You're an Internal Medicine Attending at a hospital in Denver. How (and why) did you end up making a move into cosmetic medicine?

With the countless all –nighters as a resident and staying up studying through out Medical School, I started thinking of preventative ways to treat my skin. While researching ways that I could keep from aging, I became intrigued with lasers and how much they could change the skin. The more I learned about Botox and lasers, the more I realized how dynamic the aesthetic side of medicine is. My overall goal when starting Vitahl was to bring together a luxurious spa environment with the safety and professionalism of a medical office.

You've got two physicians, a NP, a PA, and a sizeable staff. How is your clinic organized and operated?

Vitahl is physician owned and operated. Our physicians are on-site to oversee all medical treatments performed in the office. Our Office Manager oversees all other day-to-day practices and supervises the employees. We have a team of ten employees, including doctors, nurse practitioners, physicians assistants, medical aestheticians and administrative staff. We offer a wide range of laser skin procedures, injectables, surgical and non-surgical body contouring, cosmetic surgery procedures, and facial treatments. vitahl is located in upscale Cherry Creek North in Denver, CO.

Staff compensation for clinical staff is a combination of hourly plus commission. We have different levels of clinicians, and pay increases as clinicians are promoted to higher levels. In the past we were commission only, however, we changed to hourly plus commission because we found that with commission only that our staff did not realize that patient care is about more than doing the actual treatment, it also about educating patients pre-treatment and following up with patients post-treatment.

We try to be smart about hiring, but often times it is difficult to get a good feel for a clinician until they are working in the office. We evaluate our new employees at 30, 60 and 90 days and if they are not meeting the standards we have set forth we fire them, and look for a new employee. Our goal is to keep turnover low, however, we also want a strong team that puts patient care first.

What IPL or laser technologies are you using? What are your thoughts about the technologies you’re using now?

In addition, we recently brought on miraDry, the first long term treatment for hyperhidrosis and Cellulaze, the first FDA approved procedure for long term results of Cellulite reduction. We have been pleased with all of this technology as well as the companies who make the machines. I stay on top of laser lechnology and choose the best machines and treatments available through research in the field of Lasers. With a wide variety of Laser companies and the ever changing technology it is best to continually be watching the trends and technology to stay ahead of the game in choosing the best Lasers technology and Treatments.

Wha are the hits and misses in marketing your clinic?

Marketing has definitely evolved over the years. We have transitioned from all print ads 7 years ago to mainly online, some print, and billboards over the last few years. If you’re not on Google you aren’t relevant. Medical sites with aesthetic focus have been great for us as well. Local listings are very important for branding and we try to remain an active part of our community here in Denver.

What treatments or services are most profitable for you?

Lasers and injectables are our most profitable services on the aesthetics side. We keep in mind that with injectables we have a variable cost based off the number of units of Botox or syringes of Juvederm we use, while with lasers we have a fixed cost based off our monthly lease payment. So the more Botox we sell the more we have to pay to purchase the Botox, and with lasers, if we sell more we make more because we are paying the same amount for our lease whether we sell one procedure or 100 procedures a month. In addition, two years ago we added a plastic surgeon to our practice. Cosmetic surgery is a profitable and growing business model and only adds success to our business.

What have you learned about patient care?

Treating patients comes with the responsibility of making sure a patient is all at once healthy physically and mentally for the cosmetic procedure, this poses challenges from time to time. Many patients do not consider aesthetic treatment and cosmetic surgery to be medical treatments. I have learned that as with any other type of medicine, you need to keep patient safety a priority.

We have turned patients away

One of the most memorable stories came as I was injecting a patient, it was his first time getting Botox and as soon as I finished injecting him, he bent forward and passed out! I hollered for some help from the staff, but a few smaller females trying to catch a 6 foot man from sliding out of the injection chair was a comical experience to say the least. We have all heard the saying “Pain is beauty,” you would be surprised with the number of patients whom are afraid of needles and conquer their fear to get injected.

What advice would you give to fellow physicians starting or operating a medical spa?

It is better to start small, doing fewer treatments and then add on additional treatments as you get busy. That said, it is also good to have a variety of different treatments, like Botox, laser hair removal and laser skin treatments. There is not one treatment that will be good for the different patient markets you are targeting. I learned that the best time to buy a new laser is when patients are asking for it. For example, I added fractional lasers when I had a lot of consults where my recommendation for the patient was fractional lasers and I did not have one. Stay current on the latest technology, even if you are not offering it. Patients do a lot of internet research and they expect their physicians to know about all of the treatments available.

About: Dr. Tahl N. Humes graduated Medical School at Touro University in California, and Residency at Saint Joseph Hospital in Denver. She trains physicians, nurses, and PAs from across the nation on lasers as well as in Botox and dermal filler injection techniques.She has been interviewed for her cosmetic medical expertise by news affiliates ABC, CBS, and NBC. Dr. Humes has participated in philanthropic medical care throughout her career. She has worked with the indigent population of Denver as well as participated in Medical Missions in Guatemala through DOCARE International.

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.