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Reality of starting, running aesthetic practice


The concept looks good from the outside: Offset the financial challenges of running a traditional dermatology practice by adding fee-for-service aesthetic procedures. However, dermatologists who have done it say that successfully launching or expanding a cosmetic practice requires more than whim. Dermatologists need to weigh the costs, realize the commitment they need to make to these patients and have the time to devote to an aesthetic practice.

Mark Nestor, M.D., Ph.D., director for the Center for Cosmetic Enhancements in Aventura, Fla., and clinical associate professor, University of Miami School of Medicine, says dermatologists have always done some cosmetic procedures, such as removing seborrheic keratoses. They just never thought of the services as cosmetic.

A business decision

In many markets, there are not enough dermatologists to meet the demand for dermatology services, so dermatologists first have to ask themselves if they have the capacity to add services. Aesthetic patients are not going to wait six weeks to get in, Ms. Woodcock says.

"The dollar signs might turn on, but the reality is that unless you have the capacity or can expand to get the capacity, this is something you need to think long and hard about before you jump in and look at pieces of equipment and particular services," she says.

Don't keep it a secret

Female dermatology patients are, in particular, often hungry for the information, according to Helen Torok, M.D., a dermatologist in Medina, Ohio, and clinical instructor in the department of dermatology, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio. She says that about 60 percent of her patients are women and many of them ask what they can do to improve their looks, stop the clock or reverse the damage they have done to their skin.

Written information is one way to get the word out, including office brochures, posters, newsletters (sent by regular mail or e-mail) and ads. Talking with patients is yet another. Dr. Nestor has an in-office plasma-screen television showing "before" and "after" photographs of his aesthetic patients.

"It is incredibly effective," Dr. Nestor says. "I have patients coming in for something totally different, sitting there waiting for me and leaving after having two or three aesthetic procedures done."

Don't go hog wild

"One of the biggest mistakes I see is someone coming out of the chute and spending $500,000 on different devices. Build up slowly," Dr. Nestor advises.

Dermatologists should look at their access to capital before purchasing or leasing cosmetic equipment, and they should develop a business plan, according to Ms. Woodcock.

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