Tweet an appointment reminder to a patient. Post photos from a Botox party on Instagram. Offer rewards for referrals. To social marketers, these strategies may sound like perfect cosmetic surgery promotions. But it turns out that each of these strategies could land a physician in court. That’s according to Alex Thiersch, a Chicago attorney and director of the American Med Spa Association.

Mr. ThierschCosmetic surgery has embraced social media to a greater extent than any other field of medicine, reflecting its unique reliance on marketing and advertising, says Mr. Thiersch. At the same time, he says, these retail-born strategies must be legal and ethical.

The problem is that those marketers and advertisers don’t understand the unique rules of medicine, says Thiersch, who spoke recently at The Aesthetic Meeting, the annual gathering of the American Society for Aesthetic Plastic Surgery.

“We’ve seen a lot of non-health care marketing companies start moving into this space from the insurance and auto industry worlds. They come in without any knowledge of health care regulation,” Mr. Thiersch tells Cosmetic Surgery Times. “They try to solicit doctors and say, ‘This is how we market, this is what has proved successful in industry X.’ To their credit, it often does, but they’re often using techniques that are just flat out illegal or toe the line of ethics.”

So what exactly could go wrong? Here are a few examples, compliments of Mr. Thiersch:

Tweets, Posts & Privacy

Posting Photos

Responses to Negative Reviews

Insecure Devices and Systems

Freebies for Referrals

NEXT: Tweets, Posts & Privacy

Tweets, Posts & Privacy

Twitter is a big part of social marketing, and a promotions consultant could tweet a patient with a simple message, such as, “Great seeing you today for your laser treatment. See you next week and don’t forget the sunscreen! #sunsmart”

The problem: A tweet like this violates a patient’s privacy.

Mr. Thiersch has heard “horror stories” of posts on social media that have inadvertently exposed the names of patients — and their procedures — to the world. “If you’re blasting out posts over social media, and you’re recognizing individual patients,” he says, “you need to be careful.”

NEXT: Posting Photos

Posting Photos

“Social media is all about posting photos,” Mr. Thiersch says. Cosmetic surgeons may have special events where someone snaps a photo of patients getting treatments. Or perhaps someone shoots a selfie at the event and a patient is in the background getting a Botox injection.

“Then it gets blasted on Instagram,” he says. While he hasn’t seen anyone get in trouble for this particular kind of privacy violation, Mr. Thiersch says it’s a clear-and-present danger.

NEXT: Responses to Negative Reviews

Responses to Negative Reviews

Have you ever received a negative review? It’s hard not to take it personally and your initial reaction can be to provide a detailed response to a negative review on sites like Yelp, Mr. Thiersch says. But watch out: You may violate a patient’s privacy by revealing too much information about their case.

Related: Negative reviews on Yelp: The physician perspecitve 

NEXT: Insecure Devices and Systems

Insecure Devices and Systems

“Everybody and their brother has smart phones and tablets,” Mr. Thiersch says. “People need to be careful about whether those devices are secure.”

At the office, be careful about allowing outsiders, like your marketing consultants, to gain access to computers that hold patient information. “The sole job of marketers is to bring people in,” he says. “They’re not coached on traditional medical health care issues.”

Keep in mind that protected health information goes beyond the basics of name, date of birth and condition. According to Thiersch, other protected health information includes email addresses, telephone and fax numbers, Social Security numbers and even car license plates and account numbers.

NEXT: Freebies for Referrals

Freebies for Referrals

Your credit card rewards you when you bring in a new customer. So why shouldn’t a cosmetic surgeon offer the same deal to his or her patients? A marketing consultant may want to start a program that gives patients a free gift card when they make a successful referral.

Think again, Thiersch says. “In most states you can’t pay something in value for a referral,” he says. If you try, you might violate anti-kickback laws.

Instead, just say “thank you” to the patient who provides a referral. And just say “no thanks” to a marketer who wants to take it a step too far. 

Potential plastic surgery patients are more likely to book procedures if they are price-aware than if they are not price-aware, according to a new study. The findings support price transparency in cosmetic practice, according to the study’s coauthor Jonathan Kaplan, M.D., MPH, owner, Pacific Heights Plastic Surgery, San Francisco, Calif., and developer of the lead generation-price transparency platform, BuildMyBod Health.

Dr. KaplanDr. Kaplan conducted the study in his first year in private practice in a new city by integrating the price-transparency platform, which is a cost-estimator, into his practice website. Consumers would make wish lists of cosmetic procedures and check to see what Dr. Kaplan would charge to perform them. Consumers got the price estimates, while Dr. Kaplan’s practice got consumers’ contact information for follow-up.

In the first year and without spending money on advertising, Dr. Kaplan’s website received 412 wish lists from 208 consumers. Nearly 18% of those consumers came in for a consultation and 62% of the people who came in booked a procedure. The average value of the booked procedures was more than $4,000 and the total revenue generated from all leads from the price transparency platform was $92,000, according to the study’s abstract.

When Dr. Kaplan compared non–price-aware patients with price-aware patients, those who knew price were 41% more likely to book a procedure.

The study concludes that prudent integration of price transparency into a medical practice can generate leads for patients who are paying out of pocket for medically necessary procedures, as well as procedures and services not typically covered by insurance, such as cosmetic surgery.

Cosmetic Surgery Times asked Dr. Kaplan if physicians who put their prices online should consider lowering prices or making sure they’re competitive in their communities.

“The point of price transparency, at least in cosmetic surgery, is not to have the most competitive, lowest price. We're not trying to attract ‘price shoppers,’" he says. “The doctor should want to provide honest pricing so that the consults he or she sees are more likely to progress from the exam room to the operating room.”

The key, according to Dr. Kaplan, is that cosmetic surgeons post pricing honestly — reflecting the true prices that patients would be quoted in the office.

“Sometimes I overestimate the cost to be more inclusive for all body types — a tummy tuck, for example,” Dr. Kaplan says. “That way, when most patients come in, because they're smaller than average, the OR time is less, so their cost is less. How many times has your actual price been less than the estimated price?! Patients love the surprise of something being more affordable!”

NEXT: Price Transparency: Not for Everyone

Price Transparency: Not for Everyone

Despite the potential benefits, price transparency isn't for everyone, according to Dr. Kaplan.

“I worked with one doctor … that integrated this pricing estimator into his website. He got a lead from a patient that checked pricing on a breast aug after entering [her] contact information into his pricing estimator. The patient came in for a consult and booked,” Dr. Kaplan says. “Instead of being thrilled that this lead became a paying patient, he told me how disappointed he was that the patient knew the price ahead of time because, once he saw the patient, he realized [she] could probably afford to pay more. Aside from being unethical to economically profile your patients, if you're this type of doctor, price transparency may not be for you.”

While the prices cosmetic surgeons post should be honest, they are estimates.

“If a patient checks pricing for a mini tummy tuck and they come to the consult and they really need a full tummy tuck, that's not an example of ‘bait and switch’ (which is illegal and unethical). That's educating the patient on realistic expectations,” Dr. Kaplan says.

Another important component of the online BuildMyBod platform, according to Dr. Kaplan, is that no one can see the prices for specific procedures until they submit a wish list of procedures and their contact information.

“So, if there's a nosy doctor that wants to check their competitor’s prices, then that nosy doctor will be receiving a call from the price transparent doctor's office, trying to book them for a consult,” Dr. Kaplan says.