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When considering the best way to spend $100,000 on one’s practice, an expert who spoke at the Cosmetic Surgery Forum recommends a pragmatic approach.
Las Vegas - When considering the best way to spend $100,000 on one’s practice, an expert who spoke at the Cosmetic Surgery Forum recommends a pragmatic approach.
Vivian W. Bucay, M.D., says that for her practice, “The simpler, the better.” She is clinical assistant professor of dermatology, University of Texas Health Science Center, San Antonio.
On that note, “Sometimes one of the toughest things is getting patients to come in - they forget their appointments. Then, if you don’t confirm their appointment, they assume it’s canceled.”
Because scheduling and reminder calls - and filling empty appointments - were taking up considerable staff time, Dr. Bucay says, “We enrolled in the SolutionReach service. It does much more than appointment reminders.”
SolutionReach syncs to your IT system, she explains, regardless of which practice management or electronic health record (EHR) package you use. The secure service updates patient records six times daily, Dr. Bucay says.
“So not only is it confirming appointments, but patients have the option of telling us how they want to be reminded of an appointment - be it text, email or phone call.” Some patients have difficulty taking a phone call in the middle of a workday, “Or they get their (confirmation) message at midnight, so whom are they going to talk to at that hour?”
SolutionReach has greatly reduced her practice’s no-show rate, she says. Additionally, should a no-show or late cancellation occur, the service sends an email blast to Dr. Bucay’s standby list, “And we can fill that spot immediately. There’s not an empty slot all day.” SolutionReach also sends information about new products, promotions and staff members.
Many such services exist, Dr. Bucay says, who pays a flat $299 monthly fee for SolutionReach, regardless of her practice’s size or number of offices. The fee makes the service affordable for virtually any practice, she says.
“An important distinction is, I didn’t buy a product or machine - I bought a service. So I am not paying” to maintain or fix equipment if it breaks, Dr. Bucay says.
Dr. Bucay also likes the Visia Complexion Analysis System (Canfield) she bought in 2006. Along with skin analysis, she uses it for patients with concerns ranging from skincare and acne to skin cancer. In the latter area, comparing current images to baseline images allows her to gauge the extent of a patient’s sun damage.
“Sometimes when I’m running behind schedule, it’s a nice little perk to give patients at no extra charge. It’s my hardest working employee - it needs no vacation, sick days or benefits,” she says.
The imaging system cost her practice around $16,000 (it’s now around $20,000). In this regard, Dr. Bucay says, “Remember, you can always negotiate pricing. Even if the vendor doesn’t drop price, you may be able to get extra software” or other considerations.
Regarding handheld medical devices, she says, “If you’re looking for a machine, I have a Pelleve S5 device (Ellman).” She previously tried the Thermage (Solta Medical) system, but says she was unsatisfied - not because it produced unwanted side effects, but because in her experience, it lacked efficacy. “I know it works well for many other people,” she says.
The Pelleve device enables Dr. Bucay to delegate aesthetic treatments - which take about 45 minutes - to aestheticians.
“Its advantages include the fact that it doesn’t hurt. It’s a comfortable procedure, so it creates bonding time with your aesthetician.” This can lead to purchases of skincare products or other aesthetic procedures, she says. Besides aesthetic treatments, she says, one can use the device for a broad range of medical issues, including removing acrochorda and performing biopsies. She charges $700 for a typical aesthetic treatment.
“And when you take into account additional revenue it may generate, it has been a worthwhile addition to my practice,” Dr. Bucay says.
Moreover, she says, the device’s disposables (usually less than $100 per treatment) and service contract cost relatively little. “Once your device is paid for,” she notes, “you’re still going to be paying for service contracts. And the day you decide not to, that’s the day it will break down. And you’ll spend a fortune” to fix or replace it.
In terms of payback, she says, “Theoretically, you’re going to make more from a CO2 laser. But when you consider all the follow-up visits and your cost of consumables, if you’re looking at value, and the fact that the treatment can be delegated, for me Pelleve is a better revenue generator because we use it every day.” The device currently costs around $32,000, and Dr. Bucay’s device paid for itself within three months, she says, versus at least a year for her CO2 laser, which she does not use daily.
When it comes to investing in her staff, Dr. Bucay focuses largely on benefits such as 401(k) matching and profit-sharing. “The more you give to others, the more you can sock away for yourself.”
Likewise, “You can vest your employees. That creates some loyalty, so that they can’t just walk away to another job a year later” without forfeiting this portion of their earnings. Additionally, she sets daily goals for her practice.
“If we meet that goal, everybody gets a share of the pie, because not everybody has the same opportunity to sell skincare” and earn commissions. “This is a way to empower your staff - everybody gets to do what they’re supposed to be doing. And if the team meets their quarterly goal, everyone gets an extra $3,000,” she says.
Together, she says, these strategies create higher retention rates and lower turnover. “When you don’t have to train new people over and over again, that’s a savings to your practice.”
In terms of advertising in consumer print media, Dr. Bucay says, it takes a “soft sell” approach to reach educated patients who can afford aesthetic treatments. “For me, getting just one patient that will do a couple syringes of filler or a neuromodulator covers the cost of an ad (in New Beauty) for a month.” Additionally, she says that working with consumer publications creates more opportunities for her to be quoted in other editorial projects. DT
Disclosures: Dr. Bucay is a consultant or investigator for Medicis, Allergan, Ellman, Johnson & Johnson, Aveeno, Ferndale/Biopelle, Galderma, Azure/HydroPeptide, Merz Aesthetics, Syneron and Neostrata.
For more information: www.cosmeticsurgeryforum.com