How to Choose a MedSpa You Can Trust with Terri Ross

Dr. Furnas (00:01):
Got wrinkles. Should you get Botox or Daxxify? Want filler but don't want to look like a clown? And do skincare products priced like gold really work? Where do you go to find someone you trust? Welcome to Skintuition. I'm Heather Furnas.

Dr. Korman (00:22):
And I'm Josh Korman. As two plastic surgeons, we lay aside our scalpels and explore the nonsurgical world to bring you what's new, what's safe, and what to look for when you're ready to hit refresh.

Dr. Furnas (00:35):
It's a true pleasure to introduce my good friend Terri Ross. Terri Ross is a world renowned practice management expert and sales coach for medical aesthetic practices and Fortune 500 medical aesthetic companies. She has helped thousands of practices launch, grow and skyrocket, and she is a noted international keynote speaker. Why is she so exceptional at growing sales? She builds quality in the space, the people and the processes. How do I know? Because she's consulted for my med spa. Welcome Terri.

Terri Ross (01:17):
Oh God, Heather, Dr. Furnas, Dr. Korman, thank you so much. Such an honor, such a pleasure, and congrats on this podcast. I think it's going to be amazing and I'm truly honored to be here today.

Dr. Korman (01:29):
Okay, now we'll get past the mutual admiration society and we'll move on to the questions. So let's say I'm looking for a place to do Botox and maybe some fillers for my face or my wife's lips or something. What should I think about? What should I consider in choosing where to go, assuming I actually really don't know where to go?

Terri Ross (01:53):
Such a great question and a loaded question. Obviously both of the market is so competitive, such a commodity. I think one of the really important things is everybody can talk about external marketing and perception of what they see, but really understanding the practices. If you're Googling these clients are right, prospects are going to Google, I have wrinkles, I have fine lines. Whatever their problem is, you hope to find somebody ranking high. I think what they really need to look at is, number one, what are they looking for? It's one of the phrases I use when I teach practices, but what do consumers, what are you looking for when you choose an aesthetic practice? Of course you want somebody board certified, but perhaps asking questions about how long they've been injecting. Do they have products of choice? Is there a unique value proposition that they can read right on the practices website? Are there significant before and after pictures looking for before and after photos, videos, educational content? I think the social media is taking over so much and there's a lot of fake stuff. I think really deciding are you looking for quality where price doesn't matter, where you're choosing the right physician or provider to do the best work over price.

Dr. Furnas (03:08):
That actually is a really good point and it brings up the next question. As you've helped aesthetic medical practices be their best and clearly med spas are looking to improve their bottom line, so does your coaching and practice optimization help the patient? And if so, how?

Terri Ross (03:29):
So I love that question because while I teach it in relative to how it can help the practice, it does help the patient too. Because in this now, again, competitive marketplace, people don't have to be loyal. There's no loyalty. And when you look at the business functions and processes, you want someone, you pay to get a patient to come in the door, we have to make sure they're converted, that they're qualified for the services they're getting and can afford them. More importantly that they're educated on the holistic treatments that can get them the outcome they're looking for. Now, that benefits two things. It benefits the business to say, I'm I am truly educating, I'm not selling right, I'm not bullshitting. You believe you can get them the best treatment. And why does that benefit the patient? It benefits the patient because I've been to hundreds of practices and most people treat the consultation as transactional.

(04:25):
So if I come in for wrinkles and fine lines, I'm only being told, oh, some fillers and Botox. What if I need lasers? What if I need a peel? What if I need microneedling? What if I need surgery? I could need more things. But nobody wants to talk to the patient about that. The clients, they're hungry, they want to be educated and they want to be asked questions in terms of how long has it been bothering them and how does it make them feel, and how committed are they to getting the procedures that will get them the result they're looking for? And that comes from a twofold. We have to be able to do a proper consult and ask those questions, the clients have to feel vulnerable to share how they're feeling, and it's those feelings that they feel right to hear the treatments that they could get that are going to allow them to say yes. And so to answer your question, the patients truly benefit from that because ultimately that's the outcome they're going to get.

Dr. Korman (05:18):
So for example, many med spas charge for fillers by the syringe. So in some ways that gives a patient a cross-reference. They can be shopping. And unfortunately, I always say the most important thing about the filler is the filler meaning the person doing it, not the actual stuff. But from a consumer standpoint, price really can vary a lot. And so as a consumer, how do I know if I'm being oversold?

Terri Ross (05:53):
I think that as a consumer, is somebody really trying to ask me the right questions. And if someone does ask me the right questions in terms of some of the things I just shared, how long has it been bothering me? What have I done in the past? Was I happy with it? Did it work? Why or why not? What am I willing to do? That's when the value become, that's when really price becomes a moot point. If the clients are really truly the right kind of client that we want and the ones we want are the ones that are right wanting this long-term plan because we want a high level of retention. And then I think that it never becomes feeling sold to if there's that trust and rapport built in the beginning.

(06:36):
And I think that also has to come from a step backward where the provider's saying, look, I'm Dr. Furnas and I'm going to be with you for the next 30 minutes and we're going to build this comprehensive treatment plan. And I think when the expectations are set upfront of what the client can expect, no one will feel sold to. I think it's when that doesn't happen. And then someone's just saying, you know what? I think you could get this laser, this Botox, this filler, and it's this whole host of things a confused mind won't buy. And I'm like, well, wait a minute. Why is he or she trying to sell me all these things? And I only came in for this one thing.

Dr. Furnas (07:10):
Another thing that I think is very typical for people who are exploring the med spa world to call up and say, how much do you charge for Botox? And I know you have taught us, don't just say the price. What are the best practices of the best med spas from the time you pick up the phone and call to coming in?

Terri Ross (07:36):
Look, we're in an age where cost does matter. I'm not saying it doesn't, but just like any other therapeutic area, we are not, consumers are not nickel and diming their dentists or their ob gyn or their oncologist or cardiologists. We're not asking for discounts. And what is the price of my knee surgery? It's sad that aesthetic medicine is still medicine. That's first and foremost. It's still medicine. You're putting stuff in your face, stuff in your body, and you need to really pay attention to that and where you're going. And the best practices for a practice, and even if someone asks that question, you have to start to weed out and qualify. And so the phrase I always use is, thank you, Terri, that's such, if I'm the consumer, right?... Thank you, Terri. That's such a great question. There's many choices to go to. What are you looking for when you choose an aesthetic practice?

(08:33):
That is a phrase that if people don't pick up anything, if you use the phrase, if you're a practice, let the client say, you know Josh, price. If the client says that, the client's telling you that price is what matters. You have to decide as a business owner that may or may not be the kind of client that you want. And I'm also telling you I'm a price shopper, right? So we can eliminate that. And then again, there's financing. There's so many financing options. There's not a reason for someone to be able to pay if you have a different value prop in your organization.

Dr. Korman (09:08):
So the corollary to all that is what would you say are the worst practices of the worst med spas? What is it that they do that you go, Ooh, that's not for me?

Terri Ross (09:24):
Look, I think there's different strokes for different folks, but I'm very passionate about what I believe and what I teach and what I've done for over 20 years now. And to work with some of the most world renowned, both of you, physicians across the country. And I think the worst thing practices can do is they don't invest in training their team. The training is the foundation of a business, right? Your team is your greatest asset or biggest expense. I've listened to thousands, I mean more than I can count. And I want to really kind of poke my eyes out when I call a practice and I'll say, how much do you charge for Botox? You know, 15 bucks a unit, nine, whatever it is. And that's all they say, click, bye. You've just lost a patient because we're not trained enough to just take a step back, acknowledge, right? I teach this layer, model this communication method. Acknowledge. Yeah, I understand, Josh. There's definitely a cost. There's definitely an investment. It's not an expense, an investment in coming to our practice, an investment in wanting to get some Botox, what's important for you? It just diffused the entire thing. And now we're able to build a relationship and a bond with each other.

Dr. Furnas (10:32):
It's very similar to our surgical practice where people will wonder why is surgery so expensive? And we explain safety is really expensive and training and all of that. So you're absolutely right. And then when we're overseeing, Josh and I oversee practitioners and we're only comfortable handing off the injections and whatnot if we have someone who really knows technique and safety. And so yes, so we invest and it costs money. That's a really excellent point. Now, if I just want a laser treatment and an injectable and I meet with the staff and the staff is telling me I need products, is that for my own good or is it good for the bottom line? How effective are skincare products? Is it just a moneymaker for the med spa?

Terri Ross (11:31):
I've worked with so many surgeons throughout my career. I think that the retail is a significant piece to protecting a consumer's investment. If I'm going to get surgery with you, face or body, right? There must be medical grade products that I can't go get at CVS or Walgreens that are going to be much more potent with the right chemicals and ingredients that I need to, again, reduce redness or pigment or fine lines or tone, texture, whatever it might be. Yes. So I guess to your question, retail is, it doesn't definitely contribute to the bottom line a hundred percent, but I think practices choose products that are also going to augment someone's treatment, which is what we want.

Dr. Korman (12:17):
Okay, so let's talk a little something else, which is that from a consumer often, I don't know how much consumers hear about it, but I think probably on social media quite a bit, but there are some nurses that basically do Botox in their houses, and that would certainly keep the cost down for the consumer because the practitioner doesn't have any overhead. So where do these people get their Botox from and what are some of the ways that it could maybe go wrong?

Terri Ross (12:53):
I know that makes my skin crawl when I hear that myself. Look, I had a med spa in Beverly Hills with a couple of surgeons. I can only presume that if you're taking it home and injecting it at home, you're perhaps taking it from the practice that you work with. These Allergan, Galderma, they can't ship it to someone's house, so they're getting it somewhere. You hope that they're getting some legitimate product, at least who knows, right? If it's not coming from China in some fake stuff, we don't know. So I think it's one thing to question, not just trying to save a dollar or two, but say, how would anyone know if the product is real? I think not having all of the necessary equipment that somebody might need, right? If they faint pass out, have a seizure, we talked about Dr. Furnas, you just talked about safety. We pay for an outcome and we pay for safety. That's what we're paying for. And so there's just a lot of risks with, again, the quality of the product, the potency of it, and then more importantly, just someone's health and safety overall. I mean, I know people that allow people to drink at these parties, you're not supposed to be doing that. So a whole host of things could go wrong. I think that's just something that consumers should stay away from. It's not worth the few dollars you're going to save.

Dr. Furnas (14:18):
No, absolutely not. Now you coach on many different levels. How do you coach practitioners from greeting to consultation to treatment to follow up? What would the patient be or client, customer, consumer be looking for in really that top level care?

Terri Ross (14:40):
Oh, I love it. I love that question coming from that perspective, because I think most consumers don't know what they don't know. A lot of times what I've seen, right, clients have been coming to a certain med spa, and I even used myself, I'll go to some local places here, I'm in Manhattan Beach, they won't ask me any questions. I didn't fill out a cosmetic interest questionnaire. They don't really know anything about me and they'll just do it. They don't know anything about me. And I do it on purpose to kind of see how these other practices run, but the client should expect one a highly, you'll know if you're calling a practice that just answers your questions, doesn't know any of the right how to handle objections or how to qualify or how to decipher between the different services, you will know. So look for how educated someone is when they answer the phone, look at the way that they communicate.

(15:33):
If it's a web lead coming through via an email or social media, I think when they're told, you know what Terri, what you can expect when you come to Allegro med spot is, tell me what I'm going to expect. If no one tells me I'm going to walk in, do I get the treatment that day? Is it 30 minutes, 45? Do I have to pay? What are the expectations? Those things need to be told to me. That already changes the dynamic for a consumer to be like, wow, I had no one ever tell me these things before. I've been going down the street for the same clear and brilliant and nobody ever did this treatment plan. So setting the expectations and then when you come in, someone can just stand up, greet you. Hi, I'm Terri. So nice to meet you. Thank you for coming in.

(16:17):
It looks like Susie referred you here, building that level of rapport. Can I get you some water, some coffee? And then when you're in the consultation room, it's almost the continuity of the care, the same way that the front desk person or patient concierge would say, again, Terri, what you can expect when you come to Allegro med spa is you're going to be meeting with Dr. Furnas going through a 30 to 45 minute consultation. I mean, it already just sounds nice. I'm like, that's amazing. And then when I come in, that person greeting me or putting me in the room and then you walk in, you're also saying the same thing, super excited to meet you. It looks like Susie referred, you're repeating these things back. So it looks like your whole practice that a practice has the same continuity, the same consistency, the same level of professionalism. And I'm like, this is just great. And you're like, okay, we're going to be together. I want to learn about you and I want to learn about what bothers you. And then I'm going to build you a treatment plan that I think is going to get you the outcome you're looking for. And those are best practices and it's not hard. It just really has to be practiced. And the consumer will very much see the difference between that type of a practice versus feeling it's a transaction and it's a rushy, churn and burn, versus quality.

Dr. Korman (17:33):
So that's really good point. But also though, people want a guarantee. So patients, while we always try to under promise and over deliver, it's nice, but life is not perfect. And the same product, even in expert hands may function differently in different people. So people want a guarantee. So what do you think the best way for patients and clients to actually think about this? How can anyone be given a guarantee and yet people feel, okay, I'm paying for safety, I'm paying not the cheapest price on the block because I'm paying for safety, I'm paying for quality, but that means I should get a guarantee. Now I realize some people have this idea of oh, realistic expectations, but what I really want is a guarantee it's going to work. So how from a consumer standpoint do you think we should think about this?

Terri Ross (18:41):
I was going to flip this question right back to you, Dr. Korman. Listen, that's a hard one. I'm the patient, right? I am the patient. And to some degree I think I would like to believe that in medicine, in any therapeutic area, anything, there is no guarantee in medicine. I wish we could say that and put that. And we have to again, just make very smart decisions and do enough due diligence and enough research that you are selecting the right practice. And even to your point with that, there is no guarantees, but I think consumers can do a better job. One thing to read that someone's board certified or triple board doesn't matter. And I use this analogy a lot that someone could call a plastic surgeon who does breast augmentations 90% of the time, faces 10. I don't know that I'd pick that surgeon to do a facelift, right?

(19:40):
I'd probably pick someone else. And I think consumers don't know. They don't know what to ask. So I love this podcast and that it's consumer facing because I think that there's so much education that can be delivered in terms of there's only so much research and due diligence in making sure you're selecting the right place and then understanding what those procedures are too. And then I think that from the provider level, really them being able to articulate what they can expect, all of the potential side effects, which can get scary for somebody, but so that everybody's aware that there's enough standard operating procedures and forms to check, so they're covered. I dunno if that really answers it to the best of what anybody's going to want to hear. But I think that's the truth, really.

Dr. Korman (20:32):
Yeah, but to answer your question, people will ask me that question. I say, I guarantee you that I will do my very best to give you the result, but I do not guarantee that you'll end up with the result that is exactly what you want.

Dr. Furnas (20:47):
I love it. I love that. And I say something similar, I do guarantee one thing, the left will never match the right. I'll do my best to make to come as close as possible, but I will, they will never match.

Terri Ross (21:05):
Asymmetry is not going away. I love that.

Dr. Furnas (21:08):
Yeah. So if you are a patient going into a place, we talked about what you want to hear, are there any buzzwords that you would warn against that this is not a great place to go? Like somebody says we guarantee something like that?

Terri Ross (21:27):
Yeah, I mean I think that's a word that nobody should say. We guarantee, and I might have a different opinion than others. I mean, I'm a very firm believer about the price, and I'm not here to judge. If people don't want to charge a consultation fee, that's fine. But in my mind, again, we sell time. And if someone is that educated and trained and respected and qualified to publish whatever it is, your time is money, you can't get it back. And when people just don't show up, then when you have free hours. So to me, there is a difference between someone charging a fee and someone not. That's just my opinion. And I also think, again, when the consultation's very short, very rushed, not asking enough questions in the consultation to really uncover all of the things that I care about, my lifestyle, my budget, what am I willing to do again, what have I done? Did it work, not work? How committed am I? Someone's ability to ask good questions will draw so much out of the patient that only then with those responses is someone able to navigate where the treatment plan should go. Otherwise we're just throwing up on them of all the things they could do and they won't typically do anything at all. So I think consumers should be kind of aware of some of those things. The consultation time, the price, the guarantee, and just being sort of treated as a transaction and not a really holistic patient.

Dr. Korman (23:00):
So what about the front office staff? How important are they to the patient experience and how do you coach them?

Terri Ross (23:08):
Wow, I wrote a whole training curriculum back in 2019 when I had this medical spa with three surgeons and a derm in Beverly Hills. And I think they're one of the most vital positions within a company, often overlooked, often underpaid. This is where key training, that is the first human connection that I have. So if I work for you, right? I mean I am your brand ambassador representing your brand. So I think that it's a key position within the organization. I think that it can make or break, clients make decisions very quickly. Within 30 seconds they can make or break that dialogue. So I think when people are looking to hire somebody in that role, again, the foundation of the training, what is their position? What are they responsible for? Can they multitask? Can they bond? Everyone talks about you want somebody bubbly and right and articulate, and yes, you want that, but you want them to be self-sufficient with a sense of urgency.

(24:05):
They can multitask, they can really take the time and say, if I work for Dr. Korman, I'm going to go home and I'm going to study. I'm going to study these procedures and I'm going to understand the features and the benefits and the competition. It can make or break the business. And on the business side, you guys are spending practices, spend hundreds of thousands of dollars in marketing. When I look at the data, I'll see marketing spend overinflated to try to get more people in the door. Yet we don't nurture the ones we have because they're not trained to look at the information. And the data is not an emotional thing. The data just doesn't lie. And it's facts in terms of how you can make informed decisions. So I would say that is an area everybody within the practice should be trained, but it's very key component.

Dr. Furnas (24:51):
That's great advice. Are there any resources you would recommend for anyone looking for med spa or wondering if they're at the right place? You mentioned social media and reviews. Are there any other magazines, columnists, podcasts? In other words, what homework can people do to protect themselves with knowledge?

Terri Ross (25:13):
I love that. I mean, obviously I think everybody's first and foremost going to go to Google and look up their problem. They're going to search the problem, look at the first page of Google and then start clicking. I think what they need to be aware of, right or wrong, no judgment. People that are paying for ads, that people paying for ads are going to be at the top. Once you see the organic name, no a tied to it, that means that person is ranking on their own accord, which I think is something that they should look at and consider. And then when you're going onto a site, looking at again, the quality of the before and afters, educational videos, you could Google if there's a podcast, if they were published, the credentials of their education. I think when you don't have those things, people are getting very consumed and every age group and millennial now and baby boom, we're all looking at a different place.

(26:09):
But the Instagram and TikTok is becoming so big and so many filters are out there that people are really come on, right? They're really thinking that you can look a certain way and you can't. So look, I want to filter my face too, but I think it, it's really important to make sure that you are not getting sucked up into sometimes just somebody who's blowing up their Instagram with all these pictures of lips or faces, and then you think you can look like that and you can't. And then you might go there expecting one thing and in the circumstances or something totally different.

Dr. Korman (26:49):
So what would you, actually would make you walk out of a med spa, you've gone through all the research, you did Google, you went to Google University, you read the reviews, everything. What would make you, when you walk in and you go, no, I'm going out. What are those things?

Terri Ross (27:08):
Location, maybe location when you walk in and there's just a mess everywhere, right? It's not an org, look, if this is aesthetics, you want a place to be aesthetically pleasing, not being greeted well, or when somebody doesn't acknowledge your name or stand up or tell you to wait just a moment. I'd say logistics, the decor and the way it looks. Is it clean? Is it neat? You're being greeted respectfully. I'm not a fan of people putting prices everywhere. I think then people just choose based on price and not on value. I would say those would be the main things.

Dr. Korman (27:39):
One thing that people sometimes, I mean I encountered this a long time ago where people, if they come in and it looks like there's not too many people in the waiting room, then they think, oh, not busy enough. If it's too many people in the waiting room, they go, oh, too busy. It's like that balance where people can feel like, oh, it's not too busy and not busy enough.

Terri Ross (28:00):
Right? Right. It's funny, we've built about 150 med spas across the country over the years. And it's interesting because people will build these grandiose lobbies and I'm like, do you really have 20 people sitting here now? Unless you're like a wellness clinic with B12 shots and something super fast, I don't know, but I see the point exactly. But I haven't had anybody, I think there's some cachet when I don't see anybody. It's just this very high end, people are greeted with the white glove and in the room quickly. Nobody's having to wait. And then the people that do have to wait that look, it's a bit of an annoyance. We kind of teach that when somebody is around 70% capacity a provider, we should be looking for other people. So nobody wants to, and it's hard, you guys are surgeons. I guess I would wait for the best surgeon, but then there's always that risk, right? Well, if I can't get in, I'm going to go somewhere else. But I dunno if it detracts from quality.

Dr. Furnas (29:01):
So let's move on to reviews. We've touched on that a little bit. How valuable are online reviews in a search? What would you look for and would you leave either a good review or a bad review after a good and or bad experience?

Terri Ross (29:19):
Yes. I think reviews are critical. I think it's just a day and age where people want to see what other people have to say. You want a five star review, you want them to talk about the surgeon or the doctor or provider or the treatment or the outcome and the experience. We're also paying for the experience. So I think that it's important. However, I think you have to take things with a grain of salt. You can't just read the first couple or you start to see one bad one and you're like, oh, this place is terrible. I think again, that comes down to people just wanting to be bitchy and writing something nasty. They wanted their money back or one little thing went wrong, and they're going to tell the whole world. And I think again, running an efficient sustainable business comes down to, you asked me would I leave a review?

(30:06):
I would if you asked me to and if I had a great experience. And I think that comes from processes within the practice to have in place. When you have happy people, happy people will shout from the rooftops, right? People that are unhappy will go tell 10 other people and that supersedes everything else. And so I think that has to be something implemented in the practice where everybody is, you know, even compensated or rewarded or there's a team bonus for having people write their happy thing. I wouldn't proactively though, not unless somebody asked me, but I certainly would go research to see what other people had to say.

Dr. Korman (30:44):
So what do you see as the next wave? What is the new thing that might start creating? Oh, this will be the new thing for med spas.

Terri Ross (30:58):
Look, the hot topic that has been the last couple of months, the whole semaglutide. I think this wellness, hormones, hair restoration, semaglutide, peptides, that's the new thing. And look, and I get it, and I'm sure we all want to look and feel our best and have that happening from the inside out so it makes sense. It's really going to be about who's allowed to do these things. I think that's the traction I'm seeing.

Dr. Furnas (31:36):
So we've been over a lot of things. Is there anything else you'd like to add for the consumer?

Terri Ross (31:44):
Really just know that this is still a business, it's still medicine. You want the best. We're all going to choose Mayo Clinic, or we would seek out the best in any other therapeutic area. And I think it's just the same lens here that don't feel that just because somebody's this cheap place down the corner that can get you in is going to get you the result you're looking for. So pay attention, be smart, make smart decisions, and know what you're want and what you're looking for and what you expect for yourself in getting these treatments done and how you want to be treated.

Dr. Korman (32:18):
So speaking of the best, Terri, you are the best. And that was really very, very helpful for everybody.

Dr. Furnas (32:24):
Thank you so much Terri.

Dr. Korman (32:24):
So join us every two weeks, maybe Terri will join us every two weeks too, as we tackle topics from hair loss to hormones and pimples to wrinkles, discovering new ways to feel better about ourselves.

Dr. Furnas (32:38):
Follow us, comment, ask questions, and keep in touch. Have an idea for a topic? We'd love to hear from you. Theme music by Diego Canales, production and engineering by The Axis.