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HIPAA Breaches: How to Protect Patient Privacy in Your Med Spa

Posted By Administration, Friday, August 31, 2018

By Jay Reyero, JD, Partner, ByrdAdatto

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.

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

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Which Procedures Count As the Practice of Medicine in a Medical Spa?

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.

For more information on proper medical spa procedures see AmSpa’s webinars on supervision and delegation, patient-charting requirements, and much more.

Some general guidelines can help determine what is and is not a medical procedure.

Baseline Rule

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. 

Exceptions

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.

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

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9 Keys to Medical Spa Success

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. 

AmSpa members can check their medical aesthetic legal summary or schedule an annual compliance consultation call with the law firm of ByrdAdatto for more information on med spa law.

Run Your Practice Like a Business

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.

Find tools to building your practice profitably in the AmSpa store.

Invest in Good People

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. 

Attend an AmSpa Medical Spa & Aesthetic Boot Camp to learn legal and business best-practices and be the next med spa success story.

Have Fun

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.

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

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Improving Your Med Spa Business: Always Close For Something

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.

(Editor’s note: attend an AmSpa Medical Spa & Aesthetic Boot Camp to learn legal and business best practices that are key to medical spa success.)

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.

 

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

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4 Ways to Increase Med Spa Retail Sales

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.”

Your Team

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.

 

Tags:  AmSpa's 2017 Med Spa Statistical Survey  AmSpa's Med Spa & Aesthetic Boot Camps  Business and Financials  Med Spa Ownership 

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How to Build Your Med Spa Practice and Patient Base Through Networking

Posted By Administration, Wednesday, August 15, 2018

By Bryan Durocher, Founder and President of Durocher Enterprises

One of the most underused med spa marketing and business-building tools is also one of the oldest: Networking.

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.

Motivation

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. 

Perseverance

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.

Follow Up

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. 

Sample Questions:
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.

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

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Are Botox Parties Legal? Are They Worth It?

Posted By Administration, Tuesday, August 14, 2018

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

Botox parties are a common topic in med spa law because of how lucrative they can be, but are they legal?

One thing I love about the med spa industry is that med spa owners and providers are continuing to innovate. The ideas that come from AmSpa members on marketing, branding, and business always leave me impressed. This is one reason why it is so difficult to keep track of what’s legal and what’s not - many of the ideas we are asked about are brand new. They’ve never been tested before, and therefore it’s difficult, if not impossible, to determine where the legal constraints are.

While not new, Botox parties are an innovation like this. These are events hosted by a med spa or a provider, either at the med spa or another location, where people get together to socialize, learn about treatments, and try new treatments. Often the med spa provides discounts on product so that they can get new patients in the door. Often alcohol is served. These are highly social events that mix pleasure with aesthetics, which makes the idea of getting injected with a needle a little more palatable.

A question I get all the time, though, is whether these events are legal, particularly when they are held outside of the med spa (at someone’s house or a salon). And the question that always follows - is it worth it?

The answer to both of these questions is yes - it is absolutely legal (in most states - sorry, Nevada*), and it is ABSOLUTELY worth it. But like most things in this industry, both of these answers are dependent upon you adhering strictly to the law. No amount of money is worth losing your license, and, yes, I have seen nurses lose their licenses because of improperly hosted Botox parties. AmSpa members can check their medical aesthetic legal summary to find the law regarding Botox parties in their particular state.

The primary point to remember is that when you provide any medical treatment off site all the same rules apply. New patients must be seen by a doctor, nurse practitioner (NP), or physician assistant (PA) prior to being treated. Proper records must be kept. Consents must be signed. Before and After photos should be taken. Everything that you are required to do legally in your med spa should be done at the Botox party.

Additionally, check with your insurance carrier before the party to ensure that you have coverage for offsite treatments, and double check local ordinances regarding serving alcohol - sometimes a permit is required.

Initial Exam

The biggest risk at Botox parties, or any social event involving med spa treatments, is that a patient will be treated by an RN without first seeing the doctor (or NP/PA). All patients must be seen first so that a plan can be set. This can ONLY be done by an MD, or by an NP or PA operating under proper authority. Indeed, even if the patient consents to being treated by the RN without first seeing the doctor, that does not allow the RN to inject the patient without the patient first seeing a doctor.

At Botox parties this can be difficult because there are new patients socializing, there is sometimes alcohol being consumed, and everyone is more relaxed. This is a step that MUST be followed, though, because an RN cannot practice medicine, and therefore the RN cannot legally perform the initial assessment, establish the physician-patient relationship, and set a treatment plan. There are no exceptions to this rule.

Patient Consent

Equally as important is obtaining patient consents, including privacy waivers given that treatments are usually performed out in the open. And providers should be mindful of patients consuming alcohol. While not strictly illegal, we all know that alcohol makes people less inhibited and often clouds judgment. This is NOT good when it comes to patient consent. All patients should offer consent before they begin drinking, and the drinking should be kept to a minimum. This is not always easy, but trust me, if there’s an adverse outcome you’ll wish that alcohol was not involved.

Patient Privacy

Also be mindful of photos and social media. These events are a great way to market your med spa - people are having fun, everyone is happy, and you remove much of the clinical aspects of aesthetic medicine. Be careful, however, when photos or videos are posted - every patient is entitled to privacy, and if any patient has failed to sign a privacy release and an authorization to use their photos, there is a risk of a breach of patient privacy.


Find out how your state regulates Botox parties with AmSpa's State Legal Summaries.
Click Here


Are They Worth It?

So the fact that these events are legal begs the question - is it worth it? The answer is emphatically yes, provided you strictly adhere to legal guidelines. Botox parties and social events are a great way to get new clients introduced to your practice, pre-book treatments, and bring in some cash. To get started setting up your own events check out the Secrets to Successful Event Planning in the AmSpa Store.

The usual protocol is to offer discounts on treatments and pre-bookings (both for injectables and laser packages), provided they are purchased that night. Patients are encouraged to bring friends and colleagues to meet the providers and learn more about aesthetics. Depending on the size of the event, it is not uncommon for a practice to bring in six figures worth of treatments and bookings - in one day.

Even that kind of money isn’t worth losing your license, though, so be careful and diligent with your compliance efforts.

I urge you to move cautiously when it comes to planning and hosting one of these events. Do your homework and ensure compliance is in place. Go easy on the alcohol. Make sure you’ve got proper insurance. If you have any questions whatsoever, consult with a qualified lawyer ahead of time so that all of the proper documentation is in place, the needed personnel are available, and all the rules are followed.

For more information on running your med spa legally and profitably, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps, and become 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.

*Nevada recently passed a law restricting the injection of Botox and fillers to a doctor’s office, essentially banning the ability to host Botox parties.

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

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Med Spa Law: FBI Raids and Anti-Kickback Settlements in Dallas Show Increased Enforcement

Posted By Administration, Friday, August 10, 2018

By Brad Adatto, JD, Partner, ByrdAdatto

Legal enforcement has been a big topic among med spas across the country recently, and that includes Dallas. During the last 12 months we have covered a wide range of articles on significant litigation by the government and the commercial payors challenging how providers submit bills. The allegations have ranged from completely fabricated bills to overpayment of fees for out-of-network services.

The civil litigation has involved United Healthcare’s allegations against Next Health, LLC for engaging in fraudulent activity, Quest Diagnostics’ settlement of a whistleblower lawsuit; and Blue Cross Blue Shield of Mississippi’s suit against a community hospital alleging it violated its contract for overpayment and recoupment of claims.

This May, the Dallas area health care industry had two new breaking enforcement stories. The Dallas Morning News reported on an FBI raid at a Dallas-based healthcare management company. The FBI has not provided any insight as to the reason for the raid, and the company has denied any wrong doings.

That same week, the Dallas Morning News broke a separate story of federal authorities settling a civil suit with a physician for allegedly being paid kickbacks by a Dallas-based lab. Federal authorities believe that the lab used a “sham investment model” to make payments for blood and urine screens. The lab was not a part of the settlement agreement, and no allegations have been made against it.

With these types of allegations, and heightened enforcement by the federal government, parties should ensure they understand the implications of the federal anti-kickback statutes, the federal travelers act, and wire fraud rules because the federal government is using these laws to pursue providers. Providers must scrutinize all their health care related investments, be conscious of these cases, and be mindful that any arrangement they enter into must be compliant with both state and federal laws, in both form and substance. (AmSpa members: check your state’s medical aesthetic legal summary for more information on the legal regulations in your state.)

For more information on your state’s laws and regulations, attend an AmSpa Medical Spa & Aesthetic Boot and be the next med spa success story.

Brad Adatto, JD, is a partner at ByrdAdatto, a business, healthcare, and aesthetic law firm that practices across the country. He has worked with physicians, physician groups, and other medical service providers in developing ambulatory surgical centers, in-office and freestanding ancillary service facilities, and other medical joint ventures. He regularly counsels clients with respect to federal and state health care regulations that impact investments, transactions, and contract terms, including Medicare fraud and abuse, anti-trust, anti-kickback, anti-referral, and private securities laws.

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

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Potential Legal Issues With Your Med Spa Website

Posted By Administration, Thursday, August 9, 2018

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

Does your med spa website meet all your local laws and regulations? According to the 2017 Medical Spa State of the Industry Report, a website is the most frequently used marketing tool for med spa practices. If you don’t have one, you’re losing out. A very common mistake being made by med spas across the country, however, is the failure to create and maintain a website that accurately reflects and realistically represents the business structure and ownership of the med spa.

Due to recent substantial growth in the med spa industry, regulatory authorities in several states are cracking down on med spas that are, or appear to be, operating illegally. But just how are these state regulatory agencies obtaining information on the business operations and workings of med spas? And what information is leading investigators to believe a med spa is operating illegally?

Websites. Technology and social media has driven businesses, big and small, to use the Internet as a tool to provide information to their clients. Med spas are no exception. A majority of med spas across the county operate websites with information about their “team” of professionals, the services provided, specials and discounts offered and even explanations of the different treatments and procedures clients can purchase.

Many of these websites provide bios of the professionals that own and operate the med spa and perform medical procedures. But, unfortunately, in several instances those individuals are not licensed to practice medicine and thus, cannot perform medical procedures or own a medical practice. State regulatory authorities have caught onto this- and now they are enlisting investigators to examine med spa websites looking for signs of illegal ownership or the unauthorized practice of medicine.

For instance, in Illinois, the Department of Financial and Professional Regulation (“IDFPR”) has begun launching investigations against med spas based solely on their website content. (AmSpa members: check your state’s medical aesthetic legal summary for more information on medical advertising in your state.) The IDFPR, much like other state regulatory agencies, has an enormous case load and it is impossible for investigators to personally visit every med spa to investigate and determine whether the spa is in compliance with state laws. Instead, to save time and effort, investigators are tasked with reviewing the websites of med spas to obtain information on ownership, business structure, fee structure, staff qualifications, and services.

If the med spa website does not realistically reflect its business practices or falsely depicts a non-physician as an owner or co-owner of the med spa, it will quickly be on the IDFPR’S “radar” and the owners and employees associated with the med spa can face suspension of licenses, fines and penalties. Click here to read more about non-physicians owning med spas.

Although not all states have prohibitions against non-physician ownership of medical spas, most states prohibit fee-splitting between physicians and non-physicians. If a website advertises ownership by a non-physician and highlights a physician as a “medical director” for the med spa, it is likely that the non-physician owner is receiving patient fees and then splitting these fees with the physician on staff. This constitutes fee-splitting between the physician and the non-physician owner of the med spa and it is illegal.

To ensure that your med spa website is in compliance with state and federal laws and to avoid the widening “radar” of investigating state agencies, it is important to perform a careful review your website for any terms or titles that may be red flags. Although there is no script to follow in creating a flawless med spa website, here are a few essential pieces of advice:

  1. List the physician owner prominently on the website to show the physician’s involvement in the business;
  2. If you employ an advanced practice nurse or licensed nurse practitioner to consult with and treat patients under the supervision of the physician owner, include this individual prominently on the website to inform clients and potential clients of that individual’s involvement in patient care;
  3. Importantly, if employing a registered nurse or aesthetician as the med spa’s “go to” coordinator or office manager, bestow upon the individual a title that properly reflects his/her duties, responsibilities, and limitations.

As technology grows, websites and other forms of social media become increasingly important for med spas looking to grow their business and compete in the marketplace. Now is the time to reevaluate your med spa’s online presence and ensure that if you have a website, or plan to establish one that you are conforming to the law and using the website to help, not hurt your business.

To learn more about how to build and run a legal and successful medical spa practice attend an AmSpa Medical Spa & Aesthetic Boot Camp and be the next med spa success story.

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

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Can Nurse Practitioners Own a Medical Spa in Massachusetts?

Posted By Administration, Tuesday, August 7, 2018

By Alex R. Thiersch, JD, Founder/Director, The American Med Spa Association (AmSpa)

The question of who can own a med spa is always one of the most common with medical aesthetic practices, and in Massachusetts it can be a tricky one because of the nature of the laws in the state. Massachusetts is one of a few states that has a clinic licensure statute—a comprehensive regulation that outlines a process by which a person or organization other than a physician or a physician-owned company can own a health care facility, such as a medical spa.

In the past, we at AmSpa and ByrdAdatto have worked with companies in the commonwealth to obtain clinical status for their businesses. However, approximately a year ago, we were informed that in some cases, this process may not be necessary.

“We reached out [to the Massachusetts Department of Public Health] because this potential client had said that according to their conversations with the department of health, as a nurse practitioner (NP) licensed in Massachusetts, they do not have to get a license to own a clinic,” said Renee E. Coover, JD, associate at ByrdAdatto. “That was flying in the face of everything that we had been told by the department of health—they said if you’re a non-physician, you must have clinic licensure in order to operate as a medical spa.”

When ByrdAdatto reached out to the Department of Public Health, it was told that in the opinion of the department’s legal counsel, an NP does not need to obtain a clinic license to own a medical spa. However, since this was merely the opinion of one person, the firm felt uncomfortable telling clients that such a course of action was legally sound.

“If they went to the department of health and they got the same answer, we would be fine, but if they happened to talk to someone else who said, ‘No, that is not the case,’ we were fearful we were going to give out incorrect information,” Coover says. “We’re going to reach back out to the department of health, because at this point, I don’t feel as confident giving information one or way or the other as to really what the law says when it comes to clinic licensure.”

As it stands, though, this issue may be moot, because Massachusetts law states that NPs require physician supervision in order to have a prescriptive practice.

“In light of that requirement, it would be difficult at this point to say an NP could own their own practice, because if they’re going to be prescribing anything—Botox, fillers, etc.—all of those types of treatments are going to need a prescription,” Coover explains. “They’re still going to require physician supervision. Without that prescriptive authority, I don’t know really how they would be able to independently have this medical spa.”

However, Massachusetts Senate Bill S.1257, which is currently in committee, would, if passed, remove the requirement for physician supervision for an NP prescriptive practice. If this bill passes, NPs could theoretically operate a practice completely independently of a physician. This, in turn, raises some questions about how an NP who owns a practice would be able to market it—is it really “medical” if there’s no physician involved?—but these are issues that will need to be addressed when and if the bill passes.

See the process for clinic licensure in Massachusetts in the video below:

For more information on medical spa law attend AmSpa’s Medical Spa & Aesthetic Boot Camp in Boston September 15–16 where you’ll learn the keys to build and run a legally compliant and profitable medical spa practice. See the full 2018 Boot Camp schedule to find a Boot Camp near you and be the next med spa success story.

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

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