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Medical Spa Ethics = Practice Growth & Patient Retention
In this interview, Marisa Faircloth, PA-C provides a host of valuable tips that will help med spas expand their client base through ethical practice management. She explains why ethics are vital to building a strong reputation in the med spa industry. We will also cover ways to handle some of today's most challenging ethical situations that can arise with clients.
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In This Medical Spa Ethics Episode We'll Cover:
Why Sound Ethical Practices are a MUST for Today's Med Spas?
There are over 56,000 practices that offer injectable treatments in the United States. While this growth is impressive, there has been a disturbing surge in client complaints as evidenced by Better Business Bureau (BBB) reports and reviews. Many of these complaints stem from dissatisfaction with results or practices that fail to deliver promised results.
Marisa Faircloth is the founder of Restoration MedSpa, a North Carolina-based aesthetic practice that specializes in anti-aging treatments such as body contouring, injectables and hair loss treatments.
As the proud recipient of the BBB Torch Award for Ethics and an Allergan top 1% Diamond status provider, Restoration Med Spa is a model of excellence for sound medical spa ethics. She and her team live and practices this every day!
With decades of experience in the medical field, Faircloth has seen first hand how the lack of ethics can harm a med spa's growth and reputation. She has propelled her med spa to industry stardom by investing in her staff, analyzing her leads, and delivering what is promised to her clients. Which came very natural to Marisa. Unfortunately, there are many aesthetic practices that need a lesson in medical spa ethics.
The Troubling Increase in Unethical Behavior in the Med Spa Industry
The aesthetic medical industry is booming across the globe. Experts predict that the aesthetic market will hit $24 billion by the year 2026. And while this growth is encouraging to med spa owners and operators, the rapid growth has caused a significant increase in the number of dissatisfied patients and complaints about practitioners. Many of these complaints are related to two factors:
- Untrained or inexperienced people administering treatments
- Practitioners performing procedures that will not benefit clients or are not in their best interests
You may wonder how unethical med spas stay afloat. Because many of their first-time clients have a bad experience, their repeat business is virtually non-existent. So these predatory practices direct their marketing initiatives toward new, unsuspecting prospects.
They often use highly aggressive pricing to secure an initial visit and stay in business by successfully targeting new customers who are unaware of their unethical practices. In order to create a raving fan and a life long patients you must instill medical spa ethics in your staff.
4 Questions Clients Should Ask Before Choosing on a Med Spa
Awareness is the key to avoiding the pitfalls outlined above. Prospective clients should carefully evaluate a med spa before proceeding with a treatment. In general, clients should focus more on the person who will be performing the procedure than the products used.
There are four key questions they should ask before committing to a procedure such as body contouring, laser treatments, or injections:
- 1"May I please see your credentials and certifications?"
- 2"How much training do you have in this procedure?"
- 3""May I please see some before and after photos?"
- 4"How are your staff trained to perform procedures?"
Medical Spa ethics dictates the practice should display all credentials and training certificates in a highly visible location. This way clients do not even have to ask for them. Before and after photos should be displayed on the your website, along with the education and credentials of each treatment specialist.
Clients should also take some time to read the med spa's online reviews and Better Business Bureau rating. While it is normal for a well-established med spa to have an occasional one or two-star review, a disproportionate number of unfavorable ratings is a major red flag.
How to Handle Unreasonable Client Requests That Do Not Align with You Medical Spa Ethics?
Unrealistic expectations and requests for procedures that are not in a client's best interest are more common than ever in the med spa arena. And while some practitioners may know at heart that they will not be able to make a 60 year-old's wrinkles disappear after one round of Botox injections, they will agree to treat the patient without suggesting that she temper expectations.
Other clients arrive with more than unrealistic expectations. They demand procedures that will end up distorting their face or making them look unnatural. For instance, a woman who has clearly received lip injections recently arrives at the office of a new provider and demands more lip injections.
Handling these requests is not easy. However, you can manage difficult situations by keeping the following points in mind:
Design a Marketing Strategy that Showcases Your Ethics and Attracts New Clients
As outlined above, ethical practices lead to more repeat business. Med spas that consistently model outstanding practices should showcase their commitment to ethical operations in their marketing initiatives. Here are some ways to do this:
Following the tips above will help you create a "Culture of Ethics" within your med spa. From your practitioners to your marketing team to your support staff, it is important to manage client expectations and educate them about their options. This will enable you to establish a trusted relationship that will lead them to become a long-term client.
To learn more about building an ethical practice and expanding your customer base, join us at the 2020 Med Spa Growth and Profitability Summit. We look forward to helping you make 2020 your best year ever!
Full transcription of Interview with Marisa Faircloth on Med Spa Ethics = Rapid Practice Growth...
Hello and welcome back to the Med Spa Growth & Profitability show.
Before we jump into the topic of today's show, Marisa, can you tell us a little bit about your background?
Yes, I'm a PA. I graduated from wake forest back in the olden days in ‘82 and spent a lot of my career working with some great plastic surgeons in our region.
Some Oculoplastic surgeons, some cosmetic surgeons, and I had the good fortune to jump into the noninvasive end of the aesthetics as it was forming.
So I started doing injectables back when they first came out and I've had the ability to see it grow and change over the last few years.
Oh, I love that. And what made you want to open your own practice?
Well, actually I was working in another medical spa and when I went there and told them about the skills that I had and what I could offer their practice, they had Med Spa that was basically a day spa.
They did facials and waxing and nails, and then they had a cosmetic surgery center where they did surgical procedures.
And my thought was they were missing the biggest portion of the pie. They were missing everything noninvasive, all of the lasers, all the injectables.
But the physician there told me he didn't, couldn't justify paying me a salary. He didn't think I'd have enough business. So he offered me a position completely on commission.
And having owned my own businesses, knowing what this career is, knowing what this field is and what people's wants and desires are I took it. I started out working one day a week.
I worked there for five years and at the end of those five years, the practice had grown four times over. And he came to me and said, I'm going to put you on salary now because you're making too much on commission.
That made me start my own practice.
I love that. A woman after my own heart. So what do you think really made you succeed in being able to grow it?
I know there's one thing really knowing the aesthetic industry, the injectables being great at making people look amazing, but there's the other part of it is actually selling the services.
And how were you able to really, masterfully produce your own commission?
Well you know, I think people want to look better and to feel better. And I think it's really a matter of self-confidence. People want to feel good in their own skin.
They want to present themselves well, and they should. I feel like I have the ability to offer them things that can do that within their budget.
I think that when I was working in the cosmetic surgery industry, it was during a time that people didn't have enough money to do that. And the surgical part of the practice was diminishing and mine was booming.
So it didn't mean they didn't want to do anything. It just meant they had to do something within their budget. And I feel like I have a good ability to fine-tune that, to take people in, decide what is it that you want to accomplish and how can we be a good steward of your money?
Part of my job is to be able to take the amount of money that they're willing to spend and to maximize their return for it.
I love that you said before you understand the wants and desires because I think that's very important as well.
when you're not just trying to run through their money, but what is their ultimate goal and how can you really use that to get their desired outcome or close enough to it?
Exactly. And I think, unfortunately, a lot of practices are just after their money, you know, they'll do whatever procedure they come in for and people know a lot now.
They Google, they research, they come in and go, I read about this, I want it. And it may not be at all what they need.
I feel like, I can be honest with them and I can say I have to earn your trust, but once you believe me that I'm steering you correctly, I will steer you to the procedures that are going to maximize your benefit and not the ones that are just hot commodities.
And that's exactly why we wanted to have you on the show because not only did you build a successful medical spa yourself, but you surpassed the previous position in the first six months of your new business. Right?
Not only that, you are one of the top 500 CoolSculpting practices which is incredible.
Speaker 2: (05:35)
As a matter of fact, our Allergan rep called us this morning and said, as of today, in injectables, we are ranked currently at number three-hundred and eighty-fourth in the nation. And I said, that's awesome. What does that mean? How many are there?
There are over fifty six thousand injectable practices, which means that we're close to the top half percent nationwide. And I think that really speaks to happy customers.
You know, there are a lot of people who know how to inject, but if they don't know how to hear their clients and give them what they want, the client's not going to come back. Or if they run through all their money and they don't get the result they want, they're not going to be willing to do it again.
So I think the goal is really in hearing what the client has to say and knowing how to use all the tools you have to maximize that.
And for those of you that are listening, I just want to say that one more time. Your rep called today, your three hundred and twenty-eighth, no three-hundred and forty-eighth.
We will be three-hundred and twenty-eighth by next week. No, I'm kidding.
But out of fifty-six thousand that is amazing. And what is more amazing, and probably why you're so successful is that you have an unbelievably not just yourself, but your team is very ethical and that's why I wanted to have you on.
So we want to talk a little bit more, I know you touched on it briefly, but we want to talk a little bit more about some of the things that we see in the industry and really how your team is able to have incredible sales and still stay, you know, still be ethical and not over promise and under deliver.
Well, unfortunately, you're right. Medicine is in a strange spot right now. You know, a lot of medical practices feel like they're not getting the reimbursement that they used to get. They're falling short.
And I know when I worked in medical practices the first few months of the year, there's nothing because people had to meet their deductibles. You would file with the insurance company, the insurance company would file back and say the deductible isn't met and you'd have to bill the client.
There's a lot of time that goes into waiting for your return when you're doing medical procedures. When you're doing Aesthetics procedures this is not insurable, which means the client pays before they leave.
Unfortunately, that has brought a lot of people to our industry, not people that care about taking care of people, not people that care about doing an excellent job.
It's people that want a little extra income so they're in it for the wrong reasons. They take the money and run.
A few months ago we got nominated for the better business bureaus, torch award, which is an award for ethical practices. And I talked to the regional rep and I said, I'm honored that we got nominated for this. I didn't know anything about it.
Did you apply for it or is it something that just came?
No, we got nominated and so I was a little surprised. I didn't know anything about the award, but what surprised me more was the regional director said, we're really surprised that someone in the medical spa industry got nominated.
And I said, why is that? And the response stunned me. He said we get more complaints from the medical spa industry than any other industry. And when you really think about the better business Bureau, nobody calls the better business Bureau to go, I had a great experience today.
People call them when they're at their wit's end. They're trying to get money back. And feel like they've been taken. So when I looked, I started to look at some of my competitors on the better business Bureau.
Now we have an A-plus rating. One of our local competitors has an F and they had 26 reviews. Every single one was a one-star. That made me want to win this just to say that there are ethical people in this business and that people shouldn't have to be afraid.
Most of the clients that come in are concerned about being taken. Most are concerned about being overcharged. Or concerned about wasting their money, throwing it away. They're concerned about coming out looking weird or freaky or disfigured.
And all of those things, unfortunately, do happen in our industry. But I want to be one of those that stands up and goes, it shouldn't be that way.
And we should let the client have the ability to ask a few questions. They ought to do a little bit of digging into who they're trusting their face with. They should know their credentials. Are they a credible practice? Are they credentialed? How much training do they have? we display all of our credentials.
I train my staff more than anybody in the area. We spend more on my staff, but I want them to be better than anybody else. I want them to be more highly credentialed. And I want them to have the ability to offer the best service possible, not cut corners and do bare bones to make more money.
One of my employees who used to be a client who came to me, who was going to a competitive, she was working at a competitor and she was seeing me for the last three years and every time she came she said, are you looking for anybody? I need a job.
And finally, I said, where do you work? I mean, why do you keep asking me? And she told me where she worked and she said, they're so awful. She said, I just can't continue to work there.
So we did end up hiring her. But when I asked her, I said, how did you keep clients? And treat them that way. And she said we didn't. They constantly advertised. We got clients that were unhappy. we brushed them aside. And we would get new clients.
That is not at all what we want in our practice. We want long term clients. Most of our referrals are from our clients, their friends, their families. We want to keep these people forever.
They're not going to keep coming back if we don't deliver what we tell them we're going to deliver. So that's why we were so proud to get an award that named us as an ethical practice.
I love that. And I love that you invest in your staff regularly. That's something that's important to me as well. We have our staff do two hours of training every week in the spot that they're in. because everything's changing.
all the time
And you want to deliver the best results for your clients. So I love that you do that. And one of the things that unfortunately we've seen in the last few months on our side is, some practices have a lot of business because they're doing amazing marketing.
But they also have people that shouldn't be doing the injections doing the injections, just because they're trying to keep up with the demand. So that's one of the things that even if they do a great job, that is definitely not an ethical thing and we've been seeing that, unfortunately.
Unfortunately. You're right. There's a lot of people in our region. I just recently hired a new nurse practitioner and I'm a PA. I have another PA working for me and just hired another full-time nurse practitioner.
It was amazing to me when I was interviewing the people that came to respond to the job, who had nothing. They wanted a job in this industry, but they had nothing to bring to the table and they really weren't even concerned that they didn't have it. They just felt like they could take it out and run.
And we don't work that way. Our staff goes through a lot of training, but it's also, we're not, we're not held to the same standard. Like I tell my clients, you probably go to a really high-end hairdresser, but you can get a haircut at great clips. Probably not the caliber. We're not that kind of practice.
Can we talk a little bit about over promising and under delivering and what you guys do there to make sure that the clients know what the expectations are before going into the procedure? They're not going to automatically have a flat stomach after one session of cool sculpting.
Absolutely. You know, I think that this industry is so rapidly growing and people read so much, a lot of the practices just want the business. They'll tell you anything to make a sale.
I've seen people come in and tell me they've had consultations elsewhere, and they said, Oh yeah, this is going to be gone with one treatment. That's not really the case. And if that's the case, then I take their money and I do the procedure. They're not coming back.
I'll relay a story. One of the people that I was interviewing when I was looking for a new provider was working at one of these competitive practices. She was following me for the afternoon. And one of the procedures we do is therapy.
We get great results. It's a fabulous procedure. It's an expensive procedure because it takes a lot to do the procedure and every time you fire the machine, there's a cost incurred with that.
So some people just do a lesser treatment to be able to offer a cheaper price, but they're also not getting results. This girl that was interviewing with me happened to be there when I was doing a follow-up.
She saw me do the pictures, she looked at the client and she said, that's amazing that you get those kinds of results. And my response was, you just told me you've been doing this procedure for three years. What are your results?
And she said, well, for the most part, our clients aren't very happy with it. And I said, well, what are your photos show? And she said, well, our company has decided we're not going to do before and after pictures anymore. So my response to her was, so you're selling people a procedure that you know isn't going to benefit them. This is a bad example of medical spa ethics.
Yet you're taking their money and doing it anyway and you're choosing not to take a picture so that you don't show them the procedure doesn’t work and you're okay with that?
I said in our practice, we want this client to be wowed by their results. So we're going to do whatever it takes to make sure that they get an excellent result. And we want those photographs because we want to demonstrate what a great result they had.
And I said we are not going to undercut those other prices because we can't, for the caliber of a procedure that we're doing, but we also know that we're going to get some excellent results.
You know, that also speaks to the fact of why you're so successful and why a lot of your clients come from repeat business. Most of them are probably repeat business or referrals rather than somebody going out and doing the next Groupon. A revolving door is what I'm trying to say there.
You're absolutely right, but because whoever is the absolute cheapest, if next month someone else has a better sale, those people will move to that practice.
Our goal is to be fair, to give a comparable price we’re mid-range, you know. We're not the most expensive but we're definitely not the cheapest one and that's not what we lead with. We lead with our quality and the fact that we're going to give you a fair service
As far as setting the expectations. Have you ever had a client that came in or a patient that came in and wanted something that you knew was not going to look good on them?
I'm curious, do you go through with the procedure because that's what they want to? How do you have that conversation?
No, I don't, you know, I tell my clients that we have to trust each other and that I have a certain caliber of the way that I do my services and I want them to look natural. I want them to have a good result. But if I feel like what they're looking for doesn't align with me, I'm happy to refer them out.
You know, I try to educate them. I think people get some skewed education. They learn online, they heard from their friend. That might be partially true, but there may be a lot more behind it. And although it may have been a great procedure for their friend, that may not be the right one for them.
I feel like that's part of my obligation. And I tell them part of my obligation is to educate you as to the options and to educate you on what I think is and is not a good option for you. And if you disagree with that, there are other people who may agree with you, but we don't do services that we don't think will be in the best interest of our client. This is a great example of medical spa ethics.
I love that you said that because not only is it not in the best interest of your client and that's where it should stop, but for those that do go through with the procedure and possibly make their lips look unbelievably gigantic and not appropriate for their face you're now having that as your reputation. and they're showing where'd you get that done to everybody else.
Exactly right. I tell them, your face is my calling card. If you look fabulous and people ask you, why do you look so great? You are welcome to tell them my name. But if you're doing something that detracts from your looks. That looks badly on me and I'm not willing to risk my reputation on that.
And for those of you that are listening and watching, just know that it's okay to say no and you don't need to take everybody that comes through the door.
In the long run. It'll be the best decision you make.
How do you kind of steer them away? Or you have that conversation like you just said about, I don't think this is going to fit.
How do you tell them, you know that they should only have a certain amount and you know what's going to look good. They trust you. So they go through with the procedure. But if they want to add more, do you say, okay, well go home, check it out and let me know or do you
No, you know what, I do work at their pace. I think as a general role, clients typically are a little bit cautious, but I also work with dimensions of their faces. I tell them that there are perfect proportions. There are five proposed proportions and golden proportions that your facial features should fall within.
And if I make your lips bigger in proportion to your face, than your nose is. Or the height of your eyes to your eyebrows, it's going to stand out and look disproportionate. And our goal is to make you look good overall, not to just make a set of lips stuck on your face that doesn’t look like they fit.
So it depends on the width of your face. It depends on, the height of your face to whether or not more will look good on you. And I'll show them that. I think that they appreciate that. And once you do that, they realize that, there is something more than just bigger, that it has to fit their face and it has to be reasonable.
Absolutely. Have you had people that come in that maybe have had a bad experience or you have to fix somebody else's mistake from a previous procedure?
All day, every day that's my primary clientele. That's most of my clientele to be honest with you. I just had somebody a few weeks ago that came in with lip filler that was crazy bad. she went to a hair salon, had it done. I asked her, why would you do that? And she said, well, they gave me a really good deal and I said what is a really good deal?
She said, well, they had a $75 coupon. Well, even with the $75 coupon, she paid more than I would have charged her. But when she went back, the provider said, I think you look fine and really offered no solution to her. And when she left, the manager called her and gave her my number and said, you need to go over there, they can fix you.
But I think clients need to be a little more aware. You know, they're savvy as far as products and procedures, but they don't put much stock in who's actually injecting them. And I think like I'd tell my clients is a lot more to do with who's the injector, then what product they're injecting.
So you do need to ask those questions. You need to know if the person who's injecting you is qualified and how much experience they have because that's really what's going to determine the result.
But I would say, probably a majority of my clients are ones that have gone elsewhere and had problems and they come in timid. They're worried about doing it again cause they had a bad experience. And like I said, I tell them I have to earn your trust.
I don't expect you're going to walk in day one and just let me do anything, but let me show you how it can be different and we can build that relationship and then we can build on it. And most of the time after a visit or two, they come back and the results are more in line with what they're expecting and then they're willing to trust me to do what I want.
You're in charge at that point. So you're delivering amazing results. You're growing very, very quickly. Do you have a referral program that, because your clients are happy, they're referring you anyway? Do you have a certain system or a referral program that you use?
Well, we do, you know, we appreciate the fact that our clients will refer a client and so we offer them free services for referrals. Most of our clients don't even know that we do that. You know, they don't do it for that. When they come in the next time and we say, you've got this sitting in your account, they're surprised.
Why is that there? And we tell them, well, this is because you referred Susie Smith. You know, we're appreciative that you're willing to tell your friends and your family. And so we want to thank you for that. Now I know that there are some referral laws that you can't pay people for referrals, but you can offer some services just as a thank you for that.
Yeah, absolutely. Do you have that automated or where you're asking for a testimonial after? Is anything or is it, is it kind of manual?
yeah, we do it manually, you know, in my consults, the first question I ask is, how'd you find out about us? And you know, usually it's a friend, a referral or they read about us on Google and then the next question is, well, that's great, but there's a thousand people that pull up. What made you pick us?
The reason is almost always our reviews because we have tons of happy clients that post reviews. And when our clients come in and we do their after photos and they're pleased with their results. We ask them if they're willing to share that, if they're willing to allow us to post their photograph and if they're willing to share that in a review. But we don't do it automated. We ask them when they're here in the office.
I noticed you dig a little deeper. So if they say they found you on Google, well how'd you find us on Google? I love that we do want to know where all of our leads are coming from and because we want to keep doing more of where they're coming from.
Well, I unfortunately have learned about advertising not always the right ways. I've learned lots of things that I spent money on that never gave a return. So I want to know if I'm spending on something and I don't ever hear people say that that's where they're coming back.
That's something that I'll change. but you really do want to know where those referrals are coming from and what's working for you and what's not.
Absolutely. We are running out of time, but is there something that you wish you would've known at the beginning?
Oh gosh. Advertising at the beginning. So that's the one thing that you can spend a lot of money on and throw away a lot of money. I think you just need to monitor what you do and nothing's perfect for anybody. I happen to do a lot of print advertising and I did print because when I left my old practice, they absolutely did not tell people where I went.
And although I opened a new practice under restoration med spa, if my old clients were looking for me, they had no idea that restoration was me.
So I did a lot of print advertising where I put my face on that advertising so people would look at that and realize that's where she went. That was very productive for me. But that doesn't mean it's productive for other people.
You definitely need to monitor that and ask your clients, find out why they're coming to you so that the things that you were doing right, you can do more up and the things that are not paying off, cut your losses and move on.
Absolutely. And if you're doing any online marketing, you should be able to constantly monitor and measure and see where each customer is coming from, where each lead is coming from.
Definitely in your consultation have where you're asking as well because there's a lot that come from referrals.
Also if you're doing any kind of mailers, it's a little harder to measure, mailers in the print. So if you ask, hopefully, they remember they saw you there.
Well, your right, and sometimes if you're doing a lot of advertising and multiple different sources, clients want to be helpful. And when you ask them and they don't know they're going to say something, you know, they may make up something. They may say, I saw you on a billboard and, and we don't have a billboard, but they'll be helpful.
But more often than not, if you're doing really good print that is being beneficial. A lot of times clients will come in with that in their hand, you know, they'll save it. But knowing what's being successful will keep you from continually spending on something that happens not to be.
Absolutely. So what's the next stage for you or restoration medical spa?
Well, I've been in multiple different areas. I've had a pretty long career in this arena and I've owned weight loss clinics that were actually franchise clinics. And as a franchisee, I've been part of an excellent franchise that gave us systems and software and websites and protocols and marketing plans and things that made our business easier to run because they already had a systemized plan.
Also, I've been part of a franchise that got sold out and the person that bought it just bought it to collect royalties but didn't do anything. So having started a business from scratch and knowing all the challenges and the pitfalls and the things that are difficult to learn and the research that you have to do the amount of people that you have to pull in on a team to help do all these things.
We've been able to develop an excellent team, excellent systems, and strategies. My goal is to take that and be able to use that to duplicate restoration in a franchise manner. So somebody who is maybe an injector who is great at the medical part but has no business background, or even someone who's an entrepreneur who wants to find a business that they can feel good about, that we're helping boost people's self-esteem, that we're able to help people feel good about themselves.
It's a great opportunity. So that's the next step on our platform.
If people want to learn a little bit more what is your website that they can go check out and keep an eye out for the franchise model?
Absolutely. It's restorationmedspa.com.
Guest Expert Marisa Faircloth - Medical Spa Ethics = Rapid Practice Growth
Marisa Faircloth, PA-C
A graduate of Wake Forest University’s Bowman Gray School of Medicine’s Physician Assistant Program, Marisa is a seasoned professional who has dedicated more than 35 years of her health care career toward medical aesthetics, plastic surgery and weight loss.
During the early years of her career, she had the good fortune to work with some of the best plastic surgeons in the region. She thought then what she knows now, that less-invasive procedures are perfect for people who don’t want or need a drastic change to their overall appearance.
Marisa passionately describes her mission: “My calling and my God-given gift is to uncover the hidden beauty in each person who walks through my doors.” Her years of experience and devotion to her work make her a sought-after injector of Botox®, Juvéderm™, Voluma™, Volbella™, Vollure™, and Kybella™. She is credentialed as a Master Level Injector and is also awarded Top 500 Status with Allergan, placing her among the Top One Percent (1%) of injectors in the nation. Marisa is a trainer for both Allergan and Merz, and she’s a sought-after Forbes speaker. Marisa recently spoke at the virtual Aesthetic Extender Symposium.
She is known for her “excellent eye” and is well versed in the use of CoolSculpting®, Ultherapy, lasers, radio frequency, and much more. She also has extensive experience in weight loss, having owned four weight loss clinics and implemented weight loss programs for 20 medical clinics. Her goal is to restore the beauty that is within and discover the best non-invasive procedures. She creates a customized treatment plan for each client during their complimentary consultation.
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