These past couple of weeks, I have been sharing pictures with you in regards to conditions of the Nails and Skin on the Feet.  I hope they have helped you recognize the need to familiarize yourself with what you may encounter on a daily basis.  Remember, the Nail Technician “we” are many times the first responders.

However, a question I get asked many times and speak about in almost all my classes is “how do I form a partnership with a Dr. to refer to?”  this is a great question and not as easy as it sounds (I’m being honest here).  Finding that Dr. is challenging, it takes time and perseverance and it takes persistance.

The first thing you want to do, is find a group of Dr’s you “want” to do business with.  I recommend you seek out a Podiatrist or Medically licensed Pedologist.  I also recommend you seek out a Dermatologist and a Medical Dr or Internist.  All three of these Professions will be helpful associates.

The question is how do you find these Dr’s.  Referral is the best practice.  Kinda ironic huh?  But seriously, ask your clients, your family and your friends first.  Second, look in the newspaper, read local medical blogs, ask anyone you know involved in the Medical field.

Once you’ve obtained a list of names, do your research.  Google their names and see what comes up.  Go to their website and look at reviews.  You have to feel confident the Dr. you are referring to has great credentials and happy clients.

Once you have your three names, it’s time now to “ask” for their referrals.

My first recommendation is a letter.  Dr’s will not answer your phone call. A letter is the best first approach outside of scheduling an appointment with them…..and that in itself is not a bad idea.

I have a sample letter i’m happy to share, but the one thing to remember about Dr’s is their Ego!  Telling them they are GREAT, is a good way to approach them.

They also don’t really give a hoot about what your qualifications are.  It can make them feel intimidated.  You don’t want them to feel like you are better then them nor that you plan to take all their business away.

Therefore, the best approach is to tell them what you seek, by letting them know upfront……you NEVER want to go out of the limits of your license or as they would say “out of your scope of practice”  Which, is why you NEED them.

After you have stroked their ego and made your reasons clear, then you can state your qualifications.  Keep it simple and you don’t have to list the entire kitchen sink.  Also, express to them it is because of your qualifications or education that you recognize the need and the importance of a referral connection.

Finally, invite them into your facility.  Offering a Pedicure is the best approach.  However, you best make sure your sanitary procedures are over par and you are confident with the work you do.  Remember, you only have one chance to make a good first impression.  It doesn’t hurt either, to invite their staff for a service from your facility as well.

Now you have the letter complete, what do you do?  Mail it, fax it, email it….all of the above.  Several times!  That’s right……Several times is what it will take before you get a response.  You have to work through the Receptionist, the Office manager, the Nurse Practitioner and the Wife or Husband.  It takes many times and different venues before you may even be acknowledged.  Follow up with a phone call if necessary, but stay persistent and persevere.

Am I trying to scare you away?  Absolutely not.  I’m being realistic.  I’ve been in this industry a long time.  If I were to start a Salon again, finding Dr. referrals would happen before I even open.  In this day and age, it’s a necessity…..not a luxury.

Next week we’ll talk about referral slips and how the referral process actually works.

Feel free to email me for my recommendation on how to word a Dr. Referral seeking letter!  cj@centreforbeauty.com

In focusing on staying within the Limits of our License, I want to focus on how to handle a situation with a client of whom you may not be able to service.  

It’s not that difficult but it does take know how and confidence to turn down $$$$.  You can be sure however, not only do you end up making more money in the long run, you gain a lifetime client and you build a reputation of Professionalism with Honest intent.  We first need to make sure we are ALWAYS providing a consultation service.   But yet, there are still many out there that do not provide a consultation service.  

A consultation speaks of Professionalism.  I couldn’t imagine getting my hair done and my Hair Stylist performs a service without asking me questions, looking at my hair and discussing options.  This should be the same for the Foot Care service.  In my opinion, even more crucial.  You can’t identify and make your recommendations without a visual consult.  Not all feet are created equal, and neither should our Foot Care service be.

So now we have done our visual and we determine by the appearance of the thickness and discoloration, there is an “indication” our client has a toenail fungus.  Notice I use the word “indication”.  Short and sweet, WE AS NAIL TECHNICIANS CAN NOT DIAGNOSE!   However, based on our Education and Experience Mrs. XYZ, what I am observing is indicative of a fungus on your great toenail.

Your next 2 steps should be as follows;  1) Recommend she visits a Dr. for a culture test to determine if it is indeed a fungus.  This is why having a referral partnership set up with a team of local Dr’s is so important.  And yes, I mean a team.  You should have referral partners in Podiatry, Dermatology and General Practice.  2) You should carry an OTC product you can recommend to Mrs. XYZ.  OTC anti-fungal products vary from product to product in regards to what effectiveness these produce.  We don’t “kill” the fungus, that would be a Medical position.  But, we have great products that appear to dormant the growth or slow it.  And, the reality is……if you don’t recommend a product to Mrs. XYZ then she is driving to CVS to purchase an OTC product from them.

Now we are done with our consultation….can we proceed with the service?  Some may say no, but I say yes…..with provisions!  1)  No work is performed on the nail in question.  This means no clipping, filing, cuticle work or polish. 2) CLEAN, SANITIZE, DISINFECT!  Sadly, many take short cuts when it comes to products used for disinfection.  Know your products, know what your State requires AND go above and beyond.  Believe me, cutting corners on disinfection will cost you $$$$ later.

Do you ever feel like…..ARRRRRRRGGGGGGHHHHHH?  Helping all of you with what to do and not to do in the Pedicure chair is really challenging.  As Technicians we can’t diagnose, yet….in many cases, we are the First Responders.  Yet, one wrong move, one wrong statement can start a tizzy of comments.  And, one wrong mis-step in the Salon can not only cause potential damage to your client, but a potential lawsuit for you.

It occurred to me with so much talk about what we can and can NOT do and making sure we are staying within the limits of our license or not going out of our “Scope of Practice” that the importance of having some idea of what we are looking at is crucial.

As I sit in my office and look at ALL the educational books I have from various different entities of our business like (MiLady) (Death by Pedicure) as an example, why are we even being introduced to things which they want us to identify yet according to the “rules” we really have no business being introduced to? 

Well, i’m gonna take my chances and share with you some pictures of Nail & Skin conditions which, you will probably see in your lifetime of working in the Salon.  And, which each one…identify whether or not you should proceed with your service.  Which….BTW…..is the #1 question I get asked all the time.

Heel Callus:  Yes, as Nail Technicians “reducing” a callus is within the limits of our license.  However, remember to remove no more than 80{41aa4bb89c477f1e334505d76149b7c47b1e52c0a22817e445c0fb4c76e652bd}.  And, if there is any broken skin this could be a condition brought on by fungus and should be sent home with at home care products and/or referred to a Podiatrist.

   Hard corn:  NO….In the USA we are not licensed to remove corns.  You can slightly reduce with an acid free callous softening product (treat as a callous), but gently and softly and NOT all the way down.  Refer to a Podiatrist if client wishes to have it removed.  At home softening products also recommended.

  Trumpet Nail:  Also known as a Pincer Nail.  Commonly caused by an inherited disorder.  In rare occasions, improperly fit shoes.  Not a problem for the Technician to perform a Pedicure service as long as they have been cleared of any fungus.

Onychomadesis;  The nail shedding at the matrix bed as a result of a long-standing fungal infection.  Signs of a new nail would be prominent.  If cleared of infection, should be no problem for Technician to perform a pedicure service.  FYI…this can sometimes be associated in children with hand, foot, mouth disease.

Onychomycosis:  Most common disorder of the toenail.                                                It is a fungal infection of the nail module.  Should always be referred.                                                              Soooooo many different types and soooooo many different causes.  

Brittle, discolored, thick nails may mean you have nail fungus. It can affect fingernails or toenails. Prevent nail fungus by keeping hands and feet clean and dry, wearing dry socks and changing them often, wearing shoes in a public shower, pool, or locker room, and not scratching infected skin, such as athlete’s foot. Wear wide-toed shoes (so toes aren’t crammed together), and don’t share nail clippers.

  Nail pitting is most commonly seen in people who suffer from psoriasis. Approximately 50{41aa4bb89c477f1e334505d76149b7c47b1e52c0a22817e445c0fb4c76e652bd} of people who suffer from psoriasis will have pitting of the nails. Trauma to the nail growth plate or nail bed can also cause a pitted appearance with ridges. Sarcoidosis and bacterial and/or fungal infections may also cause pitting of the toenails.

Many conditions can cause white nails. One of the more common is psoriasis, which can affect the appearance and texture of the nails. Yeast and fungal infections may also cause the nails to appear white. Trauma to the nail from an injury or ill-fitting shoes can sometimes lead to an accumulation of fluid that lifts the nail and gives it a more white appearance. In some cases, white nails may be indicative of a more serious underlying condition, such as liver disease, diabetes, or congestive heart failure.  

 A fungal infection of the nails that causes discoloration and thickening of the toenails may cause yellow toenails. Other causes of yellow toenails can be diseases such as lymphedema, arthriticconditions, lung disease, or even repetitive trauma to the nails from tight shoe gear and stop-start athletic activities.

Occurring when microscopic fungi enter through a break in the nail or surrounding skin, a fungal infection can make your nails thick, discolored, and brittle. If left untreated, a fungal infection can spread to other nails. Thriving in warm, wet places such as shoes, pool decks, spas, and gyms, the fungi can be spread from person to person. It may begin from contracting athlete’s foot or incurring an injury to the nail, allowing an opportunity for the fungi to invade the nail. 

Being able to Recognize what you are looking for is Imperative

Referring to a B2B partner for testing and/or treatment is Professional

Recommending at home care products for at home care maintenance is                            Imperative & Professional

I will cover a few more over the next couple of weeks.  Print these pictures, keep them handy and always be prepared for What NOT To do!

www.cjscentreforbeauty.com