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How to Buy a New Medical Laser – What the Laser Manufacturers Don’t Want You To Know

June 17, 2011 7 comments

The goal of negotiating for a new medical laser is to try to get the largest possible discount off the laser manufacture’s “List price.” The list price is what a manufacturer, such as Alma Lasers or Palomar Medical, posts as the selling price. You’ll see the manufacturer’s suggested list price in many of the trade magazines such as the Aesthetic Buyers Guide or at Aesthetic Trade Shows.  This is a price that is not commonly paid by most doctors, however there are many physicians who don’t like to negotiate and accept the list price as the final price.  Unfortunately, they end up losing thousands of dollars in the process and even more money down the road when they try to resell it.  I’ll get to how this happens a little later.

Obviously, before you even start negotiating, you need to decide which medical laser(s) you want to buy. So take the time to investigate what you’re looking for, request the manufacturers to demo their equipment in your clinic.  Attend the various laser conferences and do your own research.  Ask your more experienced colleagues what laser systems they have used and which ones they recommend.  If you’re not part of some of the laser societies, I would strongly recommend that you join some of these organizations.  A great one that I like is the American Society for Laser Medicine and Surgery (ASLMS.org).  The networking aspect is tremendous and you will get invaluable user feedback on all of the major laser systems out there.  Walk the floor of the trade booths and don’t be afraid to ask questions.

Try to become as knowledgeable as possible regarding laser biophysics so that you don’t get “bamboozled” by the slick “laser-techno-babble” of the sales reps.  During this initial demo phase inside your clinic, never promise anything to a salesperson, never give a deposit, and never sign any type of contract. Don’t feel pressured either — if you do, inform the salesperson that you never buy any equipment on the first visit to your office.

You need to be sure that your sales reps know that you are looking at many different laser manufacturers.  If they get the slightest idea that you really only want their equipment (even if you do), you have lost considerable leverage when it comes time to negotiate.  You should also get comparative price quotes of each model you are testing.  You can use this pricing to your advantage by having each sales rep bidding against each other on price.

You have to think outside of the box to get a good discount. The worst thing you can do is negotiate a price without having any information on the TRUE sales price.  So, how do you get the true sales price?  Ask for references from the sales rep in your area of other doctors he has sold to.  Once you have this information, it is important that you call these doctors and ask them about their level of satisfaction with the equipment as well as how much they paid for their system.  This may seem a little crass to ask for this type of information from a total stranger, however it’s your money and you could be saving thousands of dollars by doing so.

You may also know other associates who own this equipment.  If you’re able to get accurate sales price information, you can use this as leverage when you are presented with an offer.  The sad reality is this, whatever you pay for a new system, all new medical lasers typically depreciate by at least 40 to 50% as soon as they are sold.  Even if you buy a new medical laser and never use it, it still loses at least 40% of its original value.

Why does this happen?  It doesn’t really seem possible or fair does it?  There are critical reasons for this and it is not by accident.  One of the main reasons is that most laser manufacturers do not allow the original one year warranty to be transferred to another buyer.   If you want to sell a laser you just purchased, the original warranty is voided because it is typically non-transferrable.  Most doctors who are buying their first laser do not know this, and they naively sign the purchase agreement with these clauses contained in the agreement. In addition, the new buyer will need to pay a “recertification fee” to the manufacturer in order to get the laser serviced by the manufacturer.

As if that’s not painful enough, the “recertification fee” doesn’t include the warranty.  The new buyer has to also purchase an entirely NEW warranty if they want the laser serviced by the manufacturer because the last warranty was just voided due to the transfer of ownership!  What a racket huh?  Whether these practices by the manufacturers are truly legal is highly questionable, however the sad reality is this is the standard practice inside the medical laser industry.  All of this gets very expensive very quickly!  In some cases, the recertification fee is in upwards of $25,000 plus a new warranty of around $10,000 = $35,000 TOTAL – just because the laser changed ownership. These extra fees charged by the manufacturer cause the value of the equipment to plummet!

Unfortunately, most doctors don’t realize this until after they’ve already bought their laser and it comes time to sell their equipment.  How do you avoid this?  First of all, I would highly recommend that you have your attorney review any purchase agreement you are being asked to sign before you sign it.  He or she will be able to detect any clauses that are oppressive or unfair and will give you recommendations on what clauses should be revised or deleted.

This is probably the most important paragraph I am placing in this article.  Please read and re-read this paragraph because it is so critically important and can save you thousands of dollars.  You need to enter the purchase negotiations for a new medical laser with the goal of accomplishing these four objectives:  (1) Revise the purchase agreement to allow the warranty to be transferred to a new buyer without penalties or fees of any kind, (2) Request that the warranty be extended beyond the standard one year to two or three years, (3) Eliminate any language in the agreement regarding a “recertification fee” should the laser be sold beyond the warranty period, and (4) require that the warranty include a Laser Depot service to be sure you have no downtime in your clinic.  A laser depot service is when the manufacturer ships you a replacement laser should your laser break down during the warranty period.  It is a critical service to have when you have just purchased a new laser.  Be sure this is always included.  If you can, request that the Depot service is extended through the entire life of the warranty, whether it be one year or up to three years.  If you are able to accomplish these four objectives, you will be way ahead of the game.

Changing the purchase contract so that the warranty can be transferred without penalty will dramatically help you sell your laser down the road, should you choose to do so.  It will also help increase the laser’s resale value and how much money ends up in your pocket.  Requesting that the warranty be extended beyond a standard one year is another key strategy to help you maintain your laser and ensures that you don’t incur expensive repairs after the first year of use.

Most medical laser malfunctions and breakdowns occur after the first year of ownership, so extending the warranty to two or three years will ensure you don’t incur expensive repairs during this period.  Recertification fees are the manufacturers way of leveling the playing field when competing against their own used medical lasers in the used marketplace.  By having a “recertification fee” of $10,000 to $25,000, it closes the gap between the cost of a new laser versus a new one.  Quite frankly they are ridiculous fees and I don’t believe they are legal, but no one has challenged the manufacturers in this area to my knowledge.  What if an automobile manufacturer were to charge such bogus fees?  The public would revolt!  I’m not sure why it’s tolerated in the medical community.

Keep in mind that you have the greatest leverage in the negotiation process before you buy.  You can never get what you don’t ask for, so ask for it!  You will be surprised with the sales rep says yes to.  If you are a qualified buyer, there aren’t many of you around, especially for new medical lasers!  You need to exploit this fact to your greatest advantage.  The strongest arrow in your quiver is your ability to “walk away” from any deal.  The sales reps don’t want this to happen and they will do anything in their power to avoid this!  If you do walk away, you can typically buy the exact same system on the used market for much, much less – up to 60 to 70% off!  In most cases, all of this equipment can be serviced by third party repair companies without going through the manufacturer, so who needs em!  If you are reading this, you obviously have access to the Internet.

Take advantage of that and inform yourself by surfing the Web. One of the most important steps you can take is to see what your laser is selling for on the used market.  A good place to start is www.Dotmed.com.  This is a very large Internet Portal connecting buyers and sellers of all used medical equipment.

Key word:  DEMO UNIT.  Often times you can secure a very good price on a “new” medical laser by asking if they have any “demo” units available.  A “Demo Unit” is often times a new piece of equipment, however by calling it a “demo” unit it allows the manufacturer to “save face” and dramatically drop their sales price below the acceptable range.  Most of the time if the laser is actually used, it has been used very lightly and the manufacturer still carriers at least a six month to one year warranty on the unit.

Once you’ve tested a medical laser inside your clinic, there is no need for the sales rep to return except to sign a contract.  Try to maintain negotiations on the phone or by email — you will be less intimidated and less likely to falter to pressure.  Some sales reps/manufacturers refuse to give you a price on the phone. Inform them that you are serious about buying and will do so quickly if offered a good price.

Make sure the final price is the final price: Compare apples with apples. Have all taxes and fees included in the final quote.  Ask them, “If I were to buy this medical laser outright, and had to get a certified check, what would the amount on the check say?”

Remember that in the end, you end up with a new medical laser at a lower cost. Saving money is never a wasted effort. In addition, when it comes time to sell your medical laser, your equipment will have a higher resell value if your contract allows a transfer of the warranty and no “recertification fees!”

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Used Medical Laser Financing

June 16, 2011 1 comment

Once you have found the used medical laser you want to buy, you have three ways to pay for it:

  1. Cash.  Need we say more?  Money talks, you know-what walks.  If you can close quickly on a laser purchase you can normally negotiate a larger discount.  Cash is the fastest way to close on anything and can save you significant dollars if you have it available to buy a laser.  If you have the liquidity, you can bring down the price by promising to pay same day or next day.  The ability to buy quickly from the seller always gets their attention and is an excellent way to save money.
  2. Credit Card / PayPal.  Not all laser brokers accept credit cards, but if they do, this is the safest way to go because you can dispute a charge if you’re having trouble with the laser or it isn’t what you were promised.  Always ask the laser broker if you can pay by credit card.  If you can’t pay the entire amount, perhaps you can pay some percentage of the payment with a credit card, sometimes up to 25 – 50%.   In my opinion any reputable used medical laser broker should accept credit cards for all medical laser purchases.  It is one of the key ways of showing they are reputable and that they stand behind the lasers they sell.
  3. Third Party Leasing.  You will typically pay a higher rate of interest if you choose to finance a used laser, in upwards of 12 to 18%.  You need to personally guarantee most laser leases, which isn’t fun, and you normally can’t pay off the lease early without a prepayment penalty.  You need to carefully review any type of lease agreement, especially for pay-off terms.  Ideally you would like to have a lease that is similar to a loan in which you can pay it offer early without any interest penalties.

It can be difficult to secure a lease, especially with the tightening credit markets.  Capital equipment makers, who had seen aggressive growth and comfortable margins before the economic slowdown, were hit hard when tight credit left few physicians available to buy big-ticket items.

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Stay Away From Medical Lasers That Are Not FDA Approved

June 15, 2011 1 comment

There are several manufacturers from China who are now promoting their aesthetic devices on the internet and Ebay.  While it is tempting to try these devices out and buy them due to their inexpensive price tag, the vast majority of this equipment is not FDA approved.   Section 510(k) of the Federal Food, Drug, and Cosmetic Act requires that all medical device manufacturers must register to notify FDA, at least 90 days in advance, of their intent to market a medical device.  Most foreign manufacturers have not done this.  Is is therefore illegal to use these devices in the United States.

It is extremely risky to be using any equipment that is not FDA approved.  It is very important to use only FDA approved devices and substances.  If anything were to go wrong during the treatment, the fact that a patient was given an FDA approved treatment limits your clinic’s liability dramatically.  In addition, you could be prosecuted by the FDA which is something don’t want to have happen.

As long as you follow the guidelines for use with those FDA approved aesthetic devices, you are on very safe ground.  A large portion of the liability is shared by the manufacturer, and most plaintiff’s go after the entities with the deepest pockets, which are typically the manufacturers.  If you are using a medical device that does not have FDA approval, you are on very shaky ground and if trouble arises, you could be the one left “holding the bag.”

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Stay Away From Used Medical Laser Equipment That is “Too Old”

June 15, 2011 1 comment

It may be tempting to buy older medical laser equipment because of the great price, however you must be extremely cautious about this.  The newer equipment on the market has become more user-friendly and safer to use.  Using older technology can be much more “expertise” driven and in the wrong hands, can have disastrous results.  Some of the problems with older technology is inadequate cooling on the skin, a lack of ongoing calibration and maintenance, and a poor user-friendly interface that helps ensure the operator provides a safe treatment.  While newer equipment can never replace someone who has been properly trained in the safe user of lasers, it goes a long way to help prevent adverse reactions from occurring in the first place.

Ideally, you want to buy a laser that has seen little use that is no greater than 3 or 4 years old.  If you go too far beyond this point, you can run into a lack of third party support for the laser and a lack of people who can repair it or find replacement parts.  It can also be too outdated and more dangerous to use.  That said, some technology has not changed dramatically over the past 8 or 9 years and it may still be worth a look, laser hair removal being a prime example  If you find a laser with a low pulse count that is an older model unit (Candela Gentlelase for example), find out if the same unit is still manufactured today.  If it is, then obsolescence may not be a problem and you can potentially get a really great deal on a very effective and reliable laser.

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Why Medical Spas Fail Reason #6: Poor Liability Protection

June 15, 2011 Leave a comment

Liability protection is not just about properly medical malpractice coverage, it’s about several layers of protection within your aesthetic practice that help to insulate you from the potential you will be sued.  While you can never completely protect yourself from lawsuits, the following areas can serve as extra layers of protection:

1) Newer, Safer Equipment.  The newer equipment on the market has become more user-friendly and safer to use.  Using older technology can be much more “expertise” driven and in the wrong hands, can have disastrous results.  Some of the problems with older technology is inadequate cooling on the skin, a lack of ongoing calibration and maintenance of the older equipment, and a poor user-friendly interface that helps ensure the operator provides a safe treatment.  While newer equipment can never replace someone who has been properly trained in the safe user of lasers, it goes a long way to help prevent adverse reactions from occurring in the first place.

2) A Very Client-Friendly Practice.  It is important that your practice develops client friendly procedures within your practice.  Some of these include:  all clients who have received a procedure should receive a follow up clinical telephone call the day after treatment to make sure they are responding well to treatment.   Research has shown that most malpractice problems arise when patients feel they have no other recourse but to sue.   You should encourage your customers to contact you if they are dissatisified for any reason.   If they have any concerns regarding their treatment, you want to hear from them.  Doctors are required to be accessible telephone if they need to contact any client who is concerned for any reason.

3) Consent Forms Signed by Each Client.  Prior to receiving any treatment at your clinic, your clients should be required to read and sign an informed consent form that explains the risks associated with the treatment they are undergoing.  Typical risks include blistering, hyperpigmentation, and hypopigmentation.   In the event any of these adverse events happen to any client, you have signed a consent form that documents the client was aware of the risks prior to undergoing treatment.  If legal action is taken, you will have the consent form as proof that the client was aware of the risks of treatment.  Adverse events are very rare, however, and typically resolve over time so there is no lasting negative effect.  If no permanent damage remains, then there is no case for legal action.

4) Using FDA Approved Devices and Cosmetic Substances.  It is important to use only FDA approved devices and substances.  If anything were to go wrong during the treatment, the fact that a client was given an FDA approved treatment limits your clinic’s liability dramatically.  As long as you follow the guidelines for use with those FDA approved substances and devices, you are on very safe ground.

5) The Issue of Permanent Damage.  In order for a malpractice suit to hold up in court, there must be evidence of permanent damage.  In virtually every case with non-invasive cosmetic procedures, any damage caused to the client is typically temporary.  A good example would be hyperpigmentation.  In every case, hyperpigmentation will go away, leaving NO causation for someone to sue the center.

6)  Onsite Physician Providers.  The vast majority of reported lawsuits stemming from cosmetic procedures have been performed by poorly trained non-physicians who did not receive adequate physician supervision.  Having an on-site physician who has been trained and certified to perform and supervise all clinical procedures allows you to bypass a lot of the potential pitfalls of a standard “Medspa”

7) Arbitration Agreement Signed by Each Patient.  A signed arbitration agreement should be required of every client prior that undergoes any treatment offered at your clinic.  The arbitration agreement requires that any dispute that arises between a client and your practice will be determined by submission to arbitration as provided by state law and not by a lawsuit.  Both parties give up their constitutional rights to have any dispute decided in a court of law before a jury, and instead are accepting the use of arbitration.

8)  Professional Liability Insurance.  The final layer of protection is professional liability insurance.  You want to make sure you have a policy that covers both the physician and all individuals who are performing any aesthetic treatment under the doctor’s supervision.  The good news is there are now many insurance programs available for aesthetic practices and the price for coverage is very competitively priced.

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Why Medical Spas Fail Reason #5: No Physician Ownership

June 15, 2011 1 comment

If you don’t have a doctor involved in your medspa, this could be the kiss of death to your business.

A major key to success for aesthetic practices who have weathered the recession has been the use of doctor-owners who provide high-end treatments and oversee the care delivered at each clinic.  Doctors should be viewed as profit centers who provide a substantial amount of the high-end services offered at each clinic.  This allows you to provide treatments that many competitors cannot at their facilities such as CO2 Fractional Skin Resurfacing, Laser Lipolysis, Body Jet Body Contouring, Fat Grafting, Laser Tattoo Removal, and other physician-based treatments.

The use of doctor-owners also increases customer-confidence and is used as a strong selling point to customers as they build relationships of trust with the doctor and other staff members.  In the event of an adverse reaction or customer concern, the value of a dedicated, full time physician to address customers’ concerns cannot be underestimated.  The vast majority of reported lawsuits stemming from cosmetic procedures have been performed by poorly trained non-physicians who did not receive adequate physician supervision.

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Do Your Own Research on the Best Used Medical Lasers & Manufacturers

June 14, 2011 3 comments

Most laser reps/brokers know very little about the equipment they are selling, aside from the one-day crash course of single-sided “facts” about their equipment that they could simply get from a datasheet.  What is really bothersome is that so many doctors will believe what the reps/brokers say but not do the diligence and research it. Going off of marketing brochures really does not iterate the actual equipment or the workings of the equipment.

Get a technical explanation, if they can do it, of how the laser works.  If they can’t, then you should really question their ability to know what the laser can do and why.  Cost alone should not and should never be a deciding factor in buying a laser.  Quality, longevity, repairs / replacements, efficacy and the light delivery methods are far more important than the cost.  All too often I see doctors take the cheaper route and end up getting less of a laser that ultimately costs more in the long run, also costing them patients referrals, trust and more replacement parts to keep the laser operating it (thus keeping them in the pocket of the laser maker).

Anyone looking to buy a laser needs to pick up the phone, call around and get technical info on everything you want to consider.  I recommend the following company that does an EXCELLENT job in providing laser technical information:  Medical Insight.  This company has some aesthetic laser charts that provide across the board comparisons of every laser that’s out there for every type of aesthetic modality.

Take your time, be patient, stay in control of your decisions and simply tell the broker exactly what you want.  Don’t let them guide you into anything else, just make them give you the stats, the facts and their technical support case of why. If they cannot give you these answers on the spot or in a timely manner, say goodbye and move on to a broker and a company who will support you in this expensive and long-term decision.

There are some excellent resources for finding out which lasers are the favorites among physicians.  One such resource can be found online atwww.MedicalSpaMD.com.  This is a blog of aesthetic physicians who discuss very openly their experiences with all of the various manufacturers and equipment that is on the market today.  Once you begin reading this information, it will become very clear which manufacturers and which equipment you should stay away from and which equipment is a favorite among the physicians in the group.

I also highly recommend that you sign up for the free webinars that are offered by almost all of the laser manufacturers.  These are free, you don’t have to travel, and it allows you to get a solid idea of the benefits of the laser technology available.  Attending trade shows can also be another great way to learn of the technologies that are in favor with the industry.  Two shows that I recommend you attend are the American Society for Laser Medicine and Surgery (http://www.aslms.org) and The Aesthetic Show sponsored by Medical Insight (http://www.miinews.com).

Test-driving a used car helps you decide if it is the right car for you and also if this particular car is in good condition.  It may not hurt to rent a laser from the manufacturer before you decide to buy so that you can give it a good “test drive.”  Find out if this option is available to you.  They may be able to provide you with a demo unit they can rent out to you.  This will allow you to find out if the laser is a good fit for your practice.

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Choosing the Right Used Medical Lasers for Your Practice

June 14, 2011 3 comments

At the beginning of the laser-buying process, many people already know the laser they want. But it’s a good idea to stop right now and test your decision with this question: Will this laser fit into my practice and my monthly budget?  Buying a laser at the right price is an important first step.  Developing a realistic pro forma of the revenue you anticipate generating from this laser is critical.  The key word here being realistic.  It is important to be sure your revenue numbers are very conservative so you won’t have problems getting a solid ROI on your new device.  If your revenue numbers can easily support the price you are paying for this unit, then it may be the right laser and the right price. 

  • Patient Population.  What kind of population are you serving? gender, age range, ethnic types (Fitzpatrick Skin Types I thru VI), your surrounding competition?  There is no true all-purpose laser platform.  Make your determination FIRST based on your practice profile, then decide on specific platforms.  It is imperative that you objectively identify your market first before making decision on laser machines. This will minimize risks of side effects or poor clinical outcomes or buying the wrong laser platform for your targeted client base.
  • Wavelength.  If you have a patient population of darker skin types and you wish to do laser hair removal, you will need to be sure to have a laser that can treat darker skin, such as a 1064 Nd Yag.  On the same token, if you have a patient population of lighter skin types you want a hair removal laser that best treats this patient base, such as an Alexandrite.  If you have a mix of all skin types, then perhaps a diode laser with a long pulse width would be the best fit for you.
  • Profitability.  If you want your practice to be profitable, you must focus on HIGH DOLLAR / HIGH MARGIN treatments.  In general, the most worthwhile investment to focus on is skin resurfacing, skin tightening and body shaping (laser lipolysis, Radio Frequency).  People are willing to spend big dollars to rejuvenate and tighten their face and sculpt their body.  Selling larger packages typically means combination therapy which results in happier clients.  It is important that you understand that your goal of increased revenue is aligned with the client wanting the best results possible  Small packages or single treatments typically do not yield good results and the client walks away dissatisfied – never to return!
  • Spot size.   The spot size of a laser determines how much skin area can be covered per laser pulse.  Lasers with larger spot sizes can cover more area much more quickly. For example, a laser hair removal treatment of the back or full legs could take as long as 2 hours with older lasers. Today, these areas can be completely treated in less than 20 minutes.  The spot size not only determines the speed and comfort of the treatment, but the efficacy as well.
  • Hertz.  The hertz, or pulses per second, tells you how fast the laser emits each pulse.  Some lasers can go as fast as 3 pulses per second, which allows you to cover more surface area faster.  This is an important feature, especially for laser hair removal lasers.
  • Consumables.  Some aesthetic devices are very expensive to operate, however it may still be worth your while IF you are able to charge higher prices with these same medical devices.  Some examples of consumables include:  Single use treatment tips, Cryogen Canisters, Coupling Fluid, Lightguides, Handpieces with a certain pulse life, Filters, Fibers, etc.  You need to factor in the cost of these consumables as you create your pro forma revenue to determine your break even costs and profits.

Understanding the Technology:  3 Key Improvements to the Face:  The 3 Ts.

To assist in determining what technology is best for which procedure, we have developed a very simple model that helps the practitioner to know what aesthetic equipment may best fit his practice and his patient population.  For simplicity’s sake, I use the following rejuvenation model called the “3 Ts”.

a)     Tone (Even Color).  The goals of even color are to eliminate pigmentation and redness (facial veins)

b)     Texture (Smooth Skin).  The goals of texture are to smooth rough skin and reduce fine lines and wrinkles

c)      Tighten (Skin Tightness & Fullness). The goal of tightening is to reduce skin laxity caused by solar elastosis, aging and other skin oxidants.

The following chart diagrams the available aesthetic procedures and their role assisting in one of the three areas of Tone, Texture or Tighten.  On a scale of 1 to 3, a 1 is considered the most effective treatment for the designated area of Tone, Texture, or Tighten while a 3 is considered the least effective treatment2 is considered middle of the road and not as effective.

3 Key Areas of Improvement to the Face
1 = Best Treatment, 2 = Helpful Treatment, 3 = Least Effective Treatment

Procedure

Tone

Texture

Tighten

Advantages Disadvantages
Portrait Plasma

3

1

1

Single treatment 5-7 days of downtime
CO2 Fractional

3

1

1

Great results 3-5 days of downtime
RF Fractional

3

1

2

Little to No downtime Series of treatments
Erbium Fractional Resurfacing

2

1

3

Little to No downtime Series of treatments
Thermage & Accent RF

2

1

No downtime, “permanent” Variable results
Permanent Fillers

2

1

Immediate Results Potential side events
Temporary Fillers

1

2

Immediate Results Temporary results
IPL

1

2

No downtime Series of treatments
Botox™

1

Quick, predictable results Temporary results / repeat necessary

In general, for fine wrinkle (crow’s feet) you can go with fractional skin resurfacing.  For moderate to deeper ones, this is more difficult. You can go with Portrait Rhytec, CO2, Thermage, Velashape or Alma Accent.  With Thermage or Accent, you get the added “lifting” effect which work better on the sagging wrinkles/skin as in the jowls or the droopy upper eyelids though a strong full ablative CO2 as in Luminis Active FX can do such for the eyelids.

Sometimes, wrinkles can also be corrected with fillers such as Radiesse, Perlane or Restylane as those on forehead or glabellar. Wrinkles can also result from tissue atrophy in the mid and lower face. In these instances, an AUGMENTATIVE volumizing injection (with Perlane or Radiesse) will stretch out the loose skin thus not only fading out the wrinkles and folds but also giving the lifting effects.

Be sure to ask your broker his opinion of the laser her or she recommends and why.  This will help you to determine how knowledgeable the broker is regarding the laser technology they are selling you.  Often the broker may have hands-on experience working with the laser in question.  If so, that is a plus because it shows the broker has some hands-on laser operations experience.

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097

Why Medical Spas Fail Reason #4: Poor Aesthetic Consultations

June 14, 2011 1 comment

If you are like most aesthetic practices, you will be spending a considerable amount of money on advertising to try to get people through your doors.  As we have already discussed, you need to make sure you are spending your advertising effectively and that your receptionist is skillful in getting a consultation booked.  The next critical step is to conduct a quality consultation and that your client moves forward with treatment and pays you money.

You are doing our clients a HUGE disservice if you do not give them a thorough, quality consultation.  In addition, the quality of your services is judged during the initial consultation.  If you perform a poor consult, how can people expect that you provide exceptional service or results?  This step is what separates you from other aesthetic practices and establishes your credibility as a skin care expert.  It can also be the difference between having a profitable practice and failing miserably.

Tracking Data and Holding Employees Accountable

Employees conducting consultations should be held accountable for their performance and be rewarded if they do well.  Every practice should track consultation closing percentages and the average dollar collected per consultation booked.  If you aren’t tracking this information, the old adage holds true, “If you don’t know where you’re going, any road will get you there.”  You should hold regular meetings with your consultants to review their performance and help them establish future goals for improving along with training in areas of weakness they may have demonstrated.

The Right Person with the Right Skills

A quality consultation establishes a strong relationship that can pay large dividends for many years to come and requires significant positive energy and work.  You can’t delegate this responsibility to just anyone in your practice.  You need to make sure the right person with the right people skills is performing this critical step and that you incentivize him or her appropriately.  This person must find great personal satisfaction in helping the client achieve her aesthetic goals.  They should also be motivated by money and you need to provide proper incentives to make sure they commit the appropriate amount of energy during the consultation.  Aesthetic consultations is a sales process, plain and simple and you need to hire good salespeople.  This shouldn’t come as a surprise to anyone.

What skills do top consultants possess?

  • They have presence (energy, conviction, interest when speaking & listening)
  • They are good at relating to other people
  • They use good questions to uncover needs
  • They understand what the customer communicates in words, tone, and body language
  • They are good at customizing their products to the needs of the customer
  • They ask follow up questions to make sure the customer understands what they are saying
  • Understand and present the appropriate procedures with before/after benefits

Developing a Consultation Certification Program

To be a good consultant, you must become well-educated in the following areas:  skin anatomy, cosmetic skin diseases, current aesthetic treatments & technologies, light-based treatments (ablative & non – ablative), botox & cosmetic fillers, laser lipolysis, radio frequency technology (tightening, fat & cellulite), fractional skin resurfacing.  Even if you clinic does not perform all of these treatments, you need to be knowledgeable because chances are the client will be.  Most prospective clients have done their research in advance through the internet and if you’re not careful, they could very well have more knowledge than you.  If you aren’t knowledgeable in these areas, this will become very clear to the prospective client and will hurt your consultation performance.

There are plenty of good books out there that you can use as your curriculum and you can also have your staff develop quizzes and tests and hold regular meetings to get your entire staff knowledgeable regarding all of these areas.

Focus on High Dollar / High Margin Procedures

You have a limited time to spend with each client during a consultation.  You can easily spend one hour per consultation or more.  To maximize your time during these consultations, you need to make sure you understand your sources of greatest revenue.  You must focus on HIGH DOLLAR / HIGH MARGIN treatments.  Selling larger packages typically means combination therapy which results in happier clients.  It is important that you understand that your goal of increased revenue is aligned with the client wanting the best results possible Small packages or single treatments typically do not yield good results and the client walks away dissatisfied – never to return!!!

Do not pre-judge what the client wants, needs or how much she can spend.  Do not judge a book by its cover.  As a consultant, do not impose your project your value system onto the client.  Personally, I would rather spend $3,000 on a new HD TV, not on a package of facial rejuvenation treatments, however I am not the prospective client!  Give the client what her or she wants, not what you want.

Where to focus your energies

People are willing to spend big dollars to rejuvenate their face and sculpt their body.  Your skin analysis and consultations are designed to generate COMBO PACKAGES / HIGH DOLLAR SALES.  The amount of quality time you spend with clients is proportionate to the size of packages you sell them.  You want to spend at least one hour on facial consultations – if not more

Conduct a Quality Skin Analysis

Conducting a skin analysis is a critical step in the consultation process and it is how we get the client to open up regarding their perceived skin issues and problems.  There are many different types of equipment that’s out there that you can use as tools for the skin analysis. Some of the most simple yet effective tools are the following:  (1) a lighted mirror magnifier, (2) a Woods Lamp (3) a Video Skin Microscope.  We use these tools to help the client reveal to us what there most important skin issues are.  It is important to remember that the prospective client should be the one doing most of the talking while using these tools.  The client is ultimately the one “conducting” the skin analysis.  What are issues to you may not be issues to them.  You need to focus on their expressed issues!  After the skin analysis, we then determine the client’s hot buttons and help them prioritize their expressed issues.

Adding Systems To Your Consultation Process

Your chances to develop good consultants increase exponentially if you have developed systems to help your sales staff perform consultations.  In addition to a system for skin analysis, we have also developed other tools in our clinics to help our salespeople succeed.  We have developed PowerPoint presentations that the consultant can use to review how treatments work with the prospective client and show appropriate before and after photographs.  These presentations cover the same material every time and eliminate the variability of different expectations that can arise if each consultant is promising different results.  It is important to set the right expectations (number of treatments, potential side effects, good candidates for the procedure, etc.).  Having a system to present strengthens our expertise in the client’s eyes.

Closing the Sale

All of your work during the consultation is for nothing unless you can close the sale.  It is important that you close the sale with a timeline incentive that motivates the prospect to action.  If you don’t close them during the consultation, you only have a small chance (10-15%) of closing them later.  We typically give the client a free treatment if they commit to move forward on the day of their consultation.  It is important to place pressure on the client without it being a “hard sell” approach.

Another important approach is to give the client a choice between “YES” commitments.  An example of this would be:  You can pay for the entire package today and receive a $500 free treatment, or you can opt for the 6 month payment plan at $X per month, which option would work best for you?”

Items Needed for Consultations

We use the following tools for all of our consultations:  a Price Sheet, Client Profile Sheet, Skin Analysis Sheet, Suggested Treatment Plan, a Hand Calculator, Flat Screen TV or Projector, a computer to connect to TV or Projector, Consultation Power points, and Skin Analysis Equipment.

In summary, consultations require passion, energy, and intensity.  If any of your employees aren’t strong in these areas, they should not be performing consultations.  Consultations also require a systemized approach that ensures a certain level of consistency for each client who receives a consultation.  There is TOO MUCH at stake to leave consultations to chance or to someone who doesn’t care.

We offer FREE AESTHETIC CONSULTATION TRAINING on this website!  Please go to the following link for the training:

https://medicalspabusiness.org/aesthetic-consultation-training/

Vin Wells, MHSA

www.RockBottomLasers.com
800-794-1097

Why Medical Spas Fail Reason #3: Poor Telephone Conversion

June 14, 2011 2 comments

First impressions mean a lot.  And because the telephone represents most people’s first impression of your aesthetic practice, it could mean everything–if they don’t love what they hear, they’ll hang up and keep calling around till they find someplace that they will love.  And if a caller is not interested in what they hear within the first 30 seconds, you’ve lost them for good!

You as the owner of the aesthetic practice have paid far too much in advertising dollars to hope your receptionist does a good job over the phone.  You can’t leave anything to chance, you could easily see all of your precious advertising money go right down the drain!  You need to convert a high percentage of prospective callers into scheduled consultation appointments.

How you answer the caller’s first question will set the tone for the rest of the conversation…and maybe the rest of the caller’s relationship with your aesthetic practice.   Most people who call in will ask you one or two questions either about the offer, the practitioner, prices, location, etc.  They ask these questions because they don’t know you, and they don’t know what else to ask.  These inquiries are the lifeblood of your aesthetic practice, and must be handled properly, using appropriate scripts.

Remember that your objective is to sell the appointment, not to sell a service over the phone.  Try not to veer away from the script and get into a detailed discussion of your services.  What is important is to defer the caller while keeping their trust.  Tell the prospect, “The consultant will explain all of the details to you after she’s had a chance to meet with you.”  The following principles are essential to converting callers to scheduled appointments at your aesthetic practice.

Principal #1:  Your Receptionists Must Be Knowledgeable Regarding Your Services

How much does your receptionist know about the aesthetic services offered at your practice?  If the answer is, “very little” then you need to make some radical changes in how you view your telephone help.  Whether for good or bad, callers expect your staff to be knowledgable about the services you offer.  Callers make a judgment on the quality of your services by the knowledge of your front desk staff.

If you have brochures on all of your treatments or if you have a website that explains your treatments, then you need to have your telephone receptionists study this information and TEST them on their knowledge of this information.  When someone asks them about how IPL works, they need to be able to provide a concise answer that addresses the question yet sets the stage for the caller to receive a scheduled consultation at your clinic.  I recommend that you establish weekly education meetings that require your staff to read material and take quizzes on the material.  You can get your staff involved by assigning a new staff member to develop the weekly quiz for the material you will be reviewing.

In addition to informational knowledge, there is no better way to help your receptionists become champions of your services but by receiving the treatments themselves.  This allows them to relate personal experiences of your treatments and help you pre-sell over the phone and book consultation appointments.

Principal #2  You Must Track and Record Your Telephone Calls.

You like your receptionists, but how do you know they are doing a good job?  Technology exists that allows you to record all incoming telephone calls into your practice and audit the responses your receptionists are giving to your prospective clients.  You can track your appointment conversion rates and assess how well your practice is doing in converting callers to appointments.  There are a number of services that allow you to audit your telephone calls, but what you really want is some savvy patient review marketing using a service like Podium.

Principal #3  You Must Incentivize Your Receptionists to Book Consultations

If you are converting at least 50% of all prospective callers into scheduled appointments, this is a good start, however it is only the beginning.  Your goal should be to continually improve your consultation booking percentage and reward your receptionists for doing a good job.  How do you incentivize your receptionists to book more consultations?  At our clinics one strategy that works very well is to pay your receptionist a base pay of $10-12 per hour and reward them for each new consultation they book during their shift.  This could be an incentive of $2 per consultation booked.  If the receptionist books 7 consultations during her shift, this results in an extra $14 they have made for the day and has increased their hourly pay from a base pay of $10 to $12 per hour to $12 to $14 per hour.

There are two caveats to this strategy:  (1) The Receptionist is in charge of tracking her own booked appointments in a log sheet if she wishes to be paid this bonus.  This makes your job of tracking a bit easier because the receptionist knows she must track the calls and report which consultations she booked for the day.  (2) In order for the receptionist to receive the $2 bonus per consultation booked, the booked consultation must actually show up for their appointment and receive a consultation.  This ensures the receptionist is setting up quality appointments and not just putting names on the schedule to receive extra pay.

Principle #4  The Receptionist Must Engage the Prospect. 

Help the prospect participate in the conversation.  When I consult with aesthetic practices, the biggest problem I see is the receptionist passively answering questions posed by the caller.  When the caller is done with his / her questions, often times the receptionist doesn’t know what to do or say!  Nothing could be further from what MUST be done to keep your medspa running profitably.

The key to success in converting an incoming inquiry call into a booked appointment is to establish value and win their trust.  You accomplish this through your ability to ENGAGE the prospect right up front in the call.  Simply put, this means that you must help the prospect participate in the conversation so that they can feel comfortable asking their questions.

Listen Attentively.  The key to engaging the prospect is to listen attentively to them.  Be certain that you have heard what the prospect has said.  Restate their idea in your own words to be sure you have it right, and to let the other person know that you understand.  Make them feel comfortable asking questions.

Establish a relationship up-front.  If you answer the prospect’s questions directly, without engaging them in at least a brief conversation about their needs and concerns, they will still feel unsure or suspicious, and often will be reluctant to set an appointment.  That’s because you haven’t established a relationship with the prospect up front.

Be a good conversationalist.  When you “break the ice” and make them feel that they can trust you, they will feel much more comfortable about coming to see you.  Breaking the ice will enable you to set appointments a much higher percentage of the time.  Thus you must have a sincere interest in the people who are calling.  You must be a very good conversationalist while being sales-oriented in booking an appointment for the prospect.  And you must know about your aesthetic practice’s services, the practitioners and technicians and their backgrounds and certifications.

Ask open-ended questions.  They key to being a successful telephone call handler is to ask good, open-ended questions.   Open-ended questions are those that cannot be answered yes or no, and tend to lead to a long reply on the part of the prospect.  Examples include:

  1. How long have you been considering this type of treatment?
  2. How long have you had this problem?
  3. When did you first notice the problem?
  4. What type of cosmetic services are you interested in?
  5. Does it seem to be getting worse?

Principle #5  Be Enthusiastic.

Be enthusiastic and caring in all that you say.  If it helps you to get the right attitude, think of the caller as a close friend who needs your help.

  1. Smile when you talk.  If may sound trite, but smile when you talk – this actually helps you to transmit a positive “vocal transmission.”  Top converters smile when they speak.
  2. Vary your tone and pitch.  Use the range of your voice to be louder, softer, faster, and slower – as it would sound naturally.  A monotone conversation will not sell anything.
  3. Develop a Strong Belief in Your Aesthetic Practice’s Services.  People like to be convinced.  They want to hear how “wonderful” something is, and they hear that through your enthusiasm, your glowing reports, and your personal endorsements.  Become a user of your aesthetic practice’s treatments so that you can tell clients your own first-hand experiences.

After answering questions, schedule the appointment.  After you’ve answered a question, assume the call is convinced, and go right into setting the appointment.  If the caller has another question, he or she will ask, so you don’t need to say, “Do you have any more questions?”  That will only make them think of one.

Principle #6  Be Prepared With Your Scripts.

  • Be Ready to Talk When You Answer the Phone.    It’s more important to be comfortable and ready to talk with a caller when you answer the phone than it is to answer on the first ring.  Be sure you’re at your desk with your script in front of you.
  • No one on hold for more than 30 seconds.  If you have too many calls to handle at once, and you have to put one (or several) on hold, make sure you come back at least once every 30 seconds to tell the caller that you’ll be right with them.  Studies show that after about 30 seconds on hold attention and interest falls dramatically.  If this is not possible, ask for their phone number so that you can call them back.
  • Know the scripts given to you by your aesthetic practice.  Know the scripts, but put it in your own words so that it feels natural to you.  Keep the call conversational, like you’re talking to a friend.  Speak the words cheerfully, as if welcoming guests to a party you’re giving.
  • Rehearse, rehearse, rehearse.  Go over the scenarios many times, both by yourself and by role-playing with someone else.  You may feel self-conscious at first, but that is exactly why you are rehearsing.  When the words become very natural to you, you are ready to take on real calls.
  • Understand what you’re saying.  You must understand every single word and concept, otherwise it really will sound like you’re reading a script.  Discuss and define every term before you talk to anyone.

Principle #7  Show Empathy.

Mirror the prospect’s mannerisms.  This means matching their tone and pace.  If they speak slowly, you do the same.  If they speak at a fast pace, you speed up slightly.

  • Try to ease their fears.  Remember that many people are a little intimidated when they have to call a new place.  Just like you, they want to make a good impression. So remember that they might already be uncomfortable so do what you can to ease their fears.
  • Listen to the prospect’s concerns (emotional hot buttons) and give them what they need as a solution.  Never forget that you are talking to a real person.  Though you will hear the same questions, objections and concerns over and over, they are expressing them for the first time.  Each call must be considered an individual event, not just a piece of your day.  Each prospect you talk to must be treated as an individual as well.
  • Show that you care about their concerns.  For instance, if the caller says, “I have to wait when I have an appointment” you can reply, “I know what you mean.   It makes me feel like my time doesn’t matter.”
  • Learn the name of your caller and use that name frequently.  It’ll make him or her feel more comfortable.
  • Listen carefully and empathetically to your caller, instead of just waiting until he or she stops speaking so that you can talk again.  Here’s a handy listening checklist:

1.      Think like the caller

2.      Don’t interrupt

3.      Listen for ideas, not words

4.      Interject occasionally, to indicate understanding of what the caller is saying

5.      Turn off personal worries

6.      React to ideas, not the person (you may not like the personality of the caller)

7.      Don’t’ jump to conclusions

Principal #8:  Follow a Basic Script

Below is a script we train our receptionists on and we expect them to study and become fluent in speaking.  By following this script it will dramatically increase your appointment conversion rate.  Please note the bold areas, these questions are critical.

Receptionist:  Thank you for calling (Practice Name), this is __________________ how may I help you?

Caller:  Yes, I’m calling about_________________________________.

If this is an established client, assist the client immediately with their question or need.  If this is a prospective client, proceed with the following dialogue:

Receptionist: That’s great!  Thank you for calling us.  I’ll be glad to answer that question for you.  May I ask your name first?

Prospect:  My name is:__________________.You get their name here so that you can use it to address them throughout the conversation.  This makes your conversation more personal.

Receptionist:  Thank you (prospect’s name). By the way, how did you hear about us?

Prospect:  From your (newspaper ad/ kiosk / passed by / other)

Receptionist:  (Prospect’ name), what was it that made you decide to call us?

Prospect:  (I’m tired of my wrinkles, I am tired of my unwanted facial hair, my friend spoke highly of you, etc.) – Draw them into additional conversation with this answer.

Receptionist:  Thanks for your help, (prospect’s name).  Okay, you wanted to find out more about (the reason for the prospect’s call) Example (laser hair removal price for the upper lip)  YOU NOW ANSWER THEIR QUESTION.

All calls lead to an appointment

We would be happy to get all of your questions answered about:_________, this normally begins with a free consultation at our center.    What day of the week is best for you?

Are mornings, afternoons or evenings best?

I’m not sure if that will work.  If you don’t mind, may I put you on hold?  I’ll see what arrangements I can make.

Thanks for holding.  It looks like I was able to squeeze you in on (Day) at (time).

In summary, having a strategy behind your telephone answering and training your staff well, you can dramatically increase your appointment conversion rates and your clinics profitability.  With no plan in place, you are leaving too much to chance and throwing precious dollars down the drain!

Vin Wells, MHSA
www.RockBottomLasers.com
800-794-1097