Medical Laser Blog - Fotona Straight Talk for the Physician

Can A Medical Laser 'Recession-Proof' Your Office?

Well, the truth is, nothing can recession-proof your office, but it can diversify and stratify your income stream.

You need to think about your income in the same way that a good financial advisor would teach you about your investments. In difficult economic times, most experts would agree that the best defense is diversification. So you have stocks and bonds and real estate and precious metals…but in your office you have third-party payers – and that is all. And the third-party payers are getting more aggressive. They are decreasing reimbursement and increasing the hassle-factor of getting that reimbursement. In fact, a portion of the strategy is simply to deny and a certain percentage of physicians won’t fight the claim and therefore that’s less that have to pay out. Increasing the hassle factor for getting reimbursement is actually part of their economic strategy.

The truth is, insurance companies often live on the float. What that means is that every day that they keep the money they owe you, they earn interest on it and that interest (to a large bank account) can add up to substantial sums of money. Insurance companies are really investment companies. They take the premiums and they invest them.

So we need to take on similar strategies. We need to diversify our income strategy just like we diversify our personal investment strategies and the way insurance companies diversify their strategy. A laser can help you with that because a laser creates a pure, cash income stream – totally separate from your third party payers!

Now, how does this become a recession hedge? If you look at the statistics on any aesthetic medicine downturn during the recent financial difficulties, you’ll see that it was large cosmetic procedures like face lifts, breast augmentation and major body contouring that really went to near zero. In our office, the laser hair removal, laser spider vein treatments stayed reasonably constant. Ok – it took a bit of a dip, but nothing like liposuction or breast augmentation and those kinds of procedures.

Why would this be? Well, these procedures are in the domain of reasonable discretionary spending. They cost a few hundred dollars, but not several thousands of dollars. So an individual who has active acne and wants it treated is significantly motivated. A person with a lot of spider veins on their legs or face also has a significant motivator to getting them treated. Somebody who is maybe even fearful for their job and continuously wanting to place their best foot forward wants to treat themselves so they can compete in today’s youth-oriented job market.

There are many reasons why people will continue to pay for the relatively lower cost laser treatments during an economic downtime. Throughout 2009 and into 2010, the laser portion of our aesthetic office has remained busy. And I want to remind you that our office is in a small, mid-Minnesota, agricultural community, so it’s not like we are somehow on Rodeo Drive or in Scottsdale, AZ or Manhattan. We are in a small community. I’ve always felt that if our laser practice can survive and thrive, we have to be the worst-case scenario.

Diversification is the key to weathering any economic situation. If you are fully dependant upon the whims of insurance companies for your income, you ought to think about diversification. It can de-stress your practice, it can increase the “happy” quotient and it can make your financial world better.

Top 5 Reasons to Add Aesthetic Laser Medicine to Your Practice

1. Your patients are already getting it. If you do a survey of your patients, you’ll find out that a significant fraction of your patients are either already getting aesthetic procedures OR they are seriously contemplating it.

2. It’s a great fit for your practice. This isn’t fluff. It’s about HEALTH and WELLNESS. People want to look as good as they feel. People want to be vibrant and to be healthy both on the inside and the out.

3. With proper training, it is absolutely safe and effective. A lot of companies talk about comprehensive laser medicine training and on-going support, but our experience in working with many, many physicians over the last decade has been that a lot of companies roll their equipment into your office and then they’re gone forever. In contrast, we provide comprehensive, on-going laser training – period.

4. You can achieve EXCELLENT results. If you’ve read through my blog, you’ll know that I’m about the “wow” result. What I’m NOT about is the “well, if you squint your eyes and turn your head sideways you can see some improvement.” No! I don’t care about that. I care about excellent results and you can achieve these excellent results as well.

5. It is a great, GREAT secondary income stream. Many of the aesthetic procedures can be done by your nurse or a technician while you are seeing your regular patients. Along with the treatment of the day, the laser operator will also be “mining” for those larger ticket items that you will need to do, such as medium depth peels, etc.

Aesthetic Laser Medicine: your patients already want it, it’s a great fit for a wellness practice, if properly trained it is absolutely safe and effective, you can achieve excellent results and it is a wonderful secondary income. That’s a GRAND SLAM. Think about it.

Offer Something Special At Your Aesthetic Laser Practice

Well it was Mother’s Day last Sunday, and over the course of the past week, this has been a reminder to me that part of your mission for your medical practice is to be busy.   While we are called to our work and love our work, we don’t necessarily do it entirely for fun.  I guess if I were unlimitedly wealthy, I’d probably be on my yacht someplace on the Mediterranean Sea.  The only problem with that is that I don’t have a yacht and probably never will!

The point is, our practice should be busy so that we’re helping the maximum number of patients with their aesthetic procedures/needs, and so that we can achieve the lifestyle that we (as my son would say), “hope to become accustomed to.”

So we should take advantage of everyone else’s advertising.  I have talked in the past in these blogs about jumping onto the fraxel bandwagon.  “Do you do fraxel?”  “YES we do fractionated treatments” would be our response.  “Do you do botox?  “Of course we do botox - come on in for your free consultation.”    And in the end they may or may not need botox, but at least once they’re in your office, you can help to determine (and provide) exactly what they do need.

Back to Mother’s Day – another way to get people into your office.  Or maybe it’s Easter or Hannakah or Christmas or whatever holiday you choose, - you should have promotions.  Don’t forget promotions!!

People like little special things.  Don’t forget the idea of a birthday club.  Keep track of the month of your patients’ birthdays and send them an email giving them some percent discount – but make it a percent that gets their attention (15, 20, 25%) and get them in your office!  Or maybe it’s not a discount of the service, but rather a free product that you supply when they come in for a service.  Or maybe the “special thing” is a gift certificate for a specific dollar figure.  Consider a $100 gift certificate.  There are very few services you will offer in your office that cost less than a $100, so the patient is likely to “spend” their gift certificate in addition to putting down say another $100 or more towards the service they’ve chosen to pursue.

Sometimes you have to spend a dime to make a dollar – and when it comes to services, it really doesn’t cost you anything.  Think it through and remember the holidays of all sorts coming up throughout the year.  Get on the hallmark bandwagon and have something special to offer every holiday!

How To Prepare For Opening A Medical Laser Aesthetics Practice

I was on the phone this evening with a doc who is interested in opening a medical laser Aesthetics practice.  He is really afraid of the investment and was wondering what to do to hit the floor running.  I recommend what has work for us and for others….

1.  Start talking to your patients today about your plans.  Let them know what you are planning and when you plan to start.  Whether it is laser hair removal, laser vein removal, skin resurfacing, acne or onychomychosis or more, many of your patients will be quite excited.  The really interesting thing is that you will be surprised which patients are the excited ones.  So don’t assume - tell everyone.  At one time, I thought I knew who would buy treatments and who would not.  Boy have I been wrong.  One of our best patients is a 50 year old, never married, never been kissed, farmer.  Go figure.

2.  Next, put a nicely framed (remember this is Aesthetics) poster in your waiting area about what you are doing. You might even find or take a photo of an over 50 friend who is looking good.  Have her dress up nicely - black dress and pearls sort of thing. At the top it should say: “I’m 50 (or 60 or what ever) and loving it.  Austin Laser Skin Clinic.” At the bottom it should say something like “Coming Soon: Austin Laser Skin Clinic.  Featuring Laser Hair Removal, Spider Vein Treatments, Skin Tightening, Collagen Rejuvenation and so much more!”

3.  Get your staff involved.  Keeping this secret will kill you.  Your staff should be able to answer basic questions and if not making an appointment with the interested party, at least starting a list of those interested patients.  If you make a list, select a few for your training day.  Charge them half price and make some money while being trained on your new laser.

If you are willing to follow these few steps you can make money from day one.  From a standing start, in a stand-alone office, with no established patient base, this is how we had over $36,000 in the bank at the end of our 3rd month in business.  That was over 8 years ago and we are still going strong.

Laser Hair Removal - why offer in your practice?

It has been said that if you give people what they need, you can make a living.  That is being in the commodity business. Commodities are where the competition is, the price pressure is and the hard work lives.  Give people what they want and now you are in a different business.  You are now in the business of helping people achieve their dreams. Dreams are different than needs. Dreams are what motivate us, drive us.  They are what make us happy.  We, as physicians, strive to give people what they need, every day.  It's our calling, our duty.  We provide it willingly, and with a sense of honor.  For that effort we get complaints about the co-pay, complaints about the next appointment, complaints about the cost of medicine and complaints about the problems of compliance to the treatment plan.  We also get continuous pressure from the insurance companies - complaints on both sides.  Our malpractice carriers want us to order more tests, write longer notes and createmore work.  Our health insurance contracts are getting harder to live with.  At times the reimbursement is less than the cost of doing business.
 
What can one do?

Diversify your practice.  Your patients need what they need - so continue to provide it.  But they want what they want!  You can provide that as well.  This is true diversification as these types of cosmetic procedures are cash.  No insurance companies, no contracts - just a pure and true relationship with your patient. Laser Hair Removal is the single most popular laser procedure. With the right equipment it is fast, safe and fun.  Generally you as the physician are not required to perform the hair removal, so it becomes a parallel income stream. While you are treating hypertension and reducing the risk of CVA, one of your staff can be treating a woman's upper lip and chin hair growth.  On the surface of it, that seems trivial.  I assure you it is not trivial to the women with a mustache.  Below is a woman we will call Janet.  Janet has had problem hair growth since her teens.  She is your typical patient. She is only one of a hundred women in your practice right now with problem hair growth.

Janet is so self-conscious about her hair growth that she shaves twice a day.  She has turned down opportunities to go on "shopping weekends" with her girl friends. She covers her mouth when speaking to people because she feels as if they are looking at her hair growth.

We saw her about a week after going to Chicago with a group of her friends for the first time. This was after six laser treatments for her hair growth.  She is a new woman.  She smiles more, talks without a hand over her face and simply looks more happy.  This is not trivial.

So it is a cash business, for patients you already serve.  Right now you give them the things they need and they have to go elsewhere to get what they want.
 
Learn more about hair removal... click here.

"No one can possibly achieve any real and lasting successor 'get rich' in business by being a conformist."
J. Paul Getty

Setting up a medi-spa for college and retirement

As a dedicated health care professional you work hard and meet the needs of your patients every day.  But how are you rewarded?  Often it is by lower reimbursements for what you do.  Don’t get me wrong, I love being a doctor.  I love treating patients with diabetes, HTN, and the like.  It is very rewarding, just not necessarily lucrative.  With two people to process paper work, fight with insurance companies and resubmit claims for every one person that is in direct patient care, it gets harder and harder to make ends meet.

A Medi-Spa (in my practice we call it a Medical Laser Center) is a cash practice providing what people really want.  In our center, we do everything that people are seeing on Oprah and other TV shows.  Laser hair removal, spider vein treatments, skin tightening, acne, warts and skin resurfacing.  Look, if you can do a biopsy, you can do this stuff.  Right now your patients are getting this stuff done… just not by you.  While they are complaining to your front desk about the co-pay, they are coming into my office and laying down $100 dollar bills to get these services.  Yes they are.

The trick is picking the right technology.  There is a lot of smoke and mirrors out there. Find out more about understanding the technology that matters...click to receive article.  When I go to conferences like ASLMS (American Society for Laser Medicine & Surgery) I am amazed at what some companies are willing to put up as before and after pictures.  They are often terrible.  One needs to squint and turn your head sideways to determine which is before and which is after.  Take a look at our before and after photo gallery - it is clear, you don’t need to read the caption or any explanation… before is before and after is after - period.

So how will this help put your kids through college or improve your retirement?  Simple… parallel income streams. You will only make the money you can make until you start to delegate.  Right now you delegate your patients care to the nurse in the ICU, you delegate giving shots, but that makes you little money.  Delegating hair removal or spider vein treatments can make you a lot of money.  Having your staff “mining” your spa patients for the bigger procedures like skin resurfacing can make a lot of money.  It’s all about parallel income streams.