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Knowing How Is Only Half the Battle

Posted By Administration, Tuesday, April 9, 2019

laser tattoo removal

By Patrick O’Brien, JD, legal coordinator for the American Med Spa Association

Training and education are valuable tools that can help you grow and develop your practice. However, before you spend a fortune on training, make sure you legally are able to perform the procedures. Education, skill and competency—these or similar terms are found throughout rules and regulations that govern medical and nursing practices, and they communicate the uncontroversial idea that a person should have some skill to safely perform a medical procedure on another person. But training and education alone won’t empower you to perform procedures—only a professional license or certification can do that.

This is the case with all professional licensure, from barbers to lawyers to nurses and doctors: Completing courses will give you the important skills you will need in your future profession. But it is the state-granted license that legally authorizes you to offer those professional services to others. You can quit reading this blog right now (please don’t) and go attend a barbering program to learn how to give the smoothest shaves known to man, but you will be breaking the law if you start practicing before getting a barber’s license from your state’s barbering board.

Laser or injection training can be invaluable, but it is useless to a medical assistant (MA) or nurse in a state that prohibits a physician from delegating injections to nurses or unlicensed individuals. As is often the case, “who can do what” varies significantly from state to state. (AmSpa Members can click here to check their state legal summary.) For example, in Texas, an MA with proper training and supervision is able to perform Botox injections. However, in California, MAs may not perform injections, nor may license vocational nurses (LVN)—only registered nurses (RN) and higher may perform those procedures there. In Florida, the nursing board has consistently denied RNs from including Botox injections in their scope of practice. Similarly, the Rhode Island Board of Nurse Registration and Nursing Education holds the stance that RNs and LVNs are not able to inject Botox or other fillers. AmSpa advises that as a best practice, medical aesthetic practices should only utilize RNs and higher for cosmetic injections, even if your state permits others to perform the procedures. But whatever you choose to do, it isn’t a good idea to spend time and money training up an employee who legally can’t use the training.

Now, the professional license that grants this authority doesn’t necessarily need to be your own. Many states allow appropriately trained people to perform procedures under the delegation and supervision of a licensed professional. In these cases, showing documentation of the appropriate training and skill is critical for compliant delegation of the procedure.

Laser hair removal and tattoo removal technician “certifications” are other common areas where this crops up. Most states do not recognize such certifications and restrict the use of lasers only to individuals with medical or nursing licenses. Even in states with laser technician licenses, the person must complete a particular state-approved education course and then apply for licensure with the state; simply taking any training course won’t do. So before signing up for training, find out how your state treats laser technicians and if that course meets state requirements.

Investing in training, education and skill development is crucial to having a successful medical aesthetic practice. But because states have different rules on professional scopes of practice, supervision and delegation, it is important to make sure your money is wisely spent. You must be sure that your state’s licensing boards include the new procedure in your scope of practice.

Tags:  Med Spa Employee Types  Med Spa Law  Med Spa Trends 

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The Pros & Cons of Membership Programs for Medical Spas

Posted By Administration, Monday, April 8, 2019

business growth

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

In 2019, it seems that people have subscriptions to everything. When they shop, they go to Costco or use their Amazon Prime membership. When they eat, they prepare a meal kit that was shipped to them by a Blue Apron or HelloFresh. When they want entertainment, they watch movies or television from Netflix or Hulu.

Now medical spas are getting in on the act by offering patients subscriptions for their services, and while practices are still feeling their way around the specifics of what can make a successful membership program, the experiences of early adopters suggest that the subscription model has legs, as it can build loyalty for your practice and provide the customer with consistent results.

“You want your patients to come back, on average, 3.5 times a year,” said Dr. A. Jay Burns, senior partner at Dallas Plastic Surgery Institute and board member of HintMD, a cloud-based patient engagement and commerce platform. “When we go into every practice, we will pull their data, and the average number of visits per year is 1.44, not 3.5. If they join the subscription model, they come 2.9 times a year, they spend 35% more—so it’s good for a run rate—and they come back more loyal, so it’s good for the doctor.”

There are two major types of membership models: static and dynamic. Static models typically feature the client paying a monthly fee for either a certain number of treatments per month or a percentage off of those treatments. Dynamic models are much more complex and are tailored around a patient’s usage patterns. Companies such as HintMD are working to develop dynamic models for their clients, but early results are extremely encouraging.

Regardless of their type, membership programs provide customers with cost benefits beyond what they experience as a normal patient.

“Something I always stress whenever anyone sets up a membership program is value for the customer,” said Brandon H. Robinson, founder of Skin Body Soul Spa of Ankeny and West Des Moines, Iowa. “If your medical spa sells Botox at $14 per unit, then your membership should give your members Botox at a value far exceeding the monthly fee, based on the average number of units that member would utilize. It needs to be substantial. Another example is a ‘Kiss Club’ for perfect lips. The membership is $19 per month, and the filler is over $200 off. This makes the membership valuable for that client and will make them want to come back for more filler every nine months.”

While this might make it seem that medical aesthetics practices might lose money on these programs, the loyalty these memberships build more than pays for the initial losses over the life of the program.

“We pulled all of our data for the last [American Society of Aesthetic Plastic Surgeons (ASAPS)] meeting, and at that time in April [2018]—I had started in September [2017]—I had 377 members,” Burns said. “The average increase in run rate, or spend, per patient was $1,196. My patients went from coming 1.7 times a year to 3.03 times a year. They spent 35% more per visit. It wasn’t just the run rate, either. I had a 33% increase rate in people using filler who had never used filler, so they get used to their subscription, and then they make an additional purchase because they’re comfortable with that level.”

If you feel your patient base could be more engaged with your practice and you have the logistical infrastructure to handle it, a membership program might prove very beneficial.

Tags:  Business and Financials  Med Spa Trends 

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Legislative Update: PAs & APRNs Gain Ground in First Quarter of 2019

Posted By Administration, Friday, April 5, 2019

legislature

By Patrick O’Brien, JD, legal coordinator for the American Med Spa Association

As the first quarter of 2019 draw to a close, so does a flurry of new bills being filed in legislative bodies across the country, and a good number of these bills may affect how medical spas operate. Additional bills will continue to trickle in, but in many states, congressional and senate sessions adjourn in late spring or early summer, so this is by far the busiest season of the year for new legislation. Tens of thousands of bills have been filed, and some have the potential to affect the medical aesthetic industry. If you are an AmSpa Plus Member, you may have received updates about legislation of interest in your state. Here is a short recap of the bills we’ve seen so far and some possible trends that may be emerging.

A move towards independent or less restrictive practice for advance practice registered nurses (APRNs) and physician assistants (PAs) is by far the most prominent development we have observed. These bills run the gamut from allowing physicians to oversee more PAs and APRNs to allowing PAs and APRNs to practice without any formal agreement or supervisory relationship at all. If these bills pass, they will change the landscape of medical practice. Once health professionals are able to practice on their own, it will lead to an explosion of independent practices and clinics, and that almost certainly will include practices that focus on aesthetic procedures. We’ll provide a deeper dive into these bills in a future article.

Next, we have not so much a trend, but rather a class of bills that would regulate aspects of medical practice or procedures at medical spas. For example, AB 821 and SB 2834 in New York would provide a regulation and licensing regime for the practice of laser hair removal, a practice that currently is unregulated in the state. Both Colorado and Oregon have introduced bills to regulate smoke that results from laser procedures; these laws currently would only affect hospitals and ambulatory surgical centers, but could easily be expanded to include all laser procedure practices. In Kansas, SB 120 would allow corporations to practice medicine. In Arizona, SB 1287 would allow laser technicians to perform procedures without medical supervision—instead, they only would be overseen by a laser safety officer. And in Florida, SB 732 originally would have brought significantly more regulations to medical spas but has since been amended to be less onerous. Most recently, in Texas, SB 2366—which we have covered in previous articles and a webinar—would greatly restrict who could perform procedures in a medical spa.

Overall, a mix of beneficial, neutral and restrictive bills has been introduced this year. However, the restrictive bills would prove far more damaging than the “good” bills are beneficial if they pass. All new laws will result in a period of compliance and adaptation. Good bills may let medical aesthetic professionals do things they couldn’t do before or streamline processes. Restrictive bills, on the other hand, may impose entirely new requirements or make some of current practices illegal or uneconomical. It could only take a single bill passing to disrupt the whole industry—successful bills often spread to other states, as legislators look to other states for inspiration for their efforts, so a successful push for a restrictive law in the name of “public safety” may continue in other states. That is why it is critical, now more than ever, to come together as an industry to help determine the rules and regulations that affect this industry. The aesthetic medical field is growing larger every year, and every year will bring more notice from lawmakers.

To receive updates whenever new laws are introduced in your state, become an AmSpa Member—click here to learn more. There is no better way to keep track of the legal matters that affect your medical aesthetic practice.

Tags:  Med Spa Employee Types  Med Spa Law  Med Spa Trends 

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Do You Believe Strong Leadership Can Affect Your Medical Spa’s Profitability?

Posted By Administration, Thursday, April 4, 2019

money

By Tim Sawyer, president & co-founder of Crystal Clear Digital Marketing

Does anyone in the med spa industry think strong leadership can affect profitability?

If you had asked me this question a week ago, I would have replied with a resounding, “Yes, of course.” After my experience this past weekend, I’m not so sure. In fact, I am more convinced that the basic concept of leadership in this community is not just undervalued, but almost deemed irrelevant. While I have given many talks on the subject at dozens of shows—including The Medical Spa Show, Vegas Cosmetic Surgery, A4M and The Aesthetic Show, to name a few—my experience this past weekend cemented my belief that now more than ever, we need to keep this topic in the forefront of our discussion through our lectures, blog posts, podcasts and national meetings.

Why? As the co-founder of two separate marketing and software businesses appearing in the Inc. 500 list of fastest-growing privately held companies, I am a firm believer in the very direct link between strong leadership and profitability. As a lifelong entrepreneur, I am constantly bombarded with books, seminars, podcasts and events touting the value and strategies for effective modern leadership. I get it. No leadership equals no sustainable growth. As a former business student, it’s one of those, “Duh, obvious,” things. For surgeons and med spa owners who have spent their lives focused on anatomy, clinical outcomes and patient safety—not so much. And I am not suggesting there is a lack of desire to be stronger leaders; I am suggesting there is diminished value and a lack of understanding.

Back to this past weekend. As I walked onstage to deliver my best 15-minute lecture on leadership, about 40% of the 150 attendees in the room—mostly surgeons—took the opportunity to use this time to take a break, get coffee and mingle. In other words, almost half of the attendees viewed this topic as somewhat irrelevant.

At this point, I know what you’re thinking: “Tim is a sore loser because people walked out of his talk.” Fair enough, and there may be some truth to that. However, it is more concerning to me that these leaders lacked the appreciation of the important role they play in their practices’ success outside of the 12-hour days spent doing treatments and procedures. In fact, I even asked the question, “How many of you want to spend the rest of your lives working 12-hour days with your primary (only) source of revenue coming from your physical labor?” Of course, that drew some intense stares, intentionally. Because this is what is at stake for many of the people in the room.

Entrepreneurs understand that you can’t scale a business if the majority of the revenue comes from the owner’s direct labor. To further explore this concept, I recommend you read The E-Myth; this would be a great investment of your time if this topic is remotely interesting to you. To get scale in your business, surrounding yourself with great people who can also make significant contributions to the business in terms of revenue is the number-one priority. The most successful entrepreneurs know they have done their job well when their businesses can function on its own with little or no direct involvement or supervision from the founders. Many of these strong leaders begin their business with the end in mind. They ask the question, “What do I need to do in this circumstance to create an entity that is either investable by others or saleable to another entity?” More simply put, if I bust my butt for 10 years, how do I exit and get paid? This is every entrepreneur’s dream.

That said, the rules are a little different in elective medicine, as the skills and training of the surgeon or provider essentially represent 100% of the value of the practice. And here’s the billion-dollar question: Is the current state a situation that can never be changed, or is there perhaps another way of looking at the role of the modern entrepreneurial surgeon leader?

I think part of the problem lies in the way we talk about, celebrate and showcase only those practices experiencing hypergrowth (for a variety of reasons, and I include myself in this group). We create this unrealistic expectation that anyone who applies this model or buys that device will immediately ascend to the elective medical elite, which is at best a bunch of B.S. When we do this, we disenfranchise the 90% of practices and med spas that could benefit the most from applying a few basic leadership principles, even if they only have a few employees.

Here are a few principles you can apply right away to increase the value of your practice and set it on a path to realistic sustainable growth. First, ask yourself, “Do I believe there is a correlation between effective leadership and increased profitability?” If the answer is no, sorry about the time you wasted reading this, and hopefully you will find my next article more valuable.

When I pose this question to live audiences, I always get a lukewarm response. But let’s assume we agree that leadership could make a 10% difference in the profit of your clinic. So, step one is to assign a dollar value to the 10%. Now, the next logical step (if we agree) is to first be realistic. Do you spend 10% of your time working on your leadership skills and strategic thinking? If the answer is no, we have already diagnosed a major problem, which is great and free.

Next, how can you put leadership to work in a small elective medical practice?

  • Lead yourself. Be mindful of the words you use, be respectful to employees and manage to your principles. Ask yourself, “What are my most important guiding principles that I will not compromise?” Are you walking that out daily?
  • Share skills. Employee turnover hurts when you have invested time and energy into training. Get over it. Things could be worse, like if you don’t train them and they never leave… yikes. Don’t forget—if you’re not training someone up to replace you, you will never be replaced. (Cue the surgeon-working-in-a-coffin music.)
  • Train and practice together. It’s a team and you’re the leader. Lead. This requires time. If you make it a priority and then a habit, you will improve the culture in your practice.
  • Hold your team accountable.
  • Have a plan, set goals and manage to the plan. You can’t manage what you can’t measure.
  • Share your vision and passion often. People love to feel like they are a part of something special.
  • Incentivize the right behaviors and address the wrong ones.
  • Be inspired. These simple universal truths can apply to any business of any size. You don’t need more consultants, more devices or more marketing. You just need some time to reflect in front of the mirror. Look past the outside and the comparative narrative and focus on the incredible leader inside of you. This is truly one of those scenarios where size doesn’t matter. Crystal Clear started with three employees, and now we have 80. Remember, if we agree that improved leadership skills could make just a 10% difference in the profitability of the business, that’s 10% more time and money you have to do the things that mean the most.

In addition to a world-class digital marketing and software platform, Crystal Clear offers a full-service consulting team to help you get the most out of your people, your processes and the tools you use to grow your clinic in 2019 and beyond. We get it. You can’t do everything by yourself. Fortunately, you don’t have to. Our world-class training team is here to help. They have been in your shoes in real life, long before becoming trainers. To learn more about Crystal Clear, visit www.crystalcleardm.com or call 888.611.8279.

Tags:  Business and Financials  Guest Post  Med Spa Ownership  Med Spa Trends 

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Join AmSpa at the L.A. Medical Spa & Aesthetic Boot Camp

Posted By Administration, Wednesday, April 3, 2019

la boot camp

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

We are just a few days away from AmSpa’s Los Angeles Medical Spa & Aesthetic Boot Camp at the Sofitel Los Angeles at Beverly Hills, 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:

Friday, April 5

Prior to the Boot Camp, AmSpa will present a special after-hours tour of the Lasky Aesthetics & Laser Center, one of the most successful medical spas in the United States. This event, which is sponsored by BTL Aesthetics, takes place from 5:30 – 7:30 p.m. PST and will show attendees how this well-appointed practice makes its clients comfortable while providing a high standard of service. Space for this exciting event is limited, so click here to register.

Saturday, April 6

The Boot Camp begins at 8 a.m. with a 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 Toni Lee Roldan-Ortiz (Environ Skincare) and Tim Sawyer (Crystal Clear Digital Marketing)—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 Michael Byrd (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 (Lasky Aesthetics)—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, April 7

Once again, the Boot Camp begins at 8 a.m. with a 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 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 (Lasky Aesthetics)—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 L.A. Medical Spa Boot Camp to check out the latest and greatest from the following companies:

We hope you can join us in Los Angeles 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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Apply to Join AmSpa’s Mastermind Group Today

Posted By Administration, Thursday, March 28, 2019

mastermind group

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

Shortly before The Medical Spa Show 2019, I posted in this space about the value and utility of mastermind groups—groups of like-minded business leaders who congregate occasionally to share ideas and encourage each other to address their issues with an entrepreneurial mindset. At The Medical Spa Show, AmSpa announced the Aesthetic Mastermind groups, which provide the benefits of a mastermind experience while addressing the specific issues facing medical spa owners and operators.

The Aesthetic Mastermind is not a standard mastermind group—it is custom-designed for medical aesthetic practice owners. Instead of having one large group, the Aesthetic Mastermind will be split into smaller groups of up to five people; the membership is based on factors such as revenue, location and business stage. (Direct competitors will be added to separate groups.) Each group will challenge owners to not only maintain sensible, realistic business plans based on reliable metrics, but also expand their visions in order to become an even more effective entrepreneur.

Each group begins with a three-day, two-night “Vision Quest” retreat. This gathering will feature an experienced business coach and is designed to help group members step back from their day-to-day businesses and create a rapport with their fellow owners, share their business experiences and learn about the industry from a number of different perspectives. After the Vision Quest, the group will meet once a month, 11 times per year, via teleconference; each meeting will include the business coach to keep the group on track and “hot seat” sessions for each member. Before the actual meeting, a guest from the industry will speak about his or her experience and field questions from group members.

Watch business coach Wendy Collier discuss the Aesthetic Mastermind in this brief video.

This package costs $7,995 for the entire year, though AmSpa Members will receive an additional $500 off. Importantly, the Vision Quest’s lodging, meals and program materials are included in this cost; airfare is not included, but AmSpa can provide booking assistance for your flights.

Prospective group members must complete an application so that they are placed in groups that can effectively address their professional needs. Click here to fill out the application.

May 1 is the deadline for registration for the first session of the Aesthetic Mastermind, so fill out your application today and become a part of this exciting project. You won’t find a better opportunity to learn about the medical aesthetic industry from your peers in a format that encourages entrepreneurship, so act now.

Tags:  Business and Financials  Med Spa Trends  The Medical Spa Show 2019 

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Capturing Your Captive Audience

Posted By Administration, Tuesday, March 26, 2019

computer software

By Tyler Terry, vice president of sales, TouchMD

Medical aesthetic practices spend a lot of their money and resources on marketing to attract patients to their practice, as well as on a savvy website to sell patients on why to choose them over their competition. All this results in a patient scheduling a consult. What happens next is where most practices “strike out looking.”

I've been in more than 400 cosmetic practices spanning more than 40 states across the country, and the problem is always the same: Patients—your captive audience—are either on their smartphones or reading magazines in both the waiting and consultation rooms. They are literally waiting to be sold on whatever product, procedure and/or service that attracted them to your office in the first place. Wouldn't their time be better spent learning about that product, procedure or service? This surely would prepare them to ask better questions and participate in a more efficient and effective consult. Sure, most patients are already sold on Botox, but why wouldn't you give them the opportunity to engage with and learn about the new laser you just purchased or any specials or events that are coming up?

Brag books and brochures were sufficient back in the early 2000s, but it's time to retire them both and invest in technology that will enhance the patient experience and showcase the products, procedures and services that your practice offers. You can start by adding a waiting room solution consisting of either a patient-friendly app for patients to download and watch videos and look at before-and-after pictures, a waiting room loop system to stream educational and promotional content, and/or a tablet with which patients can interact. The same concept applies to your consult room—take advantage of any downtime the patient might have while he or she is waiting.

Here are a few ways to implement captive audience experiences:

  • In-house marketing: Utilize promotional videos and images to educate patients about services you offer.
  • Visual consultation: Everyone is a visual learner—combine videos, images, before-and-after galleries, and educational content into a patient education platform.
  • Patient education: Allow the patients the opportunity to relive the consultation at home using software. Your patients can review drawings, signed consents, operational instructions and custom educational videos.

The captive audience experience is too often forgotten or left out of the equation. It's an easy fix with the right technology.

TouchMD is a visual consultation, marketing and imaging software utilizing touch-screen technology that enhances the patient experience with proven revenue generation. To learn more about TouchMD or request a demo, please email tyler@touchmd.com.

Tags:  Business and Financials  Guest Post  Med Spa Trends 

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Why a Risk Assessment Is Critical for Your Practice

Posted By Administration, Monday, March 25, 2019

checklist risk assessment

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

For a medical aesthetics practice to best serve its patients and maintain a viable business, it needs to understand the ways in which it may be compromising patient safety or otherwise violating the law. Therefore, if your practice has not undergone a thorough risk assessment recently, it should do so as soon as possible.

“A risk assessment establishes the baseline of where a practice is from a compliance perspective and helps identify risk areas that need to be fixed,” said Michael Byrd, partner at ByrdAdatto, a Dallas-based law firm that specializes in business and health care law. “Let’s get a baseline of where you are so we can figure out what needs to happen.”

A properly conducted risk assessment will cover both business and medical concerns, and it will identify areas where the practice is compliant, areas where the practice needs to be mindful to remain in compliance, and areas where the practice is not compliant that need to be corrected.

“A risk assessment is essentially a blend of legal and clinical evaluation of compliance,” Byrd said. “From a legal perspective, we’re making sure that the ownership is set up in a compliant way, and then that the policies and procedures are set up in a compliant manner. Clinically, do they have appropriate policies and procedures as it relates to treatment, delegation and supervision, OSHA, telemedicine, HIPAA, etc.? A lot of times when we’re doing a risk assessment, we have a lawyer look at it, plus a clinical person, and sometimes even an IT person helping to evaluate if there’s a cyber-security risk from a HIPAA perspective.”

To begin the process of conducting a risk assessment, a practice should engage with a health care law firm that has a great deal of experience conducting such investigations. Additionally, stakeholders need to be prepared to be as open as possible so evaluators can get a clear idea of what is going on at the practice.

“We’ll identify the ownership documents to send us, and then if it’s a full risk assessment, we’ll involve a clinical consultant who’ll look at it from a clinical perspective, and then we’ll work together to make sure that the policies and procedures navigate that particular state’s laws,” Byrd said. “There’s a big element of knowing who’s doing the initial exams and who can be delegated to provide the treatment, and even by procedure, there are certain procedures that are only appropriate for certain providers. That’s a lot of the back and forth we’ll have with the consultant.”

If this sounds like a major undertaking, well… it is. However, it is assuredly better to know the areas in which your practice falls short of compliance and what can be done to correct that rather than remain ignorant and be surprised when an investigation uncovers violations.

“It can be overwhelming, but if it can be integrated as part of the culture of the business, our clients are very successful,” Byrd said. “A risk assessment is really just a starting point, but then you have a culture of following these procedures and evaluating as laws change, technology and procedures change, and your personnel changes, evolving your compliance plan with that. The clients that adopt that as part of the culture of their business have been really successful in minimizing that risk.”

Byrd says that after his firm conducts a risk assessment, it typically will check in with clients every three months to make sure that everything is on track. If a firm does not offer periodic check-ins, he recommends repeating the risk assessment process annually.

Tags:  Business and Financials  Compliance is Cool  Med Spa Law  Med Spa Ownership  Med Spa Trends 

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What Is a Mastermind Group?

Posted By Administration, Tuesday, February 5, 2019

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

In business, every idea is valuable. Internal brainstorming can only offer you so much, since it may reflect your company’s corporate culture in ways that limit its efficacy. However, from day-to-day, you are likely far too busy managing the operations of your business to seek out and consider ideas from outside your immediate circle. Therefore, it is important for business leaders to seek out ways to interact with peers from around the world in order to help develop new ideas and keep their companies on the cutting edge of their markets.

Participation in mastermind groups is a very successful way business leaders develop new and exciting ideas. Initially named by noted self-help author Napoleon Hill in 1925, this concept involves a group of entrepreneurs who get together to give each other support, talk about their business, knock each other down and build each other up, and make themselves available as resources. This idea isn’t exactly new—for example, Benjamin Franklin founded a group called the Junto in 1727 that was designed to provide mutual improvement for its members. Franklin was inspired by numerous other similar groups throughout history. Nowadays, these groups convene once a month, usually as a teleconference, and during the meetings, each person will be given a limited amount of time on the “hot seat,” when his or her ideas are reviewed and evaluated.

However, the structures of such meetings and even of the groups themselves are flexible and can be amended to better reflect the circumstances in which they exist. In the aesthetics industry, for example, many resources are available to practice owners and operators, but much of the information out there is very topical and may have limited utility for many members of the group. Therefore, a mastermind group based in the medical aesthetics industry might hypothetically benefit from a certain amount of curation—the groups should be kept small and grouped according to factors such as revenue, location, business cycle, personality, etc. Because the groups are small, the members can go into greater depth during their “hot seat” segments and learn more about issues endemic to their particular section of the industry. What’s more, these groups should also consider having a business coach in order to help group members get into an entrepreneurial mindset to better build their companies.

People who have participated in mastermind groups typically give the process positive evaluations. When knowledge is coordinated in such a way, it provides tangible benefits to those who participate, and helps create accountability that often carries over to members’ standard business. These groups can also help members look at problems and develop solutions in ways they wouldn’t have otherwise, and encourage participants to reach for levels of success that they may previously have thought unobtainable.

If you find the idea of mastermind groups intriguing or potentially beneficial for your business, be sure to keep an eye on the news that comes out following The Medical Spa Show 2019, which takes place at the Aria Resort & Casino in Las Vegas, February 8 – 10. 

Tags:  Med Spa Ownership  Med Spa Trends 

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Should Your Med Spa Offer Aesthetician Services?

Posted By Administration, Tuesday, January 29, 2019

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

While medical spa services command higher prices than traditional spa treatments, medical spa owners and operators shouldn’t overlook aesthetician services. These can be lucrative opportunities for added services for your patients, increasing both retention and profitability of your med spa practice.

What Can Aestheticians Do For You?

According to the American Med Spa Association’s 2017 Medical Spa State of the Industry Report, aesthetician services were one of the leading revenue-generators in medical spas. These treatments can include facials, aesthetician-grade chemical peels, and waxing, to name a few. This category also includes Hydrafacials, which is one of the fastest-growing treatments in medical spas regardless of practitioner type.

Some Caveats

In many states, treatments such as microneedling and dermaplaning are considered to be the practice of medicine. Because of this, they should only be done by a licensed medical professional. However, there are some situations in which a person holding an aesthetician license may perform these procedures.


Microblading is also a treatment that individuals holding aesthetician licenses perform in many states. State laws can vary regarding this procedure, but it is often categorized as permanent makeup and, with some additional training, these practitioners can often offer this service in medical spas.

Contact an attorney familiar with medical aesthetic laws in your state for more information on microneedling, dermaplaning, or microblading. (AmSpa members can take advantage of their annual complimentary compliance consult with the law firm of ByrdAdatto, or check their medical aesthetic state legal summary.)

Legal Requirements
To add these aesthetician services to your medical spa, first be sure that the practitioners you hire are properly licensed to perform these treatments. This should be of paramount importance for all of your service providers, whether offering beauty services or medical treatments. In-depth training and proper licensure ensures that your patients are getting the best possible services and results, and also protects your staff and business against fines and other punishments from regulatory agencies. Your business will also need to obtain an establishment license for these procedures, and that license must be displayed in your facility during business hours. Additionally, be sure to double check with your insurance-provider to make sure you are covered to offer these additional treatments. Assuming that your other business housekeeping is in order (LLC, tax ID, etc.), you should now be set to offer another tier of services to your clients.

For more information on medical spa legal best-practices attend The Medical Spa Show 2019 or one of AmSpa’s Medical Spa & Aesthetic Boot Camps.

Tags:  Med Spa Law  Med Spa Trends  The Medical Spa Show 2019 

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