Hi,
I am an internist certified in cosmetic injections. I wanted to join up with a day spa and start doing cosmetic procedures. I don't however want to buy 51% of the business. Can I pay a portion of my profit as the "rent" for the room in the spa and avoid all that legal issues having to do with ownership of medspa's. Any advise would be greatly appreciated. Thanks

Dr. S
Where in Cali are you located? What kind of certification??

I am not sure what it means to be certified in cosmetic injections. The only reason I bring this up is for physicians to watch out for this marketing ploy. Many weekend seminars state they will give a physician "certification" for these injections. As a physician, you were certified to do these injections the day you received your medical license. The "certification" is meaningless and has no value whatsoever.

As physicians we are responsible to learn techniques and become proficient at them before we start doing it on our own. A weekend course is a great start but working with someone that has been doing it for a while is a great asset. Simply being "certified" means nothing if you end up in court.

I also recommend that you do not hire a nurse, NP or PA that has been "certified" at a weekend course. Please make sure that they are proficient at the injectables they use.

Ok- my mistake. I have learned to do injections- but I want to know if I have to own the spa in order to practice there- or can I just lease a room in the spa and avoid having to buy the practice!!

southern cali., los angeles. CME certification

Really your best choice is to talk to a lawyer. You can also start with your state medical association. This will give you a start.

Thanks LH

Dr. S:
There are 2 options:
1) You are part of the spa ownership. Thus it becomes a medspa, a medical professional corporation where you and/or other "medical professionals" have to own at least 51%
2) The other option is you "sublease" a space there to call "your own office" independent of the spa.
Hope this helps

what do you think fair market value or the cost to rent this room would be? What if you were also renting lasers?

CT,

It depends (don't you love that answer). It will depend on the going rate per square foot in your area as well as how often you will be there. Will you be there every hour they are open or just a fraction of it? Will you be using any of their staff such as receptionist for scheduling or nursing for rooming and prepping patients? You will need to know their pay and percentage of time with you. You need to take all of this into account and this should give you a place to start your negotiations.

You need to answer similar questions with the laser. How often will you use it? Who is responsible for repairs if it breaks down? What about general maintenance?

So as you can see it is not a simple answer.

CT:
The first question is a bit easier to answer but not the second one.
For the 1st question, your better option would be paying them for the room based on an hourly rate. The hourly rate could in a sense comprise of the costs of using their phone, electricity, fax, staff for scheduling, etc.This will minimize your financial risks.
For the second question: I need to know what kind of state law that is in regards to WHO can own and operate a laser machine thus a laser business.

it's in wisconsin. Anyone essentially can operate the laser, I think. I would be there 5days per week as my sole practice. So they would charge me a management fee (admin/utilities/accounting/billing etc) + an hourly room rental fee (for a full time assistant, equiptment, use of a room). Are there any fair market values for these types of things? is $200 per hour for room rental absurd or does that sound about right? I would use about 25-30hours per week.
How do i figure out the going rate per sq foot?
THank you for all your help!

CT:
LOL, your recent posting makes things more complicated for me to address now :-)
Let me ask first: are they providing you with EVERYTHING from A-Z including laser equipment?? Who does the marketing for you, THAT spa entity??? Are you sure you want to commit 25-30 hrs there already?? Would you be that busy to start with?? If so then the hourly rate would be very costly for you. There is one other option:
1) Treat the spa as an MSO (Medical Service Organization). Make a contract that spells out everything they would provide you with. If they provide just about everything then you could probably give them as much as 50-60% of your revenue. In Florida, I believe there is a cap of 50%. It is imperative that 100% of money goes to you first, then you cut the check based on the contract terms. There are a few caveats that must be mentioned here, i.e. if your relationship is ever scrutinized by someone.
1) To be a legitimate MSO, it must also show that it has at least another or preferably 2 more contractual relationships with other MD entities besides yours, be it for marketing or billing services
2) Who actually performs the procedures?? you or some from them???This gets a bit hairy due to your "supervisory role"
3) You must be very careful with HOW the MSO entity "market" for clients. If it is not proper then it can be an issue also. Is this practice only cash-based or also PPO/Medicare based???? This can get VERY hairy if it is the latter.

Thank you everyone for your advise!!

Dr. S, are you still around. i am an investor and have some genius ideas for a new type of med spa. i am not an MD but need one to own 51% although we are not asking you to put up any money!! i know this will be incredibly successful. If you or any other MDs would like to talk to me about this please e-mail me innotan@gmail.com -kyle