Spiraling consumer demand for aesthetic cosmetic services means family physicians with the desire to offer such services can tap into a multibillion dollar market.
According to a recently released survey from the American Society for Aesthetic Plastic Surgery, 11.5 million cosmetic procedures, surgical and nonsurgical, were performed in 2006 in the United States, an overall increase of 446 percent since the collection of statistics began in 1997. The survey reports that Americans spent a whopping $4.5 billion for nonsurgical procedures, with botulinum toxin injections and laser hair removal -- procedures easily performed in FPs' offices -- topping the list.
Better Your Bottom Line
Aesthetic Cosmetic Procedures Can Be Boon to FPs
By Sheri Porter
5/17/2007
FP Greta McLaren, M.D., injects a cosmetic filler into an FP volunteer during a workshop at the 2005 AAFP Scientific Assembly in San Francisco.
This is real medicine and it's fun, said two family physicians who dived into the market several years ago and now encourage colleagues to do the same.
"Laser technology is an adrenalin stimulator," said Greta McLaren, M.D., a family physician and medical director for two medical aesthetic skin spas in the Denver area, as she described her passion for doing aesthetic cosmetic procedures. "What you can do now with lasers is phenomenal. This is huge -- huge -- for that mother who has the baby with the port wine stain all over its face."
McLaren and FP Mark Needham, M.D., M.B.A., of Santa Monica, Calif. -- both of whom incorporated the use of lasers and other procedures, such as injecting botulinum toxin and cosmetic fillers, into their practices -- said adding these kinds of procedures can boost physician morale and pump revenue into a practice.
"If you're a family medicine clinic … and you're doing it part time with a nurse or aesthetician, I think you can reach the $10,000 to $20,000 a month mark" before expenses are deducted, said McLaren. "Start with one to two half-days a week," she added, noting that revenue will go up as FPs devote more time to doing the procedures.
Needham, who is CEO of Santa Monica Bay Physicians Health Services, said he and four other physicians in his 30-physician practice began offering cosmetic procedures about seven years ago "as a very small portion of our practice." He said he enjoys the variety and added that practices like his -- where physicians may do as few as a couple of cosmetic procedures a week -- could expect additional net revenue of $3,000 to $15,000 a year.
"Laser technology is an adrenalin stimulator," said Greta McLaren, M.D., a family physician and medical director for two medical aesthetic skin spas in the Denver area, as she described her passion for doing aesthetic cosmetic procedures. "What you can do now with lasers is phenomenal. This is huge -- huge -- for that mother who has the baby with the port wine stain all over its face."
McLaren and FP Mark Needham, M.D., M.B.A., of Santa Monica, Calif. -- both of whom incorporated the use of lasers and other procedures, such as injecting botulinum toxin and cosmetic fillers, into their practices -- said adding these kinds of procedures can boost physician morale and pump revenue into a practice.
"If you're a family medicine clinic … and you're doing it part time with a nurse or aesthetician, I think you can reach the $10,000 to $20,000 a month mark" before expenses are deducted, said McLaren. "Start with one to two half-days a week," she added, noting that revenue will go up as FPs devote more time to doing the procedures.
Needham, who is CEO of Santa Monica Bay Physicians Health Services, said he and four other physicians in his 30-physician practice began offering cosmetic procedures about seven years ago "as a very small portion of our practice." He said he enjoys the variety and added that practices like his -- where physicians may do as few as a couple of cosmetic procedures a week -- could expect additional net revenue of $3,000 to $15,000 a year.
Procedures Are Perfect Fit for FPs
McLaren is not only passionate about the results that can be obtained through the use of cosmetic procedures now available; she's also adamant that family physicians should do the procedures.
"If we can deliver babies, if we can do circumcisions, and if we can run every aspect of medicine in all the small towns all over Colorado -- including running those emergency rooms -- I think we are way overqualified to be doing these aesthetic procedures. I'm tired of hearing (from subspecialists) we're not qualified," said McLaren.
"My patients already have confidence in me because I'm their primary care physician," said Needham. "Family physicians are comfortable doing dermatologic procedures; with training and instruction, they can do these (cosmetic) procedures very nicely," he added.
"If we can deliver babies, if we can do circumcisions, and if we can run every aspect of medicine in all the small towns all over Colorado -- including running those emergency rooms -- I think we are way overqualified to be doing these aesthetic procedures. I'm tired of hearing (from subspecialists) we're not qualified," said McLaren.
"My patients already have confidence in me because I'm their primary care physician," said Needham. "Family physicians are comfortable doing dermatologic procedures; with training and instruction, they can do these (cosmetic) procedures very nicely," he added.
Resources
When FP Greta McLaren, M.D., first became interested in learning about cosmetic procedures six years ago, she was surprised at the lack of training materials available to physicians. Many more educational resources are available in 2007, and McLaren recommended her favorites.
- AAFP Scientific Assembly The 2007 Scientific Assembly takes place Oct. 3-6 in Chicago and will devote a number of CME courses and clinical procedure workshops to aesthetic cosmetic topics.
- American Society for Laser Medicine and Surgery
- Skin Disease Education Foundation
- Procedures in Cosmetic Dermatology book series
It's easy for FPs to add these cosmetic procedures to their regular family medicine practices and get really good at them, while still offering regular family medicine services, said McLaren, speaking from experience. She became interested in the field six years ago, learned a few procedures and incorporated an aesthetic cosmetic clinic into the University of Colorado Family Medicine Clinic in Aurora. Three years later, her passion for the work led her to her full-time position at the medical spa.
Make Good Business Decisions
Adding new procedures to your practice is a business decision, so take some time to assess your patient population, said Needham. In this case, your patients' disposable income is an important consideration. Are there enough patients in your practice who would spend $500 to $1,000 a year for treatments such as botulinum injections? Also consider the percentage of female patients between the ages of 30 and 60, said Needham, because that's the patient population most often seeking aesthetic procedures.
Go slowly, advised McLaren. "There's a big difference between what I do now and family doctors starting out doing this," she said. "Putting all of your eggs in this basket before you've gotten your training could be a big financial mistake." Instead, McLaren suggested FPs start slowly with one or two procedures that require little or no overhead.
"Laser procedures are great, but family physicians get carried away; they want all the bells and whistles. You can always upgrade … but pick the device that fits your budget and add to it," she said.
Needham said the cost of purchasing a laser device -- as well as rapidly evolving laser technology -- led his practice to take a different route. "We decided to lease a machine rather than buy," he said, adding that his and other medical practices in town can reserve the equipment for as little as one-half day a week.
Go slowly, advised McLaren. "There's a big difference between what I do now and family doctors starting out doing this," she said. "Putting all of your eggs in this basket before you've gotten your training could be a big financial mistake." Instead, McLaren suggested FPs start slowly with one or two procedures that require little or no overhead.
"Laser procedures are great, but family physicians get carried away; they want all the bells and whistles. You can always upgrade … but pick the device that fits your budget and add to it," she said.
Needham said the cost of purchasing a laser device -- as well as rapidly evolving laser technology -- led his practice to take a different route. "We decided to lease a machine rather than buy," he said, adding that his and other medical practices in town can reserve the equipment for as little as one-half day a week.
Expect Workflow Changes
Family medicine practices are extremely busy, said McLaren, and mixing primary care with cosmetic procedures can be disastrous if the expansion is not carefully planned.
Separating the family medicine clinic from the aesthetic clinic is at the top of McLaren's "must do" list. The aesthetic portion of your practice needs its own separate space, even if it's just a large procedure room within your family medicine clinic, said McLaren. Anything less "will confuse the patient, and it will drive you crazy," she said. Expand the space as you expand the number of procedures you offer, she added.
Consider these additional suggestions to help ensure a successful transition.
Separating the family medicine clinic from the aesthetic clinic is at the top of McLaren's "must do" list. The aesthetic portion of your practice needs its own separate space, even if it's just a large procedure room within your family medicine clinic, said McLaren. Anything less "will confuse the patient, and it will drive you crazy," she said. Expand the space as you expand the number of procedures you offer, she added.
Consider these additional suggestions to help ensure a successful transition.
- Separate patients' medical charts. Cosmetic procedures require completely different patient forms. Keep these patient files in a separate file cabinet in your designated aesthetic clinic area and away from your primary care charts.
- Devote a staff person to the aesthetic clinic. "Aestheticians are like gold to you," said McLaren. "If you can hire an aesthetician even part time, that is one of the most lucrative things you will do." Nurses and medical assistants also can fill this role, but you need someone to take phone calls, answer patient questions and explain cosmetic procedures when you're busy with a primary care patient.
- Dedicate a phone line to the aesthetic clinic.
- Promote the cosmetic clinic in all of your practice exam rooms. "We used to have 'before and after' photos in a book in every single exam room," in the family medicine clinic, said McLaren. When patients have questions about procedures, "refer them to your cosmetic clinic, which is the room down the hall," said McLaren.
- Design a separate consent form. "It's very important to have a good consent form that includes all the risks of the procedures," said Needham.
- Establish a cash-only policy. This will eliminate any patient confusion over health insurance coverage. "Our pricing is pretty straightforward," said Needham. "We tell patients at the beginning, 'Here's what we're going to do, and here's what it will cost.'"
Practice Due Diligence
McLaren cautioned FPs not to lose sight of the fact that cosmetic procedures are medical procedures and that physician oversight is essential. Regardless of how much trust a physician puts in nurses and aestheticians, there's a reason they're not licensed to operate aesthetic cosmetic procedure clinics on their own, she said, adding that regulations vary from state to state.
"You need to oversee everything, you need to know about procedures and you need to know how to do them," said McLaren. Give your aesthetic clinic just as much attention as you do your family medicine practice, she advised.
"You need to oversee everything, you need to know about procedures and you need to know how to do them," said McLaren. Give your aesthetic clinic just as much attention as you do your family medicine practice, she advised.
