Find someone smarter than you: The most important step is good management. Without that, people can, and have, lost everything. If you don't have good management skills, hire someone from outside medicine who does.

Franchises: “Turn key solutions”. That’s how almost everything is marketed to physicians. Buy this technology, hire this personnel, run these ad slicks, and everything will fall into place. Sorry. It doesn’t work that way. Most of these franchises are sold as a sort of “we’ve already worked out kinks” sort of deal. It’s a lie. Franchises focus on treatments that everybody else will be able to replicate with ease. It’s more a case of, “ In kingdom of blind, one-eyed man is king”. You don’t need a franchise.

All technology is not created equal: Despite what company reps will tell you, choosing right technology will mean big differences at end of year. Efficacy, cost per treatment, initial costs, usage, and a long list of other considerations should go into technology decisions. Many physicians jump first and then end up with $80,000 towel dryers that they still have to make payments on every month. Used medical devices are readily available from constant stream of bankruptcies and failed medical practices. Choose your technology carefully.

Understand marketplace: Medical spas are a luxury business. And for most physicians it comes as an unwelcome surprise that their new patients are more demanding. Long waits, aloof staff members, poor communication, and ambivalent staff, are all in past. You’re touting yourself as a luxury service, act like one. Hire top-notch people that are service-oriented, friendly and courteous. Protocols can be taught easier than attitude.

Rein in your ego: This is business. It’s not personal. If you feel you must charge twice as much as your competitors because you “deserve it” or you’re board certified, get used to empty appointment book. One of my personal pet peeves is condescending attitude of many physicians.

Do not use “advanced” or “laser” in your name: The number of “advanced” laser clinics is staggering. Don’t do it. It’s inane, overused, and bland. I actually had a physician ask me if changing his name from Advanced Laser Centers to Advanced Laser Group would get him more business.

Network with successful medical spas: Successful business owners are only to happy to help newcomers to industry. We have constant dialogue with physicians and investors who are investigating marketplace and have advised clinics on four continents. Successful medical spas will be happy to build bridges with smart businesses.

Don’t look to day spas to solve your problems: Physicians hear “spa” and immediately think that day spas have answers they’re looking for. Wrong. The average net margins for day spas are around 8%-10%. The average physicians is 60%. This is a different market.

Don’t base your pay on commission: Commissions sound like a great solution. You save overhead and motivate your staff to grow business. Wrong. Commissions are used in spas to keep overhead low, but guess what. Staff members working for commission aren’t working for you. Commissions lead to overly aggressive staff that don’t do anything for your reputation.

Don’t gild Lily: You may have heard that you have to “build out” your clinic at cost of $80-$120 per square foot. Nope. You don’t have to start with treatment tables that have your clinics name embossed on them. Spend all your money before you open and you won’t be able to spend it where you’ll really need it… getting butts in seats.

Stay lean: Physicians practice medicine based on science. You don’t need to offer massage and you don’t know anything about it anyway. Stick to basics.

More information is available online at www.surface-med.com

How does it get inside our bodies? It is mainly passed on through body fluids. The main fluids are:

Breast milk Blood Semen Vaginal fluids.

The most common ways that HIV gets inside our bodies include:

Penetrative sex (without a condom) Drug equipment (if it's already been used by an infected person) Getting blood infected with HIV inside us, such as sharing razors, or tatooing or body/ear piercing equipment. A woman to her baby during birth, or breast feeding.

What is AIDS? Although with careful medical interventions such as various drugs and treatments, many people with HIV can stay well for many years. Some people will still have times of illness, and people still die of AIDS-related illness.

If someone with HIV does become ill with one or more of a number of particular illnesses, they may be diagnosed medically as having "Acquired Immune Deficiency Syndrome" (AIDS).

AIDS itself is not a virus or a single illness. It is a term used to describe certain illnesses connected with HIV.

Help & Support One place to go is Department of Genito-Urinary Medicine (GU) clinic at a large hospital. The clinics are free and confidential. Anyone can go; doctors do not need to refer you.

There may be a specialist agency offering information, emotional support and practical help in your area. National AIDS help line (24 hours) Call: 0800 567 123