Dr. Glynis Ablon - Ablon Skin Institute, California

The Ablon Skin Institute in Manhattan Beach is a single physician clinic where dermatologist Dr. Glynis Ablon provides a wide range of cosmetic care and research.

Name: Glynis Ablon
Clinic: Ablon Skin Institute
Location: Manhattan Beach, California
Website: http://abloninstitute.com/

Brief Bio:

Glynis Ablon, M.D., F.A.A.D., is a board certified dermatologist and cosmetic surgeon, who completed her training at Baylor School of Medicine in Houston, Texas. Dr. Ablon is an Associate Clinical Professor at UCLA, practicing at both UCLA and LCMH. She is active in clinical research and the first published author in the United States in mesotherapy. Dr. Ablon is an on-camera medical consultant for The Doctors Show, E! Entertainment, Extra, ABC, CBS, KCAL and Lifetime. She is a Fellow of the American Academy of Dermatology, American Academy of Liposuction Surgery, American Society for Laser Medicine and Surgery, and American Society for Dermatologic Surgery. Dr. Ablon also received the IMCAS Research Award 2010 for innovative research on Botulinum Toxins.

We got together with Dr. Ablon to ask her a few questons about her career and clinic.

How did your background influence your journey to cosmetic dermatology?

I always wanted to be a doctor. My parents called me a “Red Cross Nurse” because I always wanted to help people. I loved the diversity found in dermatology from medical, pediatric and surgical dermatology, to cosmetic dermatology. It is nice to follow entire families through their lives. We can offer our patients a more full service clinic and lifestyle.

I really started in the cosmetic dermatology realm in my residency at Baylor with mentors like Ted Rosen and Leonard Goldberg, and lasers with Dr Moise Levy. I liked the challenge of difficult cases, but also making people look and feel their best, starting with my very first and most difficult cosmetic client, my mom.

You're in a LA which has to be a hyper-competitive market. What can you tell us about Ablon Skin Institute?

My clinic is located on the Manhattan Beach Studio Lot in Manhattan Beach, California, offering full service medical, pediatric, surgical and cosmetic dermatology.

I am still a very type A solo practitioner with a staff of 8 and an office that includes a research center of almost 5000 square feet. I oversee everything, but am good at delegating tasks. I think it is critical if you run a small solo practice to have good checks and balances. A good office manager can really lighten your load, but finding one that will do diligence evaluating office expenses to keep your overhead as low as possible can be challenging, so I do it myself.

Staffing is always and issue. How have you made that work?

Staff is probably the second most critical issue in a medical office (first being your talent as a physician). My staff is paid well; I give bonuses every year (and sometimes during the year, if they are performing exceptionally). I also offer 401K and profit sharing. If you have good staff you want them to stay, so you must be a great boss and offer competitive monetary compensation. I don’t like commissions because I don’t want my staff promoting things they don’t believe in just to make extra money. If my patients are happy, which means the office is doing well, then my staff is rewarded. I have individuals that have been with me for 5-15 years. If you have a problem employee, move on it quickly. Give them written warning, and then say goodbye; they can be a cancer in your office if you don’t.

You also have a lot of technology. What are your considerations before buying laser or IPL technologies?

I have 20 lasers in my office. I love new technology but it has to fit into your practice and patient population. Don’t just buy to buy. I test all technology before purchasing. I have only one laser purchase regret and it’s the one laser I didn’t test out before buying. I went along with a colleague’s recommendation and It sits in my storage closet. I love radiofrequency with microneedling. I still love my IPL and versapulse. Always look at the revenue you can generate from a laser against the purchase price. Always negotiate prices! I don’t like machines that are extremely painful even if results are decent.

Your thoughts on marketing?

I have been lucky to have some free media exposure early on in my career, so I have never advertised. I have recently started social media, as it appears to be the wave of the future and not going away anytime soon. I do charge for all cosmetic consultations. I don’t want looky-loos. If patients are willing to pay for consult they are more likely to do the procedure. We do apply our consult fees to future treatments, so it is not lost or wasted. I do believe word of mouth is still the best way to get new patients.

Are you looking to add any new treatments in the near future? Is anything on your radar?

I am always on the look out for new treatments, but I am extremely picky. It is important to try out new technology in your office to know how it works, how it feels, what’s the pain level, and who needs to run the machine. You don’t really want to buy just to have “the newest” technology but rather the best. And you must look at your specific patient population and what they need (you wouldn’t spend money on a new hair removal laser if you are treating the majority of light haired individuals). I think radiofrequency with microneedling is an amazing advancement. We can treat all skin types and don’t have the complications like lasers with pigmentary alteration.

What are things you've learned that you'd like to share?

You can’t please all of the patients all of the time! It is so important in this time of social media that you stay true to yourself. Do your best, and if you get a bad feeling from a patient before you start performing cosmetic procedures on them, don’t do it. If a patient comes in complaining about another good doctor you know, don’t treat the patient. And if your staff has a really bad feeling about the patient, don’t treat that patient. It will make your life less stressful, and I really believe less stress is the key to longevity both in life and the profession. This business can be life altering (I treated a patient with fillers status post brain surgery with a skull depression that hadn’t looked or felt normal in 6 years since her surgery, making her skull now a normal shape leaving her ecstatic), but it can also drain you if you don’t stay true to your self. Going to work doesn’t feel like a job because I love it so much, but I think that’s because I have found a great balance in work, home life and playtime.

It took my mom’s meningitis and near death experience and my own attack of facial paralysis to realize 5 years ago that I needed to be more serious about reducing stress. I wrote a book called What’s Stressing Your Face to teach others what I learned and how to better manage the environment we live in. My best advice is to find balance in your life. Work on lowering stress in every aspect of your life. Spend time with those you love, doing what you love. Surround yourself with great people, great staff and great friends who bring you up, and envelop you with love. Life is short, don’t waste a day not being happy!

About Dr. Ablon and the Institute

ASI Research Center is an independent clinical research site specializing in cosmetic and medical dermatology clinical trials. The Center was founded by Glynis Ablon, MD, FAAD in 2008. Dr. Ablon began her interest in research at Pomona College in the Genetics Department in 1990, and has expanded her research experience over the past 20 years culminating in the opening of ASI Research Center. The center has its own full-time staff and dedicated office within Ablon Skin Institute. Our research center is equipped with more than 20 laser systems and state of the art photography systems including Visia, Janus, FotoFinder Mediscope and Nikon Dermalite Macrophotography. ASI provides a full range of medical, surgical, and cosmetic dermatology services.

Millennials Are Starting To Hit Cosmetic Medicine

Millennials are now hitting the age where they're looking for cosmetic medical care... but reaching them requires a change in the way you're getting your message out.

Social media is a key factor in engagement. It has opened doors for physicians to update patients with the latest offers in the clinic or with the newest in the health world or by simply educating them about your specialty or practice. The power of social media would help you become an influencer, allowing you to be known across different channels and even through different generations.

Moz, an SEO company, released a series of infographics about generational use and reach of social media.

See them here: https://moz.com/blog/the-generational-content-gap-three-ways-to-reach-multiple-generations

According to some experts, physicians have difficulty reaching Generation Y (millennials). While many millennials are active in social media, physicians may have to step up their game in order to reach this demographic to garner more patients in their practice. Millennials have trust issues, and as physicians who want to reach Gen Y, you may need to build up your online reputation and website. After all, they're looking at everyting online via their smart phone.

If you're a single physician, make your name a brand. According to Forbes, Millennials are able to connect with companies better as a brand, so try to condense your popular procedures into 140 characters on Twitter. Another alternative to wordiness is visuals. So, put your name out there and differentiate yourself from the others.

If you're running a larger clinic, you can do the same thing with your clinic's name.

Reviews will remain important. Forbes also reports that Millennials trust reviews before getting into anything. It helps them discern if the cosmetic procedure is right for them or is too expensive and the risks that follow. Ask returning patients to give you reviews so that Millennials will be able to read about your treatments and the way you and your staff handle patients as well.

Lessen advertising. Advertisements sound the alarms on a Millennial’s head. This causes their trust issues to rise, and they . Don’t target their insecurities, target their possible needs. In addition to what they would need, elaborate further as to how this procedure could be beneificial and risky it could be. In that sense, you could have them consider getting the procedure and look more into it.

So physicians, what should be your 2017 strategy?

Change it up. Don’t stay on Twitter or on Facebook all the time. Try Instagram and Snapchat. According to most SEO experts, Expired Content—posts that last for only a few hours—would keep them curious or wanting more. If you are already established on Twitter or Facebook, go on live video to introduce products and services, show your whole practice, and flaunt your practice or clinic. It allows your audience to see how the clinic looks like and your staff also runs the practice.

Content is always essential. No updates could hinder your conversion strategy. Always have relevant content on your blog and your social media channels. Churn out significant content. Remember, there is a difference between spamming your followers and posting regularly.

Ask returning patients to follow and mention you. This is important, because in this regard you can retweet or like their posts and some of your followers will be able to see that.

Educate and inform. To establish yourself further on the social media front, you will need to post educational content about cosmetic procedures. This way, your patients know what to expect and at the same time see you as their reliable sources.

Skinboosters: Your Medispa Needs to Add This Service

My Love Affair with Restylane Vital

In our medispa businesses, we all know and can't deny the following equation: Happy Patient = Happy Doctor

This is why your medispa needs to add skinboosters to its range of injectable treatments.

What are skinboosters?

Most importantly, skinboosters are not dermal fillers. They are "an injectable moisturiser" which improve the skin's quality by boosting hydration in the skin, they increase smoothness, elasticity and firmness. They are a hyaluronic acid injectable treatment, which have been proven to improve skin quality.

My clinic's experience with skinboosters:

We introduced Restylane Vital at our Sydney clinic several years ago after it was approved in Australia. It was a difficult start. The original protocol involved multiple treatment sessions (typically 3) using needles. This created too much downtime and bruising, so patient satisfaction wasn't high. We improved the treatment regime, by performing the full treatment in one session, using a cannula. Bruising and downtime were reduced, and patient satisfaction soared.

My clinic's specialty is injectables, so we do a high volume of dermal fillers. Our figures reveal the growth of skinboosters. In the last year, for every 6mls of hyaluronic acid dermal filler we injected, we injected 1ml of Restylane Vital.

The feedback from patients is that they get compliments about their skin. Injectors know how much that can reinforce a new behaviour.

We have minimal experience with other brands of skinboosters. The Juvederm brand skinbooster is not available in Australia yet.

They key with skinboosters is to choose the right patients. They will love the results and come back for more every 6-12 months.

The right patients for skinboosters

• Those into the "natural look" who want a subtle improvement in their skin and  don't want to change the general look of their facial anatomy
• The skin obsessed
• Those higher on the Fitzpatrick scale who want general skin improvement but don't want the risk of PIH (post imflammatory hyperpigmentation) which is associated with lasers and other skin treatments
• Patients with acne scarring or photodamage
• Patients who you have made structurally perfect with dermal fillers who come into your office and want more improvement
• The young/young at heart who are scared of or don't need or feel ready for dermal fillers
• The girl/guy who has everything:)
• Those with or motivated to prevent accordion lines (lower cheek smile lines) and barcodes (smoker's lines)
• Those wanting neck, decolletage and hand skin improvement.

The wrong patients for skinboosters

• I like to call them the "glass half empties", that is, their default position is unhappy, and they will never see their glass (or wrinkles for that matter) as half full.... Actually I could make a case to sack all of these types of patients from your practice, but that subject deserves its own post.
• Those who are less sensitive to aesthetics eg if you put 1ml of dermal filler in their lips, they won't see the difference. Skinbooster results are subtle so these patients are not ideal.
• Those who need and want obvious structural change in their face eg volumising or wrinkle filling. Skinboosters need to be looked at as icing on the cake in this circumstance. That is, you need to bake the structural cake first.

Skinboosters Revenue

Skinboosters are very affordable for the patient, which makes it attractive to them. Often multiple syringes are wanted and required, which improves the revenue for the doctor. The satisfaction rate and the retention rate for the procedure is high. The other good news for the injector is that the "blanket coverage" style of injecting required for skinboosters is less taxing, unlike the "precision injecting" which is required for the treatment of wrinkles and volume.

My technique

We perform a single injecting session using 3 mls of Restylane Vital in the mid and lower face. We use cannula or needles, whichever the patient prefers. If the forehead is included, an extra 1ml will be required.

Repeat this procedure every 6-12  months or sooner if requested by the patient.

Skinboosters around the World

Restylane Skinboosters continue to grow around the world. The product is becoming available in an increasing number of countries each year. Particular areas of growth at the moment are Latin America and Asian countires. Skinboosters aren't available as yet in the US, but American injectors can look forward to adding an innovative tool to their toolkits when skinboosters become FDA aproved.

Dr. Michael Gold - Gold Skin Care Center, Nashville

With 30 years of cosmetic dermatology experience Dr. Gold shows no signs of slowing down as he continues to grow his Nashville practice.

Dr. Michael Gold is a cosmetic dermatologist in Nashville Tennessee who was kind enough to sit down for an interview and give us his insights into how he runs his clinics, what technologies he uses, and what he's learned.

Name: Michael H. Gold, MD
Clinic: Gold Skin Care Center
Location: Nashville, Tennessee
Website: www.goldskincare.com

You've been working in this area for quite a while. What made you pursue cosmetic dermatology and aesthetic medicine?

I actually got started thinking about dermatology and aesthetics when I was 16 years old due to a bad case of acne, that I had when I was a young man. My dermatologist was Dr. Albert Kligman who invented Retin A and I was one of his first patients he placed on this medication. It was a strong formulation and within a week I had peeled the equivalent of today’s medium depth chemical peels. My skin was really smooth after that, and I thought - derm is the route I want to pursue in medicine. In my residency - actually my first day, I did a hair transplant with Dr. JB Pinski and the second day I did a liposuction procedure with my chairman Dr. Henry Roenigk. Dr. Roenigk was keen on cosmetic dermatology and instilled this love for aesthetics and surgery into me. I learned much from him and my other professors at Northwestern during my time there - especially from Drs. Jerry Garden, Ruth Frankel, and June Robinson. When I finished my residency I moved to Nashville, TN where I began seeing lots of patients interested in cosmetic concerns. This, along with my love of dermatology in general, helped propel my career in this field.

I was very fortunate to have played a role in the use of topical silicone gel sheets for hypertrophic scars and keloids and was part of the team that helped bring topical ALA into the US for not only AK use but for rejuvenation of the skin as well. I have been involved in lasers and light sources for years and had the first dedicated IPL for hair removal, which became a popular method around the world for hair removal. And I have played a role in absorbable suture technology for skin lifting.

Cosmetic dermatology has been very good to me - and with hard work and determination it can be for anyone who so desires.

You must have learned a little something about what you want as a work-life balance overseeing what is really quite a large clinic. What can you tell us about how you run your clinic and how it's organized?

Our clinic is very efficient - at least we like to think so. We have about 25,000 square feet of space all under one roof. We have many facets of our business and we have proven leaders who help oversee the various parts of our puzzle. We have a general dermatology area with 22 exam rooms that is staffed with 3 mid-level providers and myself. We have a medical spa with a dedicated aesthetician staff who perform services and sell skin products - which number about 500. We have a dedicated laser and rejuvenation center with their own dedicated staff where cutting edge treatments occur with either energy based devices (n=43) or with one of the injectable products we use. And we have a separate, dedicated research center, staffed with trained and outstanding nurses - all certified research professionals under my guidance. We have recently just added one of the most respected plastic surgeons in the US, he is now focusing his attention on hair transplants.

We have a staff of almost 50 employees and they are coordinated by our COO and CFO, Ms. Amy Anderson and for the research department we have Ms. Julie Biron. Amy uses department managers to assist her in the daily operations of the practice, which has been estimated by some to be one of the busiest practices anywhere in the nation. Our patient population varies from day to day but on average between 200 and 250 people pass through our doors daily. Patients come to us from all over the region and from most states in the US as well. Because of my international travel, we have visitors train with us on a regular basis and teaching these young and eager students has been some of the most rewarding work we have done.

A clinic that large, with that number of patients every day, is some serious work... It had to take some time to build out. How do you manage your team?

At the beginning it was easy - find the best of the best and pay them more than anyone else. But most importantly, treat them with respect and allow them to do the work that you hired them to do. Do not micromanage your senior staff - trust them to have your best interests at heart, and have the proper checks and balances in place to make sure that things run smoothly and efficiently.

We do use commission for our spa staff - shared amongst them so not to have a competition for each and every patient who comes to our spa. This has worked for me and therefore we have used this plan the longest.

Which technologies - IPL, lasers -  are you using in your practice and how do you decide what to buy?

I may be a little different when it comes to IPLs and how we use them and how we decide to get them into the clinic. I had the second dedicated IPL for vascular lesions way back when and had the first dedicated IPL for hair removal after that. Which means that we have been working with IPLs for over 23 years now. Our clinic, along with a few others, studied and worked through the parameters to make what we now have - safe and effective and reproducible IPLs. When you decide to purchase an IPL make sure that it has a squared pulse, contact cooling, and sophisticated software parameters. The major device companies all have great IPLs - we usually stick with Lumenis, Syneron, Alma, Venus, and Sciton - where we have devices from. These are well made, well studied IPLs that one can surely trust.

Technology purchases are run through the committee in my office - I want everything so we have my office COO and CFO who must sign off on anything I want, which means we only get what we need. You don’t need devices sitting around and collecting dust - you need them to be productive and used on a regular basis. If we buy a new device today, we try to set a time line as to when that device needs to be paid off for us to be successful. It works most every time, and makes us concentrate on the task at hand.

What can you tell us about your marketing strategies?

Marketing has changed over time and I do things a lot different than I did when I first started in practice 30 years ago. Now things like social media are key to getting the message out there and we do use social media to spread the word and advertise what we are doing in our clinic. I think intrinsic advertising - using your own data base for advertising is the way to go today and having means of getting referrals from patients and colleagues as well. This is where we are today, plus newsletters and e-mail blasts and signs in the office.

In the past we used a lot of print advertising which at the time made sense - it really does not any more.

The other thing that we did 30 years ago was to be very involved in the community and we attended almost every charity event in town which was a great way to meet people and to determine which charities and causes would shape our giving’s over time. We still participate as often as we can and our community has been incredible kind to us over these 30 years.

Where do you see the aesthetic market going? Which treatments are the most popular?

Everything we do hopefully is profitable. As I said, we value our purchases and try to have them paid off in a specific period of time to make sure that profit starts at an appropriate time. If you buy a 100K machine and use it once a year, it is not going to be profitable. If you use that same device 5 times a day, then it is a different story.

My most profitable device at this time is the Aerolase Neo - I have a large acne population - as you can tell from question one - and we use the Neo to treat acne painlessly and successfully. It can be used for many indications but for us acne is number one.

But every procedure needs to be profitable and I am happy to say that almost everyone is in our clinic.

You've undoubtedly seen a lot running a large clinic with thousands of patients. What have you learned, and what advice would you give to other physicians?

I have learned much over these past 30 years. I have learned that my best friends do the same things that I do - David Goldberg, Mark Nestor, and Mitch Goldman. All of my mentors and friends taught me to be ethical and honest, to work harder than anyone else, and to give back to my specialty whenever I could. And hopefully the examples I have set for some of my mentees over the year have shown that drive, determination, compassion, and skill make for the best cosmetic practitioner and dermatologist.

My advice to others is real simple - learn your craft well, treat it with respect, and always put the interests of your patients above your interests.

We are blessed in what we do and we need to remember this each and every day.

About Dr. Gold

Dr. Michael H. Gold is the founder of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center, and Tennessee Clinical Research Center located in Nashville, Tennessee. Dr. Gold is also a Clinical Assistant Professor at Vanderbilt University School of Nursing and an Adjunct Assistant Professor at Meharry Medical College, School of Medicine, which is also in Nashville. He is a Visiting Professor of Dermatology for Huashan Hospital, Fudan University in Shanghai, China (11/2006), Guangdong Provincial People’s Hospital, Guangzhou, China, as well as a Visiting Professor of Dermatology at Number One Hospital of China Medical University (11/2008) in Shenyang, China.

Dr. Gold is a board-certified dermatologist and cosmetic surgeon who oversees the various facets of the Center’s operations: a combination of medical and surgical dermatology, cosmetic dermatology, aesthetic services, and research endeavors. Dr. Gold has earned a national and international reputation for providing patients with leading-edge technological advances and has expertise in all facets of dermatology and aesthetic care. The Tennessee Clinical Research Center is now one of the leading dermatologic research institutions in the U.S.

Dr. Gold speaks on national and international fronts, focusing on dermatology issues related to the use of lasers and energy-based devices, as well as the use of fillers and toxins in aesthetic and cosmetic dermatology. He lectures in venues around the world and is a sought-after contributor to educational meetings globally.

Your Comfort Zone

Laura Carlsen, RN - Colorado Skin & Vein Center

Vice President and Clinical Director of the Colorado Skin & Vein Center, RN Laura Carlsen proves to be an all-around cosmetic provider.

Colorado Skin & Vein Center provides a wide range of services from clinical dermatology (provided by a physician) to cosmetic care (provided by an RN), a common strategy. In this interview Laura Carlsen RN discusses her work and path to a successful career and business.

Name: Laura Carlsen, RN
Clinic: Colorado Skin and Vein Center
Location: Englewood, CO
Website: coloradoskinandvein.com

Brief Bio:

I graduated from Northern Illinois University in 1989 with a marketing degree. After graduation, I sold IBM electric typewriters, computer maintenance contracts and Aveda skin care. In 1990, I started a home-based business performing facials, microdermabrasion and waxing treatments. I ran that business for 13 years, before graduating from the University of Colorado Denver with a nursing degree in 2009. As a Registered Nurse, I went to work for Colorado Skin & Vein (which was previously known as Colorado Center for Photomedicine) where I have proudly worked for eight years.

What sparked your interest in cosmetic medicine?

When I went to school to become an RN, it was with the intention to stay in the cosmetic industry. I loved doing facials and skincare but wanted to expand on that knowledge. I was doing a lot of acne facials and had several patients ask me about blue light. I knew then that I had to know more about what was available and how I could be involved.

What can you tell us about the clinic?

For eight out of the 11 years that Colorado Skin & Vein has been in practice, we operated with one doctor, one nurse (myself), and one to two support staff. Sometimes we had an esthetician, yet oftentimes we did not. We went from a 2500 square feet space in Highlands Ranch to our current building at I-25 and County Line with over 20,000 square feet. We occupy the top floor and rent out the bottom floor. Our staff has grown to 10 full-time and a few part-time employees. We have three main areas of focus: Dr. David Verebelyi, who does vascular treatments (leg veins, facial veins, port wine stains, etc.), Smartlipo and CO2 resurfacing.

Dr. Kimberly Neyman is our dermatologist and dermatopathologist, and I am the clinical nurse manager who oversees all the aesthetic treatments in our office. The areas that I manage include: Botox, filler, Kybella, cosmetic sclerotherapy, tattoo removal, hair removal, Genesis, IPL, PDL, CO2 for stretch marks, and chemical peels. Our patient population is diverse due to the multitude of services we provide. The cosmetic side is dominated by females in the 30-60-year range, but veins and dermatology attract a more equally mixed ratio of male to female clientele.

As a hiring manager, how do you manage staff?

I am personally involved in most of the hiring. The one thing we found that has worked very well in our favor is doing working interviews. We begin by doing phone interviews, progress to face-to-face interviews and then take our top 2-3 candidates and have them spend a day with us. This allows us to see how they interact with our clients and staff, to see what type of questions they ask and to see if they offer any insight into our current way of doing things. This has dramatically changed who we extend offers to and the culture of our practice. We currently have a staff that we truly love and that are passionate about being here.

The cosmetic providers receive compensation in the form of a base salary and commission based on profit. We used to do it based on revenue, but found that it made sense to the office and provider to focus on profit. When the business makes money, the provider makes money. The front office staff also receives a base or hourly wage, plus commission. Each employee’s commission may be based on increasing production totals, or collection levels, and each year we review their commission structure and decide what to focus on for the coming year.

Which technologies do you usually use in the clinic?

We have a lot of technology in our office which includes: Cellfina, Ulthera, Smartlipo, and CoolSculpting. We use the Lumenis FX for our CO2 procedures and for IPL, Nd:Yag and Genesis, we use the Cutera Xeo. For laser hair removal, we use the Cynosure Apogee Elite and the Lumenis LightSheer Duet and we can treat all skin types. The Lumenis Fotona is used to perform tattoo removal and for superficial vessels, we use the Candela Pulsed Dye Laser.

We are very cautious with how we buy equipment. Years ago, you would buy a machine and own the right to use it. Today, companies like Ulthera and CoolSculpting require disposables or cards to operate. When CoolSculpting came out with the Cool Mini, we had to evaluate whether the $10,000 new hand piece would generate enough business to justify its cost. Since we offer multiple modalities, we had to ask ourselves “could we treat those same areas with Kybella or liposuction” and “could we offer better results than the Mini?”

We never want to be put in a position that we must sell something because we are trying to recoup our investment. We currently do not have the Mini hand piece, but we will constantly revisit this decision as demand grows.

What ways do you get the word out for new patients?

Converting a new patient is always more expensive and time consuming than obtaining more business from a current patient. We try to focus on what our patients want and what they are asking for and we enjoy offering two annual parties per year. One focuses more specifically on new equipment or offerings, while the other is more of a patient appreciation party. Our patients look forward to these parties and enjoy the education, specials and goody bags they receive at them.

As for advertising, we often test the waters. We will try an avenue such as print media and track how many calls came based off the ad. If we don’t see our money back, we don’t continue our business with them. Over the years, we have tried billboards, radio advertising, local print media and community events. While advertising a procedure, like CoolSculpting, can generate some interest, we found that when other practices advertise, it helps drive business to our practice also. Often patients will hear about a procedure they are interested in and then Google to see who offers it at the most convenient location.

Which equipment do you think would be helpful in the practice?

We are currently excited about Cellfina and are planning to see a good return on investment. The research is very good and the patient satisfaction is very high, even after 4 years. We also do very well with CoolSculpting and sclerotherapy. We used to offer facials and microdermabrasion treatments, however, we have dropped those offerings as the profit margin was low. We are considering adding miraDry to our practice.

Can you tell us about any encounters in your eight years of working in the clinic?

I always try to meet or exceed expectations, and I often turn patients away if I don’t feel we are a good fit for each other. Even with that said, you cannot hit a homerun 100% of the time. For instance, I just finished a follow-up appointment with a patient who had recently visited a plastic surgeon for a facelift, but ultimately decided she did not want to have surgery. She wants lift in the cheek area but is cautious. We did Botox and one vial of Juvederm UltraPlus split between both cheeks. Normally, I would have done Voluma, but the patient wanted a natural lift that would perk her up a little and money was tight. I was concerned that doing such a small amount of filler would leave her unhappy as it would not be enough product to lift her cheeks significantly, yet she assured me she would be happy with trying anything.

Now, two weeks later, patient feels she is too full in the cheek area. The photos are beautiful. One half vial of Juvederm in the cheek of a 54-year old woman cannot possibly be too much filler. At the end of the follow-up she asked me to do filler on her jawline, but also stated that she didn’t want it to look any fuller. I told her I could not meet that expectation. I had her take a picture of her before and after on her phone so she can remember what the service did for her and perhaps also get advice from family and friends. As hard as I tried with conversation and showing before and after photos, somewhere the communication was not clear enough that filler will provide a more volumized look. It reminds me to keep attempting to be as clear as possible.

What advice can you impart to physicians or to any provider that is in the aesthetic business?

The best advice I could give is to take great before and after photos and to listen intently to what the patient wants. In the above story, if I had not taken photos, I may have believed that I made the client look worse than before they came in.

About Laura Carlsen, RN

Armed with a Nursing degree and a certificate of Registered Nurse, Laura went to work for Dr. Verebelyi in 2009. Laura has been able to contribute to Colorado Skin and Vein by writing protocol and assisting in surgery, learning laser safety and parameters, taking over the injectable practice, training and overseeing estheticians, and being responsible for all clinic supplies. The number of Botox patients has tripled in the last few years and her filler numbers put her practice in the top 6% in the nation.

Laura’s passion is in helping people to look younger and better, but not “done”. She prefers a conservative, natural approach. Because of her dedication to the long-term care of her patient’s skin, she still retains many of her original clientele from Secret World Day Spa. If you have an interest in perking up your looks but are not sure what to do, meet with Laura for a complimentary consultation. Her expert eye combined with incredible training from some of the top injectors in the world, will have you smiling in no time.

Help us decide what to build into Medical Spa MD!

Take the 1 minute survey below and let us know what you want most. Then we'll build it.

From time to time we reach out to the community to help set the agenda and uncover what is uppermost in everyone's mind. This is one of those times. The button below launches a quick, multiple choice survey to get your opoinion and thoughts on what you're most interested in so that we can focus on providing that information. Take a moment and share.

This survey should take you about 1 minute to complete.

Build ____ For Me

Marketing Strategies to Retain in 2017

Here's where you might look to focus your marketing and advertising efforts from the experts at TeaAndMuffins.com

Like with any other retail, direct-to-consumer business, cosmetic medical practices need to be exposed in the digital world as there is a shift with marketing online. After all, 90%+ of your potential patients will start their search for a provider solution online, even if you're local and well known.

So, what do you do?

The first step is understanding that you have two different types of marketing; farming and hunting.

Hunting-marketing is what you're doing when you're buying advertising. It can work, but once your ad run is over, you're pretty much done.

Farming-marketing is somewhat different. Farming demands some work up front, but there are benefits that accrue long after that work is completed. Things like SEO, patient referral programs, customer service, front desk videos and other areas touch more of farming than of hunting. The main difference with farming is that you often own the distribution platform rather than just renting someone elses expensive space. The challenge with farming is that it's often not a quick-win but performs more like compounding interest.

There's need and a place for both.

Social media is [STILL] one of the best areas to get in front of potential patients

Social media is going nowhere. Almost everyone is hooked on their phones, stuck on their social media accounts finding something new or posting updates. Twitter, Facebook, Pinterest, and among others can be used as an avenue to get new patients. With the right hashtag and relevant content, you can access new patients. Make sure that your content is new and up-to-date with the current technologies and procedures available to patients.

As for your present pool of patients, you can always show them your newest procedures or convince them you are still their go-to physician. New technologies and procedures are created and developed every year, and you could show your patients that you offer those that would help you in your practice. Not only that, people would see you as an expert of new methods in cosmetic medicine and you are constantly learning to improve your practice.

The goal here is to add value so that you're not muted. If the only thing you ever do is hard-sell your services or blather on about how great you are, well, you're stuck in first gear. Get your head out of your ass and figure out how you can serve your patients by teaching them something that they didn't already know, and that they value in some way.

It's not about you. It's always about the buyer.

Keep your website updated

This is crucial with any business since search and your rankings are critical to the top of your marketing funnel. If you keep your site the way it went live the first time a few years ago, it may not look good, and the search engines can see the tumbleweeds blowing across the page. (They don't like that.)

Internet users want to look at a modernized site that has a quick loading time and is easy to use and navigate... AND it's critical that it works on mobile devices, especially phones. Do not forget to update not only the look of your site, but also the information housed in the website. You do not want an old telephone number or a defunct email address on your CONTACT US page that may cost you your new patients.

Update your site regularly... meaning that you should have some content that changes every week or so (which is why blogging is so effective).

Positive reviews

This is the lifeblood of every doctor. Reviews help new patients discern if the physician would be the right fit for them. Teresa Iafolla of eVisit says that you may need to urge and encourage your patients to write reviews about you, your clinic, your staff, the procedure and anything else. Put them up on your website or broadcast it over your social media accounts, chances are patients will find them.

Beware of posting fake reviews or 'buying' reviews online. If you get caught the search penalties can be pretty severe.

These are simple tips that you may have to apply on your website or social media accounts to build your online presence further. You don’t even have to pay for these strategies either. While these are simple, it could go a long way. Do not forget these tips and it may help boost your revenue and sales.

If you have any questons, visit us at http://TeaAndMuffins.com and fire off a question. We've been growing cosmetic medicial clincs and medspas for more than a decade and will be hapy to help.

Dr. Mohiba Tareen - Tareen Dermatology, Minnesota

In our interview with Dr. Mohiba Tareen, she shares her views about staffing and running a successful dermatology and cosmetic practice.

Name: Dr. Mohiba Tareen
Clinic: Tareen Dermatology
Location: Minneapolis, Minnesota
Website: www.tareendermatology.com

Dr. Mohiba K. Tareen is a board certified dermatologist and dermatologic surgeon. She serves as medical director for Tareen Dermatology, a full service medical, surgical, and cosmetic dermatology practice located in Roseville, Minnesota. Dr. Tareen is proud to be the mother of 4 young and active sons.

About Tareen Dermatology:

Since its inception in 2011, Tareen Dermatology has provided high quality dermatologic care to thousands of patients in the Twin Cities and suburbs of Minneapolis and St. Paul. Dr Tareen trained at University of Michigan in Ann Arbor and Columbia University and also worked at a number of high profile New York City Dermatology practices prior to relocating to Minnesota. The Tareen Dermatology aesthetic practice began as a natural extension of the dermatology practice. It has now grown to employing 5 aestheticians in 2 different locations as well as a total of 4 physician assistants and 40 support staff members (clinic administrator, receptionists, clinical assistants, pharmacy staff, etc).

As a dermatologist, what sparked your interest in cosmetic medicine?

Dermatology and aesthetic medicine are complementary. I trained and worked in New York City for several years before moving to Minnesota. Patients in the midwest were surprised by the minimal and natural approach that I brought to toxins, fillers, lasers and skin care. The practice has grown tremendously as patients know that I will recommend simple and cost effective interventions that will enhance their youthfulness and beauty, while keeping them natural.

Tareen Dermatology prides itself as a comprehensive practice that cares for all aspects and ages of skin and health. I am proud to care for 3 and 4 generations of patients. From a cosmetic perspective, this may translate to chemical peels for a teenager with acne, filler/botox for a middle aged parent, and full face laser resurfacing for the grandmother to rejuvenate the skin. I also care for all of their medical needs.

As the physician, I form the center of the wheel. My four physician assistants work with me to provide excellent medical care. Our aestheticans perform procedures and consults. Our medical assistants make sure patients are comfortable and all their needs are taken care of. I surround myself with the best- a patient recently remarked that Tareen Dermatology is like "Dermatology Disneyland" as we really have such a happy office!

Can you tell us more about you think of and use your staff?

My rule is to always over-staff. My job is much less stressful if we have enough staff. When I enjoy my job, everything always runs more smoothly! Also, I have learned that, these days, most staff only work at any given place for a few years. I used to take it personally when staff left, but now I have changed my perspective and try to feel fortunate that I was able to have a skilled individual for a few years. Most of my staff keep in great touch and it is exciting to see the great things that they go on to do.

You've got a number of lasers, and in some cases more than one of the same kind. Can you give us a run-down of the technology you're using?

We have three Excimer lasers for Psoriasis, three vascular specific lasers, 2 Candela Gentlemax units for hair removal and deep vascular lesions, a fractional and non fractional CO2, 2 coolsculpting machines, and we just purchased an Enlighten laser for tattoo removal!

In general, I prefer specific lasers, not IPL modaliies, as I feel they deliver safer and more predictable results

Most of your marketing is word-of-mouth and based on your exisiting dermatology patients. Is that so?

Our marketing is almost completely internal. We are fortunate to have an audience of 150- 200 dermatology patients who trust us who come into our office every day as well as patients who spread the great work that we do.

My time is money- so the services that I do not have to perform directly- coolsculpting, vascular laser, laser skin tightening, and laser resurfacing- are the most profitable. I still do filler and toxin personally so I always struggle as I likely could make more money seeing medical patients during the time it takes me to do these procedures. However, I do enjoy the artistry and patients love my natural approach!

As a dermatologist whose practice is not entirely cosmetic, what have you learned about practicing cosmetic medicine?

In a medical and cosmetic dermatology office, often the lines can be blurred. Several years ago, we did a full face CO2 on a wonderful patient who had many medical and cosmetic procedures in the past. As she was checking out my assistant presented her with the $2,500 charge. She was confused and said, "Oh, I thought this was medical and we were doing it for my pre-cancer spots!" This taught me that I need to always draw a line between medical and cosmetic. Now, PRIOR to procedures, patients sign a form delineating their charges.

What advice can you impart to your fellow dermatologists or physicians?

Ironically, I was against the significant growth of my aesthetic practice. I thought that it would take away from the legitimacy of my very successful medical and surgical dermatology practice. I resisted the growth and purchase of expensive lasers. My husband, a urologist and my business manager, encouraged me. He said "Mohiba, people know you do good work. They are going to other places now and not getting the results they desire." My husband was correct, and our practice has grown exponentially. I think that if people know you do great work medically, aesthetics is a natural extension. I wish I would have grown my aesthetic practice sooner!

About Dr. Tareen

Dr. Tareen completed her dermatology residency at Columbia Presbyterian Medical Center in New York, New York. During this time, she also lectured extensively and had her work published in a number of prestigious medical journals, including The New England Journal of Medicine. In addition, she was awarded the Conrad Stritzler Award of the New York Dermatological Society while a second year resident.

Dr. Renier van Aardt - NS MediSpa and Vitality MediSpa in Truro and Halifax

Opening a medi-spa was a natural extension of Dr. Renier van Aardt’s passion for medicine, beauty and helping people. He began practicing family medicine in Canada in 1993, and now spends much of his time in the practice of cosmetic medicine.

Name: Dr Renier van Aardt MB,ChB,CCFP
Clinics: NS MediSpa, Vitality Medi-Spa
Locations: Truro and Halifax Nova Scotia Canada
Website: www.drvanaardt.com

Brief Bio:

Graduated with degrees in medicine and surgery in 1991 from the University of Stellenbosch, South Africa. Practiced Family Medicine and ER medicine in Canada from 1993 to 2004, Canadian Board Certified in FM. Started doing laser and cosmetic medical procedures in 2000 & transitioning full time in 2004. Now the Medical Director of 5 clinics in NS, NB & ON, President of the Canadian Association of Aesthetic Medicine and a fellow of the ASLMS, teaching and speaking nationally & internationally, authored 2 chapters for Elsevier and contributing to journal articles for Aesthetic Medicine, many TV and radio interviews.

When you were in South Africa you were a surgeon. What led to your switch to cosmetic medicine when you moved to Canada?

After leaving South Africa for Canada I was forced to abandon surgery and the many hands on procedures that I loved to do, so I was itching to specialize in a surgical area of practice. In 2000 I happened attended a presentation in Toronto on laser tattoo removal and laser skin treatments. Early that morning I met Dr Mark Lupin at the venue and he encouraged me to take the leap to offer cosmetic medical treatments in my practice. The rest is history.

You've got two clinics, one in Truro and one in Halifax. Could you tell us about your practice and where your focus is?

My practice is definitely unique and unlike most others. I have two main locations in Nova Scotia and three satellite clinics between NS, NB & Ontario. I have an amazing team that manage and operate these locations, while I focus on patient care and travel between them along with my nurse.

My focus is on injectables and minimally invasive medical cosmetic treatments with minimal to no downtime. The patient demographic ranges from teens to patients in their 80's, some medical, most with cosmetic concerns and we have noticed a shift from middle aged, to more patients in their 20's and 30's in the past 8 years. According to industry partners, my practice size ranks amongst the top 25 in Canada.

What have you learned about managing and motivating your staff? Do you work on commissions?

It has taken me many years to distill many employees into a cohesive and focusing team with a common goal of success. It is an ever evolving and constantly growing effort. Staff have to have initiative, be self motivated and have a spark of entrepreneurship in order to be a good fit for my practice. It requires a good sense of reading character and intuition to identify the individuals who will make up a winning team.

All of my staff work on some type of commission structure. I'm a firm believer in capitalism, the harder you work, the better you do. There is no one perfect compensating plan & I use at leasts 3 different types across my clinics and they all seem to work fine. All staff are subject to a 3 month trial period & If any red flags arise, we make a clean break right away.

Technology is always a critical decison for a clinic. Could you tell us more about the technologies you use and what you think of the tech you're familiar with?

I've learnt a lot of hard lessons with technology purchases over the years. The best approach that I can advise is to start your practice with low overhead procedures, build up equity to where you can make an outright purchase, or at least be in a very comfortable financial position in order to make an equipment purchase. It should never be a burden on you or your practice. Never make an emotional purchase!

In my practice, I have laser and IPL platforms that I have purchased outright that perform many functions, as well as niche treatments that we have identified as good additions for revenue and practice growth like CoolSculpting and the ThermiRF suite of treatments. These niche treatments are definitely for the more mature practice that is established and financially sound.

Most of our energy device treatments are delegated to well trained staff. As Medical Director, along with my board of directors, any device purchase is very carefully considered and the advantage vs cost and marketing efforts are considered. I'm no longer influenced by sales representative pressure and glamour and glitz presentations, but rather consider my practice goals, practicality and feasibility of an additional procedure at any given point in time. Some companies will actually partner with a physicians in a non threatening way to assess their needs and make realistic suggestions for optimizing the practice portfolio - be alert and take the time to think it over.

I don't believe that there is any "bad" technology in our industry, however I'm careful to select the best bang for the buck options that have at least some track record of performing well and providing patients with impressive results before I'd continue make a purchase. I'd also always discuss it with a colleague that has used it for a while before taking the plunge.

Any marketing strategies or tips you can share?

Marketing is challenging as we have to abide by College rules, but within the restrictions that apply, I tend to stick to the lowest cost options. My advice is to avoid costly advertising and rather spend your marketing dollars on a great website and gradually develop a solid social media following. Open houses and patient focused in-house events are also very beneficial. At the end of the day, word of mouth is the best way to build a practice. Slow but sure and consistent efforts will pay big dividends.

Botox and fillers are often cited as amont the most popular treatments in most medspas or clinics. What are the most popular treatments in your practice?

It is imperative to track every treatment's profitability and monitor what's working and what's not. We market the treatments that do best and axe those that don't perform, if possible. Injectables are our top earners, followed by body contouring, skin care and lastly laser treatments. Minor surgeries like resections, sclerotherapy and scar treatment have fallen by the wayside in my practice. One of the newest trends is vaginal rejuvenation and we have just begun promoting that treatment in our practice.

Could you tell us some stories in your career in cosmetic medicine?

There are so many anecdotes! My nurse and I have started filming little video clips of funny situations that we reenact to show at the next annual meeting of CAAM in Toronto next November. We definitely have fun and enjoy our work tremendously. Of course, like any area medicine, complications and side effects occur and we need to be ever vigilant. We've also come across scam artists that complain about their outcomes for the sole purpose of obtaining a refund and one woman wrote 2 horrible reviews of me on RateMD's because I refused to reimburse her. It's par for the course and I think if we practice ethically and honestly, then we should stand up for what we do and believe in. This particular woman screamed at the top of her lungs how we've ripper her off and stormed out of the office to the shock and dismay of all the other patients waiting. I called a few colleagues in the area and they all new her and had blacklisted her for the same reason.

Any advice for fellow physicians who are just starting out in cosmetic medicine?

Dream big. Believe in yourself. Be patient. Set goals and write them down. Have passion for what you do. Have a "no matter what" attitude. Learn from others, do preceptorships with physicians that are successful. Be open to teach and share ideas with your colleagues so that we can all grow together. Attend conferences regularly. Be a member of CAAM to network with peers and obtain good CME and have access to the complications hotline. Don't make big debts when you're just getting started. Never give up.

Believe in yourself!

About Dr. van Aardt

Dr. van Aardt has studied medical aesthetics extensively, and approaches his patients with a thorough understanding of the person as a whole. He appreciates the medical, psychological and aesthetic considerations that go into making someone feel better – even more beautiful.

Through years of experience, Dr van Aardt has perfected the art of providing medical cosmetic treatments with remarkable patient comfort. The results speak to his attention to detail and ability to reveal or enhance a patient’s natural beauty.