Legally & Profitably Offer Medical Spa Treatments

Anyone who intends to (or already has) introduced medical treatments into their offices and does not have a license to practice medicine in your state. The course is also recommended for MD’s considering opening spa’s or becoming medical directors for non-medical practices, and for salon and day-spa owners.

Botox is a drug that is manufactured from a toxin produced by a bacterium known as Clostridium botulinum. Doctors use this drug in small doses to correct and treat health problems that include temporary smoothening of facial wrinkles and improvement off facial appearances. Botox injections work by paralyzing certain muscles or blocking certain nerves.

The economics of dental practice and facial injectable therapy with Botox and dermal fillers are impressive due to the exponential growth of this aspect of practice. As the demand continues to grow, this practice yields a significantly healthy profit margin. Many specialists understand that if they start providing Botox, they will, financially, come out way ahead of their contemporaries who do not perform these services. After all, these health professionals are not required to invest in large or special pieces of capital equipment. They have no monthly lease payments that are separate from their already existing health services. Furthermore, the accessory items needed to deliver these products cost very little, and the more products delivered, the more profitable the practice. There is little need to keep a large inventory of these products in-office because the providers often ship overnight. Below is a brief analysis of Botox and filler fees; depending upon how much materials are being used, how many areas are being treated, and if any kind of soft tissue augmentation is being accomplished:

• There is a patient fee of $600 to $3,000 just for the Botox and dermal filler therapy in addition to any other aesthetic treatment, for a time involvement of anywhere between 5 to 20 minutes
• There is a product cost for that kind of treatment which is anywhere from $50 to $500.

Dermal fillers will volumize creases and folds in the face in areas that have lost fat and collagen as we age, and have collapsed. After the age of 30, human bodies lose approximately 1% of their hyaluronic acidthat are important for hydrating and adding volume to the skin.The hyaluronic acid also known as hyaluronan or hyaluronate acidis the natural dermal filler substance of the human body. It is a carbohydrate or more specifically, it is a mucopolysaccharide; a viscous gel that is found naturally throughout the human body. But it is more highly concentrated inside the eyeball. The depletion of hyaluronic acid continues until it completely stops at the age of about 50. As a result the face starts to lack its youth supple volume and appears aged. It develops an appearance characterized by deeper nasolabial folds, unaesthetic marionette lines, and deeper mentalis folds. The lips start to get thinner and to turn downwards at the corners. For individuals who desire to recapture their lost youthfulness, hyaluronic acid fillers are available on the market in the form of Restylane and Juvederm, Perlane, Evolence and Radiesse.

These drugs are injected extraorally right underneath the folds of the skin to replace the volume lost. This creates a younger, fuller look in the face. Hyaluronic acid is the main chemical component in dermal fillers such as Restylane, Juvederm (Allergan), Juvederm Ultra and Juvederm Ultra Plus (Allergan) and Perlane. But the main ingredient in the Radiesse drug is calcium hydroxylapatite. Evolence has Porcine collagen as its main component.

Restylane is used to smoothen moderate wrinkles and for lip enhancement. It is usually injected in the dermis or middle layer of the skin. Other form of Restylane include Restylane Touch (for correction of thin superficial lines); RestylaneLipp (for lip enhancement); RestylaneSubQ (ideal for replacing fat loss in the face); Restylane Vital and Vital Light (both used for abroader range of skin therapy for the face, neck and hands to re-hydrate the skin and improve its elasticity). A breakdown in profitability of different dermal fillersper patient is as depicted in the table below:

Needless to say, the greater the number of patients seeking these services the greater the profit margin realized.

A chemical peel is a procedure that is used to improve the appearance of the skin on the face, neck or hands by applying a chemical solution to the skin, which causes it to exfoliate and eventually peel off to reveal a new regenerated and smoother skin.The average cost of a chemical peel is $720, according to 2013 statistics from the American Society of Plastic Surgeons. A chemical peel is also used to improve acne or acne scars, age and liver spots, fine lines and wrinkles, freckles, and irregular skin pigmentation. In the United States, a chemical peel can cost anywhere between $600 and $900, on average, but the cost of the chemical peel can vary widely depending on the type of peel chosen, the cost of living in the region where the patient resides, and the size of the area being peeled. The cost can be as low as $150 for a light peel. A medium chemical can cost from $1000 to $2000. A deep peel costs between $2,500 and $6,000. This treatment is recommended for darker-skinned patients. It is important to note that the chemical peel price range encompasses the doctor’s fee only. Other fees associated with the chemical peel procedure, such as those for anesthesia, operating room use, and a possible hospital stay may be added to the cost.

Estimated average prices of chemical peel therapy are as follows:
• Startup Costs are Low: Minimum chemical peel startup cost is $2,000. This excludes office accommodation and table.
• Margin is high: The cost to provide a chemical peel treatment is $25 ($20 labor, $5 products) and the retail is typically around $125, so the profit is $100; about once a month.
• Patients repeat the treatment often: For success in chemical peel treatment of one patient, a provider can make a minimum of $1,200/yr.

Profitable Laser Therapies include:
a) Laser Hair Removal: This type of laser therapy uses selective photothermolysis, or heat produced by light, to target the melanin in hair follicles. The resulting deliberate follicle damage disrupts the growth cycle and permanently reduces the volume of hair regrowth. The average cost of this type of treatment is anywhere between $100 and $500, but this is dependent upon the size of the area that needs the treatment. The larger the area the higher the cost and greater the profit margin. The number of initial treatments per patient range from 6 to 10 treatments. The treatment regularity is 4 to 6 weeks. The demographic groups who qualify for this treatment are people with skin type I-VI. The minimum income potential for per patient for the provider is approximately $5,000 and above.

b) IPL Photofacial: This laser treatment delivers exact amounts of scattered light energy through the skin’s surface, targeting unwanted skin pigmentation and stimulating collagen production. This softens the appearance of fine lines and wrinkles, lessens age spots and sun damage, and reduces skin redness associated with rosacea. The average cost is between $300 and $500. Again this is dependent upon the size of the surface area that needs the treatment. The number of treatment required is between 3 and 5. The treatment regularity is once every four weeks. Demographic groups that qualify for this treatment are those with skin type I-III. The minimum income potential per patient for the provider is $2,500.

c) Laser Tattoo Removal: In this form of treatment, the provider uses the Q-switcher to project heat via laser beams into the tattoo ink trapped in the skin’s dermis. The idea is to break up the ink particles and allow the body’s lymphatic system to absorb and disperse the color, fading and removing the tattoo through time. The average cos is between $200 and $500, depending on the size of the treatment area. The number of treatments are between 12 and 15 maximum results. Treatment must be done every four weeks. People who can receive this treatment are those of skin type I-III. Minimum income potential per patient for the provider is about $7,500.

d) Fractional Laser Wrinkle Reduction: This therapy takes a standard beam of laser light and splits it into thousands of microbeams. These microbeams are then projected into the epidermis and dermis, coagulating narrow columns of tissue while leaving the surrounding area unharmed. This process stimulates the body’s healing process, creating new collagen and healthy tissue. Fractional laser treatment is used to reduce the appearance of wrinkles. It also treats dark hyperpigmentation associated with melasma, and aids in correcting the discoloration and uneven texture of scars caused by acne, surgery or other injuries. The average cost ranges from $1,000 to $3,000 depending on the area being treated. Treatment is done 4 to 5 times every four weeks for maximum benefits. Individuals who qualify for this treatment have skin type I-IV. The income potential per patient for the provider is $15,000 or more.

Mesotherapy involves the use of multiple intradermal or subcutaneous injections of a mixture of compounds in minute doses, by means of very fine needles, directly over/near the affected sites. The wider reception of mesotherapy by its stakeholders is probably due to factors like inexpensive equipment, relatively minimal training for providers, much reduced dosage need of the drugs with positive results. This cost is separate from the initial $225 consultation feel. The average cost per session ranges from $200 to $600 although cost varies by doctor and geographical location. In addition, the cost is very much dependent upon the nature of the medical condition and the number of sessions needed to achieve the results desired. One session lasts only one hour, maximum.

The average patient gets one treatment per week and requires 8 to 10 treatments. Thinner patients seeking treatment for problem areas such as love handles or cellulite sometimes require fewer treatments, while moderately overweight patients sometimes require more. The total cost for all sessions for one body part usually ranges from $2,500 to $4,000. For three body parts, the charge is $12,000. For an investment cost of about $3,000 in training to administer mesotherapy, the profit margin is quite high.

A sample break-down of charges are as follows:
• Chin $300-$500
• Under eyes $150-$400
• Thighs $400-$700
• Stomach $300-$800
• Back $300-$800
• Arms $300-$600

Another alternative it to charge a fixed $300 for single sessions and a full treatment series generating anywhere between $2,400 and $3,000.

Provider cost for microdermabrasion can be as low as $40 in supplies. But the average cost of microdermabrasion therapy per patient is about $148, according to 2013 statistics from the American Society of Plastic Surgeons. The cost of microdermabrasion treatment can vary. The average fee referenced above does not include anesthesia, facilities or other related expenses. These can be billed separately at the discretion of the provider.

Convenient and virtually painless, the microdermabrasion procedure takes only 30 to 60 minutes and is commonly referred to as the “lunch hour facial.” On average, patients should expect to pay between $75 and $100 per microdermabrasion treatment, which considering the time required to administer treatment, equates to high profitability. A patient might need between five and 12 treatments, in total. These are often spaced two to three weeks apart. Many other periodic maintenance treatments might be required subsequent to the initial treatment regimens.

Microdermabrasion can be performed by a plastic surgeon as well as by a registered nurse or aesthetician. Some practitioners recommend an additional individualized skin care program, which might require the patient to buy products such as cleansers, masques and moisturizers. These can cost up to $200.

The US market for pain management devices will continue to expand and reach a value of nearly $2.7 billion by 2022. This is due to an increased focus on pain management as a result of the Centers for Medicare & Medicaid Services incentives for facilities with high patient satisfaction ratings as well as pain research initiatives from the Affordable Care Act.

Typical pain management costs are as follows:
• For mild, shorter-term pain, a provider might recommend over-the-counter drugs such as Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These cost anywhere between $5 and$25, depending on the quantity and whether the patient buys a name brand or its generic equivalent.
• Provider prescription medications for relief of ongoing, severe pain can include anticonvulsants , such as carbamazepine or Tegretol. These cost about $53 for 30, 100 mg capsules. Provides might also prescribe antidepressants like Amitriptyline costing $12 for 30, 10 mg tablets. Opiate pain relievers such as hydrocodone (Norco, Vicodin) cost an average $18 for 30, 325 mg tablets.
• A physician may refer a patient to a pain center, in which a team of health professionals create a treatment plan, which might incorporate professionals from different disciplines. According to Marketdata Enterprises, a market-research firm, the average cost of such a pain program is $4,873. Fees are based on the procedures involved and complexity of the problem. For example, an initial consultation might be $225, but required monthly office visit could cost $195 each, and additional treatments might also be needed.
• Equipment and devices used to fight chronic pain differ in cost. For example, carrying a Transcutaneous Electrical Nerve Stimulators (which is a battery-operated units connected to the skin that emit electrical impulses to block pain signals), only cost in the neighborhood of $100.

Sclerotherapy is used for relief of varicose veins. It is a gold standard for treatment of leg veins, and costs about $354 for the initial treatment and $150 for additional or succeeding sessions. The procedure takes anywhere between 5 to 30 minutes depending on the number of veins being treated. Other providers charge as much as $600 per session. The recommended national average is between $250 and $500 per session, but doctors are free to work out their own charges in a free market economy.

Medicare suggested costs conducted in doctors’ offices are as follows:
• Injection therapy of vein costs minimum $159
• Injection therapy of multiple veins costs minimum of $181
• Ultrasonic guidance for needle placement costs $209

Medicare costs for procedures conducted within a health care facility are as follows:
• Injection therapy of vein costs minimum $88
• Injection therapy of multiple veins costs minimum of $103
• Ultrasonic guidance for needle placement costs $209

Profit margins for individual procedures vary depending on local reimbursement structures, whether equipment is owned or leased, methods of payment for support staff, and facility utilization contracts. Usually, performing approximately 200 or more procedures a year is associated with a high profit margin. The initial estimated equipment costs is $20,000. Procedures conducted on a few patients can easily recover this expense. Other price suggestions are depicted in the table below:

Innovative laser technologies for skin rejuvenation offer deeper and more aggressive penetration of the skin than traditional skin rejuvenation lasers, stimulating optimal collagen remodeling for the ultimate in skin resurfacing. These treatments effectively improve tone, tightening and texture of the skin by reducing the appearance of fine lines, uneven texture, dyschromia, skin laxity as well as moderate to deep wrinkles and scars. The treatments offer high profit margins as the average ablative skin resurfacing treatment typically retails for about $2,500 and above.

In this procedure, an abrasive instrument is used to mechanically sand the skin to remove some of the top skin layer (epidermis) and stimulate new skin growth. By removing the outer skin layers and smoothing the treated skin the physician can achieve a rejuvenated appearance.

In a countries with free market economies such as the United States, the charges may vary from provider to provider. For example, the fee for procedures such as ablative skin resurfacing or rejuvenation per patient might be $2,500 and for non-ablative skin resurfacing the minimum recommended charge would be $1,025. Nevertheless some physicians do charge as much as $3,000 and $2,500 for the two procedures, respectively. Rejuvenation machines cost between $500 and $5,000 depending on the quality.

Sleep apnea occurs when the muscles in the back of the throat relax. This causes an airway obstruction that can stop a person’s breathing for several seconds, even minutes. It causes restless sleep and, sometimes, dangerously-low blood oxygen levels. One form of treatmentfor this condition is a laser and RF procedure, which costs a minimum of $3,500. This treatment is used to tighten the muscles of the soft palate to reduce vibration during sleep. One single night spent at a hospital sleep lab as part of sleep apnea treatment can cost up to $1,900, besides the cost for the actual procedure.

The Harvard Medical School Division of Sleep Medicine claims that unmanaged moderate to severe sleep apnea is estimated to cost an incremental $2,700 to $3,000 in treatment costs, annually. This is the average incremental cost only. But individual provider prices have continued to steadily increase from $1,661 in 1996 to about $4,000 in 2010.

The other most common treatment for sleep apnea applies continuous positive airway pressure or CPAP. A machine is used to deliver air through a mouthpiece all night. For patients who cannot tolerate CPAP researchers at Stanaford University suggest laser-assisted uvulopalatoplasty surgery. But the efficacy of this surgery has received mixed scientific reviews. Some scientists claim that the condition tends to recur a year or so after surgery. The minimum patient cost for the surgery is $3,500. Sometimes people who have had this surgery are also required to procure and use a CPAP machine after all.

The American Sleep Apnea Association places the minimum cost for diagnosing and treating sleep apnea at a minimum of $1,000, but acknowledges that as the treatment is ongoing the cost is also increasing. In some cases treatment using CPAP is between $2,000 and $3,000 per unit cost. The profit margin range is between 25% and 40% depending on the region the patient lives in and the type of provider. With continuous increase in obesity rates, which is a risk factor for sleep apnea, the treatment costs are likely to keep escalating.

Teeth whitening is a common form of dental bleaching, which according to the FDA, restores natural tooth color. Practices can provide these types of services with relatively low overhead considerations, resulting in high profitability. As an example, profit margin on Crest Whitestrips Supreme is quite high because the product cost for practices is as low as $31. However, the price for patients to procure the whitening kit is typically $55. This gives the provider a profit margin of $24 on every kit sold in the practice. The entire $24 per kit is counted as profit because Crest Whitestrips Supreme requires no doctor time.
Below is an example of profit margin analysis:

• 32 kits of Crest Whitestrips Supreme dispensed per month, (approx. 2 kits x 4 days workweek x 4 weeks a month)
• An average cost to the practice of $31 per kit.
• A recommended cost to the patient of $55 per kit.
• An average net profit of $24 per kit.

Based on these figures, a practice that dispenses 32 whitening kits each month will generate revenues of $21,120 per year (32 kits x $55 patient fee x 12 months). The result is an overall profit of $9,216 (revenue minus overhead) annually for the practice. For a practice that averages $400,000 a year in production, an increase of 12% in revenue from introducing professional whitening kits translates into increased production reaching $448,000 a year, which is a $48,000 increase. Due to the low overhead involved with adding Crest Whitestrips to the service mix, practices can count on more than 50% of that $48,000 as additional profit.