Pros and Cons of Nurse Injectors — with Lisa Marie Wark, MBA (Ep.194)

Pros and Cons of Nurse Injectors — with Lisa Marie Wark, MBA

Catherine Maley, MBA: Hello, welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and the pros and cons of nurse injectors. I’m your host, Catherine Maley, author of “Your Aesthetic Practice, what your patients are saying”, and consultant of plastic surgeons to get them more patients and profits. Now, I have a special guest today that’s a non-surgeon, and I’d like to introduce you to Lisa Marie Wark, MBA.

Now she’s a practice management consultant just like myself (as in an expert on the pros and cons of nurse injectors), and she’s focused on business develop. Best practices as well as marketing. And she’s even created and formulated beauty and wellness products for our industry. Now, Lisa Marie founded and operated the very first luxury medical spot in Vegas, and we’ll ask her more about that.

And then she’s also, a very sought-after speaker at the medical conferences. She and I have been sharing the podium for years, like all over the us and now we’re going international. So, Lisa Marie also, supports many nonprofit organizations within her community. And she’s interested. Now, this is really interesting.

I don’t know. This was so, random. She reads and speaks Japanese fluently, so, we’ll ask her about that too, along with the pros and cons of nurse injectors. So, Lisa Marie, welcome to Beauty and the Biz.

Lisa Marie Wark, MBA: Oh, Catherine, thank you so, much for having me. I’m Beauty and the Biz. I’m an avid follower and I listen to your podcast religiously. So, big fan. And also, I’m a big fan of you as a consultant in the plastic surgery space.

You’ve been around for a while and I’ve learned a lot from you.

Catherine Maley, MBA: And that’s the pleasure of this. Like I love hanging around with the competitors and some of them don’t like it, and you and I just get along very, very well and I love sharing ideas and nobody has the market on all the ideas, you know?

And frankly at this point there are probably not many new ideas. It’s who can put them out there creatively and. And get people’s attention and get people fired up, you know, for this industry. So, there, I don’t, there’s plenty for everybody, quite frankly. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Absolutely. Absolutely. And you know, I think a lot of times too when we get clients, it’s the clients that resonate with us.

And that’s why they choose us because we have different styles and, you know, that’s what makes us, you know, unique and also, be able to work together and to lean on each other. So, yeah, no, it’s, it’s wonderful to be a peer of.

Catherine Maley, MBA: And that was a really good point. Not everybody jives with each other.

Yeah. So, so, you would, we definitely have different personalities and so, that’s a really good point. So, before I get off course, how in the world did you learn Japanese? The rest of us, usually we learn Spanish or I learn French. How did you go to Japanese? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: You know, in college, in undergrad, I went to Willamette University in Oregon and I was in the Japanese dorm and I had a Japanese roommate.

And so, every day she would come in and she would actually knock on the door before she’d come into our room and her name was Como. And I said, Como, you don’t have to knock on the door. This is your room too. And she would say, oh, okay. Thank you so, much. Then she turned around, come back, and knock on the door and I thought, ok, I need to learn Japanese.

So, I studied Japanese for seven years, lived there for three years, and then I got my M B A in international management emphasis to East Asian Japanese techniques.

Catherine Maley, MBA: Nice. And you were also, a news reporter, right? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: I was. I was. I’ve had nine lives. Who’s counting? Yeah. I was a financial news anchor in San Francisco.

Up the street from you? Yeah. Yeah.

Catherine Maley, MBA: All right. I do. That is on my bucket list. I’ve never been, I want to go to Tokyo and I would, I’m assuming I’m like going to be the tallest person ever. Oh my gosh. You would be. You would be. You would be. I love, I, I love the culture. I love how graceful they are. I love the food.

Like if I could eat sushi every day, I would that it is clean eating. So, was it, did you love the food while you were there? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: You know, I did. I got tired of fish; you know? Yes. If you went to a, if you went to, you know, McDonald’s, I mean, they have McDonald’s there and you were to, or like, you know, you’re American and sometimes you’re like, you know, I could just use a Big Mac.

but unfortunately, the Big Mac would taste like fish. So, you’d be like, ah, just doesn’t, it’s not like America, but I love Japan and I obviously was treated very differently because of what I look like. You know, there’s not a lot of, well, I had red hair, if you can believe that back in the day and people would come, I’d be sitting on the train station and.

Feel people touch my hair that I didn’t know. And I just, you know, it was very awkward for me to have that happen. And then people would come up and ask me if they could take my picture Oh, wow. And say, well, I don’t know. You, you know, what are you using this for? And they said, ah, you know, you’re, you’re an American, you’re a foreigner.

We want to take pictures of you. So, It was a very different experience. I loved every second of it. I climbed Mount Fuji, if you can believe that, and taught English to homestay moms and to executives at N E C in Panasonic. And. The different Japanese companies and you know, I also, went to Tokyo International University.

There, I was going to get into their Becca program, which is a prerequisite for learning Japanese fluently enough to get your M B A over there.

Catherine Maley, MBA: I know somehow you went from that to our industry and we’re glad you did. And that was like what, 15 years ago and you opened, you founded and opened your very first, the very first medical spot. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: I did, I did back in 2005. You know, it was funny. I went to San Antonio to a medical. It’s a medical spa. That’s what, I can’t remember the name, but it was this wonderful conference and I still know people from that conference today. And what I loved about the whole concept of medical spas was that it created that spa environment, that relaxation, that calming experience with medicine.

And it reminded me of. Meets West, right? Where, you know, a lot of eastern practices, medical practices are, are very they’re just very calming and, and everything is about, it’s, it’s not so, sterile and cold. And so, I thought if we could bring that together and marry that together people would love to, you know, come in and they’d get their facials.

And then we did injectables, and then we did hormone replacement therapies. So, it was the first one in Las Vegas. Wow. And how long did you own it? We were in business until 2011, and then I decided to, you know, start a family and, you know, move on to my next season of life. So, that’s, that’s how, that’s, that’s how that ended.

And I started consulting and loved consulting. I went around with a wonderful architect who worked for the spa at. At Spanish Bay and at Pebble Beach Lodge and the Grand Yle. And he actually got into creating more like villas and overnight you know, care facilities for plastic surgeons. And so, he was help building those out back then, and I was writing his feasibility studies and making sure we were within.

Catherine Maley, MBA: Gotcha. So, the reason I brought you on is because we want to talk about nurse injectors. What is happening is, I’ll tell you what, what happened, why this all exploded, was the surgeons always wanted to do surgery and. I, I’ve known the surgeons forever, and I thought your customer service is terrible.

Like, they wouldn’t answer the phone. The staff wasn’t friendly. The waiting was out of control, and it was just ripe for the taking because the patient with a credit card was not going to stand for that. They wanted service to go with these high prices. And the surgeons just, it’s, they, it wasn’t their focus.

Like they didn’t want to do injectables, they wanted to do surgery. So, that was. Such an opportunity for somebody to develop this medical spa concept, and now it’s completely, you know, taken over. So, then the, the now the surgeon has to say, okay, some surgeons have embraced injectables and they love doing them.

They like doing them themselves. They love building that relationship. Some surgeons say, I still don’t want to do injectables, but I don’t want to lose the patient either, right? Cause this one and done. If you’re around for a while, you realize, wait a. This one and done can’t be a good business model either, right?

So, that was creating this this vacillating, should I get a nurse injector, should I not get one? And in some practices, they’ve done such a great job that nurse injector’s bringing in a million or two and she’s well worth the money in other practice. They’re just complaining the whole time saying, oh my God, I’m giving her so, much money for what?

So, that’s what we’re here to talk about. And you know so, much about it because not only, you know, do you consult on it, you actually experienced it. Right. So, in your own, what was your own experience when you opened up your medical spa, when you were going to bring in a nurse injector? On what criteria did you. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Well, the criteria for me, because I’m not a doctor we had a medical doctor at the time and a supervising physician. We also, had a visiting plastic surgeon that would come in and do consults. So, what I needed is someone that is a, either a nurse practitioner or a physician assistant. I didn’t feel comfortable with a registered nurse just because the Nevada.

Require you to have a doctor that should be on site if you’re a registered nurse and you are doing any type of injectables. So, my first experience with this was hiring a physician assistant and a nurse practitioner. One Nur the nurse practitioner was actually experienced. While the physician assistant was a newbie and she was trying to gain experience in injectables because she, and like a lot of these you know healthcare providers, mid-level healthcare providers, they.

They are looking to make money. They’re looking to make money in injectables and create a following and then you know, take that following from your practice. And so, that was the first time that I, you know, really was around what the politics, right, of hiring someone, having them come in, interface with the patients, do the procedures.

And then the question was, whose patient? Are they, because a lot of times the, you know, PA or the nurse practitioner will say, well, really that’s my patient. I’ve been injecting that patient. That patient comes to me, that patient’s going to follow me if I leave this this medical spa or if, or practice.

And so, you really. It was really a quandary at the time as to, gee, you know, how do I protect my business from losing patients when the, when the injector walks out the door.

Catherine Maley, MBA: So, that’s the big question. When you bring somebody on board, are you trying to bring an experienced person that has a following?

Because I love that idea. If you can make it work and get the right person, what a great team, because she just brought an influx of patients to you and. So, so, you haven’t, oh, you know, there’s your marketing for the year. You know, she’s got, she’s brought the whole group with, however, on the other hand, she’s one of those people who knows everything and she, she thinks she’s the boss and she doesn’t do well.

You know, w you know, working under a doctor, so, what do, what do you think is better? Do you hire or do you hire a brand new one and, and they’re green and you hire and train them yourself and, and then hope they catch on and hope they’re going to ejector because they have no experience. And you can’t afford, in today’s world, too, you can’t afford bad results.

You don’t need any Guinea pigs. You know, your patients don’t want to be Guinea pigs you know, training somebody else. So, what, what’s what, what would you suggest bringing on a newbie or an…? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Well, it really depends on the type of practice, right? So, we talked in the beginning, we talked about plastic surgeons.

They start their practice and a lot of them aren’t as busy as they’d like to be in the, OR doing surgeries. So, to supplement that income, they start doing, you know, non-invasive procedures like injectables. And so, when they first start out, the injectables are some money that’s coming in. Their or is not at full capacity.

So, they bring in someone that, well first they don’t bring in anybody in, right? They, they’re doing it all. Then they start to realize, listen, I need to bring someone in because I don’t want to be doing injectables. I’m a surgeon. I belong in the OR. So, you can either have someone who comes in as a newbie, but when they come in as a newbie, you really need to.

Protect the practice. And that means that they need to know that the patients that you’re feeding them, meaning feeding the, the injector that those are the practices patients. And how is that, like how do you how do you explain that to the injector is you say, well, Who, when you think of the patient, who is the patient paying?

Is the patient paying that injector or is that patient paying the practice? And just that answer alone is going to tell you it’s the patient, the patient belongs to the practice. The second thing that, that when you bring in an injector, even if it’s a newbie or an experienced. Is, you know, what kind of social media policy are you going to implement at that time?

A lot of times you see plastic surgery, you see medical, any type of medical spas, they, they allow their injector to have their own Instagram account and the Instagram followers, well, that hurts your… Because that should be under the umbrella of your practice. So, whenever I would hire an injector, regardless if they had a following or not, I would make sure that the social media is under.

Let’s say, for example, Smith Plastic Surgery, it’d be Smith Plastic Surgery injectables. So, there is no question as to who those patients belong to. So, going back to, is it a, is it a newbie or is it someone who has a following? Well, that just depends on how much money are you willing to spend. A lot of practices when they first start out or when they’re getting going, they can’t afford to pay.

400,000 a year. To an experienced with a large following injector or starting at 40 to $60 an hour for a, a registered nurse that’s a lot of money. For, for a, for a practice, for a, for a medical spa. So, you really need to look at, well, am I going to pay that person? On a base pay. And what does that mean?

What are the job descriptions and the roles and responsibilities of that employee? Or are you going to have it as an independent contractor? Are they just coming in and you’re doing a 10 99 form and you, they log in the hours that they’ve spent with you, they send you, they give you an invoice, and then you pay off that invoice.

So, there’s many different ways to set up an agreement with an injector, but always make sure that your practice is being protected.

Catherine Maley, MBA: I highly recommend when you are bringing somebody on board, have them sign an NDA or a non-compete, and the first thing somebody says is, well, you can’t hold those up in court.

It’s not, that’s not the point. The point is, is if they’re not going to sign it, they’re telling you right now. They’re, they’re, it’s a yellow flag, a red flag, whatever color you want, That’s, that’s a clue that they’re not thinking the same way you are. And I would also, have them sign the social media policy.

And that means everybody, all photos are watermark and all posts go to this practice. She can’t have her own, she’s not building her practice on your. You know, in your name. So, or it has to all stay together and if she won’t sign, he or she won’t sign those two agreements. Then I would say it’s a no-go because it’ll be, it’ll, if it goes sideways.

That kind of stuff gets ugly. Exactly. You know, and you don’t need that negativity. But, you know, a lot of this, you do have some responsibility. If you hire the right person, you’ve got to take care of them and respect them and make them feel part of the team. Because I’ve talked to plenty of nurse injectors and they feel used and abused and the, the ones that aren’t happy, you know, so, it goes, it goes two ways.

I would, I would hire slowly. I also, what do you think about hiring the competitors? Like when the nurse comes to you and says, Hey, I work for your competitor, but I. I’d love to come over to you. How, how would you handle that? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: You know what I it’s always a red flag for me, and I’ll tell you why, because obviously, or not obviously, but you really need to look and see if they’ve signed a non-compete clause with the other doctor and.

If, if, let’s say, if they have, and they haven’t told you about it, you don’t need that bad blood between another doctor or another practice. You, we all need to, you know, be amicable, work together, so, to speak. There’s plenty of business out there for all of us, and so, we want to, you know, we, we want to be on the up and up as opposed to.

You know, doing something shady and taking on an injector that signed a non-compete clause and an n d A agreement was someone that, that you know, and is, is a neighboring plastic surgeon or medical spa.

Catherine Maley, MBA: And a lot of times if I were the surgeon, I would pick up the phone and call the other surgeon and Oh yeah, one-on-one and just say, you know what?

I just want you to know Susan was in here looking for a job. What’s up? You know? Yeah. I, I would just I would be that transparent in today’s world because you can head off an awful lot of drama at the front end rather than at the back end when you have to deal. Just a lot of bad blood. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: That’s true. That’s true. And you also, have to make sure they have active licenses. A lot of times they’ll come in and they’ll say, oh yeah, I’ve done this and this and this. Okay, well let me see your license. And it has to be in good standing just to protect yourself. There’s a, I mean, sadly there’s a lot of. People out there that will say anything, you know, really to get the job, but you really need to do your due diligence as an employer and really find out, okay, you know, did they sign in noncompete with someone else?

Do they have a good standing? Is there license active? You know, you really need to make sure that those references have are clear. Sometimes you need to even to do a background check. In fact, I recommend background checks. Anytime I hire someone.

Catherine Maley, MBA: I’ll tell you a story about that. I was consulting with a group in, I’ll just say Texas cause it’s big enough that nobody will know what I’m talking about.

And she was a nurse injector there for a couple years. Really resisted my consulting, very much resisted it because I was digging in and asking questions. And long story short, it turns out she had, she had called Allergan a year ago and changed the accounts. So, all of the money that Allergan gives back to the practices was going into her own account.

By the time they found out they were 200 grand out. Oh, and he the surgeon actually pressed charges and somehow, they’re still, it was like pending forever. And she had the audacity to get a job with the competitor right there in the neighborhood. And I don’t, and the competitor was also, a little on the shady side, I guess.

So, they were meant for each other, but. That surgeon lost so, much sleep over that and so, much negativity and what a shame, like. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah. Well, it’s a shame because you start to invest in that, in that employee or that independent contractor, you start training them. You start you know transferring institutional knowledge about your, your practice, about your medical spa, about your organization, and.

It becomes a waste. It all becomes, you know it, it just, you, you don’t get that return on your investment. In fact, you lose money as the moment you find out something like that because they’re taking all of that out the door.

Catherine Maley, MBA: Well, another tip would be everything should be set up as a profit center on, on its own because they were such a big practice.

Nobody was noticing. The money was missing because they had a lot of big numbers going. But if they had practiced like a silo, like the injectable silo, the skincare was a silo. The lasers were a silo, they would’ve caught that much faster. Oh, oh yeah. I highly recommend that. Yeah. Let’s talk about pay because it is all over the board.

It matters where you live. It matters what your overhead is. A, a nurse here in California is a joke. It’s ridiculously expensive versus maybe, I don’t know, somebody. I don’t know, Oklahoma, I’m sure it’s very different. Correct? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah, no, it’s all over the place when it comes to, you know when it comes to you know, compensation.

Catherine Maley, MBA: Absolutely. So, there are so, many different scenarios, but the major ones are usually number one, you either hire them as an employee and you just pay them an hourly period. Right. And they get perks. Cause some of them, like the employee perks, some of them actually are looking for stability. Because they, they’ve tried to do this on their own.

They’ve tried to be this, the traveling injector, and it doesn’t, it’s. Sexy as it seems. Yeah. So, a lot of them are just ready to settle. They want to find a home, they want benefits. They want to just do their nine to five, but make them full-time, that kind of thing. Okay. So, they’re employee, right? Another way is to make them an employee but give them less of a base pay and then give them some incentive to go above and beyond that. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Right, right. And so, so, you can start, okay, so, first of all, you can start with just a commission, right? And I recommend that a commission, when you have an experienced injector, who has a, a, a large following, right? Because you are only going to, you are only going, she’s only going to get her commission based off of the money she brings in off of the revenue.

The injector generates, right? So, when, let’s say, let’s say just for example and this is a very low number, but let’s just say she brings in your injector, brings in 10,000 a month, right? And let’s say you, your, you’re base monthly commission based off of a hundred thousand is 18%. So, right there, she’s getting 1800 a month, and this is 10,000.

Listen, people can make that in a day, less than a day, $10,000 on injectables. So, right there, right, she’s, her annual commission would be, you know let’s say $22,000, right? That’s her annual commission. Now, let’s say sh you have an injector that does 30,000. A month. So, you’re looking at the annual revenue generated as 360,000 a year.

Right? So, let’s say you increase her, her monthly base commission to 22%. Now you’re looking at, she’s making 6,600 a month just based off of commission, and her annual commission is about 80,000 a month or 80,000 a year. So, it all, I mean, You know, it, it’s all negotiable is what I’m saying. But the, but what we really want to be careful is, is that we don’t want to give 40, 50% commission off of.

Generated revenue sales, right? So, you don’t want to say, I will give you 50% or 40% off your gross commission because someone has to buy the products, right? Somebody has to buy the office supplies, somebody has to pay for the overhead, and usually that’s the practice.

Catherine Maley, MBA: You know what when it comes to the money part, because sometimes the doctors get caught up on, I’ve heard this over and over, I’m going to pay her six figures.

No way. Like all they see is that six figures. But if she was bringing in a million. That that’s 10%, that’s fine. You know, like, just keep remembering. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: There’s a, a, a math problem there, there is a math problem. You want to stay between 18 to 23% on any type of gross commission generated from the revenue coming in.

That, that, that, that injector generates you don’t want to go over 25%, otherwise it’s not sustainable. It’s just not sustainable for the way I…

Catherine Maley, MBA: You know, the way I look at it, just generally speaking, when it’s all said and done, when you know your costs, you know, your fixed costs, your variable, your commissions, when it’s all said and done, if you can keep 25% profit margin, you can’t make 25% any more, any, like in the stock market.

So, if you can make it there, because your business is still probably your best business investment, you’ll make then I would say it, it’s a go. Yeah. If it’s anything under that, I would say, You don’t need the hassle. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: No. And then, and then you got to think about it too. Let’s say you do a base pay. So, let’s say you’re going to give someone $50 for them coming in.

I would, their commission, I would have between two to 4% commission based on the revenue that comes in. So, here again, we’re looking at numbers, right? But let’s say you work 24 hours a week on $50 an hour. Your, your monthly salary is going to be over 5,000 a month. And then if you, let’s say you generate $30,000 in revenue, you’re going to at 4% your base monthly commission’s going to be $1,200.

So, add that you’re going to hit 14,000, so, your total, total compensations are almost $80,000 for your base pay and your commission. and was that part-time? That could be 24 hours a week.

Catherine Maley, MBA: Mm-hmm. So, yeah, that’s part-time because one of the issues I have with the part-time in today’s world, you’re just trying to get really good at this because it’s so, uber competitive now.

You’re going to win if you are. A smooth-running operation than if you’re not. A lot of money is lost in the processes or lack thereof, right? It’s so, difficult to build a team and a smooth operation when people are coming and going, like when they’re. They’re not there all the time. And team building’s really tough when one person’s, the prim donna who comes in just twice a day, twice a week, and then Jackson leaves and then the, and they, they’re not building a team effort.

So, and I don’t know what the answer is. I’m just trying to give the variables. What kind of practice are you trying to. And can you do it with part-timers? And I will tell you it’s way more difficult to do it that way. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: It is, it is way more difficult. You can have someone that’s, let’s say is your sole injector.

And a client that I’ve had had the, the injector had the L l C, the injector bot. All of the products. Oh. And then, and then gave that plastic surgeon a percentage, right. Of what she brought in. Well, she obviously brought in a million, and then she gave him 400,000 and she kept 600,000. Right. So, and he, and, and the whole thing is he’s like, well, I want to build, you know, a bigger injector.

You know, I want to scale my inject, you know, my injector. And she was like, why? What’s the point? I’m making good enough money. I don’t need to, so, it you, your kind of, there is that, you know that mark there where they lose the incentive. There’s no more incentive to build the business. So, you’re kind of stuck.

Catherine Maley, MBA: How interesting though, that she, she paid for everything. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: She, yeah, she was a pa and she paid for the, she paid for it all. He didn’t want to worry about it. And so, she, and he fed her, all of her patients and, and then she put it under her LLC. Okay.

Catherine Maley, MBA: Very interesting. I would just say where a lot of it goes sideways is the doctor’s not watching the money. How does this relate to the topic of the pros and cons of nurse injectors?

So, Oh, yeah. I just wouldn’t take that car blanche. Oh, okay. Thanks for the 400. Like, I, and, and he, it was almost like a gift, you know, I, yes. That I just would never. Abdicate the accounting, you know, just, yeah.

Lisa Marie Wark, MBA: No, you have to count your pennies as a physician, even when you don’t have time. You really have to.

Catherine Maley, MBA: I mean, yeah, somebody has to because you’ve got to know, is this a profitable system that we’re running here? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah. Your bookkeeping, your accounts receivables. Your accounts payables. Yeah.

Catherine Maley, MBA: Yeah. That’s the only way to do that. So, that’s really interesting. What do you think about Who’s medical? If somebody comes in, like a nurse comes in, that who’s liable? How does this relate to the topic of the pros and cons of nurse injectors?

Like how liable is a practice for a contractor or like a…?

Lisa Marie Wark, MBA: Right. You know, a contractor needs to, they need to carry their own medical malpractice, right? Because no matter whatever happens, That patient is going to go after the doctor for sure. They go after the deepest pockets and they will go after the, the injector.

They go after both. But I recommend that the injector has also, insurance to help you know, protect the, protect the, the providers.,

Catherine Maley, MBA: Would you say most of them do, and should you be asking that during the hiring process? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yes. Yes, you should. You should be asking for that, especially if they’re an independent contractor.

If they’re an employee, it’s under the preview or the purview of the Of the physician.

Catherine Maley, MBA: Do you think a lot of them are covered?

Lisa Marie Wark, MBA: Personally, I don’t think that, I don’t think they are. I don’t think they are.

Catherine Maley, MBA: I’ve never heard of it.

Lisa Marie Wark, MBA: Have you seen it? I don’t think they’re, I asked for it. I asked, I said, well, what’s your medical malpractice?

Oh, well I need to get that. Yes, you do. Yes, you do. Yeah. Interesting.

Catherine Maley, MBA: Yeah. What do you think about the injector? Who’s the traveling injector in the area and she works for three different competitors? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Oh gosh. It’s, it’s, it could be a big Hornet, you know, nest if, if something happens, you don’t, you know, it might be a great thing at first, she’s going to a salon, but, You know, she also, needs to make sure that the medical director knows exactly what she’s doing, where she’s going.

The medical director needs to sign off on her charts. It depends on, is it a nurse, is it a pa, is a nurse practitioner? It can be messy in all these different places just because. Well, if they’re using an E M R it might be easier, but back in the day when they would have all these charts and then, you know, they’d have to leave the charts there because you really can’t take the charts everywhere because you don’t want anyone to get into, you know, for HIPAA violations or anything like that.

But I prefer you just stay in one location and if you grow out of that location, then you can have a second location and, and hire someone else to, you know, help you with injecting.

Catherine Maley, MBA: So, we’re, we’re probably being really negative because, but we want the audience to know that you want to watch out for this because it can be the stickiest relationship.

You have it. Well, next to bringing a partner on, you know, that’s another Yeah. Yeah. But my tips would be, hire slowly. Yes. Time. Really know who this person. Mentally, psychologically, reputation, credentials, all know them well. I definitely would do back background checks. I’m shocked at how many shady people there are out there. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Oh, a hundred percent, yes.

Catherine Maley, MBA: I mean, I’ve seen some people on mugshots.com for God’s sakes. You know, so, I don’t know why. Yeah, How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: I know. I shouldn’t laugh. I mean, I, I believe you. It’s, we’re, we’re very naive and you know, a lot of physicians and my father’s a physician they don’t learn business in medical school.

Right. So, they’re very trusting people and that’s a good part about them. And then it’s also, can be very dangerous for them in.

Catherine Maley, MBA: Well, and, but they’re also, not at all interested in business typically. So, they’d rather abdicate that whole thing and hope it all works out fine. And they just want to know the bottom line, you know, how much did she cost me?

Yeah. So, I, but you know, so, you have to take some responsibility for that. So, I would say the ones that I have seen work the best. Yeah. I will just do this. The ones that work the best, they’re full-time. They have very clear. Tasks very clear. It was all done in writing at the beginning. This is what I expect from you.

They signed the non-compete, even if it weren’t going to, they signed the non-compete, they signed the social media policy. They were they’re told very specifically; all watermarks go on all our photos. We own the patient, obviously, that you can’t hold everyone to it, but the more that’s discussed upfront, but then treat them like a team.

Don’t treat them, don’t treat them differently. Don’t treat them like a pre-Madonna either. You know, like when they start calling the doctor by his first name because they think they’re, you know one-on-one with the doctor. That I would say those are some of the signs. They won’t sign anything. They resist anything in the office, like team meetings.

They won’t show up for team things. They won’t show up for trainings or meetings. They leave early. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah, all of that is red flags. If you have someone that works like that in your office, and I don’t care how great of an injector they are they’re just not a team player. They don’t belong in your, in your, you know, practice it, it creates.

it really creates some kind of toxic work environment because everybody else is going and everybody else’s team building and everybody else, you know, is really trying to, you know, make the practice the best that they can possibly do. And then when you have someone who doesn’t want to join the meeting or leaves early, comes in late, that’s, you know, that’s unacceptable.

You, it doesn’t matter who you are. It doesn’t matter if you’re the injector or if you’re the esthetician or if you’re the front office person. We all are a team when it comes down to it, and we all rely on each other. And to have a Pri Madonna in your office really is a strain on the other employee.

Catherine Maley, MBA: I’ll give one last tip that I have learned through my own experience. Yes. That injector needs to know that all arrows point to surgery. A lot of the injectors never, they, it’s their patients, they protect their patients, but a really good injector works as a team with the surgeon and she or he is the funnel to the surgeon.

So, when I show up in a practice, I want in-house. in her treatment room, and it’s all about surgery. Like and the patient who’s waiting for their Botox or filler to be, you know, prepared, they look over at a digital photo frame and they see tummy tuck, breast dog, breast lift, mommy makeover. And they’re like, what?

So, today they’re there for filler tomorrow they could be there for tummy tuck and that. Injector needs to have some type of paper trail. I personally like paper trails. So, she could have a cute little comp card. A comp console card. Yes. And, you know, and she hands it and because the patient looks over and says, wow, can you tell me more about that tummy tuck?

And she said, I can do better. We have we charge the doctor, it costs, you know, $200 to see him for his time, but because you know me, I can get you in there for free. So, here’s a comp consult card. Perfect. And literal., there’s a paper trail straight from that cord that injector to that surgeon, and now we know that she’s working as a team member.

And then the doctor can always give the patient back again to the, to the injector. Like it’s such small thinking, thinking, no, no, no, I’m going to keep everything with me. That’s not how you work this. You know, a good surgical patient will go up the ladder, back down to nonsurgical, back up to surgical, back down to nonsurgical. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Absolutely. I mean, if you think about it, just like when you say abdominoplasty or liposuction or whatever that patient might be inquiring about, it’s, it’s imperative for you to refer that patient to the surgeon for many reasons. One that’s, they want that result and then that surgeon should refer back to the medical spa, for example.

And let’s say do maintenance like m sculpt or cool sculpting use machines that can help maintain the surgery. So, it, it works together. It’s not just one, it’s not just one procedure over another. for sure. Yeah. And there’s also, one other thing that I forgot to discuss about, about injectors is that if you were training an injector and you were doing all this advanced training, which we all know is not, Inexpensive.

It’s very expensive to train, especially advanced training. I am, I, I like to implement an aesthetic educational agreement with your injector, and essentially what that means is saying that if I invest in training for you to have to know advanced techniques and to be able to. You know, do I don’t know, Russian lips or P D O threads, you are obligated.

The injector is obligated to stay an amount of time with that practice until that training investment has been paid off. So, I think that’s a really big we don’t really talk about it, but I know like a lot of injectors, they want all this training, training, training, training, training only to walk out the door.

Right. And, you know, you really want to keep them there.

Catherine Maley, MBA: And, but it’s the same thing with that. If they won’t sign it, that’s a big sign. If they will sign it, it could still go sideways. But at least you, you set the expectations ahead of time, you know? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Exactly, exactly.

Catherine Maley, MBA: Better all the way around. Yeah. So, that pretty much wraps it up. How does this relate to the topic of the pros and cons of nurse injectors?

Do you have any final words or anything else you want?

Lisa Marie Wark, MBA: No, I don’t, but it’s so, great to see you and I, I put a light on me because it just got dark, so. See me. I don’t know if you notice. No, I saw that. Oh my God. Is that me in there?

Catherine Maley, MBA: No. I’ve literally been on these zoom calls where it was getting darker and darker and I’m sitting still and the light is way across the room.

I’m like, I can’t get over there. I don’t and I just started talking faster. So, Lisa Marie, thank you. So, much for being on. How can people get ahold of you if they want to learn more? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Sure. Okay, so, you can go to my website, www.LisaMarieWark.com. You can email me at [email protected], or you can call me.

It’s (702) 374-1944.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on the pros and cons of nurse injectors.

If you’ve got any questions or feedback for Lisa Marie Wark, MD, you can reach out to her website at, www.LisaMarieWark.com.

A big thanks to Lisa Marie for sharing her experience on the pros and cons of nurse injectors.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

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-End transcript for “Pros and Cons of Nurse Injectors— with Lisa Marie Wark, MBA”.