As dermatologists, we view our competition in very different ways when we consider fellow physicians and “outside facilities,” such as med spas and free-standing clinics. Based on recent considerations, I think it is important for us to reconsider the effects of our physical plant and care on consumer acceptance of us as the premier facilities for facial and cosmetic enhancement. Sadly, we have to stop thinking as doctors and start thinking as marketers.

Recently, I read a puff-piece in a magazine about a med-spa in a west coast city. The piece was replete with the usual description of the beauty of the spa and the skills (somewhat dubious though they were) of the physician. This physician was trained in family medicine and has done well in his practice, to the point where he has a thriving clinic with good reviews. His secret has been making it simple to get into his practice and pleasant to be in it once there.

Clearly, he does none of the injections of neurotoxins or fillers, as he is too busy with other procedures or business duties, but the overall focus was on the efficiency of the practice and the gleaming waiting room and exam rooms.

As core-physicians, we probably put too large an emphasis on our training, our sterility of facility, and the risk-avoidance methods we employ when performing procedures, and less weight on the “experience” that consumers have when they visit. I am guilty of this and have redoubled efforts on my part to remedy this.

In the past year I have redone the carpet, the paint, and any wallpaper in my facility. Additionally, I replaced the sinks and counters throughout to give it a more up-to-date look. While it was not “broken” per se, the aura the decor gave was clearly circa 2000s and not 2020. There are other aspects of the office that I have and will be redoing over time, including the lighting, the exam chairs, and waiting room as a totality.

As practical as we are as physicians, we often rely too much on the comfort of what we have stared at for many years and don’t apprise it as a new patient walking in the door will. Therefore, every piece of art and poster in the clinic should be witheringly examined when doing a renovation. Things have a way of becoming ensconced in the environment, and there is a huge inertial cost to getting them removed that defies logic.

If you are considering this now, please take special note of what may be hugely unnecessary in the digital age, such as pamphlets and magazine racks. While these are currently on the “bubble” of helpful/necessary, they are likely going to be completely useless (and a waste of paper) in less than five years. Getting a monitor in each room that displays procedures and information, on the other hand, is completely needed in the present. There are many companies that can supply them.

Staffing needs have changed over time. Those of us who perform cosmetic procedures—some of which are quite pricey—need more staffing than the typical dermatologist ever needed. Benchmarking can be a help in determining if you are too low or too high in your staffing levels, but my guess is that “too low” is the most likely answer you will find. Patients want more and they deserve more “hand-holding” if they are going to choose us versus the pretty spa next to the fitness club they frequent.

Winter months are a great time to consider projects like this given the availability of contractors at a reasonable cost and the closing of most practices for the holidays or vacation.

Whatever you do, think critically about your space, your staff, and your needs in competing with the new crop of cosmetic offerings out there. It will be a worthwhile exercise and one that you should continue to do on a yearly basis.