Chapter 3: Who De nes Your Market?
Continued
Geogra p h ic Ma rket Area s
Thegeographic market fromwhich you drawyour patient/client population
has three related areas:
Theimmediatecommunityin which your practiceislocated.
The community in which your practice is located, and adja-
cent communities of similar demographics through which
your potentialpatientstravelfor work, commerce, and school.
Your overall demographic market area (DMA), a term used
to de ne media markets for advertisers. Understanding your
DMA means knowing the region that your dominant local
print (newspaper and magazine) and electronic (broadcast
television and radio) media sources cover.
Knowing how far your patients are willing to travel and the geographic area
in which theyareconcentrated is moreimportant than simplyselectingalo-
cation for your practice and understanding your physical reach. It can de-
ne your limits and o er new opportunities for attracting patients.
IN P RACTICE: Goin g th e Distan ce
She was young and opened her practice during challenging times. She care-
fully studied the opportunities and communities where there was a need for
her services. Eighteen years later, in this remote and beautiful part of the
world, she had a busy practice where patients came to her from a 150-mile
radius. Hers was the only practice in her specialty in the area, and then an-
other physician moved into town, and her practice’smonopolywasat an end.
Panicked, the physician decided to reinvent her practice and expand her
services. She wanted to add a spa and an on-site recovery center for surgical
patients. She envisioned concierge services and attention-getting television
commercials about the expanded facility. She wasn’t going to let anyone in-
vade her turf and draw away even one patient.
After many conversations and meetings, I asked the physician, “Do the
people who have traveled to see you want or need all these things you are
proposing to o er?” After some thought, she realized that if people wanted
30
Section I: Who
treatment by her hands, they had no other choice; her practice was the most
convenient option for them. I had theo cemanager run one simplereport: a
zip code breakdown ofallher patients over the past 36 months. In this nearly
1,000-square-milearea, patientswereconcentrated in threespeci clocations.
Theresultingmovefor this physician: sheestablished two satellite o ces,
where she practices several days each month. The resulting outcome: the
newcompetition in town has not been asigni cant factor. Bychoosingto lo-
cate in the areas from which her patients had to travel, she not only retained
her loyal patients, but also garnered many new ones.
MEDICAL TOURISM
Foad Nahai, MD, FACS
Searching for excellence in health care at home or even by leaving one’s
country is nothing new. Throughout history those who have had the means
have traveled to centers of excellence in search of the best care.
A ordability, the dramatic growth of medical centers and clinics, media
coverage, and thelossofcertain stigmashaveallcontributed tounprecedented
growth in the number ofpeoplewho seekmedicalservices outsidetheir own
country. To give this phenomenon a name, the support industries that have
fostered inbound medical services coined the phrase medical tourism.
Over the past two decades we have seen remarkable growth of people
fromdeveloped countries travelingto other developed and developingcoun-
tries in search ofbargains in health care. The traveland tourismministries of
manydevelopingcountries aresupportiveofthis trend. Recent studies show
that outbound medicaltourismbyfar outnumbers inbound tourism, in some
instances by as much as twentyfold. Although there are no hard data on the
number ofmedical tourists, it is estimated that 4 million medical tourists per
year receive health care services outside their home countries.
Medical tourism is a huge business. It is estimated that the industry gen-
erates between $ 0 and $40 billion annually, with predictions that revenues
from medical tourism could reach $100 billion within a few years.
Medical tourists inbound to the United States and Western Europe travel
to world-famous medicalcenters and seekout individualsurgeons renowned
for excellence. Too often, outbound patients are motivated by only one
thing: savingmoney. This phenomenon is not uniqueto aesthetic plastic sur-
gery; millions of medical tourists travel for bargains in numerous specialties.
IN P RACTICE: Goin g th e Distan ce—con t’d
Chapter 3: Who De nes Your Market?
31
Leading specialties include organ transplantation, heart surgery, joint re-
placement, and dentistry.
Asian countries top the list of medical tourism destinations because of
lower medical care costs, a legal environment more favorable to a variety of
procedures, government subsidies, and quality medical professionals. All of
these factors contribute to competitive or comparatively bargain prices that
cannot be matched by health care providers in the West.
As with anygrowingtrend, themultibillion-dollar medicaltourismindus-
try has attracted entrepreneurs from other industries, speci cally tour oper-
ators, tourist boards, hotel groups, hospital groups, and individual medical
and paramedicalpersonnel who see the increase in medical tourismas aper-
fect opportunity to cash in on the boom. Most of these entrepreneurs pro-
mote their bargain-priced aesthetic surgery through glossy brochures as if it
were acommodity. Theyemphasize attractive pricing, vacation destinations,
and tourist attractions, with the surgicalprocedurementioned as an inciden-
tal part of the trip and the seriousness of a surgical operation downplayed.
Veryfew, ifany, ofthese medicaltourismoperators discuss thequali cations
ofthe surgeons involved or the safetyrecords ofthe clinics or physicians’of-
ces where such procedures will take place. Some patients leave home with-
out even knowing the name of the surgeon or whether they are suitable can-
didates for the procedures around which they have organized a vacation.
The most troubling aspect of this scenario is how the entrepreneur or
travel organizer displaces the medical professional and becomes an interme-
diary, supplanting what should be a doctor/patient relationship with a con-
tact person who knows little about medicine and more about local hot spots.
There is no question that some patients are operated on by well-quali ed
surgeons in certi ed and safe facilities with good results for a fraction of the
price theywould have paid in their home country. Regrettably, this is not al-
ways the case. It is estimated that as manyas 0%ofthe cosmetic tourists re-
turning to the United Kingdom have a complication that requires attention
byaspecialist or even hospitalization. Arecent report1 in theJournal of Plas-
tic, Reconstructive, and Aesthetic Surgery (JPRAS) addressed the nancial
burden this puts on the United Kingdom’s NationalHealth Service. Medical
tourists who return with complications areoften unableto a ord privatecare
to treat these complications, so they turn to the government. In some in-
stances physicians in the home country are reluctant to deal with complica-
tions resulting from medical tourism; this may be related to the legal issues
involved. In response to problems such as this, certain insurance companies
are beginning to o er policies to cover complications incurred by medical
tourists.
Continued
3
Section I: Who
These medicalforays raise safetyissues for patients and moraland ethical
issues for surgeons. In responseto thesechallenges, theInternationalSociety
ofAesthetic Plastic Surgery(ISAPS) and the American Societyfor Aesthetic
Plastic Surgery (ASAPS) have developed guidelines not only for would-be
medical tourists, but also for surgeon-members who receive and treat them
(see ).
It is the ethical duty of the surgeon involved to insist that he or she be the
focus in establishing the physician/patient relationship, not the tour opera-
tor. The physician must reveal his or her credentials, training and expertise
in the procedure requested; enter into formal consent discussions with the
patient, describingthe natureoftheprocedure, alternativeprocedures, risks,
the likely outcome, and potential complications. The surgeon must outline
plans for dealing with complications should they occur, either in the host
country or on the patient’s return home. These discussions should include
delineation of responsibility for additional expenses or an unexpected hos-
pitalization incurred as aresult ofcomplications. Continued careon return to
the home country must also be discussed and arrangements made.
Discussion should also cover the use of medical devices. Not all prosthe-
ses and implants are created equal. Inferior-quality implants and prostheses
may be available at a fraction of the price in developing countries compared
with costs in the West. A frank discussion concerning any prostheses or im-
plants, such as breast implants, should be part of this consultation in estab-
lishing the physician/patient relationship.
Finally, thereis an underlyingissue that is rarelyaddressed. It is unethical
for aphysician to engage in fee-splittingor other nancialarrangements with
a third party or corporate entity for the procurement and referral of patients.
For tour operators whose goal is to make as much moneyas possible fromas
manysources as possible, the possibilityofcommissions fromphysicians for
referrals becomes a problem that threatens the integrity of our profession.
Likeit or not, medicaltourismis hereto stay. It willcontinueto grow, and
it will continue to attract those who wish to pro t from this multibillion dol-
lar industry. The question that remains to be answered is: What price will
the public and the profession pay for this largely unregulated practice?
REFERENCE
1. Cosmetic tourism and the burden on the NHS [editorial]. J Plast Reconstr Aesthetic
Surg 61:14 3-14 4, 00 .
MEDICAL TOURISM—con t’d
Chapter 3: Who De nes Your Market?
33
DEMOGRAP H ICS
I hate the way market forces try to separate us out
into the appropriate demographic—basically in order
to sell us things. We need to nd stories that we can
enjoy together, not separately.
— EMMA THOMPSON, ACTOR
Choosingto undergo an aesthetic procedureis averypersonaland intimate
decision. Your patientsareindividuals, and you must consider themassuch.
While locating prospective patients by geography is the most basic seg-
mentation, pinpointing a market of existing or prospective clients/patients
includes a study of demographics—income, age, sex, race, education, and
interests.
In com e
In some regions there is signi cant income disparity among populations;
other regions are fairly homogeneous based on housing and industry. An
areawith great disparityin incomelevels willalso havegreat disparityin ed-
ucation, race, and perhaps age.
Aesthetic procedures are not government subsidized or covered by insur-
ance anywhere in North America or Europe. You need to target individuals
with theabilityto payfor your services, and populations with higher income
levels generallyencompass peoplewith apersonaldesirefor your services as
well as the ability to pay for them. However, do not discount those in lower
income brackets; the value ofyour services maybe equallydesired bythose
to whom a small change in appearance can lead to newfound con dence
and opportunities in life.
34
Section I: Who
Age
You must decide whether your practice will encompass all ages or target a
speci c age-de ned segment. Age de nes a client population’s most likely
aesthetic needs. Those in a younger segment may be more interested in
maintaining their youth, re ning their appearance, or reshaping their bod-
ies. Older individuals are more likely to be interested in restorative proce-
dures, from a desire to either stop the clock or to look like a younger ver-
sion of themselves. A population with a balance between the age groups
presents the option of targeting one or the other or embracing both.
Sex
Manymaketheassumption that thosewho seekaesthetic surgeryor medical
treatments are women. In some markets this may hold true, but do not mis-
judge your male population. Aesthetic medicine, more than surgery, has
been demonstrated to be a successful niche among men. Men want to im-
prove their appearance, but some are averse to more involved procedures,
such as surgery.
Ra ce
If there is a dominant ethnic or racial makeup in your geographic market,
you should determine whether you are capable of attracting these individu-
als and understanding their aesthetic requirements, and whether you are
quali ed to handle the special needs of this group. If the potential popula-
tion is strong enough, you may decide to cater to this segment, creating a
unique practice niche.
Ed u ca tion
Knowingyour potentialpatients’levelofeducation is essentialto e ectively
communicate with that population on an appropriate level. If you commu-
nicatebelowthat level, you mayinsult someoneor appear unsophisticated. If
you communicateabovethat level, you maybemisunderstood or tuned out.
Chapter 3: Who De nes Your Market?
35
Although most practices target the majority population’s educational level,
some may choose to cater to a niche group. The greater value of under-
standingeducational levels is not in attractingpatients, but in appropriately
communicating the expectations, options, risks, and instructions for treat-
ment. Assuming, without verifying, that a patient comprehends these op-
tions and risks puts both your patient’s well-being and your practice’s rep-
utation at risk.
ON TARGET
Procedural statistics and data from recognized professional groups support-
ing the specialties that include aesthetic medicine, as well as your own prac-
tice’s procedural statistics and data, are important tools for de ning your
practice mix and growth e orts. For example, ASAPS reported that in 00
there was a surprising increase in the number of cheek implant procedures
performed, but there was a slight decrease in the cosmetic injectables used
in recent years to enhance or augment the cheeks. Does this mean that your
patients willstart askingfor morecheekimplants or that cheekimplants are a
new trend you should begin to o er patients more readily? Research trends
carefully—statistics are not absolutes, but they help to de ne and build a
practice, its mix of services, and the audience to which that mix is targeted.
Using the right tools helps to build your practice.
YOUR TARGET P OP ULATION
In terest
Although individuals may be geographically close, have the money to pay
for your services, meet the age, sex, and race that you have targeted, and be
educated enough to understand what you and your practice provide, they
may simply not be interested in your services.
There are two signi cant indicators for measuring overall interest within a
target population: lifestyle interests and retail purchasing habits. Whether
you are tapping an existing interest or creating an interest in your services
36
Section I: Who
among a target population, a look at their lifestyles and retail purchasing
habits willyield keyinformation about howsigni cant the potentialinterest
is among the target group. These factors will also help you determine the
appropriate messages and the means to communicate with that population.
LIF ESTYLE
If the lifestyle interests of your target population are high on self ( tness,
sports, and health) and what is demographically de ned as “the good life”
(arts, travel, fashion, food, and wine), this group is also likely to be inter-
ested in aesthetic procedures and therapies. Quite simply, these are people
who havean interest in and the nancialabilityto payfor self-improvement.
Therefore these people represent a high potential for becoming clients.
R ETAIL P URCH ASING
Retailbuyinghabits are another indicator ofinterest, and theyrelate to how
you willbuild your practiceand what messages you willconveyto thetarget
population. Consider these questions:
Do your potentialpatients/clientsspend asigni cant amount
on health, beauty, and fashion?
Will they spend more for something of greater quality or de-
sign? Are they label or value conscious?
Do they focus on needs, or trends?
There are varying degrees of lifestyle and retail purchasing habits among
any population. Uncovering these factors is essential to building a success-
ful practice, because you will refer to these factors when de ning:
Thebest channelsofcommunication for thetarget population
Opportunities to connect with this group
Cycles that in uence the target population
Understanding the nuances of your marketplace and existing patient popu-
lation is important in identifying needs and trends. It is also essential to use
Chapter 3: Who De nes Your Market?
3
your resources e ectivelyto bringpotentialclients to your door, to continue
to serve those already in your practice, and to draw on those within your
practiceto help you growbygeneratingreferrals. Population studies arenot
reserved for the people you hope to attract; the data you have in your pa-
tient records are invaluable to better identify the group of people you cur-
rentlytreat or recentlytreated. Themoreyou knowabout your patients, the
better you are able to evolve to meet the changing characteristics, prefer-
ences, and needs of your patients.
Socia l In d ica tors
There are social indicators that can greatly in uence your success and the
goals your patients pursue. The community may be high on self or on self-
lessness, may appreciate and understand the desire for self-improvement,
or may label such desires as vain. In some cultures, the desire for aesthetic
procedures can be viewed as denying one’s ethnicity and therefore may be
severely condemned, whereas in other cultures, seeking out a provider of
aesthetic procedures to nd a true balance and harmony of appearance is
desirable, as has been documented in Muslim cultures, where women’s
public appearance is cloaked with achador, burka, or veil. Even an individ-
ual who has left a gang has separated from a type of community that has its
own in uences, and this person may want to erase the signs of belonging,
including removal of tattoos, piercings, and other identifying alterations to
appearance.
Economics willplayarolein thepatient population. The matter ofpersonal
wealth is not as signi cant as economic desires are; those who want to alter
or enhance their appearance will nd the means to pay for what they want.
For some, aesthetic improvements are desired to increase acceptance and
better opportunities for employment and compensation, or may stem from
the attraction of those who have greater economic resources.
Additionally, economic status often compels competition for materialthings
and among individuals to be t, slim, youthful, or beautiful. Other services
desired byyour patients can also havean in uenceon your practice, or they
may con ict with your opportunities to attract and provide services to a
community, culture, or social group.
3
Section I: Who
RELATIVE WISDOM: Exa ctly Wh at I W an t
When you buyagift, do you select it with therecipient in mind, or do you se-
lect the present based on your own tastes?
A brilliant physician with a solid practice understood the concept of
evolving and growing to meet one’s market. He regularly reviewed the con-
tent of his website, ads, and patient communications; he was completely
hands-on in his approach. He often looked at revisions or additions and
proudly told me, “I have everything exactly the way I want it.”
I replied, “It is not what you want—it must be what your patients want
and expect.”
Relative wisdom: Whether you are changing the paint on the walls, the
photos or message on your website, or the location of your o ce, make cer-
tain that it re ects your image, but delivers value for your patients. It is no
di erent than presenting a gift: the gift may re ect your taste, but it must
make your recipient happy.
DATA COMP ENDIUMS
Data on your region are everywhere and in many cases can be obtained for
free. This simply requires an investment of your time to gather data about
your patients and your market.
P ra ctice Ma n a gem en t a n d Electron ic Med ica l
Record Softw a re
You can learn many things by simply isolating the data you’ve already col-
lected about your patients. Each month, look at the breakdown of services
provided. Each year, look at the age range of patients per service provided.
There are innumerable combinations of data you can collect and review.
Don’t just make it a practice to run data—use it to build the practice.
Med ia Kits
Although you may not want to advertise your practice, obtaining rate cards
and media kits for local print and broadcast media can provide valuable in-
formation. Most media kits contain demographic information about a spe-
ci c geographic market and the demographics of the audience they reach;
Chapter 3: Who De nes Your Market?
3
some pro leaudienceinterests. Consider the quality, content, and purpose
of the publication according to their target audience and how they have se-
lected their market. An unsolicited, free coupon envelope mass mailed to
“resident” addresses will give you nothing more than mass data.
Loca l Govern m en t a n d Sch ool Boa rd s
Local government and school boards keep current census data on le such
as property values, business licenses, community residential and commer-
cial pro les, and more.
Med ia
Newspapers, regional magazines, and business journals often publish pro-
les for thecommunities theyserve. Lookonlineto tap thesedataresources.
Visit your local library for the following easy-to-use yet comprehensive de-
mographic data and pro le publications. Neither publication o ers online
data free of charge, but most libraries have the print versions.
TheLifestyleMarket Analyst: Focuson the“Market Pro les”
section for your metropolitan region or county. Included are
basic demographic data per household in a region, such as
occupation, education, race, age, income, and lifestyle inter-
ests. This publication is updated annually.
Woods& PooleEconomics, Inc.: Thispublication o erssim-
ilar basic demographic information to The Lifestyle Market
Analyst but focuseson industryand commercerather than on
households. It also o ers a breakdown of retail sales in de-
mographic markets.
The purpose of business is to create and keep a customer.
— PETER F. DRUCKER
TARGET SOURCES
Once you de ne your target population, you need a target source, a starting
point.
40
Section I: Who
You r Sta rtin g P oin t
In an established practice, the initial target source is your current satis ed
patient/client population. Theyknowyou and trust you. Although theymay
not de ne your target population for all your services, they are essential to
the single most important means of reaching clients: referral.
Ifyou arejust beginningpracticeor areexpandingan existingpractice, your
target source is someone or something with an existing channel of commu-
nication to your target population that you can reasonably and credibly at-
tach yourself to for referrals. It bears repeating: referral is the single most
important means of building your practice. Referral holds many bene ts
that no other source for clients can. What is most important is that it pro-
vides abasis offamiliarity. When potentialclients need or want aprocedure
that involves some amount of risk, is voluntary, and will have monetary,
physical, and emotional costs, the rst point of contact or reference will al-
ways be someone:
The potential client knows and with whom there is an estab-
lished relationship of trust
Who isrecommended bysomeonethepotentialclient knows
with whom there exists an established relationship of trust—
a family member, friend, or another physician
Thelinkoffamiliarityand trust is not theonlyreason referralis thebest way
to reach your target population. Referral grows as it passes fromone source
to the next. Referralmaybe positive word ofmouth and apersonalendorse-
ment of you. Therefore maintaining a healthy, consistently positive referral
relationship is as important as having a source of referral. To achieve this,
you should:
Recognize and extend gratitude to the referral source (main-
taining con dentiality where appropriate)
Continue consistent, relevant communication with the refer-
ral source
Chapter 3: Who De nes Your Market?
41
Without this communication with your referral sources you may be forgot-
ten, and a competitor may succeed in gaining the interest of your sources.
LESSON LEARNED
I encourage the practices I consult with to track the number of procedures
performed weekly and monthly and to tie these to speci c variables such as
age, or for a new patient, to the referral source. One of my clients suddenly
had a signi cant increase in injection appointments, although no promotion
or special event had been announced. One month later, it happened again.
Everyone was happyabout the tra c, but no one thought to nd the source.
I was on-site visiting one day and took a patient back for her rst injec-
tion. She was nervous, but excited, so I engaged her in small talk. “Do you
knowanyone who has been treated herebefore? Haveyou heard ofother pa-
tients’ experiences?”
What I learned in that little exchange was golden. “Yes,” she replied, “all
the teachers at the high school have been getting injections. My friend was
the rst who came here, and when we saw her results, we all wanted to give
it a try. I’m not the early adopter, but as more of the teachers get injections,
we just seem to be a happier-looking group. Believe it, the kids notice. It’s
my turn. Our secretary’s sister runs the medical spa across town, and she is
now o ering a teacher’s discount day on our day o from school. But I
wanted to comehere. I’mnervous about this, and you treated myfriend, and
she looks great.”
I asked the o ce manager if and how the practice was tracking referral.
They did: the typical magazine, Internet, patient referral, physician referral,
and word of mouth were on the list of sources. “Do you ask the patient’s
name, the physician’s name, or the source for the word of mouth referral?” I
asked. The o ce manager looked at me, puzzled.
Had the practice been more careful, they would have realized they had
just tapped into a new source for patients, all by word of mouth: teachers.
Had they been even more thoughtful, they would have realized the source:
the initial patient who opened the oodgates. Had they been proactive, they
would have reached out directly to this market and would not lose any of
these new patients.
Nowthat thepracticewas aware, thesta started o eringideas to help ex-
pand this new market. I stopped them all. “Before you decide to grow this
market, let’sseewhat other opportunitiesyou haveoverlooked, or lost, byfail-
ing to connect with and collect important information about your patients.”
4
Section I: Who
TARGET RESOURCES
En ab le P oten tial Clien ts an d P atien ts to Fin d You
Target sources bringclients to you; target resources enable potentialclients
to nd you. Although referral will likelybe the core ofgrowth in your client
population, there are many potential clients among the target population
with an interest in your aesthetic services who do not have a referral source
to you. These potential clients will:
Find you based on your visibility among resources
Choose you based on your ability to connect on a practical
and personal level through these resources
Who you are and what services your practice provides must be e ectively
communicated to potential patients/clients. This is where lifestyles, inter-
ests, and retail purchasing patterns provide the greatest insight to your po-
tentialtarget population, the resources to reach them, and thetoneand type
of messages to use. Your research will guide your choice of e ective com-
munication tools or resources, aid in developing appropriate and attractive
messages to use, and help you meet the levels of expectation among the tar-
get population. Your messages, resources, and connections can be used to
de ne your identity or brand, build visibility for the practice, and commu-
nicate your value.
E ective, targeted communication through strategic resources is essential
to makeyou visibleto your target audience—includingreferralsources. Vis-
ibility and appropriate communication, second to referral, are key to draw-
ing a potential client to you rst, before that person seeks a competitor’s
practice. The rst provider the person goes to has the advantage in con-
verting that potential client into a repeat client and a patient.
Chapter 3: Who De nes Your Market?
43
IN P RACTICE: Movin g Ou t
A plastic surgeon, well-established for 1 years, opened a satellite o ce just
miles from his existing o ce. The new o ce was not drawing an aesthetic
patient population, nor was it well received in the community. His general
market was a large metropolitan area, and the satellite location was in an ex-
urb, where many new homes were popping up on former farm elds. The
area hospital was building a $ 0 million addition, and there was no direct or
indirect competition in like providers. The expanding metropolis he prac-
ticed in was growing, and this exurb was fast becoming a suburb.
The surgeon communicated his new location to his existing client base
through direct mail to newhomes in the areaand through established adver-
tising channels that had proved successful to him in his home market. He
was ba ed as to why things were not working in the new location.
I asked if he had researched the growing community’s demographics,
lifestyles, and interests. “Time not well spent,” he replied. “It’s just outside
my current door; how di erent can it be?”
Then I asked the doctor to meet me for lunch near his new o ce so we
could discuss the situation. “Well, there’s nothing but fast food nearby,” he
told me. I asked about retail. “There’s aWalmart, an Old Navy, and aGap,”
he laughed.
“What do people in the community read?” I asked.
“I don’t know,” he admitted.
The doctor then realized the mistake he had made. He had moved to an
area that by all accounts was growing positively in number of households,
commerce, and medical services, but he had not researched the population
the community was attracting.
In fact, the growth of “luxury homes” involved large homes on inexpen-
sivepropertythat drew rst-timehome-buyersand familiesfromtheinner city
hoping to establish a better life for themselves. The new population in this
communityconsisted ofhard-working, young, middle-income families who:
Had littleextraincometo spend and weredeterred bythe doctor’s
projected image of elegance
Could not relate to his practice identity, which focused on treating
the signs of aging
Continued
44
Section I: Who
Did not connect to his existing patient base, because they had not
moved from the next town; they had moved from downtown
Did not read the publications he advertised in, because these were
targeted toward a higher demographic group and were not widely
distributed in the newly growing community
The doctor did not want to move, but he agreed to retool: building on the
existing practice location, but altering his communication strategy to meet
the speci c needs and interests of this new population through new sources
and communication resources.
For this satellite location, his focus changed from antiaging to youth and
vitality. The tone of his message changed from elegant to simple and direct.
New communication resources were a problem, however. There were no
media targeted speci cally to this new area, and the doctor did not want to
give too much visibilityto his newimage in his old market. So we focused on
creating a client source, and through a new relationship with the booming
OB/GYN practice in town, a successful focus on breast surgery and body-
contouring led to a practice that, although not quite what he had expected,
has succeeded.
IN P RACTICE: Movin g Ou t—con t’d
c mp t t n s n t b —y u nn t d ny t t mp t t n x sts f r t
s r s y u pr d nd t t mp t t rs r y ng f r y ur p t nts’ d -
rs. R t r t n s mp y mp t ng, y ur pr t must r m n mp t t :
w ys b n st p d nd b tt r t n n t r pr t w t t p t nt
t dr w t nt r st nd pur s ng p w r f y ur t rg t p pu t n w y
fr m y u.
UNDERSTANDING COMP ETITION
c mp t t n s ub qu t us f r t tt nt n, d rs, nd fu m nt f s r-
s y ur pr sp t nd x st ng p t nts s k. “c mp t t n” r ng s
fr m t p ys n w t t s m r d nt s n y ur bu d ng t t d -
s gn r ndb g t t y ur p t nt m y s t buy nst d f n st ng n
st t s r s. T r r f ur typ s f mp t t n n bus n ss: d r t,
s nd ry, xt nd d, nd nd r t.
Direct Com p etition
Y ur d r t mp t t n s pr d r w t t s m r s m r r d nt s,
pr d ng t s m s r s n s m r n r nm nt t s m r y d n d
t rg t p pu t n.
WhoIstheCompetition?
No enterprise is more likely to succeed than one concealed
from the enemy until it is ripe for execution.
— Nic c o l o Ma c h ia v el l i
CHAPTER 4
S t n i: W
Secon d a ry Com p etition
S nd ry mp t t n n s pr d r f d ss m r r d nt s r n
d ss m r n r nm nt w s pr d ngt s m s r s y u r t s m-
r y d n d t rg t p pu t n. T d y fr n s m d sp s t t n
qu d p ys n n d n p t nt r r w d s s nd ry m-
p t t n. h w r, f y u d n d y ur xp rt s nd r d nt s w ,
t pub w s y d st ngu s y ur pr t fr m su bus n ss s.
Exten d ed Com p etition
ext nd d mp t t n s m r r m t fr m w y u r nd w t y u d .
W t t s f rm f mp t t n, s m n r s m t ng s t p t nt t
fu t p rs n d s r s f y ur t rg t p pu t n w t s r r pr du t
d r nt fr m t s y u pr d , n f t d gr f r su ts s d ss m r.
ext nd d mp t t n r ts t d r n b tw n pt ng f r m d
pr dur nd r ng p rs n sty st r w rdr b nsu t nt t r u
y ur w rdr b .
In d irect Com p etition
ind r t mp t t n s t m st d st nt f rm f mp t t n. T s n s
s m n r s m t ng mp t yd r nt fr mw y u r nd w t y u
d , y t s st mp t ng f r t nt r st nd sp nd ng p w r f y ur t rg t
p pu t n n fu ng p rs n d s r s. ind r t mp t t n s t d r-
n b tw n t f - n st ng xp r n f n st t pr dur nd
n - n- - f t m t n.
WH O IS YOUR BIGGEST COMP ETITOR?
Karen A. Zupko
a sk ny p st surg n, “W s y ur b gg st mp t t r?” nd typ y
y u’ g t st f n m s w t tt r n s t t n.
a s t t ur y f t t st, w ’s t s y? T r sp ns s r fr qu nt y
b s d n xt rn p r pt ns. “My mp t t r g ts m r r b tt r s ts n
t sp t nd t mbu t rysurg ry nt r’s p r t ngs du ” m yb
tru f r n r tw f t s. But w kn ws wfu s r r s du s t
f tyy u n’t m n t r b us y u r n’t n st t r ? “h r r pt n
c pt r : W is t c mp t t n?
r m s w ys d” m g t b t s n rt n d ys, but y u d n’t kn w
w t’s r y g ng n n t . S ppy bus n ss syst ms n m k n
b g r nu str ms nt pr t tr k s. o r m yb t p p n t w t-
ng r m r t r f r d s unt d r fr s r s.
M d mmun ty g ss p, s m t m s f d by mp ny s s r pr s nt -
t s, ntr but s t t s mpr ss ns. a d rt s ng, m d m nt ns, t -
s n pp r n s, nd mm nts by sp us s nd p t nts dd t t ur f
t d ng mp t t r.
T m t s s rs y. it’s mp ss b t ur t y mp r y ur pr -
t t t t f t rs, y t m ny surg ns m sur t r su ss by su r t -
r . it’s sy t t nk t t f y u d s o R s du , r t n, r
s Tv s w r d ts, y ur pr t w u d b ur s ng.
in my p n n, mp t ng w t y urs f s t n y r t t unts.
l k ng r y ur s u d r t mp t t rs pr d s f s p r pt n f
w t t rs r d ng nd n r s s t k d t t y u’ m ss w t’s g -
ng n n y ur wn . T f t s, y u n’t ntr w t t p st sur-
g n upst rs d s r t d rm t g st r ss t str t s d rt s ng ’s
n w d ng. But y u n ntr — r s u d b b t ntr —y ur wn
pr t . a nd n kn ws t r ’s t t ntr r g t t r : fr m st t-
t tud s t mput r z d r rds t t nu n s f y ur nsu t t ns.
h r ’s n x mp : T mp t ng p ys n st rts r ng fr nsu t -
t ns—s y u rus t m t t t t . M st k ! T b tt r r sp ns s t f -
us n wy u n m r r y rt u t y ur u pr p s t n t pr sp -
t p t nts. T s, f urs , nt s s m r rt n y ur p rt, su s
m t ng w t y ur st , d p ng s r pt, nd r rs ng nd m n t r ng
t r su ts. T s t rg t d m t d w surpr s y u; t’s s p rsus
w d s w ppr . W n mp m nt d rr t y, y u’ s f w r p t nts,
but y u w tu yimprovey ur p t nt pt n r t nd s du m r
surg r s. l ss ss , m r r nu —w t’s n t t k b ut t t?
l s r k ppr s r qu r t m nd tt nt n t d t . Unf rtun t y,
nst d f n st ngt r qu r d t m , m nysurg ns nd t s r t f nt
t TWeeiD rut. N t f m r w t t t r nym? it st nds f r “t t’s w t
ry n s s d ng.” a nd t m ns y u w n r d t p k, b us
y u’ b n t m dd f t. a s t s y ng g s, “if y u r n’t t d d g,
t s n ry n r ng s.”
Su ssfu surg ns b n m rk g nst t ms s by m n t r ng n-
r s s f n w p t nts s n r st m nt , r st y r. T y r fu y
m n t r n t s - d g b n rs n r t , but t tu numb r f p -
t nts, by procedure, w pt t r surg p ns. Sm rt surg ns r gu-
r y r w d t d r p rts nd n -tun d y pr t p r t ns. T s
Continued
S t n i: W
“M st l k yt Su d” surg ns kn wt numb r nd n m s f p t nts
w r skt r p rs n r put t n byr f rr ngf m y nd fr nds t t pr -
t . T y w rry nd w nd r w n t s numb r dr ps.
Su ssfu surg ns nn t , t r s r un qu , t r nsu t t ns
r d r nt t d, nd t y r p t nts m r t m nd b tt r du t n.
T y wr t f w-up tt rs. T y m k t r p t nts feel special—n t just
look younger.
T b st p ys ns d n’t mp r t ms s t t rs. T y’ m t
t r wn ng s nd pr f ss n g s by d m nd ng t b st f t m-
s s nd pr d ng t b st s r , r su t, nd r t t r p t nts. P s-
t surg ns tru y nt r st d n b ngsu ssfu r z t t t r b gg st m-
p t t r s t n t t gr ts t m n t m rr r ry m rn ng.
EVALUATING TH E COMP ETITION
it s w rt w t u t s f mp t t n. T r ug mp t t
stud s y u n d n t mp t t n sp y y ng f r y ur nts,
nd y u n r gn z p t nt p rtn rs.
T b mp t t y u must u t t mp t t n’s d nt ty nd p r -
t ns, ust m rs nd bus n ss p rtn rs, t r s b tyt y ur t rg t p pu -
t n, t r m g nd br nd, mmun t n sty s, nd rs m nts, nd
pr m s s. D n ng t rg t-sp mp t t n d sn’t m n g ng d t
d; n ny p rs n s r bus n ss, sp y st t m d n , tt
g d n m fr md r t y tt k ngt mp t t n n n rt t t
n ’s wn st tus r ttr t nts. D t rm n ng w t m k s mp t t rs
un qu nd ttr t , w t t y r nd tu y pr d , w nd w r
t y mmun t , nd w r t ysu d nd f s ss nt s t t y u n
turn n mmun t y ur wn br nd nd w t m k s t ttr t t t
t rg t p pu t n. Y u must d t rm n x t y w t s ts y u p rt fr m t
mp t t n t f r p t nt nts n s r d t rg t p pu t n.
id nt fy ng t mp t t n nd mp r ng t s nf rm t n t y ur r -
s r n y ur t rg t p pu t n r ss nt t un r n unt pp d n ,
r gn z ds nd s tur t n, m d y ur br nd, nd r gn z p t nt
p rtn r. T b st mutu p rtn r s g n r y n t y ur n rr w mp t t n;
WH O IS YOUR BIGGEST COMP ETITOR?—con t’d
c pt r : W is t c mp t t n?
y u r t k . T b st p rtn r w u d m fr m y ur s nd ry r x-
t nd d mp t t n. W t t d rs ty f nts m ng d r nt mp t -
t rs, y u r m r k yt g n n w nts/p t nts fr my ur b st p ss b
s ur : r f rr fr m x st ng pr t nts.
ACQUIRING TH E COMP ETITION
Daniel C. Mills, MD, FACS
Pur s ng n t r p ys n’s pr t n b sm rt d f ns m ,
w s w t i d d r y n my r r. T r t r ng wn r f t pr t w s
b rd- rt d p st surg n w t tw s, n m fr m my
nd n t r 1 m s w y. i w nt d t d ng n t r p st surg n
m nt my mm d t r t pr nt t furt r s tur t n f p st sur-
g ns n r dy p ys n-r S ut o r ng c unty, c f rn . if i pur-
s d t t pr t , t m nt t t n t r surg n d d n t. My g w s n t
t g nt s pr t nd nt nu n s st ps; t w s t f m r z mys f
w t s p t nts nd g t m n t g t t kn w m . h s p t nt st
w s ry u b — t w s gr up f p p w d r dy s wn n n-
t r st n p st surg ry nd w u d pr b b y d s r subs qu nt surg r s t
s m p nt. h d p rf rm d s gn nt numb r f br st mp nt sur-
g r s, nd i nt nu t s t s p t nts s t y n d mp nt r p -
m nts. i d d m nt n pr s n n s f r f w y rs s w y t s-
t b s mf rt w t s p t nts n n n r nm nt t t w s f m r t
t m. o n ft m st u b sp ts w s t wn nd m nt n s x st ng
p n numb rs, w i t t s d y. P t nts st t t numb r fr m
rds t y k pt fr m pp ntm nts y rs g .
St y ng mp t t s m ns i d t nt nu y u t my wn
pr t nd w rk d. i b n f rtun t t t mypr t s gr wn r
t y rs s t t i m n rm y n t p r t ng r m ry d y. o n i g t
t t p nt w r my wn t m m t t ns w r n b t ng s du ng p -
t nts s qu k y s t y w u d k , t w s t m t br n ut w t p ys n
xt nd rs nd ns d r p rtn r. a b ut t t m i st rt d tr n ng Pa s t
p rf rm s r pr dur s nd nj t ns, m d sp m up f r s
n rby, nd i pur s d t t pr t f r m ny ft s m r s ns t t i d
pur s d t p st surg ry pr t . T s ddr ss d tw ssu s f r m : t
w d m t br n ut w t p ys n xt nd rs s i u d d g t tr t-
m nt w n p ss b , nd t ptur d t p ys n’s x st ngm d sp p -
t nts t du t t m b ut p st surg ry pr dur s t t t y m g t b
Continued
S t n i: W
ACQUIRING TH E COMP ETITION—con t’d
nt r st d n. a g n, s d f ns m t s b k d n t r p ys n
fr m m ng n nd ptur ng t s sp p t nts.
a dd ng p rtn r g m n t r p r f nds t mp s m r sur-
g ry nd pr d m r b n d pr t . i s p rtn r w mp -
m nts r t r t n mp t s w t m . in u t ng w t p ys n pr f
w u d b st r und ut p t nt , i w nt d t dd f m surg n t t
pr t . T s s w rk d ryw f r m ; t r r s m p t nts n S ut -
rn c f rn w r d m nt b ut w nt ng f m surg n. h ng
p rtn r w ptur s t s p t nts s br ng ng n w p t nts t t pr t
w s mp y w u d n t ns d r d m s t r surg n. it s br ngs
fr s , f m p rsp t t mypr t . h ng p rtn r ws us t m n-
t n ur r f rr r t ns ps w t t r p ys ns f r r nstru t s s.
Mypr t d b m pr m r y sm t , nd i d dn’t n ug urs
n t d yt s s t r nstru t s s. N ww r b t pr d
b t typ s f nsu t t n nd surg ry. it s pfu t n m s f
s nd s r xp ns s w ff r ng w d r rr y f s f r p t nts.
RELATIVE WISDOM: Again st You rself
i m mp t t . i n r w nt t t s m n s d w t i kn wi n. But
t r r t m s y u s mp y s u d n t try t mp t .
My d r s n N s w s y rs d w n d d d w nt d t
rn t p y f tb . Gr w ng up w t us ns nd fr nds r und m w
p y d g s , g , nd n pr f ss n b , i w s up t t t sk.
My usb nd d n y p y d s r, nd N s d dn’t w nt r und b ;
w nt d t rn t t r w p rf t p gsk n sp r . W t my mp t t n -
tur , i d t pr i w s r b y’s m m. i d t p y f tb .
W d fun n t y rd t r w ng nd t ng sp r s. a nd t n t p-
p n d. Mypr d gyb m my mp t t r. i t d N s t t r w b mb,
nd d d. T r su t: M m r d d s t d ng r nd t rn t nd ns
fr m f tb t r wn by -y r- d.
R t w sd m: M ny pr d rs f st t m d n r mp t t
n t s m w y: t y n r w nt t t s m n s tr t t p t nt t y
kn w t y n. But f y u r g ng t mp t , b r st b ut y ur n-
t nt ns, subj ts, m ts, nd t p t nt ut m s. By und r st m t ng
s m t ng s s mp s g m f t , y u m y f nd y urs f n t t n-
qu r ng mp t t r, but t n s tt ng n t s d n s.
c pt r : W is t c mp t t n?
1
ABOVE TH E CROW D
Bus n ss s d r, nd n s m s s mp t n t mm n r b s f
qu t ns, m g , xp r n s, ut m s, nd pr .
Qu a li ca tion s
Qu t ns r s y r d nd mp r d; mp t n qu t ns
n yw n y urs r m ngt ryb st. T r s n w yt t p ngt
ry b st qu t ns. in m ny st t s, ws r qu r t t n d rt s ng nd
pub mmun t ns, p ys ns’qu t ns b sp yd n d by
r gn z d b rd rt t n. But d n’t st p t r : n ud r gn z d n -
t n , st t , nd r d nt s, nd nt rn t n r d nt s f y urs s
n nt rn t n m rk t.
Im a ge
Pr st g , n n n , w rmt , pr f ss n sm, ss, pt ns, mp -
m nts, nd m n t s r just f w f t nu n s t t n d st ngu s y ur
pr t nd d n y ur m g . Y u must r gn z t t y ur p t nts r
k ng f r s m , , r n n f t r b s t t d n y ur m g , nd
y u t pt t t t r r p t nts w w n’t r t t r b nt r-
st d n y ur m g . a w s mp t t r kn w dg s t t y u nn t b
t ngs t p p .
Exp erien ces
T u f n xp r n s r t nd subj t . T d y y ur p t nt
m y b fu d by w k nd w y w t r g r fr nds; t m rr w, r d -
s r m y b t k t y ung st, t b st m ng r fr nds. Y u n n y
mp t w t n xp r n f y u kn w w t y ur p t nts’ tru d s r s
nd m t t ns r , nd f y u n ns st nt y m t t m.
Ou tcom es
D m nstr t ng ut m s nd m k ngpr m s s r tw ryd r nt t ngs.
et s pr b ts m k ngpr m s s b ut ut m s. G ngy ur pr sp t
p t nt t nf rm t n n ss ry t w g d s n r s n b y s t
n y w y t r sp nd t mp t t r’s st t m nts b ut ut m s.
S t n i: W
P rice
D n’t mp t n pr , w t r w t t r pr d rs r y urs f. S t f
s du nd st kt t. o r djustm nts w n w rr nt d, su s f r mu -
t p pr dur s r r p t pr dur s. D n p y f r r s ns nd
st nd rm. e ryt m y u r sp nd t r djust pr ng, y u s t pr d nt.
it’s mp rt nt t kn w w y ur mp t t rs r , n g n r nd f r
sp p t nt (i d n’t m n t r p ys ns; i m n t r w ys n w
p t nt m y s t sp nd d rs). it’s u b t kn w t n
w t t mp t t r m y b ttr t ng y ur p t nts, r s mp y m k ng
y u k ss ttr t t y ur p t nts. But t’s n t ss nt t g t t t ;
us mp t t n t s p nd d n y ur wn str t g m s, t mpr
y ur wn pr t , r t nd n w nu s t r y ur p t nts. F r x-
mp , f rp r t -run m d sp p ns r ss t wn, w t t d n-
t g s f bu kbuy ng, r s ur s r ng, nd p r s d rt s ng, must y u
gn y urs f w t t xp r n , pr , r m g t y n t m rk t-
p t r m n mp t t ? N t un ss y u r y ng f r t x t p t nt
p pu t n w t t s m xp t t ns f qu t ns, ut m s, xp r -
n , nd pr . T u f study ng t mp t t n s t b tt r und r-
st nd y ur wn b st pr t s, n t t nt nu y k r y ur s u d r t
utd st n t p r d mp t t n.
Un exp ected Com p etition
R str t d ss t y ur s r s s r su t f n m r r gu t ry
f r s n s pr s nt n bst . F r x mp , t n ty t x s pr p s d
n s m st t s r mmun t s n sm t pr dur s u d f r pr -
d rs b rd r ng t r st t s r mmun t s t djust pr s t unt f r
t n r m nt n r s , r s mp y d w t t xp ns f m ng.
R gu t n n n b t r r str t n ’s b tyt pr t st t m d n
s y u t us f r kn wn t. W t r r qu r ng str t sup r s n f n n-
p ys ns, m t ng r d n ng t s p f pr t f r n np ys ns, r
nf r ng str t r s f ty pr t s f r tr tm nt r surg ry, r gu t n s
ng n t d f st t m d n . if y u’ f w d b st pr t s
ng, y u s u d w m r gu t n, b us t w n y n b t t
mp t t n, n t y u.
c pt r : W is t c mp t t n?
IN P RACTICE: P rice Wars
i m ft n sk d w pr t s s u d r sp nd t p t nt qu st ns b ut
m t ng w, w d y d rt s d pr ng n st t tr tm nts, su s
B t x nj t ns r br st mp nts.
i w s s t ng pr t nd y ung, n r us w m n w s b k ng r
surg ry. “i r yw nt t s d t r t p rf rmmysurg ry,” s s d, “but w
y u m t t pr n t r d t r d rt s s n t r d ?”
T surg n w s sp ss, s i m d n: “W r pr t t t d s
n t n d r pt p t nts b s d n d rt s ng. o ur pr t s pr n
nd ns st nt r rd f ut m s, ppy p t nts, nd f r pr s. W w nt
t fu y ur g s, nd w kn w w n. B f r y u m k y ur d s n, i
w nt y u t t nk b ut t s: t m y u k n t m rr r r y u r n
n nt m t m m nt, d y u w nt t b ppy w t w t y u s nd w
y u r , r d y u w nt t r skt nst nt r gr tt b r m nd r t t y u d -
d d t s f w d rs n y ur b dy nd y ur pp r n ?” T y ung
w m n ft, nd t surg n w s fur us w t m b us f t d st
t s p t nt. Tw urs t r, s d nd b k d t pr dur .
T s s r x mp f mp t ng, r try ngt , n n s mp r b .
it s b d d , b us t n t n ys ts pr d nt, t s d u s y ur n-
t r m g .
in t t s m pr t i n unt r d n t r br st ugm nt t n p t nt
f r w mt pr t r d “r f rr ” d s unt. i sk d w t t t m nt.
“S w s r f rr d t t d t r by n t r p t nt ft pr t , s w r
d s unt,” t m n g r st t d. T n i sk d, “h w w t t r f r-
r ng p t nt f t kn w r fr nd w s rg d ss t n s w s? T t’s
qu t w y n sty w y f s y ng ‘t nk y u f r t r f rr .’”
i sk d t d t r b ut t p y f r f rr d s unt. “i d n’t d t
t t m ; n yw n t s w rr nt d,” st t d. i sk d w t w rr nt d d s-
unt, nd n t s s st t d t t t w s t r f rr by pr r p t nt. h
st d dn’t und rst nd.
S i tr d t m k t r t : “Y u g t c fé F bu s n w k nd
y ur f r t m : dr nks, d nn r, d ss rt. it s y ur j unt. Y u
d nn r nd p y t b n fu . N mp m nt ry d ss rt, n fr b tt f
w n . N t ng. Y u s nd gu t c fé F bu s , nd s y u w t
rw m ng t nks. it w s t b st m r. T y sk d f r t w t r
y u sugg st d, nd t w t r g t m mp m nt ry kt b us
y u, s b st ust m r, r f rr d t m.”
T d t r r p d, “T t w u d m k m ngry; i m t n w s
g n t m y ty nd n w p tr n. i d s r t p rks.” l ss n rn d:
D n’t mp t n pr w t t rs r w t y urs f.
S t n i: W
COMP ETITOR OR P ARTNER?
c mp t ng nt s mu m r t n nd ngy ur m st su ssfu mp t t r
nd try ng t d t b tt r. it n s m r t n pr d ng b tt r s r ,
b tt r pr , b tt r xp r n , r gr t r u . it s ft s t ngs, but
t s r qu r s t t y u r m n tru t w y u r , ng g n t pr -
t s, nd m k sm rt bus n ss d s ns.
M ny m d sp t s, sp y t s n ng ry u r t n n-
p y r st t s r s, m d wn rs p f rt n pr dur s. By
d ngs t y dr wn n n t s nd m ngt sp t s s gr up
nd m ng t nd du pr d rs w r m mb rs f t s gr ups. But
r t s d r nt sp t s tru y mp t t rs, r n t y b p rtn rs?
c ns d r t p st surg n r d rm t g st, t sm t d nt st w s
b g nn ng pr t r r t ng n x st ng n . if t p ys n p rtn rs
w t s m n f t s m sp ty, t y n s r r s ur s, n n
kn w dg nd sk s, nd w rkt g t r t gr wt pr t , pr d ngt
x t s m s r s. h w r, t s n r t d r t mp t t n nd n-
t w t n t n n s f n pr t .
Com p lem en ts
if tw mp m nt ry (s nd ry r xt nd d) mp t t rs t m up, t y
mu t p d nt g s t t g b y nd t p r t n s ngs f pr t -
ng n p rtn rs p. T y s ng , un qu br nd t t s ttr t t d f-
f r nt s f nts’ d s r s nd p b f fu ng t s d s r s. T -
g t r t y r b t ttr t rg r p f pr sp t p t nts t n t y
m g t nd du y.
P t nt r t nt n m y s b n n d by mp m nt ryp rtn r ng. o r
t m , d rm t g p t nt m y w nt m r mpr ns tr tm nt
t r ug p st surg ry. F w ng p st surg ry, p t nt m y w s t
m nt n t r su ts t r ug sk n tr tm nt. in b t nst n s p t nt r t n-
t n s st b s d m ng mp m nt ry t m, nd t p t nt b n ts
t r ug p r t r t t rs n n n , mf rt, nd f m r ty.
c pt r : W is t c mp t t n?
Su pr t s m r k yt r t nt s ur t r ug s m n w
s s t s d w t , du t d b ut, nd w ng t nd rs y ur un qu br nd
t t rs t r ug r f rr , nd t s s m r k y t br d n t nt
s ur t sp t s f t pr t .
i d d n t n nt t n pt, but i d fu y nd rs t: bu d y ur nt b s
by bu d ng y ur pr t w t mp m nts—pr d rs w , w n n t
pr t ng w t y u, r m ng y ur m st g y r g rd d s nd ry nd
xt nd d mp t t rs. Y u n d n t pr t w t t m; y u n n tw rk,
r ss-pr m t , nd r f r t t r. S ng s t mm n g nd t
ru s mp t t n r d n d, p rtn r ng w t y ur mp t t rs n b
mutu y pr du t nd r.
(Trang không có chữ)
What
Your practice exists for one simple reason—service.
What di erentiates you from others is the means,
method, and meticulous manner by which you
extend aesthetic medicine to others.
SECTION II
5 What Is Your Identity?
6 What Is Your Model?
7 What Do Your Patients Expect?
8 What De nes Risk?
(Trang không có chữ)
Wh a bra a i ag o ot xi t, th o y thi g that i r tiat o
pro uct or rvic fro th xt i pric . Co p ti g o pric ca b tri-
ta wh h a th, af ty, a fu i gth o t p r o a ir ofoth r
ar at tak .
Brand, image, a mission ar thr v ry tro g ark ti g co c pt that
co ctiv y i tify you. Th i vo v tho ua c that t you apart
fro a yo or a ythi g co p ti g for your c i t’ a your ark t’
att tio .
W H AT IS YOUR BRAND?
Bra i th a , wor , or i pri atur that ab your practic a u iqu .
Bra i g a o you by your p cia ty, cr tia , a th rvic
your practic provi . It i c u th fo owi g:
A prof io a trai i g, or th ki a rvic pro-
vi . exa p i c u tr ati g ki of co or, tr ati g chi -
r , a c rti catio i i i a yi va iv t ch iqu or
a r proc ur , r arch, a trai i g a r hip—a th
thi g b yo tit a boar c rti catio that you or
your ta a ica prof io a .
sp cia p r o a trai i g, ki , or i t r t , uch a u cy
i a for ig a guag , phi a thropic car , p r o a xp ri-
c , a co u icatio ki .
What IsYourIdentity?
There is nothing worse than a brilliant image of a fuzzy concept.
— An sel Ad Ams
CHAPTER 5
s ctio II: What
A c rti catio or accr itatio of th ta , o c , a
tr at t a urgica faci iti .
A iatio , b r hip , privi g , a a r hip a o g
r cog iz oca , r gio a , a atio a ica oci ti ,
p r group , ucatio a i titutio , a phi a thropic or-
ga izatio .
Your bra i your a a w a a th thi g that your bu i
a that p op acc pt about your bu i . n ik , l xu , Ar a i, star-
buck , Ty o , a R ty a ar a a that ar o tro g y bra
that w k ow th ar ho , car , Ita ia c othi g, co , pai r i v r ,
a a a th tic i j ctio , v though th bra i c u o a guag
that th pro uct. Bavari h motorw rk (BmW) i a bra that
c ar y co v y that thi i a G r a v hic , y t o t of u i p y r f r to
it by it i itia .
I th practic of ici , bra i gha b ca marketing on steroids.
You probab y o ’t hav th r ourc or th to bui a bra a
tro g a a - ark t co u r a r o, but you o to hav a
i g, co i t t a by which you ar i ti . You a bra
that i co i t t i wor a ig (co or , typ ty , a for at) ach
ti a i ach p ac you ar i ti . Your bra ay b :
Your name: Richar Richar , md
A name that de nes your services: d r ato ogy a P a tic
s urg ry A ociat ; A th tic m ica spa; d ux l a r
C t r; s i I titut
Relative to your geography: A th tic C t r of Bigvi ;
south C tra A ociat ; I a A th tic
Chapt r : What I Your I tity?
Anycombination ofthese: Richar d r ato ogya P a tic
surg ry; Richar A th tic C t r of Bigvi ; I a A -
th tic a s i I titut
Evocative: B B autifu P a tic surg ry; P rf ctio m ica
spa
None of the above: Auroraboria iu
Your bra ay to v ra i r t provi r , rvic , or co -
c pt . It u t b tro g ough to i tify you, to a ow p op to a i y
you, a to ur throughout your car r. It u t a o b xib
ough to vo v with cha g i your practic ov r ti , without i i -
i hi g th va u of th bra or ra atica y cha gi g it.
RELATIVE WISDOM: Bran d Matters
Cha gi g a bu i ’ a wi ot cha g it i tak . A f-prof
a th tic provi r wa th focu of a t vi io r port r’ i v tigatio i to
provi r ark ti g a g rou a u prov fat- ti gi j ctio . Th r -
u t of thi i v tigatio a ct ot o y thi provi r’ bu i for th
i j ctio but a o hi ov ra op ratio , a rv y put hi out of bu i-
. H wa xpo a u qua i , i p y riv by o ar , a hi prac-
tic a g rou . I a hort ti h c o hi oor .
Four o th at r, u i ghi wif ’ ur a , h op hi bu i o c
agai , ot o yo ri gth a u prov tr at t a poor-qua itycar ,
but a o ark ti g th xt iv y with hi v ry i ti ct acc t that ha
b h ar o ra io co rcia ru for hi pr viou practic , a th
w r o c agai airi g r gu ar y.
Four o th at r, hi oor w r p r a t yc o , a h ov out
of tow . Th r wa o bu i for hi to b fou a ywh r .
R ativ wi o : Your bra i or tha your a . It i a itio
you wi carry with you, o att r what tra gr io or tra itio you
ak .
s ctio II: What
COOKIE-CUTTER BRANDING
Th r ar a yopportu iti to pr t your practic to th wor . Th I -
t r t ha b co o of th o t o ipr t p ac wh r practic ar
howca a bra . Cooki -cutt r bra i g i a proc by which a
rvic (wh th r a ir ctory, a r f rra ourc , or a prix x I t r t it ,
a o goth r ) group a participa t by p cia ty. You ar i p yo of v-
ra pr , qua y packag optio a i ag pr t to pro p c-
tiv pati t . Th o ythi gthat i ti gui h you i thi typ of progra i
your pictur a a phra or wor withi th bra i g packag .
B for i v ti g i uch rvic , a k your f:
How wi I ta out a o g cou t oth r provi r bra i
th a way by thi rvic ?
A I forc to co p y with p ci c practic that i u c y
i ag , uch a o i co u tatio , fr co u tatio , or pr t
pric for co u tatio or rvic ?
What o th i ag of thi rvic o to y i ag ?
How o th i ag of oth r provi r with who I a packag
a ct y i ag ?
What i th tru r tur o cooki -cutt r bra i g—wi th pro-
p ctiv pati t who k out through thi co tact poi t b -
co qua i , va uab , a irab pati t ?
Cooki -cutt r bra i g o ’t top th r : it a o tai co u ta t , r-
vic , a progra that o ’t a ow you th xibi ity to p r o a iz th
v ry vi ib i ag a i for atio that hap th u iqu i tity that
hou b your a o .
W H AT IS YOUR IMAGE?
I ag i vo v th ua c that i ivi ua iz you a a prof io a a w
a your practic . It i a co bi atio of app ara c , p r o a ity, co u i-
catio ty , va u , a iti , a th cr ibi ity a thic you co v y.
I ag i howyou ar byoth r , a howyou ar charact riz . I ag
Chapt r : What I Your I tity?
i co v y by a y thi g , a ca b i t rpr t , acc pt , or r j ct
by your ark t a your pati t i p y by how thi i ag i pr t :
I th pho a w r byafri yvoic r a yto h p, or by
a auto at y t ?
Ar your for a co t g ric, r vi , or i co i t t-
ooki g copi ? Or ar th y c ar a co i t t i co t t,
ty , a bra ? Ar th y co p t y ctro ic?
Ar you r i ca ua co fort, p rf ct y tai or ta t fu
bu i w ar, or at u ? Or o you gr t your pati t
r a though you ar h a to a baro ’ ba ?
I your practic tti g qui t a co fortab , t ri a
fu ctio a , or chaotic a ou ? I it crow with c utt r,
art, fur itur , quip t, wa of ip o a a awar , a
rack of brochur ? Or i it ta t fu y appoi t a orga-
iz , privat a w co i g? Hav you bui t a i viti gc -
t r with wat rfa , c t tow , va t parki g, a privat
co ci rg ?
d oyou a your ta ak y co tact with pati t a tr at
th a i ivi ua , or o you i p y i t , r p y p rfu c-
tori y, a ov o ?
d o you fo owup with your pati t , o att r how a or
arg th ir goa a proc ur , or o you a u th y wi
co tact you if th y to?
C ar y, o ofth i ag - i g tai r u t i ig i ca t faux pa i
if a i practic . But co i r thi : ctro icfor ayb w co bya
you g r, co put r- it rat popu atio but cou b a ob tac to o r,
t ch o ogy- avvypati t or tho with o ir to u ctro ic . I o
ark t , a ca ua y r octor i too ca ua ; i oth r , a octor i a uit
ay i ti i ati g. If parki g i a prob at your ocatio , va t park-
i g ay b c ary, but i oth r ocatio it ay co v y a o t tatio
that pati t wi i vitab yb part ofth f th ypay. so pati t
ay b k ow g ab ough to k ow wh or if to fo ow up; oth r ay
wa t a r p at co tact. d your i ag bywho you ar , byyour
pati t ’ a xp ctatio , a by what i acc pt i your ark t.
s ctio II: What
W H AT IS YOUR MISSION?
Th fact that you hav th abi ity to tr at pati t with a th tic ici i
tia , but qua yi porta t i howyou a your practic carrythat out.
It i i porta t to tak th ti to co po a i io tat t, which i -
ti what you a a provi r xp ct of your f. It r ct th r po ibi ity
you tak a th xp ctatio you t for your bra . It a o a r your
r atio hip to your co u ity, p r , tu t , a ta . Your i io
tat t ay b a i g i , or it ay b a tai cr o.
To a r your ro i provi i gth p r o a app ara c ir ofc i t
a pati t byabi itya o ov r ook th ourc for your r atio hip with
your pati t: p r o a ir . Fu i g a pati t’ p r o a ir r quir
aki g a ir ct p r o a co ctio . Accor i g y, part of your i io
u t b to ak that co ctio with pot tia c i t or pati t . It
ot b co v y i v ryco u icatio that r pr t your o c , but th
to it t u t b co i t t with your i ag a bra .
RELATIVE WISDOM: Th e Sixth Diam on d
Co i t t y ti gor xc i g xp ctatio br oya ty, a i i p -
ab a t to a y bu i .
Th hot bu i ha a ot of iv r ity i rvic o . But two hot
chai , th Ritz Car to a Four s a o , c ai th gr at t r t tio
a o g patro . I fact, aft r / , wh n w York hot roo w r -
rt , Four s a o a th Ritz Car to k pt th ir or a , bri k pac of
occupa cy. Why th ucc ?
Th bra r pri th v o th ir rvic o a th ir
i io . I fact, RitzCar to o r atrai i gaca yfor rvic i ivi ua
i oth r bu i to ar th Ritz way, by th ir cr o, otto, th
thr t p of rvic , th ir -poi t rvic va u , p oy pro i , a
or . A though hot ar co o y rat by ia o , v b i g th
o t, th Ritz Car to r i th a i a g t a who ar part of th
Ritz Car to t a that th r i a ixth ia o : “ y tiqu , otio a -
gag t, a fu ctio a .”
Ritz Car to k ow how i porta t v ry vi itor i , fro a u t trav i g
o bu i to fa i i o vacatio . R gar of th co o ic co itio ,
Chapt r : What I Your I tity?
th r a o for trav , ocatio , or ti of y ar, th ir rvic o v r fai
to t or xc xp ctatio .
R ativ wi o : s rvic i your bu i ; th r for a rvic i io
tat t i tia . Your pati t ay ot r a it, but th y wi i fact x-
p ri c , appr ciat , a xp ct it.
IN P RACTICE: Mission Accom p lish ed
A phy icia wa t r i to bri g h r practic to th xt v , to cr at
a i ag , a bra that wa u iqu y p r o a , privat , a acco o ati g,
with a i io to provi a xp ri c that a way put th pati t’ phy i-
ca , otio a , a ocia co fort r t.
sh i v t a gr at a i th wor , po ici , a trai i g that hap
h r ta a co v y to h r pati t th xact i tity h wa prou to -
. Th ort w r xc ptio a . Th prob : h i p y i ot a
cou ot iv r. Th octor ca , u ab to u r ta why h r f-
fort w r ot worki g. A th tic pati t w r i p y ot co fortab , ot
acc pti g tr at t.
Aft r p i g a ay at th o c I i ti th ob tac to achi vi g th
bra h ir : i th ix of a th tic pati t h aw a u b r of chi -
r i of riou c i ica car . A wo a wi hi g to i prov a agi g
app ara c ight r gu ar y cou t r a chi with a v r c ft ip i th of-
c . ma yp op ar u co fortab arou o o with a for ity; th y
o ’t k owhowto r po , or v wh r to ook. “I wo ’t giv up tr ati g
tho chi r ,” h to . “I pri y f o rvi g tho i a
uch a rvi g tho with wa t .” I agr .
Th o utio : sh r vi h r ch u o that a th tic pati t a p -
iatric pati t w r o i r t ay , a h ha a co tra c
put i that wa or chi fri y. d corativ cov r ba k t i ach x-
a i atio roo co tai toy to k p th chi r bu y. e ga t bi r
o i tab co tai a th tic practic i for atio , a co p tary
bright bi r co tai p iatric i for atio . sta w r giv th a
uty ach ight to “tur th roo ” with a f w i or a iti fro p i-
atric to a th tic, a ta b r v ha i r t r gui i for
a th tic a p iatric ay . Th cha g a co it t to thi w i -
tity w r o ucc fu that th octor’ practic gr w, a oo th r wa
uch a for a th tic rvic that h wa pr pari gto hir a a ociat
a xpa h r o c .
s ctio II: What
W H AT DEF INES YOU?
so ay that th o t p r o a a i cu t ta k i v opi g th ir
bu i p a i i g th ir i tity: pr ci y articu ati g th ir bra ,
charact rizi gth ir ir i ag , a rafti ga i c r i io tat t.
Thi ta k i i cu t o y if you t out to cr at a i a o rath r tha
a r a i tic, achi vab obj ctiv . ev provi r fr h out of a f ow hip
a b gi i g practic hav a ba i for bra , i ag , a i io ; th y ar
ot tarti g fro cratch. n ua c that h p hap o ’ i tity ay b
ar fro tor , for by xp ri c , or fu y by your ki
a p r o a ity.
d i g your practic u t b gi with what xi t ; th you bui o your
tr gth , i tify a corr ct w ak , a r va p wh r c ary.
d o ot cr at a o a your f by it; your f r t, th
hap a o that ha c a vat your itio a a r th
of tho you rv .
What IsYourModel?
In business, a successful model is not one fashioned
after someone or something; it is a sincere expression
of your desire for operational perfection.
CHAPTER 6
A s rvic m d l is m r tha a m u f th tr atm ts a d pr c dur s y u
pr vid . It i v lv s th ma r a d s tti g i which y u, r th s wh
w rk f r r with y u, pr vid th m a d h w y u addr ss what y u d ’t
r. It’s th am iti s y u r r th c v i c a d acc ss y u pr vid
f r y ur pati ts. I sh rt, as rvic m d lis th simpl st m a s fd i g
a c mpl x s t f m dical a d busi ss d iti s.
MEDICAL MODELS:
DEF INING YOUR MEDICAL P RACTICE
Y ur practic mayb classi d by r ac mbi ati fth d iti s f
m dical practic s:
Core: Y u pr vid th xact s rvic s d d by y ur c r
trai i g. Y u ar d dicat d a d limit d sp ci cally t th
sc p f y ur sp cialty. Th r is rati f cli ical t a s-
th tic s rvic s; y u r th m all.
Clinical: Y ur f cus is th m dically c ssary s rvic s
r lat d t y ur sp cialty. Y u ar d dicat d t physical h al-
i g, such as tr ati g ski ca c r.
S cti II: What
Restorative/reconstructive: Y u p rf rmm dically c ssary
r r imburs d pr c dur s that abl y ur pati t t r st r
am r rmalapp ara c r fu cti , such asbr ast r p st-
tum r r c structi .
Cosmetic/aesthetic: Y ur practic sp cializ si l ctiv m d-
ical s rvic s that impr v , ha c , r cha g p rs al ap-
p ara c . Y u ar d dicat d t m dicals luti sthat addr ss
th physical a d m ti al ds f y ur pati ts.
Surgical: A p rti f y ur m dical s rvic s is d dicat d t
surgicals luti s, wh th r i y ur accr dit d -sit facility,
a ambulat ry c t r, r a h spital.
Nonsurgical: Y u pr vid pati ts with tr atm ts that ar
m dicala d d tr quir m r i vasiv surgicali t rv ti .
Academic: Y u ar i v lv d i th t achi g a d trai i g f
th rs i y ur c r sp cialty.
Research: Y u i v stigat , xpl r , xp rim t, a d d
w pr c dur s, d vic s, pr ducts, t ch iqu s, r th ri s.
Military: All r a p rti f y ur tim is d dicat d t pr -
vidi g m dical s rvic t th m a d w m wh s rv i
th arm d f rc s a d th ir famili s.
Multispecialty: Y u r r lat d r u r lat d sp cialtym d-
ical s rvic s.
Multiphysician: Sam -sp cialty, c mpl m tary, r u r -
lat d-sp cialty m dical pr vid rs practic with y u.
Multidisciplinary: A vari ty f r lat d r u r lat d s rvic s
ar bl d d i th sam practic vir m t, such as a s-
th tics, bariatrics, a d c u s li g.
Retail: Pr ducts that ar r quir d r that ha c r xt d
y ur s rvic s ar s ld t y ur pati ts.
Spa: S rvic s ar pr vid d i a luxuri us a d sybaritic vi-
r m t. n o Te: Y u d ’t d t cally ur practic aspat
surr u d y ur pati ts with warmth, c mf rt, a d pl asur .
Chapt r : What Is Y ur M d l?
Th s ar th m dical m d ls that shap a larg p rti f y ur practic ,
but y u ar t wh lly d d by th s pti s. Th m dical m d l, al g
with y ur busi ss m d l, utli s th structur f y ur practic . It is th
missi thr ugh which y u x cut y ur m dical a d busi ss m d l that
will disti guish y u, attract pati ts, a d ful ll th ir xp ri tial a d a s-
th tic ds.
BUSINESS MODELS
Busi ss m d ls i a sth tic m dici ar cha gi g, but i t r sti gly, it is
th traditi al m d ls that dur .
Sole P rop rietor
Y u ar y ur w , a d y u w y ur practic . A y wh w rks with
y u w rks f r y u. Y u ar , th r tically a d l gally, th practic /busi ss
w r; all liability is y urs. This is th m st c mm busi ss m d l f r
a sth tic pr vid rs t day, a d with g d r as : as th Ceo y u s t th
t , c tr l what y u wish, mp w r th rs as y u s t, ar r sp sibl
i dividually f r th succ ss r failur f y ur d av r, a d ca mak d ci-
si s fr ly. Y u al d th t a d f rc it, cr at a car ful bal-
a c b tw v rsight a d micr ma ag m t, a d s rv qually as physi-
cia a d busi ss w r. W ak ss i ith r ar a will r ct a d a ct
th practic as a wh l .
P a rtn er
Y u a d r m r pr vid rs ar j i t w rs fs m p rti fth prac-
tic . Y u th r tically a d l gally shar th burd f d bt a d risk, r -
sp sibility, a d r s urc s. B caus th practic f a sth tic m dici is a
c mp titiv ld a d i v lv s g f r b th pati ts a d pr vid rs, succ ss-
ful l g-t rm part rships ar rar : f w ca d th car ful d iti a d
bala c t w rk t g th r harm i usly t s rv a lik p pulati a d lik
ds, u l ss th y c mpl m t a th r i trai i g a d ma ag m t
styl s. D i g t ly th i dividual sc p f s rvic , but als th i di-
vidual l ad rship, ma ag m t, a d r s urc c tributi s t th practic
is fu dam tal t a y part rship agr m t, wh th r th r lati ship was
t r d i t fr m th uts t r v lv d fr m a mpl ym t r c tractual
S cti II: What
agr m t. Th part rship m d l is b c mi g i cr asi gly p pular wh
th part rs ar fr m di r t c r sp cialti s a d th ir practic t g th r
ha c s th sc p fs rvic s, such as aplastic r facialplastic surg a d
a d rmat l gist.
Em p loyee
I this m d l y u w rk f r s m , wh th r a th r physicia , a u iv r-
sity, r a c rp rati ; y u d t w th practic . Y ur auth rity, r sp -
sibility, a d sc p , f s, g als, pr ductivity, a d limits ar d d by y ur
mpl y r. A mpl ym t situati may d y u with a mpl y r wh is
familiar with a d r sp cts y ur practic i a sth tics, r it c uld plac y u
i a situati that xpl its y ur cr d tials. Ch s y ur mpl y r as car -
fully as y u w uld a part r.
Sa tellite
Wh r y u practic is th xt si f y ur busi ss m d l. A sat llit f-
f rs a sth tic s rvic s at a s c dary l cati , such as a t ss club, spa,
sal , h t l, r s rt, r r tail sit . Th primary busi ss l cati /m dical
practic , acad mic s tti g, r h spital practic fully v rs s a d s ts th
sta dards f r a sat llit , bas d th m d l a d missi f th primary
busi ss.
Con tra ctor
Vari us c tractualm d ls xist, but ss tiallyac tract r practic s as a
i d p d t pr vid r f m dici withi a th r m dical practic r a -
th r busi ss tity such as a h spital, t ss club, spa, sal , h t l, r -
s rt, r tail utl t, r c s rtium.
Tim e-Sh a re
I atim -shar structur , y u ar i as l practic r part rship a d shar
r s urc s, such as c spac a d mpl y s, with a th r busi ss tity.
Th r was a tim wh that busi ss tity was a th r m dical practic .
T dayit mayals b aw ll ss c t r, h spital, t ss club, spa, sal , h -
t l, r s rt, r r tail utl t.
Chapt r : What Is Y ur M d l?
Su p ervision
I a sup rvis ry m d l, y u v rs th s rvic s f th rs as a fu cti f
mpl ym t. T day th r ar a umb r f a sth tic m dical c t rs with
w r- p rat rs wh ar t physicia s; physicia s ar hir d byth w rs
t sup rvis r dir ct. Wh r th physicia ca a d d s hav abs lut c -
tr l f th l gitimacy, saf ty, a d appr priat ss t which pr c dur s ar
r c mm d d a d d liv r d, sup rvisi ca ha c a practic . Wh r it
xists simply t l d l gitimacy t a th rwis u quali d m dical
m d l pr vidi g a sth tic s rvic s, it is a accid t waiti g t happ , a d
y u may d up with bl d y ur ha ds, d spit v r havi g had y ur
ha ds th busi ss.
Corp ora te
Y u ar th mpl y f a c rp rati that pr vid s m dical s rvic s. T -
day c rp rat m dici d s a practic f m dici xclusiv t th d -
liv ry f s rvic t a pr d d s t f x cutiv s i a tim , ma r, a d
plac that d s t disrupt th ir ability t d busi ss.
F ra n ch ise
As a participa t i a fra chis practic , y u ar i v st d i r w rk f r a
m d l that has s t pri cipl s f r bra d, imag , missi , a d pr vidi g s r-
vic . CAVeAT: A sth tic m dici is a v ry p rs al d av r, wh r as fast
f d m d ls f s rvic ar m a t f r th mass s. I this m d l, startup c sts
ca b high, a d y u will lik ly b r quir d t carry c rtai pr ducts a d
m t c rp rat qu tas f pr ductivity.
Con cierge
A wbusi ssm d lf r ma ydi r t s rvic -bas d i dustri s, c ci rg
m d ls ar bas d m r a d liv ry m d l tha a m dical busi ss m d l.
This m d l dictat s that v ry d, d sir , a d whim f th pati t b d -
liv r d, wh th r this i v lv s arra gi g f r a lit p st p rativ r c v ry
xp ri c , r d liv ry f r qu st d m als, massag s, r ma icur s duri g
th pati t’s r c v ry p ri d at h m .
S cti II: What
Wh will d cid h w y u will d , r , r v lv y ur a sth tic prac-
tic m d l? A y umb r f p pl a d c diti s hav i u c : t ach rs
a d m t rs, sp us s a d family, p rs a d c mp tit rs, d m graphic a d
c mic fact rs, part rs, mpl y rs, advis rs, a d mpl y s, a d v
ba ks, lawy rs, r gulat rs, a d i sur rs. Tr ds may i trigu y u r dis-
suad y u. Traditi al m d ls may s m limiti g. Th r is a sw r,
but bycar fully xami i gy ur pti s a d mark tplac a d d i gy ur
g als, y u ca d a a sw r that w rks f r t day a d has th xibility t
dur r r adily cha g f r th futur .
IN P RACTICE: Wh at Sh ou ld I Do? It’s You r Decision
I visit d a practic that i clud d a 5-y ar v t ra f a sth tics a d a y u g
pr vid r wh had r c tlyb hir d. Th v t ra was h p fulthat th w
pr vid r w uld h lp pr vid car t a busy str am f pati ts. Th w
pr vid r was rgiz d ab ut th pp rtu ity t ha g a shi gl a d b c m
a i t gral part f th practic . Th v t ra ask d m , “What sh uld I d ?”
i t rms fd i ga d ri gth y u gd ct r a pp rtu ityt gr wi t
a part rship r lati ship. Th y u g d ct r als ask d, “What sh uld I
d ?” H p d r d wh th r th r was c mp titiv , g d f r him i th
sh rt a d l g t rm, fair, a d attai abl .
Ad ct r i privat practic f r arlyad cad , hit hard byth struggli g
c my, was r d a cha c t v rs a larg chai f c rp rat -ru
m dical spas. “What sh uld I d ?” h ask d. Th m y was g d, th r
s m d t b littl d iti t his r sp sibility, a d a l t f limitati t
his ability.
A d ct r limit d by a larg multisp cialty gr up r aliz d that his pati ts
w r ’t g tti gth att ti h wa t d th mt hav amid avast array fcli -
ical a d a sth tic pati ts. “What sh uld I d ?” h ask d. G his w
a d try t r vis p rati s t m t his a sth tic pati ts’ ds, r simply
d al with th situati at ha d?
Thr ugh ut y ur car r th r will b tim s wh y u w d r, “What
sh uld I d ?” M t rs, advis rs, c sulta ts, b ks, a d l ctur s ar avail-
abl t put thi gs i p rsp ctiv , t r advic v if it may b u p pular,
a d t h lp d strat gi s a d carry ut pla s. But th d cisi s that d -
t rmi h w y u will apply y ur cr d tials a d y ur skills i m dici a d
i busi ss must b y ur w .
Chapt r : What Is Y ur M d l?
3
I’v l ar d fr m th wisd m f th rs, a d I’v ask d, “What sh uld I
d ?” ma y tim s i lif . n v rth l ss, wh it c m s t d cisi -maki g,
“What sh uld I d ?” b gs th f ll wi g advic :
. It’s your decision, not mine. List t a d valuat th advic y u
ar giv . W igh th m tivati , bias, xp ri c , a d cr dibility
f th s urc . H w v r, y u must d cid .
. Every decision needs a plan. Advic may h lp y u t arriv at a
d cisi , but h w will y u carry it ut? D th pr c ss by
which y u must arriv at a d cisi . o th rs may h lp y u i d -
visi g y ur strat gy, but y u must impl m t a d sustai it.
3. Yes-men are followers, not advisors. D t s k th advic f
th rs t qualify y ur d cisi . Advis rs a d c sulta ts wh
simply agr with y u, wh w ’t pr v k y u t thi k d ply r
play d vil’s adv cat , ar t us ful t y ur pr c ss. S k th
c u s l f th s wh will push y ur d cisi -maki g t i clud
l gical but far-r achi g pti s.
SERVICE MODELS
Abra d, imag , a d missi ar us fula d succ ssful lywh th yc m-
mu icat a d h stly mbrac th practic ’s p rati s. Buildi g r r -
t li g id tity a d s rvic m d ls c gru tly has gr at r valu tha cr -
ati g t t th th r.
With ut qu sti , th p rati s f a y m dical practic r practic s g-
m t must uph ld sp ci c sta dards i saf ty, thics, a d privacy. A s-
th tic practic s ar charact riz d bya v gr at r d f r pati t privacy
a d f r th add d am iti s f c mf rt, i dividual att ti , a d p sitiv
supp rt. F r a a sth tic r c sm tic pr c dur , tr atm t is d sir d, but
t ss tial. Alth ugh tr atm ts may cr at t mp rary pai f r pati ts,
pr duc str ss, a xi ty, a d v f ar, a succ ssfully ru a sth tic practic
willcr at ap sitiv , c uragi g vir m t that d s t disc u t th s
r sp s s. Th pati t’s tir xp ri c as w llas th tr atm t utc m
will d a succ ssful a sth tic practic , wh r h sty, ducati ,
a d s s ry a d m ti al c mf rt ar th c r f m dical a d p rs al
s rvic s a d r tail c mpl m ts.
S cti II: What
Th e Op era tion a l Trilogy
A y a sth tic practic must l k at p rati s as thr disti ct titi s:
. M dical s rvic s
. P rs al s rvic s
3. R tail
each fac t f th p rati altril gyhas adisti ct fu cti , i dividualg als
i ful lli g pati t ds, a d a u iqu c tributi t r v u . Alth ugh
ach ca sta d al , it is th sy rgyam gth thr p rati als gm ts
that cr at s th gr at st valu .
M EDICAL SERVICES
Th m dical tr atm t a practic pr vid s, wh th pr vid rs ar , a d
wh r tr atm t is pr vid d charact riz m dical s rvic s. Y ur skill a d
car a d that fy ur cli ical sta a d supp rti gsta r pr s t th charac-
t r f y ur cli ical p rati s. Th c , surgical facility, a d p st p ra-
tiv car pr vid d r pr s t th c mf rt f y ur p rati s. I a a sth tic
practic th f cus f car r sts ability as much as th basics f charac-
t r a d c mf rt:
H w a d wh r d y u c duct c sultati s?
Wh is y ur pati t supp rt adv cat ?
Wh r ar diag stic t sts p rf rm d a d h w?
What is th c s t pr t c l?
What is th pr p rativ pr t c l?
Wh r is th p rati g r m? Is it u d r y ur p rati al
c tr l, r ar y u usi g spac i a larg r facility?
Wh admi ist rsa sth sia, a d wh pr vid spr p rativ ,
surgical, r c v ry, a d p st p rativ car ?
Chapt r : What Is Y ur M d l?
5
Fully xami allfac ts fcli ical p rati s, i y ur c a d -sit . Y u
sh uld d c gru c i y ur bra d, imag , a d missi . H w y u d -
liv r s rvic s t ach pati t pr gr ssiv ly builds a xp ctati that y u
must m t r xc d, t just f r tr atm t, but v ry tim h r sh is
tr at d. Quit simply, a sth tic m dici is t a li ar pr c ss, wh r th
r lati ship b gi s wh th pati t gag s y u f r d sir d tr atm t a d
ds with a p sitiv cli ical utc m . Th r lati ship is cyclical f r tw
disti ct r as s:
n surgical tr atm ts, what is c mm ly call d cosmetic
medicine, must b r p at d t pr duc r mai tai r sults,
a d this may l ad t a r qu st f r a sth tic surg ry as th i -
dividualc ti u si th pati t cycl . Ify u ca t ful ll r
mai tai th tr atm ts, y u hav br k th cycl a d y u
will l s th pati t.
Happy pati ts ar y ur b st s urc f r succ ss a d gr wth.
K pi ghappypati tsi a activ cycl mai tai sy ur vis-
ibility with th m a d r mi ds th m f th valu f y ur s r-
vic s. This will bri gth pati ts backt y u f r di r t r
add d s rvic s, r th ywillr f r th rs t y u wh willk p
y ur r lati ship a d th s rvic cycl gr wi g.
TH E EVOLUTION AND IMP ORTANCE OF COSMETIC
MEDICINE
Renato Saltz, MD, FACS
S ismic cha g s ar shaki g up th ld f c sm tic surg ry a d c sm tic
m dici . Th gl balizati fb auty, cha gi gd m graphics, culturalpr -
f r c s, pati t d ma ds, a d adva c s i t ch l gy ar c v rgi g t
shap a d tra sf rm a burg i g a sth tic mark tplac . F r plastic sur-
g s th s d v l pm ts ar havi gamaj r impact th wayw practic .
W fac a cha gi g pati t p pulati as baby b m rs i cr asi gly s k
c sm tic ha c m ts. W ar als subj ct t a umb r f pr ssur s fr m
th m dia, th c sm tic i dustry, a d fr mpati ts wh wa t ptimalr sults
with mi imal d w tim .
These trends mandate change. Th y r quir us t r valuat th way w
d busi ss a d t grasp th big pictur . T day th umb r f surgical
Continued
S cti II: What
c sm tic pr c dur s p rf rm d is xp ri ci g xpl siv gr wth, far ut-
paci g that f traditi al surgical pr c dur s. A sth tic surg s ca
l g r a rd t ig r th gr wi g imp rta c that surgical c sm tic
pr c dur s play i a sth tic surg ry practic s. All ur surv ys a d i dustry
statistics i dicat th imp rta c f r c g izi g a d adapti g t th w
tr ds that ar sw pi g ur sp cialty. F r plastic surg s practici g c s-
m tic surg ry i t day’s c mp titiv vir m t, c sm tic m dici rs
xciti g pti s f r practic gr wth a d pati t r t ti . By i c rp rati g
c sm tic m dici i t ur practic s w ca app alt abr ad r ra g fpa-
ti ts v r th l g t rm. W hav th pr f ssi alism, trai i g, a d ability
t b th tryp rtalf r pati ts s ki gc sm tic tr atm ts a d th datat
substa tiat saf utc m s thr ugh ur s rvic s.
The key is to view aesthetic surgery as a continuum in which nonsurgical
cosmetic treatments provide an opportunity to establish a relationship with a
patient that will lead to more invasive surgical rejuvenation as the patient
ages. Thus it is crucial f r us t u d rsta d th f rc s that ar shapi g ur
sp cialty, t pla th b st way t mbrac th m, a d t d a way t i c r-
p rat c sm tic m dici tr atm ts i t ur dailypractic s. Th lyqu s-
ti is h w t acc mplish this g al i a ci t, ctiv , a d a cially
viabl ma r.
RELATIVE WISDOM: Lu xu ry Bran d s
Th pri cipl s f luxurymark ti gstat that c c sum rs ar i tr duc d
t a d satis d with ac rtai l v l fs rvic r qualityi apr duct, th ywill
b c m l yal. Luxurymark ti ghas littl t d with lab ls r a high pric ; it
r quir s valu , satisfacti , a d c sist cy.
I hav a di cult tim buyi gsh s b caus myf t ar arr w. Sal sp -
pl hav always tri d t c vi c m that s m thi gwill t, v th ugh r g-
ular siz s d ’t. S v ral y ars ag a pati t sal sma sugg st d that I c -
sid r buyi g Prada, a littl b tt r quality a d prici r sh that h b li v d
w uld b th right t f r m . It was p rf ct. I l v d th styl a d t. A d I
quickly l ar d th l ss f luxury l yalty: fr m that p i t I always
TH E EVOLUTION AND IMP ORTANCE OF COSMETIC
MEDICINE—con t’d
Chapt r : What Is Y ur M d l?
tur d t Prada, r that sal sma , f r my sh s l cti s. But it did ’t st p
th r : I als l k d t this bra d f r th r pr ducts that w uld r th sam
quality.
R lativ wisd m: Pradais aluxurybra d, a d y ur bra d is als aluxury
bra d; it d s a ss tial s rvic a d a wa t ful ll d. Fill y u cus-
t m r’s ds a d wa ts pr cis ly, giv th mth right t, th right styl , a d
th right r sult—c sist tly. Giv th m valu , v ry tim , v ry visit, v ry
purchas . Start smallwith a i j cti r ski car s rvic a d th ywillc -
sist tlyc m backf r m r . Th ywill xpa d th s rvic s th ytrust y u t
pr vid . Th y will bri g w cust m rs t y u. All th r sult f c mpl t
satisfacti .
Wh I wr t th rst diti f this b k, surgical pr c dur s a d
tr atm ts w r burg i g. Si c that tim th yhav c ti u d t v lv ,
s rvi g as a try p i t a d i tr duci g c sum rs t a sth tic m dici .
If y u l kcar fullyat th m d ls fa sth tic m dici t day, y u will d:
Pur ly surgical practic s ar rar ; g rally th s ar highly
sp cializ d a d limit d i th ra g f surgical pr c dur s
p rf rm d.
A sth tic surgical practic s arly always r c sm tic
i j cti s. Acc rdi g t a surv y by th Physicia s
C aliti f r I j ctabl Saf ty, % f a sth tic surg s
(b ard-c rti d plastic, facialplastic, r cul plastic)p rf rm
i j cti s i th ir practic s th ms lv s.
n surgical pr c dur s ar ut umb ri g surgical pr c -
dur s arly .5 t , acc rdi g t th a ual statistics
f th Am rica S ci ty f r A sth tic Plastic Surg ry.
Th i cr as i p pularity f a d d ma d f r surgical
pr c dur s a d th atur f th ir d liv ry has cr at d th
d f r physicia xt d rs: lic s d physicia assista ts,
urs practiti rs, r gist r d urs s, a d a sth ticia s wh
admi ist r tr atm ts pr scrib d by th physicia .
S cti II: What
P H YSICIAN E XTENDERS
Cli ical sta play a imp rta t r l i y ur practic , but wh th r th s i -
dividuals will supp rt y u wh y u pr vid tr atm t r carry ut th
tr atm ts y u pr scrib is s m thi gy u must car fullyd t rmi . I d -
i gs , y u must tak i t acc u t th r gulat ryr quir m ts i y ur c m-
mu ity r stat a d th liability d iti s a d r stricti s d d by y ur
risk-ma ag m t i sura c carri r whil r sp cti gth practic a d thical
guid li s f y ur sp cialty.
I t r ally, y u must als d sp ci c s rvic r quir m ts fy ur physi-
cia xt d rs:
Trai i gi t ch iqu a d y ur practic ’s m th d fd liv r-
i g tr atm t, c mmu icati g with pati ts, mai tai i g
r c rds, a d pr vidi g f ll w-up
Sup rvisi r quir m ts
R stricti sa d c v a tst y ur xt d rs’abilityt prac-
tic utsid y ur m dical practic a d t pr v t th m fr m
taki g y ur pati ts’ privat i f rmati if th y l av y ur
practic
Physicia xt d rs ca b avaluabl additi t y ur practic m d lwh
car fullys l ct d, trai d, a d i t grat d i t y ur t ama d wh giv cl ar
pr t c lsa d guid li s. Physicia xt d rswh act aut m uslywithi
y ur practic r utsid it ar cl arly t b cial t y u r y ur pati ts.
DEFINING TH E RULES AND ROLES FOR P H YSICIAN
EXTENDERS
Marian D. O’Hagan, RN, BSN
Th succ ss f a y practic hi g s all sta m mb rs u d rsta di g a d
r sp cti gth ir j bs. It is th r f r ss tialthat th urs /t ch icia hav a
j b d scripti a d u d rsta d it. educati a d u d rsta di gar c r r-
st s t pr f ssi als c rr ctly p rf rmi g a sth tic tr atm ts.
Whil p rf rmi g las r/light tr atm ts f r a succ ssful d rmat l gist, I
hav gai d a xc ll t u d rsta di g f h w th i t rp rs al dy amics