Offering laser hair removal as an adjunct service proves to be a practice-builder for three California DCs

For quite some time, laser hair removal was an ancillary the chiropractors at Millennium Health just outside Los Angeles wanted to add to their service mix. They envisioned it attracting more patients to their practice. And, of course, more patients would mean greater success for the group.

The Millennium Health staff in the Burbank office: (front row L–R) Maral Bardakjian, CA; Susanne Collelo, CA; and Debra Rowlett, RN; (back row L–R) Gagik Alvandian, DC; Armen Haroutiounian, DC; and Darab Badkoubei, DC.

Problem was Millennium Health lacked the financial wherewithal to fund the equipment, staff, and facility modifications.

“We felt that if we could just get our foot in the door, we knew we’d do well with it,” says Armen Haroutiounian (pronounced Har-toon-ee-an), DC, who with practice partners Gagik Alvandian, DC, and Darab Badkoubei, DC, runs Millennium Health from offices in the San Fernando Valley burghs of Burbank and Tarzana.

The doctors’ big break came when a local physician who also had been wanting to set up a laser hair removal service and approached them with a proposition: Would Millennium Health be willing to make available some space for a laser hair removal venture if he were to supply the equipment and a state-approved clinician to operate it?

Answering with a resounding yes, the Millennium Health chiropractors found themselves in the laser hair removal business, which, thus far, has lived up to their expectations.

“We not only receive a share of the revenues generated by the service, but, additionally, the medical doctor pays to rent the office space from us,” says Haroutiounian. “He also pays us to provide administrative support. As such, we’re able to reduce our office overhead. We consider decreasing overhead as much as possible to be important since it’s one of the main aspects that can prevent a practice from achieving profitability.”

Further, Millennium Health is reimbursed by the MD for costs incurred in the advertising and promotion of the laser hair removal service.

“The marketing we do for the service is our responsibility, but it is something we conduct separately from our chiropractic outreach, although the one benefits the other and vice versa,” says Haroutiounian. “There is a lot of lateral migration of patients between these two facets of our practice.”

That is not surprising, since laser patients mingle in the same waiting room with the chiropractic patients.

“Right there you’ve got the people talking to one another about the various services,” he says. “The word gets spread that way.”

Overcoming the Skeptics
Most first-time patients of Millennium Health come as a result of a referral. However, the group also relies on formal marketing to attract new patients. Gambits that have worked: cable-TV commercials (they are relatively inexpensive, so they can be aired repeatedly) and guest appearances on local talk shows (which allow audiences to judge whether the chiropractors are doctors to whom they would feel comfortable entrusting their care). Efforts that have bombed: Yellow Pages ads (the doctors are not sure why these do not work) and direct-mail coupons (prospective patients in this somewhat sophisticated market tend to be leery of doctors who rely on promotional gimmickry—it is seen as tacky and implies a lack of professionalism, Alvandian explains).

Naturally, some referred patients arrive harboring skepticism about chiropractic in general, Haroutiounian notes.

“It’s understandable,” he says. “A lot of them have been to four, five, six medical doctors and haven’t seen much in the way of results. When we finally get them, it’s usually because a family member or friend—someone we’ve treated and who has experienced good results—has pushed and pushed for them to come here. So, right off the bat, these first-timers have big doubts that we’re going to be able to accomplish anything positive for them. To get them past their skepticism, we usually have to spend most of the first encounter just explaining the cause of their problem and why nothing before has been able to help them. By the time we get to the end of that discussion, they usually start to show at least a little enthusiasm and hopefulness.

“The effort is often worth it, though. If we later help them get better, they then tend to become some of our strongest advocates and best referral sources.”

Among the biggest skeptics are, of course, medical doctors. However, the Millennium Health chiropractors are winning more and more referrals from them.

“The MDs here are slowly becoming more familiar with us, what we do, and the results we deliver,” says Haroutiounian. “In part, that’s because we’ve been determined to reach out to them with requests to let us show them our stuff. But it’s also because sometimes their patients are our patients too, and the word gets back to those doctors that we are getting good results, which makes them feel confident about referring others to us.”

Since launching in 1998, Millennium Health has acquired a reputation for taking active, patient-centered approaches to healing, Alvandian offers.

“We do some passive care, but mainly just to get patients out of the acute stage when they first present to us,” he says. “Education is really the major part of what we do. The goal is to educate patients so they are able to participate in their own recovery and then in the maintenance of their good health. Once patients become full participants in this, that is when they really see the results.”

Familiar Territory
Millennium Health’s sources of revenue are 30% cash, 40% insurance, and the balance split between workers’ compensation and personal injury.

In addition to straight chiropractic, the practice offers various adjunct therapies, including massage therapy, acupuncture, and nutrition counseling.

“There is one massage therapist at each office on a regular basis,” says Alvandian. “The acupuncturist and nutritionist have their own practices and visit our offices periodically. There are also two other chiropractors who are not part of our practice but use our facilities at specific times during the week.”

Badkoubei is based at the Tarzana office, while Alvandian works from the Burbank office. Haroutiounian divides his time between the two sites. They are 15 miles apart, and Haroutiounian’s commute takes him on one of the most congested freeways in Southern California.

“Traffic makes the drive longer than I would like,” he laments. “But I still put that time to good use. I get on the phone, I talk to the office, and resolve problems, or I talk to patients and answer their questions. It is also a good opportunity to contemplate about the practice and how to improve what we’ve got in place, make things operate more efficiently.”

When the practice was still in its infancy, there was but a single office, the one in Burbank. The doctors chose to set up shop there because that is where they grew up.

“We figured our practice would have the best chances of success if we served a community where we were already known to quite a few people,” says Haroutiounian.

Although all three lived in the same area, it was only Alvandian and Badkoubei who knew each other as kids. They were close pals in high school and remained so through college. Shortly after enrolling at Cleveland Chiropractic College in Los Angeles, they met Haroutiounian and became good friends with him as well.

“It was just sort of a given that the three of us would one day open an office and practice together,” says Haroutiounian. “We never really sat down and drew up a formal plan for it; the bond of our friendship was so strong that we just kind of automatically assumed we’d be business partners.”

Badkoubei adjusts a rehab patient’s upper thoracic spine.

Three’s Company
Haroutiounian decided on a career in chiropractic while in his late teens and recovering from a severe leg injury sustained during a hockey game in a Burbank city league.

“After surgery, I went to a chiropractor for rehab. I improved, got back up on skates, and was so happy with the outcome that it inspired me to become a chiropractor myself,” he recalls.

As soon as he was able, he enrolled at Cleveland. Alvandian showed up a year later, driven by a somewhat different inspiration. “I wasn’t too keen on allopathic medicine approaches to health, having seen several family members go to a succession of medical doctors who could only offer them pills that really didn’t help; I felt there had to be a better way,” Alvandian tells.

Gradually, Alvandian—a University of California, Los Angeles (UCLA) graduate with a degree in biology—came to realize that the human body possessed an innate ability to take care of itself. Once he developed that awareness, he needed hardly any prodding to look into the benefits of chiropractic.

“One of my friends went to chiropractic college after completing his undergraduate work at UCLA, and he showed me a lot of things about chiropractic that really opened my eyes,” he says.

Haroutiounian wrapped up his chiropractic training in 1997 and spent his first 8 months as a DC working for an established chiropractor. After obtaining his license in full, he went into practice with Alvandian and Badkoubei, both of whom graduated from Cleveland in 1998.

About 3 years after opening their practice, they added the office in Tarzana, which was close to the home Badkoubei had acquired.

Eventually, Millennium Health will relocate its Burbank office into a larger facility to accommodate more services. The doctors also are thinking of opening a new office about 30 miles north in the Santa Clarita Valley, an area to which one of them has been thinking of moving.

“We’ll be far enough away from any of our existing offices and established patient bases that we’ll effectively be starting from scratch in the Santa Clarita Valley,” says Haroutiounian. “That’s going to present challenges in and of itself. But the good news is that we know what works and what doesn’t, so we should be able to avoid many problems this next time around. Plus, the Santa Clarita Valley is a booming area—lots of growth and opportunity. We should be able to quickly build the practice and be successful early on.” CP

Rich Smith is a contributing writer for Chiropractic Products.