13 Things Successful Cosmetic Clinics Don't Do

What Successful Cosmetic Clinics Don't Do

Strong cosmetic practices have leadership and teams that are able to manage their behaviors, patient interactions and ways that set them up for business success. Much of what's written is about what to do, but what you don't do is just as important. H

ere's a list of things that strong and profitable cosmetic clinics (and their teams) don't do.

1. They Don't Waste Time Focusing On The Competition.

Successful clinics don't sit around worried about the medical spa that's offering lower prices or spending more on advertising. Instead, they focus on delivering on what's critical for their success; delivering perceived and real value to their patients. They understand that competitors are part of every business environment.

2. They Don't Avoid Change

Great clinics don't coast. They actively look - continually - for the changes they can make that improve their business operations and the value they're delivering to patients. Successful clinics embrace change as a continual business need and an opportunity to improve.

3. They Don't Waste Time & Energy On Things They Can't Control

Successful clinics are all about what they are doing, not bitching and moaning about why they can't win and how the competition down the street isn't fair. Instead, they focus on what they do control and recognize that their success is in their own hands - always.

4. They Don't Try To Please Everyone

Great clinics focus on a few things that they do exceptionally well. They don't try to flail away and capture every patient. They realize that you can only be the best at one or two things, and they focus on delivering exceptional value in those areas.

5. They Don't Fear Taking Calculated Risks

Success isn't given and it doesn't ever follow your business plan. It's survival of the fittest and successful practices embrace the fact that they're going to have to make smart decisions and take some risks. In fact, they know that the biggest risk is not taking any risks.

6. They Don't Dwell On The Past

Successful clinics are forward looking. They're not talking about their past successes or grievances. They're looking forward to what they can improve in the future and they embrace continual improvement.

7. They Don't Make The Same Mistakes Over And Over

Successful cosmetic clinics make (a lot of) mistakes, but they only make those mistakes once. They learn fast and are voracious in rooting out why the mistakes were made and how they can avoid them next time.

8. They Don't Resent Other People's Success

Successful clinics can appreciate other clinic's successes. They know when the're being beaten and are intellectually honest enough to know that there are reasons that the market is rewarding someone else, most often because they're doing something right.

9. They Don't Give Up After Failure

Along with mistakes come failures; a terrible Groupon, a bad hire,  a cosmetic laser that is a lemon... Every successful clinic has a long list of failures that they can point to. They can also point to what they did, and kept doing, after every one.

10. They Don't Feel The World Owes Them Anything

Successful clinics don't think that they're owed success, and they certainly don't think that patients owe them anything. Instead, they look for opportunities based on their own work and merits and work to serve patients first.

11. They Don't Expect Immediate Results

Successful clinics know that success is a journey, not a destination, and like every journey it takes time. They don't expect immediate results. Instead, they apply their skills and effort to build the clinic.

12. They Say No More Than They Say Yes

Sales reps, patients, vendors... everyone is asking for yes. Successful clinics learn to say 'no' more than they say yes. It's harder, but it keeps your head in the game and your clinic pointed in the right direction.

13. They Don't Resent Their Patients

Successful clinics don't resent patients who don't want to be upsold or balk at a price. They know that all of their patients contribute to success and that their reputation is not what they want it to be, but what their patients actually think and say about them.

Persuasion & Your Medical Spa

Persuading your medical spa clients to take action.

Think about the last 10 decisions you have made.  How did you come to your decisions?  You probably made a mental note of the pros and cons, factored in your intuition along with some sound logic and came up with an intelligent decision.  You probably understand that most people aren’t as strong and smart as you and therefore are easy targets to sway.  But, that never happens to you.  You are just too smart.

You just made your first mistake.  You experienced something called the “fundamental attribution error”.  This is the belief that other people’s behavior is solely based on their personality, rather than external factors.  For example, “Mary is late because she doesn’t care if others have to wait for her” verses “Mary is late because she must have had car trouble”.

These types of biases are very common and play a big role in the way decisions are made.  So of course web designers are using this information to influence the behavior of users.  Some designers intuitively know what techniques to use to achieve this, but they many not be able to tell you exactly “why” it works.  However, there are some very skilled “persuasion architects” that understand the psychological behavior and intentionally design with this in mind.

There are 7 main components in the persuasion architect’s toolbox:  Authority, Commitment, Scarcity, Salience, Reciprocation, Framing and Social Proof.

#1 Authority: 

This principle is about influencing behavior via credibility. This is why you will see a lot of name-dropping, used to give the reader confidence that this information is valuable and credible.

Readers are more likely to believe information if it is written by an “expert” in the field.  In turn, they are more likely to act (buy) as a result of this information.

Persuasion architects exploit this principle by listing rave reviews and testimonials on their site. E-commerce sites show highly visible icons assuring the user that the site is secure.  Forums are another way to use authority.  People have the opportunity to rate their peers and users might rely on those ratings as if they were from an expert.

#2 Commitment:

This principle is about taking a stand on an issue that is consistent with our own beliefs.  When you take a stand on something that is visible to other people, you usually feel a drive to maintain that point of view to appear credible and consistent.

Designers use this principle by asking for a small, but visible, commitment from you. If they can get you to behave in a certain way, you’ll soon start believing it. An example of this is Facebook.  If a group page can get you to “like” their page and it appears on your newsfeed, you are basically recommending this to all your friends.  If you choose to “like” the Brady Bunch fan page, you have “publicly committed” to being a Brady Bunch fan.

#3 Scarcity:

This principle takes me back to the gas shortages of the 70’s.  The newspapers run the headline “Gas shortage in the US” and there are immediately lines around every block of people wanting to fill up their tanks. 

People are more likely to want something if they think it is in short supply or more valuable than it actually is. For example, psychologists have reported that if you give people a cookie from a jar, they rate the cookie as more delicious if it comes from a jar with only 3 cookies list verses a jar with 10 cookies.

Persuasion architects exploit this by showing scarcity of a product.  This could include airline tickets at a discounted price or a popular toy for Christmas showing just a few items left in stock.  They understand that perceived scarcity will generate demand.

Another example of this might be a Grand Opening sale.  How many times have you seen that sign stay up for months and months, hoping that new customers will take advantage of the “special” price?

#4 Salience:

People are more likely to pay attention to details in your user interface that are unique such as a colored “continue shopping” button.  For example, there are certain times during a purchase when consumers are more likely to investigate a special offer. Being able to understand this gives you an opportunity to sell more products or services by offering them at just the right time in the buying cycle.

#5 Reciprocation:

Do you like to return favors?  Most people do and it’s this psychology that is the basis for this principle.  If someone helps you paint your house or babysit your kids, you feel obligated to help them at a future date.

Persuasion architects know that if they offer you a small gift – a free newsletter or a sample chapter from a book – you are very likely to do something for them in return like buying the entire book or additional products.  At first they may not ask you to buy something.  They may start by asking you to comment on their blog or link to a website.  They know that it usually take several contacts with a user to make them an actual “customer”. 

#6 Framing:

Savvy web designers know that we like making choices.  It makes up feel in control of our destiny.  So, if we are given a choice of 3 tiers of products, you can be assured that there is one of them that they are pointing you towards whether you realize it or not.  Another example of framing is the car dealer who shows you the most expensive car on the lot knowing you can’t afford it.  Then the next cars he shows you seem like a real bargain in comparison!

#7 Social Proof:

Have you ever gone to lunch with a group of friends?  Have you ever watched as everyone orders and then base your decision on their choices? 

A great example of Social Proof is shopping on Amazon.  When you buy a certain product, say a digital camera, Amazon will then post a note to you saying “other people who bought this camera bought this case and memory card”.  Well, if other people bought them, you certainly should as well!

Another example is default buttons.  When ordering a television online, a good persuasion architect will have the 3-year warranty add-on already checked.  The buyer thinks, “I guess everyone buys this so I should too”. 

So back to my original question: How do you come to your decisions?  Maybe now you can see that your decisions aren’t always under your control!  Smart web designers are 2 steps ahead of all of us.

Medical Spa MD: Online Defamation FAQ For Physicians

Understanding what is libel or defamation and what is protected speech.

Your medical spa, plastic surgery practice, or professional reputation are are open to criticism and 'reveiws' online. Here's what you need to know about what's protected free speech, and what might cross the line into Libel.

Here are some links about these kinds of CyberSlapp suits and where the law comes down on free speech and other issues around this:

Chilling Effects Clearinghouse: A joint project of the Electronic Frontier Foundation and Harvard, Stanford, Berkeley, University of San Francisco, University of Maine, George Washington School of Law, and Santa Clara University School of Law clinics.

DefamationThe law of defamation balances two important, and sometimes competing, rights: the right to engage in free speech and the right to be free from untrue attacks on reputation. In practice, the filing or even the threat to file a lawsuit for defamation has sometimes been used as a tool to shut down legitimate comment and free speech on the Internet.

John Doe AnonymityDo you post to a public message boards or discussion areas on websites such as Yahoo, AOL or Raging Bull? Do you use a pseudonym, fake name or a "handle"? Has someone asked the host of the discussion or your ISP to turn over information about you or your identity? If so, then the John Doe/Anonymity section may answer some of your questions. 

Protest, Parody and Criticism SitesThe Internet, which offers inexpensive access to a worldwide audience, provides an unparalleled opportunity for individuals to criticize, protest and parody.

The following is long but you'll come away with a much better understanding of what this all means and what speech is protected in the U.S.

Need to protect your reputation? Check out Frontdesk's Reputation Protection for Physicians

Online Defamation FAQ

Question: What are the elements of a defamation claim?

Answer: The party making a defamation claim (plaintiff) must ordinarily prove all four elements:

  1. a publication to one other than the person defamed;
  2. a false statement of fact;
  3. that is understood as
        a. being of and concerning the plaintif; and
        b. tending to harm the reputation of the plaintiff. 
  4. If the plaintiff is a public figure, he or she must also prove actual malice.

Question: What defenses may be available to someone who is sued for defamation?

Answer: There are ordinarily 6 possible defenses available to a defendant who is sued for libel (published defamatory communication.)
1. Truth. This is a complete defense, but may be difficult to prove.
2. Fair comment on a matter of public interest. This defense applies to "opinion" only, as compared to a statement of fact. The defendant usually needs to prove that the opinion is honestly held and the comments were not motivated by actual "malice." ( Malice means knowledge of falsity or reckless disregard for the truth of falsity of the defamatory statement.)
3. Privilege. The privilege may be absolute or qualified. Privilege generally exists where the speaker or writer has a duty to communicate to a specific person or persons on a given occasion. In some cases the privilege is qualified and may be lost if the publication is unnecessarily wide or made with malice.
4. Consent. This is rarely available, as plaintiffs will not ordinarily agree to the publication of statements that they find offensive.
5. Innocent dissemination. In some cases a party who has no knowledge of the content of a defamatory statement may use this defense. For example, a mailman who delivers a sealed envelope containing a defamatory statement, is not legally liable for any damages that come about from the statement.
6. Plaintiff's poor reputation. Defendant can mitigate (lessen) damages for a defamatory statement by proving that the plaintiff did not have a good reputation to begin with. Defendant ordinarily can prove plaintiff's poor reputation by calling witnesses with knowledge of the plaintiff's prior reputation relating to the defamatory content.

Question: Can an opinion be defamatory?

Answer: No — but merely labeling a statement as your "opinion" does not make it so. Courts look at whether a reasonable reader or listener could understand the statement as asserting a statement of verifiable fact. (A verifiable fact is one capable of being proven true or false.) This is determined in light of the context of the statement. A few courts have said that statements made in the context of an Internet bulletin board or chat room are highly likely to be opinions or hyperbole, but they do look at the remark in context to see if it's likely to be seen as a true, even if controversial, opinion rather than an assertion of fact dressed up as an opinion.

Question: Is there a difference between reporting on public and private figures?

Answer: Yes. A private figure claiming defamation — your neighbor, your roommate, the guy who walks his dog by your favorite coffee shop — only has to prove you acted negligently, which is to say that a "reasonable person" would not have published the defamatory statement.

A public figure must show "actual malice" — that you published with either knowledge of falsity or in reckless disregard for the truth. This is a difficult standard for a plaintiff to meet and especially if you're running a business that engages in any marketing or advertising that effectively makes your business 'public'.

Question: Who is a public figure?

Answer: A public figure is someone who has actively sought, in a given matter of public interest, to influence the resolution of the matter. In addition to the obvious public figures — a government employee, a senator, a presidential candidate — someone may be a limited-purpose public figure. A limited-purpose public figure is one who (a) voluntarily participates in a discussion about a public controversy, and (b) has access to the media to get his or her own view across. One can also be an involuntary limited-purpose public figure — for example, an air traffic controller on duty at time of fatal crash was held to be an involuntary, limited-purpose public figure, due to his role in a major public occurrence. 

Examples of public figures:

  • An attorney for a corporation organized to recall members of city counsel
  • A psychologist who conducted "nude marathon" group therapy
  • A land developer seeking public approval for housing near a toxic chemical plant
  • Members of an activist group who spoke with reporters at public events
  • Your medical spa or clinic...

Corporations are not always public figures. They are judged by the same standards as individuals.

Question: May someone other than the person who originally made the defamatory statement be legally liable in defamation?

Answer: One who "publishes" a defamatory statement may be liable. However, 47 U.S.C. sec. 230 says that online service providers are not publishers of content posted by their users. Section 230 gives most ISPs and message board hosts the discretion to keep postings or delete them, whichever they prefer, in response to claims by others that a posting is defamatory or libelous. Most ISPs and message board hosts also post terms of service that give them the right to delete or not delete messages as they see fit and such terms have generally been held to be enforceable under law. 

Question: Can an ISP or the host of the message board or chat room be held liable for
defamatory of libelous statements made by others on the message board?

Answer: No. Not in the United States.

Under 47 U.S.C. sec. 230(c)(1) (CDA Sec. 230): "No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider." This provision has been uniformly interpreted by the Courts to provide complete protection against defamation or libel claims made against an ISP, message board, blog comments or cummunity forums where the statements are made by third parties. Note that this immunity does not extend to claims made under intellectual property laws.

Question: Must an ISP or message board host delete postings that someone tells him/her are defamatory? Can the ISP or message board delete postings in response to a request from a third party?

Answer: 47 U.S.C. sec. 230 gives most ISPs and message board hosts the discretion to keep postings or delete them, whichever they prefer, in response to claims by others that a posting is defamatory or libelous. Most ISPs and message board hosts also post terms of service that give them the right to delete or not delete messages as they see fit and such terms have generally been held to be enforceable under law. 

CyberSLAPP & John Doe Lawsuits

Question: How is Internet anonymity affected by John Doe lawsuits?

Answer: Often called "CyberSLAPP" suits, these lawsuits typically involve a person who has posted anonymous criticisms of a corporation or public figure on the Internet. The target of the criticism then files a lawsuit so they can issue a subpoena to the Web site or Internet Service Provider (ISP) involved and thereby discover the identity of their anonymous critic. The concern is that this discovery of their identity will intimidate or silence online speakers even though they were engaging in protected expression under the First Amendment.

Question: Why is anonymous speech important?

Answer: There are a wide variety of reasons why people choose to speak anonymously. Many use anonymity to make criticisms that are difficult to state openly - to their boss, for example, or the principal of their children's school. The Internet has become a place where persons who might otherwise be stigmatized or embarrassed can gather and share information and support - victims of violence, cancer patients, AIDS sufferers, child abuse and spousal abuse survivors, for example. They use newsgroups, Web sites, chat rooms, message boards, and other services to share sensitive and personal information anonymously without fear of embarrassment or harm. Some police departments run phone services that allow anonymous reporting of crimes; it is only a matter of time before such services are available on the Internet. Anonymity also allows "whistleblowers" reporting on government or company abuses to bring important safety issues to light without fear of stigma or retaliation. And human rights workers and citizens of repressive regimes around the world who want to share information or just tell their stories frequently depend on staying anonymous – sometimes for their very lives.

Question: Is anonymous speech a right?

Answer: Yes. Anonymous speech is presumptively protected by the First Amendment to the Constitution. Anonymous pamphleteering played an important role for the Founding Fathers, including James Madison, Alexander Hamilton, and John Jay, whose Federalist Papers were first published anonymously.

And the Supreme Court has consistently backed up that tradition. The key U.S. Supreme Court case is McIntyre v. Ohio Elections Commission. http://www.eff.org/Legal/Cases/mcintyre_v_ohio.decision

Question: What are the typical claims behind a CyberSLAPP suit?

Answer: The most common complaints by CyberSLAPP plaintiffs are defamation, trademark or copyright infringement, and breach of contract. Speech that involves a public figure - such as your medical spa or practice - is only defamatory if it is false and said with "actual malice." It also must be promoted as being factual rather than an expression of opinion. In the US, because of our strong free speech protections, it is almost impossible to prove defamation against a public figure.

Trademark and copyright complaints typically claim that defendants have violated intellectual property rights by using the name of a corporation or its products, or by quoting from some of their copyrighted materials such as an annual report. In reality, the First Amendment includes a clear right to criticize and discuss corporations and their products, and the law includes clear exceptions for the "fair use" of protected material for those purposes.

Breach of contract suits often involve a claim that anonymous speakers might be employees who have violated a contract by releasing confidential information. Of course, the right to anonymous speech is meaningless if a corporation can unmask your identity at will because you might be an employee breaking a promise of confidentiality.

Question: What other resources are available?

Answer: Web sites dealing with this issue include:

www.aclu.org
www.citizen.org
www.johndoes.org
www.casp.net
www.cybersecuritieslaw.com,
cyber.findlaw.com/expression/censorship.html

Question: What are the key federal decisions involving anonymous speech?

Answer: 1. Buckley v. American Constitutional Law Foundation (1999) 525 U.S. 182, 197-200;

2. McIntyre v. Ohio Elections Commission (1995) 514 U.S. 334. In that case, on page 357, the Supreme Court said:

"[A]n author is generally free to decide whether or not to disclose his or her true identity. The decision in favor of anonymity may be motivated by fear of economic or official retaliation, by concern about social ostracism, or merely by a desire to preserve as much of one’s privacy as possible. Whatever the motivation may be, . . . the interest in having anonymous works enter the marketplace of ideas unquestionably outweighs any public interest in requiring disclosure as a condition of entry. Accordingly, an author’s decision to remain anonymous, like other decisions concerning omissions or additions to the content Amendment.
* * *
Under our Constitution, anonymous pamphleteering is not a pernicious, fraudulent practice, but an honorable tradition of advocacy and dissent.

3. Talley v. California (1960) 362 U.S. 60. (holding unconstitutional a state ordinance prohibiting the distribution of anonymous handbills)

4. Lamont v. Postmaster General (1965) 381 U.S. 301, 307 (finding unconstitutional a requirement that recipients of Communist literature notify the post office that they wish to receive it, thereby losing their anonymity);

5. ACLU of Georgia v. Miller (N.D. Ga. 1997) 977 F. Supp. 1228 (striking down a Georgia statute that would have made it a crime for Internet users to “falsely identify” themselves online).

Question: Aren’t people required to explain why they’re subpoenaing my identity and other information?

Answer: Not with the initial request. The reasons for the subpena are only provided if the subpena is challenged, through a motion to quash. In opposing the motion to quash, the person seeking the information must demonstrate, at a minimum, that it is likely to lead to the discovery of information that would be useful in a lawsuit.

Question: I signed a confidentiality/privacy agreement with my ISP that provides that they will not release my information. Doesn’t that protect me?

Answer: No. Most privacy agreements state that information will be turned over in response to legal requests, and a subpena is such a request. Even if the agreement does not say so, a legally issued subpoena overrides such agreements as a matter of public policy. Each ISP has a different policy about notifying users when their information has been subpoenaed, but they cannot simply ignore a subpoena under the law without risking legal santion themselves.

Question: What does "respond" to the subpena mean?

Answer: Usually, it means that the ISP will give the requested information to the requesting person. In some cases, ISPs have resisted requests for information on behalf of their customers, but this is not the norm. Unless specifically told differently by your ISP, you should assume that your ISP will turn over your information as part of its response.

Question: Can an ISP or the host of the message board or chat room be held liable for defamatory of libelous statements made by others on the message board?

Answer: No. Under 47 U.S.C. sec. 230(c)(1): "No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider." This provision has been uniformly interpreted by the Courts to provide complete protection
against defamation or libel claims made against an ISP, message board or chat room where the statements are made by third parties. Note that this immunity does not extend to claims made under intellectual property laws.

Question: Can my ISP or the host of a message board be held liable for defamatory statements I make on the grounds that they are a "publisher" or "republisher" of the information?

Answer: No. Federal law provides: "No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider." This has been interpreted to protect hosts of discussions between other people against defamation and libel claims as a "republisher" of the information. Note that this protection does not extend to claims under intellectual property laws.

Question: Must an ISP or message board host delete postings that someone tells him/her are defamatory? Can the ISP or message board delete postings in response to a request from a third party?

Answer47 U.S.C. sec. 230 gives most ISPs and message board hosts the discretion to keep postings or delete them, whichever they prefer, in response to claims by others that a posting is defamatory or libelous. Most ISPs and message board hosts also post terms of service that give them the right to delete or not delete messages as they see fit and such terms have generally been held to be enforceable under law.

Question: My ISP tells me it's been asked to turn over my name as part of a lawsuit against hundreds of "John Does" in a faraway state. What can I do?

Answer: You should probably contact a lawyer, and suggest that the lawyer take a look at arguments raised by the EFF, ACLU, and Public Citizen in one of these suits (e.g.,http://www.eff.org/IP/P2P/RIAA_v_ThePeople/JohnDoe/20040202_UMG_Amicus_Memo.pdf)

Need to protect your reputation? Check out Frontdesk's Reputation Protection for Physicians

The Medical Spa Physician Report: Learn From Experienced Operators

The Medical Spa Physician Report is critical information compiled from the answers of experienced doctors in cosmetic medicine.

Each Medical Spa Physician Report includes a survey of cosmetic clinics around the worlds physician interviews and case studies. We reach out to not only our member base, but also other prominent doctors in cosmetic medicine to find out what doctors are really thinking about technology, marketing, staffing and clinic operations.

And this is an experienced group.

Look at this graph from the last Physician Report and you'll see that 58% of physicians indicating that they've been practicing full time cosmetic medicine for 6 years or more.

You can always find the latest Medical Spa Report (as wells as previous issues) free to download in the Medical Spa MD Free Deals for Members... and if you're not a Member yet, you can join the thousand of other physician members and access all of the free deals right now.

Push Your Medical Spa Overboard With Customer Service

Some of the best marketing for your medical spa is not 'marketing' at all... it's incredible customer service.

(A regular physicians office is probably the very worst customer experience there is... and of course many medical spas are run by physicians who have started a cosmetic practice as an add or or a transition from a regular practice.)

Customer service is probably the easiest way to distance yourself from the competition.

Read the forums and you'll find lots of threads discussing how commoditized the market for Botox or laser hair removal has become, how much to pay your staff, and how Groupon is destroying everyone's margins... but you'll be hard pressed to find discussions about how to deliver service that generates sales.

But delivering great customer service is something that you should think of as driving sales, not lost time and a money-sink.

Our clinic staff operations were designed to provide fantastic customer service to everyone, but to really go above and beyond with selected patients in an effort to wow them, even if it cost us money. In fact, wowing patients had budget set aside from marketing.

 The key is make your customer ecstatic about your business by catering to what they need so they’ll tell their friends about it. In fact the more egregious the demand or the more dramatic the effort needed, the more likely that word about your clinic will spread. As anyone in cosmetic medicine can attest, you don't have to wait long for some stressed out patient who's a candidate. In one case a bride called us in tears on a Saturday morning asking if there was any way that she could get her mother and mother-in-law treated with Botox before her wedding on Wednesday morning... and they weren't arriving until 10PM that night. One of our physicians actually met the wedding party at our clinic on Sunday morning in order to make sure that the effects of the Botox had time to take maximum effect before the wedding. 

Most clinics or physicians would not have done this, they would have scheduled the treatment for Monday if they could fit them in and lost the opportunity to create fanatically loyal clients.

In the above case the physician went above and beyond even what we would ask, but the results were really quite remarkable. Within the following 45 days we had 8 new patient consultations that were directly attributed to that one event. (New patient consultations were something that I tracked carefully since our analytics showed that every new patient consultation was worth approximately $1,300 in revenue within the following 30 days.)

That Sunday treatment drove an extra $10k in revenue at that clinic that month. 

How you deal with your customer service will define your business and your revenues.

Some recommendations for fantastic customer service:

  • If you think that any customer is acting in good faith, don't even question what they're asking. Just do it. If they're unsatisfied, make them happy and take extra time to do it. (This is not a recommendation to deal with those who are clearly just trying to take advantage of you.)
  • The more hoops you have to jump through, the more likely word will spread. Dig out the really extraordinary ways that you can make a splash.
  • Other physicians and clinics aren't likely to offer this level of support. Focus on this and use it to your advantage.  All it takes is a few over the top customer stories, and people will talk, people will post to their Facebook page or Twitter account, and people will tell every friend they have about your clinic.

 Tell me I'm wrong.. or right. Tell your own customer service story in the comments.

The Medical Spa MD Physician Report Out! Download It Here.

The FREE Medical Spa MD Physician Report is now available. Whew.

download

Our entire report team has been busting their ass collecting answers from physicians and clinics for the last month and compiling them into the only report of it's kind that deep-dives into aesthetic medicine and gives you information you can't find anywhere else. (Thank you Dar, Apple, Marco, and Laurie!)

We've taken on a herculean task in compiling this report and we're pretty happy with the result.

The Medical Spa MD Physician Report researches and tracks all aspects of what's working in cosmetic medicine (and what's not), not only in the U.S. and Canada but across the world.

These reports are published to give our entire physician and clinician community access to the information, statistics, and inspiration to improve their medical (and business) results.

Do you want to know how other clinics are choosing technology, attracting new patients, marketing to their existing clients and compensating their staff? Would you like to discover what's the most effective uses for that new fractional laser, or what other clinicians think of it? Could you use more info about how successful medical spas are expanding their business, saving money, or deciding on what new treatments to add or get rid of?

Answer yes to any of the above you will love, love, love this new report.

Download the report here.

download

 

The Medical Spa MD Physician Report

With the power and knowledge of our growing membership, our goal is to bring together all the valuable information, successes and failures; giving you an insider’s point-of-view to improve your business and your bottom line. Which products sell best? Which treatments are most profitable? Which equipment manufacturers are recommended and which are not? Our reports deep-dive into the various areas, such as “Growing your business”, “Advertising and marketing”, and “Staffing and training”.

The reports generally include a survey of cosmetic clinics around the world, an interview or case study, and an area for sponsors or select partners who wish to get in front of our Members and readers with their products and services. To begin, we reached out to not only our member base, but also other prominent doctors in our field. The response was overwhelming. About 80% of our respondents practice in the US, but the other 20% come from all over the world, including South America, Europe, the Middle East and Russia. About 92% are physicians, with the other 8% working as RNs or PAs in cosmetic clinics and medical spas.

Another way to contribute to our Physicians’ Report is to participate in our monthly interview. We choose and office or medical spa each month to get their unique perspective on running their business. The interviews add insight into working medical spas and cosmetic practices, what works, what doesn’t work, successes, failures and anything else you want to share with your peers.

A special thanks to our growing group of physicians and clinics for participating in this month's report. If you would like to join our panel, please sign up to contribute to the next report here. The more participation we get, the greater the value for the group. (Sign up to contribute to the next report here.)

Do you have a suggestion to improve our services or an idea for as research project you think we should be doing? Would you like to be interviewed, or sponsor a report? Please contact us.

Warmly,

Medical Spa MD Report

Founder, Medical Spa MD

P.S. Please feel free to distribute, email, link to, tweet, post or send this report to anyone who may be interested as long as you do not modify or change the report in any way.

 

Contributing Physicians & Clinics

The following is a partial list of the physicians and clinics that contributed to this report and gave us permission to identify and link to them. Sign up to contribute to the next report here.

Note: We do not identify individual physicians or clinics with specific answers to make sure that all respondents can be completely candid in their answers. (Our surveys are done through our online software and provide confidentiality and anonymity and they take about 10 minutes to complete.)

paceslaserMd.com

cos-medica.com

JaneAesthetics.com

naturophoria.com

delajeness.ru

koe-aesthetics.de

centrosbys.com

dermavogue.net

smacboca.com

plasticsurgerysandiego.com

rhamawy.com

LaserCosMedix.com

wimedispa.com

landecker.com.br

jdvmedspa.com

chirurgiefaciala.ro

RomoPlasticSurgery.com

NewportWellessBoutique.com

drminniti.com

dryveshebert.ca

doctorhoefflin.com

monarchbaylaser.com

thenyac.com

mandalaclinic.pl

plasticsurgeryoftheface.com

Our contributing physician list is growing fast. Thank you to the physicians and clinics who have contributed to this report.

Introducing The New & Free Medical Spa MD Physician Report

The Physician Report from Medspa MD is a free monthly report complied from physicians and clinicians in medical spas and laser clinics.

Medical Spa MD Physician Report

Each new report contains answers about what other laser centers, skin clinics and medspas are doing to manage their business, save money, and increase profitability, from opinions on IPLs and software, to marketing, staff compensation, and specific treatment modalities. It's the inside scoop on what other physicians are doing, and what they think.

The Report is distributed to more than 5,000 physician Members via email as well as mainstream and online media outlets.

(Members can also access the archive in the Members Only area.)

Get specific answers from leading physicians and cosmetic practices.

The Medspa MD Physician Report researches and tracks all aspects of what's working in cosmetic medicine (and what does not).

So, we're not an agency, consultancy or other vendor seeking your business. All of our research is published for the entire Medical Spa MD community to benefit from. Our goal - to give physicians and clinicians the information, stats, and inspiration to improve their medical (and business) results.

Do you want to know how other clinics are choosing technology, attracting new patients, or compensating their staff? Would you like to discover what's the most effective settings for your new fractional laser, and how to avoid problems and complications? Could you use more info about how successful clinics are growing their business, negotiating with vendors, or saving money?

Answer yes to any of the above you'll love this free monthly report.

Each month, a new report contains answers about what other laser centers, skin clinics and medspas are doing to manage their business, save money, and increase profitability, from opinions on IPLs and software, to marketing, staff compensation, and specific treatment modalities. It's the inside scoop on what other physicians and medical spas are doing, and what they think.

Medical Spa MD researches what works in cosmetic practices through exclusive case studies, surveys, interviews and data analysis. Then we publish and distribute the report monthly to more than 5,000 Medical Spa MD Member Physicians as well as online and mainstream media. Join Medspa MD to receive the report.

Medical Spa MD Physician Report

Physician Report FAQ

Here are some answers to frequently asked questions.

How Do I get The Report?

Just join Medical Spa MD. It's free, which is a terrific price. (Members are able to download archived reports from the Members Only Area.)

What's in the Report?

Specific answers from other physicians and clinics. Each month, we email specific questions to physicians practicing cosmetic medicine and compile their answers into an easy-to-read Report that's then distributed to our Members. It's easy to read and provides information about what physicians practicing cosmetic medicine are thinking and doing to manage, control and grow their business.

But that's not all.

We also include specific case studies, interviews and we even have a sponsor area that will allow our Select Partners and other service and technology companies to offer one-time limited offers to our subscribers.

Can I contribute?

Yes. If you're a physician or clinician practicing cosmetic medicine, you can become one of our Contributing Members by submitting the form below. (The report deals with specific medical treatments and technology and is limited to licensed and practicing medical clinicians; MDs, DOs, PAs, NPs, and RNs)

Are Contributing Members Personally Identified?

No. Contributors are not individually identified inside the report. While clinicians can choose to identify themselves as a contributor on their own website by adding one of our badges, our process ensures that individuals are not associated with any specific response so that they can be absolutely candid in their responses.

Who are Contributing Physicians & Clinics?

Contributors are the clinicians that are in the trenches. They're the physicians and clinicians who own and run skin clinics, laser clinics, medical spas, plastic surgery centers, and cosmetic dermatology practices. Many of our contributors are Medspa MD Members but that's not a requirement.

 

Become a Contributing Member

Complete this form to contribute to the report.

If you're a licensed clinician (MD, DO, NP, PA, RN) and would like to be included as a Contributing Member, please fill out this form. You will then be added to our Contributing Members and receive a monthly questionnaire. (Submitting this form does NOT mean that you're a Medical Spa MD Member. You'll need to join Medspa MD to receive the report.)

After completing the application form you will be contacted by our team who will answer any questions or concerns you may have.

Questions?  Leave a comment and we'll answer them.

Own A Niche. Any Niche. (Medical Spa Blueprint)

"If you can, be first. If you can't be first, create a new category in which you can be first."  - Al Ries & Jack Trout, The 22 Immutable Laws of Marketing

There's something innately attractive about uniqueness.

To be unique you need to dominate a niche. I don't care what niche it is, but you need to dominate it.  If you can't dominate the niche where you are, you need to create a new one.

How can you tell if you're considered to be unique? Pretty simply. There's a single two word phrase that people use to describe someone who's dominating a niche. You'll hear it used all of the time as a recommendation: "The best".

It doesn't matter what you're the best at, only that you're the best at it.

Now all uniqueness is not created equal. If you're 'the best orthopedic surgeon in the country', you're going to be sitting pretty. If you're 'the best orthopedic surgeon in Evanston, Wyoming', it's less of a talking point.

Perhaps you're in cosmetic medicine like a lot of the docs that I know. It's probable that there are  dozens of plastic surgeons, dermatologists, and medical spas that are in your target area and trying to get to your target clients.  How are you going to set yourself above the noise as the single choice? How are you going to get those patient referrals?

How are you going to position yourself as 'unique' in order to compete?

You're going to find something that you can be the best at.

You may be in family practice or internal medicine. Fine. You're clinical practice is general in nature, but that doesn't mean that there's no uniqueness to be had. You always start where you are.

Sure you have patients that already love you. So what. So does everyone else.

Like everyone in cosmetic medicine, already know that you’re ‘target’ is generally going to be women. You’re right of course, more than 95% of your clients will be female, but what else do you KNOW about the women that want YOU to be their cosmetic medical provider. If you’re like the average medspa, even those that have been doing this for years, not that much. You’ll also be able to deduce pretty easily that women looking for Botox. or fillers, or cosmetic surgery are generally over 30 and less than 55 or so. Right again. That’s a ‘second qualifier’. In fact, those two items put you on par with 99% of what cosmetic clinics know about their Botox and filler patients… but that’s not the end.

If this sounds like you, then you’ve joined the 99% of other providers who think they should target EVERYONE instead of a small, focused niche. In the best case, these clinics limit their success, in the worst, they set themselves up to fail miserably.

You need to learn how to target your perfect client with laser-like focus. With the right niche targeting, you’ll be able to tailor and optimize not only your services, but also your medspas pricing. And when you learn to target your services SPECIFICALLY to this person – making it truly personalized – they will pay virtually anything, and they’ll thank you for it.

Of course targeting this way isn’t easy. It takes a little work so it’s generally ignored by the lazy.

Let’s go through a quick example to set the stage. Imagine that you’re hired by a medical spa or laser clinic and you’re told, “Help us get more patients.”

The first question you ask should probably be, “Who are you trying to reach?”

If the response is, “Well, everybody. We just want a lot of them.” Turn in your notice. You’re doomed.

What’s wrong with this approach?

Think about it this; when was the last time you went out of your way to purchase a product that was just right for you, but it was also “just right” for your retired father and your 18-year-old neighbors kid? If you found such a product would you buy it? Would you pay a premium price for it? Of course not.

You’re looking for something that speaks directly to you. That serves YOUR needs – not your needs and everyone else. That’s why a woman will spend $600 on a Kate Spade handbag instead of the Target knock-off, men buy ‘men’s razors’ when cheaper women’s razors work just fine, and why your perfect target patient will pay you a premium and beg you to treat them.

Take note of this point because it’s important: If you’re targeting to EVERYBODY then you’re selling to NOBODY.

It may sound counter-intuitive but it’s true: The more you niche yourself, the more money you can make.

An excellent example of this is Johnson & Johnson Baby Shampoo. It’s been around forever and you probably already know the ‘No more tears’ slogan. Know who their market is? It’s not babies. Babies don’t by shampoo. In fact, it’s used by adults far more than it’s use on babies. Why, because it’s ‘niched’. It says right on the label who it’s for… even though they know that more adults use it.

You’re not offering exercise videos… you’re P90x who’s blowing the doors of of sales by targeting the hardest workout for the hardest bodies.

You’re not selling cooking lessons…  you’re selling cooking lessons for new brides.

And you’re not just selling Botox and fillers.

See the difference?

STORY

Dr. Greg Bledsoe wanted to teach wilderness medicine. He's edited a book on Wilderness Medicine, had tremendous domain expertise and vast experience. The problem was, there was already someone there. The Wilderness Medical Society had a hold on that niche as the biggest player in the market and liked it that way. There was no room to join that organization and then work up. The committees running medical organizations rarely change. So Greg created his own niche. He called on all of the A-list physicians he knew in wilderness medicine and put together his own conference. He focused on physicians who were entrepreneurial and wanted adventure. He ignored compaines and organizations and targeted the 'small fry'.

Now, ExpedMed hosts wilderness medicine conferences that include exotic travel locations, CME accreditation, and incredible teachers. Not only did Greg created his own niche and made a profitable business, he's put himself at the center of a network that have generated three new businesses.

This is an iterative process after all. You're not going to decide that you're the best

STORY

When I first started writing Medical Spa MD I was running a number of cosmetic medical clinics. It was 2002 and the 'medical spa' craze made is seem that there was a physician squirting Botox on every corner and a 'medspa franchise' in every strip mall. I needed a way to recruit physicians easily and quickly as we opened up new locations around the US.

I attracted physicians to Medical Spa MD by offering unique content that they couldn't get anywhere else.

If you're a physician running a cosmetic medical practice, almost all of your information comes from marketing and sales materials. Trade magazines, conferences, and the rest of the information pipeline are all sponsored by the manufactures and service companies. No advertising supported trade publication is going to come out and name the winners and losers or tell you which technology is best. They couldn't, but I could.

I created Medical Spa MD as site that was for physicians who wanted real information. Since I didn't need to make money from sponsors or advertising, I could offer the 'secret' information that physicians were looking for.

We give honest opinions and reviews. We connect physicians in cosmetic medicine in a way that no one else can. We turn down 99% of businesses that want to partner with us.

The result? Medical Spa MD has 5,000 physician members worldwide and is the primary community for physicians around non-surgical cosmetic medicine.

As a generalist, you have to make sure that you are one of the best in the industry, have unique service offerings, and you are considered accomplished in a few other fields. 

If you do it persistently enough, you will OWN that niche. People will not be able to imagine that niche without you.

The secret to commanding premium rates is in identifying a very specific niche that buyers demand, and focusing on that niche while excluding everything else.

There's no really good short cut around this. If you don't already have any unique skill set, you're going to have to develop one. You can't hoodwink everyone into buyers by just saying that you're better. Decide on a single special attribute or 'specialty' and make it your own. Actually BE better at it in some way.

Oh, by the way, you can only pick one niche.

Listen to this as a claim; I'm the worlds leading proctologist and neurosurgeon. Or how about this; I'm the city's leading Botox provider and the best at liposuction.

You can not be 'the best' at more than one specialty. I know that you want to be the best at more than one thing. I know that you think you are and you might actually be, but the marketplace won't believe you, and belief determines 'what someone will pay'.

Here's a perfect display of niching: Alexander Rivkin MD at Westside Medical Spa came up with a niche; the non-surgical nose job in which he uses Restylane or Juvederm. Nice. Look at the press he's getting.

Now Dr. Rivkin is offering all sorts of treatments and most of his revenue comes through other services but his 'brand' and positioning starts with the niche that he built. It set him apart and let's him dominate a niche.

Have the confidence to find your niche, define who you are, then declare it again and again and again and again.  If you target your martket smartly, over time you will own that niche.

Your Medical Spa Pricing, Cognitive Dissonance, & How To Charge More

Your profits are in your prices. Where are the psychological triggers you can use to raise your prices and charge more?

You'd like to be able to charge a premium for your services and rake in the big bucks, right? Then why are so many physicians and clinics utilizing the slow death spiral of constantly trying to undercut the competition and using discounting coupon services like Groupon. Why are some physicians able to charge 50% more for Botox and others are trying to give it away and scrambling for any new patient. Where's the disconnect?

Guess what. It's psychological.

Look, there are only two things that determine ANY price.  Put these lines on a graph.

  1. How much you're willing to sell something for.
  2. How much someone's willing to pay for it.

That's it. Just those two things, and the second of those is based on psychological triggers more than anything else. (Of course, those two lines cross at some point or you're pricing yourself out of the market and in big trouble.)

As a physician running a cosmetic medical practice or medical spa, when you’re essentially selling time, how do decide where you can set — and then raise — your rates?

Guess what? People actually want to pay a lot.

I learned this as a young painter in New York. My paintings sold between $25,000 and $60,000. Why? It's pretty simple. I wouldn't sell them for less and I could easily get buyers who would pay that amount. I could find lots of buyers that would purchase my work as fast as I could produce it. I had both the skills and business savvy to understand that the quality and uniqueness of my work created the demand and drove up my prices. I didn't just set my prices high. I started by creating a unique niche that I completely dominated; beautiful, realistic women in oil with old world craft. I would never have been able to charge $60,000 for paintings that no one wants and anyone could produce.

Even more, I set myself up as able to demand those prices. Believe me, no one want's to pay $50,000 for a painting. They only pay that amount for a story, and the story is around something that's unique and scarce.

People want to pay a lot for cosmetic treatments.

If you don't know it already, you're in the vanity business. People will pay outrageous prices for vanity. Think of the prices that high end vanity commands; $600 for a felt purse by Kate Spade, $1,150 pumps from Christian Louboutin, the $84,000 Audi A8, the Omega Seamaster watch, any Apple product... The cost is actually integral to the enjoyment.

People want to pay a lot for your cosmetic treatments IF you position yourself correctly AND your treatments are both unique and scarce.

No one wants to pay more for the same coach seat on an airline, but there's obvious satisfaction when someone describes the purchase of an expensive luxury item, even if the price is never mentioned.

If you cater to the lowest common denominator, you'll have to price your services that way too. Specialize in a lucrative niche and your services become not only unique, but scarce as well. Uniqueness and scarcity work hand-in-hand to drive up demand and allow you to raise your rates.

So uniqueness and scarcity are primary ingredients to any offering that want's to charge a premium. We'll deal with both uniqueness and scarcity in other posts. What I want to talk about here is the psychology of pricing and how it relates to your own pricing and your customer loyalty.

Once you have something that's both unique and scarce, you can move on to increasing your prices.

Where's your current pricing?

I’ve met many, many physicians who under price their services.The primary reason that's give is that they have to have low prices to remain competitive in an every more productized marketplace, where every corner has a medical spa trying anything to attract new clients.

This can be true — especially around mass consumer treatments like Botox and laser hair removal — but whatever the reason, charging too little for your services is self-sabotage for two primary reasons:

  1. When you don’t charge enough you end up resenting your clinic. You do too much work for too little money. It’s not worth it. (Try to tell me this isn't the primary reason that so many physicians are trying to leave clinical medicine.)
  2. A low price tells patients that you’re not worth it. It may be all smoke and mirrors in the beginning, but if you want to be perceived as the best, you’d better price your services accordingly. Low prices are THE primary indicator of low quality.

I've seen any number of small clinics where the marketing and pricing plans, if there was one, wasn't well articulated or just rattling around in the physicians head. As a result, these clinics, in an effort to build their own business, underbid services on low quality clients. As a result, they ended up with lots and lots of low fee procedures and special offers. Instead of focusing on high quality premium treatments, these staffs are pushed to get things done as fast as possible to keep the treatments profitable despite the low fees. This poor quality of training, service and oversight leads to mistakes. Clients nitpick and try to get additional discounts or haggle about pricing. Accounts receivable grows. Lawsuits happen. It's no surprise when clients start leaving for the next low bidder to open up shop.

Remember, people value things by price. Just one of the reasons why I’m sitting in Starbucks right now drinking a $4 coffee.  (And no, I don’t think $1 coffee is their best move.)

One of the primary components in positioning yourself is how you price your services.

Price Influences Your Perception Of Quality

As price goes up, so does your perception of quality AND pleasure (satisfaction).

I don't know this for sure but I would bet that 'premium' medical providers are sued less frequently and have higher satisfaction rates than lower priced physicians. It could well be that being the low cost provider puts you at greater risk for lawsuits for a number of reasons. (If you have any relevant information to this, please leave it in the comments.)

A well known study out of the California Institute of Technology and Stanford University details how price influences peoples perception of quality in wines.

Antonio Rangel, an associate professor of economics at Caltech, and his colleagues found that changes in the stated price of a sampled wine influenced not only how good volunteers thought it tasted, but the activity of a brain region that is involved in our experience of pleasure. In other words, "prices, by themselves, affect activity in an area of the brain that is thought to encode the experienced pleasantness of an experience," Rangel says.

Rangel and his colleagues had 20 volunteers taste five wine samples which, they were told, were identified by their different retail prices: $5, $10, $35, $45, and $90 per bottle. While the subjects tasted and evaluated the wines, their brains were scanned using functional magnetic resonance imaging, or fMRI.

The subjects consistently reported that they liked the taste of the $90 bottle better than the $5 one, and the $45 bottle better than the $35 one. Scans of their brains supported their subjective reports; a region of the brain called the medial orbitofrontal cortex, or mOFC, showed higher activity when the subjects drank the wines they said were more pleasurable.

But the experiment was rigged. While the subjects had been told that they would taste five different wines, they had actually sampled only three. Wines 1 and 2 were used twice, but labeled with two different prices. One wine 2 was presented as a $90 bottle (its actual retail price) and also as a cheaper $10 wine. When the subjects were told the wine cost $90 a bottle, they loved it; at $10, not so much.

In a follow-up experiment, the subjects again tasted all five wines but without any prices; this time, they rated the cheapest wine as their most preferred.

Previous marketing studies have shown that it's possible to change people's perception of how good an experience is by changing their beliefs about the experience. For example,  moviegoers report liking a movie more when they hear how good it is beforehand. Studies show that the neural encoding of the quality of an experience is actually modulated by variables such as price, which people believe is correlated with experienced pleasantness.

The results make sense. Your brain encodes pleasure because it is useful for learning which activities to repeat and which ones to avoid, and good decision making requires good measures of the quality of an experience. But your brain is also a noisy environment, and "thus, as a way of improving its measurements, it makes sense to add up other sources of information about the experience. In particular, if you are very sure cognitively that an experience is good (perhaps because of previous experiences), it makes sense to incorporate that into your current measurements of pleasure." Most people believe, quite correctly, that price and the quality of a wine are correlated, so it is therefore natural for the brain to factor price into an evaluation of a wine's taste.

How 'Cognitive Dissonance' Affects Pricing

Cognitive dissonance is that uncomfortable feeling you get when you're holding conflicting ideas simultaneously. The theory of cognitive dissonance proposes that people have a strong motivational drive to reduce dissonance since it causes internal conflict. They do this by changing their attitudes, beliefs, and actions. Dissonance is also reduced by justifying, blaming, and denying. It is one of the most influential and extensively studied theories in social psychology.

I'm not trying to force a psychology degree on you but  it is useful to have understanding some basic underpinnings of behavior and how they affect pricing, such as why critics don't like your favorite wine, and how wineries get away with charging $500 for a bottle.

Have you ever noticed fans almost never complain about lousy music concerts or albums, yet critics frequently give them poor reviews? What's going on? Are critics just inherently nasty?

Maybe, but the fact is that there's a psychological principal at work that's also in effect every single time you exchange something of value (money) for a product or service.

Here's an example of cognitive dissonance at work.

In a landmark study by Leon Festinger and James Carlsmith, seventy-one male students in the introductory psychology course at Stanford University were asked to spend two hours doing a very boring task, sticking wooden pegs in holes.

Participants were divided into three groups. Some were paid $20 (a lot of money back in 1959). Some were paid $1. And some were told they were volunteers and paid nothing. All were told what their payment (or non-payment) would be before they began.

After two hours of what was surely hellish tedium, participants were asked to rate the 'enjoyment' of the task.

So what do you think? Which of the groups ($20, $1, nothing) thought that sticking pegs in holes for two hours was the most fun?

Here's the answer: The group that was paid $1 found the task most pleasurable. The group paid $20 found it the most boring.

Why? Cognitive dissonance at work.

Here's the way that cognitive dissonance is at work in the real world:

  1. If you are induced to do or say something which is contrary to your personal opinion, there is a tendency for you to change your opinion to bring it into correspondence with what you have done or said.
  2. The greater the pressure used to elicit the overt behavior (beyond the minimum needed to elicit it) the weaker the tendency to change the opinion.

Let's discuss the first point. In the peg study the task was, objectively, tedious and boring, but people who were paid $20 could easily explain to themselves why they did it: they wanted $20. They rated the task as the most boring. People who were volunteers and got nothing could tell themselves they did it to advance science. They found it less boring than the $20 group, but still somewhat boring.

But here's where cognitive dissonance comes in. The people who were paid only $1 couldn't reconcile with themselves why they spent two hours putting round pegs in round holes. Their brain held two dissonant thoughts: "This task is dull" and "I'm wasting my time for a $1." The second statement was 'fixed' and couldn't be changed, so the brain unconsciously modified its belief about the first to decrease the conflict. People decided they were having fun; otherwise they would be fools for doing it at all.

But don't forget the second point; The greater the pressure used to elicit the overt behavior (beyond the minimum needed to elicit it) the weaker the tendency to change the opinion.

This is why the 'soft sell' can be so effective. Using less 'pressure' to elicit the behavior actually results in the strongest tendency for a person to modify their opinion.

Let's apply this lesson to how pricing affects the enjoyment of a product or service.

When you pay for anything; food, Botox, liposuction, or wine — your brain knows the price, and you're pretty sure that you're not stupid. So, if you pay $200 to see a live band and they're all singing off-key, your brain can change its evaluation of the performance to "charmingly gritty and spontaneous" or "incredible live performance". Your subconscious is pushing you to find the experience pleasurable.

But the critic sitting in back didn't pay for his tickets. He's just there to do a job, and his brain knows that. If the concert is bad and he says so, that doesn't make him a fool for going, he's just more objective.

Think about it: How often have glossed over a obvious shortcoming in order to avoid tainting your enjoyment of something you've paid a lot for? I know I do it all the time.

Here's what W. Blake Gray says about cognitive dissonance and wine.

I get a lot of free wine, and I pay for wine frequently also. Even though I'm aware of cognitive dissonance, I still think I'm more likely to give the benefit of the doubt to a so-so wine I order by the glass in a restaurant over a wine I taste in a professional setting. I'm paying for it, I'm no fool, it can't be that bad.

There are several implications here:

  1. Why do fans of an expensive wine like it more than the critics? Simple: they're paying for it
  2. The more money the wine costs, the more powerful the effect of cognitive dissonance. You can freely diss Two Buck Chuck, but that overripe $60 Syrah? It must have some good points. Many Napa Valley vintners understand the implication of this: Charge more, and while the wine might be difficult to sell, people who do buy it will like it more. Hows that for increasing your customer satisfaction?
  3. Why does Robert Parker give higher scores to wines than other critics? To his credit, he is well-known for paying for a lot more wines than any other critic. He chooses what to pay for, he doesn't taste blind, and I submit that even for a man whose palate is as consistent as anyone in the business, cognitive dissonance is at work.
  4. Why does wine taste better in the tasting room? There are other factors at work as well, but consider this potential dissonance: "I drove out of my way to get here and chose this winery over its neighbors. Plus I paid a $10 tasting fee." Cognitive dissonance is a good motivator for every tasting room to charge a modest fee. (Sorry, consumers.)
  5. Why don't professional critics rush to embrace funky, expressive wines, especially those in niche categories? We don't have to; we don't have the cognitive dissonance of "I paid $12.99 for this no-added-sulfite 'organic wine' and it smells like feet." Mmm, feet.
  6. How do the Bordeaux first growths get away with those outrageous release prices -- over $500 a bottle for some? In Hong Kong, people are thinking in Cantonese, "I paid $900 for this wine. And I am no fool. This is so worth it." Cognitive dissonance knows no language barrier.

Cognitive Dissonance & Irrational Customer Loyalty

Of course pricing isn't the only factor we're discussing. Let's talk some cognitive dissonance and how it leads to irrational customer loyalty, just what we're looking for.

In a study looking at why cognitive dissonance with dentists and their patients, Duke University behavioral economist Dan Ariely revealed the probability of two dentists separately finding the same cavity in an X-ray as being about 50%. And often, what dentists think is a cavity, turns out to be nothing. All the more odd, then, that as patients, we’re incredibly loyal to our dentists - more faithful, in fact, than to other medical practitioners.

Why? It's cognitive dissonance here as well. In order to rationalize all of the unpleasant poking, scraping and drilling that dentists subject us to, we convince ourselves that our particular dentist knows best:

"Dentistry is basically the unpleasant experience. They poke in your mouth. It's uncomfortable. It's painful. It's unpleasant. You have to keep your mouth open. And I think all of this pain actually causes cognitive dissonance - and cause higher loyalty to your dentist. Because who wants to go through this pain and say, 'I'm not sure if I did it for the right reason? I'm not sure this is the right guy.'"

(Kinda reminds me of Stockholm Syndrome in which people who are kidnapped actually begin to identify with their captors.)

But cognitive dissonance accounts for more than our loyalty to dentists. It also generating increased revenue for dentists and adding to their profits.

And it increases over time.

Imagine that at some point in your dental treatment, you have a choice between two treatments that have exactly the same possible outcome, but one of them is more expensive to you and better financially for the dentist. Which one would you choose, and how would the duration of the relationship with your dentist be affecting that?

It turns out that the more time people have been seeing the same dentist, the more likely the decision is going to go in favor of the dentist. People are going to go for the treatment that is more expensive but has the same outcome. More out of pocket for them, more money for the doctor. So in this case, loyalty actually creates more benefit for the dentists with no better potential outcome for the patient.

Now, while it may sound like I'm advocating standing on a patients toes while injecting Botox... not so.

There may be some effect of cognitive dissonance at work when you're performing a Melasma or other treatment where there's some pain and downtime, but what we really want to focus on here is how pricing your treatments higher, can actually increase both your patient satisfaction and revenue at the same time.

Does A Premium Price Drive Actual As Well As Perceived Value?

I would say yes in many instances.

Take a look at our medical spa training manuals and you'll see that they're more than a big hardcover at Barnes & Noble, much more. But we deliver on those prices since the quality of the content is so far above what you can get elsewhere. This isn't generic information, it's specialized, and it's valuable.

The medical spa staff training manuals are priced where they need to be to make the creation and distribution profitable enough that it's worth creating AND creates an incentive for buyers to actually use the information. Some of the most successful medical spas and cosmetic clinics around are using these training manuals. Do you think that someone who's at all serious about their business thinks anything at all about dropping $300 on a product that can optimize their operations and train their staff? Are you kidding?

Sure, I could give all that stuff away. Perhaps there are those that think that I should. This isn't for them. We give away 99% of everything for free already, but real products that give you the most benefit aren't valued if they're free.

It's not about information. It's about motivation. Paying a premium for them actually gives you more value... and pleasure.

Clarity

Look, you know more about your own situation than I do. I'm not trying to convince you to raise your prices if you can't support it, but hopefully you've got something to think about. There's a lot of obvious, anecdotal and researched evidence that shows that higher prices will make you more money and make your patients happier... but pricing is the second step. Creating a service menu and reputation that is unique and scarce is step one.

Pricing is one of the things that all physicians and medical spas struggle with. It is one of the handful of items that actually dictate how much money your clinic will make and where your profits are.

One last point: You've been reading this post for something like 3 minutes now. Isn't this the most interesting blog you've ever read? Please tell your physician friends. They're no fools either.

The Medical Spa Blueprint: This post deals with some of the topics we'll cover in The Medical Spa Blueprint, a guide to opening and operating a highly successful and profitable cosmetic medical clinic. To be notified when the Medical Spa Blueprint is available, just join Medical Spa MD. It's free, which is a terrific price.

If you have some thoughts on this stuff, please leave a comment. We want to hear from you and if we use it in the Blueprint, we'll credit you. ; )

References

Marketing actions can modulate neural representations of experienced pleasantness published January 14 2008 in the early online edition of the Proceedings of the National Academy of Sciences.

Cognitive Cinsequences Of Forced Compliance Leon Festinger & James M. Carlsmith First published in Journal of Abnormal and Social Psychology

William H. Cummings, M. Venkatesan (1975), Cognative Dissonance and Consumer Behavior: A Review Of The Evidence in Advances in Consumer Research Volume 02, eds. Mary Jane Schlinger: Association for Consumer Research, Pages: 21-32.

The Gray Market Report, Why Expensive Wines Taste Better: Psychology 101 W. Blake Gray

Cognative dissonance on Wikipedia

Understand Your Patient's Home Run In The Consultation Room

Before you leave the consultation room ask your patient this question: What's a 'home run' for you?

Consultations are where the money gets made in a medical spa but understanding and managing expectations with your cosmetic patients will keep you out of trouble, and your patients coming back. One of the very best ways to understand where your patient's head and expectations are is to ask, 'What's going to be a home run for you?'.

You're probably already trying to set expectations and get to know what your patient's after - you're in a consultation room after all - but I'm talking about some thing other than asking about 'What are you looking for?' or 'What are you trying to change?' which are the most common types of questions.

There's a lot you can do to increase your revenue in the consultation room. Don't miss the opportunity to set up your patient for the big win.

When you ask, 'What would knock the ball out of the park for you?', you're tapping in to some triggers that give you a much better feel for where the patient is, and creates a complete buy-in if you're able to align those 'big win' thoughts with manageable expectations. This is a part of the consultation that a lot of physicians miss by just asking general expectation questions like 'What are we trying to accomplish?' or 'What are you looking for?'. These kinds of milquetoast questions don't have any teeth.

The worst kind of ham-fisted consultation - and I've seen this - is just to hand a mirror to a patient and tell them to tell you what they don't like about their face. (A perfect example of a doc that never understood the psychology of buying and though of himself as a mechanic. Lame.)

Look, no one is coming in to your clinic with 'age management' as their goal. That's a totally goofy doc-talk deal. Patients are looking to drop 20 years. Once you've gone through the consultation you'll have a pretty good feel for if you're going to be in the running for making this patient happy or not. If you're not going to make the person thrilled, give careful consideration to treating the patient at all. But if you're pretty comfortable with the treatment and feel that you can deliver, ask the patient what they would consider to be a grand slam home run and then discuss it. Don't try to talk them down too far. They'll be pretty reasonable (or you'll see that you can't make them happy) if you give them some rope here.

Drive patient happiness.

Everyone likes to have happy patients. They don't sue you and if you're lucky, they'll tell a friend or two. But how often do you think of 'patient satisfaction' as a byproduct rather than the actual aim.

Setting up your consultation with this kind of 'big win' potential gives the patient a target to aim for and a peg to hang their hat on if you come close. If you deliver, the patient feels that it wasn't just an average treatment and that you really are the cosmetic guru you're website says you are, and if you fall short you're still in the ball park and all is not lost.

Managing your patients expectations should really be around finding the buy-in point of where this 'grand slam' outcome is, NOT the base hit of finding an adequate result. (I know there's a lot of baseball analogies in here.)

Don't create more patients. Create more zealots.

Meeting expectations creates another satisfied customer. Boring, and not the way to build your business. But if you can use the consultation to define what a 'big win' is, manage expectations around that end point and then deliver on those, you're creating a zealot, and zealots build your business for you.

Yes, you already have a few zealots. Everyone else does too.

What you're looking to do here is bump up the percentage of zealots that you produce, because they'll work tirelessly to drive new patient traffic.

This tiny change in the way you think about your consultations can deliver disproportionate results.

What do you think?