Estheticians & Laser Technicians: Want to work at a laser clinic or medical spa?

I get emails and emails from estheticians looking for advice on how to get hired by a laser clinc or medical spa.

 
So here's some advice:

First, read these threads from esthicians who have worked for American Laser Clinics from the thread on American Laser Clinics  & the Armed Guard.  Then read the comments on this post if there are any.

Now take this list to heart: (At least if I'm interviewing you.)

• Don't work for any medspa, doctor, laser clinic, or franchise that looks as thought they may be cutting corners. Why? The esthetician is always named in any trouble and it's common practice to cut the esthetician loose. Let me reiterate... Estheticians will always be the first to get in trouble when a treatment they're performing goes wrong. Poor training and oversight is the most common shortfall and it takes experience before you can recognize potential trouble. Anyone can perform a treatment when everything goes right, but it takes time to learn contraindications and how to handle them. Shoddy business practices will get you in trouble every time.
• Look for a laser clinic / medspa that has a physician that's intimately involved and there all the time. (Surface's protocols specify that every single patient is seen by the supervising physician before any treatment.)
  
• Don't try to tell the physician how many clients you're going to bring with you. (Certainly I'd never believe you.) You may get hired by some doctor who's not experienced either but you won't be able to deliver. Patients make medical decisions on different factors than day spas.
  
• Get off your prima donna pedestal: This is not a day spa where you're on commission. (If it is, it may well be illegal since it could be construed as fee splitting.) You should expect to answer phones and take out the garbage. You may want to think that you're indespensible, make yourself such.
• Work as though you own the clinic. Staff that don't whine and bitch and look out for the clinic as though they owned it are the keepers. If you're not one of these, don't expect to make an impression.

Everyone, and I mean everyone, is paid by how hard they are to replace. Physicians are harder to replace than front desk staff... they make more money. Someone who bitches and moans, is hard on the other staff, is careless... Hey, you're easy to replace. The amount of money you make is a direct correlation between two thins:

1. How hard you are to replace.
2. What the market will bear.

 Thant's it. Make yourself hard to replace and you'll demand a premium.

One last story: I had a master esthetician who sold more product than the next staff member like clockwork. She thought that  that made her indespensible. But she was a prima-donna. She was hard on the other staff. She always whined. In short, the fact that she sold more was offset by other troubles. She felt she was indespensible and acted like it. She was not. The trouble she created inside the system as a whole ment that she was just barely scraping by for quite a while. I tried to remedy the situation and make it work but I couldn't get through. She was more than just a little surprised when she was fired. She gave a long speech about how she sold more of everything than anyone else. So what. The trouble she caused just wasn't worth it. Don't be this person.

Non Compete Agreements: Keeping your Medspa staff from killing you.

Are Non compete Agreements Valid?

It's common for physicians to ask about how to prevent nurses, estheticians, or even other physicians from leaving to work for a competitor?

Many physicians ask their staff to enter into broad non compete agreements or employment contracts with non compete provisions to prohibit departing employees from working for a competitor or from using information they acquired while working for you. Or perhaps you just want to specify how soon an employee can begin working in a similar business.

There are problems with many non compete agreements valid and if overly broad they're not legally enforceable?

As a general rule, non compete agreements--often referred to as agreements or covenants not to compete--aren't valid or are not readily enforcible. In most states, there's a longstanding, strong public policy against such agreements since they're often so one-sided and impinge upon an individuals ability to make a living which is frowned upon by legislatures. The rationale for this policy is to ensure that employees have the right to pursue any lawful employment of their choice. (The California Legislature has enacted a law that declares void every contract that prevents someone from engaging in a lawful profession, trade or business of any kind.) Of course, as with most laws, there are exceptions provided in the law and created by the courts. In most states, the courts have carved out an exception to the general rule that covenants not to compete are void. They're typically permitted when deemed necessary to protect valid trade secrets of the employer. When former employees engage in unfair competition through the unauthorized use of trade secrets or confidential information, the courts will generally enforce proper non compete agreements.

A non-compete agreement which prohibits someone from working anywhere is far less likely to be valid than one which prohibits someone from working within 10 miles of the former employer’s business but this will depend on the kind of work. Your medical spa may have an interest in keeping an esthetician you trained from competing across the street, but if the non-compete agreement says nowhere in the state, it becomes less reasonable. If the esthetician can find a job in the state 50 miles away, most of the clients will not travel that distance for the service, but will stay with your medspa. On the other hand, this non-compete could force the esthetician to move to look for work or otherwise to travel hundreds of miles.

A non-compete must also be for a limited and specified time. If the esthetician is gone for a year, the medical spa can expect that the vast majority of the customers will have stayed and the estheticians departure will likely do little harm to the business. Thus, keeping the esthetician out of work for three years does little to help the business, but seriously harms the esthetician .

Depending on the circumstances and the language used, agreements not to compete signed by employees when starting a new job can prevent them from legally using secret formulas, recipes, certain protected customer lists and other trade secrets. Of course, merely labeling information as a trade secret or as confidential doesn't make it so. Disputes as to whether certain information is truly secret or confidential are decided by the courts on a case-by-case basis.

A similar issue arises when an employment agreement attempts to prevent a departing employee from taking other employees with them to a competitor. Such non-interference agreements aim to prohibit employees from soliciting other staff members to leave the employer. It's clearly improper for a departing employee to induce fellow employees to breach their employment contracts. On the other hand, if there's not an employment contract, nothing prohibits employees from deciding to join a colleague at a new employer.

In the end, to be valid a non-compete agreement must be narrowly tailored to meet the needs of the employer which will be balanced against those of the employee. If you are preparing a non-compete agreement, you need an experienced lawyer to draft it in a way that it will not be held invalid. If you are dealing with a non-compete agreement as an employee, there are lots of ways to attack it.

However, there are ways to accomplish what you're trying to do without having to rely on non-compete agreements exclusively. The key is that any agreement must be made by knowledgeable and informed parties and can't limit an individuals ability to make a living. 

When Surface was first formed I had all of our staff sign non-competes since they were constantly being poached by both competitors and schools who wanted to boast that "the instructors worked at Surface". I found that my energies were better spent elsewhere. My staffs will often receive boastful offers from competitors. Interestingly, they're almost never accepted. (The last one was years ago.) Why? I'm transparent with my staff to an extent that they know they can trust me. (Another post on this later.) 

We do prevent our physicians from competing directly with us, but it's not through non-competes.

Of course, as with any legal matter, you are always advised to consult an employment law attorney when considering anything legal. If you do something stupid, it's your fault.

Dermatology Staff Salaries:

Staffing is the highest expense item for most dermatology practices, often comprising more than 50% of total practice overhead.

Via Skin & Aging Journal. The staff salary national averages in this issue of Skin & Aging were drawn from The Health Care Group�s 2006 Staff Salary Survey. In the fourth quarter of 2005, questionnaires were mailed to more than 9,000 medical practices nationwide and 739 practices responded, including 49 dermatology practices. Those dermatology practices supplied 565 different staff salaries. The complete 2006 Staff Salary Survey, with more staff categories and additional results, is organized by staff position, geographic region and metropolitan statistical area.

Customer Service Obsession: Love your patients the Amazon way.

 Is obsessive customer service part of your medical practice?

Amazon is taking a page from Nordstrom's 'heroic customer service' book. Why? Because it's good business. I posted on the oft-induldged stupidity of price wars. One of the differentiators that drives business is customer service. Notice I did not say 'patient care'. Customer service is outside of the medical care you're providing. Customer service is the touchy-feely warm and cozy perceptions that your patients have or don't have.

From my friend Shmula's blog on Amazon's customer obsession:
pushing 300,000 - 600,000 units of product per day through a fulfillment center is no easy task. gratefully, Amazon’s home-grown software and efficient processes help to deal with the immense volume. sometimes, if there are inventory gliches or poor product flow, an activity known in warehousing as “product chasing” occurs. “chasing” is when a product is ordered, but it is nowhere to be found in the (1MMft^2) facility. in reality, it is somewhere, but according to the inventory software the product is supposed to be in its assigned bin, but it has been moved somehow, drifted to another bin, or stolen. this defect is called Inventory Record Defect Rate and is one of the most important metrics at Amazon, and is highly scrutinized and reviewed by Bezos and his senior team.

Why is it important? because when the front-end Amazon store allows you to order something, the precondition is that the product and the quantity desired is currently in an Amazon facility: the software follows a very complicated algorithm based on network optimization, shortest path techniques, and traveling salesman routing; a check is made against the inventory database — in real time — how many are available, which facility, and how many have been committed already. when the order drops into the assigned facility, the picker goes to the bin where the product is supposed to be, but because IRDR is poor, the item is not there. this situation leads to two following options: (1) go to a local store and buy the item and ship it to the customer or (2) do a “network flip”, where the assigned facility “flips” the order to another facility that has that product. option (2) is ideal, but during the holiday season, it is very difficult to do. during the holidays, option (1) is common.

doing option (1) is heroic and is a true example of customer obsession at work: it’s not about serving all customers as an aggregate, but it’s about serving one really well, several million times. at Amazon, they really believe this and live this.

This kind of take-no-prisoners approach to customer service is absent in most clinics I see. You're asking your patients to spend their money inside of your business. Great customer service is your obligation.

How to: Hire estheticians for your medical spa or clinic. Part 2

Read: How to hire estheticians for your medical spa or clinic, Part 1 here.

Interviewing & hiring estheticians, part 2

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How to: Hire estheticians for your medical spa or clinic. Part 1

How to hire an esthetician for your medspa or laser clinic.

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Aestheticians And The Doctors Who Love/Hate Them, Part 2.

I first posted here about Estheticians and the doctors who love + hate them.

Since that first post I've received some negative comments from estheticians who think that they're a pleasure to work with.  You can read a thread of esthetician comments on medical spas and physicians here.  While they blast me as having a bone to pick, you'll notice that twice during the thread doctors are referred to as 'greedy bastards'. 

If anyone's still unaware, embezzlement is the number one problem in medical clinics.

Here are some memorable quotes: 

Well said, Nondy!! I have never worked with a doctor as an esthetician but worked with plenty of them as a nurse for 25 yrs. and yes, they are greedy bastards!  This is why I don't believe anything negative they print about our profession, our products or our equipment not being up to standards.  They just want all the business streamlined to them and will stomp on reputable esties to get it.

I will say not ALL docs fall into this category. It's just precious few, I have found, williing to think outside of the box and give credit where credit is due... Overall though, I found the article to be offensive.

The esty's were paid low hourly wages with no tips... If I go back to the treatment side, I think I'd prefer spa/resort and a percentage of the services/sales over my experience in medical.

Aestheticians And The Doctors Who Love/Hate Them.

Aestheticians seem to be one of the primary components for medical spas these days. Almost anywhere you look a medical spa now has a Aesthetician who is posted on their website. Medical spas that are primarily cosmetic, seem to have a bunch, but there are a growing number of physicians who are hiring individual aestheticians to provide skin care consultations, do the microdermabrasions and facials, and give a little fluff to their practice.

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Preventive Hiring: How To Hire For Your Medical Spa

Nothing you do as an business owner is as important as hiring the right people.

But hiring is tricky. It's very easy to pluck someone that's immediately available when you need boots on the ground. But, I always keep two things in mind when looking to hire someone.

1. A bad employee always damages your company.

2. Successful recruiting means hiring above yourself, not below.

As technology companies seeking the best talent, Microsoft and Google have developed a number of interviewing techniques and systems to avoid hiring the wrong people. (The emphasis here is on 'avoid hiring the wrong people', not 'hiring the right people'. Why? Both of these companies feel that there's a tremendous pool of talented people that will be attracted to them and that the screening process is best used to keep sub-par staff outside the gates.

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Three Great Rules Of Productivity For Your Medical Spa

How can you improve the productivity of your medical spa?

Here is an excerpt from an article in Connect Magazine. 

Employer Rule No. 1: Give employees ownership of real deliverables. Depending on the kind of manager you are, you’ll either shy away from this because: a) you can do it better, or b) you don’t want to overload your direct reports. Either is a mistake. In my experience, most complaints I’ve had with any of my past employers have related to having too little to do, rather than insufficient salary/title/etc. Give your employees meaningful work, and they will (eventually) love you for it.

Employee Corollary No. 1: Insist on personal accountability. Yes, it’s scary to have people counting on you. It’s much easier to coast along behind the scenes. But admit it: it’s not very satisfying. Sloth never is. It’s much better to be king of an infinitesimal pond than a nobody in a massive ocean. Go for the responsibility, not the title. (I’ve made this mistake on several occasions, and each time I’ve regretted it.)

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