Our Next Steps readers had the opportunity to ask Dr. Leslie Baumann questions on Skincare Retailing, Staff and Patient Education, and the Art of Designing Custom Skincare Regimens. See all her insightful answers below.
I am a board-certified dermatologist practicing in Nigeria for the last 2 years. I recently set out running a dermatology clinic and I have a huge interest in aesthetic dermatology. Here are my questions.
The challenges I have retailing skin care products is the availability of these products. I know the challenge is peculiar to my area of residence as I find it difficult to source for products. Any suggestions?
Dr. Baumann: Each brand needs to be registered in each country- this is why it is so hard for you to get products. If you send me a list of brands you are interested in, I might be able to help. My email is [email protected] Solutions.com.
I end up educating patients on skin care instruction myself. My patient load is small. However, how do I get staff to give these instructions properly?
Dr. Baumann: I developed skin type solutions software that diagnoses the skin type and then generates an efficacious regimen with corresponding instructions. The staff can just read the instructions to the patient until they have memorized them. See STSFranchise.com to learn more about how this works. I have many blogs there. We also offer online staff training. Over 100 dermatologists in the US use this software. I agree that the staff should play a very important role in patient education and I can help you train them.
How do you suggest I increase my patient inflow?
Dr. Baumann:You need to offer something unique such as skin typing and feature it on social media. You could do something like- invite 5 friends to follow us on Instagram and be registered to win a free skin type diagnosis and customized skin care regimen. Look at Instagram @SkinTypeSolutions for suggestions or read my blogs at STSFranchise.com.
One of the biggest challenges I have with skin care regimens in my practice is patient compliance. What’s your advice for overcoming patient compliance issues?
Dr. Baumann: Compliance is a HUGE issue. Studies show that the most effective ways to increase compliance is with through patient engagement and education. I developed software to do this. It asks the patient questions about their skin and diagnoses them as one of 16 skin types. It then generates an efficacious regimen and corresponding information sheets. The colors and numbers of the skin types get them excited about trying to improve their skin type to the perfect “Number 10” skin type. There is a mobile app that helps patients remember what products to use. We also have “Step 1, step 2 etc.” stickers to put on their products. Every visit I ask them if they have been compliant. Usually they are not doing everything they should. Patients require education, engagement, motivation and accountability in order to stay compliant. I suggest some sort of follow up every 4 weeks.
Engaging and educating patients takes time- so that is why I developed the skin type solutions software to streamline this process and get my staff to help me.
Here is an article I wrote about this issue: https://stsfranchise.com/2017/04/improve-patient-compliance-combining-cosmeceutical-prescription-treatments/
When suggesting skin care products to my patients, I feel they are frequently skeptical to buying products I carry in my office. I believe this in part due to patients thinking I’m trying to push a sale, which is never the case. How do you suggest I handle this with my patients?
Dr. Baumann: How you bring up and approach the subject of skin care is critical. I have over 120 doctors using my Skin Type Solutions Software. We have found that the best approach is through consistent education. (By “consistent”, I mean that they get the exact same information from every staff member every office visit- which requires a streamlined methodology). If you educate patients about their skin type and what products are best for them, and what order to use them in- patients will appreciate it. Then explain that you retail the products in your practice for their convenience.
How to bring up the conversation is very important, so you do not seem pushy. When you use the Skin Type Solutions Software to diagnose the skin type in the waiting room, it helps them begin to understand what their skin issues are and what issues need to be addressed to improve skin health. Then they are open to the discussion- in fact they expect it. When you discuss skin care, emphasize the facts and need for the right skin care. It may take a few visits of them hearing the exact same message- but they will eventually realize that “Medical Advice on Skincare” is superior to the other options out there and advice from less qualified individuals who are just trying to make a sale and do not care about skin health. In addition- you must realize that the advice you are giving them is best for their skin health and superior to other non-dermatology-based advice they are receiving. You are not selling to them- you are educating them and offering products out of convenience. I independently test skin care brands against the various skin type to see what really works for each skin type. I am confident that when I give a patient a printed skin care regimen- and they use it correctly- their skin will get better. Patients sense my confidence and expertise and then it changes the patient interaction. You should never feel like you are trying to “sell” your patients. To learn more about my skin care process and software visit STSFranchise.com.
What do you think is the best way to educate patients on skin care ingredients? While I carry a nice selection of professional grade skin care products in my office, patients usually prefer to buy products from retail stores. I’m always concerned about the choices they make and how much they focus on price vs. quality.
Dr. Baumann: I agree with you that every skin care product that the patient places on their skin is important. In addition- the order of products is critical for maximal efficacy. Patients need to be given printed step by step instructions and told exactly what products to use. I developed software to solve this issue. Over 120 doctors are using it. The doctor can sell whatever brand and price point of products they choose from a list that I have tested. I independently test the products to make sure they meet certain criteria for the software and skin types they will be used on.
The software works like this: A questionnaire is given in the waiting room. It diagnoses the skin type and then generates an efficacious regimen based on brands the doctor has chosen to sell. Each regimen has corresponding information sheets that explain ingredients to patients in a way they can understand. For example- if the patient answers in the questionnaire that they have frequent sun exposure, or they smoke or have other factors that increase their risk for aging- they are prescribed a retinoid, antioxidants and sunscreen. Information sheets about skin aging, antioxidants, sunscreen and retinoids are automatically generated. This information is also available in a downloadable app for younger patients.
Pricing- If your patients are concerned with price, I suggest you choose cheaper effective brands or lower the price of the brands you sell. We are taught to sell the product at double the wholesale price. I personally sell products in my office less than MSRP because I believe that patients will buy more and be more compliant when the products are affordable. I admit I get cheaper pricing anyway because I have 120 doctors using my system and buying over 40 brands though me. This helps me keep the price down.
With so many skin care products in the market, making sure we carry the best product selection in our offices has become a challenge. What are your recommendations for selecting the best product line? Do you think price is really an indication of quality?
Dr. Baumann: It is very hard. You must know a lot about ingredients and regimen design. You also want to limit your inventory as much as possible, so you want to use products that will work well on multiple skin types. It is not just which products to carry, but you also need to give the patients printed instructions about the order in which to apply them as this affects efficacy as well. (Email [email protected]if you want to see a lecture on this topic.)
But – you don’t have to know! I can do this for you! In my company Skin Type Solutions, I independently test all the brands for efficacy. I have tested over 40 brands at multiple price points and know which have the most efficacy. I also know what products and in what order to combine them to get the best outcome. I can help you choose what to carry and share information with you from the other 120+ doctors using my software to recommend skin care. In most, cases price is not an indication of efficacy. Regimen design is more important. For example, the cleanser and moisturizer you chose dramatically affects the efficacy of the other products. To learn more visit STSFranchise.com. I have many blogs on this topic there.
Some of my colleagues have implemented incentive plans to motivate their staff (i.e. PA’s) to sell more skin care products. However, I feel this is borderline unethical. How do you think we should encourage our staff to make skin care recommendations without pushing the limits?
Dr. Baumann: I think the staff should be incentivized. There are many issues to your question. One is that I believe that patients deserve medical advice on skincare. Too often they are pushed to buy all sorts of products that do nothing and may even be harmful. They need you to educate them—but you are busy and cannot do it thoroughly. You need your staff to help you- but they need motivation for this.
The second issue is that for patients to be compliant with skin care advice and medications– they must be engaged, educated and motivated. Physician extenders are busy and may cut corners on the education component if they are not incentivized. I believe that when patients are educated about what to use and why, they will buy products from you because you insure product quality and that they purchase the correct product. For that reason, I incentivize my staff on skin care sales.
I developed software that diagnoses the patients skin type and generates an efficacious regimen based on the brands the doctor has chosen to recommend. I have over 120 doctors using it and they report that it makes it much easier for their staff to properly educate patients on skin care. Sure –you will sell more products using the software, but that is not the point. The real issue is that your staff is educating, engaging and motivating patients to use the proper products for their skin type and to be compliant using these products (such as sunscreen every day). In my opinion, it is unethical not to educate your patients on the proper skin care if you are a dermatologist. If you have to incentivize your staff to educate patients properly (because education leads to sales)- then do it with a clear conscience. Studies show that 95% of patient underuse their skin care and medications. This is because they are confused and do not receive clear instructions. Email me at [email protected]if you have any questions about this.
I work for a private practice that has a high turnover rate of physician assistants and support staff. Training them on skin care regimens/products has become a nightmare and a waste of time. It’s almost impossible for me as a dermatologist to spend the necessary time with my patients and educate them on products and regimens. Do you have any advice on how to simplify this with staff and patients? Are written materials the way to go?
Dr. Baumann: When I was at the University of Miami, I had the same issue. I solved this by developing software that generates the regimens and information sheets automatically by skin type. That way the staff can give the correct skin care advice and regimen, even if it is their first day. It also solves another problem. It ensures that every patient gets the same advice no matter who they ask. I love teaching, so I developed an online training program for the staff to keep them updated on skin care and how to recommend regimens. To learn more email me at [email protected]or visit STSFranchise.com
How do you handle adverse reactions to products you have recommended to a patient? I have had a few situations in the past where patients will not return to see me after experiencing an adverse reaction.
Dr. Baumann: This is very rare but when it happens, I ask them to come in to see me or send a picture. It is usually the retinol that they are using incorrectly. If you encourage them to come in to exchange the product- that would maybe get them to return. I always have my staff schedule a 4 week follow up before they leave to see how their skin care regimen is working. I think it is important to tell them up front that you will prescribe a regimen and see them back in 4 weeks at which time you will adjust their regimen based on how their skin responds. A series of appointments is required to get them on track- not just the initial appointment.