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Physician to Physician Discussions > Opening a Medspa

Hello All-

Longtime reader first time poster. I am currently planning on opening a medspa in the state of Florida and wanted to run my plan by you guys and see if I could get any helpful advice. I have read through the forums and gained some useful knowledge but wanted to make a thread dedicated to opening a medspa in Florida.

1) I plan on training with National Laser Institute for injectables, lasers, sclerotherapy, and peels. I have looked at Empire (seems like a nightmare from what Ive read here), A4M (more expensive for what seems to be the same product as NLI), AAAM (definitely an option), amongst others.
2) Finding a location. I have a building available to me that is NEAR a very nice area of the city I plan on opening the spa in but not in it. Advantages of this are that the owner of the building is my business partners mother so we will get a good deal on the building. The building is also quite large and formerly functioned as an acupuncturists spa, they moved because she wouldn't sell the building to them. It has three treatment rooms, two of which have a divider which could be used for salon and massage services. Other treatment room for medical procedures. Other three rooms are quite large and could be used for office space, physical therapy, amongst other possible renters.

So really what Im asking is for any advice if my training plan is adequate, what kind of equipment should I invest in, should I invest in patient records software, what kind of zoning or licensing issues might I confront, and how much capital will be required to start the business?

I know kind of vague just looking for tips.

Also, my partner plans on paying for all of the startup costs so what kind of business agreement do you think would be fair? I was thinking 50/50 plus salary with option to buy out a higher percentage at a later date as I will be providing the majority of the workload in a couple of years. I am also what kind of referral commissions you guys offer as well.


03.31 | Registered CommenterDaniel B

Lets not jump to stat up costs lets first see if any of this is legal .
I cant tell for sure but it dosent sound as if you are a medical professional since there is no office , no patient load, no knowledge of charting and record keeping.
The state of Florida is cracking down on illegal spas so better check with the licensing boards.
Simply taking these classes is not adequate to state you are certified for anything, certification has to be coupled with some form of state approved licensure and thus meaningless if otherwise.

If you are not a physician , RN or PA injectables are not even an option as most invasive laser therapy.

I would find out all these legal issues before having your friend spend any money and yes tell them the amount will easily break $200k and better be FDA approved lasers not cheap overseas items or else your friend may find that after harming someone they may not own that building any longer.

04.1 | Unregistered Commentergm

BTW having deep pockets will not allow for your friend to fund the lasers. The majority of functional lasers are class IV medical devices so you will need an MD to sign on the line.

04.1 | Unregistered Commentergm

Im an MD coming out of residency, hence no office, in a highly procedural field and I am looking into aesthetics. Should I have done derm? Probably but I don't want to go through another residency.

I have plenty of knowledge on how to chart and keep records but not in private practice aesthetics. Do you guys get your patient load through patients you already have? I plan on marketing to local nail salons, tattoo shops, and gyms to start. I am going to be a foot soldier marketing wise when we get our plan together.

04.1 | Registered CommenterDaniel B

Anybody? Would love some advice

04.8 | Unregistered CommenterDB

DB sorry I haven't gotten back to you. One reason it is very quiet is because this field is very difficult to earn a living in. I come from an academic background and believe that proper training is key. The situation in this industry is everyone believes they can do it. Persons with little or no training become " international experts" overnight and become your competition.
THe public as a while does not respect your status as a physician, you may purchase the best laser, get the best training and they will ask you to meet the price of the spa lady on the corner who was a cashier at target a month ago. If you don't they will go to the lady. Hence my diatribe to your first question.
That being said, if you are residency trained in a procedural field start with that. Insurance pays for procedures above cognitive medicine like internal medicine. The spa industry is quite expensive overhead very high and with competition its time consuming to build a practice.
Some practices can add a spa and may do well. I say may because see how many OB/GYN added laser hair 8 years ago only to find that the patient mentality is insurance co pay not $500 to laser my leg hair. Yet some did work out.
Its hard to tell,
The problem also is laser cost, you must use fda systems you have a license to loose that means your laser starts at 60K and likely to break $200k ( eg sciton with BBL, Dual YAG, Profractional, Abalitive) that system would allow for laser hair, veins, pigments, resurfacing . After a year you need to maintain the system that silent cost ( the sales rep kindly forgets this during the sale) which is 10% list price so figure another 20K a year . That's one laser if you get more like tattoo removal , skin tightening etc there are contracts on those as well so costs are high.
Now add rent, staff fees, malpractice insurance and office furnishings you can see that you are easily over $250k and have not seen patient one.
One thing spa practices need to advertise that's really costly and often a shot in the dark radio didn't work for me but did for others and that was about $1200/week!!! Print mixed, internet is best. The other thing is fee splitting. Almost all of those people you mentioned doing your foot work will expect a cut, they don't realize that that juvederm cost you about $600 all they see is you collecting $800 and fee splitting is a real no no. That can cost a license.

Forget groupon great for window washing but your medical, it attracts the cheapskate who will think nothing of slandering you for taking their precious time away should they wait 15 min to see you.

All in all it do think you should practice your trained field and slowly add on laser services. The other way is to much money out

04.9 | Unregistered Commentergm

Thanks for getting back to me.

How does fee splitting apply to aesthetics? I see all over this website docs paying commissions to nail techs and employees for referrals.

I was planning on injectables and two lasers with about 10 grand per month applied to marketing. Ill check out the laser forum for best advice but I want to do tat removal hair removal and skin resurfacing.

04.9 | Unregistered CommenterDB

In traditional medicine fee splitting is easier to find , Ie cardiologist sends patients to a specific surgeon etc. Aesthetics is the practice of medicine lasers are laser skin surgery so sharing profit is splitting. It goes un detected but if someone gets pissed off and calls authorities then there are consequences. Recentl;y there were splits from gastroenterologists with anesthesiologists in their office, They were collecting large sums of money from anesthesia and stating it was rent. Well when investigated they measured to room and figured out the going rate of rental for that room and it was determined that the fees wrer way out of proportion and fines levied .

Be careful you are talking about large sums of money here. 10k a month 120K a year for ads how much do you think you are going to make a year? Remember I said expenses for the lasers alone are high. Really look into things.

04.9 | Unregistered Commentergm

With that kind of marketing I imagine we could see at least 40 botox patients per week, assuming 30 units of botox per patient with a profit margin of $5/unit would be $6000/wk, in addition to fillers assume 20 patients per week with a profit of $300/pt another 6000/wk, then adding in lasers, medical weight loss, and hormone replacement therapy as well as traditional spa services looking at approximately 70k profit/month minus overhead at approx 20k/month that is 50k net/month. I haven't completed the exact numbers crunching but this is a rough estimate.

04.13 | Unregistered CommenterDB

I can't comment on the marketing, but for lasers, you can mitigate costs by leasing.

In addition to the significant tax benefits (consult your accountant), most can get approved for a 5 year lease up to $300k. Splitting that big investment into 60 monthly payments can really soften the blow.

To comment on a few earlier posts:

-You do not have to be a MD to sign for a laser. Your state may require a medical director on staff to operate the laser, but to purchase a laser, no.

-If you are an MD, you will be much more likely to secure financing and competitive lease terms. You may not need a partner with deep pockets!

-You can negotiate service and warranty with most major equipment manufacturers. Some will offer up to 3 year warranty. Keep in mind, based on the laser use, it may have consumables. Aka, more costs.

I'm with an equipment leasing fund. We finance aesthetic lasers from almost every manufacturer, but unlike conventional lenders and banks, we'll work with start-ups and non-physicians. Happy to answer any questions about the process or medspa business structure in general. (When you're lending to a couple hundred medspa's, you start to really understand what makes a successful business!) -Jeff

04.13 | Unregistered CommenterJeff M

ether your state has no laws regarding laser sales but in the majority of the states they are class IV medical devices under the purchase of a physician.

04.14 | Unregistered Commentergm

I've been in business since 2005 and I'm also in Florida. FAR more involved than you likely realize... If you want send me an email and I'll set up a time to discuss.

04.21 | Unregistered Commenterbrian

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