. What is the cost of the investment? What is the potential return? What is the risk? All these questions should be answered in the contract.
A contract is a complicated matter. Both sides must assess the value of the risks and rewards, and they must be willing to compromise on matters that may not be as important. A careful reading of a contract is absolutely imperative, however—if a physician or practice doesn’t thoroughly read the contract, they have nobody to blame for their unhappiness but themselves.
For more information on structuring your medical spa profitably and compliantly, attend an AmSpa Medical Spa & Aesthetic Boot Camp and be the next med spa success story.
Posted By Administration,
Friday, September 7, 2018
By: Sam Pondrom, JD, Associate at ByrdAdatto
When it comes to advertising, social media is the hot new trend. It’s cheap, has a far reach and the potential to lure in many new customers. But it can also cost you if you aren’t advertising yourself and your business accurately. (AmSpa members can check their state legal summary, or utilize their annual compliance consultation with the business, healthcare, and aesthetic law firm of ByrdAdatto for more information on medical spa law.)
Social media marketing is being embraced across industries because of its cost-effective, direct-access marketing to potential consumers. An additional bonus to social media marketing is its self-selecting nature, which allows social media users to seek out the advertising themselves, making them more receptive to the messages. But when it comes to using social media marketing to select a plastic surgeon for treatment, it is important that social media users still perform their due diligence to ensure the advertisements are posted by board-certified, credentialed plastic surgeons.
A report recently published by the Aesthetic Surgery Journal examined all of the plastic surgery related advertisements posted to Instagram on a single day—January 9, 2017—to assess who was publishing the social media content. The Journal found that there were about 1.79 million Instagram posts on that day that included at least one plastic surgery-related hashtag, like #plasticsurgery, #plasticsurgeon, #breastlift, #liposuction, or #brazilianbuttlift (hashtags categorize content and clicking on a hashtag retrieves similar content; they are functionally a search for similar content). The Journal then evaluated the content of the top nine posts (top posts are those with the most engagement) in 21 plastic surgery related hashtags
The Journal also found that only 17.8% of the top posts for these hashtags came from board-certified plastic surgeons. Another 26.4% came from physicians that did not have specialized plastic surgery training, and another 5.5% of the top posts came from persons who were not physicians at all, including dentists, medical spas with no physician/medical director, and even one hair salon. The Journal also found that the majority of the posts were self-promotional (67.1%), rather than educational (32.9%), and that board-certified plastic surgeons were much more likely to post educational content than non-plastic surgeons (62.1% versus 38.1%, respectively).
This is particularly troubling because of social media’s reach and influence on young people, who now make up a large sector of the plastic surgery population in our country. The American Society of Plastic Surgeons reported that in 2014, nearly 64,000 cosmetic surgery patients were aged 13 – 19 and industry experts believe this number increases every year. Moreover, in 2016, the American Academy of Facial Plastic and Reconstructive Surgery polled its members and more than half of the respondents reported an increase in cosmetic procedures in patients under age 30 in 2016. 42% of respondents also reported that their clients were at least partially motivated to seek plastic surgery because of a desire to look better in selfies posted to Instagram, Snapchat, and other social media platforms.
This means that social media users should research potential surgeons beyond their social media presence, and users wanting plastic surgery should seek out a board-certified plastic surgeon. Board-certified plastic surgeons are doctors with more than six years of surgical training and experience, at least three of which are specifically in plastic surgery. Moreover, social media users should move beyond Instagram and meet with the surgeon in person to obtain information like how many surgeries the surgeon has performed, what recover times are, and whether the patient is a good candidate for the surgery.
There are many resources to verify whether a physician is a board-certified plastic surgeon, including the American Board of Plastic Surgery’s website that lists physicians’ credentials, the American Society for Aesthetic Plastic Surgery that maintains a searchable database of board-certified physicians, and the America Society of Plastic Surgeons that allows a person to search for board-certified plastic surgeons by location.
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As the youngest of three brothers, Sam Pondrom learned early on how to work effectively as part of a team. After graduating from Oklahoma State, an intrinsic sense of curiosity and a keen eye for details led Sam to work as an accountant for two Engineering-News Record top 40 construction firms. It was here where he honed his ability to analyze complex issues and craft clear, concise answers. Sam utilizes these skills to work in partnership with our clients to resolve their complex business and regulatory concerns in the most simple, straightforward way.
Posted By Administration,
Thursday, September 6, 2018
By Alex R. Thiersch, JD, Founder and Director of the American Med Spa Association
Excellent medical spas require a commitment to building an excellent team, and once that team is in place many medical spa owners look to non-compete and non-solicitation clauses to protect their investment in time and training. Conscientious medical spa owners invest a great deal of time, effort and money toward making their employees the best they can be, and these contractual clauses, known as restrictive covenants, can prevent former employees from working for a competing medical spa and taking its clients and/or employees for a certain period of time. Implementing these clauses and enforcing them, however, are two very different things, so medical spa owners and operators must understand what they’re all about before attempting to utilize them.
A non-competition agreement is a part of a contract that is designed to bar an individual from working for a competing medical spa for a set period of time in a designated geographic area. If employees with non-competition clauses in their contracts choose to leave your medical spa, they would theoretically be subject to legal action if they went to work for another medical spa within the agreed-upon time span and geographic area.
This seems fairly straightforward; however, in reality, non-competition agreements are somewhat difficult to enforce to their fullest extent because American courts tend to be very reluctant to prevent people from working where they want.
As with many things in this industry, the laws governing these arrangements vary from state to state. California, for example, has essentially established a ban on non-competition agreements. In Illinois, according to Renee Coover, JD, attorney with the law firm ByrdAdatto, “In a 2015 decision, the Third District of the Illinois Appellate Court readily followed and applied a rule established by a ground-breaking 2013 First District Appellate Court ruling. In Prairie Rheumatology Associates, S.C. v. Francis, the court reiterated that continued employment is sufficient consideration for a non-compete only where the employment is for a substantial period of time. Citing the 2013 Fifield v. Premier Dealer Services, Inc. opinion, the court held that two or more years of continued employment amounts to adequate consideration. This means that the employee must be employed, under the terms of the non-compete agreement, for two years before the non-compete is enforceable against the employee.”
A non-solicitation agreement is a part of a contract that is designed to prevent a former employee from soliciting clients and/or other employees from your practice for a specified amount of time. In the medical spa setting, it’s not unusual for patients to become attached to the nurse practitioners, laser technicians and nurse injectors to whom physicians commonly delegate treatment.
When one of these people decides to leave a practice, that practice needs to make sure that no effort is made to take said patients along—those are the practice’s patients, not the individual’s. If former employees make any effort to reach out to those patients and entice them to follow the employees to another practice, it is a clear violation of any non-solicitation agreement has been accepted.
Unlike non-competition agreements, non-solicitation agreements are commonly enforced, as courts are consistently willing to punish the misappropriation of a company’s assets—in this case, patients and employees. And with good cause—imagine the financial hit a medical spa could take if nurse injectors or laser techs were simply allowed to take the clients they’ve treated when they leave. However, like with non-compete agreements, you must be sure that any non-solicitation agreement you employ is carefully crafted to best protect your interests.
Keys to Enforceable Contracts
Simply writing a non-competition or non-solicitation agreement into your employment contracts does not guarantee that they will be enforced when push comes to shove. But if these clauses adhere to the following guidelines, a medical spa’s chances of collecting damages if they are violated improve dramatically.
Adequate Consideration: In order to get something—in this case, protection for your medical spa should an employee leave—you must give something. This is known as adequate consideration, and every contract must include it in order for it to be enforceable. If you include a non-competition or non-solicitation clause in employees’ initial contract when they are hired, it is understood that employment is the consideration they are receiving in return for signing the contract.
“In the employment context, when an employee is at will, meaning he or she can be terminated at any time without cause, the employment itself constitutes adequate consideration,” says Coover. “Similarly, if a new employee signs a non-compete agreement as a condition of employment, the employment itself is also adequate consideration.”
However, if you wish to incorporate one of these restrictive covenants into an existing contract, some states require that you provide your employee with something extra in return for it—typically a pay raise or a promotion These states do not consider continued employment to be adequate consideration. If an employee does not receive something in return for this newly incorporated restriction, it is unlikely that a court will view the contract as enforceable.
Coover adds, “For continued employment to be adequate to enforce a non-compete agreement on the existing employee, the employment must last a sufficient amount of time. For example, if a new employee signs a non-compete and the employer fires the individual the next day, it would not be fair to restrict the employee from competing for years in the future.”
Legitimate business interests: Courts typically permit the enforcement of restrictive covenants when they are utilized in the protection of confidential information, investment in specialized training and patient/client relationships. Make sure that any restrictive clause you wish to employ addresses these issues in some fashion—reach for anything more and you risk its enforceability.
Reasonableness: A restrictive covenant should not be excessively long in duration or cover a geographic area any larger than need be. Of course, both of these factors are case-specific—if a medical spa is in an urban area with a great deal of nearby competition, for example, it makes sense that the geographic restriction should cover a smaller area than if it were in a small rural community with one other medical spa in a 20-mile radius.
When delving into the world of restrictive covenants, it’s crucial to make sure that any non-competition or non-solicitation contract provided to employees be legal and binding. After all, a medical spa’s employees and clients are its lifeblood, and need to be protected. If you have existing contracts, make it a point to have a local health care attorney review them for viability. If you don’t have them in place and want to include them in your employment packet, make sure to work with a health care attorney to craft them correctly the first time.
Patient privacy and HIPAA go hand-in-hand in any medical setting, including your med spa. While cyberattacks, whether on large hospital systems or small clinics, make for splashy headlines, healthcare providers should not forget to look within when it comes to vulnerabilities.
A recent examination by Verizon of security incidents across 27 countries found that the majority (58%) of healthcare protected health information (“PHI”) data breaches were due to insider threats. (For more information on patient privacy, sign up for our upcoming live webinar. It is free for all AmSpa members.)
The report highlighted several areas that healthcare providers encounter on a frequent basis where risks could arise internally, such as the potential for privilege abuse. Personnel require access to specific PHI to perform their duties but providing such access puts them in position to easily use or access the PHI for other, malicious purposes. This can be especially problematic with disgruntled or recently fired employees. The three steps a healthcare provider should take to protect itself are: (1) Identify; (2) Address; and (3) Audit.
Identification requires healthcare providers to identify all of the vulnerabilities to PHI; not only those risks from the outside, but just as important, those risks from within the organization.
Once a healthcare provider identifies its vulnerabilities, steps should be taken to address each by implementing the appropriate safeguards necessary to protect the PHI, both in terms of technology and internal policies and procedures. Many may recognize this as the first step of any HIPAA compliance plan, which is the Risk Analysis and Management required under the Security Rule.
Finally, healthcare providers must continue to be vigilant against the ever-present threat to extremely valuable data through regular audits of the systems and policies in place to find new vulnerabilities or current vulnerabilities being exploited.
Healthcare providers would be wise to conduct an updated (or first) risk analysis and understand where they stand in the fight against threats to PHI.
For more information on ways to build and run a successful, profitable, and legally compliant medical spa attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and be the next med spa success story.
ByrdAdatto represents physician practices, dental practices, law firms, medical spas, and other professional services companies throughout the United States. AmSpa members can take advantage of an annual compliance consultation call with the firm.
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.
Posted By Administration,
Thursday, August 30, 2018
By Alex R. Thiersch, Founder and Director of the American Med Spa Association
Determining the distinction between medical and non-medical treatments is perhaps the defining issue of the medical aesthetic industry and, in many cases, that distinction is not as clear-cut as all involved would like it to be—what’s legal in one state might not be in another, for example. (AmSpa members can check their medical aesthetic legal summary to find this information.)
Medical spas, unlike most plastic surgeons’ offices and traditional doctors’ offices, make a lot of their money from offering non-medical treatments—such as facials, chemical peels, and aesthetician services—in addition to medical services. In fact, aesthetician services typically are among the top three treatments offered by most medical spas according to the AmSpa 2017 Medical Spa State of the Industry Survey. Many people begin their experience with a medical spa by partaking of these non-medical treatments before moving on to more invasive solutions so, needless to say, these services can be extremely valuable to a medical aesthetic business.
It is extremely important for employees of a medical spa to understand which procedures they perform are medical in nature so that they can approach them accordingly. If an aesthetician can perform a procedure by him- or herself, costs are much lower and margins are likely much higher; when you move into the medical realm, however, you must involve a physician, nurse practitioner, or physician assistant, and you must follow medical protocol and regulations. Costs go up, record-keeping requirements are far greater, patient privacy becomes an issue, and on and on.
Some general guidelines can help determine what is and is not a medical procedure.
The baseline rule is that anything that impacts living tissue is considered medical. Generally speaking, if you’re doing something that goes beneath the outer dead layers of skin—known as the stratum corneum—you can assume that you are engaging in the practice of medicine.
However, there are some exceptions to this rule. In several states, laser hair removal is the subject of certifications and rules that place it at least adjacent to the medical realm, despite the fact that it does not penetrate the skin.
Additionally, microneedling, one of the trendiest procedures in the business, has been determined to be medical in nature by all the regulatory agencies that have looked at it, despite the fact that in many cases, the needles are set to a depth that does not actually penetrate the stratum corneum. Regardless, the fact that metal needles are the tools being used makes this a medical procedure in the eyes of the law in many cases.
Finally, subdermal fat-removing treatments, such as SculpSure and CoolSculpting, which don’t involve any sort of conventional laser use or invasiveness, still should be considered medical, even though the matter hasn’t as yet been widely investigated by state boards. There is very little doubt in my mind that as soon as an influential state board looks at them, it will determine these treatments to be medical in nature because they affect living tissue; therefore, you must observe medical protocol when performing them.
Beyond these general guidelines, AmSpa can help you determine what is and is not considered a medical procedure in your state. Use our website to keep up with the latest regulatory updates and, join us for an upcoming Medical Spa & Aesthetic Boot Camp (Boston in September, Nashville in October, and Orlando in November), to learn everything you need to know to keep your medical spa compliant and successful.
Posted By Administration,
Thursday, August 23, 2018
By Alex R. Thiersch, JD, Founder and Director of the American Med Spa Association (AmSpa)
Medical spas occupy a unique place between medical facilities and retail storefronts, and require unique solutions to be successful. Medical spa treatments are generally classified as medical procedures and are regulated as such, however since these treatments are by and large elective this also introduces very specific business realities that med spas MUST understand. The best med spas use the following keys to unlock their true potential.
Be Legally Compliant
Medical spa owners and operators must understand and follow the rules and regulations of the state in which they conduct business. This is easier said than done, as medical aesthetics practices are held to the same standards as more traditional medical practices. However, it is absolutely essential that medical spas are compliant. Consult with a local health care attorney if you haven’t already.
Although a medical spa is legally viewed as a medical practice, it cannot simply be run as an extension of a doctor’s office or a plastic surgery center—it must be run as a separate business. It has to have its own business plan, its own profit-and-loss statements, and its own manager. A medical spa is a very different type of business than a doctor’s office or a surgical practice, and it must be run in a different way.
Medical spa offerings are purely elective, and they do not deal with insurance providers. As such, they have much more in common with day spas and salons than with more traditional medical practices. Conscientious owners and operators realize this, and make efforts to fit into the retail market as much as the medical market.
Employ Traditional Business Techniques
Because medical spas are closer in form and function to retail outlets than medical practices, it makes sense that businesspeople are having a huge impact on the medical spa market. They create business plans, make budgets, create goals, and monitor the medical spa’s day-to-day operations in ways that reflect the retail market. This results in success, because a large part of a medical spa business actually exists in a retail environment instead of hewing to the tenets of more traditional medical practices.
Medical spa employees should be knowledgeable people who are good at selling, who understand the business, and who believe in the products and treatments they’re offering. Successful medical spas simply do not employ inefficient people who are not making them money. It’s imperative that a successful med spa be able to turn its staff into a high-performing team.
Employ Sales Techniques
In traditional medical settings, salesmanship is considered gauche. However, as has already been established, medical spas are very different from traditional medical practices. The medical spa that sells itself and its services most effectively will be the one that rises above its competition.
Track Sales and Marketing Metrics
The businesspeople who have begun working with medical spas are compiling as much data as they can in order to determine what’s working and what isn’t. They track and measure everything the business does, and then they tailor their projections and goals accordingly. The ultimate ceiling of your medical spa practice’s success could be determined by whether or not you are tracking and measuring key business metrics, and letting those results inform your decisions.
Find a Niche and Market to It
Many of today’s most successful medical spas focus on a niche market. They concentrate on certain demographics or one particular treatment—such as CoolSculpting, laser hair removal, or injectables. Do your market research, find the gaps in your local market, and claim your niche.
Invest in Processes
Profitable medical aesthetics practices have processes in place to convert customer interest into sales. They tend to have initial interactions with prospective clients laid out, scripted, and rehearsed so the staff knows exactly what to say and do when somebody expresses interest in their services.
The best medical spas work hard to create a business that is efficient, compliant, and profitable, but they also understand that this is a fun business. They don’t try to be something they’re not, and they enjoy coming into work every day. They make the most out of their opportunity.
A medical spa is a complex business; however, as with most things in life, you get out of it what you put into it. Make the most of your medical spa and you can ensure success and a ton of fun to go along with it.
Posted By Administration,
Wednesday, August 22, 2018
Rebecca Gelber, MD, Tahoe Aesthetic Medicine
A successful medical spa requires two things: 1) A patient-first focus on results and service and 2) tightly buttoned-up business practices. As clinicians opening a new aesthetic practice we are often already trained in the first, but we are rarely armed with the second.
Medical aesthetic practitioners have extensive training in performing procedures, but most of us have close to zero experience with the business side of aesthetic medicine. Practices rarely run into trouble because they can’t perform treatments properly. They run into trouble because they don’t know how to sell those treatments.
You can have the best equipment and skills, but if you never get patients to sign up to sit in your treatment chair it's all for naught. Even when we do have a patient coming into our practice it’s all too common for them to leave without taking full advantage of the services we offer.
There are missed opportunities in our path each day. Every patient encounter is a chance to add value to their life and strengthen their relationship with your office. If someone comes in for Botox, ask if there is anything else they would like help with. This may be the time for them to learn about fillers, lasers or even a skincare product.
If you’re unsure where to start, learn from people who know how to sell. When sales reps come into your office, study what they are doing - especially the ones who have been around a long time. There is a mantra in the sales world: “Always close for something.” In other words, always move the process forward, even if it’s a baby step. Bad sales reps make you feel uncomfortable when they do it; good sales reps make it natural and non-threatening. They might ask, “Is there anything else that’s bothering you?” or “May we call in a couple of months to check in?” A good sales rep moves the process forward without making you feel pressured.
Believe it or not, dental offices are fantastic at selling. They “always close for something”. They have methods perfected for getting people to sign up for their next appointment before they leave, and ensure that the patient shows up six months later. Try incorporating something like this in your practice. Even if they aren’t ready or able to block out their next appointment, you can get permission to call or send them a reminder card.
In our office, we have a sheet of paper for every patient. If they come in during May and say that they would like to do a laser treatment in September when they can be out of the sun, we ask if they would like a call in August to make sure they get the best appointment slot. If they say yes, we make a note of that and then put that paper in a folder marked August. We have a folder for every month and keep each page with an action item in the appropriate month. That way, when anyone in the office has a free moment, they can pull out the current month's folder and follow up with someone.
This one little thing can keep your calendar full without having to resort to expensive marketing and specials. It keeps patients coming in regularly, greatly improving your revenue stream and also the results and service you provide.
“Sell” is a four-letter word, but in your medical aesthetic practice it doesn’t have to be a bad one. By taking every opportunity to educate your patients on the services that you offer you can improve the quality of their results while also increasing the profitability of your business.
Dr. Rebecca Gelber graduated from the Johns Hopkins School of Medicine in 1993 and completed her residency training at the University of Pittsburgh Medical Center. Since that time, she has completed a preceptorship in aesthetics, liposculpture and stem cell therapies, as well as specialized training with luminaries across the country in BBL and laser therapies, Botox, dermal fillers, and thread lifts. She founded and owns Tahoe Aesthetic Medicine and also offers specialized training to other providers.
Posted By Administration,
Tuesday, August 21, 2018
By Alex R. Thiersch, JD, Founder/Director of the American Med Spa Association (AmSpa)
Increasing medical spa retail product sales can be one of the fastest ways to boost the profitability of your medical aesthetic practice.
Focusing on product sales can benefit your medical spa in a number of key ways, and according to the AmSpa 2017 Medical Spa State of the Industry Report retail products account for 18% of total revenue at the average medical spa. Once you’ve decided that you want to make this a larger part of your business, where do you get started?
A Product to Fit Your Business
When choosing product you want to make sure that what you are bringing in not only fits in with the brand direction of your business, but also that the products match the services you offer since proper use of a skin care program can produce better treatment results for your patients. You don’t necessarily have to stop at treatment products, however. A few on-brand retail pieces that don’t require a recommendation to buy can help create a more full experience for your customers. Are you a luxury brand? A wellness brand? You might consider dedicating some shelf space to items that reinforce this message.
Tyranny of Choice
Though it’s good to have some selection of product in your medical spa, offering too many options at the same level of product treatment can be a detriment. Too many choices that aren’t differentiated can leave customers confused and less likely to purchase. Choosing a few lines that each have multiple levels of treatment will often serve you better.
As medical spa industry expert Bryan Durocher of Durocher Enterprises states, “While selection is important, sometimes it is better to go an inch wide and a mile deep.”
Make Sense of Senses
Major retailers know that engaging customers through multiple senses can yield benefits in retail sales. Visually interesting displays combined with calming music, or scents that match the scents of some of your products provide subtle boosts for retail sales.
Small changes to the layout of your space can also make a difference. Do you keep the lion’s share of your product behind a counter or in a locked case? This will impact your sales since people like to look at and hold things as they consider buying it. Does your retail area overlap with your waiting room? Think about separating them, because as Durocher states, “People that sit don’t shop.”
Of all the possible points of improvement in retail sales you can possibly see in your business, training your team will give you the biggest benefit, bar none. When talking about retail sales Dori Soukup, of InSPAration Management says, “How can you expect to improve performance and achieve new results if the team is not held accountable for their actions or performance?”
She emphasizes concrete expectations, measureable goals, sales systems, and team coaching when setting up a business for retail success.
As Durocher states, “Have a defined client experience that incorporates retail products during the consultation, during service, and at the close of the visit.”
It’s also important to incentivize your team. While, in most states, you generally cannot pay staff commission for services in a medical spa because of fee splitting laws, you are generally allowed to pay percent commission on retail product sales.
Selling product is one of the keys to increased profitability in medical spas, and if you’re looking to get into the industry it’s a core principle you need to be familiar with.
For more information on ways to build and run a successful, profitable, and legally compliant medical spa attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and be the next med spa success story.
Networking is a reciprocal process based on the exchange of ideas, advice, contacts and referrals. It is a social activity that most of us do every day as we exchange information with others. To turn a casual networking process into a valuable resource, however, it is necessary to “systematize” this process. By attending networking meetings, you can broaden your networking base while maintaining a high quality of contacts with professionals who are enthusiastic about networking.
Making and maintaining professional relationships is essential to career growth, regardless of whether you own your own business, or are employed as a service provider. Networking is an important, invaluable and essential activity for every professional that can help you both get new ideas and solve challenges in your business, but also serve as a funnel for new patients.
Trade notes and share ideas with medical spa professionals just like you at The Medical Spa Show, February 8–10, 2019, at the Aria Resort & Casino in Las Vegas. AmSpa members can also join the members-only Facebook group to get real insight from other owners and practitioners from across the country.
If you are not doing anything about networking right now, it is likely that you are curtailing your prospects and ultimately harming your business opportunity.
The Power Lunch is Dead
In general, the idea of interrupting a day’s workflow to entertain a client over lunch is becoming less popular.
Business professionals rarely have time for a full sit-down lunch meeting in order to network and continue building business. Some business pros are setting up walking meetings and or networking spin classes. They’re finding active meetings to be much more productive because you can’t be distracted by your phone or laptop.
The trend of Sweatworking is certainly more common among tech or media companies, where employees tend to be more willing to stray from tradition. Even on Wall Street, however, today’s business lunches pale in extravagance compared with the meetings bankers held before the recession. Many businesses are becoming more image-conscious and, along with that, more cautious about appearing wasteful.
There are many different networking groups empowering and motivating people who want to expand the possibilities for generating business. Getting the maximum benefit out of networking requires effort and motivation, and each provider must take responsibility for their own progress.
It is important that your motivation does not dissipate once you are enjoying many successful business relationships. Relying on an established network is dangerous as any network will tend to shrink over time due to relocations, job changes, deaths and retirements. If you are not adding contacts on a regular basis and actively trying to expand your network it will naturally diminish.
Joining any new group of people can sometimes be a little scary or intimidating, but remember that this is a natural feeling for everyone. The important factor is to get out there. Everyone in the group you are visiting was a new member at one time and felt the same way. They are going to look forward to seeing you because of how many clients you have coming to visit you who are possible referral sources for them.
Though networking vastly enhances your odds of receiving positive responses, building rewarding relationships can take time. You may be lucky and develop a strong and lucrative relationship with the first person you meet. It may take you several meetings with different professionals before you find someone you are comfortable developing a relationship with.
Building trust in a relationship takes time and requires follow up with the professional concerned and the clients you refer to that professional. This establishes trust with the person who will remember that you cared enough to call and provides you with invaluable feedback on the business practices of that professional with whom you are building a relationship.
Networking is a powerful way of building professional relationships and generating new business opportunities. The more relationships you build, the more you increase your referral network, bolster your reputation, and improve the quality of your client base.
Follow these 10 steps to choose the networking group for you.
1. Research the groups in your community. There will be several types of networking groups that will have different ground rules for how they are run. For example, a group like BNI or Le Tip can only have one member of a specific profession in their group. If you are an aesthetician and admitted to this type of group you will be the only member in that category.
2. Choose groups that meet at times that are realistic with your time schedule. Your ability to be there consistently is essential to your success. If you are not a morning person and have difficulty getting up and going, perhaps a lunch time leads groups or an after-work gathering is a better choice. Showing up consistently is essential in building the relationships that will help in growing your business.
3. Try before you buy – Visit your perspective networking groups a couple of times before you decide to join. Get a feel for the people who are participating. Look how the group is organized and functions. Make sure this a match with your personality and objectives. If the group is filled with very conservative businessmen and your target is creative stay at home moms, that may not be the best fit. You must be comfortable in being able to effectively get your message across to members who can relate to your perspective and get excited to pass referrals. A final note: Watch how many qualified referrals are passed. This is the standard to measure the group by. If there are not a lot being passed this could be a sign of their ineffectiveness. You are there to build clients not just to socialize.
4. Prepare a sixty-second commercial. Let people know who you are and what you do. Make sure to be specific about what it is that you do and what types of referrals you are looking for. The best sixty-second commercials tell a story. People love to hear stories and are much more apt to listen attentively to you. Story telling takes practice, so do not worry you’re not perfect the first time out. Share examples of how you work with your clients, the attention to detail you give with each service and what makes you or your services unique.
5. Create a defining statement. A defining statement is shorter version of your sixty-second commercial. This is something that can be said in fifteen seconds or less. A defining statement should include two distinctions about you and your business. Remember people only buy for two reasons. They buy solutions to challenges or buy into good feelings; your defining statement needs both.
Example Stylist: I provide easy care and low maintenance hairstyles for men and women.
Example Aesthetician: I help people to have clear complexions and radiant, youthful looking skin.
6. You must give to get. The surest way to get referrals from your networking partners is to give them referrals. Create a book with the business cards of all your networking-partners inside. Really listen to the needs of all the people you meet. It is amazing when you are listening in this way how many requests you will get from people who need goods or services in the community. When you make referrals, you become a knowledgeable source of information for your clients to turn to. Help people achieve their goals and they will help you to achieve yours.
7. Get to know your networking partners. The key to successful networking is to build relationships with each member in your group. This takes time and your best efforts will come from setting up one– on–one meetings with your group’s members. Set up a lunch date or get together for coffee so you can discuss specifically how you can help each other. Come to your meeting prepared. Have a list of questions you can ask so you can get clear on how you can support them in referring their ideal and best client or customer. Once you have gathered information from them share the same distinctions about you and your business. The more precise you are the more likely you will help them and yourself.
•How long have you been in your profession?
•Tell me more about the products and services you offer.
•What makes your product or services unique?
•What distinguishes you from other professionals in your field?
•Who has benefited most from your products or services?
•Who is your ideal and best client and why?
•What questions can I ask prospective referrals to qualify them for you?
•Where do you find most of your best referral sources?
•What is one action I can take on this week to help you grow your business?
8. Participate in networking training. Most networking groups such as BNI or Le Tip having networking training or mentoring available. Take advantage of this because it can support you in being more effective in other larger group situations such as your local chamber of commerce where they may not have this opportunity. Not everyone is a brilliant networker or communicator right from the start. Many groups will walk you through the process of creating a dynamic presentation and how to specifically ask for your ideal and best client. Learn from experienced members of your group or within your community. Do what other successful individuals have done and you will realize the same results.
9. Know the difference between a lead and a referral. There is a BIG difference between a lead and a referral. A referral is where one of your networking partners has found someone who has a need for your service, done some qualifying of the prospect for you, given them your information or business card and told them that you will follow up with a call. When you call, they know who you are and are open to doing business with you. A lead is where someone gives you a name and says “I think this could be a good source of clients” but has not spoken to a person specifically about you. When you make contact, you are calling cold, which means you are doing all the groundwork. It is much more powerful to have someone else sell your products or services’ features and benefits.
10. Diversify your interests. Belonging to more than one networking group can have its advantages. You can reach out to a broader pool of perspective clients. For example if you have a couple of different favorite client choices, belonging to two different groups could help you bring both types in. Some networking professionals say that they attribute their success to belonging to five different network spheres of influence. These can include church, professional industry specific organizations, social clubs and networking groups
Carry your cards with you wherever you go. You never know when the perfect opportunity will arise and gain you additional business.
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.