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Member Spotlight: Take a Ride on the Beauty Bus

Posted By Administration, Monday, February 24, 2020

beauty bus

By Michael Meyer, Content Writer/Editor, American Med Spa Association

 As any marketing professional can tell you, it helps to have a hook—and Sara Trammell, MD, of Abilene, Texas, has a worthy one.

Trammell spent several years working in family practice at a hospital in Abilene; she also spent some time consulting at a medical spa owned by the hospital, where her love of aesthetics originated. After the hospital shifted its medical spa to a plastic surgeon’s office, Trammell decided to explore her own path in medical aesthetics.

“I started off by doing Botox parties, mainly because I had friends and coworkers asking if they could still come get their Botox,” Trammell explains. “I did that by just literally packing up a little box, going to people’s houses, getting groups of people together and doing Botox. Then they started asking for more and more services—’Are you going to start doing fillers? Can you get a laser? What are you going to do next?’ So, I started looking into that.”

Going Mobile

Trammell began to expand the services she offered, and also started investigating some ways to provide mobile aesthetics services around the Abilene area. What she found helped shape her practice’s identity.

“I ran across an Airstream nail salon that was up in Canada,” Trammell says. “I loved the concept and just the look of it. So, my husband and I started looking for an Airstream trailer in our area, and after several weeks of looking, we found one in Dallas.”

Trammell bought the trailer, gutted it, redid the interior to include a treatment chair and cabinets, and decorated both the interior and exterior in a fun, kitschy retro style. With that, the Beauty Bus was born.

“I go to people’s homes, I’ve been to businesses and I’ve been to different shopping centers that put together weekend pop-ups,” she says. “There’s a restaurant and shopping area outside of Abilene where we did a big event, and I offered Botox and consultations. I was able to get about 10 new regular patients just from that event. I think people like the mobile aspect of it, the fun aspect of it—it’s a cute, eye-catching thing.”

Trammell runs her primary aesthetics practice, which she opened in March 2019, out of her guest house. She does not have any employees, but she says her patients appreciate the individual attention they receive from her and are glad that she performs all procedures herself.

“Most people say how much they like the personalized care,” she says. “They’re not having to talk to anybody on the phone to schedule appointments—I do all of my appointments through Square, so they can schedule their appointments 24 hours a day and manage it on their own. I think I’ve been able to take my experience at the hospital, where the medical spa was run in a very large, corporate setting where there were lots of restrictions and rules and regulations, and make it super personal and make it fit my lifestyle.”

Membership Has Its Privileges

Trammell joined the American Med Spa Association (AmSpa) while she was setting up her practice, and she’s used the knowledge available to her through her membership to help her practice get on its feet.

“It was one of the first groups that I joined, and it has really been a life-saver,” Trammell says. “It’s really been a positive experience—the legal and business aspects of the industry were things that I knew nothing about.”

Trammell says that she has watched all the webinars and listened to all the podcasts produced and hosted by AmSpa and, in September 2019, she attended AmSpa’s Dallas Medical Spa & Aesthetic Boot Camp, where she learned even more about how to operate a successful medical spa.

“I just started adding some retail to my shelves, and I learned that actually from the Boot Camp, when Bryan Durocher said, ‘You need to have retail—you need so much retail,’” Trammell explains. “I literally got on my phone and started ordering retail that day. I’ve put it up since then and it’s done really well.”

Growing the Brand

Now that her practice is up and running, Trammell is considering her next steps. She has installed a permanent parking space for the Airstream, complete with hookups for electricity and air conditioning, and she intends to use it as a second room at her home practice when it’s not being used as a mobile medical spa. She’s also considering hiring someone to administer treatments with which she is not currently familiar, such as body contouring.
Regardless of what she does next, however, it’s safe to say that Trammell has found her calling in medical aesthetics.

“I want people to be confident in who they are,” she says. “Your appearance is not the most important thing, that is true, but I think when people are confident in their appearance, then it allows them to be confident in all areas and aspects of their lives. I’m not trying to change your looks—I just want to make you a more confident person so you can go out and share that confidence with everybody else that you come in contact with.”

AmSpa members receive QP every quarter. Click here to learn how to become a member and make your med spa the next aesthetic success story.

Tags:  Med Spa Trends  Member Spotlight  QP 

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What Aesthetic Practices Need to Know About Naturopathic Medicine

Posted By Administration, Friday, February 21, 2020

naturopathy

By Courtney P. Cowan, JD, ByrdAdatto

Medical consumers are becoming more and more discerning when it comes to seeking health care. Healthier lifestyles, a growing distrust of pharmaceuticals and an opioid crisis have many seeking treatment outside of traditional medicine. Naturopathic medicine, or naturopathy, is one such alternative. Rather than treating and diagnosing individual symptoms, naturopathy aims to treat the whole patient, often prescribing changes in diet and lifestyle, as well as a wide array of holistic supplements.

Due to a lack of industry standards or overall governing authority of the field, there are potential risks that both naturopath clinicians and consumers should be aware of, beginning with the very title—“naturopath.” Many are unaware of the difference between a traditional naturopath and naturopathic doctor (ND). The two are not interchangeable, and regulations surrounding the two professions vary from state to state. According to the Association of Accredited Naturopathic Medical Colleges (AANMC), a licensed ND is a primary care provider who is trained to diagnose and prescribe, while a traditional naturopath is not.

Confusing the distinction further is that naturopathic medicine is not yet a regulated profession in some states, and thus a traditional naturopath may use the title ND, without having earned that degree. In fact, to receive an ND, one must complete four years of schooling by an accredited institution, complete thousands of hours of supervised clinical training and complete two national board exams. In contrast, traditional naturopaths may receive training from online correspondence or certificate programs ranging from a few months to years. These traditional programs lack standardization or onsite clinical training. Even in states where the profession is regulated, the services that each distinction (traditional or ND) is legally able to provide vary.

It is important to note that while licensed MDs and DOs can practice naturopathic modalities, many NDs are not actually licensed by any state medical or osteopathic board. Moreover, while NDs often use holistic medicine to treat patients, there may be some crossover treatments that fall under the definition of the practice of medicine. For example, prescribing medicine, lasers and intravenous treatments may be used in naturopathic medicine; however, these may qualify as statutory medical procedures that legally should only be performed by MDs, DOs or providers who have had specific training for the procedure. In many states, the “corporate practice of medicine” rule, which prohibits anyone but a physician from practicing what is deemed medical, may also apply.

AmSpa members receive a complimentary 20-minute Introductory Compliance Assessment with a ByrdAdatto attorney. Click here to learn how to join AmSpa today!

As the daughter of a periodontist, Courtney P. Cowan has been fascinated by the health care field since childhood. She often accompanied her father to his office, where she developed an appreciation for physicians and their respective practices. Having absolutely none of the dexterity that is required to be a surgeon, however, Cowan instead decided to pursue a degree in business while attending Baylor University. It wasn’t until she was required to take a business law course that she discovered her passion for the law. After graduating from Southern Methodist University Dedman School of Law, Cowan serendipitously connected with ByrdAdatto and now assists clients by combining her business background with her enthusiasm for health care and the law.

Tags:  ByrdAdatto  Med Spa Law  Med Spa Trends 

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Take an X-Ray of Your Practice

Posted By Administration, Wednesday, February 19, 2020

financial analysis

By Terri Ross, Terri Ross Consulting

As a practice management consultant and sales performance coach in the aesthetic space, I speak all over the country. Some of the most common questions I receive from staff and medical providers time and time again are:

  • Why are we not growing as fast or generating as much revenue as we would like to?
  • Why aren’t our schedules full?
  • What reports should I run?
  • Why isn’t my website generating any leads?

These are very valid questions. In fact, I asked myself the very same questions years ago.

When I was hired by Lasky Aesthetics & Laser Center in Beverly Hills, California, back in 2012, I created a comprehensive process designed to analyze the entire business from the ground up. I made bold recommendations that resulted in an incredible turnaround and generated more than $600,000 of additional revenue in one year.

So, how did I do it? I realized that data doesn’t lie. It was factual, and I needed to take a good hard look at that data and figure out where the gaps existed. Then, I had to find the opportunities for growth. Most importantly, I had to take action and make the investment into the business.

Getting a Clear Picture

My clients consider my Practice Assessment to be the ultimate X-ray tool to uncover missing revenue and growth opportunities.

The Practice Assessment is a robust, 17-page tool (your homework) that asks comprehensive, probing questions and requires you to provide meticulous details about your business. I’ve been told it is an enlightening exercise. This assessment will help me to evaluate every area of your practice, including:

  • Revenue sources and goals;
  • Facility and overhead costs;
  • Services offered and profitability;
  • Equipment; 
  • Strengths and weaknesses analysis;
  • Patient retention; 
  • Lead generation sources and follow-up;
  • Consultations and conversion rates;
  • Operations;
  • Marketing;
  • Website and SEO;
  • Information technology; and
  • Human resources.

Once you complete the Practice Assessment, I will analyze your information and provide you with a high-level summary report of concrete action steps. You’ll get my expert recommendations based on years of experience that, if implemented, will turn your business around. (Click here to learn more). I highly recommend you investing the time and resources into completing this detail-oriented assessment to achieve concrete results.

Nevertheless, I wanted to give you an overview of how to get started gathering your own information to evaluate.

Gather Necessary Information

Before you can accurately find the gaps in your practice and identify areas to improve, you must have data to analyze. Money is an important factor, and knowing your financial facts and bottom line is critical to future growth.

Gather what you can from your patient management software, your profit and loss statements, and any and all sales- and marketing-related information you have access to, and…

Let’s Get Started

Here are some sample questions from the Practice Assessment to get you started.

  • What is your previous year’s revenue? Your current revenue? Your retail revenue? Your current goals?
  • What treatments are your most profitable? How much revenue does each treatment generate?

Does anything jump out at you so far?

  • What services do you offer (surgical and nonsurgical)? How many appointments have you booked for each type this month, quarter or year?
  • What is your consultation conversion ratio?

Now let’s think about leads coming in.

  • How many leads does your website generate per month, if any?
  • Do you have a process in place for following up on leads?
  • What percentage of leads convert to consultations?

Let’s move on to marketing.

  • What kind of marketing are you doing, and are you measuring results?
  • How often do you communicate with your patients?

Let’s talk technology.

  • What kind of patient management software are you using?
  • What kinds of KPIs do you measure?

Consider your staff.

  • How many staff members do you currently employ?
  • Have they been trained in sales, consultations and customer service? If not, how do you know if they are doing a good job?

Interpreting Practice X-Ray Results

Based on the breakdown of your revenue and expenditures, you might need to shift to higher-revenue-generating treatments, increase your pricing, and evaluate your staff and their skill sets. Hire more or reduce your staff, incorporate long-term treatment plans and increase your marketing spend.

You might need to revamp your website. Is it dynamic and producing hundreds of leads per month? You also may need to establish a better follow-up system for tracking leads. Additionally, you most likely need to invest in expert sales training for your staff so that you feel confident in their ability to do their job successfully.

Now that you know what types of questions to ask yourself and what information is needed for an accurate assessment, you might be feeling a bit overwhelmed.

I want to give back and help you like I’ve helped others. To reduce risk, invest in experts who will save you time and money, and avoid costly mistakes. I am here to support you. Please feel free to reach out if I can answer any questions.

Ready to Roll?

If you would like to get started bridging the gaps in your practice so you can improve the patient experience, convert more patients into paid services and generate more revenue, click here to get started with your practice assessment today.

Terri Ross brings more than 20 years of sales and management experience to the field, having worked with leading-edge medical device companies such as Zeltiq, Medicis, EMD Serono, Merck Schering Plough and Indigo Medical, a surgical division of Johnson.

Ross’ vast knowledge and experience as a sales director managing upwards of $20M in revenue and successful teams has allowed her to become a renowned plastic surgery management consultant helping aesthetic practices thrive.

To optimize revenues and business performance, Ross’ practice management consulting services help physicians evaluate practice processes including, but not limited to, overall-operating efficiencies, staff skill assessment, customer service and operating efficiency strategies. The goal is to develop a comprehensive plan of action to improve productivity, quality, efficiency and return on investment.

Tags:  Business and Financials  Med Spa Trends  Terri Ross Consulting 

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Are Medical Director Agreements Required in MSO Arrangements?

Posted By Administration, Monday, February 17, 2020

mso agreement

By Kita McCray, JD, ByrdAdatto

The purpose of a medical director agreement is to memorialize the responsibilities of a physician, which typically entail supervision and delegation, and address physician compensation. In a management services organization (MSO), the physician who owns the medical entity usually is the physician who is in charge of supervision and delegation. Where a single physician owns, delegates and supervises, he or she would not need a medical director contract with themselves. Moreover, financial terms, including medical director compensation, typically are captured in the management services agreement (MSA) between the MSO and the physician-owned medical entity. Thus, medical director agreements are only necessary when a company is operating in a state that allows non-physician-owned companies to contract with or directly employ physicians, and in MSO arrangements where the supervising physician is different than the physician owner.

To determine whether your company needs a medical director agreement, you should begin by looking to two places:

  1. Your state’s corporate practice of medicine (CPOM) doctrine, if any; and
  2. Any applicable supervision and delegation laws or regulations applicable to physicians.

The CPOM is a doctrine that prohibits an unlicensed individual or non-professional entity from:

  1. Practicing medicine;
  2. Employing or contracting with a physician to practice medicine on its behalf; or 
  3. Interfering with or influencing a physician’s professional judgment or practice of medicine.

This includes both the physician’s health care or medical decisions, and business or management decisions that necessarily implicate the practice of medicine.

In CPOM states—such as California, Texas and New York—the medical entity must be properly owned by a licensed physician. A company owned by a non-physician who employs a physician to render medical services and receives compensation in exchange for providing those services is structured in violation of CPOM. Where the MSO model is used to comply with CPOM prohibitions, a medical director agreement would be unnecessary, unless the physician-owner hires a different physician to supervise the medical entity’s operations.

In non-CPOM states, such as Florida, non-physician-owned companies are allowed to contract with or directly employ physicians, so long as the physician’s professional judgment and practice of medicine are not interfered with. Therefore, a medical director agreement would be necessary to specify the responsibilities and compensation of a physician acting as a medical director. Such responsibilities typically are for treatment plans, supervision and delegation, and they are in accordance with state supervision and delegation laws or regulations that are applicable to physicians.

AmSpa members receive a complimentary 20-minute Introductory Compliance Assessment with a ByrdAdatto attorney. Click here to learn how to join AmSpa today!

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

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

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One Week Until The Medical Spa Show in Las Vegas

Posted By Administration, Friday, January 24, 2020

medical spa show

The Medical Spa Show is only a week away, and there’s still time to make your plans to join the more than 1,000 people who have already registered. It takes place from January 31 – February 2, 2020—with Thursday Pre-show Education on January 30—at the Aria Hotel & Casino in Las Vegas. Regular registration ends on Tuesday, January 28, so if you’re considering attending, make sure to complete your registration by then—the cost for onsite registration is higher than if you register in advance.

The Medical Spa Show features six concurrent tracks of education—including two tracks of sponsored education—and an Expo Hall featuring more than 120 exhibitors demonstrating the medical aesthetic industry’s newest and most exciting products and services. Of course, it also features the industry’s best parties, and it’s a great place to network with fellow medical aesthetic professionals and industry leaders. There's something at the show that will help each member of your team, so bring them all to maximize the show's benefits!

What’s more, AmSpa Members can attend Thursday night’s Members Meeting, sponsored by Allergan—featuring influential, inspirational podcast superstar Cathy Heller—and everyone can come to the Opening Night Party on Friday night. Finally, after the regular show program ends on Sunday, AmSpa will present Live Cadaver Training: Facial Anatomy Course, taught by Jonathan M. Sykes, MD, for an additional fee for Medical Spa Show attendees who wish to learn more about what their injectables are actually doing. (Click here to learn more.)

Be sure to register today to reserve your space in the sessions you want to attend—several sessions are already at capacity, and others are nearing it, so don’t wait! Click here to begin the registration process right now!

We at AmSpa hope to see you in Las Vegas next weekend! It promises to be the biggest, best Medical Spa Show yet!

Tags:  Business and Financials  Med Spa Law  Med Spa Trends  The Medical Spa Show 2020 

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Hyaluronic Injection Pens: What You Need to Know

Posted By Administration, Wednesday, January 15, 2020

hyaluronic acid

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

 In the past several months, you may have noticed an explosion of ads, social media posts, articles, videos and training events talking about an “incredible” new injection device that can place hyaluronic acid filler in the skin without using a needle. These devices are often marketed as “non-invasive” or “non-medical,” using names such as “hyaluron pen” or “hyaluronic acid atomizer.”

However, make no mistake—just because they do not have needles does not mean these products are not medical devices or that they can be used without risk. On September 13, 2019, the Canadian Department of Health issued a warning regarding these devices. It stated these injectors pose health risks and are not authorized for sale in Canada. In the U.S., while no state has publicly commented on these devices yet, “administering medication,” no matter the method used, is part of the definition of each state’s “practice of medicine.” Therefore, these needle-free injection devices should be treated the same as traditional syringes. People wanting to perform these treatments still need to have the same type of professional license they would need to inject using a needle and syringe, and they will still need to work under the supervision of a physician or another appropriate professional.

No Needle, No Problem?

Needle-free injection devices generally are used to deliver vaccines and medications either intramuscularly or subcutaneously, similar to a traditional needle and syringe. They work by creating a very narrow high-pressure jet of medication that is able to penetrate the skin; the jet is generated using gas or spring pressure to force the medicine through a small opening in a disposable vial. The benefits claimed include lower chances of cross-contamination, reduced needle-stick injuries, and less sharp medical waste. This makes these devices particularly well suited for inoculation campaigns, clinics and home self-administration of insulin or other medication.

Medical devices and substances may not be marketed in the United States without obtaining U.S. Food and Drug Administration (FDA) approval. FDA approved or classified devices may be marketed only for their approved use. For FDA registration, needle-free or jet devices fall into three broad groups:

  1. General-purpose injection devices meant to be used for injecting drugs that work in needle-free systems;
  2. Devices meant for a certain class of drugs, such as insulin, or use with a specific manufacturer’s specific product line—both of these groups are considered class II medical devices; and
  3. Devices intended to be marketed with a specific product, either labeled for use or sold together, and therefore treated as a combination device.

The first and second group of injectors are regulated using the premarket notification process under the 510(k) provision. These premarket notifications are granted when a new device is substantially similar to an existing approved device, and they allow the manufacturer to begin marketing the product while it complies with the more lengthy registration and approval process. In order to be cleared in this process, at least one drug or injectable substance must already be approved for this method of injection.

A number of needle-free and jet injectors have these filed premarket notifications with FDA; however, none of the “hyaluronic pens” currently on the market appear to correspond with any of these premarket notifications or be from manufacturers who have applied for one. Additionally, FDA has approved a number of hyaluronic acid-based fillers for injection using the traditional needle and syringe method. Thus far, no hyaluronic acid fillers have been approved for use in needle-free injectors. So, any pen injector under the premarket category would need to be compatible with an approved substance other than hyaluronic acid, and, once approved, could not be marketed for use with hyaluronic acid-based fillers.

The majority of the hyaluronic pens currently listed online are packaged with a supply of hyaluronic acid, which would most likely place them in the third category. Devices in this category are considered combination products and can be marketed for that specific use and product after approval. It does not appear that any of the currently marketed “hyaluronic pens” have any FDA approval for their use as Class II devices meant for general injections, and certainly not specifically for using hyaluronic acid.

On the Up-and-up

While no needle-free devices have been approved for hyaluronic acid, several needle-free injection devices have received FDA approval for use with specific drugs, which is something a properly marketed hyaluronic filler device would need to receive. For example, in 2014, a needle-free injector manufactured by PharmaJet and Seqirus Pty. Ltd.—manufacturer of the influenza vaccine Afluria—received approval to administer the Afluria vaccine using the PharmaJet Stratis injector for patients from 18 to 64 years old. FDA made clear, however, that it still recommends sterile needles and syringes for other vaccines and for patients younger than 18 and older than 64.

FDA approvals for both injectable drugs and injection devices are narrow and specific. In the above example, a pediatric office would be in violation if it advertised this service to its patients, since using it on those under 18 is not approved.

Many of these devices are marketed for at-home personal use and can be purchased through several online retailers. Some issues with the marketing of these devices are discussed above, but there are other issues for those who want to use these devices at home.

Safe and Sound

Surprisingly, there are relatively few legal issues for those wanting to treat themselves. While hyaluronic pens can’t legally be sold, they can be possessed for personal or non-medical use. Furthermore, people are generally free to do things for themselves that would normally require a professional license if performed by another—you can cut your own hair without a barber’s license, you can write your own contracts without a law license, and you can treat your fever without being a doctor. Similarly, someone can possess a jet injector for their personal use, as well as possess syringes and scalpels if they so choose. It is worth noting, however, that in some states, possessing prescription drugs and substances—such as injectable hyaluronic acid—without a prescription is prohibited. And offering to perform these treatments on others is considered the practice of medicine without a license.

From a practical standpoint, people should think carefully before choosing to perform medical procedures on themselves. The jet injectors being sold are not designed for this use—they appear to be rebranded and repurposed injectors that are not approved in the U.S. The hyaluronic acid fillers sold with them and available online also are not approved for injection into humans and often are of unknown sterility, safety or quality.

Additionally, much like the concept of “cutting hair,” the concept of using the pen injector sounds very simple. However, just as successfully giving yourself a haircut is far more complex than it seems, performing injections on yourself more complicated than it might appear. Those wanting to perform these treatments should first discuss the risks and potential complications—such as infection, contamination or vascular occlusion—with their physician.

Professional Considerations

Medical aesthetics professionals may be interested in bringing needle-free devices into their medical spa practice. This creates its own set of questions—namely, can you? And should you? Licensed health care professionals can be subject to professional penalties and discipline on their license if they are found to be using non-FDA-approved medication or devices. However, physicians generally are able to use otherwise-approved devices and drugs in ways that are not yet approved by the FDA. This is commonly known as “off-label use,” and it is the source of a great deal of innovation and advancement in the medical field. However, physicians are not allowed to advertise and promote off-label uses. Additionally, using unapproved devices in an unapproved way can create standard-of-care and liability issues for the practitioner if the patient experiences an adverse outcome.

So, while it would not be advisable for a nurse or physician to purchase one of these unapproved, illegally marketed devices off eBay, for example, a physician could take an FDA-approved needle-free injector and repurpose it for injecting FDA-approved fillers, so long as they did not market or advertise this practice. The question then becomes—does it make sense to do this? Do such devices bring additional capabilities over the current syringe-and-needle techniques?

While many of the approved devices allow for the dosage per “firing” to be metered, it does not appear that the placement of the medication can be done as precisely as using a syringe and needle—there is no way to ensure that the filler is injected in the precise location or depth, or in the amount desired. According to studies conducted by jet injector manufacturers, the amount of the drug that is actually delivered and the precise location of delivery can vary from injection to injection. The depth and penetration also can be influenced by tissue density, the angle of the injector to the skin, and the pressure applied against the skin prior to firing.

While these variables can be within acceptable limits for administering vaccines and medicine, would they be acceptable for cosmetic treatments on someone’s lips or face? Additionally, in the FDA’s Afluria/PharmaJet announcement on August 15, 2014, both the study performed for the approval and two prior needle-free injector studies (Jackson et. al. Vaccine 2001, Simon et. al. Vaccine 2011) found that needle-free injections had a higher rate of pain, redness and swelling at the injection site than those who received traditional hypodermic injections. Newer devices may remedy some of these issues, but any licensed practitioner should carefully consider the pros and cons before integrating this off-label use into their practice.

Taking Your Chances

The current crop of “hyaluronic pen” devices that are unscrupulously and illegally being marketed to the public create many issues, even beyond their lack of FDA approval. The public should be extremely wary about using these devices, and under no circumstances should anyone perform this treatment—or any other cosmetic injectable—unless they hold an appropriate health care professional license or are working under the supervision of a physician. Licensed health care professionals should educate their patients about the risks of these at-home, unapproved products and should always carefully consider the benefits of adding a new or novel treatment to their practice.

Tags:  Med Spa Law  Med Spa Trends 

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Marketing vs. Laws: Tips That Might Land You in Hot Water

Posted By Administration, Friday, January 3, 2020

marketing

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

In the medical aesthetic industry, marketing is a bit more difficult than in other retail segments. It might seem to make sense for a medical aesthetic facility, medical spa or laser clinic to invest in a flashy ad campaign, complete with lavish praise from patients and offers of discounts; however, going down this path may attract the attention of not only prospective clients, but also state regulators. Here are some ways medical aesthetic practices get in trouble with their marketing efforts, as well as some ways to conduct compliant advertising campaigns.

Understanding the Rules

Even though medical aesthetic businesses tend to engage in the same marketing techniques as other retail businesses—including websites, social media and print advertising—it is important that their owners and operators remember that these practices are, above all, medical practices. And because they are medical in nature, they are subject to the same rules and regulations that govern other, more traditional medical institutions, such as doctor’s offices and hospitals.

Because of this, the ways that a medical aesthetic practice can advertise are very restrictive. The specifics of these restrictions vary from state to state, but they all tend to revolve around the notion that medical care is something that people need rather than choose to indulge in, so any advertising for medical facilities should deal only in facts.

This idea was obviously conceived with traditional medical outlets in mind. For them, the practice of medicine should not be about making money—it should be treating patients in need in their best interest. With this idea in mind, an advertisement for a physician’s services is expected to convey that the physician is an MD, highlight his or her specializations and board certifications, and reveal his or her pricing in an honest and straightforward manner. Furthermore, physicians cannot make grandiose claims of life-changing results or claims of professional superiority—they must only deal in facts.

Of course, medical aesthetic practices are not traditional medical practices, and these somewhat high-minded ideals would seem to run counter to their goals. Medical aesthetic practices deal exclusively in elective procedures and, therefore, may be tempted to make certain claims in order to convince people to choose them over their competitors. However, because medical aesthetic practices are medical practices (it is right there in the name), they must still abide by the rules that govern medical advertising—they must be totally honest.

  • They must specify who is performing medical treatments and what their qualifications are;
  • They must present their pricing in a straightforward manner; and
  • They must not attempt to compare themselves to competitors.

Therefore, if a medical aesthetic practice’s advertising includes words such as “best,” “greatest” or “amazing,” that facility is likely in violation of its state’s medical advertising statutes. A medical spa may operate like a retail outlet, but it cannot advertise itself like one.

Another thing to keep in mind is that if a practice is owned or co-owned by someone who is not a physician—a nurse, nurse practitioner, or entrepreneur, for example—it must make clear in its advertising that it is a physician who is advertising for medical services. For example, if a salon owner contracts with a physician to administer Botox treatments at his or her facility, the salon cannot advertise that it is offering Botox injections—it must specify that the physician is providing that service.

Websites are typically where issues regarding these types of distinctions are found. Many medical aesthetic practice websites state that their treatments are provided by “licensed laser technicians” or “medical aestheticians.” Unfortunately, in most states there are no actual laser certifications, and under no circumstances is any aesthetician permitted to perform medical procedures. The presence of titles such as these on a practice’s website implies that the facility is not structured properly, and it calls into question the credibility of the physician or physicians who are supposed to be overseeing the medical aspects of the practice.

Employees of state regulatory agencies—which are almost always underfunded and understaffed—often simply browse the websites of medical aesthetic practices to determine which of these businesses should be investigated. Using terms such as the ones mentioned above on your website is a good way to attract unwanted attention from regulators, regardless of whether or not your employee swears that he or she is a medical aesthetician. If you distribute advertising materials using these titles, whether online or via other channels, your chances of being investigated are better still.

If a practice is found to be in violation of state regulations regarding medical advertising, it can incur severe financial penalties, and its physicians may even be subject to the suspension or revocation of their licenses. Regulatory agencies take issues such as these—which can rise to the level of “practicing medicine without a license”—extremely seriously.

The bottom line for owners and operators of medical aesthetic practices is that their advertising is under a great deal of scrutiny—far more than they may think. The requirements for medical advertising vary from state to state, so it is important to consult a health care attorney who is familiar with the regulations that govern medical advertising in your state before launching a marketing campaign in order to learn what is and is not legal. (Author’s note: AmSpa works with ByrdAdatto, a national law firm that focuses on medical aesthetic legalities, and as a member, you receive a discount off of your initial consultation, along with a number of other great benefits.)

How to Use Testimonials

If a patient of your medical aesthetic practice is over the moon about an experience there, you may be inclined to ask him or her to provide a testimonial that can be used for marketing purposes. However, there are limitations to the ways in which patient testimonials can be used in advertising for health care providers and, for reasons we’ve previously discussed, medical aesthetic practices must also abide by those rules.

Generally speaking, most states forbid hyperbolic testimonials that use statements such as, “Dr. Brown is the best doctor in the city!” As previously established, advertising for medical institutions must be based on facts, experience and credentials, so medical spa owners and operators must make sure that the testimonials they use are factually correct and address only the customer’s experience with the practice he or she is endorsing.

It is also important that you obtain proper consent from your patients before you post or distribute their testimonials. Even though the patients’ participation may seem to represent tacit consent, you must still go through proper channels to make sure that you are not opening yourself up to patient privacy issues. After all, acknowledging that a patient enjoyed a visit to your facility intrinsically reveals that he or she is your patient, which is a HIPAA violation. Again, speak with a knowledgeable health care attorney to learn what you are required to do to remain compliant when using testimonials.

Mind Your Business Partners

If a medical aesthetic practice is marketing its services via deal websites such as Groupon (which is of questionable legality in the first place—again, consult with your health care attorney before launching such a campaign to determine if it is allowed in your state), it should make sure that everything posted on those sites and disseminated via email by those outlets conforms to the rules of health care advertising previously discussed. These sites sometimes create their own copy and distribute it without running it by the client first. Regardless of whether or not it produced the copy, your practice would be the one facing blowback from state regulatory agencies, so make sure that you see everything associated with your practice before it is posted or sent.

Don’t Offer Incentives for Referrals

A medical spa operator may be inclined to create a promotion that offers, say, 50% off a Restylane treatment if you refer a friend to the practice. Although it might be perfectly fine for a salon or a traditional spa to offer such a deal on a facial, a medical practice making such an offer is essentially telling the world that it is giving monetary value for referrals, which is potentially a direct violation of local anti-kickback or patient solicitation statutes. Laws regarding kickbacks vary from state to state, but most states with powerful, influential medical boards consider such promotions to represent kickbacks. For the same reason, it’s generally a bad idea to offer gift cards in exchange for referrals.

Putting Your Best Foot Forward

Medical aesthetic practices must use a great deal of caution when conducting marketing campaigns. If a medical spa’s ad campaign is properly executed, it can be very effective; however, the practice must be very careful about what it says and what its patients say about it so that it does not run afoul of the strict statutes and regulations that govern medical advertising.

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

Tags:  Business and Financials  Med Spa Law  Med Spa Trends 

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The Secret Weapon That Will Explode Your Medical Spa Sales

Posted By Administration, Wednesday, December 18, 2019

medical spa receptionist

By Terri Ross, Terri Ross Consulting

As a leading sales training expert in the aesthetic industry with vast experience as a medical device sales director managing successful, peak performance teams and generating upwards of $20 million in revenue, one of the questions I get asked most frequently when I conduct staff trainings and seminars across the country is, “Terri, what is the number one thing we can do to increase our practice’s revenue?”

Can you guess what it is? Increasing pricing? Cramming in more patients per day? Shortening your consultation allotted time? Selling more expensive product lines or adding more retail products? Hiring more staff?

Those are usually the guesses I hear when I’m out speaking on expert panels at industry events or conducting onsite sales training in cosmetic surgery practices and medical spas around the country.

However, investing in powerful sales training for your team is the most overlooked strategy to increase your practice’s revenue, conversion rates and retention rates—whether you are in the process of launching your practice or are wanting to scale your current practice.

Understanding the Patient Journey

Sales and customer service are at the core of any successful business. The aesthetics patient is smart, savvy, educated and has a lot of choices when choosing one practice over another. Having a well-trained, knowledgeable and professional team is the difference between “good” and “great.”

It is critical to understand the importance of the patient journey and how each phase represents a distinct opportunity to provide high-quality patient care and ensure a positive, memorable customer service experience.

Approximately 52% of patient leads come from finding your website online, 25% are referrals from other patients, and the other 25% come from social media, other referring sites, other physicians or paid advertising.

A patient’s first point of contact with your practice is the initial phone call. This is your first and probably most important opportunity to make a great first impression.

Here are some questions to consider when evaluating how your staff is answering phone calls:

  • What kind of tone and attitude are they conveying with their voices?
  • Are they knowledgeable? Can they answer all of a prospective patient’s questions?
  • How well-trained are your team members on all procedures you perform and the products you use?
  • Can your staff easily explain why your practice stands out from the competition? In other words, can they answer “Why choose us?”
  • How solution-focused is your staff and how well-versed are they on the outcomes and benefits of each procedure?
  • Can your staff confidently navigate questions regarding pricing and potential objections?
  • Can they engage in dialogue to ask questions, rather than simply answering with a yes or no?
  • Are they making sure all of the prospects’ questions are answered?
  • Are they engaging in active/intuitive listening—hearing potential concerns behind the surface question?
  • Are they offering to schedule a consultation appointment to every caller?
  • What is their conversion rate for turning phone leads into consultation appointments?

I’ve created a free e-book resource that specifically focuses on this subject. Click here to download your free copy of The 13 Critical Components of a Successful Phone Call. As always, feel free to reach out if you have any questions or would like to set up a strategy session with me on this critical aspect of the art of sales.

Scheduling a Consultation

The goal of each patient inquiry should end with a call to action. Potential clients want to know the next step to take, even if they don’t verbalize that. Your team should always offer a clear path and call to action to schedule an appointment for a consultation.

The initial phone call is critical to book a consultation, which is an opportunity to convert a patient to a paying procedure.

Here are some questions for evaluating your staff’s ability to capture all the relevant information needed:

  • Are they gathering complete patient information, including name, referral source, best contact information, email, phone number, procedures they are interested in, address, zip code, date of birth, gender, concerns or any specific notes?
  • Are they following up with appointment reminders via text and phone calls?
  • Do they explain your cancellation policy and fee?
  • Are they taking credit card information to keep on file to reduce no-show rates?

If you are like most physicians, you are so busy working in your practice and using your gifts to perform highly skilled procedures that you may often overlook the critical component of working on your practice and training your front office sales team.

That is why it is vital to give your own practice a checkup. Scheduling one to three more patients a day for consultations could translate into $50,000 to $100,000 more a month.

Isn’t that worth the investment in sales training?

Even if your practice has not launched yet, now is the time to invest in expert sales training to start out on the right track.

Your front office team can easily be trained to be your most efficient, revenue-generating sales force, and as a clinical provider, your consultations can improve drastically for a better patient experience.

Remember, I’m here to help you make your practice thrive. If you would like to schedule a call to see how expert sales training can generate more revenue for your practice, please fill out this discovery questionnaire, and I will be happy to connect with you.

Terri Ross brings more than 20 years of sales and management experience to the field, having worked with leading-edge medical device companies such as Zeltiq, Medicis, EMD Serono, Merck Schering Plough and Indigo Medical, a surgical division of Johnson.

Ross’ vast knowledge and experience as a sales director managing upwards of $20M in revenue and successful teams has allowed her to become a renowned plastic surgery management consultant helping aesthetic practices thrive.

To optimize revenues and business performance, Ross’ practice management consulting services help physicians evaluate practice processes including, but not limited to, overall-operating efficiencies, staff skill assessment, customer service and operating efficiency strategies. The goal is to develop a comprehensive plan of action to improve productivity, quality, efficiency and return on investment.

Tags:  Business and Financials  Med Spa Trends  Terri Ross Consulting 

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Portrait of a Medical Spa Owner, Part 4: The Entrepreneur

Posted By Administration, Friday, December 6, 2019

christina imes

By Michael Meyer, Content Writer/Editor, American Med Spa Association

In the early days of the medical aesthetic business, it was more or less presumed that a medical spa would be owned by a “core doctor”—i.e. a plastic surgeon, facial plastic surgeon, otolaryngologist or cosmetic dermatologist. However, as the field has matured, the group of owners involved has become more and more diverse, ranging from doctors and nurses to entrepreneurs and even estheticians. In fact, it’s somewhat difficult to find a medical spa owned by a core doctor today—according to the American Med Spa Association’s 2019 Medical Spa State of the Industry Report, of all of the medical spas owned by medical professionals, only 20% owned by core doctors.

Today, it’s much more common to find doctors with backgrounds in family practice and emergency medicine owning medical spas—each of those specialties owns 23% of the practices owned by medical professionals, according to the report. Why is this? As you’ll read in this series, there seems to be a certain frustration with the way managed care has caused health care in the United States to evolve, and doctors, nurses and physician assistants are interested in providing more personalized care to their patients without having to deal with insurance and other payment issues.

However, doctors aren’t the only people involved in medical spa ownership—entrepreneurs are making their mark on the industry, as well. According to the report, 12% of medical spas owned by individuals and 24% of medical spas owned by groups are owned by entrepreneurs. It speaks to the broad appeal of the industry—and the amount of money people are making in it—that this many people from outside the traditional boundaries of it are willing to invest their money in medical aesthetics.

In this series, you will be introduced to four people—a doctor, a mid-level practitioner, an RN and an entrepreneur—who came into the medical spa industry from different backgrounds, but managed to find success because of their determination and love for the business. Each one is true success story and an example of how, in this industry, hard work and quality care are a winning combination.

The Entrepreneur

In 2014, shortly after Christina Imes sold the yoga and wellness clinic she owned in Chicago and moved out to the suburbs to be a full-time mom, her neighbor, a nurse, asked her if she’d consider buying a medical spa. Imes said that she hadn’t considered it, but would ask her stepfather, an ER doctor, if he was interested in getting involved in the medical aesthetics business.

“I asked him a couple days later; he said, ‘Absolutely not. I’m happy in the ER, making a lot of money. No,’” Imes says. “Seven months later, he calls me—this is totally how my stepdad is—and he says, ‘Hey, do you want to come with me this weekend to a laser show?’ And I’m like, what? What are you talking about? And he said, ‘You know what? I’ve kind of warmed up to that whole med spa idea. I’ve been thinking about that.’”

Imes’ stepfather ended up buying $350,000 worth of laser equipment that weekend, and in March 2015, he and Imes opened Rejuvenate Med Spa in Oak Brook, Illinois, just west of Chicago. Since it was founded, Rejuvenate has grown to offer a wide variety of treatments—more than enough to stand out from its competition—and features an experienced, talented team of providers that Imes has built through the years.

“I don’t do any of the treatments here,” Imes explains. “I can’t give a facial—I can’t do any of it. But I’m very good at connecting with people. I am incredibly good at forming relationships. My Allergan rep, my Galderma rep, my Alastin rep, they all love me and they would do anything for me. They come in here like once a week, just because we have so much fun here. I create a very fun culture to work for and be in.”

Imes values the freedom that being an entrepreneur in the medical aesthetic industry affords her, but also says that freedom can be a double-edged sword.

“I love that I can do anything I want, whenever I want. I can work wherever,” Imes says. “People are always like, ‘You’re so lucky—you get to go on vacation.’ I’m like, you know what? I am actually always working. I’m constantly worried and checking what’s going on and brainstorming. But that’s also what I love about it as well—the flexibility.”

And despite the financial risk involved in owning a medical spa, Imes believes the money currently being made in the aesthetics industry represents the tip of the iceberg.

“It’s an incredible time to be an entrepreneur in this industry,” she says. “At Allergan’s big meeting this year, someone said that we’re only touching 6% of the population in the aesthetics world. So what does that mean? There’s a ton of money to be made. Get going, people, because hopefully pretty soon the hedge funds will come in and buy us all up and we’ll all be millionaires.”

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

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

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How to Build Your Retail Program

Posted By Administration, Wednesday, December 4, 2019

retail products

By Terri Ross, Terri Ross Consulting

Incorporating retail products into your medical aesthetic practice can substantially strengthen your sales program, increase patient satisfaction, boost profitability and increase patient retention—all things that are vital to positive patient outcomes and a healthy practice.

The key to a successful retail program is focusing on products that compliment your treatments and services. Don’t try to be a one-stop-shop—carefully define which products will augment laser skin resurfacing, body contouring or skin tightening; research the options; have the reps come in and do an in-service; and ask to evaluate the products in addition to understanding the numbers and the support the company offers.

Once you’ve selected your vendors and the lines you want to carry (my recommendation is to choose no more than 3-4 SKUs), spend the time and resources necessary to train your staff and integrate the products into your personalized treatment plans and services. ABE—always be educating; if you’re not, or your team is not, stats show your patients will go to a department store or drugstore and buy products, and this obviously does not add value to your practice. After you’ve launched your retail program, follow up on the numbers and make adjustments as necessary to fine-tune and maximize your profitability.

Define Your Niche

Defining your niche is the most important step in building a successful retail program. Just as you seek to define your niche in the world of medical aesthetics through specialized treatments and services, you should seek to define your niche in the products you offer. They should be carefully tailored to your treatment plans. Don’t try to offer every product on the market—this will overwhelm your patients and will negatively impact your retail profitability. Why? Because patients will feel less like they are being offered a product to enhance their specialized treatment and more like they are being sold as many products as possible to increase their overall expenses. When you hone in on a specific retail line, you give patients the impression that you have carefully selected a product that will complement their services, leading to increased patient satisfaction and trust. Also, by focusing on a particular product line, you give your staff the opportunity to really learn the products, applications and relevant technology. Their ability to answer patient questions accurately and thoughtfully is critical and will further enhance the patient experience.

Research the Options

Conduct careful and thorough research of potential retail partners, their products and their current relationships with other offices. Once you’ve honed in on a specific type of product, take note of how many retailers offer that product and what types of products are typically offered in parallel. When choosing a vendor, prioritize product quality and partnership satisfaction. Product quality is crucial—the products you offer patients at your practice will reflect on the overall quality of your services, and your goal is to offer the best patient experience possible. Partnership satisfaction is equally as important. How easy is the vendor to work with? How frequently are they willing to deliver and replenish inventory? What are the potential markups on each product? Is there an opportunity to grow with the vendor and expand as demand increases? What educational support do they offer? Are there minimum quantities? Do they buy back? These are key details to know in advance of making any binding commitments with potential vendors. Read more about how to choose the right vendor in this article from Business.org. The vendor you choose should have a strong record of sales, customer reviews and partner relationships.

Evaluate the Numbers

Once you’ve identified a few vendors, you’ll want to dig deeper into the numbers. What types of products offer the highest profitability in the medical aesthetics market? What products offer patients the best outcomes, both in combination and stand-alone? What are the profit margins for some of the key products in each retail line you’ve targeted? What is a typical quarterly return on investment (ROI)? While some of these numbers are relatively straightforward to calculate, others may be more difficult to pinpoint and will require careful research.

A key part of your investigation should be based on patient satisfaction. After all, even if profitability on a product historically is high, you must first sell the product to make a profit. Research how well customers respond to specific products offered by each vendor and calculate an estimate of overall satisfaction. It also may be beneficial to reach out to other medical aesthetics practices that offer specific products and request a rough estimate of patient satisfaction. What percentage of patients who buy this product review it positively? Would they recommend it to a friend or colleague? How many times have they purchased the product over the last year? How many products does a patient purchase, on average? Some of these numbers may be provided by the vendor themselves, particularly if they are a more established entity. Though careful research takes time, it will be worth your investment to evaluate potential vendors by the numbers before making a commitment.

Manage Your Relationship with Vendors

Once you’ve identified the vendors you want to work with, your next step is to establish and maintain a healthy relationship with this business partner. First, make sure any contractual agreements signed are mutually beneficial. In most cases, they will be, because you have parallel goals—to satisfy patients and sell products. Because product prices can fluctuate with the market, you may want to request written confirmation that the price will not fluctuate more than a maximum allowable percentage, based on your evaluation of profitability. Maintaining transparency is the most important part of managing your relationship with vendors. Pass along feedback on their products from your patients, whether it be positive or negative. They may be able to expand a specific line or improve upon existing products to better satisfy patients in your office. The goal is to grow together. If your sales program is performing exceedingly well, they will be able to learn from you. If your sales have become stagnant, they may be able to offer tips on how to boost your marketing program and may even provide literature or product demonstrations to increase your success with the product. Seek to establish and maintain a positive, honest and mutually beneficial relationship with your vendor.

Integrate Products into Your Treatment Plans

Aside from product quality and vendor relations, how well you integrate product lines into your treatment plans and services is the most important part of a successful retail program. Create in-house literature to support the products you offer, such as pamphlets, posters and quarterly newsletters. Include the expert opinions of physicians, as well as positive feedback from patients who have already tried the products in your office. You want to give your patients the impression that these products will enhance their overall experience and the success of the treatments they receive. If a specific product has been shown to increase the effectiveness of a certain treatment or prolong the effects of a certain service, emphasize that in your marketing plan. In short, the product line you’ve chosen to sell should not stand alone in the back corner of your waiting area. Spotlight the products by featuring them in personalized treatment plans and monthly specials. A successfully integrated retail program will enhance the overall patient experience, resulting in increased patient satisfaction and increased profitability.

Train Your Staff

The success of your retail program is directly proportional to how well your staff is trained. As I discuss in my LAER model of staff training, it is critical that every member of your staff listens to and engages your patient population. They should be intimately familiar with the personalized treatment plans and services you offer. When you launch a retail program, invest in staff training. A well-trained staff will have a thorough understanding of your products, how they will be incorporated into your treatment plans and how they compare to similar products on the market. The goal is to inform your staff so they can inform your patients. When a patient asks about a specific product, they should receive a well-informed, positive response. This will not only help to increase trust in your staff, but also boost sales and lead to increased profitability.

Staff training is critical to almost every aspect of your medical aesthetic office. You invest in a beautiful office, you invest in expense equipment, and you invest in marketing to get new patients, but often internal training is overlooked or neglected. Training your team to convert calls into appointments, convert web leads and conduct an effective patient consultation require skills, confidence, knowledge and effective communication. Investing in training will yield the greatest ROI and build confidence for empowering your staff to help you grow your business and provide five-star customer service. To learn more about the processes and techniques that go into an effective sales program, contact me today and ask about my workshop on staff training.

Keep an Eye on the Numbers

Once you’ve built a retail program, you’ll want to review the numbers at least once per quarter. Calculate your overall ROI on retail sales and determine which products have the highest sales and profitability rates. Also, take note of which products patients purchase more than once. The most expensive products do not always offer the highest profit margins. Use this data to tailor your marketing program and staff training, if needed.

If a particular product isn’t selling well, execute a plan to incorporate it into a monthly special, or feature it in a specific service or treatment plan. Consider sending out a product survey in your quarterly newsletter to learn which products your current and prospective patients are most interested in; use this data to hone your inventory and boost sales. You also can report this data back to your vendors, so they can better plan and tailor their production and inventory delivery. If you want to sustain a successful retail program, you’ll need to keep a regular eye on the numbers and make the necessary adjustments in your protocols, processes, marketing and staff training.

Building and maintaining a successful retail program can substantially increase patient satisfaction and boost profitability. Have you maximized profitability in your office? Contact me to find out how you can implement a successful sales program in your office today.

Terri Ross brings more than 20 years of sales and management experience to the field, having worked with leading-edge medical device companies such as Zeltiq, Medicis, EMD Serono, Merck Schering Plough and Indigo Medical, a surgical division of Johnson.

Ross’ vast knowledge and experience as a sales director managing upwards of $20M in revenue and successful teams has allowed her to become a renowned plastic surgery management consultant helping aesthetic practices thrive.

To optimize revenues and business performance, Ross’ practice management consulting services help physicians evaluate practice processes including, but not limited to, overall-operating efficiencies, staff skill assessment, customer service and operating efficiency strategies. The goal is to develop a comprehensive plan of action to improve productivity, quality, efficiency and return on investment.

Tags:  Business and Financials  Med Spa Trends  Terri Ross Consulting 

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