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Adding ancillaries: Laser hair removal


This is the first in a series of articles on specific ancillary services that can boost your bottom line and keep you and your practice busy in a competivtive healthcare market.

Beauty salons have been on the hair-reduction gravy train for years, and many upscale spas offer laser hair removal. Many people, however, feel that a laser is safest in a physician's hand. James Mirabile and Howard D. Ellis tapped into that sentiment when they added laser hair removal to their Overland Park, KS, ob/gyn practice in 1998. That proved so successful that the doctors expanded their aesthetic repertoire to include Botox, vein therapy, and face, neck, and hand rejuvenation. They also give seminars on how to add aesthetic procedures to a medical practice. Here's some of the advice they offer on photo depilation and some of the facts you'll need to decide whether to offer it.


There are several types of lasers on the market for hair removal. Look for one that has FDA clearance. To check for clearance, go to or ask the manufacturer for a copy of the clearance letter. (Recently cleared items probably won't be listed on the FDA's Web site.)

Before purchasing a laser, research the company. If it has a poor track record, you'll be canceling appointments and turning away potential customers while you wait for parts and service. Ask the sales rep for the names of other physicians who use the machine, and call these doctors to ask about their experience with the company.

Review the service contract carefully. A company might require you to ship back a malfunctioning machine, or it might outsource service-related telephone calls and repairs. Worse, it might shift liability for an improperly manufactured machine to you. Go with a company that sends its own service representative to your office and guarantees a 24-hour turnaround, even if it has to give you a loaner until it can fix your machine.


You can use your existing waiting room, exam rooms, and restrooms until business picks up. Ultimately, 1,000 square feet of space for this ancillary service is ideal. That allows for a small waiting room separate from your regular waiting room, two extra exam rooms, and a restroom/dressing area.


The laws governing who-other than physicians-can use a laser or light-based hair removal device vary from state to state, says Lisia Cooley-Walch, president of The Society for Clinical & Medical Hair Removal (SCMHR) in Madison, WI. For example, in Florida, the technician has to be an electrologist, have 30 hours of continuing education in laser physiology, and be accredited as a CME (certified medical electrologist) by the SCMHR. In Michigan, certified PAs and NPs can operate lasers in healthcare facilities. All others must be under the supervision of a licensed physician. Texas has no guidelines, so anyone can use a laser for clinical purposes, but this may change: A bill is pending in the Texas legislature to regulate laser utilization.

Courses in cosmetic laser uses provide instruction in the basics of laser physiology, and on marketing and managing the service. To find such courses, contact the American Society for Lasers in Medicine and Surgery ( 715-845-9283), or check manufacturers' Web sites. Topics covered include hair growth cycles, how to tailor treatment to a client's hair and skin type, and pre- and post-treatment care.

Because lasers differ, Cooley-Walch notes, most reputable manufacturers will send a trained technician to a purchaser's site for three or four days to train those who will be using the laser.

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Jennifer N. Lee, MD, FAAFP
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