How to make your medical spa impossible to compete with.

The world is changing rapidly — you might have heard to all of the A.I. tools like ChatGPT, Bard and the rest… and what used to work for cosmetic clinics and providers in the past is no longer enough to compete in today's market.

There’s been a 63x increase in telemedicine since 2020 (Yep. Covid.) [1]. Additionally, a whopping 71% of all in-person clinical visits can now be done remotely [1]. Patient expectations have shifted too. The result is that 81% of existing patients are open to switching providers at any time[1]. Patient churn, redundant and inefficient practices, and lost revenue opportunities are killing your growth, and your practice.

With increased competition, evolving patient expectations, and the need for a unique value proposition, it's crucial to find you unfair advantage and put it to work — you need to be impossible for others to compete with.

Just because you’re unaware of the losses doesn’t make them any less real. Remember this; you can’t just be good — you have to be better than everyone else. Patients have access to everyone and all the information they need, and they will move to whomever they feel best fits them.

Finding Your Unfair Advantage

In this new healthcare landscape, there will inevitably be winners and losers. To ensure that your clinic is among the winners, you need to find your unfair advantage and learn to compete in ways that other’s can’t simply copy, and they’re working hard too. Think of it as ‘asymmetrical competition’ — the ability to redefine the playing field and the rules of the game.

Hint: It’s not going to be your IPL or laser or the lemon water or any of the bullshit that you hear from the sales reps about how they’re going to put you on their vendor website.

But you have a real problem…. you’re not actually much different.

If you’re like most providers, you’re kidding yourself. A massive 84% of clinicians believe they deliver superior patient care and experience, but only 8% of their patients agree.

While it’s most likely that your current patient care and experiences are lockstep with what they can get down the street. Your staff is similar, your offerings are largely the same, and your pricing too. The fact that you’ve got a different RF device or were the first to perform ‘whatever-treatment-you-want-to-insert-here’ for longer than your competitors is irrelevant.

Guess what; nobody cares. That’s just more marketing b.s. and you should not delude yourself based on hopeful thinking.

What does a real competitive advantage look like?

Success in this new world isn’t easy. It requires a combination of factors; exceptional patient experiences, streamlined operations, and new business models. All of these are massive opportunities for those who are smart enough to adapt and use them — especially since most clinics will be too slow to make the needed changes.

There are new technologies that provide a clear path to market dominance.

• Patient experience: Creating and automating exceptional and personalized patient experiences that go far beyond current tools to build strong patient relationships, and real loyalty.

• Productivity: Automating redundant tasks, personalize patient experiences, and build strong relationships with their patients.

• New business models: Creating new ‘hybrid’ business models that provide recurring revenue and subscriptions as well as your current services model.

There are technologies you can use do do all of these things.

Imagine your clinic where your staffs productivity is increased by 4x, and you’re increasing high-touch patient interactions by 260% (without any additional time)[3], and you’re generating recurring revenue from subscriptions (since we’re now in a subscription economy).

In this future, your clinic is more efficient, patient-focused, and ultimately, more successful.

You can’t just work harder, or do this by yourself.

Several obstacles stand in the way of achieving this vision of success for your clinic. In the past, you’ve just worked longer hours and hired more bodies, but those strategies have had diminishing returns for a while. It’s no longer a workable solutions, especially in competitive markets. This focus on manual work and care delivery forces multiple problems into your clinic:

• Time-consuming, manual tasks that prevent healthcare providers from focusing on patient care.

• Difficulty in personalizing patient experiences and building strong relationships.

• Inefficient workflows and processes that hinder overall clinic productivity.

To overcome these obstacles, you need tools that offer:

• Intelligent automation to streamline administrative tasks and optimize workflows.

• Personalization capabilities to create tailored patient experiences and foster trust.

• Advanced technology solutions, such as behavioral AI, to automate patient interactions and improve care.

Here’s what market domination actually looks like.

The reality is that dominating a market requires that you’re doing things that others can’t match. If you have unlimited funds you can simply outspend the competition and suck up all the oxygen. (When I was running clinics my average spend per clinic was $40,000 per month.)

The better way is to build a much better patient experience, but you can’t do that with your current tools or by adding aromatherapy or whatever. You actually have to deliver value that no one else can match.

Fortunately, the newest healthcare technologies that have been developed for the enterprise and clinical trials that are now available.

The best of these is Storyline.

Clinics that have adopted Storyline have experienced a 4x increase in team productivity, a 260% increase in patient interactions without additional provider burden, and a 17% increase in total revenue [3]. And 96% of patients would recommend Storyline to their primary care physician, and give it 4.9 stars.

The landscape has changed, and clinics must adapt to compete effectively. By finding your unfair advantage - which is probably going to be tech - you can build a market dominating clinic.

References

Telemedicine's growth and potential:
"Telehealth: A Quarter-Trillion-Dollar Post-COVID-19 Reality?”
Description: This article discusses the rapid growth of telemedicine and its potential to become a significant part of healthcare services post-COVID-19.
URL: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality

The changing landscape of patient expectations:
"The Healthcare Consumer of the Future: How Patient Expectations Are Changing"Description: This article outlines the evolving expectations of healthcare consumers and the factors driving these changes.URL: https://www.forbes.com/sites/forbeshealth/2021/06/29/the-healthcare-consumer-of-the-future-how-patient-expectations-are-changing/?sh=1d4e40d07351

The importance of patient-centered care and relationships"The Importance of the Patient-Provider Relationship in the Digital Age"Description: This article highlights the significance of patient-provider relationships in delivering high-quality care and the role technology can play in strengthening these connections.
URL: https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0556

Clinician workload and the impact on patient care:
"Physician Burnout, Interrupted"
Description: This paper discusses the issue of physician burnout, its consequences on patient care, and potential solutions to address the problem.
URL: https://www.nejm.org/doi/full/10.1056/NEJMp2003149

Remote Patient Monitoring Research

Remote Patient Monitoring via Smartphone

Telehealth is finally beginning to show real adoption with the move to outcome based care.

Any number of virtual care platforms have now thrown their hat in the ring to attempt to make patient communications as easy as regular calls. 

Smartphone monitoring seems like a good option for physicians and patients alike. The literature on smartphone monitoring is limited, but it shows potential for clinical use.

In a recent study by Dalla Pozza et al. (2017), the researchers explored patient monitoring after treatment, which asked their patients to take photos of post-op procedure as they were instructed by their surgeons. Patients were asked to send photos of the front and side views of their face to send to the surgeons.

Out of the original 57 in the sample, only fifty followed-up with post-operative photos.

The following procedures performed were:

• (32) Facelifts, platysmaplasty, submental lipectomy;
• (14) Upper and lower blerophaplasty;
• (11) Fat injections

After treatment, three patients experienced complications early on. The patient in the study still preferred the usual face to face consultation, but the researchers mention that most of their sample were older patients, and were not able to adapt to some applications used for the study.

A similar study also examined the use of patient monitoring via smartphone. Chee et al. (2016) focused more on laser resurfacing on the dermatological aspect of it. Their study provided insight on the patient’s use of smartphone monitoring. There were 123 patients in the study, and having done the procedure around 12% had adverse events after it. Due to the complications, the dermatologist treated them the day after. Numbers dwindled as only a few answered the follow-up survey leaving only a few to report the smartphone review had good effects on them.

According to the authors, 95% out of the 24 who completed their survey felt at ease with the teledermatology process.

There is the risk of violating HIPAA and HITECH. In the first study, the researchers mention that limitation as patients may not have a HIPAA-compliant smartphone to send images or details of their condition. In this case, physicians have the responsibility to make sure their images are secure. In the second study, patients were wary with sharing their photos as well.

To learn more you might take a look at the scores from the KLAS 2017 Virtual Care Platform Report in which a dozen or so telehealth platforms (TruClinic, American Wellness, InTouch, etc.) were scored across a number of criteria.

The Coming Shift to Telemedicine (Everywhere)

There is a rise of telemedicine startups everywhere, especially in cosmetic medicine. What might this mean for you?

Silicon Valley, New York, London and Berlin all are investing big in telemedicine, A.I. and big data services. There are massive changes in the US that are opening doors for new services. what does it all mean for a little one-doc clinic in Des Moines, Charolette or San Antonio?

Why is there a need to utilize telemedicine?

Telemedicine makes it easier to keep patient records, track patient progress, saves time (and money) and offers the promise of integrated deep learning for clinical decision support.

There has been a report that patient preference leans towards employing telemedicine. It provides follow-up care for those who underwent surgery and many patients favor that. The convenience allowed for better communication with the physician through email.

Why are some physicians skeptical about telemedicine?

While there are many benefits to telemedicine, it is still faced with criticism. Many physicians are hesitant to adopt telemedicine because of costs. One of the many concerns about adopting telemedicine is the HIPAA. Patient privacy can be breached, especially with aesthetic medicine where photographs and video can be saved or used as before and after media output. Tools and software can be costly, because of this doctors would prefer to stick with traditional practice instead.

When will aesthetic medicine adopt telemedicine practices?

Several dermatology and plastic surgery practices have made progress in using telemedicine. The most common telemedicine method for aesthetic practices are Skype consults. Virtual consults cost less and patient retention is slightly higher.

Another example of telemedicine applicable for aesthetic practices are Virtual (VR) and Augmented Reality (AR). Primarily known for its use in gaming, it has branched out to other science and technology fields. Several plastic surgery practices have installed some devices such as VR or AR for patients to visualize the expected outcome of their procedure. Back in 2015, plastic surgery performed through Google Glass resulted successfully. In other uses, scribes send data to physicians via Glass. Expectations to use Google Glass in the practice is huge.

Telemedicine is also not limited to patient care, as it focuses also on the devices you use for your practice. While Luan et al., (2015) study focuses on access to plastic surgery literature, a physician can utilize their devices to use to communicate with patients. In addition, since the rise of smartphones, it is easier to enforce telemedicine. Video messaging apps like FaceTime and Skype can be used for telemedicine.

How to prepare yourself in integrating telemedicine in your practice?

Telemedicine, while mostly beneficial, may be difficult to integrate to a practice especially if it is not telemedicine-ready. You may need to consider these factors.

According to Krupinski (2014), set-up a room dedicated for all telemedicine needs. You will need to examine factors such as lighting and audio and video so you can examine them better. Let your patients feel comfortable inside the room as well.

Choose the telemedicine tools, methods, and technologies you will adopt. As we have mentioned there are various tools and devices for the physician’s use, but you do not need to employ everything. Some examples of the telemedicine methods you can use are Real Time (RT), which you can do on your own devices or through store-forward (SF). A physician can find a telemedicine tool or software online, which one can subscribe to.

Training is important, as studies have shown that those who are mishandling telemedicine tools or software can make patients feel uncomfortable. Train along with your staff so everyone in the practice has an idea how your telemedicine devices and software work.

Most physicians overlook the hindrances and barriers to using telemedicine for easier accessibility. Telemedicine is not just implementation just to keep up with trends, but its convenience and eventual cost-cutting advantages can help save practices.

Download the Medical Spa MD Telemedicine Report here.

Getting Naked on the Internet: What does the law say?

Telemedicine and Cyber Security

The Health Information Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of your personal health information (PHI). HIPAA includes several rules and provisions that set guidelines and requirements for the administration and enforcement of HIPAA. The relevant ones for the exchange of PHI in the digital cyberspace are the Privacy Rule1, the Security Rule2, and the aptly named Health Information Technology for Economic and Clinical Health (HITECH) Act3.

Telemedicine is a burgeoning field of medicine that incorporates digital technology such as electronic health records (EHR), information sharing, and videoconferencing to enhance the interaction between physicians and their patients, and ultimately, improve the delivery of healthcare. Having been a plastic surgeon for several years now, I’m all too familiar with meeting people at social events, and immediately getting bombarded with intrusive and unusual questions and requests as soon as my chosen profession is ousted. Sure, it’s unlikely that a woman will disrobe and expose herself in front of me and my wife at a friend’s dinner party, but get us into an online “private” videoconference call, and who knows what body parts will make an abrupt entrance into the conversation. Physicians must approach with caution, says American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) President Stephen S. Park, M.D. in a recent article4. But, for me and most physicians I know, I feel like the cat is already out of the bag. Considering the amount of texts, emails, online chats, phone conversations over internet and satellite lines, and selfies of both pre- and post-op patients I’ve been privy to, I’m sure I’ve already broken too many laws, and completely disregarded the good doctor’s advice. The truth is, though, that we’ve only begun to scratch the surface.

Telemedicine may involve the electronic exchange of PHI which is protected under HIPAA law. Security considerations with telemedicine involve making sure unauthorized third parties cannot eavesdrop on or record a videoconferencing session where sensitive PHI is transmitted seamlessly, and unfortunately, innocently. Recently, a monumental data breach at one of the nation’s largest insurance providers has spurred a bipartisan political effort to reexamine HIPAA as it relates to telemedicine, possibly adding costly and cumbersome requirements to encrypt EHR data5. Additionally, a recent report done by BitSight Technologies, a cyber security risk analysis and management firm, found that healthcare and pharmaceutical companies ranked the lowest among the four industry categories studied6. Suffice it to say, people are taking heed of this emerging new threat.

The aforementioned laws, rules, and regulations guide the generation, maintenance, and implementation of telemedicine HIPAA compliance. We must be cautioned, though, that HIPAA compliance does not necessarily equate to actual cyber security, and that simply meeting standards set forth in these regulations may not be enough. As more public attention and scrutiny rise to the forefront of media exposure, look for the healthcare industry to take the cyber security threat much more seriously.

Daniel Kaufman, MD
Discreet Plastic Surgery

Bibliography
1. http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/
2. http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/
3. http://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations
4. http://cosmeticsurgerytimes.modernmedicine.com/cosmetic-surgery-times/news/cosmetic-virtual-consult
5. http://medicaleconomics.modernmedicine.com/medical-economics/news/senate-review-hipaa-security-medical-records-light-anthem-breach
6. http://info.bitsighttech.com/bitsight-insights-industry-security-ratings-vol-4-rc