Don’t miss out! Tattoo removal, short recovery cosmetic cases in demand
Reach new patients with innovative community programs
Attracting new patients to your surgery program is a constant challenge for day surgery program managers. Not only is it important to identify the market segment you want to reach, but you must also figure out which services are important to these new patients. Once you’ve identified the services, you need promote your services and get paid.
While participation in community programs can always generate publicity, two facilities have gone beyond traditional health fairs and festival sponsorships. The day-surgery programs at Abbott Northwestern Hospital in Minneapolis and Provena St. Joseph Medical Center in Joliet, IL, have teamed up with other community organizations to offer former gang members a free program for the removal of their gang tattoos. The program encompasses not only laser removal of the tattoos, but also counseling, job placement, and mentoring services. The actual removal of the gang tattoo is essential for the program’s success, says Lupe Salazar, CBET, laser safety officer at Provena St. Joseph.
"We see young people who find out they are going to have a child and they want to move out of the gang culture. Unfortunately, the tattoo may keep them from getting a job or moving away from the influence of the gang," he explains.
Abbott Northwestern has 80 people undergoing treatment for tattoo removal, says Paul K. Plumb, manager of laser services. "Since the program began in 1996, we’ve had 200 youth enter the program, and we’ve seen a dropout rate of about 25%," Plumb says. The approximately 70 youth who have not yet begun treatment are still undergoing the first steps of the program, which include mentoring and self-development counseling with employees of the local parks department. (See story on setting up a tattoo removal program, p. 91.)
Because young people congregate in parks, the parks department police get to know youth who are involved with or in proximity to gangs and become key in identifying potential program participants, says Plumb.
The price for removing a tattoo can be as high as $3,000 or $500 for each of four to six treatments necessary for removal. "Our tattoo removal program gives former gang members access to a procedure that they normally could not afford," Salazar explains.
While most of the clients Salazar sees are in their late teens to early 20s, the program also has some clients who are in their 30s and 40s. "Our older clients are parents of teen-agers who want to remove evidence of their own gang involvement so their children won’t think being in a gang is OK," he explains.
Salazar’s facility purchased the laser used for tattoo removal specifically to participate in the community program, which is run by the police department, YMCA, and local Boys and Girls Clubs. The facility performs about 10 tattoo removals per month through this program.
The MedLite laser, manufactured by Continuum Biomedical in Livermore, CA, cost $50,000. Funds for the laser came from the day-surgery program budget, but having the laser also has attracted paying patients, Salazar says. Media coverage of the program has increased awareness of the technology that is available to remove tattoos. This publicity has created a new patient base of young people for the day-surgery program, Salazar says.
"We see young women in their 20s who want to remove tattoos that fit the image of a college kid but not a professional woman," he says.
While most tattoo removals can be done in a physician’s office, Salazar says his program has some surgeons who prefer the convenience of the day-surgery program’s laser.
"Not all plastic surgeons want to invest in a laser for tattoo removal, so our laser is available to them," he says. "We also have some surgeons who may have a laser in their office, but they will schedule tattoo removals in our facility on days they have a number of surgical cases scheduled in our operating rooms. Our laser enables them to schedule tattoo removals between their larger cases."
Plumb’s laser center sees a number of people in their 20s and 30s for tattoo removal. His program also receives calls from people considering a tattoo. "They want to know how much it costs to remove a tattoo before they get one," he says. "We don’t know how many change their minds after hearing the $3,000 price tag and the warning that we can only guarantee removal of 80% to 85% of the tattoo."
Tattoo removal is one way to reach a young, affluent market with cosmetic surgery. The general public has heard and read about "lunchtime surgeries" that take place in a physician’s office with the patient returning to work after the lunch hour.
"I don’t like the term lunch-hour surgery,’" says Harlan Pollock, MD, public education chair of the American Society of Plastic and Reconstructive Surgeons in Arlington Heights, IL. "There are a number of cosmetic procedures that require short recovery times, but you must not foster unrealistic expectations by implying that cosmetic surgery can be performed and recovered from in one or two hours."
The time it takes to perform the surgery is not the key to defining short recovery procedures. It is more important to look at what activities the patient has scheduled after surgery, says John B. Harris MD, head of the plastic surgery section of the Mayo Clinic in Jacksonville, FL. "If a patient wants to return to work after surgery, he or she cannot be taking pain medication," he explains.
Many procedures that fall into this category, such as Botox injections or chemical peels, are performed in physicians’ offices rather than day-surgery programs, says Harris. Surgeries that a day-surgery program staff might encounter, he says, include:
- small liposuction procedures of the hips or abdomen in which the local anesthetic used for liposuction will prevent pain;
- removal of extra skin on the eyelid.
"The eyelid surgery would be for removal of skin only, not blepharoplasty or removal of fat. Blepharoplasty would require bandages and pain medication," he adds.
The best way to appeal to women in their early 30s to 50s who are interested in cosmetic surgery is to offer surgery times late in the week for procedures that have recovery times of three to four days, says Harris. This enables the patient to undergo surgery on Thursday, then go back to work on Monday, missing only one or two days of work and having no visible signs of surgery, he adds.
The procedures most likely to have short recovery times are minor breast augmentation, minor breast reduction, and limited liposuction, says Pollock. Facial surgeries do not fall into this category because there is a lot of bruising, explains Harris.
One advantage of adding cosmetic surgery to a day-surgery program’s service offering: Most centers have the equipment. However, they may need to add liposuction equipment or some lasers, he says.
"If a day-surgery program needs to add equipment, I would recommend evaluating leases because the technology is changing so quickly," says Pollock. "I would not purchase a laser until it had been on the market for a while. This gives the surgery staff time to make sure it does what is needed and to make sure it isn’t updated every few months."
Staffing requirements don’t change as a result of cosmetic surgery, but you may want to take a look at the environment experienced by the patient, says Harris. "It is important to remember that these patients are not sick, so their perception of their experience is different," he explains. A calm, soothing environment that extends from the waiting area to the operating suite to the recovery area becomes a priority, Harris emphasizes.
It’s also important to have separate waiting rooms for patients choosing elective surgery and staff education that emphasizes the need that cosmetic patients are not made to feel self-conscious about their surgery, explains Harris. (See SDS Manager column, Same-Day Surgery, April 1999, p. 46.)
Most cosmetic patients pay on the basis of cash only with payment up front. However, cosmetic surgery programs also can enhance managed care negotiations, says Harris.
"As managed care companies try to attract more subscribers to their plans, they want to add other services that make them stand out from other companies," he says. "Although they won’t pay for cosmetic surgery, they will negotiate discounts for their members as a way of adding value to their health plan."
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