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Join AmSpa at the Asheville Medical Spa & Aesthetic Boot Camp EXTRA

Posted By Administration, Friday, May 24, 2019

asheville omni hotel

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

Starting next Saturday, June 1, AmSpa will host its Asheville Medical Spa & Aesthetic Boot Camp EXTRA at the Omni Grove Park Inn. We’re extremely excited for the opportunity to help medical aesthetic professionals develop their practices in this beautiful setting. There’s still time to register for the event—just click here to sign up. Here is a quick overview of the program:

Saturday, June 1

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

  • 9 – 10:30 a.m.: The Plan, presented by Bryan Durocher (Durocher Enterprises)—What are the most effective ways to develop a business plan for your medical spa? Medical Spa Consultant Bryan Durocher discusses the ins and outs of the planning process and helps determine how long it realistically takes to open a practice.
  • 11 – 11:30 a.m.: The Marketing Plan, presented by Terri Ross (Terri Ross Consulting)—Renowned medical spa consultant Terri Ross shows you how to most effectively market your practice using market research and defining your objectives.
  • 11:30 a.m. – 12:30 p.m. The Social Media Plan, presented by Danielle Smith (Smith & Popov)—This session will help you determine how to promote your medical aesthetic practice using cutting-edge social media techniques.
  • 1:30 – 3:30 p.m.: The Law, presented by Alex Thiersch (AmSpa) and Renee E. Coover (ByrdAdatto)—In this presentation, we’ll discuss the long-standing and emerging legal issues that every medical spa owner needs to know about. As you can imagine, there is a lot to cover here, since new concerns seem to be arising daily lately.
  • 4 – 5 p.m.: The Lessons, presented by Louis Frisina—Every medical spa is different, but the successful ones share several common traits. In this session, Business Strategy Consultant Louis Frisina discusses the qualities that are typically found in practices that bring in a significant amount of revenue.
  • 5 – 6 p.m.: The Team, presented by Bryan Durocher (Durocher Enterprises)—A medical spa is only as good as its personnel, so it’s important to make sure that you hire a staff that can do everything you want it to—and more. In this session, you’ll learn about recruiting, hiring and retaining employees who can make your medical spa dreams come true.

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

Sunday, June 2

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

  • 8:30 – 9 a.m.: Anatomy of a $5-Million Med Spa, presented by Alex Thiersch (AmSpa)—Have you ever wondered what the difference is between your medical spa and one that’s mega-successful? It might be less significant than you think. This presentation will show what a $5-million med spa is doing right—and what you might be doing wrong.
  • 9 – 10 a.m.: The Financials, presented by Bryan Durocher (Durocher Enterprises)—At the end of the day, the money you’re bringing in is the most important measure of your practice’s success. This presentation will, among other things, demonstrate how to properly develop a budget and use metrics to determine your med spa’s strengths and weaknesses.
  • 10:30 – 11:30 a.m.: The Digital Marketing Ecosystem, presented by Audrey Neff (Crystal Clear Digital Marketing)—Find out how to effectively spread the word about your medical aesthetic practice and how best to determine what’s working and what’s not. Your practice’s digital presence is more important than ever before, and curating it should be a top priority.
  • 11:30 a.m. – 12:15 p.m.: Medical Aesthetic Hot Topics Panel, featuring Page Piland (Galderma), Audrey Neff (Crystal Clear Digital Marketing), Terri Ross (Terri Ross Consulting) and Nealy Skeldon (Environ Skincare)—This panel, moderated by yours truly, will feature a spirited discussion of the current issues and events that concern medical spa owners and operators.
  • 1 – 1:45 p.m.: The Consultation, presented by Terri Ross (Terri Ross Consulting)—As the old saying goes, you never get a second chance to make a first impression. Learn how to put your best foot forward with effective patient consultations—and how to turn them into consistent business.
  • 1:45 – 2:45 p.m.: The Long-term Revenue, presented by Bryan Durocher (Durocher Enterprises)—Simply being successful isn’t enough for a medical aesthetic practice; you have to know how to maintain and grow your success. In this session, Bryan will show you how to build patient loyalty and move your business forward.

Monday, June 3

The Boot Camp begins at 8:30 a.m. with a continental breakfast.

  • 9 a.m. – 12 p.m.: Making Money in Your Medical Spa, presented by Terri Ross (Terri Ross Consulting)—Learn about the most profitable and popular treatments available to your practice, and get a preview of The Roadmap to a 7-figure Medical Spa—Terri’s sales training course—which will show you how to convert web leads and develop phone skills, both of which are vital to medical spa success.

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

We hope you can join us in Asheville next weekend. This AmSpa Boot Camp is a tremendous opportunity to get your medical aesthetic business headed in the right direction and learn some tips and tricks that can take it to the next level. Click here to register!

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

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What You Need to Know About Parallel Importation

Posted By Administration, Wednesday, May 22, 2019

package delivery

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

In June 2018, Oregon-based physician Brenda Roberts had her medical license revoked for obtaining and using prescription medication from foreign countries. Roberts was a family practice doctor who was administering Botox treatments at her home on the side. She wasn’t necessarily doing anything inappropriate in terms of patient care, and she kept detailed records on her patients, but she was buying Botox from United Pharmacies—a “rogue pharmacy” that operates outside of U.S. Food and Drug Administration (FDA) governance—because Allergan noticed it was sending Botox to her home and cut off her account. FDA agents went through her trash and found that the Botox she used was intended for sale in Europe.

Roberts was participating in a practice called parallel importation, and while it is extremely enticing for medical spa owners looking after their bottom lines, it should be avoided at all costs, as Roberts’ case demonstrates.

A Controversial Practice

In countries such as the United Kingdom, Germany, France, Sweden and Canada, governments regulate the cost of pharmaceuticals. These measures are ostensibly designed to prevent drug manufacturers from charging excessive prices for essential medicine, but they also apply to pharmaceuticals used for elective procedures, including Botox.

In the U.S., however, FDA does not regulate drug prices, so drug manufacturers essentially can charge whatever they feel the market will bear for their products; that price is invariably much higher than what is charged in countries that have cost controls.

Because of this, it has become somewhat common for U.S.-based providers to buy drugs from licensed dealers in countries where cost controls are enforced. The prices are up to 50% lower than what the buyers would have to pay if they were purchasing the drugs directly from the manufacturer.

Both parties benefit from this arrangement. The buyers get legitimate pharmaceuticals for much less than they would pay if they bought directly from the manufacturers, and the dealers can make their money simply by marking the product up slightly. These are not counterfeit pharmaceuticals like the ones that are typically manufactured in China that have flooded the market in recent years—these are almost invariably the same drugs that are approved by the FDA and sold in the U.S.

Understanding the Rules

While parallel importation of consumer goods is broadly legal in the U.S.—the Supreme Court ruled that to be the case in a 2013 case involving textbooks—Roberts’ case demonstrates that the distribution of drugs that are not explicitly intended for use in the U.S. is absolutely illegal, and that FDA and the U.S. Drug Enforcement Agency (which also participated in the investigation) are taking cases such as this extremely seriously. There hasn’t been much enforcement yet, but this demonstrates that the issue is definitely on the agencies’ radars.

Despite the relatively low risk of being caught, ByrdAdatto and AmSpa steadfastly believe that medical aesthetics practices should not participate in parallel importation. The potential consequences definitely outweigh the cost savings. If your practice’s profitability depends on buying cheap drugs, you need to re-evaluate the way you do business. Practices should remain compliant with FDA and other regulatory agencies, regardless of whether they think a drug is overpriced. It is absolutely possible to run a medical aesthetic practice that is both very profitable and compliant with all laws and regulations.

If you need more information about parallel importation, consult with your healthcare attorney. AmSpa members can take advantage of their annual compliance consultation with ByrdAdatto. You can also learn the keys to running a medical spa practice profitably and compliantly at an AmSpa Medical Spa & Aesthetic Boot Camp.

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

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How Core Doctors Can Cash In on Medical Spas

Posted By Administration, Wednesday, May 15, 2019

core doctors

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

The medical aesthetic industry continues to boom, and core doctors—plastic surgeons, facial plastic surgeons, oculoplastic surgeons, and cosmetic dermatologists—would seem to be set to profit in this space. As physicians, they are allowed to own medical spas, and they can ideally not only profit from the medical spas themselves, but also use them to direct business to their surgical practices. After all, medical spas tend to offer non-invasive procedures that are similar to some things core doctors do, and it does stand to reason that if patients go to a medical spa looking for a Botox injection, they might eventually want a nose job or a face-lift. That being the case, the core doctor who owns the medical spa should be uniquely positioned to offer his or her services.

However, that’s not necessarily the case. I chat with core doctors all the time, and those who open medical spas intending to use them primarily as feeders for their practices tend to view them as poor investments. Their medical spas tend to fail, and the amount of business they drive to their surgical practices is insignificant.

In truth, medical spas that are designed primarily to act as feeders for surgical practices are set up to fail, and most core doctors tend to be very bad medical spa owners. They typically don’t understand the medical spa business, how much work it takes, the profit margins, the necessary volume, and numerous other factors vital to maintaining a successful medical spa. But that doesn’t mean that a medical spa can’t still be a successful business for a core doctor or help to generate surgical business—it simply means that a core doctor needs to understand the realities of the medical spa industry before he or she decides to dive headlong into it.

A Singular Paradigm

The business model core doctors typically understand is very different from the one under which medical spas operate. Surgical practices offer big-ticket procedures, such as breast augmentations and face-lifts; they do not need to deal with a large volume of patients, and they do not need to market themselves like a retail outlet—by the nature of their business, they tend to generate sufficient revenue to get by.

While medical spas must follow the same rules and regulations to which more traditional medical facilities adhere, they are unique in that their services are entirely elective and entirely cash-based. People who use medical spas do so because they want to, and treatments at medical spas are much less expensive than those available from core doctors’ surgical practices. Therefore, for a medical spa to succeed, it must have a lot of patients, its employees must master the art of selling, and it must entice patients to return. In other words, it must operate like a retail center rather than a medical office.

For this reason, medical spas need to be run with a totally different mind-set than core doctors are typically used to. Medical spas owned by core doctors who do not adapt to a more retail-oriented emphasis often end up failing. When I tell core doctors that I have medical spa clients who generate up to $6 million annually, many of them cannot wrap their minds around how that is possible.

A New Perspective

In order for a medical spa to create business for a surgical practice, it must first succeed on its own terms. To facilitate that, core doctors typically need to let others run their medical spas. Core doctors need to understand that the medical spa business is much, much different than the ones they are used to, and they need to partner with people who are experienced with marketing and sales in a retail environment.

A core doctor’s time is better spent performing highly profitable surgical procedures, which medical spas cannot do. If a core doctor can get an experienced businessperson to operate the med spa, they will have a much better chance to succeed. Giving up this control can be difficult for core doctors, since a lifetime of academic and financial success tends to make them think they can achieve anything. However, most doctors don’t go to business school—they don’t know retail and they don’t understand sales. These qualities—rather than medical knowledge or surgical skill—tend to lead to medical spa success.

In addition, medical spa team members must be provided the tools and processes to sell. A medical spa receptionist, for example, should not be someone being paid $12 an hour with no experience; he or she should be one of the highest-paid people on an administrative staff, because he or she needs to be able to sell.

A medical spa also should provide talk tracks for nurses and aestheticians so they understand that their jobs are about selling themselves and the doctor. Employees at medical spas also need to understand that selling retail products is extremely important to maintaining a healthy business. These characteristics of successful medical spas may seem distasteful to doctors, who are used to professional environments that are less aggressive, but this is the reality of the medical spa industry, and every day more and more physicians discover this to be true.

The businesspeople who enter the medical spa industry are willing to do whatever it takes to be successful. A core doctor might believe he or she doesn’t need the help, but chances are the opposite is true.

There are several resources in the AmSpa store to help you build your business and train your team to put your medical spa practice in an excellent position to succeed.

The Practice of Medicine

A medical aesthetic practice must be focused on sales, but it also is required to follow the medical rules and regulations of the state in which it is located. These laws can vary significantly depending on the state, so a med spa operator should consult an attorney familiar with the industry when setting up the practice and procedures. AmSpa members can check their state’s medical aesthetic legal summary to learn about the rules and regulations governing their practice.

Most states observe a doctrine known as the corporate practice of medicine, which decrees that a medical practice must be owned by a physician or a physician-owned corporation. As previously established, medical spas are retail outlets, but they also are unquestionably medical practices, so medical spas must be entirely owned by a doctor or his or her corporation in states where the corporate practice of medicine is observed.

This can present problems for a core doctor who wishes to partner with a businessperson to run a medical spa, because the businessperson likely is going to want some equity in the practice. However, giving any ownership stake to a non-physician is illegal if the state where the medical spa is located observes the corporate practice of medicine.

Opportunities for Ownership

There are solutions, however. If a core doctor wishes to partner with an entrepreneur to open a medical spa in a corporate-practice-of-medicine state, he or she can set up a management services organization (MSO). An MSO provides practice management services, while the doctor, for whom a separate company is created, exclusively provides medical services.

This arrangement, known as a management service agreement (MSA), allows the non-physician who owns and/or operates the MSO to supervise almost every aspect of a medical aesthetic business, including branding, marketing, owning the real estate, payroll, human resources, accounting and billing—everything except the administration of medical services.

This is akin to a lessor/lessee situation. Generally, the MSO owns and maintains the facility, while the doctor inhabits the space. The doctor pays the MSO for the right to occupy the space, and the MSO acts as a landlord, maintaining the facility and keeping the doctor as comfortable as possible.

However, unlike a rental agreement that is managed by a lease that dictates the occupant pay a set amount of money for a certain term, the amount paid to the MSO fluctuates according to the amount of money the physician is paid by patients. If the medical organization treats more patients in a term than it did the previous term, the MSO will also make more money. This represents a sort of equity—in function, if not form. Read more about MSOs here.

The corporate practice of medicine also dictates the ways medical spa employees can be incentivized. In retail, salespeople are often offered commission—a percentage of the sales they make that meet certain conditions set by their employers. However, under the corporate practice of medicine, all payments for medical services must be made in full to a physician or physician-owned corporation. In these states, if a medical spa owner pays employees commission, he or she is engaging in fee-splitting, which is illegal.

This is somewhat common at medical spas. The people who own and operate these establishments generally only wish to reward the people who bring business to the practice, but if a medical spa is found to have engaged in fee-splitting in a state where it is illegal, the doctor who owns the practice could face the suspension or revocation of his or her license, as well as a significant fine. Additionally, the provider who receives the commission payment is subject to a fine. A performance-based bonus structure should be offered instead of commission. Read more about med spa compensation here.

Medical spa owners and operators who need to learn about the ownership requirements in their states should contact an experienced health care attorney to find out what is legal in their state.

Becoming a medical director for an existing medical spa, rather than opening a new practice, is another option for a core doctor. Several core doctors I have represented are doing this very successfully. They don’t need to deal with actual day-to-day operation of a retail store—they can simply lend their name to a medical spa, perform some consultations, oversee the practice’s other medical professionals, and then head back to their own practice rather than worrying about the intricacies of the business. This offers a core doctor a look at the industry without requiring him or her to make an enormous ownership commitment. It’s important, however, to understand the risks and responsibilities of med spa medical directors before committing to this course of action.

A Path to Success

The core doctors who oversee a compliant, well-run medical spa stand to gain a great deal from the arrangement. A successful medical aesthetic practice can earn a lot of money by itself, and if a med spa has a lot of patients, it makes sense that the number of referrals to an affiliated surgical practice will be higher than if it is struggling.

If a core doctor wants to enter the medical aesthetic industry, he or she cannot do it halfway. A medical spa that is created to function primarily as a compliment to a surgical practice is unlikely to find a great deal of success; one that is designed to succeed on its own terms, however, offers numerous benefits to its owners, including the possibility of increased surgical business.

Attend an AmSpa Medical Spa & Aesthetic Boot Camp to learn the legal and business best-practices you can employ to build and run a successful medical spa practice.

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

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MSOs Help Non-Physicians Own Medical Spas

Posted By Administration, Monday, May 13, 2019

contract

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

For many of the people who work in the medical aesthetics industry, the goal of owning a med spa is difficult to realize. After all, most states observe a doctrine known as the corporate practice of medicine, which dictates that only a physician or physician-owned corporation can receive payment for medical services. Since many of the treatments offered at med spas are medical in nature, this means that the ownership of such facilities is governed by this doctrine.

However, there is a path to med spa ownership that doesn’t involve you attending medical school for four years and then working as a resident for several more. It is called a management services organization (MSO), and while it still requires the participation of a physician, it allows non-physicians to play a very significant role in the day-to-day operations of a medical aesthetics business.

As its name suggests, an MSO provides management services. It partners with a physician, for whom a separate company that only provides medical services is created. This arrangement, known as a management service agreement (MSA), essentially allows a non-physician to supervise most aspects of a medical aesthetics business, including branding, marketing, owning the real estate, payroll, human resources, accounting, and billing—everything except the administration of medical services.

This can be thought of as a lessor/lessee situation. The MSO typically owns and maintains the facility, and the physician occupies the space. The physician pays the MSO for the right to occupy the space, and the MSO functions in much the same way as a landlord, maintaining the facility and keeping the physician as comfortable as possible. However, unlike an apartment rental that is governed by a lease that dictates the occupant pay a set amount of money for a certain term, the amount paid to the MSO is determined by the amount of business conducted by the physician. If the medical organization treats more patients in a period of time than it did the previous period, the MSO will also make more money. This helps to create a bond between the physician and the MSO—if one side of the business succeeds, they both succeed.

The contractual separation of the two entities also provides benefits to both parties. For example, the physician incurs very little risk when it comes to setting up the business. If the practice fails, he or she is not on the hook for the facility, its contents, and the land on which it is located—that is on the MSO. Additionally, the creation of a separate company for the physician helps to prevent any liability issue incurred at the medical spa from affecting any of the physician’s other medical pursuits. The MSO also typically covers the physician’s liability insurance. This arrangement might seem to favor the physician, but that’s why he or she pays the MSO. And should the physician incur any sort of liability claim, the MSO is in the clear. 

It is important to note that while it may seem that a properly set up MSO is in charge of its medical spa, in order for the practice to be compliant, the doctor must be in charge of medical and clinical decisions. The easiest way for an MSO to get in trouble is for it to not actually treat the practice as a medical company. The doctor must manage the medical aspects of the med spa; if he or she does not do this, they are subject to severe punishments, including license forfeiture and large fines. Furthermore, the MSO is subject to repercussions for practicing medicine without a license. As such, it is vital that all parties must understand their roles and obligations.

MSOs have been used by entrepreneurs to form management companies for medical organizations as large as hospitals and managed care facilities, so it stands to reason that creating an MSO for a medical spa would be comparatively simple. However, this is not the sort of thing that can be properly executed using forms you can download off the internet, so you should consult an attorney who has experience successfully setting up MSOs if you are considering entering into this sort of arrangement. This is especially important if a business wants to sell to a large entrepreneur or expand across state lines.

If you want to learn more about MSOs, they are covered in depth at AmSpa’s Boot Camps. Click here to find out when we will be coming to a city near you and register to take part in the course.

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

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Botox Parties: What You Need to Know

Posted By Administration, Wednesday, May 8, 2019

botox

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

One thing I love about the med spa industry is that med spa owners and providers continue to innovate. The ideas that come from AmSpa members on marketing, branding and business are always impressive. This is one reason why it is difficult to keep track of what’s legal in the medical aesthetic industry—many of the ideas we are asked about are brand new. They’ve never been tested before, and therefore it’s difficult, to determine where the legal constraints are.

Botox parties are examples of this. These events are hosted by a med spa or a provider—either at the med spa or another location—and at them, people get together to socialize, learn about treatments and try new treatments. Often, the med spa provides discounts on product to get new patients in the door. These are highly social events, often featuring alcohol, that mix pleasure with aesthetics, which makes the idea of getting injected with a needle a bit more palatable.

I’m often asked whether these events are legal, particularly when they are held outside of the med spa—at someone’s house or a salon, for example. What’s more, are they worth it?

The answer to both of these questions is yes—they are absolutely legal in most states (Nevada recently passed a law restricting the injection of Botox and fillers to a doctor’s office, essentially banning offsite Botox parties), and they are absolutely worth it. But like most things in this industry, these answers are contingent upon you adhering strictly to the law. No amount of money is worth losing your license, and yes, nurses have lost their licenses because of improperly hosted Botox parties. AmSpa members can check their medical aesthetic legal summaries to find laws pertaining to Botox parties in their particular state.

Primarily, you need to remember that when you provide any offsite medical treatment, all the same rules apply. New patients must be examined by a doctor, nurse practitioner (NP) or physician assistant (PA) prior to being treated. Proper records must be kept. Consent forms must be signed. Before and after photos should be taken. Everything you are legally required to do at your med spa should be done at a 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—you may need to obtain a permit for this.

Exam

A patient being treated by an RN without first seeing the doctor (or NP or PA) is the biggest legal risk at Botox parties, or any other social event involving med spa treatments. All patients must first be examined so that a plan can be set. This can only be performed by a doctor, or by an NP or PA operating under proper authority. Even if the patient consents to being treated by the RN without first seeing a doctor, the RN is not allowed to inject the patient without the exam.

At Botox parties, this can be difficult because new patients are socializing, alcohol is sometimes being consumed, and everyone is more relaxed. However, this is a step that must be followed, because an RN cannot practice medicine, so he or she cannot legally perform the initial assessment, establish the physician/patient relationship and set a treatment plan.

Consent

Obtaining patient consents—including privacy waivers, since treatments are usually performed out in the open—is also important. Providers also should be mindful of patients consuming alcohol. While obtaining consent from people who have been drinking is not strictly illegal, alcohol makes people less inhibited and often clouds judgment, which is not good when it comes to patient consent. All prospective patients should offer consent before they begin drinking, and you should try to keep the drinking 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.

Privacy

You should also be mindful of photos and social media. These events are ideal for marketing purposes—people are having fun, everyone is happy, and you remove many of the clinical aspects of aesthetic medicine. However, you need to be careful when photos or videos are posted—every patient is entitled to privacy, and if any of them fail to sign a privacy release and an authorization to use their photos, you risk breaching their privacy.

Conclusion

So since these events are broadly legal, we need to ask—are these events are worth it? The answer is emphatically yes, provided you strictly adhere to legal guidelines. Botox parties and social events are great ways to introduce new clients to your practice, pre-book treatments and bring in some cash.

Offer discounts on treatments and pre-bookings—both for injectables and laser packages—is standard operating procedure, provided they are purchased that night. Patients are encouraged to bring friends and colleagues to meet the providers and learn more about aesthetics. It is not uncommon for a practice to earn six figures in treatments and bookings in just one day. Even that kind of money isn’t worth losing your license, however, so be vigilant with your compliance efforts.

I urge you to move cautiously when planning and hosting one of these events. Do your homework and ensure you are completely compliant. 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 the proper documentation is in place, the required personnel are available, and all rules are observed.

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

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

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Join AmSpa at the Chicago Medical Spa & Aesthetic Boot Camp

Posted By Administration, Friday, May 3, 2019

chicago boot camp

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

Starting tomorrow, AmSpa will host its Chicago Medical Spa & Aesthetic Boot Camp at the Chicago Marriott Southwest at Burr Ridge, and we’re extremely excited for the opportunity to help medical aesthetic professionals develop their practices. There's still time to register for the event—just click here to sign up. Here’s a quick overview of the program:

Saturday, May 4

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

  • 9 – 10:30 a.m.: The Plan, presented by Bryan Durocher (Durocher Enterprises)—What are the most effective ways to develop a business plan for your medical spa? Medical Spa Consultant Bryan Durocher discusses the ins and outs of the planning process and helps determine how long it realistically takes to open a practice.
  • 11 a.m. – 12 p.m.: The Marketing Plan and Social Media, presented by Brandon and Jenny Robinson (Skin Body Soul MedSpa)—This session will help you determine how to most effectively market your medical aesthetic practice using both traditional methods and cutting-edge techniques.
  • 1 – 1:30 p.m.: Medical Aesthetic Hot Topics Panel, featuring Tim Sawyer (Crystal Clear Digital Marketing) and Nealy Skeldon (Environ Skincare)—This panel, moderated by yours truly, will feature a spirited discussion of the current issues and events that concern medical spa owners and operators.
  • 1:30 – 3:30 p.m.: The Law, presented by Alex Thiersch (AmSpa) and Renee E. Coover (ByrdAdatto)—In this presentation, we’ll discuss the long-standing and emerging legal issues that every medical spa owner needs to know about. As you can imagine, there is a lot to cover here, since new concerns seem to be arising daily lately.
  • 4:15 – 5 p.m.: The Treatments, presented by Terri Ross (Terri Ross Consulting)—Learn about the most profitable and popular treatments available to your practice, and find out how to best determine which treatments are right for you based on the state of your practice.
  • 5 – 6 p.m.: The Digital Marketing Ecosystem, presented by Tim Sawyer (Crystal Clear Digital Marketing)—Find out how to effectively spread the word about your medical aesthetic practice and how best to determine what’s working and what’s not. Your practice’s digital presence is more important than ever before, and curating it should be a top priority.

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

Sunday, May 5

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

  • 8:30 – 9 a.m.: Anatomy of a $5-Million Med Spa, presented by Alex Thiersch (AmSpa)—Have you ever wondered what the difference is between your medical spa and one that’s mega-successful? It might be less significant than you think. This presentation will show what a $5-million med spa is doing right—and what you might be doing wrong.
  • 9 – 10 a.m.: The Financials, presented by Bryan Durocher (Durocher Enterprises)—At the end of the day, the money you’re bringing in is the most important measure of your practice’s success. This presentation will, among other things, demonstrate how to properly develop a budget and use metrics to determine your med spa’s strengths and weaknesses.
  • 10:45 – 11:15 a.m.: The Long-term Revenue, presented by Brandon and Jenny Robinson (Skin Body Soul MedSpa)—Simply being successful isn’t enough for a medical aesthetic practice; you have to know how to maintain and grow your success. In this session, the Robinsons will show you how to build patient loyalty and move your business forward.
  • 11:30 a.m. – 12:15 p.m.: The Consultation, presented by Terri Ross (Terri Ross Consulting)—As the old saying goes, you never get a second chance to make a first impression. Learn how to put your best foot forward with effective patient consultations—and how to turn them into consistent business.
  • 1 – 2 p.m.: The Lessons, presented by Louis Frisina—Every medical spa is different, but the successful ones share several common traits. In this session, Business Strategy Consultant Louis Frisina discusses the qualities that are typically found in practices that bring in a significant amount of revenue.
  • 2 – 3 p.m.: The Team, presented by Bryan Durocher (Durocher Enterprises)—A medical spa is only as good as its personnel, so it’s important to make sure that you hire a staff that can do everything you want it to—and more. In this session, you’ll learn about recruiting, hiring and retaining employees who can make your medical spa dreams come true.

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

We hope you can join us in Chicago this weekend. This AmSpa Boot Camp is a tremendous opportunity to get your medical aesthetic business headed in the right direction and learn some tips and tricks that can take it to the next level. Click here to register!

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

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Payment Options for Maximizing Your Med Spa Guests' Treatments

Posted By Mike Meyer, Thursday, May 2, 2019
Updated: Tuesday, May 7, 2019

credit online shopping

By Karen Zupko, on behalf of CareCredit

Help grow your business by promoting available payment options. Present patients with choices at multiple points in the sales process, and offer additional ways to pay for treatments. By doing so, you may increase the chance that they use one of these methods to experience more services and schedule more frequent visits.

Here are five simple solutions to promote patient financing as a payment option:

  1. Put a button in multiple places on your website. Link visitors to information as well as an online application, and post the button in multiple locations—not just the home page. Think about creating a financing or payment tab to show the options you have available.
  2. Include a short sentence in all email responses to website inquiries. Keep it simple; for example, "We offer convenient payment options—click here to learn more."
  3. When scheduling new patient consultations, explain that you offer a payment option with promotional financing. Train staff to direct patients to apply on your website prior to the appointment. A service-oriented way to explain this could be, "That way, when you decide to schedule that peel, if you’re approved you’re all set to use patient financing options…”
  4. Remind patients about payment options in conjunction with a special offer. For example, if you promote Kybella in an e-blast, mention your patient financing options as an available payment option underneath the special fee. “Ask about payment options that can be used with this special offer.”
  5. Encourage patients to apply when they check-in for their first appointment. For example, “While you are waiting for your CoolSculpting treatment, you can apply for patient financing. You will know the credit decision in seconds.” Make the client's experience simple—hand him or her an iPad with the browser open to your website and touch the “Apply Now” button for them to open the application.

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

CareCredit is a health, wellness and beauty care credit card dedicated to helping people get the care they want and need. With CareCredit, your guests can move forward with your treatment recommendations to look and feel their best*. CareCredit offers promotional financing options to provide your patients a convenient way to fit beauty into their monthly budget. CareCredit is accepted at more than 210,000 locations for a wide variety of health and wellness procedures, treatments and skin care products.

Amspa members receive 20% off promotional financing merchant fees.1 Click here to learn more.

* Subject to credit approval
1 On purchases of $200+

Tags:  Business and Financials  Guest Post 

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How to Increase Your Med Spa Retail Sales

Posted By Administration, Wednesday, April 24, 2019

retail

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

Increasing medical spa retail product sales is a fast way to boost the profitability of your medical aesthetic practice. 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. So if you want to make this a larger part of your business, where do you start?

A Perfect Fit

When choosing products, you need to make sure that they not only fit in with the brand direction of your business, but also match the services you offer, since a skin care program can produce good treatment results for your patients. You don’t necessarily need to stop at treatment products, however—a few on-brand retail pieces that don’t require a prescription to buy can help create a fuller experience for your customers. If you fancy yourself a luxury brand or a wellness brand, you should consider dedicating some shelf space to items that reinforce this message.

Too Much Choice

It’s good to have a selection of products in your medical spa, but offering too many options at the same level of treatment can be a detriment. Too many similar choices can leave customers confused and less likely to purchase anything. Selecting a few lines that each have multiple levels of treatment will likely serve you better.

“While selection is important, sometimes it is better to go an inch wide and a mile deep,” said medical spa industry expert Bryan Durocher of Durocher Enterprises.

The Sense in It

Engaging customers through multiple senses can benefit retail sales. Visually interesting displays combined with calming music or scents that match some of your products provide subtle boosts for retail sales.

You also can alter the layout of your space. Do you keep the majority of your products behind a counter or in a locked case? This will impact your sales, since customers like to look at and hold products as they consider buying them. Does your retail area overlap with your waiting room? Think about separating them—“People that sit don’t shop,” Durocher said.

Teamwork Makes the Dream Work

Of all the possible points of improvement in retail sales, training your team will give you the biggest benefit, bar none. “How can you expect to improve performance and achieve new results if the team is not held accountable for their actions or performance?” said Dori Soukup of InSPAration Management.

Soukup suggests implementing concrete expectations, measurable goals, sales systems and team coaching when attempting to set up a business for retail success.

“Have a defined client experience that incorporates retail products during the consultation, during service and at the close of the visit,” Durocher said.

It’s also important to offer your team incentives. In most states, you generally cannot pay staff commission for services in a medical spa because of fee-splitting laws, you generally are allowed to pay percent commission on retail product sales.

Selling retail products is a key to increased profitability in medical spas, and if you’re looking to enter the industry, it’s a core principle you should 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 learn how to become the next med spa success story.

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

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How to Create an Effective MSA

Posted By Administration, Thursday, April 18, 2019

By Michael S. Byrd, JD, partner, ByrdAdatto

Performance of a car may be best measured by the engine, not the outer workings. A monitor or program does not deliver performance for a computer; that is found in the hardware. One must dig beneath the surface to find the source of performance. The same may be said about the management services agreement (MSA) for the management services organization (MSO) model commonly deployed in health care arrangements. The arrangement performs by the design of the MSA.

The MSO is the tried and true model for non-physicians to own a business in the medical services market. Alex Thiersch, partner at ByrdAdatto and CEO of the American Med Spa Association, published an article about unpacking MSOs. ByrdAdatto also published an article about nuances that may impact the design of the MSO model. We’ve even written an article about the influx of private equity into the medical and dental markets and the use of the MSO model for these investments.

Yet, to truly understand the essence of the MSO model, like the engine of the car or the hardware for computer, you must understand the MSA. The MSA defines the relationship between the medical entity providing medical services and the MSO entity providing management services. The importance of the MSA can be seen by the essential components of the arrangement that are defined in the MSA:

  • The flow of funds from patient encounter to profit;
  • The economic sharing of funds between the medical practice and the MSO entity;
  • The precise services to be provided by the MSO entity to the medical entity;
  • The separation of clinical responsibility to the medical entity in a way that complies with state regulations; and
  • The role of the physician often found in a medical director agreement (123s of a Medical Director).

A well-written MSA should look approximately 80% the same as another well-written MSA in another arrangement. This 80% should define boundaries from a compliance perspective, and hopefully it’s tailored in a way to work from one arrangement to the other. The other 20% deals with the heavy details of the particular arrangement. The 20% addresses the economics between the parties, as well as the roles and responsibilities of the physician providers, the use of space, the payment of personnel and the use of equipment.

The number one mistake with MSAs is for clients to grab onto a previously used MSA or, even worse, an MSA used by a colleague to memorialize their arrangement. The risk is obvious from a business perspective if the MSA flow of funds does not match the business plan. However, if the MSA does not reflect the reality of how the arrangement is functioning, the greater risk becomes one of compliance violations and the risk of enforcement that may lead to invalid arrangements, medical board sanctions, and, in some cases, arrests and criminal prosecution.

The greatest risk for using a faulty engine for a car or faulty hardware for a computer is economic loss. The greatest risk for using a faulty MSA is economic loss and compliance enforcement.

For more information on setting up a compliant MSA, please contact ByrdAdatto to schedule a consult.

With his background as both a litigator and transactional attorney, Michael Byrd brings a comprehensive perspective to business and health care issues. He has been named to Texas Rising Stars and Texas Super Lawyers, published by Thompson Reuters, for multiple years (2009-2018) and recognized as a Best Lawyer in Dallas by D Magazine (2013, 2016, 2017, 2018). He routinely lectures at continuing medical education seminars on the various business and legal issues that medical professionals face.

Tags:  Business and Financials  Med Spa Law  Med Spa Ownership  Med Spa Trends 

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The Ins and Outs of Physician Contracts

Posted By Administration, Wednesday, April 17, 2019

contract

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

An effective employment contract between a medical practice and a physician should be a win-win for the employer and employee. If one or both sides don’t approach the negotiation in a thoughtful manner, they could find themselves disappointed with the outcome. Here are a few features that should be included in a mutually beneficial contract.

(For more information on medical spa employment contracts, view AmSpa’s webinar on the topic; it is free to AmSpa Plus members.)

Goals

A practice should consider what it wants to accomplish with a contract with a physician. Does it need to fill a position? Does it want to provide service to more patients? Is a transition of ownership part of the equation? The answer to this can dictate the type of person the practice wants to recruit (i.e., a younger doctor versus a more experienced one) and affect the way the employment agreement is designed. If a physician who has entrepreneurial aspirations is hired to simply tend to patients, for example, neither side will be particularly happy, and the relationship likely will not last very long.

The practice’s intentions must be clearly communicated during the recruitment process, and the contract must be built around that philosophy.

Along the same lines, a physician must honestly evaluate his or her goals when negotiating a contract with a medical spa. These contracts typically last for one to two years, but both sides typically expect that the relationship will continue thereafter, so a physician must come to terms with his or her long-term plan. Is this where he or she wants to forge a career? This should influence how the contract is negotiated.

The physician also needs to consider a “plan B”—if this arrangement does not work out, how does he or she continue his or her career? The answer to this question heavily influences how the contract is evaluated. For example, if the physician wants to put down roots in the city where the practice is located but the contract has a restrictive non-compete clause, it is in his or her best interest to negotiate the terms of that clause, as it would severely restrict his or her options if it the relationship with the medical spa does not work out. Click here to learn more about non-compete and non-solicitation clauses.

Compensation

A medical spa needs to balance the practice’s economics, the risk tolerance of its owners, and salary expectations in its market when negotiating a contract. A competitive guaranteed base salary with some form of incentive-based bonus system can help secure top talent who might be considering other options. There are several ways this can be arranged, depending on what the physician prefers.

The physician, on the other hand, must understand his or her risk tolerance. While a high base/low bonus structure might appeal to some, others will want to pursue a low base/high bonus structure. The physician must determine his or her comfort level with the contract’s salary structure—if it is not optimal, it must be negotiated.

The physician also must be rational when determining his or her actual earning power. If the market does not offer enough potential business to justify taking a low base/high bonus salary, the physician should seek a different deal.

Ownership

The practice must determine what it wants to accomplish in terms of ownership with the hire, as it will affect everything from scheduling and coordination to top-level decision-making. The practice’s owner(s) also must consider if the hiring should be part of their exit strategy; if so, the contract must be created with that in mind.

The physician, meanwhile, must determine how he or she would build the practice and determine how the practice’s ancillary revenue streams compare to those offered by others. Ownership offers different appearances for different entities, so the physician must establish what he or she wants and what the practice can provide. What is the investment? What is the potential return? What is the risk? The contract should answer all these questions.

Creating a mutually beneficial contract is a complicated matter. Both sides must assess the risks and rewards, and they must also be willing to compromise on less pressing matters. A careful reading of a contract is a must, however—if both sides don’t thoroughly read the contract, they have nobody to blame but themselves if it doesn’t work out.

For more information about structuring your medical spa profitably and compliantly, attend an AmSpa Medical Spa & Aesthetic Boot Camp and become the next med spa success story.

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

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