The author reports on her visit to a particularly up-to-date plastic surgery practice

Committing to using technology is about managing information to help you better treat your patients and to better manage and grow your practice. Ultimately, it is about improving efficiency and productivity, which allow your practice to be more profitable. As with all technology, however, a large commitment of time and money is needed to learn and implement a new system.

For many physicians who are inching toward the latter part of their career, a large change in their current practice pattern does not make sense. However, the value of a practice in which patient demographic and photographic data cannot be accessed easily is significantly lower than one in which a current patient database that can be used to market and grow the practice is maintained.

Going paperless and wireless enables the physician to eliminate the inefficiency, waste generation, and unnecessary costs typical of medical practices. The goal is to have the information you need at your fingertips when you need it.

This need is greater in the aesthetic practice that is customized to fit each patient’s needs and wants. If the system is set up efficiently, it should give each patient the right message, using the most convenient avenue—such as direct mail or e-mail—at the right time.

Management reports—containing inventory, revenues, trends, and expenses—that detail every aspect of your practice should be available to you at the push of a button. From a marketing perspective, this allows you to take advantage of market trends and to quickly recognize  failing strategies.

Obviously, whenever new technology is introduced, the physician must change at some level. The biggest hurdle when you introduce new technology that will save you time and money down the road is the learning curve. Initially, it can be frustrating to conquer new technology, but it can really pay off in terms of efficiency, in improved patient relations, and in a happier and more efficient staff.

This is something that you cannot do alone; you must enlist a cadre of staff and specialists to set up, train, and maintain the system. This is not because you cannot do it on your own, but because your energies are best directed toward patient care duties and personal obligations such as family. Think of it as “buying time.”

To learn firsthand the benefits of a high-tech medical practice, I visited the medical offices and surgical suite of Kirk Churukian, MD, a board-certified plastic surgeon in an upscale neighborhood in Los Gatos, Calif. Churukian has been in practice for more than 10 years and understands the value of investing in efficiency.

Churukian has invested hundreds of thousands of dollars in his new, state-of-the-art, state-certified surgical suite and medical offices. He guided me through the ins and outs of his high-tech office.

Churukian’s Facilities
The new office. With increased media focus on plastic surgery, patients have expectations with regard to the facility. This reflects the surgeon’s success and helps to confirm the patients’ expectations. The photo above shows what patients see when they enter Churukian’s practice.

Information and management of this information demands dedicated space for computer equipment—it’s noisy, so locate it away from staff work areas—and hardwiring of the offices and exam rooms for Internet and network access. A primary server and a way to back up the information are requirements for the office that is committed to building a high-tech information-management system.

Emergency power is a must! When your power goes out, so does your information-management system and your ability to effectively run your practice. There is a short delay between when the emergency generator senses the power outage and when it fires up. Thus, all your workstations and servers must be protected with power-conversion systems. This is a relatively expensive precaution, and it ensures that your practice remains open.

The state-of-the-art surgical suite.  Integrated surgical suites, a must in a modern surgical practice, are becoming a larger part of the aesthetic surgeon’s armamentarium (see photo on page 50). Your system’s video processor can access your server data and display preoperative photos and planning diagrams for intra­operative use. By using ceiling-mounted equipment booms, they use space efficiently. The monitors, drugs, and equipment must be equivalent to that available in surgery centers. The surgical suite must be well above the standard of care to minimize liability issues.

The information-management system. This is the keystone system in the office. Managing your patient demographic data and optimizing the scheduling of your time are key factors in using your time efficiently and minimizing patient dissatisfaction. An integrated program that can easily record, manage, and report data about your practice is the easiest one for the staff to learn and master.

Adding an inventory system to manage product sales, commissions, and stock levels is important to offer feedback and monitor the profitability of nonsurgical offerings. This system can track the supplies used during certain surgical procedures to analyze the expenses per procedure or surgeon.

When introducing new products and procedures, your best marketing opportunities are with your past satisfied patients. They should be quickly accessible through your own database.

One of the most powerful marketing tools is an Internet presence. This medium’s power as well as the marketing opportunities it can generate cannot be underestimated. The Internet is rapidly becoming the new “yellow pages” for the current and next generation of patients. An updated Web site is key to establishing a presence in an extremely competitive marketplace.

High-Tech Equipment List
Interested in setting up a high-tech practice? These items are musts:
• voice-recognition-to-text software for transcribing medical records and charting;
• a digital camera for patient photos;
• computer imaging to visually communicate patient expectations;
• video conferencing;
• an e-mail system for daily communication and e-mail marketing;
• video-presentation software using Microsoft Producer and digital stream;
• touch-screen monitors for patient information;
• endoscopic equipment for the surgical suite;
• PDAs;
• PC tablets used for EMR record-keeping;
• a scanning system to control inventory;
• flat-panel monitors with wireless connections;
• an LCD display panel (photo and video) for patient seminars and shows;
• computer imaging and photography equipment designed for consistent patient before-and-after photos; and
• the latest practice software with state-of-the-art patient-relations database management.

Patient information management. Moving into the realm of the electronic medical record (EMR) will likely be the most challenging for most physicians. Getting used to the digital format and establishing a workable routine for common procedures is the key to making this new technology practical. This is an evolving area, and significant and rapid changes are expected.

Voice-recognition software that converts speech to text has helped improve documentation and minimize transcription costs. Currently, with proper use, it approaches approximately 95% accuracy. Tablet PCs, which are about the size of a clipboard and use pen-based technology, seem to be the most popular for EMR use.

The recent technological advances can also enhance patient communication. Web conferencing, Web-based instructional programs, Internet video phones, and communication by e-mail to a BlackBerry® or Palm® Treo™ phone can teach, inform, and easily keep you in touch with your patients. Your talking head can easily be featured with your presentations using any digital movie camera and an existing slide set using a free program called Mi­cro­­soft Producer.

Documentation using photographs is a large part of a practice. A system using reproducible lighting and accurate positioning is key to comparing the effectiveness of your treatments. Extra flashes can be triggered by hard-wired attachments to the main flash, or by infrared beams.

Special positioning devices can ensure reproducibility. In addition, image manipulation to show patients the possible effects of surgery helps them visualize their concerns and markedly improves the communication with them.

The Bottom Line
I asked Churukian why he incorporated the latest technology into his office and if it was affecting his bottom line. He said that although the learning curve was steeper than he anticipated, it has been well worth it.

His patients—and, more importantly, his prospective patients—view him differently when they see his up-to-date office. They comment on it regularly, and he knows that this is differentiating him from all the other surgeons in this affluent and popular area.

He has also seen a change in his staff. They act more professionally and even dress better since they moved into his high-tech offices.

The bottom line is that technology helps you get organized and keeps you efficient. As a matter of fact, this entire article was created virtually using personal digital assistants, e-mail, digital photography, and cell phones.

Catherine Maley, MBA, is president and senior marketing strategist of Cosmetic Image Marketing in San Francisco. She specializes in helping aesthetic practices grow. You can contact her via her Web site,