Dr. Bae:
Hey Greg, how you doing?

Greg:
I am amazing Dr. Bae. Hey, I wanted to talk to you about this, you are very transparent with your pricing. You have a pricing tool right here on the website that people can find out how much something cost. Not everybody can pay for everything right upfront I mean, you’re not going to sit here and tell people, “Yeah I can do this for next to nothing.” And I don’t want my surgeon saying that by the way.

Dr. Bae:
Right. Cheap plastic surgery isn’t good and good plastic surgery isn’t cheap.

Greg:
No. So tell me some options that people have, maybe I can’t roll out five, six, seven, $10,000 just right off the bat but I want to get a procedure done that cost that.

Dr. Bae:
Yeah. So it’s a tough question because we don’t want people overextending themselves but there are definitely ways of financing these operations through different services. We don’t actually do any in… people ask all the time, do we do in-house financing? We don’t do in-house financing meaning that we won’t do your operation for nothing upfront and then you pay us back over time. We don’t do that but we do use some finance… You’d be surprised how many people ask that-

Greg:
Well, and by the way, I don’t do that for the radio station either. I don’t say, “I’ll work for a couple of months and you pay me later.” So I get that. I don’t do that either Dr. Bae.

Dr. Bae:
So that’s what I’m hoping is once the utility company says, “Oh, we’ll just give you the electricity [crosstalk 00:01:35] and you can pay us next year.” That’s when I’ll start doing. But for now what we do is that we use some third-party financing companies. We use CareCredit which a lot of people use, not just for cosmetic procedures but if you have a high deductible health plan and you got to pay out of pocket for medically necessary services, people use CareCredit for that, they use it for dental work. So we use CareCredit, We use another company called Alphaeon Credit, there’s Prosper Healthcare Lending. There’s several of them out there and they do things different ways as far as how they pay but the idea is that we get paid upfront for the service from that company and then the patient pays them back.

Dr. Bae:
So like CareCredit for example, they will pay the pers… pay the CareCredit back. The consumer will pay CareCredit back monthly for a certain period of time. And the thing people need to keep in mind there are options. There are some options like you can do six months no interest where CareCredit pays us everything and then if you pay CareCredit back within that six month period, you have to pay them the full amount but no interest that’s pretty awesome. But just to be sure-

Greg:
That is awesome, that’s like cash, yeah.

Dr. Bae:
It’s like cash but just be sure that you’re going to be able to pay it back within that six months because if not, then they are going to start to add interest and the interest is like 26%. It’s very high. Now-

Greg:
Oh, I see you do financial advice to Dr. Bay. So you are a financial advisor and… Yeah I mean, [crosstalk 00:02:55] don’t understand the interest rates and stuff like that so you have to do your research.

Dr. Bae:
Right. And that you got to keep in mind, how do these companies make money? They don’t make money by paying… people paying them back interest free in six months, they make money by people not being able to pay them back in six months interest free and then they have to pay a 7th and 8th month and the 9th month with that 20% interest rate. So of course, whatever advice I’m providing make sure you clear with an accountant first or your tax advisor. But the other thing to keep in mind is like, okay, well still you’re thinking, “Okay. You know what? I can’t afford it six months. I can’t pay it all off in six months so I don’t want us to be stuck paying some usury interest rate for that after those six months.” So the other option you might think is like, “I’ll pay it off over five years or I’ll pay it off over six years.”

Dr. Bae:
And they do have plans like that but keep in mind, those interest rates are pretty high too. Maybe they’re not as high as 26%, but they are may be like 14% or something like that. So they do get kind of high if you’re not going to pay them off within a year or two. So just keep that in mind, be safe, read the fine print. The fine print is there. They’re not trying to hide it from you. They have actually, I think by law had to made the fine print bigger. It can’t be as fine has to be bigger and easier to read. The other thing the state of California has done is that we can’t sign you up for CareCredit. That’d would be the way it could be done in the past and we could be done honestly where we would sign the patient up for CareCredit.

Dr. Bae:
They would give us their information and we would physically sign them up online. Now we no longer can do that. They have to physically log in and sign up for themselves because obviously some doctors may be or some institutions were signing people up without their knowledge so that’s why you can’t do that anymore. We never did that of course but anyway, read the print, know what you’re getting yourself into. And a lot of people you’d be surprised I mean, even if your credit score is not awesome, people are still getting approved by these different companies and they’re getting their procedure and hopefully paying back the company to keep the company whole so they don’t turn them over to collections.

Greg:
All right. And what about crypto coin? Do you take crypto coin? That’s a big thing-

Dr. Bae:
We do actually. You got to-

Greg:
What?

Dr. Bae:
Yeah you got to stay up with all the time. So yeah, we take Bitcoin, Ethereum, Litecoin, Dozer Coin. We [crosstalk 00:05:08]. I don’t know that we can take XRP right now. I think that’s tied up in litigation the SEC or whatever but yeah, we do take crypto coin if people are interested in paying that way. The trick is to get paid by that crypto coin and then cash it out immediately because the price fluctuates [crosstalk 00:05:28]. Yeah somebody can pay you when it’s $10,000 and then when you’re cashing in it’s $8,000, you just lost $2,000 on the operation but-

Greg:
There you go. [crosstalk 00:05:36] got to work out your finances on your end too.

Dr. Bae:
Exactly. That is true.

Greg:
All right. Well thanks Dr. Bay. And if you want pricing, it’s right here on the website, everything is transparent. You can book appointments, you can call to ask questions. You can email to ask questions or probably the easiest way is to reach out on social media.

Dr. Bae:
Yeah, you can reach us on TiTok, Snapchat, Instagram @realdrbae R-E-A-L-D-R-B-A-E. You’re a great spokesperson Greg, I might pay you to do this.

Greg:
Oh, you should in crypto. I’ll take Bitcoin.

Dr. Bae:
Fair enough.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Financing your medical or cosmetic procedure first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Alternatively, if there’s no human on the other side of that conversation, then you’re using a chatbot! A robotic or non-human interface that hopes to understand your natural language and provide you with the information you’re seeking.

But to those of us who’ve interacted with a chatbot before knows, the days of feeling like you’re having a conversation with a human is still not realized. The typical chatbot conversation starts with the chatbot asking how they can help you, hoping and praying you’ll use a keyword the bot recognizes! Almost immediately, it’s clear that a bot using natural language processing can’t help you with your problem. At that point, the chatbot hands off the conversation to a live agent.

A live agent can be expensive. At the very least, it’s another full-time employee. While a company like American Express can afford to staff their own chat platform, most small businesses, like medical practices, outsource their chat capability to 3rd party vendors.

Chatbox vs Chatbot

Chatbox vendors try and keep their costs low, but knowledgeable live agents can be understandably expensive. So we’re left with a conundrum. Live chat that can more ably answer an online visitor’s question but is potentially costly, vs a chatbot that’s more economical but has a tough time answering anyone’s questions?

The answer? A chatbot that specializes in one topic and limits the user to a finite number of choices to ultimately provide them with the answer they seek. By focusing on only one topic, we reduce the complexity of options provided to the consumer, increasing the likelihood they end up where they want.

Take for example, the chatbot I use on my website. Our chatbot doesn’t try and answer every question the user may have. It answers the one question everyone has: “how much does “it” cost?” With ‘it’ being the cost of any procedure or service we offer.

To be clear, that means the chatbot won’t answer any questions other than price. However, when it comes to questions regarding price, it answers the question correctly every time! If the user wants to know about the recovery process, they’ll have to read about it on one of our dedicated procedure pages. If they want to know how to book a consult, hopefully they’ll notice our online booking tool under the Contact tab. At the risk of sounding redundant, if they want to know about anything other than price, they’ll have to look for the answer elsewhere on our site. But if they want to know about cost, we’ve got them covered with either our streamlined “quick and dirty” chatbot or our Price Estimator that offers more information like videos, before and after photos or the ability to purchase non-surgical services online.

What do visitors prefer?

Once our chatbot went live back in September of 2020, we immediately started collecting data. We wanted to know if most interactions came through our website submission form, through our Price Estimator or our pricing chatbot? All three tools have one thing in common: their primary purpose is lead generation, and as such, all three require contact information to work.

In other words, if the user wants to ask a question through our website submission form, they have to enter their name and email address. If they want to check pricing on our more elaborate Price Estimator, they have to either create an account with their email address or sign in using their Google or Facebook accounts. And with the pricing chatbot, they have to enter their name, email address and ZIP code. But no matter what, we capture their contact information for immediate follow up or add them to our email marketing database for future email marketing.

So what did we find? The graphs below highlight some important findings. The overwhelming majority of leads came through the Price Estimator that’s been on our site for years. It’s possible there’s more traffic to this page because of the large number of links to this page in cyberspace.

But notice an interesting evolution in the second figure. Users were starting to use the pricing chatbot more towards the end of the study period. They’re embracing the no-frills chatbot because they’re able to get an estimate sent to their inbox in fewer steps than the Price Estimator. The chatbot, which resides on our homepage, may also be better at capturing the visitor’s attention, compared to the Get A Quote Now call-to-action button that requires users to navigate to the Price Estimator on a separate pricing page. The chatbot may overtake the Price Estimator as our strongest lead generation technique in the months to come.

Which is the best automated tool for lead generation?

The graph below provides a head-to-head comparison of the three lead capture techniques on our website. Included are the number of leads and subsequent consultations generated by those leads.

It would seem that the website submission form is most productive in that two consultations from 18 inquiries were booked. But generating leads and booking consults is a numbers game. The more leads, the more consults. And generating only two consults from the website submission form, regardless of the ratio of leads to consults, is woefully inadequate as a business model.

One could argue the reason we had so few submissions through our website submission form is because they require the user wait on a manual response from our team. In this instant gratification-obsessed world, consumers are more likely to use a more automated option on our website. Like the Price Estimator or chatbot to get an instant quote.

It’s very exciting to see online visitors’ relatively quick adoption of new technology like a pricing chatbot. And not only for us, but also for Netflix reality star Dr. Sheila Nazarian, whose chatbot generated 121 leads in its first 24 hours on her site.

Seeing so many new leads fill our sales funnel, thanks to our chatbot team member, gives me hope that as we exit this pandemic, the future of aesthetics will come out stronger than when we entered.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Why a chatbot is my newest employee of the month! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Introducing BuildMyBod 2.0. The revolutionary way to check pricing from healthcare providers near you. Price transparency in healthcare used to be the stuff of dreams. But thanks to changing policy and political winds, the day of true price transparency has arrived!

Price Transparency and BuildMyBod 2.0: Hospitals

Traditionally, healthcare was the only area of commerce where you would find out the cost after utilizing their goods and services. Not anymore. With the BuildMyBod Health Price Estimator, you can research costs ahead of time.

Since January 1st, CMS, the Centers for Medicare and Medicaid Services, began requiring hospitals to post their prices online in a spreadsheet format. Additionally, the government is requiring that hospitals showcase their pricing within a user-friendly pricing tool. Granted, the tools developed by the hospitals themselves are more user-friendly than no tool at all, but still not as easy as the newly revamped BuildMyBod Price Estimator. For example, see how easy it is to research prices posted by MedStar-Georgetown University Hospital right here!

The user can choose their insurance plan or check the cash pay rate. And as per CMS guidelines, the user can see their potential out-of-pocket cost compared to other insurers. The video below explains how BuildMyBod Health is making it easier for hospitals to comply with these new CMS rules:

See how BuildMyBod can help hospitals with the new CMS price transparency rules

And whether it’s a hospital, surgery center or physician practice, the facility can choose how they want to show their pricing. The cash rate, bundled rate or allowable rate based on the consumer’s insurance.

Price Transparency and BuildMyBod 2.0: Physicians and Practices

As consumers explore pricing prior to a hospital visit, they will come to expect price transparency in all aspects of their healthcare. Eventually, physicians and physician practices will have to provide pricing info on their own sites.

However, in contrast to hospitals that are not allowed to require the user create an account to determine their out-of-pocket costs, physician practices can require the consumer enter their contact info prior to getting a quote. Therefore, physicians have the extra benefit of generating leads through their price transparency efforts.

To make it easier for the consumer, they will be able to create an account with their email address, Facebook or Google (gmail) account! Single sign-on technology is making account creation and lead generation easier than ever.

As consumer attitudes change, BuildMyBod will help private practices and physicians connect with consumers checking their pricing too!

Introducing the BuildMyBod PriceChecker Chatbot

For consumers more comfortable with texting and automated interactions, there’s an even easier method to check pricing. The PriceChecker Chatbot provides a “quick and dirty” method to check pricing.

Sure, it doesn’t provide the patient with video education or the ability to purchase online like the Price Estimator. But it does make the option of checking pricing easy, and front and center on the doctor’s homepage.

The PriceChecker Chatbot may become the practice’s newest employee of the month!

Demo of the Price Estimator and PriceChecker Chatbot

If you’re a consumer and want to check pricing near you, click here. If you’re a provider that wants to generate leads or a hospital that wants to comply with the latest CMS price transparency rules, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Welcome to the future of price transparency! BuildMyBod 2.0 first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Virtual visits aren’t just safe, they’re convenient

Forcing patients into non-urgent virtual visits has made them realize, “why weren’t we always doing this?!” Patient behaviors will change as they recognize the convenience of online doctor visits. First, they will be much more discerning about which visits actually require in-person visits. This will evolve even further once a vaccine is available and we’re truly past the pandemic.

Consider that in-person visits require many patients to leave work early. That consequently requires them to ask their employer to leave early for a doctor’s appointment. Which may or may not lead to a discussion of their particular malady.

Leaving early may also require them to desert some of their duties or hand off those duties to a fellow employee. Which may also lead to a discussion of their medical issues with a colleague.

And this is all before the patient has to contend with a commute to the doctor’s office and the cost of parking. It’s no wonder more consumers will prefer a non-emergent virtual visit if their doctor offers it or if their condition allows for it. If they haven’t already, patients will realize that not only are virtual visits safe, they often suffice for a real in-person visit and are more convenient.

The one issue that may curtail a full blown embrace of virtual visits is the cost. During the pandemic, online visits for COVID 19 related and unrelated issues were covered by insurance companies. Now, as insurance companies curtail coverage for virtual visits, or shift some of the copay to consumers, virtual visits will continue to rise, but possibly not at as steep an incline as seen during the peak of the pandemic. But make no mistake, virtual visits are here to stay.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Virtual visits are convenient, not just for COVID avoidance first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

$300 per day penalty – is it enough?

If hospitals miss the deadline to place shoppable services on their website, a $300 per day penalty will be levied. But if your facility makes hundreds of millions of dollars on average, maybe $300 per day is just a rounding error?!

I’m not suggesting they should fine hospitals a higher dollar amount. Because in truth, providing all of the various types of pricing (bundled rates, cash rates, negotiated rates) for 300 shoppable services , while totally doable, will take a great deal of time. It also depends on the effort hospitals will put forth. Will they just list a huge readable database of pricing along with each procedure? Or will they make it more user friendly and searchable.

Time will tell whether any, some or most hospitals meet the deadline. In the meantime, we will always have pricing available and searchable on our website.

Video: Background to the Trump Price Transparency Rule

Physicians and outpatient facilities: this affects you too!

Physicians, surgery centers and independent practitioners need to get ahead of the curve. Don’t wait for hospitals and insurers to list your rates. Price transparency, when done correctly, can be a customer service satisfier. Whether it’s providing the consumer the bundled rate, the negotiated rate or the cash rate for their healthcare services, the consumer will find it much easier to determine their costs through the physician’s site rather than a clunky hospital or insurer’s site. So don’t think this only affects hospitals. Consumers will expect price transparency from you too!

Dr. Jonathan Kaplan is a board-certified plastic surgeon based in San Francisco, CA and founder/CEO of BuildMyBod Health, a price transparency-lead generation platform. You can watch him operate and educate @realdrbae on Instagram, Snapchat and TikTok.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Will a $300 per day penalty bring hospitals in line? [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

One of the reasons I’ve built a worldview that includes price transparency is because I recognized early on that everyone wants to know cost ahead of time.  So why make it difficult for them. No one likes sticker shock. But there’s another benefit of price transparency.

By knowing the cost ahead of time, the hope is the patient will feel less of an urge to ask for a discount or a special. In other words, “this is the price, be prepared when you come in.” However, as we all know, it doesn’t always work out that way. In this Amazon world, discounts and specials are just a way of life. If left unchecked, discounting and specials can lead to a race to the bottom where everyone is undercutting their competitors. This potentially leads to the cheapening of a brand.

Which is why bargaining, an even more insidious cousin of discounting and promotions, takes things a bit too far. If you have to choose between the two, discounts vs bargaining, discounting is the lesser evil. If we embrace discounts and promotions in certain circumstances using certain techniques, we can “build a fence” around the potential for bargaining so that it never gets to that point.

Bargaining in a bazaar may be in the natural order of things in that setting, but it has no role in healthcare. Even for medically unnecessary aesthetic procedures.

How to use discounts and specials the “right” way

Having a set program or programs to allow for discounting can be an effective way to draw patients in. And at the same time, avoid cheapening the brand.

In our practice, we offer discounts and specials in three different formats. While they all provide a discount to the patient, there’s an equally important benefit to the practice, in addition to greater patient volume. In each format description below, take special note of the additional benefits that show how discounting and specials can serve a greater purpose.

Online purchases

On our website, we allow patients to purchase non-surgical services (neuromodulators like BOTOX®/Xeomin and fillers) and skin care products online.  And when these purchases are made online, a nominal discount is included.

Even before we realized the benefits of contactless payments during the pandemic, online purchasing is just plain more convenient. Convenient for the patient and the practice. Consider a patient that purchases skin care online. Tax, shipping and a discount are already  included. This saves the patient from having to come in unnecessarily but it also encourages the patient to continue taking the path of least resistance. Why seek out another practice when the patient can get the products (or prescription creams) they want delivered to their door with just a few clicks!

For injectables like Botox or fillers, the patient of course still needs to come in for treatment. But similar to buying a movie ticket online, there’s no need to stop at the front desk/ticket booth to make a payment. The transaction already occured online. More importantly, there’s the added benefit of privacy for the patients by not having to check out on the way out the door.

On an equally practical note, how do practices that run specials keep up with all of the deals swirling around all the time? Have you ever sent out or received an email from an aesthetic physician’s office? There’s a ton of specials listed! How does the front office staff track the current specials and not accidentally discount the wrong item for the wrong amount? With online-only discounts, they’ll always pay the correct amount. In our practice, whenever a patient purchases online, a voucher is automatically generated that clarifies the amount paid and the amount of product or Injectible they’re eligible to redeem.

We’re fans of online purchasing. Here are some of the benefits:

1. contactless payments
2. enhance privacy by avoiding front desk checkout
3. reduce lost revenue from inaccurate discounting

Subscriptions and Memberships

This specials format includes recurring payments that either cover the entire cost of the service in question (subscriptions) or give the consumer access to additional discounts in the future (memberships).

For subscriptions, payments are structured so that a monthly payment covers the entire cost of a discounted quarterly treatment, such as Botox. Therefore, when the patient comes in for their treatment every three months, they pay nothing out of pocket during that visit. Psychologically, if the patient feels like the treatment cost nothing at the time of their office visit, they’re open to purchasing another service. Thus leading to greater, unexpected revenue.

Memberships involve lower monthly payments that don’t cover the cost of any service. But they do offer the availability of VIP (discounted) services. Similar to subscriptions, patients may rationalize additional purchases because of the savings.

While a one-time online purchase described above has the benefit of capturing the patient, it doesn’t incur loyalty the way subscriptions and memberships do. With recurring payments and repeat traffic, this is the easiest way to build a long-term patient-doctor relationship.

Consider subscriptions and memberships to realize these benefits:

1. loyalty
2. recurring revenue
3. increased revenue from the purchase of non-subscription items while in the office

Day of consult discounts

Consider this scenario that takes place in most offices: A patient puts down a deposit to hold their place for a larger procedure. Then, 2-3 weeks prior to the procedure, the balance is due. Capturing the balance is never as easy as one would hope.

Often times, the office staff must go to great lengths to track down the patient to collect those remaining funds. Multiple phone calls, patients not calling back, endless games. And even if it doesn’t require multiple phone calls, it still requires at least one, potentially avoidable phone call.

Why do physicians’ practices put themselves in this time-consuming position? Wasting so many hours following up with the patient, trying to collect prior to the procedure? Not to mention the angst of wondering if the patient can pay the balance in advance of the operation. Or the frustration of postponing the procedure because they can’t. Which in turn leads to awkward conversations, hurt feelings, miscommunication and potentially a bad online review.

Wouldn’t it be great if the patient would book and pay in full at the time of the consultation? That would have the benefit of less wasted time trying to track down the patient and your office staff wouldn’t feel like a bounty hunter! With the right incentive, it’s possible.

At the time the patient schedules the consultation over the phone, we let them know the probable cost of their procedure. This is based on the information they provide regarding their concerns. We let them know that if they come in prepared to pay that amount in full at the time of consultation, they’ll receive a discount ($1000 for a procedure greater than $10,000 or $500 for a procedure less than $10,000).

This discount is a great benefit for the patient but clearly, there’s also a huge benefit to the practice. We gain increased productivity not chasing patients for the balance of their procedure. With a combination of price transparency prior to the consultation and incentivizing the patient with a discount, 72% of patients that booked surgery at the time of their consult paid in full, including procedures costing $22,000!

Benefit to the practice:

1. improved cash flow with full payment up front
2. incentivize only the most serious patients to come in for consultation
3. avoid wasted time on tracking down patients for the remainder of their balance

Summary

Bottom line, don’t discount without a purpose! By linking discounts and specials to  specific goals, other benefits will reveal themselves. These include 1) improving cash flow, 2) incurring loyalty, 3) increasing productivity (reducing time wasted), 4) avoiding confusion in regards to which specials are being offered and 5) having enough hard-wired options for discounting that a reasonable patient knows the practice’s disposition on price, and never has the opportunity or urge to resort to bargaining.

Let your competitors race to the bottom while you stay above the fray!

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Discounts and specials? Sure. Bargaining? Absolutely not. first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

After the protests in June, and celebrations involving Memorial Day and July 4th weekends, we’re seeing an inevitable surge associated with mass gatherings. This leads to a continuing shelter-in-place, reducing travel plans and working from home for the foreseeable future. These mass gatherings and changes in consumer behavior are leading to a surge in both coronavirus and cosmetic surgery. What’s the connection?

Coronavirus and Cosmetic Surgery are surging

This phenomenon of increasing cosmetic surgery along with an increase in the coronavirus was recently highlighted in this article.

Since March, consumers are home, on ZOOM, seeing their reflection more than ever before. Naturally, some will see things they want to address. Like Botox or fillers for wrinkles.

They’re also realizing this is the best time to get that Mommy Makeover or other procedures they’ve been considering. With trips cancelled, that frees up more disposable income. And with the ability to work from home after a procedure, it’s easy to avoid questions from coworkers about why you were “out” or what you had done. If you just had a Brazilian Butt Lift, you won’t have to explain why you’re sitting on a pillow!

This increase in cosmetic surgery isn’t isolated. Across elective surgery websites, including BuildMyBod.com, where consumers can check pricing on outpatient services, traffic is up 73.4%! So while not everyone is getting cosmetic surgery or other elective procedures, they’re certainly considering it.

Think of a sales funnel. More consumers are entering the top of the funnel and checking pricing. As more folks enter the funnel, more will progress through the funnel, ask questions, schedule consults and then book surgery.

Safeguards with coronavirus and cosmetic surgery are surging

With the increasing surge in both coronavirus and cosmetic surgery, new safeguards are necessary. For plastic surgeons that perform cosmetic surgery at hospitals, their ability to operate is being curbed. As discussed here, cosmetic surgery is slow to start for several reasons at hospitals. Most significantly, the need for hospitals to make up lost revenue with better paying elective cases like orthopedic procedures.

But for outpatient surgery centers or office-based operating rooms, surgeons are performing a great deal of cosmetic surgery. To keep those patients safe, patients are undergoing COVID testing in the community prior to surgery. And in some offices, like ours, we perform an antibody test the morning of surgery.

While the coronavirus is a serious ongoing pandemic, it’s becoming increasingly clear that the end is not in sight. Therefore, we must mitigate the risks and move forward with our lives as safely as possible. That includes accommodating patients that want non-essential procedures such as cosmetic surgery. And based on web traffic and bookings, they’re clearly on board.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Why coronavirus and cosmetic surgery are surging first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Let’s review the initial response to the first wave of coronavirus by hospitals, city and state governments. Hospitals cancelled elective cases. Cities and states ordered a shelter in place order, shut down restaurants and closed parks and beaches.

These techniques were able to mitigate some of the worst predictions. 100,000 deaths instead of 2 million deaths. The healthcare system was not overwhelmed as it was in Italy. We should consider these results a success. However, aside from expected economic consequences, there are unanticipated consequences of shutting down our communities. Those of which will become clearer in the weeks and months ahead.

As we navigate this post-COVID world, we will carry forward some best practices. But we’ll also learn what we can not do during the next, new surge of coronavirus cases.

New surge of coronavirus: what’s not going to happen

As we well know, hospitals became solely focused on the coronavirus. Entryways required screening of every healthcare worker. Visitors were not allowed to be with their hospitalized loved ones. All elective cases were cancelled. Aside from the economic damage, this created a backlog and delay of care. Regular screenings were also delayed. This affected the timely diagnosis of cancer, heart attacks and strokes.

In a recent NY Times op-ed, the CEO’s of Cleveland Clinic and Mayo Clinic paint a very disturbing consequence of delaying care for non-covid patients. Across the country, there was a sizable decrease in new cancer diagnoses (45 percent) and reports of heart attacks (38 percent) and strokes (30 percent). Cancer, heart attacks and strokes were/are still occurring. They just weren’t being addressed in a timely manner. This means there will be many preventable deaths in the coming months.

In the case of cancer alone, the Cleveland Clinic and Mayo Clinic calculate there could be a quarter of a million additional preventable deaths annually if normal care does not resume!

That means, even if there is a new surge of coronavirus cases, hospitals can’t stop screenings. They won’t stop elective care. Aside from saving patient lives, forging ahead with routine care will save the hospitals economically. This doesn’t mean they’ll dismiss the seriousness of the coronavirus. It means they will incorporate what they have learned during these last several months with testing and screening and perform those duties in parallel with non-covid care.

What cities and states won’t do during a new surge of coronavirus

Because of the economic devastation, cities and states won’t be able to shut down economic activity as they did previously. Just as the hospitals learned how to mitigate coronavirus cases and forge ahead, communities will have to do the same.

They will not shut down restaurants. They will instead encourage limiting capacity of patrons dining in and encourage takeout and delivery. The self care industry like barbers and nail salons will not shut down either. Everyone will continue to wear masks, wash hands and practice social distancing amongst other customers while getting their hair cut or nails painted.

In other words, a new surge of coronavirus is inevitable. But the political will and public cooperation for a complete shutdown is not. We can’t afford it as a country and citizens won’t tolerate it. However, that doesn’t mean everything will proceed like “normal.” We will all take what we learned during the pandemic and apply best practices to our daily lives, while also continuing with our daily lives. A complete shutdown is not in our future, even if a surge is.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post What’s not going to happen if there’s a new surge of coronavirus first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

When we consider black swan events, which I’ve discussed here before, they’re often looked at in a negative connotation. And rightly so. But in an effort to find a silver lining to this pandemic, we should consider the pandemic as a black swan event, a once-in-a-lifetime opportunity to make a dramatic improvement in society. There are many changes that will occur post acute phase pandemic. As we enter this new chronic pandemic phase, things will change. Ironically, many changes will result in better customer service in the healthcare setting. One example? No more waiting in doctor’s offices!

No more waiting in doctor’s offices

If you’ve received an email from your doctor as they start to see patients in person again, you’ll notice a common thread. They all detail the changes you should expect when coming into the office. This is part of phase 2 in many states. Our office is no different.

Based on the San Francisco Mayor’s recent announcements and clearance by the Department of Public Health, hospitalizations due to the coronavirus are flat which means we can resume non-essential services as part of Phase 2 on Monday, May 18th.

Just as so many other physician office’s prepare for this next phase, we are implementing several safeguards as well. Our office building already requires that everyone entering the building wear a mask. But standalone offices are requiring the same of anyone entering their office.

Many offices will begin spacing appointments further apart so patients can be brought directly to the exam room after entering the office and having your temperature checked. That means no more waiting in our waiting room! This is a huge paradigm shift for patient care and customer service. Something that has been a long time coming.

Doctors and staff will also wear masks during consultations and treatments. To ensure patients don’t come into the office sick, staff will confirm they are not experiencing any symptoms associated with COVID-19 such as fever, cough, loss of taste (ageusia) or loss of smell (anosmia) before they leave home.

Elective surgery

For facilities that offer surgery, this will also be a new experience. Elective procedures that were originally postponed will be allowed to reschedule. That means rescheduling hip and knee replacements. Or cataract surgery. But for hospitals and surgery centers that have lost a great deal of revenue during the pandemic because they had to cancel elective procedures, they will probably not allow cosmetic procedures for the time being.

Why the difference? For patients undergoing cosmetic procedures, they must pay out of pocket. For the surgeon’s fee and also for the facility and anesthesia fee. When comparing cosmetic vs medically necessary, insurance-based procedures, hospitals get paid a small facility fee from cosmetic patients. So if the name of the game is prioritization of procedures as facilities ramp back up, they will preferentially go with better paying procedures, of which cosmetics is not.

Benefits of an office-based operating room

To be clear, this is not because cosmetic procedures are not allowed. On the contrary, new health orders are allowing any type of elective procedure, including, and without limitation, cosmetic and dental procedures. But there is a caveat. Facilities that resume elective procedures must have a protocol in place that ensures the safety of the surgical patients. And since it appears most hospitals and surgery centers will not prioritize cosmetic procedures, patients may find it’s easiest to schedule their cosmetic procedure in an office-based operating room like ours.

Here are several surgery specific protocols that facilities, including ours, will put in place to avoid the possibility of operating on a COVID+ patient. We are requiring all surgery patients to obtain a COVID test at one of the free testing centers in the Bay Area prior to their surgery date. As a follow up, we will also perform a rapid COVID-19 antibody blood test the morning of surgery. This is to rule in (or rule out) exposure. But also, this test will confirm they possess antibodies that confer immunity to the virus.

Flattening the curve

Based on recommendations by the country’s foremost experts, a complete return to normalcy via a vaccine or herd immunity, may take at least 18 months. Sadly, waiting to reopen society once there is absolutely no risk of contracting the coronavirus is not realistic or plausible. That is why we as a society must restart, with safeguards in place. Throughout this entire crisis, the overarching goal was to flatten the curve (and thus far, at least as San Franciscans, we have done that), not eliminate the curve.

In other words, the goal is to minimize the number of people that get COVID-19 at any one time so as not to overwhelm the healthcare system. To that end, the shelter-in-place and quarantine are relaxing in a way to allow life to move forward. And at the same time continue with various forms of surveillance and social distancing to minimize the risk of spread.

The irony is these changes will actually provide much better customer service than many expect from the healthcare system. From more convenient virtual consults to no more waiting in doctor’s offices. We can use this opportunity as a black swan event of improvement, not failure.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post No more waiting in doctor’s offices! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Virtual consults are nothing new

The first thing that should be made very clear is that virtual consults are nothing new for us. We’ve always offered them as an option for out-of-town patients but also in-town patients that couldn’t get off of work early enough. The only thing that’s changed now is that virtual consults are the only option during the shelter-in-place.

After the shelter-in-place designation is lifted, we will continue to “push” virtual consults as our preferred method of seeing patients who want to discuss surgery. Yes, that means that the first time we see the patient in person could be the morning of surgery! While that may seem odd to see your surgeon only for the first time the morning of surgery, in the age of social media, there’s more to the story.

The patients that we see in our office virtually or in-person, are rarely seeing us for the first time. Most of our patients have been following us on social media, watching us operate, for months, before their consultation. So it’s not accurate to say they’re seeing us for the first time on the day of surgery. Because even before the virtual consult, they were seeing us operate and interact in our office on social media day in and day out!

Why we charge for virtual consults, just like regular consults

Whether it’s virtual or in-person, the doctor still avails the patient of their time and expertise. Whether it’s in person or not, that fact doesn’t change. So the fee shouldn’t change either. In fact, one could argue that, in the case of virtual consults, the consultation fee is a convenience charge! Because of the virtual consult option, the patient avoids the imposition of asking to leave work early, then driving to the office and searching for parking.

That being said, we did toy with the idea of not charging for virtual consults when this crisis began. We thought it might give people stuck at home something to do. But guess what we found? Just as we made it so easy to book a virtual consult online and not charge for it, it was just as easy for patients not to show up! With a greater than 80% no show rate, we reinstituted consult fees. In other words, those no shows ruined it for everyone!

So we’re back to charging for virtual consults and we’ve had a no show rate of 0%. We also have much more serious patients booking consultations. If you’re considering a cosmetic procedure, click here to check pricing online and then schedule your FaceTime or Skype consult online here!
 

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Yes, we charge for virtual consults first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Why San Francisco is ready to reopen for business

As I discussed here previously, San Francisco has had fewer COVID-19 deaths than most large cities in the country. The city benefited from the early institution of shelter-in-place orders. Additionally, the large number of tech workers in the area began working remotely even earlier in the month of March. These early social distancing recommendations are having far reaching benefits in San Francisco.

There were only 12 COVID-19+ inpatients at all three Sutter Health CPMC San Francisco  hospitals as of Friday, April 10th. Clearly, not every city has these same low rates of inpatient admissions for patients with the coronavirus. And that’s why the decision to reopen for business or relax the shelter-in-place orders are not a national-level decision. These decisions are necessary on a local and regional basis, when appropriate, in coordination with state decision makers.

Because there are so few COVID-19+ inpatients in San Francisco, that means the hospital has the capacity to accept more of these patients if necessary. But it also means hospitals can start performing elective procedures again. With beds available, we can reassure every patient they will have a bed if needed.

Concerning news for San Francisco

While San Francisco is controlling the outbreak with social distancing, there is a potential problem on the horizon. On April 10th, public health officials announced that 70 people at San Francisco’s largest homeless shelter were found to be COVID-19 positive.

At this time, it remains to be seen if this will lead to the surge that has yet to materialize.

Benchmarks before reopening businesses

Based on the roadmap to reopening issued by former FDA commissioner Scott Gottlieb, there are four benchmarks before we can move to the next phase (Phase II) of this crisis. In his words, the current quarantine and shelter at home is Phase I. Now that we have 1) a reduction of patients needing inpatient medical care over the course of 14 days (one incubation period) and 2) hospitals in the area can safely treat all patients requiring hospitalization, San Francsico satisfies two of his four milestones at this moment.

The third and fourth benchmarks include widespread testing along with active monitoring and tracing of all confirmed cases. This is possible to implement over the remaining days in April.

On a case by case basis, doctor’s offices can join the city and other lab testing facilities in providing rapid testing capabilities to our citizens. My office is receiving delivery this week of antibody testing kits. These rapid blood testing kits can determine if one of my patients has 1) not been exposed to the virus, 2) was recently exposed and does not have full immunity yet or 3) they’ve been exposed and now has full immunity. If any patients test positive, but not yet immune, in our office, they will be sent home or to the hospital depending on symptomatology and they will be reported to the CDC.

The last requirement to move on to Phase II, contact tracing, will be available by the end of April. This includes the notification of an individual via smartphone if they’ve been near someone else that has since tested positive for the virus. By tracking this information, affected individuals can be monitored, sent home, isolated or seek out treatment. The technology to accomplish this is being provided by both Apple and Google. The software or API (application programming interface) they’re building for health department apps will have interoperability between both iPhone and Android.

Guidelines when reopening businesses

According to Gottlieb, in Phase II, the majority of schools, universities, and businesses can reopen. The truth is, many governors are leaning towards leaving schools closed for the rest of the school year. But working from home, when feasible, should continue. And he suggests gatherings be no more than 50 people at a time.

While grocery stores and convenience stores can limit the number of people that come in at once, this is a more complicated decision for restaurants and bars. Many restaurants can continue delivery through DoorDash, Caviar, Postmates and UberEats. And I suppose dine-in restaurants can operate at 50% capacity where some social distancing is possible.

However, most restaurants operate on a thin margin. Being in a situation wherein their expenses/payroll are at pre-pandemic levels, but the restaurant is generating half the revenue may be untenable and impractical. It will also be interesting to review the numbers, when available, if restaurants whose business model is not meant for delivery and take out only, are generating enough revenue.

When it comes to bars, is there any scenario where they can reopen during Phase II? Bars seem to be less conducive to social distancing and more likely for patrons to be in close proximity to one another. Can a bar operate at 50% capacity? This may be a decision for a later phase.

Having realistic expectations

It’s critically important the public understands it’s not realistic to expect no one to get sick during the process of relaxing social distancing protocols. We just have to minimize the number of people that get sick at any one time. That’s what flattening the curve is all about.

We should not frame the question as, if we stop social distancing too soon, will people die? Unfortunately, it’s inevitable that as home quarantines are lifted, more people will die. More people will contract COVID-19, some will require admission to the hospital, and a few of those people will then go to the ICU and succumb to the virus. That’s unavoidable to some extent.

The right question is, how to do we relax social distancing, lockdowns and quarantines in such a way as to reduce the possibility of a spike in new infections that overwhelms the healthcare system? Just as flattening the curve was the goal at the beginning and in the midst of this crisis, flattening the curve is still the goal as we start to return to a more normal (but definitely not normal) way of life.

A phased return to “business as usual” is necessary. But only in areas that are ready based on the four benchmarks above. With contact tracing and rapid immunity testing, businesses can reopen. And as time goes on and new data becomes available, more test-proven immune employees will be able to return to work. We can eventually gather in successive waves of 50, 100, or a 1000 people. And then one day, we’ll be able to attend an NFL game. One day.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post America has to reopen for business… but not at the same time first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

This weekend, Dr. Jonathan Kaplan, Founder/CEO of BuildMyBod Health is lecturing on social media and social media influencers at the AACS in Vegas!

BuildMyBod Health: A primer

For those of you not familiar, BuildMyBod Health allows consumers to check pricing on healthcare services that are typically paid out of pocket. They are paid out of pocket because 1) you haven’t met your deductible for a medically necessary service (think colonoscopy, lab test or X-ray) or 2) because the procedure is considered cosmetic and insurance doesn’t cover it anyway. Consumers interested in pricing can visit BuildMyBod.com or download the BuildMyBod iPhone app. Even more user friendly, consumers can utilize the BuildMyBod Price Estimator on a doctor’s website.

Regardless of how you find the doctor, you add procedures or services of interest to your “wishlist.” Then submit your wishlist along with your contact info. After that, you’ll instantly get an email with a breakdown of the costs and the doctor’s contact info. The doctor’s office will also receive your contact info for follow up. By receiving your contact info, the doctor’s office can help you navigate through the healthcare process.

What presentations are on tap at the AACS?!

On Saturday, Dr. Kaplan will speak on utilizing social media influencers in your practice. What’s the difference between influencer pages on Instagram and social media influencers? How can you tell if a social media influencer that wants free product to promote your practice has a legitimate following? Dr. Kaplan will provide the attendees with the tools and knowledge to answer these questions.

If you’re attending the AACS in Vegas, be sure and attend his lecture and panel discussion. It’s not everyday you learn something new!

To check pricing on healthcare services through the BuildMyBod Health platform from a doctor near you, click here. Or to sign up as a provider and offer pricing information to consumers in an automated way and generate leads, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Dr.Kaplan speaking at AACS in Vegas this weekend! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.