We have helped a lot of Docs set up MediSpas. We have seen some pretty big blunders as well as some great successes. When we are called in to “rescue” a practice we are often mystified by the issues:

- Take for example the guy who did not understand why it was a problem for his high-strung dog to run around the practice and “poop” if he did not get his way. Is that the MediSpa experience you are looking for? Nor us.

- At the other end of the spectrum are poor equipment choices. Sure you can buy an IPL that will claim to do everything you need in just one unit. You might even get that for say 70K. But as we have seen many times, you will not get the results claimed and you will have many unhappy customers. This is no way to grow a practice.

- Yet another problem is the use of ultra-specific equipment that can do only one type of treatment. Unfortunately, that leads to fitting the patient to the treatment you can perform, rather than the other way around.

A problem with cost is not recognizing the per-patient cost of the treatments you are interested in giving. As an example, if you purchase a laser with the laser-head in your hand piece you can expect to replace it more often than one that is better protected in the laser box. Not only is the “laser in the hand piece” more susceptible to being dropped etc, it has bigger issues with cooling, thus shortening its life expectancy. If the laser you purchase requires a new “treatment head” for each new patient, you can expect that to add up quickly as well. If you buy a laser that is slow, you will have the added cost of time for each treatment. All of these issues have an impact on the bottom line.

So ‘this’ laser costs 100K and ‘that’ one costs 120K. Which should I buy? I often hear this question. Unfortunately, this is not even the right question. The right question is: “what is the true cost of ownership?” Some lasers have poor cooling systems and you need to replace parts more often. Others are not made with the “real world” in mind and have high operator damage (ie: laser head in your hand and not in the box). Others have high per-patient cost or parts that wear out (think Fractional treatment heads or IPL filters)

What you should look for…

Look for a versatile system that can perform several procedures but is not a “jack-of-all-trades master-of-none”. You need a piece of equipment that can deliver an extended set of treatments at published parameters, under safe conditions and in a fast and economical manner.

On the non-ablative side, one of the great work horse lasers of Aesthetic Medicine is the Nd:YAG. But not all Nd:YAG’s are created equal. With the proper machine, this wavelength can do all of your hair removal, spider-veins, collagen remodeling (skin tightening), active acne, wart treatments and fungus treatments. With the right models, the Nd:YAG can also do lipolysis and endo-venous therapy for varicose veins. For a laser to have this kind of versatility you need to look for one with energy feed back control, auto calibration and variable square pulsing. These are the features that will allow the laser to be flexible enough to do all of these treatments.

On the ablative side is the Er:YAG laser. This wavelength is the most versatile of the three major ablative lasers. Because of its high absorption in water it can be used in a “cold ablation mode.” In addition, with a variable pulse width it can be made to function more CO2 like, resulting in more heat deposition. It can also be used in a pure heat mode. Because of this versatility, the Er:YAG laser can be used in a wide variety of treatments. It is used for all ablative therapies, including pigments, wrinkles, acne scaring, benign mole removal and solar damage, skin resurfacing and other applications. It can be used in both full resurfacing and in fractional resurfacing modes. Again, to get this level of versatility you will need a laser with high power, energy feedback control, self calibration and variable square pulsing.

With just the two lasers described above, one is able to give most of the treatments that one sees on the various talk shows or reads about in magazines. An additional benefit of these lasers, if properly configured, is they will have very low operating costs. The costs of operation are low because there will be little in the way of consumables. Sure you could break a fiber or drop an optical (not laser) hand piece, but by in large the lasers are built to last. The consumables that one uses on patients are 4 X 4 gauze pads and isopropyl alcohol - things that cost very little.

One additional laser that may be of use is a Q-Switched laser. A Q-Switched laser is one with a very short pulse duration, generally in the microsecond range. These lasers are used for pigment changes, skin rejuvenation, birthmark and tattoo removal. To be effective, these lasers need to have a very high power rating. They will also need multiple wavelengths if used for tattoo removal. It is possible to find quite versatile machines with 4 wavelengths that can manage most tattoo colors and give excellent results for pigment removal and skin tightening. A very good choice in this regard is an Nd:YAG / KTP Q-Switched laser with 585 nm and 650 nm hand pieces. This will give good coverage for tattoo inks. The Nd:YAG will cover black brown and dark blue. The KTP will cover red, orange and purple. The 585 is good for sky blue and some yellows. The 650 covers green and some yellows.

It is important to have a high-powered Q-Switched laser because high powers are needed to break up pigments, whether they are tattoo pigments, age spots or the dyschromia of vitiligo.

When I lecture I often have docs come up to me and tell me about the 8 or 12 lasers they have in their office. They feel they need all of these to do the various treatments they offer. I can’t imagine the kind of overhead that results in. With the three lasers above you can do it all. But remember not all lasers are created equal. You will need to find the right lasers. They will need to be self-calibrating, have energy feedback control and be capable of variable square pulsing. Once you have a versatile set of lasers, you can move forward knowing that if it’s doable you can do it.

Just as if you knew you were about to be besieged by an enormous zombie apocalypse, you want to be prepared in the event of you, or one of your family, being seriously injured and requiring home care. To be serious though, we are not talking about Civil War period at-home surgery. One does, though, need to be ready in the event something does happen as well as be prepared for the eventuality of minor cuts and bruises. What if someone has to go to the hospital and then requires at-home care? Will you know where to turn in that event? While picking up a basic first aid kit can be accomplished at the local grocery store, it would behoove you to find out where you can get proper medical supplies.

Some of us are fortunate enough to live near a major hospital where various stores sell medical supplies. However, what are you to do if you live off the beaten path? One may not be able to take a quick drive to the local drug store. Not only might it be a long drive, they may not have what you are looking for. As a result, it is always a good idea to be prepared. A good at-home medical kit will contain some basic supplies. In addition to the usual band aids and antiseptics, a first aid kit will need some more substantial materials. What would you do if someone broke an arm? What about a leg? Do you know how to properly immobilize a broken bone if you have to transport the injured person any distance? To do so requires a splint. While several materials found in the average home can be used as a splint, it is more prudent to have the right materials at hand. It should go without saying, however, that the best care for a broken bone is to not move it and make the injured person as comfortable as possible while help arrives. If this can not be done, you need to be ready.

Life throws us many curve balls and we rarely see them coming. Major life-altering events like strokes and heart attacks definitely fall into this category. If someone in the home is coming back from something like these cases or surgery or a major injury, your home is going to have to become a miniature hospital on some levels. Will you have the right medical equipment? As hard as it might seem, someone will have to think about making these kinds of arrangements very shortly after the unfortunate affair. It is best to talk it over with your loved ones so everyone has an idea of what to do before something happens. In this way, the likelihood of incomplete care at home is greatly diminished.

If you find yourself nowhere near where medical supplies can be purchased, you need to put together a list of items you need. The internet is a valuable resource for this kind of information. Additionally, there are a number of online retailers of medical supplies. A great many of these are very competitive and deals can be found. Remember, however, that there often times are shipping costs so make sure you add that to you final cost. Regardless of how you get you supplies, keep them in an easy to access area out of the reach of children and pets. The last thing you want is to reach for something only to find an empty box of crayons.

Everyone needs to have, at least, a basic understanding of first aid. While we all do not need to be first responders, we should have basic medical supplies in our homes and we should know how to use them. If you have not done so already, take a basic first aid course from a Red Cross certified instructor. You will benefit others as well as yourself.

People all over the world are starting to find that the cost of medical bills is getting out of hand. Paying for prescription drugs is something that more and more people are finding hard to do. Yet, when you are ill you need to have access to the correct medication. It can be incredibly expensive for anyone who has to take medication on a daily basis. These prescription charges can be astronomical. With this in mind, a large number of people will buy cheap prescription drugs but why are they so popular?

One of the main reasons for their popularity is that these cheaper drugs work in the same way as the more expensive drugs. Most of them are regular drugs with a changed name. In many cases, the same company makes most these types of drugs.

Any cheaper drugs that are bought have been through testing to make sure they are safe. You should never buy a cheaper drug that does not state that it has been tested. Make sure you check this out before you buy any drugs.

The savings that can be made can be very significant. In fact, anyone who needs to take medication regularly should think about cheaper drugs. In just one twelve month period the money saved by purchasing cheap drugs can be massive.

Many people find that the packs of these types of drugs that are cheap are bigger. They will either have more pills in each pack or be a higher ml value for liquid drugs. So if you would like to restock your drugs cabinet you could do it at a vastly reduced price. Take a look at what is on offer and you could be very surprised.

Cheaper drugs means more access to the right treatment for many people. Now a person will not have to worry about meeting the costs of their prescription. It is possible to get exactly the same drugs at a lower price and stay healthy. This is one of the main and most prominent of the benefits of taking cheaper drugs.

Anyone who has Internet access will find that buying cheaper prescription drugs is easy. To do so, simply find a website that sells the type of prescription drug you are looking for. Then you will have to join the site and ensure that you are old enough to buy from the site. For this, you will need to be over 18 years of age. Next, you just select the type of drug that you need and go right ahead and buy it online. It will then be delivered to you in just a few days.