28 JANUARY/FEBRUARY 2014 | MedEsthetics

By Janine Ferguson

Photography by Cory Sorensen

Dermatologist Anna D. Guanche, MD,

finds success by choosing and pursuing

the right patients for her practice.

DERMATOLOGIST AND DERMATOLOGIC SURGEON Anna D. Guanche, MD, entered medical

school with her sights set on becoming an orthopedic surgeon in the fi eld of hand microsurgery, until

a friend persuaded her to do a two-week rotation in dermatology. “T e morning of my very fi rst day of

rotation we did laser resurfacing, a lip fi ller and a large skin cancer surgery on the abdomen,” she recalls.

“I was dumb-founded. I could not believe that we could do all these procedures in dermatology.” At

lunchtime, she called her husband to tell him she would be changing her specialty. “I knew I would never

be bored. I love detail work—that’s why hand microsurgery appealed to me—but this allowed me to do

more than one area of the body,” says Dr. Guanche. “I can make people feel good, and it’s artistic, which

was something I wanted from the very beginning.”

The

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Customized CareAfter obtaining her medical degree at Louisiana State Medi-

cal School and completing her residency at the University

of Minnesota Medical Center, Dr. Guanche worked in a

dermatology offi ce in Thousand Oaks, California, for three

years. The desire for more freedom and a location closer

to her home and two children led Dr. Guanche to launch

her own practice in Calabasas, California. “It’s sort of like

growing up,” she says. “You go through a bit of being a kid,

and then you get growing pains and decide you have to do

your own thing.”

Ten years later, she is the owner of the Bella Skin

Institute, a dermatology practice that specializes in medical

dermatology, noninvasive cosmetic procedures and es-

thetic facial treatments. She credits the practice’s success to

its focus on creating customized treatment options. “Each

face is different and each person’s goals and budgets are

different. I have a lot of different devices so I can create the

right treatment for each person,” says Dr. Guanche.

Some of her most popular noninvasive procedures

include IPL, CoolSculpting (Zeltiq, coolsculpting.com),

Velashape cellulite treatments (Syneron, syneron.com),

Fraxel skin resurfacing (Solta Medical, fraxel.com), laser

hair removal, the VBeam laser for vascular concerns

(Syneron-Candela, syneron-candela.com), Thermage

radiofrequency skin tightening (Solta Medical, thermage.

com), and Ultherapy ultrasound-based skin tightening

(Ulthera, ultherapy.com).

“Eyelid surgery, blepharoplasty and mini-facelifts, along

with skin cancer surgery are the most invasive procedures

we do,” says Dr. Guanche. “We have celebrity clients,

moms, families and kids. It’s a varied patient population, so

we try to have a procedure for everyone. My favorites are

fi llers and Botox because they have minimal down time,

are high yield, and the patients look so much different

afterwards, they are so excited about it.”

Building a BusinessDr. Guanche describes her current staff as her “dream

team,” but points out that mastering practice management

did entail acquiring a new skill set. While doctors spend

many years learning how to care for patients, starting your

own practice requires an entirely different type of training

to address topics such as: How will you set up your busi-

ness; how will you market it; how will you put protocols

in place; and how will you hire and train the right people

who will treat patients the way you want them to be

treated?

“I think, in general, the staff follows the leader,” says

Dr. Guanche. “If the leader is good to her patients, then

that fl ows through the staff.” She based many of her busi-

ness strategies on the book Book Yourself Solid, which she

discovered early on in her career. “It helped me realize

that you must implement policies with clients, and stick to

them,” she says. “It also helped me to garner my and my

staff’s efforts in pleasing and pampering the clients. Clients

need your best efforts, and they will bring their friends.”

The book also helped Dr. Guanche fi ne-tune her

practice-building strategies. Rather than casting a wide net,

she focused on building the patient base that she wanted.

“It’s a directed way of working,” she says. “You focus your

efforts on the clients you want to attract. I shifted my

practice, and now we’re there. The people I see every

day are people I would hang out with. Coming to work

feels like fun.”

Dr. Guanche believes that taking this type of a per-

sonal approach with patients is the best way to build and

maintain a healthy business. “I always make a connection

with my patients. I am interested in them because they

are interesting people,” she says. “I want to know about

THE PERFECT FIT

“I always make a

connection with my

patients. I want to know

them, and they feel it.”

30 JANUARY/FEBRUARY 2014 | MedEsthetics

ake a

Dr. Guanche prides herself

on providing customized

treatment options.

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JUMPHEAD

32 JANUARY/FEBRUARY 2014 | MedEsthetics

them, and they feel it. It’s not just a business where you

come in and get your procedures done. I know entire

families—the little ones for warts, the older ones for skin

cancer, and the ones in the middle are coming in for fi llers

and Botox.”

Building these types of long-term relationships starts by

focusing on patient satisfaction. Dr. Guanche schedules

every patient for a follow-up within one to two weeks of

treatment. “I like patients to come back for a follow-up,

because once everything settles down, they may want a

little adjustment,” she says. “I almost always do touch-ups

at no charge. My goal at the end of the day is to have a

happy patient who looks beautiful. I always proactively

schedule patients instead of waiting for them to call,

because I fi nd that sometimes people are shy and don’t

call back. They may not want to complain but those are

exactly the patients that I want to keep.”

Although a large percentage of her cosmetic clients are

acquired through word of mouth, Dr. Guanche maintains

an active marketing program that includes Google ad

words, an SEO-optimized website and print ads in local

magazines. She also writes for a local magazine, which

increases people’s familiarity with her business, and

purchases space in backlits—which are similar to small

billboards—in the local commons shopping area.

“I have done more national advertising, but I fi nd

that local marketing is more effective. Some clips of me

were on Oprah and, interestingly, when that happened I

told my receptionist to be ready for a lot of phone calls,

but that exposure generated less phone calls than my

appearances on the local KTLA news,” says Dr. Guanche.

“When you are in a local magazine, people think you

are more accessible and actually call and come in. So I

changed my marketing strategy based on experience.

I would say, focus on your community fi rst, and then

slowly branch out. If you have a limited budget, market

to your core audience and get a reputation going. It can

branch out from there.”

Dr. Guanche uses a reminder program called Solu-

tionReach (solutionreach.com) that sends reminders a

minimum of once a year to patients in her database. It also

sends email, text and phone reminders to alert the patient

to upcoming appointments. “Working to get a new patient

is a lot harder than retaining and keeping patients happy, so

we reward the big spenders every quarter by giving them

a discount for the following quarter,” says Dr. Guanche. “It

helps us show our appreciation and garners loyalty.”

“If you have a limited

budget, market to your

core audience and get a

reputation going. It can

branch out from there.”

The Bella Skin Institute offers an

array of cosmetic and medical

dermatology treatments.

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Utilizing DowntimeAs with any business, there are slow days. Dr. Guanche

has learned over the years not to panic and instead

to channel her downtime into creative endeavors,

like networking in the community, developing a new

marketing strategy or improving work fl ow. “Every time I

have downtime, I am trying to make my fl ow better, fi nd

a better way of charting, of reaching out to patients or

develop new marketing,” she says.

Key to staying booked in the highly competitive LA

market is keeping up-to-date on the latest advances.

Dr. Guanche achieves this by staying active in the

dermatology community through dermatologic

societies and academia. She is a clinical professor at the

UCLA David Geffen School of Medicine and volunteers

at UCLA Olive View. “I love to be around the

residents,” she says. “They are young and vibrant, and

they teach me as much as I teach them. I have been

in practice for over 10 years, so I teach them clinically

through my experience with patterns and conditions in

the skin and how to approach them, and they teach me

a lot about the newest drugs and regimens. It keeps me

connected with the academic community, and it’s a way

of giving back.”

Though medical aesthetics has become increasingly

competitive, Dr. Guanche advises new private practice

physicians to think about the type of practice they want

to be running in the long-term, rather than grabbing any

business that is available. “You are going to be stressed,

because you have a fi nancial commitment you have to

meet,” she says. “But keep in mind that you should be

spending time and putting effort and energy into the

clients that you want to be around and that you want to

work with.”

Janine Ferguson is a Los Angeles-based freelance writer.

Dr. Anna Guanche with

her “Dream Team.”

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