Laser Treatment MD

If you're a plastic surgeon or dermatologist starting a medical spa, skin clinic, or laser center, you'll need to have all of your ducks in a row.

Here are 9 tips to keep your medspa in the black, and your laser treatments and Botox appointments full.

1. Have sufficient funds to kee your Medical Spa open for months.
Don’t even think about opening a Medical Spa unless you have the capital needed to bring it through the startup and first year of operation. Invariably, your planning will not deal with all of the unforeseen issues that can occur in the MedSpa industry. From regulatory compliance changes and training costs, to increased marketing costs. Under-capitalization is a leading indicator of business failure. You should considering a combination of various financing strategies from leasing to working capital.

2. Talk with other doctors who have successful, operating Medical Spas
Ask them what they would do the same, and what they would do differently. We are starting to see some established Medical Spas out there, try and learn from their experiences and best practices.

3. Join associations that help new Medical Spas succeed
They are a great source of experienced MedSpa owners, who have already gone through what you will. In addition, they often have members who have specialized in the MedSpa industry, including: business planning, marketing, design, dealing with regulatory issues, insurance and finance. The International Medical Spa Association even has a mentorship program that is available for new MedSpa owners. It is invaluable to chat with someone across the country who has had the same problems you may have, especially if you know they are not a local competitor!

4. Know your strengths and weaknesses
No one is strong in all areas, you may be an expert in age management medicine, but you may be weak on the business and marketing side. That’s fine, but you are going to need to identify the areas where you are weak and compensate. Not all areas require a permanent, full-time employee, you may consider hiring a consultant who has the necessary experience.

5. Watch your medical spa's monthly expenses
Especially during the startup phase of a MedSpa, it can be easy to see the glamour of having marble flooring, but is it really necessary? You may be better off adding another hair removal treatment room, which will generate income. Remember the old adage: “it will take twice as long and cost twice as much as you anticipated.”

6. Determine what need your Medical Spa meets.
As with any successful business, you need to meet a consumer demand. With 11,500 people joining the over 50 crowd every day, you have a great potential market. But you need to make sure you are where they can be found (i.e. medical centers, shopping centers, established communities).

7. Know your laser clinic's monthly cash flow.
You may think financial statements are only for accountants to understand, but you need to be able to read some key financial statements. Including the cash flow statement, this lets you know where the money is coming from and where it is going. You must always know your current cash flow situation, if you cannot pay your bills, you are effectively out of business. Botox, Restylane, Juvederm, IPL, cosmetic lasers... they're all expensive.

8. Open your medical spa because you want to.
Starting a MedSpa is going to consume two things: time and money. The profit potential of a MedSpa is huge, but if you are not doing what you really enjoy, it will show on your bottom-line! As you will probably be spending more time and money than you originally planned, you need to make sure operating a Medical Spa is what you really want to do.

9. Don’t hire family and friends
They may be able to provide you with valuable assistance during the startup phase, but they most likely will not be able to get you to that next level. This is where having an experienced MedSpa director is very important. Not only are they going to hire and train your employees, but they also will be responsible for the day-to-day operations of the MedSpa. Hiring a competent MedSpa Director can allow you to run your MedSpa as a stand alone profit center; one that makes money whether you are there or not.

Is click fraud costing your skin clinic or medical spa and driving up your prices? If you’re one of the tens of thousands of cosmetic medical practices, laser clinics and med spas advertising online with Google Adwords or Yahoo, don’t be surprised to find that at least some of the money you’re paying every month is sucked out of your marketing fund by click fraud.

The practice of “click fraud” began in the early days of the Internet’s popularity with software programs that automatically surfed Web sites to increase traffic figures. This led companies to develop policing technologies touted as antidotes to the problem. (Some marketing executives estimate that up to 20 percent of fees in certain advertising categories continue to be based on nonexistent consumers in today’s search industry.)

Don’t think it’s already happening to your skin clinic, med spa or laser clinic? Here’s a recent quote from Michael Caruso, CEO of click fraud services vendor ClickFacts in an interview:

“In particularly fraud prone verticals such as finance, class action lawsuits and medical, we see click fraud rates in the 30-45 percent range. These are all categories that see high keyword pricing in the auction model. That makes them particularly tasty for click fraud artists. “If you can make more money from the dark side than the light side of search, there are plenty of people who will take advantage. Plus, it’s not even technically illegal yet.”

There are two main ways that your skin clinics and medical spas marketing budget is being drained by click fraud:

First, your medical spas and laser clinics competitors who see your ad are simply clicking on it, draining your marketing budget and costing you advertising dollars. Second, fraudsters set up ‘affiliate sites’ that run skin clinics ads where they are clicked on by bots or employees. (These sites are the most damaging since you’re paying for every click without any return at all. Click fraud around skin clinics, med spas or laser clinics can be very lucrative since dermatology or plastic surgery clinics are becoming such a competitive market and the payment per click can be as high as $4-6.)

Unfortunately, to keep your medical spas budget safe you have very few tools. (Google just gave advertisers $90 million to compensate for click fraud as the result of a class action suit but you can bet they’re not that Google’s not interested in your individual account. Especially since they’re making money from click fraud when your ads are clicked on.)

Start by limiting your skin clinics exposure. If your dermatology or plastic surgery clinic is still running an Adwords or Yahoo campaign, they allow you to limit the maximum amount you spend in a day. Take advantage of this feature by limiting your maximum cost to what you can afford to spend. You can also look for the tracks of click fraud by examining the reports you might have available to you. Multiple clicks coming from the same IP address are a sure sign of fraud.

(Malaysia has become such a haven for click fraud around medspas and IPL laser treatments.)

If you’re going to run ppc ads, protect your skin clinic, med spa or laser clinic. You can be sure that you’re the only one trying to.

When it comes to the cosmetic laser field, we can sometimes feel adrift at sea with little more than a compass and the stars to guide us. We're either doing laser treatments according to our laser manufacturers' guidelines, which are conservative and often inadequate to produce excellent clinical results. Or we're trying new laser treatment settings without the benefit of knowing what other doctors have tried.

If we discover something important, we have no forum to discuss this information with our colleagues. Many of us experiment in our clinics, but we don't share our problems, successes, failures and thought processes with anyone. As a result, we make little progress because we don't benefit from others' advances and insights.

This has flattened our learning curves. Innovation-if and when it comes-is slow. This needs to change. And it begins with doctors simply talking to each other. Participating in Internet-based user groups is one of the easiest ways to do this. Such a forum allows us to share our ideas, experiences and opinions so that we can learn from each other.

The collective intellectual capacity among us, as cosmetic laser providers, is tremendous. If we all worked together, we would discover and share treatment protocols that are more effective and less painful, and produce fewer complications. We would discover better ways to reduce and treat complications when they do arise. Our field would become stronger, and we'd become better practitioners.

Unfortunately, cosmetic laser practitioners have little clinical exchange compared to other specialists, such as cardiologists. These physicians have thorough initial training with a three-year residency and a one- to three-year fellowship. They have mentors, classmates and large practice groups so colleagues can talk to one another. Publications and newsletters keep cardiologists abreast of developments in the field. They stay in touch with their academic training centers, attend meetings and are members of professional associations. In short, they communicate and connect.

What Do We As Cosmetic Physicians Have?

Contrast this to cosmetic laser medicine. Unlike cardiologists, we don't have highly developed professional networks. Nor do we have the formal advanced training. Our main professional association is the American Society for Laser Medicine and Surgery (ASLMS), which hosts a yearly meeting and produces a monthly journal. The ASLMS is a great professional society, but it doesn't serve all of our needs.

Another source of education is the laser companies, which provide clinical training, Webinars and Web sites. The trainers teach the basics, but they're limited by company protocols, which are reviewed by corporate attorneys, and designed to prevent problems rather than to get excellent clinical results.

The laser companies' Webinars are lectures designed to sell lasers, not provide advanced training. Luminaries are paid to do the Webinars, but there's no access to them for detailed follow-up questioning.

What's more, we have to sit at our computers for two hours listening to basic, redundant information to glean one useful, advanced clinical tip. The content of the Webinars are not made available in any other format?-written summary, cassette tapes or CDs-so it's not widely accessed.

If we go to aesthetic laser manufacturers company Web sites for resources, the information is basic and limited. The marketing material, of course, is fresh and current, but the clinical material is dated and sparse.

Other resources are trade publications that keep us abreast of issues in aesthetic medicine. But these magazines don't get into the details of treatment protocols and how to get the best results.

Finally, we have independent blogs, such as MedicalSpaMD.com. This blog, in my opinion, is one of the best ways to get information and find out what other providers are thinking and doing. Some doctors who blog on MedicalSpaMD are experienced users who share their expertise and opinions?, all of which are extremely helpful. But the drawback is too few physicians blog about specific topics.

Several Solutions

Working with laser companies is one way to combat this problem. Laser companies can be particularly valuable in the clinical exchange arena. These companies have the resources to start, support and nurture this activity. They know who their users are, they can enlist the knowledge of luminaries, and they have company doctors and scientists who understand the clinical applications of their laser devices. It's important to mix all of these elements in the proper environment to spur the best advances and innovations from these groups.

M. Christine Lee, MD, MPH, writes that upstanding laser companies "put more money and resources into product development than in marketing and advertising. They have a corporate philosophy that's based on building relationships.investing in new technology and research.[and] nurturing forward vision."¹

It seems almost foolish not to work with cosmetic laser companies, especially since many providers are getting clinical results that are suboptimal. Furthermore, many patients are experiencing complications that can be avoided. (See RealSelf.com for patient complaints and see MedicalSpaMD.com for physician complaints.)

Although aesthetic laser companies don't provide the clinical exchange we need, we can find useful models to emulate outside our field. For example, a medical device company produces Philips NetForum. This community connects Philips users from around the globe in a virtual users meeting so they can share clinical experiences, learn from peers and optimize results.

I'm sure many innovations have occurred when users simply share ideas and explore insights with each other via this Internet clinical forum. If we had this resource, our field would advance dramatically.

What We're Doing As Medical Spa Physicians

As a physician, I have a responsibility to take my part in this call to action. As a result, we're now forming clinical exchange meetings at our Cherry Hill, N.J., clinic. We get together twice yearly with doctors from 20 to 30 other clinics to discuss what works and what doesn't. Part of our meeting focuses on business and marketing, and the other part addresses clinical issues.

We also work closely with MedicalSpaMD.com. We are active visitors to this site and frequent contributors. This Web site is so important that we've actually bought an intense pulsed light (IPL) system based largely on the opinions of the Web site's bloggers, many of whom have had experience with several IPL systems.

We're also forming Internet-based user groups on our own. These groups discuss everything from fractionated CO2 systems to injectables to treating patients with skin of color. Doctors from around the country and the world, including Greece, Australia, France, England and India, share their opinions and experiences.

In addition, we're setting up systems in which providers who attend conferences or listen to Webinars write summaries of what they've heard. These summaries can be posted on Medical Spa MD for others to learn from. Once these summaries are posted, other providers can read them and comment on the issues they're discussing. Of course, we cannot overlook traditional methods of clinical exchange. These are still important and should be developed further. Conferences, publications, newsletters and professional associations are excellent ways to communicate and exchange opinions and experiences.

Cosmetic laser medicine is still in its infancy. We haven't yet worked out the best protocols and new technology is continually emerging.

We have to quickly learn the best ways to use all of our technology for optimal clinical results. The best way to do this is to communicate with each other so we can learn what others are thinking, doing and experiencing. When we actively participate in this learning, our field will advance more rapidly and dramatically. This will benefit all of us. True to the Chinese maxim, when the tide rises, all boats indeed rise higher.

Reference

1. Lee CM. Lasers: what every patient should know, and what your doctor probably doesn't. The ultimate guide for the best skin ever. Bloomington, IN: AuthorHouse; 2006; 163.