Speaker 1 (00:06):
You are listening to the Aesthetically Speaking podcast presented by Nextech.

Tyler Terry (00:14):
Hey guys, welcome to our first episode of the Aesthetically Speaking podcast. I'm your host, Tyler Terry, and today's episode is on the five medspa trends you need to be ahead of in 2024. Today I have a very special guest. Her name is Robin Ntoh. Robin is the VP of Aesthetics at Nextech. Robin, welcome to the podcast.

Robin Ntoh (00:39):
Thanks, Tyler. I'm really excited to be here today. Looking forward to being part of Aesthetically Speaking, great opportunity for us to learn more about aesthetics and engage more with our audience.

Tyler Terry (00:51):
Yes, yes, super excited to have you here. You and I have actually talked about this podcast and dreaming it and building it for quite some times. I'd love for you to share a little bit about your background, what you love most about aesthetics, and just to tell us a little bit about you.

Robin Ntoh (01:08):
So I really worked in this industry for greater than 30 years. It's one of those things, got to give away the age a little bit here, but I started in a facial plastic surgery practice and from there just gained the basics of running a practice and I learned all of the positions in the practice. So the insights of working for an aesthetic practice, also some components of the insurance world simply because in facial plastics there's still a lot of insurance around the ear, nose, and throat perspective. Beyond that, I started working for a company that many of you know as Canfield, which was back then called Mirror software. So I gained a lot of insights in how you actually work around the photography world and especially ingrained in the plastic surgery arena following a shift in what they were doing and they moved on and were acquired by Canfield.

(02:00):
I went to work for myself. There was demand, I had opportunity, and so I started my own consulting business and after 20 plus years, I decided that it was time to hang up my hat and Nextech approached me and said, we really would like to look at how do we achieve more with our customers? How do we get for them the things that they need that are pivotal to their business, especially with the changing economics? And so they asked me to launch the consulting division. So a little bit more than seven years ago, we started the Nextech consulting division, which was unique for a software company. Most software tech companies really focus on using external people to really focus on their niche and knowledge around that industry. And so we brought it in-house and what better way to do it. Now we had not only just product experts, but we had a team of people that were practice management experts and they were also experts just in that industry space.

(03:01):
So when you think about the trifecta of how that really focused on improving the lives of our practices and what their needs were, incorporating the solutions that Nextech was really noted for in the aesthetics industry, it really made sense. And so seven years later, we've grown to over 450 clients that use those services in many different levels. And so it's exciting to actually then take that to another level and really take where Nextech gained its roots, which is around plastic surgery and focus on aesthetics. And part of the role that I fulfill in this business is really helping to bring together both those external resources and the market share as well as the internal resources and bring that all together with respect to how we look at and manage aesthetics. If you think about it, there's a lot going on in this industry. So, a lot of learning.

Tyler Terry (04:00):
If I'm listening to this and whether I'm a plastic surgeon, a med spa, dermatologist, what are some of the things, when I partner with a consultant at Nextech, what are some of the things that you'll immediately come into my practice and help me with or look at increasing the efficiency on?

Robin Ntoh (04:17):
That's a great question. We really start with your current state. Where are you with the usage of your product? Are you gaining all the efficiencies that you can? So we start with something as simple as a health check. So we come in and the team will actually do some data polls actually. So a lot of times what we would find with practices is that they just didn't know things that they weren't using well or were using at all. There was modules or features that were just kind of sitting in the background, almost gathering dust if you would say. So it was nice to actually show them that a lot of times the tools were already there, they just needed to understand how to use them better. A lot of times we also heard practices talk about data, and data's a big deal. Data is big in the industry.

(05:06):
People are selling data, they're using data for different ways to understand the trends. But within your own practice, it was key to understand where data helps you. So a lot of times practices would come to us and say, my data is just really bad. I haven't done a good job of maintaining it. My teams have not necessarily been diligent and putting it incorrectly. And so now I don't feel like I've got good data. Can I just start over? So we found opportunity there to teach the practices how to use some of the tools that were cleanup tools. And those cleanup tools really helped them get a foothold on data that was already there and still good, but just clean it up a little bit. So for example, think about referral sources, think about how important those are to a practice. You think about, well, how much money do I spend on marketing?

(05:53):
What is really gaining me momentum? What leads are coming in? What leads are converting? Where do my leads convert better from? Are they converting better from the web or are they converting better from my physician referrals? What are the top trends that I'm seeing with my referral sources? But if I'm not putting a referral source on my patient or my leads when I put them in the system, then how do I get that information? Or maybe I've diluted those referral sources and just really taken a list that's really should be about 10 and made it about 25. So we would teach the practices how to use the tools within the software to clean those things up so that they could start utilizing that data. They really don't have to start over. They just had to learn how to use what was there and then teach your staff how to do it correctly.

Tyler Terry (06:40):
And so Robin, in your 18 years at Nextech, I'd imagine you've seen innovation and growth and surprising places. Looking back, did you expect that non-surgical aesthetics would become so mainstream?

Robin Ntoh (06:55):
I think it's always been there. If you think about what aesthetics really is, it's just really helping consumers attain the level of beauty that they are innately looking for. And so the market has always had that desire or need. The consumers have always looked for it. If you think about it, it's just human nature. And what has happened is that manufacturers and economics and social influences and something as simple as a pandemic have drivers that have actually made it grow in different ways. The other thing that's really helped this grow and shift and change is just the generations that are part of the aesthetic market these days. If you think about it, we've got five different generations in the workplace, but we also have five different generations as aesthetic patients. And so aesthetics has always been there. It's just redefined itself. It's grown, it's changed, it's evolved as it should, and it would based upon all of the different factors involved.

Tyler Terry (08:01):
When did you first see wellness services like hormone replacement, and there's a lot of different things, IV. When did you first start to see those things being offered in aesthetics?

Robin Ntoh (08:16):
Ah, The Sleeping Giant, wellness. Well, wellness has been around for many years. I think that we've seen it in different ways. There's the concierge medicine component. There's been always a focus on weight loss, and we've seen the different types of diets, the fads that have come and gone, those that have still stuck around, and then obviously the new things that have come into the marketplace. But wellness is definitely something that, again, not to reiterate something, but if you go back and think about the generations in the marketplace, especially Gen Z, they're very focused on mental awareness and mental health and wellness is encompassing of that. And so it's natural that people start thinking about not just looking good but feeling good. And wellness has so many components that are not going to be covered by insurance. You're not going to be able to go to your doctor because the doctors are not necessarily focused on preventative care.

(09:19):
They're more focused on healing or treating what your ailment is. So if we think about how do I become proactive, just that we're proactive in beauty and we think about pre rejuvenation, that's another buzzword these days. How do I maintain or I stay ahead of aging? People are starting to think about that from a wellness perspective. And so wellness has been there from the financial marketplace. I've seen the numbers, it's growing, but I also think that now you think about your med spas and your plastic surgery practices or dermatology aesthetic practices, they're starting to see, well, why not provide this because it compliments the other services that I already offer. And so you're starting to see them lean in on some of those services and adding them into what offerings are, and that makes sense because people don't necessarily want to have to go to five different places if they can go to one place, make it a one-stop shop to really get the treatments they need. So I think what we're definitely going to see is as practices have the providers that are there to provide these services, they've got the software and the systems and the SOPs in place to support them as well as the staff that to help manage whatever efforts come in from leads or marketing efforts. Then I think you're going to start to see that there's real growth in some of our meds spas and some of our other aesthetic practices.

Tyler Terry (10:47):
So as the industry's growing, we have patients becoming more aware and more excited about receiving treatments and receiving aesthetic treatments. But at the same time, we have medical professionals like ER doctors and nurses who are jumping into the industry because they are finding a passion for it, and maybe they're even passionate about it as a patient and it speaks to them. But we're seeing this growth in the number of practices opening all while the number of patients that are wanting to be treated. So I'd love for any thoughts or feedback on that.

Robin Ntoh (11:23):
I think it's a natural career path for a nurse that wants to really understand or just participate in an area of beauty. I mean, that is definitely where there's opportunity, especially if they've become a nurse practitioner. One of the things that is ideal about nurse practitioners is that they don't necessarily have to practice under an MD or do again, all of these fall under state regulations. So we know there's a lot to dig into that, and we're not going to go down to that path today. But I think that it's a career opportunity. It's appealing, it's exciting. I mean, everybody loves it when you say, "oh, I work with plastic surgeons" or "I work in the plastic surgery industry." It just sparks a glimmer of, Ooh, that's really cool. What do you know about Botox? So the questions that ensue and the passion that you see around it is just innate, I think, and especially when you think about everybody has a sense of understanding when it comes to their desires for beauty and being beautiful.

(12:25):
And so I think for nurses or nurse practitioners or physician's assistants to think about that as a career growth opportunity, absolutely. There are so many of them that are flooding the market. I think the problem for practices is what do I structure as a career path for them that they want to stay with me? Because there's always opportunity for them to actually go elsewhere or start their own practice depending upon again, those state regulations. So I think the struggle is yes, let's go ahead and say, yeah, there's a lot of 'em entering the market, but more importantly, practices are struggling with, well, how do I compensate them? How do I keep them happy? How do I ensure that all this time and effort that I'm putting into training them, because some of them may be brand new nurses that want to venture down this arena, how do I actually invest well in that area to make sure that they want to stay with me?

(13:20):
Because we know that that's also a big problem in practices is yes, there's an influx. Most of the time they're better served to work for a physician cost training opportunity, feeding of other patients, the cross-referral base, other services that are available. So it makes more sense to work within a physician's practice. But at the same time, from the flip side, the physicians are looking for ways to work better together with these mid-levels so that they can actually ensure that as a provider, they respect them and as a provider, they're cultivating their growth as well because it all serves the same end purpose, growth for the business and then attractive services for the patients.

Tyler Terry (14:05):
I'd like to shift gears into our second trend that we're seeing here in the new year. Just to give an example to the audience here in the town I live in, I have a med spa that I go to, and then I also have an IV hydration clinic that I go to the med spa. This is about six months ago. The med spa started offering IV hydration, and they wanted me to become a patient to get that. And then the IV therapy practice started offering med spa services. They hired an injector and they're branching off to be a med spa. So we have this interesting shift of IV practices potentially opening up or offering aesthetic services, and then aesthetic practices, plastic surgeons, dermatologists offering IV. So I'd love to hear your thoughts on this service and why it's exploding.

Robin Ntoh (14:54):
Wow, okay. I'm a convert by the way. I love it.

Tyler Terry (14:59):
Me too. I was too.

Robin Ntoh (15:00):
It's interesting when I think about my journey that evolved around this and then thinking about how I can apply that back to the market as a patient and what my thoughts were. And so I'm going to take a different approach on this and kind of think about it from my own patient journey. I probably never would've done this if I had to make an appointment and go to a standalone IV hydration shop. I wouldn't have done, it wasn't appealing to me. But when I went in to have my facial and the aesthetician said, "Hey, do you want to go ahead and get an IV today?" I'm like, "um, okay. What are you recommending? And is this going to take more time?" And I had all the normal questions, I think, and she said, well, we'll do it while you're having your facial. It won't take any more time and it shouldn't be uncomfortable or cause you any pain or discomfort whatsoever.

(15:56):
I said, "okay, why not?" And since then, every time I've gone in for a facial, then I've also had an IV hydration at the same time, different cocktails to kind of mix it up a little bit. That's the fun part about it. And even one day when I wasn't feeling so well, they said, "oh, let's give you an IV and that'll help you." And I'm like, "okay." So I think that what I represented in my own space was this was easy for me to add on because I didn't have to spend any more time going out making an appointment and going someplace else. That opportunity, I think is still in its infancy because when I think about what I have seen in the many med spas that I've visited, I don't see this as being one of their core services, nor do I actually see that they even offer it on a regular basis.

(16:41):
That in and of itself is a whole other conversation where services are not readily visible to patients as being an opportunity when they come in or they don't think that they can have it today because they think they have to make a separate appointment. But for me, it was just super easy because it was same time, same commitment, really nothing more on my part that I had to do. And so that was easy when you think about where it has worked so well, it's an easy way for people to walk in, get a quick IV and feel good. It's like that whole hangover philosophy. They go in on Monday morning, they've indulged too much over the weekend. Now I'm going to go get an IV. I saw this recently when I was in Vegas for a trade show and I was in one of the hotels and I'm like, "oh, there is an actual IV store right here in the hotel."

(17:27):
And it made sense because I mean, we're in Vegas, people tend to overindulge, and it was a great way for them to kind of really think about, "oh, okay, I'm going to get a quick treatment. I'm going to feel better." So yes, it is in its infancy. The market is ripe for it. I think it is one of the big things on where people are focusing on prioritizing their wellness. So it's a beautiful intersection of med spas and medical wellness, and that to me is a beautiful thing for how that's going to actually evolve in the market.

Tyler Terry (17:58):
There's a lot of different ways in the way that we articulate and we make patients feel, but this enhances the patient experience and so many different ways. The practice was able to provide both an enhanced experience, a delightful experience, all while increasing their revenue per guest or revenue per treatment because you were there anyways, and now you're able to maximize that time, whether it's a plastic surgery or dermatology practice. How would you position IV therapy?

Robin Ntoh (18:29):
Great question. Lots of different ways to think about how this could really appeal to your patients and solving for what their needs are. So for purely aesthetic services, it's just a great add-on. Everybody is dealing with the exposure from whether it's the flu or the COVID or the change in seasons. So there's always opportunity to beef up your immune system. If you don't do it automatically with your daily intake of supplements, then here's another way to get it. The other thing that I think that is helpful is convenience. And so a lot of our patients in today's practices are looking for convenience. We see that with just things as important as online scheduling, so convenience, time management, efficiency, those things will all help practices help their patients gain more adoption for IV hydration therapy simply because they make it easy and they make it a service that is automatically aligned and done at the same time.

(19:35):
So think about it, I'm going to get my Botox and my filler and my IV at the same time automatically easy done from any type of HydraFacial or chemical peel treatment or even a laser treatment, just get the IV started and they're good to go. Then you think about those practices that are doing more reconstructive or they have a component of reconstructive or even practices that might do more medically related type of procedures like breast implant removal. And you've got patients in this day and age that are focused on that medical wellness component of removing implants because of the risks that they've seen with that and the scares that they've seen. And there's a whole host of people out there that are really focused on the removal. Those people are very intentionally focused on wellness, and so they're looking for more natural solutions. And I think IV therapy would be a natural add-on service for these types of patients.

(20:31):
So there's a lot of different ways that it can be incorporated is a simple add-on service that's going to, as you said, Tyler, increase their average encounter value. And everybody's looking for ways to increase their average encounter value without even having to do more work. And the margin for IV is huge. The cost is so low, there's just so much opportunity for practices to really increase their overall revenue from just adding on this service. I think the other component of this is it's truly an add-on service. I think you can sell the packages, you can do the memberships, but there's a lot of opportunity in your just daily foot traffic that's coming in the office by just ensuring you've got opportunity to have someone that's available to start the IV. And if you've got that personnel that are available to do that, that's going to make a difference on the adoption and the availability of it for your patients because they can easily not even think about making an appointment, walk in the door, "Hey, I know I'm getting my facial today. Can I go and get an IV?" That should never be a no. It should always be absolutely, because you're not taking up any more square footage in your practice, you're just adding onto it. So think it's just awareness, understanding of the patient type that really would need this service. And thinking about how do you socialize it amongst your staff and then just your patients.

Tyler Terry (21:52):
I know we're in the early stages. We're in the early years of IV therapy. A lot of people still don't know it. I bet four to five of my neighbors wouldn't really know it still, which is amazing, a lot of green space for practices to grow. But do you believe that over the years patients will come to expect this as a standard in an aesthetic practice?

Robin Ntoh (22:13):
Absolutely. I think it is such an easy add-on service. I think there's a lot of opportunity for practices to incorporate the right type of IV therapy for the patients, and understanding that there's obviously medical history and components of the patient history that they should understand, but good medical standards, good medical practices, it is absolutely an easy service to add on into any type of practice. And think about it, if you've already got those advanced practitioners in your practice, they're probably available to actually make this as part of one of the services that they offer. You may not even need to hire extra staff just to manage this, but again, if it becomes that much of an opportunity and you become that busy, definitely think about adding the staff on that can actually manage this as a service for your patients.

Tyler Terry (23:04):
So I want to shift gears and talk about the third trend, which is the boom and medical weight loss. So a lot of us are hearing skinny shot or Ozempic, Wegovy, semaglutide, so many different words and buzzwords out there that are talking about medical weight loss. What are your thoughts on this? What are you hearing? Where do you see this going?

Robin Ntoh (23:31):
It's going to grow. I mean, the market has already reached about 1.1 billion, and that was in 2022. It's expected to reach 1.7 billion at a closeout of 2023. Those numbers have not come back yet, and it's expected to continue to grow at a rate of about 4.3% a year. So hard facts, but again, those numbers are definitely trending in the right direction to indicate growth. I also think that pharma has actually understood the opportunity here. And with that, we've had some recent announcements where the FDA has approved additional drugs for weight loss specifically, and that's coming off of what we've seen with Ozempic and Wegovy and where that has actually evolved from being used or should have been used for medical indications, but then also became an opportunity for people to lose weight. And so people were finding creative ways to get their hands on that drug so that they could get into that program.

(24:35):
Where I think the concerns are right now is that regulations are really not tight around this. I think that practices are launching this, but not really understanding how those patients need to be vetted and then managed appropriately. I think there's a lot of opportunity, but I think there's also opportunity for practices to really focus on making sure they're still remembering it's a medical indicator, it is a medical procedure, it's something that they want to follow the guidelines of medicine. So there's opportunity, but there's also some risk there if the practices aren't clearly intentional on how they manage this.

Tyler Terry (25:16):
With this trend in the new year and plastic surgery practices that are beginning to offer this, they're not used to patients coming in every month outside of maybe for injectables and filler or maybe some of the non-surgical. What are some solutions that can actually help those practices prepare for patients coming in on a monthly cadence or any insights that you have there, Robin?

Robin Ntoh (25:39):
I think that it's an opportunity, if you think about it, if I am looking at growing my aesthetics practice, every time a patient comes in, especially if they're on some sort of prepaid program, they've already spent the money. And so when they come in, they don't feel like they're spending money a lot of times. So that psychology is there that, oh, I haven't spent any money. Oh, I can buy this new product or look at this service, maybe I add on IV today. So we think there's opportunity there for them to upsell, add more procedures to what the patients are already getting, and definitely turning into revenue opportunity for the practice.

Tyler Terry (26:18):
What are some successful ways that you've seen practices soft launch this type of service or really any type of service? I'd love for you to share that with our listeners.

Robin Ntoh (26:28):
I think pharma's going to help propel that simply because they're probably going to do enough marketing that the consumers will look for it and they will start researching for practices that are offering it. So just Allergan did that with Botox. I think you're going to see that pharma will probably set the stage for this and prepare the way. It'll just be a matter of what practices build the process internally, get the team in place and have the means to actually execute on it and launch it. Practices tend to just sometimes launch without having all of the boxes checked, and then there's opportunity and risk associated with that. But the practices that really focus on doing it well, they're not going to lose out. There's so much opportunity in this market to manage weight loss for patients that I think that if practices just step back, focus on launching this correctly, they can have a very successful practice that brings patients in every month, provides that recurring revenue, grows opportunity for other services, builds the relationship with the practice, and obviously there's opportunity for other procedures that will stem from patients that go through weight loss.

(27:49):
Weight loss is weight loss. It doesn't reshape the body. So plastic surgery practices will look at this as an entry point into managing patients that are not good candidates for surgery. Now, maybe their BMI is too high, but they go through a weight loss program that the practice actually provides, and then a year later they're on the table having surgery because now their BMI's in a place that allows them to have surgery and then they'll have better results with their surgery. So there's opportunity for the practices that are now currently turning away patients because their BMI is too high to actually start them on a course of treatment that then builds into the surgical.

Tyler Terry (28:34):
Obviously, we have world-class plastic surgeons who are clients of ours, Robin, and who are listening to this today, and they know this better than we do in terms of what they can do for those patients. And so what a great reminder for them to see this opportunity where pharma is going to be spending a lot of resources, making patients aware and educated and well-versed to direct them to the practice. But what an amazing opportunity for practices to take advantage of this and to prepare for it. And then when we talk about making sure that you are subtly and subliminally marketing to patients, not just outside of the walls of your practice, but inside the walls of your practice, making sure that you have a menu in the office. Because think anywhere that you go. If you go to a restaurant, how weird would it be if you didn't have a menu? And even if you go to that restaurant maybe every year with your spouse for your anniversary, and maybe a couple other times throughout the year, it would feel pretty weird not to have a menu. So when I looked at practices, one of the biggest swings and misses that I've seen is they don't have a menu inside the doors. There's a menu on their website, but I want a menu in the practice. So this treatment can and should be put on that menu to make patients more aware and more educated.

Robin Ntoh (29:57):
So Tyler, it's interesting you talk about how the consumer gains insights with a menu in the waiting room, something that kind of gives them awareness. It's fascinating how still today I'll go into a practice and I'll sit in the waiting room and there's nothing for me to do, but listen to what the front desk is chatting about. And it's intriguing. It's interesting. It could be not so good because it's, they're revealing patient information that they shouldn't be. That's the HIPAA concern there. But people are looking for some way to be entertained. They're a little bit uncertain, especially if they're a brand new patient. They're a little concerned about what is going to happen once they walk through that door. What's on the other side of that door? We're also used to, as physicians and providers and nurses and office administrators, we're so used to the day-to-day that we forget what it's like to be a new patient and sit in a waiting room and be a little timid and a little concerned and worried about what they're going to think.

(30:57):
And so if you give them opportunity to feel more comfortable about who you are, what your practice offers, why not use that square footage that is so often larger than what it needs to be and focus on education. There's a lot of opportunity right there in practices, just they think it takes too much effort to do it. There's so many tools out there. I mean, Tyler, I think about TouchMD and the tools that are there that provide great opportunity for people to learn in that waiting room, whether it's on their own personal device or it's on a screen or a TV that they put in the waiting room. Lots of opportunity. We just think it's harder to do than it really is.

Tyler Terry (31:35):
One of my favorite examples of this is one of my friends, Dr. Joel Schlessinger and Omaha, Nebraska, he has TouchMD, but what he's done is he's created patient education stations in the waiting room. So he actually has his TouchMD system on what's called kiosk mode. And so if I'm a patient, I could walk up to this big 27 inch all-in-one touch smart computer, and I can actually begin just exploring through and looking at the different services. And you have this digital menu that's feeding relevant content. We even had a practice on Rodeo Drive who had a huge TV, and it had the ability for you to go up and walk up just like Dr. Schlessinger did. But on Rodeo Drive, this plastic surgeon right outside of the glass windows of his practice, you would be walking by and you can actually walk up to the screen and it was TouchMD and you can actually browse through the services, which was obviously a phenomenal experience. But yeah, one of the biggest swings and misses in an aesthetic practice is in practice marketing and making sure that that's a beautiful experience and not just relying on a pop-up banner that you got from Allergan or BTL or not just relying on brochures that the patient may or may not pick up, and maybe they do put it in their purse and then they throw it away. But being able to have a beautiful experience that's as beautiful as your practice and everything about your practice.

Speaker 1 (33:06):
Thanks for listening to Aesthetically Speaking, the podcast where beauty meets business, presented by Nextech. Follow and subscribe on Apple, Spotify, YouTube, or wherever you like to listen to podcasts, links to the resources mentioned on this podcast are available in your show notes. For more information about Nextech visit Nextech.com or to learn more about TouchMD, go to touchmd.com. Aesthetically Speaking is a production of The Axis theaxis.io.