How much do you pay for your RN injectors? How do you fairly split the profit?

We pay 20% for straight commission or 10% to those also receiving an hourly rate.

Do you take the consider the cost of the product before the split? Can anyone comment on how they pay their estheticians as well? Looking to change our pay structure.

Here in the US, if you control the workers hours, provide tools-product, advertising as well as liability coverage and standing order, then you have an at will employee who must receive minimum wage. Of course then commission for service. That would be based on percentage agreed after cost of above. If your injector is a contractor, I would want a copy of agreement with physician director, liability coverage and a covenant not to compete, as well as a confidentiality agreement.

In CT we pay our PA $80.00 an hour. Her taxes are taken out just like our other employees.

if you are independent, the split should be based on the amount of work provided. if your strategic partner is providing a lot of bookings, say over 2500 a clinic session, then offer a 20% of gross. if between 1000-2500 offer 15% of gross and if below 1000, then 10% of gross.

What if the injector is providing the product as well? What would be a fair split? The injector as well can not promote own business?

I do not pay on a profit split, more out of principal than anything else. Month to month, I am assuming all the risk for the profit/loss of the center. I have the inventory carrying costs, advertising, front desk personnel, office space, etc. I do however, strongly believe in an incentive based pay scale. We pay a baseline hourly rate + injection fee per area of Botox/Dysport/Xeomin/Dermal Fillers. In this way, the more injections my nurse performs, the greater her income and the center becomes more profitable. I target for my nurse injector to earn $40-45/hour and that is very competitive in my local market.

In California, Labor Code Section 3357 provides: "Any person rendering service for another, other than as an independent contractor, or unless expressly excluded herein, is presumed to be an employee." The statute does not explain the difference between an independent contractor and an employee; however, the courts have placed the burden of proving "non-employee" status on the employer. A crucial factor in determining employment status of whether employee or independent contractor is the right to direct and control the work being performed. Is the person providing their own malpractice insurance? Does the person set their own schedule? Do they have their own clientele? Has the person performing the service independently chosen the burdens and benefits of self-employment? What is their skill level? (Our PA was also an injector trainer for a well-respected brand.) Are they providing/using their own special needles, cannulas? Be sure to discuss with your workers' comp provider.

I work as an independent contractor under my own malpractice and LLC for several physicians. The sites I work at assume the advertising, overhead, staffing and other costs that I don't have to deal with. A 50/50 split after expenses is fair if you are willing to assume all legal and medical responsibility if any issues were ever to develop, assuming you can practice independently per your BON. If the state law requires the physician must assume some sort of oversight supervision or direction, then that MD should get the larger portion of the split to offset the legal risk for any complications or litigation. My surgeons would rather do face lifts than filler so they're happy to refer to me and I also up-sell their products, lasers and surgical services (which I get a 10% commission) so we work better as a team. It's a very symbiotic relationship with no hard feelings.

I also work as an independent contractor with my own malpractice insurance. We are a brand new clinic and offer other services. The owner says she is assuming all the marketing, cleaning, supplies, etc. and because of this is only willing to give 20% of the net profit. Now that being said I have now been told I have to do my own cleaning(sweep the floors, wipe down the counter in the room, and find your own clients(market myself),etc. etc, etc. Seems like a no win situation to me. Also no hourly wage and I travel an hour each way to work.

@Hawkins: Can you open your own site? Maybe an alternative option, or see if any other Derms or Plastic Surgeons are looking. What state are you in?

Arizona. I'm looking into other options. I also do weight loss and bioidentical hormones. Those I get an hourly rate for so it's hard to just walk away from that. I'm only looking for part time work so don't really want to open my own site. I told the owner if it didn't work out for me I would just do the weight loss and BHRT. I have my cosmetic malpractice until next May.

That's very interesting. Perhaps it depends upon the state, but I was told the 'independent contractor' criteria is not met when utilizing physician's equipment (laser, & product) and that you are employee and must be paid hourly min wage (plus commission) and that commission on surgical procedures sold was 'fee splitting' and also not legal.

I am a PA and have been performing cosmetic injectables for nearly 9 years, have been an aesthetic trainer for 5 years and work one day per week as an independent contractor with my own malpractice insurance at a small medispa overseen by a plastic surgeon. I take a 22% commission which I think is very low considering my level of experience. The admin says they pay for overhead and staff but will not advertise do to the expense. At what point can I do my own advertising and ask for an increase? This has always been a point of contention and I stick with it because I want to be fair and loyal to my patients. Any advice is appreciated!

You need to negotiate an agreement upfront with the physician. I would recommend basing it on some current baseline of revenues to the practice and then you take a greater percentage once you begin advertising on the incremental revenue. In my practice, the cost of product generally is around 50% of our charge to the clients so there would not be much room to move up the percentage once I cover overhead, front staff, inventory carrying costs, etc. Your situation may be different. Advertising can be quite expensive as well. We view Botox as a "gateway service" that brings in new clients who continue to return but also go on to do other procedures as well.

What percentage of the business is aesthetics? I don't feel it is fair to make the injectors cost cover staff utilized for other parts of the business, that would include all overhead cost.

Please take a read of the fee splitting post.
As I always say, Medical seems to be the least important word in medical spa

We are 100% aesthetics. Due to the high volume of injections we perform, a large part of our overhead is actually associated with supporting this part of our business. Injections account for 35% of our revenue. We also spend more administrative time on our injections than other areas as we have to account for inventory (strict audit due to former injector theft) and have frequent meetings with our account reps for Merz, Allergan, Medicis, etc.

That then is understandable. At least you have the patients and can provide high volume for your injectors.