Our Story

The History of Einstein Medical, Cash-Pay Health Care, and the Internet

When you stop to think about how quickly technology advances these days, two years can seem like an eternity. Yet the story of Einstein Medical goes back more than two decades. In fact, our corporate history encompasses not only our own founding, growth, and development, but practically the entire history of both the cash-pay healthcare industry and the Internet as we know them today.

More than twenty years later, we're still around. We're still innovating, still growing, and still custom-crafting exceptional business solutions for doctors throughout the country and the entire world. As you will read, it has been quite a journey - for us, for our clients, and for the Web in general.


Einstein Medical: It All Began with Cataracts

Robert Silkey , an ambitious young medical consultant, is enjoying great success with a concept that has spread throughout the nation: the mobile cataract screening station. He sends the mobile station out to retirement homes and assisted living centers, offering free cataract screenings to seniors. A few days later, the vehicle is transformed into a taxi, transporting those seniors who wanted to have cataract surgery to trusted local ophthalmologists.

Although business has been good both for Mr. Silkey and for cataract surgeons, a change is in the air. During the mid-1980s, Congress began targeting Medicare reimbursement of cataract surgery in their cost-cutting measures. Now debates are raging on Capitol Hill as to whether many of the millions of patients who undergo cataract surgery each year even need it. The procedure has become the most commonly performed surgery among Americans over the age of 65, costing the government roughly .4 billion in 1991 alone.

Cash-Pay Health Care: Congress Cuts Funding of Cataract Surgery

In February, a panel of experts recommends to the United States Agency on Health Care Policy and Research that the government save millions of dollars by forcing eye surgeons to prove that cataract surgery is "medically necessary" and that patients cannot function with glasses or other visual aids. Ophthalmologists throughout the country argue that the removal of cataracts and subsequent placement of high-tech artificial lenses in the eyes vastly improves the quality of lives of senior patients. Nevertheless, Congress lays the groundwork for a plan that will limit the number of cataract surgeries that it will fund through Medicare.

Rather than have their practices constrained by government regulations, many ophthalmologists turn their sights to the emerging laser technologies that promise to revolutionize eye care. Clinical trials are being conducted to gauge the efficacy and safety of the excimer laser in reshaping the cornea. It seems inevitable that new laser procedures will very soon challenge the preeminence of radial keratotomy, or RK, in which a diamond knife is used to make corneal incisions with generally good, though not always predictable, results.

By shifting to a cash-pay model, these ophthalmologists will no longer be forced to tangle with the government over reimbursement for their work. They can better the lives of their patients while maximizing their profits. It represents a true win-win scenario.

The Internet: The Birth of a New Marketing Medium

Recognizing how attractive such a scenario will be, Robert Silkey reconsiders his business strategy. He predicts that this slow trickle of ophthalmologists from cataract surgery to refractive surgery will soon transform into a large-scale migration of physicians from managed to elective health care. And these physicians will require forward-thinking marketing solutions in order to capture the attention of prospective patients.

The Internet is still in its infancy at this point, but it is expanding rapidly. During the year, the number of websites reaches 600, a milestone that may seem quaint now, but represents an extraordinary development in 1993. Tellingly, the White House and the United Nations launch their first websites during the year. It is clear to Mr. Silkey that the emerging computer technologies would have to play a vital role in the marketing of cash-pay physicians and their services.

Revolutionary changes are being set into motion in both the information technology and the healthcare industries. The ambitious young medical consultant decides he wants to be at the forefront of it all.

A vision is born.


Einstein Medical: Open for Business

Over the course of two years, Mr. Silkey develops and refines his business plan, leading to the formation of Einstein Medical in July. He sets up shop with a few colleagues who share his vision, not to mention his boundless ambition and faith, in a 500-square-foot storefront in La Jolla. He decides to leave the "Catholic Bookstore" sign on the front of the building, not wanting to tip his hand too soon.

The initial goal for Einstein Medical is to pool the collective purchasing power of entrepreneurial physicians across the country and create a national marketing strategy. These collected resources would be used to fund national ads that would appear on network television and in major news publications and airline magazines. In turn, these ads would steer consumers toward an exclusive online directory of cash-pay healthcare professionals, which we christen DocShop.com.

Aside from being our first major product, DocShop.com is the first ever online directory of physicians, surgeons, dentists, and other practitioners in the elective healthcare field.

Consumers are able to search for experienced, reputable doctors by location and specialty. When they enter DocShop.com, they first see a map of the country. They can then click on their state, and finally their metro market area, which was based on the Nielsen breakdown of local television markets . There, they find an exclusive list of reputable specialists.

There is nothing else on the now-flourishing Internet even remotely like it.

Cash-Pay Health Care: The Elective Healthcare "Big Bang"

Robert Silkey's bet that the elective healthcare market was about to enter a period of explosive growth turns out to be a good one. In fact, if there was ever a "Big Bang" in the industry, a strong argument can be made that it occurred in 1995. Our newly founded team is fortunate enough not only to witness it, but also to be a part of it.

Ophthalmology in 1995

  • In March, the FDA approves the use of the EXCIMED™ UV200LA excimer laser system for the correction of nearsightedness in photorefractive keratotomy (PRK). This is the first time the agency has approved a laser to be used in refractive surgery.
  • Four years after it had first been performed in the United States as part of a clinical trial, LASIK becomes more widely available as an "off-label" use of the excimer laser in 1995.
  • In its September issue, Primary Care Optometry News features an article comparing radial keratotomy (RK) to PRK. The refractive surgeons surveyed for the article are said to believe that RK continues to produce results as good as, and sometimes better than, PRK. "In fact, one surgeon believes RK is so robust, it will not only coexist with PRK surface-ablation techniques but outlast them, surviving to become a complementary procedure to laser in situ keratomileusis (LASIK)." Although time will not bear out this theory, it seems like a reasonable conclusion to draw in 1995.

Plastic Surgery in 1995

  • The American Society of Plastic and Reconstructive Surgeons (ASPRS) launches Plastic Surgeons Online, a subscription-based service that allows surgeons to post and answer questions about complex cases. It also presents its first virtual conference, on rhinoplasty.
  • The American Society for Aesthetic Plastic Surgery (ASAPS) is awarded a grant to research the psychological effects of cosmetic surgery on patients. The two-year study finds that cosmetic surgery has positive effects on patients' quality of life and their perceptions of their well-being.
  • People runs an article entitled "Sexy Forever" in its October 16 issue, examining how female celebrities in their forties and fifties are managing to remain as attractive and fit as their younger counterparts. This trend is attributed in part to modern "cheek implants and collagen injections [that] are far more subtle than the artificial-looking face-lifts of yesteryear." Angela Lansbury and Goldie Hawn both endorse the current-day facelift.

Cosmetic Dentistry in 1995

  • A 1995 issue of FDA Consumer magazine features a report about the dental lasers then approved by the agency for use in soft tissue applications. The article also looks forward to the future of laser dentistry, predicting that lasers will be used in a wider variety of applications in years to come.
  • On July 1, 1995, CNN Money magazine publishes "Getting the Smile You Want at a Price You Can Afford ." The article focuses on improvements in cosmetic dentistry treatments and technology, emphasizing the fact that "elaborate treatments that were once mainly the province of the Hollywood set are trickling down to Main Street." Teeth whitening, porcelain veneers, and dental bonding are highlighted.

The Internet: The Search Engine Revolution

DocShop.com represents on a more focused scale what students, researchers, and engineers around the globe are trying to accomplish on a massive scale. They are working to find a way to catalog all of the information contained on the World Wide Web and make it accessible through a searchable user interface. 1995 is a watershed year in their attempts:

  • In January, Jerry Yang and David Filo move "David and Jerry's Guide to the World Wide Web" to its current domain at yahoo.com. By October, Yahoo! is averaging half a million visits per day and is consistently ranked among the top-ten most-visited websites.
  • Also in January, the six-month-old search engine Lycos expands its catalog of online documents to 1.5 million, the largest collection at the time.
  • Eleven months later, AltaVista premieres the first full-text searchable Internet database, comprised of 16 million documents.
  • During the summer, a Stanford student named Sergey Brin shows a prospective student named Larry Page around the university campus. They argue nearly constantly during this first meeting, so they probably have no idea that one day they will collaborate to revolutionize the Internet by creating Google.
  • In August, Microsoft launches The Microsoft Network to coincide with the release of Windows '95. The Microsoft Network, later marketed as MSN, represents the software giant's initial foray into the Internet wilderness.

It will be several more years before search engines can be relied upon to deliver relevant results for local searches. Nevertheless, the seeds of search as we know it have been planted.


Einstein Medical: The Launch of Einstein Custom Websites

During the year that Einstein Medical is formed into a legal corporation, a question is raised: How can we create a stronger bridge between our clients and their prospective patients?

With DocShop.com, we have a solid foundation upon which to build. Prospective patients who click on a physician's listing are able to find the physical address and phone number of his or her practice, along with a brief description. However, some people want a little more information about the practice, not to mention the procedures available to them, before making contact. By better serving this audience, we believe that we can increase our clients' intake of new patients exponentially.

We begin to advise our clients that they need to have customized practice websites. At this point, most of our clients don't have websites; indeed, while attending the 1996 meeting of the American Society of Cataract and Refractive Surgery (ASCRS) in Seattle, we discover that many doctors don't even know what a website is.

This stands to reason - there aren't many companies in the business of building professional, boutique websites for elective healthcare practices. This leads to some of our clients asking whether we could provide them with custom websites.

Our answer? Of course we can. (And we'll host them, too…)

Cash-Pay Health Care: Entering the Mainstream

We begin developing custom websites for our clients at a time when media attention is beginning to focus on the new technologies that will form the backbone of the cash-pay healthcare industry. Economically, times are good. People have never had more discretionary income at their disposal, and an increasing number are investing that income into elective procedures.

Ophthalmology in 1996

  • Refractive laser centers around the country devote a collective 0 million during the year to promote PRK and to educate the public about the benefits of using lasers in eye surgery.
  • Approximately 64,000 people undergo either PRK or LASIK in the United States. Although the FDA is still two years away from approving an excimer laser for use in LASIK surgery, the acronym is already on its way to becoming a household term thanks to heavy media coverage.
  • At the annual meeting of the American Academy of Optometry, a panel of experts is assembled to discuss LASIK, PRK, and RK. While relatively little of the discussion is devoted to LASIK, the merits of combining PRK and RK are debated at length.

Plastic Surgery in 1996

  • As part of then-ASPRS President Elvin G. Zook's 1994 initiative to improve the public perception of plastic surgery, the organization launches its first public website in 1996.
  • In its August 24 issue, the New York Times publishes an article about the increasing number of doctors transitioning from managed to elective health care. Among other factors contributing to this trend, the article cites the unwillingness of insurance companies to cover "new laser procedures" such as skin rejuvenation and hair removal.
  • ASPRS statistics show that an increasing number of men are undergoing cosmetic surgery. Compared to 1992, there is an 80 percent increase in male face lift surgery in 1996, while there is a 42 percent increase in brow lift.

Cosmetic Dentistry in 1996

  • The FDA approves the use of the light technology photopolymerization in professional teeth whitening treatments. The resulting power bleaching technique offers a more efficient and effective way for patients to dramatically whiten their teeth.
  • In July, Woody Oakes, DDS and Travis McFee, DDS contribute an article entitled "Saving Fee-for-Service Dentistry from the Managed Care Predator." As part of their scathing assessment of the managed care industry, the authors bemoan the fact that the American Dental Association, "unlike most other national organizations, has done practically nothing in the way of coordinating a national marketing campaign. Meanwhile, the insurance companies are spending huge sums… [on] programs that are killing our private fee-for-service dental practices."

The Internet: What a Difference Three Years Make

In a mere three-year span, the number of websites available via the Internet grew from 600 to approximately 100,000. While this number will later be dwarfed by the tens of millions of sites that would emerge in the next century, it confirms that the World Wide Web is indeed "catching on."

More importantly to our clients, consumers are beginning to turn to the Internet not only to research goods and services, but to purchase those goods and services:

  • The communications and networking company Cisco Systems, Inc., becomes one of the most aggressive pioneers of e-commerce, generating 0 million in sales from its website during the year. That number would reach
    billion the next year.
  • Jupiter Communications reports that the travel industry generated 6 million in revenue from online sources during the year.
  • During its first full year of business, Amazon.com becomes the fifth largest bookseller in the United States. The company is still years away from becoming profitable; nevertheless, its sales over six quarters (extending into 1997) grow by 3,066 percent, according to Morgan Stanley Dean Witter.

At this point, the few cash-pay healthcare websites that exist are fairly rudimentary, often consisting of one or two pages with little information. This is about to change.

1996-1997: A Tale of Ten Search Engines

At this time, Internet users usually have no choice but to search through multiple pages of results to find what they are looking for. Useful resources are as likely to be buried on page eight as they are to be found on page one. Because of this, the banner ads that frequently appear at the top and bottom of results pages are highly effective. Consumers often click on the ads, grateful that they don't have to wade through hundreds of results to find information about a product or service.

With this in mind, we buy the keyword "LASIK" on the top ten major search engines:

  • America Online (AOL)
  • Yahoo!
  • Netscape
  • Lycos
  • Webcrawler
  • HotBot
  • AltaVista
  • LookSmart
  • Goto
  • Infoseek

Many of these search engines don't realize the worth of "LASIK" as a keyword quite yet. In fact, we are only able to acquire the term from AOL by buying a bundle of more desirable eye care terms. At that point, they throw in "LASIK" for free.

At this point, there is no point in trying to buy "LASIK" on Google or MSN Search because they don't exist yet.


Einstein Medical: Continued Growth and Expansion

Einstein Medical launches dozens of websites during the year, offering five-page "starter" packages to help doctors establish their identities on the Internet. We build our reputation on providing cash-pay healthcare professionals with comprehensive web strategies. These include our proprietary "component strategy," which allows practices to expand their sites and encourage user interaction by adding the latest plugins, including the earliest versions of Java. Our clients' websites are consistently among the most dynamic, informative, and visually appealing of the day.

We stress to our clients that, in order to gain an advantage over their competitors, they must have websites that:

  • Combine engaging photos and text to tell the story of their practices
  • Educate prospective patients about the procedures they offer
  • Introduce themselves and their staffs
  • Explain the technology featured in their offices
  • Make it easy for prospective patients to contact them

Although we don't realize it at the time, we are anticipating what will become essential elements of Internet marketing. Both search engines and prospective patients are seeking information that is timely, relevant, and comprehensive. This is a concept that is not well understood in 1997, but that immediately distinguishes our clients from the rest of the pack.

In the meanwhile, the DocShop.com concept continues to grow as we launch our first procedure-specific version of the landmark directory: LASIK DocShop. Links to LASIK DocShop are prominently featured on such popular sites as CNN.com, directing thousands of prospective patients to our member doctors every day.

Cash-Pay Health Care: The Year of the Laser

Interest in laser procedures that had seemed so futuristic just five years prior reaches a new peak, while more than two-million patients undergo plastic surgery procedures that are mostly or exclusively cosmetic in nature.

Ophthalmology in 1997

  • Approximately 87,000 people undergo LASIK, even though the excimer laser has still not been approved by the FDA for use in the surgery. Clinical trials are proving extremely successful, however, and laser eye centers are continuing to open across the country at an astounding pace.
  • In the January 1997 issue of Ocular Surgery News, LASIK is characterized as "the brass ring" of refractive procedures. "The significance of LASIK is much higher than people initially thought," claimed Dr. Daniel S. Durrie, a member of the periodical's editorial board. "It gives the patients more of what they want. They want to have a quick visual recovery and no pain."
  • Drs. Junzhong Liang and David R. Williams continue their ongoing research into using wavefront technology to measure and correct aberrations in the cornea. In clinical tests, they are able to correct higher order aberrations, the first time in history this has been achieved. They present their results at the 1997 meeting of the Association for Research of Vision and Ophthalmology, laying the groundwork for custom LASIK and PRK.

Plastic Surgery in 1997

  • Laser skin resurfacing continues to emerge as a viable alternative to dermabrasion among patients looking to rejuvenate their facial skin. Plastic surgeons are looking to eclipse the record 46,253 laser resurfacing procedures they performed in 1996.
  • The American Society for Aesthetic Plastic Surgery (ASAPS) begins collecting detailed statistics on multiple specialties, including breast augmentation, abdominoplasty, and rhinoplasty. Their initial report shows that chemical peel is the most popular cosmetic procedure, with 481,227 performed during the year. The most popular surgical procedures are, in order, liposuction, blepharoplasty (cosmetic eyelid surgery), and breast augmentation. Overall, nearly 2.1 million cosmetic procedures are performed during the year.
  • Tellingly, the number of cosmetic procedures performed on males in 1997 is 286,790, or nearly 14 percent of all the procedures performed.
  • The ASAPS also reports that nearly one-quarter of the year's cosmetic procedures were performed on patients between the ages of 19 and 34. The public's perception of plastic surgery is clearly changing: it is no longer the exclusive province of the upper-middle-aged.
  • At the 30th Anniversary Meeting of the ASAPS in New York, Dr. Gregory Borah and his co-authors present a study showing that cosmetic surgery significantly improves the quality of life of most patients.

Cosmetic Dentistry in 1997

  • The laser age has also reached the dental profession, as the FDA approves the use of the erbium YAG laser for the treatment of tooth decay. This represents the first laser to be approved for the purpose of safely and effectively cutting human teeth - with little to no patient discomfort.
  • The Journal of the American Dental Association publishes the results of a survey, showing that 84 percent of dentists now offer professional, in-office teeth whitening, a procedure that had only recently been thought exotic and exclusive to celebrities and other public figures.

The Internet: The Passage of the Communications Decency Act

Congress passes the Communications Decency Act, the effects of which continue to be felt in profound ways nearly two decades later. The Act is born out of an attempt by the government to regulate Internet content, but ironically empowers people to explore the furthest boundaries of free speech under the cloak of anonymity. Per the Act:

No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider.

In essence, website owners cannot be held responsible for content posted by users, even if it is hateful, abusive, obscene, or blatantly untrue. The extent to which this Act will shape Internet communications will become increasingly clear in the next century, as review sites and social media platforms become part of the average Internet user's everyday experience.


Einstein Medical: The First Targeted Keyword Advertiser on MSN Search

By the end of the year, the FDA will have granted its approval of an excimer laser for use in LASIK, and more than 300,000 LASIK procedures will have been performed, according to American Academy of Ophthalmology estimates. As a keyword, "LASIK" becomes our crown jewel.

LASIK DocShop receives thousands of visitors a day, driven by both our organic search engine rankings and our banner ads. Anyone searching for information about LASIK on the Internet inevitably encounters our directory.

We continue to increase the profile of DocShop.com by working with new search engine companies as they the field. When we catch wind of Microsoft's intention to launch its own search engine, we call the company to discuss ways in which we might work together. Fortunately, our call is fielded by an ambitious intern who has the courage to act on his own rather than refer us up the chain of command. As a result, we become the exclusive content partner with Microsoft for the keyword "LASIK" on the fledgling MSN Search. Ours is a test case that is arranged through sheer chutzpah on both ends.

Cash-Pay Health Care: A Seismic Shift in Public Perception

The push to alter the public's perception of elective, primarily cosmetic procedures that began in the 1980s is beginning to pay major dividends. More and more people are viewing LASIK, aesthetic plastic surgery, and cosmetic dentistry not as procedures designed to correct "flaws," but as investments in a person's mental, emotional, and even physical health. As a result, cash-pay health care continues to command an increasingly large share of the total revenue generated by medical practices in the United States.

Ophthalmology in 1998

  • In July, the FDA dramatically changes the course of eye care by approving the Kremer Excimer Laser System for use in LASIK surgery. This is just the first of 29 laser systems that the FDA will approve for the procedure through the end of 2013.
  • The New York Times publishes "Call It Lasik, a Return to Normal Vision," an article that examines the current and future states of LASIK and PRK. In the article, Dr. Shachar Tauber, director of the Yale New Haven Laser Eye Center, acknowledges the importance of the Internet as an educational tool for people interested in LASIK: "Patients are becoming much smarter…The Internet has made us a whole lot smarter. When you go to your doctor and he doesn't talk to you about different options, then you feel, 'Well, maybe he doesn't keep up.' This is a blossoming field. If you don't grow, you'll die."
  • A survey conducted by Ophthalmology Management finds that the rapid growth of LASIK corresponds to an equally rapid decline in the number of RK and PRK procedures being performed. Survey participants report that, compared to 1997, they performed 43 percent fewer RK procedures and 23 percent fewer PRK procedures in 1998.

Plastic Surgery in 1998

  • Plastic surgeons continue the uphill battle to convince insurance companies that certain procedures such as gynecomastia surgery and breast reduction are "medically necessary" as opposed to purely cosmetic. The industry is awarded a major victory in October, when President Bill Clinton signs into law a budget bill mandating that insurance companies cover the cost of reconstructive breast surgery for women who have undergone mastectomy.
  • The phrase "minimally invasive" is being applied to an increasing number of plastic surgery procedures, thanks in part to the introduction of the endoscope into the field. Five years after the endoscopic technique was first successfully used in breast implant surgery, select plastic surgeons are beginning to offer minimally invasive facelifts and brow lifts.

Cosmetic Dentistry

  • An article in the April 20, 1998 edition of U.S. News & World Report warns of the potential dangers of over-the-counter, do-it-yourself teeth whitening kits. According to the article, consumers spent 3 million on such kits in 1997, with dubious returns on their investments. The safety and efficacy of professional teeth whitening are emphasized.
  • A study evaluating the overall clinical performance of porcelain veneers is published. According to the study's authors, "The retention rate of the porcelain veneers was 100%, and the maintenance of esthetics was perfect." As the phrase "smile makeover" begins to creep into the public vocabulary, the popularity of porcelain veneers continues to grow at an astronomical rate.
  • The FDA approves the BIOLASE® Waterlase® device for use in hard-tissue procedures on both adults and children. This constitutes an important milestone in both laser dentistry and pain-free dentistry, as the system uses laser-powered droplets of water to perform tasks that previously required a dental drill. Unlike the drill, the Waterlase® handpiece produces little noise and no vibration or heat and, in most cases, can be used without the need for an anesthetic shot. Not surprisingly, this new technology is marketed as a potentially ideal solution for people who avoid the dentist due to fear of the drill.

The Internet: The Beginning of the Modern Search Era

  • At a time when search engines are plentiful, if comparatively primitive, the launch of a new search engine barely causes an eyebrow to be raised. Nevertheless, the birth of Google will eventually overshadow virtually every other Internet milestone that occurs during the year. In Internet terms, the twenty-first century pretty much begins here.
  • Although there are debates as to which blog deserves the title of "first blog ever," there is no debating that the concept of the WebLog is spreading like wildfire in 1998. This is partly due to the emergence of technology that makes posting to the web much easier; no longer does a person need to know HTML or FTP to publish content. The first large-scale blog online blog resource, Open Diary, registers 10,000 accounts within six months of its October launch. Einstein Medical will become one of the first companies to recognize the potential of blogs to educate consumers about health care and generate revenue in the form of new patients from the Internet.
  • The first seven-figure sale of a domain occurs when Compaq purchases Altavista.com for .3 million. (Several months later, Larry Page and Sergey Brin offer to sell Google to Excite.com CEO George Bell for
    million. Famously, Bell declines.)


Einstein Medical: Expanding DocShop and Anticipating the Future of Search

As the decade draws to an end, nearly all of the top results for LASIK-related terms on all ten of the most popular search engines belong either to us or to our clients. Our clients are receiving national recognition from peers and patients alike. In fact, they're being flooded with calls and emails from people who want to know more about LASIK.

The only problem is that many of these calls and emails are coming from people who live nowhere near the physician they're contacting. In fact, some of them don't even live in the same country, let alone the same state.

This is not a shortcoming of our strategy, however. Search engine technology is still a few years away from catching up with the local search model we have put into place with DocShop.com. In the meanwhile, at a time when results for most search terms are haphazard at best, people who are searching for information about LASIK are finding loads of excellent information on the first page. It doesn't matter to them that these experts on the subject might be located hundreds or even thousands of miles away. Thanks to the Internet, the world has gotten a lot smaller.

The success of LASIK DocShop in funneling targeted traffic to our clients' websites confirms to us that we are heading down precisely the right trail. With the wind at our backs, we proceed to launch Dental DocShop and Cosmetics DocShop.

Cash-Pay Health Care: Business Is Booming

It's a good time to be in cash-pay health care, as thousands of physicians throughout the country are discovering. The evolution of traditional medicine has created a healthier populace with more money to spend on elective, primarily cosmetic procedures. And they are spending, in record amounts.

Ophthalmology in 1999

  • The number of LASIK procedures performed in the United States passes the one-million mark. Ophthalmology Management reports that the refractive surgery market will generate more than .1 billion in patient fees in 1999, compared to just 0 million five years earlier.
  • The approval of the VISX Excimer Laser System Model C "Star" by the FDA has ophthalmologists throughout the country abuzz. According to Ophthalmology Management, "Market leader VISX has been flooded with laser orders and is currently quoting lead times of four months or more."
  • The May 4 edition of the Canadian Medical Association Journal includes an article devoted to advances in refractive surgery, delving into the advantages and disadvantages of PRK, LASIK, RK, and other procedures. Among the chief advantages of LASIK over PRK is the rapid and relatively comfortable recovery associated with the procedure. While PRK requires an average of 514 days for vision to recover fully, LASIK requires an average of only 23 days. PRK, however, eliminates the risk of corneal flap complications. The article concludes that both surgeries are extremely effective, despite their risks, and likely to flourish in the upcoming new century.

Plastic Surgery in 1999

  • Compared to 1998, 66 percent more cosmetic procedures are performed during the year. While the number of surgical procedures rises an impressive 16 percent, the biggest increase is in the number of non-invasive procedures performed, which rises 98 percent. These numbers suggest that, along with improved awareness and acceptance of cosmetic surgery, advances in medically supervised skin care are re-energizing the industry. Of particular note, nearly half-a-million BOTOX® Cosmetic treatments are administered, three years before the FDA gives the injections their seal of approval.
  • According to an American Society for Aesthetic Plastic Surgery (ASAPS) survey, 82 percent of women and 72 percent of men would not be embarrassed if people outside of their family and friends knew that they had undergone a plastic surgery procedure. The transition of plastic surgery from social taboo to mainstream topic of conversation is nearly complete.

Cosmetic Dentistry in 1999

  • The January 3 edition of the New York Times features an article discussing "the mediagenic new breed" of dentist who is sensitive to the needs of patients and "operates in opulent surroundings, with an attractive staff trained to deliver concierge services like cappuccino and massage." American Dental Association President Timothy Rose attributes the expansion of cosmetic dentistry to "the drop in decay rate among America's fluoridated generation," which in turn has given modern dentists more time to focus on aesthetics.
  • The same New York Times article describes the shift in public attitudes about dentists, along with the burgeoning popularity of comprehensive smile makeovers: "Now, people do care about dentists, especially cosmetic dentists, who promise yet another form of makeover by whitening, straightening, or substituting inferior teeth with million-dollar…smiles."
  • On May 27, the American Academy of Cosmetic Dentistry launches Give Back a Smile (GBAS). The volunteer-driven program provides free cosmetic and restorative dental work to domestic violence victims whose smiles were damaged during an abusive attack by a former intimate partner or spouse.

The Internet: User Habits Continue to Evolve

As the century comes to a close, millions of people around the globe are terrified that the Y2K bug will lead to a complete breakdown of computer data systems, triggering mass chaos and, ultimately, the collapse of civilized society as we know. (Thankfully, this does not happen.)

The Y2K bug is seen as a threat not only to banks and other businesses, but also to the rapidly evolving Internet user, who is becoming increasingly reliant on computer technology in his or her personal life.

  • A report published by Pew Research Center for the People & the Press reveals that 32 percent of Internet users have bought something online, compared to just 8 percent in 1995.
  • According to the same report, 41 percent of Internet users use email exclusively for personal purposes, compared to 12 percent who use it exclusively for work purposes. In 1995, this ratio was 30 percent for personal purposes to 31 percent for work purposes.
  • Craigslist is incorporated, laying the groundwork for the expansion of the Internet's first major classified advertising platform.
  • The number of major players among Internet companies narrows as America Online (AOL) purchases Netscape for .2 billion.


Einstein Medical: First Round of Funding and the Launch of VAB Your Health

Einstein Medical opens the new century by closing its first round of funding, securing an additional .89 million in operating capital for the company. This makes possible the expansion of personnel, services, and product development that Robert Silkey had envisioned just five years earlier. We also introduce a new motto that reflects both our current and future direction: "Changing the Way America Buys Health Care."

During the year, we launch VAB Your Health, the first online magazine to deal exclusively with cash-pay healthcare topics. Guided by the credo "Look Better, Feel Better, Live Longer," VAB Your Health is regularly updated with original articles about laser eye surgery, cosmetic dentistry, and plastic surgery. Although marketed as a magazine, it anticipates the professional blogs that will one day become ubiquitous in virtually every industry.

The success of VAB Your Health confirms that prospective patients are seeking out quality educational content. By providing this content, we are able to augment our clients' sites and lay the blueprint for the education section that will eventually further distinguish DocShop from rival directories.

Cash-Pay Health Care: Setting the Technological Stage for the New Century

Technology across all fields is advancing at a record pace, and the cash-pay healthcare industry is no exception. As the number of patients undergoing elective procedures continues its remarkable rise, new technologies are making procedures safer, less invasive, and more cost-effective. FDA approvals continue to fly fast and furious.

Ophthalmology in 2000

  • Blade-free, all-laser LASIK is now a possibility. For the first time, a femtosecond laser is used to create the corneal flap through which the underlying tissue is accessed, eliminating the need for the handheld microkeratome blade. In 2001, the FDA will approve the IntraLase® laser system for use in the procedure. Although practices are slow to embrace the technology at first, the fact that a corneal flap was successfully created by a laser has ophthalmologists abuzz. Soon, blade-free LASIK will be widely available, with more than one-million procedures performed over the next five years.
  • The FDA approves conductive keratoplasty (CK) for "the temporary reduction" of farsightedness in people over the age of 40. The procedure involves the application of low-level radiofrequency energy to targeted sites around the cornea. This causes surrounding tissues to shrink, giving the cornea a steeper shape and restoring near vision in patients with hyperopia or presbyopia.

Plastic Surgery in 2000

  • It is becoming easier for women who wish to augment their breasts with breast implants to actually do so. In May, the FDA officially approves, with conditions, saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical (later renamed the Inamed Corporation).
  • Also in May, the results of a study showing that liposuction may offer health benefits in addition to cosmetic benefits are presented to the American Society of Aesthetic Plastic Surgery. The study found that liposuction may lower blood pressure and reduce insulin resistance. Although intended as a body contouring procedure rather than a weight-loss procedure, liposuction consistently lowers the body mass index (BMI) of patients involved in the study. In the meanwhile, liposuction continues to be the most popular form of plastic surgery, with 376,633 procedures performed in 2000.
  • The number of BOTOX® Cosmetic procedures performed tops 1 million, even though the injectable treatment has yet to receive approval from the FDA.

Cosmetic Dentistry in 2000

  • Dr. Nicholas C. Davis contributes an article entitled "COSMETIC DENTISTRY: Cosmetics 2000 and Beyond" to the Oral Health Group magazine. In the article, he examines the shifting focus in dentistry from disease and pain control toward "changing one's appearance purely for the sake of beauty." While he acknowledges that disease control will remain the primary function of dentistry, he predicts that the result of all dental work will be "a naturally beautiful, seemingly untouched dentition. Clearly, there will be a greater artistic component to our scientific approach to treatment ."
  • Dr. Davis also predicts that an increasing number of cosmetic dentists will be working as part of a muldisciplinary team that provides "smile and facial enhancement treatment." This group may comprise "orthodontists, oral and maxillofacial surgeons, periodontists, cosmetic dentists, cosmetic dental laboratories, plastic surgeons, dermatologists, estheticians, hairdressers, and make-up artists."

The Internet in 2000: Japan Leads the Charge in the Wireless Revolution

The Wireless Revolution is moving ahead at full speed in Japan, where more than seven-million people are able to access the Internet via cell phones and other mobile devices. In an article entitled "Unwired: Japan Has the Future in Its Pocket," author Daniel Scuka laments that while most of the world continues to access the Web "through clunky, old-fashioned hardware - blatantly immobile desktop PCs and two-pound laptops…Japan is the first nation to enjoy fulltime, always-on mobile access via cell phones."

In November, Scuka is treated to a preview of a technology developed by Packet Video, a tech company in Tokyo: TV-quality streaming video on a handheld iPaq computer. As quaint as this concept may seem a decade later, it's still nearly unfathomable in the United States in 2000.


Einstein Medical: Relocation to Southern California's Hi-Tech Capital

After six prosperous years in La Jolla, Einstein Medical moves its headquarters to Sorrento Valley, widely recognized as one of the most important hubs of technology in California and, indeed, the world. This move occurs as the company's growth, both in terms of its services and its team, continues unabated.

Reflective of this growth, we expand our sights beyond the cash-pay healthcare market for the first time in April, extending into reimbursed medicine in conjunction with the annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS) beginning on April 28. Just two days later, April 30 is declared Einstein's Day in Hi-Tech Ed by the California Legislative Assembly in recognition of the company's dedication to promoting technology education for San Diego's youth.

During the year, we will also make one of our most crucial hiring decisions when we bring Sergiy Zubatiy into the fold. A former research scientist at the Kharkiv Polytechnic Institute in Ukraine, where he also earned his Ph.D. in mechanical engineering, Dr. Zubatiy begins his Einstein Medical career as a software engineer, but will soon be promoted to director of software development and, in 2010, chief technology officer (CTO). Among his many accomplishments, he is a driving force behind our emergence as pioneers in Software-as-a-Service (SaaS) applications.

Cash-Pay Health Care: New Technologies, New Procedures

Faster , safer, and more effective are the catchwords driving the evolution of cash-pay healthcare technology so far in the early 21 st century. In response to the public demand for aesthetic and other elective procedures, doctors are continually integrating new technologies and techniques into their practices. In most cases, the phrase "new and improved" is no mere marketing spin - technology really is improving, and rapidly.

Ophthalmology in 2001

At the annual American Society of Cataract and Refractive Surgery (ASCRS) meeting, one of the hot topics is LASEK, the latest development in laser eye surgery. Unlike LASIK, which at this point requires the use of a microkeratome to create of a flap in the epithelial layer of the cornea, LASEK uses a dilute alcohol solution to loosen the epithelial cells. These cells are then moved aside to expose the underlying tissue, at which point the excimer laser is used to reshape the cornea exactly as it is in LASIK.

Despite its name, LASEK is a closer relative of PRK than of LASIK; in fact, in cases in which the epithelial cells are too weak to replace over the cornea, they can simply be discarded, erasing the line between LASEK and PRK.

Plastic Surgery in 2001

  • The results of a Mayo Clinic study of 250 female patients who underwent facelift surgery between 1970 and 1975 are released. When researchers followed up with the study subjects more than 20 years later, 66 percent were still alive, with an average age of 84 years. Of the patients who had died, the average age of death was nearly 82 years. The average life expectancy of the women who had had a facelift was more than ten years greater than the average life expectancy of the general female population.
  • The American Society for Aesthetic Plastic Surgery reports that 8,470,363 cosmetic surgery procedures are performed during the year. Since 1997, the number of procedures performed in the U.S. has more than quadrupled. Liposuction remains the most popular surgical procedure (385,390 performed in 2001), while BOTOX® Cosmetic continues to lead the pack among non-surgical procedures (1,600,300 in 2001).
  • More than 20 percent of the liposuction procedures performed during the year were performed on male patients. Nearly as popular among males is rhinoplasty, with 54,368 procedures performed in 2001 (compared to 123,048 procedures performed on female patients).

Cosmetic Dentistry in 2001

The reputation of the CEREC machine is improving among dentists, thanks to the launch of the CEREC 3 the previous year.

The original CEREC machine, released in 1987, had a single diamond milling wheel guided by images that, by CEREC 3's standard, were fairly low-resolution. Due to these limitations, this first version of CEREC was used exclusively to make inlays, which did not always fit perfectly.

CEREC 2 , from 1994, offered vast improvements due to its higher-resolution camera and the ability to craft all-porcelain onlays, crowns, and veneers in addition to inlays. Unfortunately, it's not the most user-friendly piece of technology, causing many dentists who otherwise might have embraced the concept of "single day restorations" to shy away.

CEREC 3 , however, combines seven years' worth of technological improvements with the friendlier user experience afforded by modern software. Word-of-mouth among dentists is positive, and the CEREC 3 is finding a home in cosmetic dentistry practices across the nation. By the end of 2002, more than 2,500 American dentists will be using CEREC 3.

The Internet in 2001: The Beginning of the Wikipedia Era

  • On January 15, Wikipedia is launched by Jimmy Wales and Larry Sanger. Although the concept of an online encyclopedia dates back to a proposal by Rick Gates (no relation to Bill) from 1993, and refined by Richard Stallman in 2000, Wikipedia represents the first successful online information resource over which no single entity has editorial control. Although many people initially assume this to mean that Wikipedia is a poor resource for reliable information - and sometimes, especially in its earliest days, it is - its insistence on credible citations helps to usher in a new age of academic integrity to the Internet.
  • The University of California Los Angeles (UCLA) publishes its 2001 Internet report. Among its findings, 72.3 percent of all Americans use the Internet, as opposed to 66.9 percent in 2000. Of these Internet users, 27.1 percent have an annual income of ,001 or more. More than 10 percent have an annual income of greater than 0,001, which bodes well for cash-pay healthcare professionals who have embraced the Internet as a marketing medium.

2001-2002: The First Shots Are Fired in the SaaS Revolution

Although computer technology is evolving at an astonishing rate, most people continue to think of software as a tangible thing: something that is bundled together with written materials, packaged in a shrink-wrapped box, and sold at any decent electronics store.

Yet, there is already an alternative, one that has the potential to revolutionize data storage and business communications. In a report published by the Software & Information Industry Association in February 2001, this alternative is defined as Software as a Service (SaaS). The report is bold in the predictions it contains:

Software as a Service (SaaS)…is heralded by many as the new wave application software distribution…many believe that traditional packaged desktop and enterprise applications will soon be swept away by the tide of Web-based, outsourced products and services that remove the responsibility for installation, maintenance, and upgrades from over-burdened MIS [management information systems] staff. Some analysts and industry members believe that packaged software, as a separate entity, will cease to exist.

This is a concept that most people are not yet ready to embrace; in fact, at a time when the phrase "in the Cloud" is still years away from coming into use, most people don't even understand the concept.

Nevertheless, the SaaS model offers solutions that will make our clients time, money, and resources. The problem is that there aren't any SaaS apps out there that are made specifically for healthcare professionals. In fact, at this point, there aren't that many great SaaS apps out there at all.

As was the case with our Einstein websites, we see a need that is going unfulfilled in the cash-pay healthcare industry and take it upon ourselves to fill it. With the launch of our proprietary IMPACT software in 2001, we not only provide our clients with a tool to make their businesses more efficient, but we also become one of the early Software as a Service (SaaS) providers.


Einstein Medical: Making an IMPACT on the Software Industry

In March, Einstein Medical releases IMPACT Version 1.5, an updated version of our initial foray into Software as a Service (SaaS). While the acronym "SaaS" may not mean much to our clients yet, the benefits of the technology are clear. Unlike traditional packaged software, SaaS apps such as IMPACT are:

  • Automatically updated
  • Accessible on any computer from anywhere in the world
  • Customizable to your needs
  • Not subject to downtime for scheduled maintenance or software patches
  • Never out-of-date - everyone has the same version at the same time
  • Built to expand in scale to accommodate user growth

IMPACT proves to be an invaluable marketing and organizational tool, allowing our clients to compile their patients and prospective patients into a sortable database. Whenever users submit a contact form, their names and provided information go into the database, and they are immediately notified via email that their inquiries were received. Doctors can then use IMPACT to send out future emails to any or all of the patients in their databases.

IMPACT lives up to its name, impacting the cash-pay healthcare market profoundly and all but making direct mail obsolete, or at least optional. Our clients are able to send special offers, brochures, practice news, appointment reminders, holiday cards, invitations to seminars, and other important information electronically and effortlessly.

The reception for IMPACT is overwhelmingly positive, confirming to us that the SaaS model is one that we should adapt for all of our software solutions going forward.

Cash-Pay Health Care: Another Big Year for FDA Approvals

The year ushers in another wave of landmark FDA approvals throughout the elective healthcare markets. Many of the technologies that continue to represent the state of the art in 2014 are approved in 2002.

Ophthalmology in 2002

  • In August, five years after Drs. Junzhong Liang and David R. Williams presented the results of their research into using wavefront technology to measure and correct flaws in the shape of the cornea, the FDA approves Alcon Surgical's CustomCornea system. In clinical trials, the wavefront-guided system was able to reduce all higher-order aberrations in 38 percent of patients while still producing consistently excellent correction of myopia. We are officially entering the age of Custom LASIK.
  • IBM researchers Rangaswamy Srinivasan, James Synne, and Samuel Blum are inducted into the National Inventors Hall of Fame for an invention without which Einstein Medical might not exist: excimer laser surgery.
  • Approximately 1.8 million LASIK procedures are performed during the year, a record number for an elective surgical treatment.

Plastic Surgery in 2002

  • Plastic surgeons and dermatologists across the country exclaim "FINALLY!" when the FDA approves the use of BOTOX® Cosmetic for the reduction of frown lines for up to 120 days. BOTOX® Cosmetic continues to be the most frequently performed non-surgical cosmetic procedure in the United States, with 1,658,667 treatments administered in 2002 according to American Society for Aesthetic Plastic Surgery (ASAPS) statistics.
  • ASAPS statistics also show that abdominoplasty (tummy tuck) is becoming increasingly popular, with 83,043 performed during the year. This represents the most significant statistical growth of any cosmetic procedure, at 17 percent year-over-year.
  • The FDA approves clinical testing of Silimed's high-strength, ultra cohesive silicone gel breast implants, which will soon informally but popularly be known as "Gummy Bear" implants. Unlike current silicone gel implants and their saline counterparts, ultra cohesive gel implants maintain their shape and will not leak in the event of rupture. They have been available in Europe for nearly a decade and were approved by Canadian regulators for use in breast augmentation in 2000. With the FDA still unwilling to allow standard silicone gel implants back onto the U.S. market, timely approval of "Gummy Bear" implants seems unlikely.
  • In April, ASAPS honors Einstein Medical with the Gold Sponsor Award, recognizing us for our commitment to and support of the plastic surgery industry.

Cosmetic Dentistry in 2002

  • The FDA approves the PerioLase® dental laser for the treatment of periodontal disease. This clearance results in the widespread availability of minimally invasive laser gum surgery throughout the United States. (Interestingly, Dr. Robert H. Gregg II, one of the founders of the company that manufactures the PerioLase® system, compares the device to the excimer laser used in laser eye surgery, noting that ophthalmologists "performed 1.5 million LASIK procedures. We believe PerioLase® will have the same kind of patient appeal."
  • In its July issue, Dentaltown magazine includes an article about the importance of imaging technology to communication between dental practices and dental labs. Drs. Merrill Grant and Adrian Jurim posit 35mm photography as the best available method of capturing dental images, but acknowledge that "more and more dentists are switching to digital…[they] are very convenient. Sometimes a dentist can email images to the lab while their patient waits to discuss a case."

The Internet: More Efficient Computers and a Breakthrough for E-commerce

  • Hitachi announces that it has developed the first water-cooled notebook computer. While water-based radiator systems have long been used to cool larger devices such as complex supercomputers, this is the first time that the technology has been applied on a smaller scale. This is yet another stride toward solving the overheating problem that has plagued portable, high-speed computers.
  • Although celebrating a net loss of .1 million in a quarter may seem odd for a business, Amazon.com is not a typical business. When the company was launched in 1995, it was built on a model in which eventual profits would reward those who had endured years of substantial losses. The loss of .1 million in the quarter ending September 30, 2002 is the closest the company has ever come to being profitable, and stands in stark contrast to the 0 million it had lost in the same quarter the previous year. This is a milestone in e-commerce, one that anticipates a bright future for businesses that have strong Internet strategies in place.


Einstein Medical: Expanding and Solidifying Our Infrastructure

Two years after moving from La Jolla to Sorrento Valley, we realize that we need an even bigger office in order to expand our infrastructure. We acquire 23,300 square feet of prime office space, also in Sorrento Valley, in order to increase the scale of our operations and continue creating exceptional business solutions for our clients.

Among those solutions is the Einstein Client Extranet, our latest Software as a Service (SaaS) innovation. Accessible 24/7 from any computer with an Internet connection, the Extranet allows clients to view their website statistics, email contacts, search engine placement for targeted keywords, and other pertinent data in one convenient location. There is no web marketing management tool like it in the world, and it remains one of our flagship SaaS products to this day.

Cash-Pay Health Care: Extreme Makeover Hits the Airwaves

The popularity of Extreme Makeover reflects the public's more positive view of cosmetic medicine, as the show shines a light not only on plastic surgery, but on cosmetic dentistry, laser eye surgery, and cosmetic dermatology, as well. In the meanwhile, the media treats the growth of the elective healthcare industry with skepticism; however, the overwhelming success of the latest cosmetic procedures is made crystal clear by the high national rates of patient satisfaction.

Ophthalmology in 2003

  • CBS News runs a story about wavefront-guided custom LASIK entitled "New, Improved LASIK Surgery." Although the story cautions about the risks associated with the procedure, it also provides a balanced presentation of the benefits. In fact, it contains a quote from a patient who had previously not been allowed by her ophthalmologist to undergo conventional LASIK but achieved 20/16 vision with custom LASIK: "It is life-altering…Can you tell I'm giddy?"
  • On November 14, the FDA approves the Crystalens® intraocular lens (IOL). The Crystalens® works with the eye's natural focusing systems to produce clear vision at all distances after cataract surgery.

Plastic Surgery in 2003

Plastic surgery gets perhaps its most powerful push into the public's consciousness yet in the form of the ABC Network's new show Extreme Makeover. The program is a surprise hit, attracting on average nearly 11 million viewers a week. Although the show largely focuses on people who volunteer to undergo plastic surgery procedures, many of the show's participants also receive cosmetic dentistry treatments and laser eye surgery.

Before launching the show, ABC producers approach the executive committee of the American Society of Plastic Surgeons (ASPS) for permission to users its members to participate in the program. The committee reviews the show's patient selection process to ensure that it reflects the high ethical standards of the organization. An agreement is reached, stipulating that ASPS member surgeons may appear as long as the importance of the doctor-patient relationship is made clear and that the program does not become a "contest."

Detecting a clear opportunity to help plastic surgery cross over into popular culture, Einstein Medical signs an exclusive advertising agreement with ABC for the Extreme Makeover website. As part of this agreement, the website will feature our before-and-after photo galleries. Our clients immediately benefit from the increased exposure, while Extreme Makeover is lauded by ASPS for its high standards.

Cosmetic Dentistry in 2003

  • One of the most popular treatments in cosmetic dentistry right now is "instant orthodontics," intended as an alternative to traditional braces for patients with minor malocclusion. The treatment entails the placement of custom-crafted porcelain veneers on teeth that are irregularly shaped, separated by gaps, or slightly crooked. Eligible candidates emerge from treatment with a smile that looks balanced and beautiful; however, they also enjoy the oral health benefits of an improved bite and reduced risk of teeth drifting out of their ideal alignment.
  • The concept of the dental spa is gaining popularity, and many cosmetic dentists are experiencing dramatically improved rates of patient retention as a result of offering spa-like services, according to an article published in the Puget Sound Business Journal. In the article, Tracy Skenandore, the coordinator of the Journal of Cosmetic Dentistry, estimates that "the majority of [the American Academy of Cosmetic Dentistry's] members are seeking" to integrate spa-like services into their practices "in some way, shape, or form."

The Internet: The Beginnings of Social Media

  • Although its popularity will later be eclipsed, MySpace sets the stage for the rise of social media as we now know it when it is launched in August 2003. Until 2008, when it is overtaken by Facebook, MySpace is the most visited social networking site in the world - and, for a month in 2006, even surpassed Google as the most trafficked site in the United States. For a while, the Rupert Murdoch's purchase of MySpace for 0 million in 2005 appears to be an absolute bargain.
  • Also in August 2003, Skype is launched. Skype users are able to communicate with each other via microphone, instant message, and webcam. While millions of individuals use the service for personal purposes, Skype's videoconferencing features give doctors a powerful communications and business tool, making practice management that much easier and convenient.


Einstein Medical: New Software, New Leadership Structure

During the year, two of Einstein Medical's long-time employees are promoted up the executive ladder, as Ted Ricasa is named vice president and general manager, and Dennis Gerasimenko is named director of information technology. Both Mr. Ricasa and Mr. Gerasimenko remain part of Einstein's executive backbone, as president/COO and vice president of information technology, respectively.

The structural changes within the company are made in response to the company's rapid growth, both in terms of personnel and in terms of product offerings. DocShop.com continues to be the Internet's premier directory of cash-pay healthcare professionals, while our medical websites are setting new standards for comprehensiveness and usability. In September, we expand our Software as a Service (SaaS) offerings with the introduction of Secure Med Mail. This proprietary, HIPAA-compliant communications software allows doctors and patients to communicate with each other more easily and effectively than ever before possible.

Cash-Pay Health Care: Another Year of Significant Market Growth

The growth of various elective healthcare markets shows no signs of slowing. Reflective of this, Americans spend nearly .5 billion on plastic surgery procedures alone during the year.

Ophthalmology in 2004

  • For the first time, eye surgeons can market custom LASIK for the correction of hyperopia (farsightedness) with the FDA's blessing. The approval allows surgeons to combine WaveScan® diagnosis and CustomVue™ treatment to correct hyperopia with or without astigmatism.
  • According to a survey conducted by Harris Interactive, 79 percent of patients who have undergone LASIK "feel safer" with their improved vision.
  • The number of LASIK procedures performed in the United States is up 14 percent versus 2003, from 1,124,000 procedures to 1,366,000 procedures.

Plastic Surgery in 2004

  • Positive media portrayals of plastic surgery, led by Extreme Makeover, are having a substantial effect on the industry: nearly 11.9 million procedures are performed in 2004, an increase of 44 percent over 2003's total. According to American Society for Aesthetic Plastic Surgery (ASAPS) President Peter Fodor, the media coverage gives the public "more opportunities to see, first hand, what plastic surgery is like and what it can do for others. That can be a strong incentive for them to seek the same benefits by having cosmetic procedures themselves."
  • The number of men who undergo plastic surgery during the year passes the 1-million mark for the second year in a row. Approximately 2.3 million cosmetic procedures are performed on male patients in 2003 and 2004, with liposuction being the most popular procedure. The increased acceptance of plastic surgery among men is drawing national attention, becoming the focus of stories published by ABC News, CBS News, and other major media outlets.

Cosmetic Dentistry in 2004

  • The latest development in porcelain veneer technology, Lumineers® by Cerinate® introduce the concept of the "prepless" veneers. Up to this point, porcelain veneers have required some removal of tooth enamel before they could be placed, primarily to accommodate their width. Lumineers®, however, are so thin that they can be placed without any alteration of the natural tooth.
  • In an article that appears in Crain's Cleveland Business, Shannon Mortland examines the cosmetic dentistry boom and its effect on the dental profession as a whole. Dr. Matthew Messina, national spokesman for the American Dental Association (ADA), tells Mortland that elective dental procedures account for approximately 20 percent of the average dentist's practice, a number that is growing annually. Another ADA representative states that the "popularity of cosmetic dentistry has enhanced the cash flow of dental practices significantly."

The Internet: Facebook, Firefox, Gmail, and Yelp Take Flight

  • Slowly but surely, Facebook is sneaking up on MySpace - so slowly, in fact, that most people have still not heard of the social networking site. This is understandable considering that, for the past year or so, membership has been restricted to students of major universities throughout the United States and Canada. In September, however, membership is extended to high-school students, albeit by invitation only. Strategically, membership is also opened to employees of Apple and Microsoft. MySpace will continue to reign supreme for another four years, but the social landscape is definitely changing.
  • In response to protests from the developers behind the Firebird database server, the Mozilla Firebird browser is launched instead as Mozilla Firefox. Within five years, Firefox will have 450 million users worldwide and have been downloaded more than a billion times.
  • In April, Google launches the beta version of Gmail, which at this time requires an invitation in order to create an account. One of the primary lures of Gmail is the 1 GB of storage space allotted to each user, which dwarfs the 2 to 4 MB allowed by Hotmail and Yahoo! Mail. By 2012, Gmail will allow up to 10 GB of storage per each of its approximately 425-million users.
  • In October, the first review is published to the newly launched Yelp, which proclaims itself "an online urban city guide." The first review, posted by Katherine W., awards four stars to San Francisco's Truly Mediterranean restaurant and is accompanied by four words: "dirt cheap, good falafels." This review will be joined by more than 53 million others over the next nine years.


Einstein Medical: Celebrating Ten Years of Excellence and the Launch of Video

In July, Einstein Medical celebrates its tenth anniversary with the launch of its Customized Video Production division. In response to the burgeoning popularity of online video, not to mention the technological advances that have made higher-quality online video possible, we assemble a professional production team and invest in state-of-the-art equipment. Within days, we are able to provide comprehensive video services, including narration, direction, scripting, video and audio editing, video hosting, and website integration.

We launch a major marketing campaign to promote our video packages, which contributes to an unprecedented demand for all of our services. In the meanwhile, our working relationship with the ABC television network continues to flourish as we sign an agreement to create the online elective surgery center for ABC.com.

Our support of and involvement in the growth of the plastic surgery industry is once again recognized by theAmerican Society of Aesthetic Plastic Surgery (ASAPS), which previously honored us in 2002 with the Gold Sponsor Award. This year we receive the distinguished Gold Level Plus Award. All in all, we enjoy a prosperous, exciting, and productive tenth year in business.

Cash-Pay Health Care: Hi-Tech Solutions to Myopia, Facial Aging, and Cavity Detection

Technological advancements are helping to keep the public's attention focused on elective healthcare services, as confirmed by the first serious statistical analysis of the cosmetic dentistry field and the annual report published by the American Society for Aesthetic Plastic Surgery (ASAPS).

Ophthalmology in 2005

  • Once the name of the Visian Implantable Contact Lens is changed to the Visian Implantable Collamer Lens (ICL) by request of the FDA, it is approved for use in the correction of myopia (nearsightedness). Unlike intraocular lenses (IOLs), the Visian ICL does not replace the eye's natural lens but rather augments it to restore vision. The foldable lens is made of a proprietary substance called collamer, and is the first lens of its type to be made available in the United States.
  • Cataract surgery patients now have even more multifocal options for replacing their natural lenses, as the premium ReSTOR® and ReZOOM® intraocular lenses are granted FDA approval.

Plastic Surgery in 2005

  • Cosmetic surgery tourism is becoming increasingly popular, much to the chagrin of the American Society of Plastic Surgeons (ASPS). The organization's primary concern is that, in order to save money, patients are jeopardizing their safety and health. Considering the long trek to public acceptance that plastic surgery has faced, the consternation of the ASPS is understandable. A briefing paper on the hazards of cosmetic surgery tourism is made available to the media and public, outlining the many risks of undergoing serious surgical procedures abroad, including the fact that the devices and products used may not have met the stringent standards of the FDA.
  • Although BOTOX® Cosmetic remains the most popular cosmetic treatment in the United States, with 3,294,782 procedures performed, Restylane® and Hylaform®, both hyaluronic-acid-based injectable fillers, are claiming their fair share of the market, with a total of 1,194,222 treatments administered. Since the FDA approved the two fillers in 2003, the number of procedures performed has shot up 928 percent. One of the reasons for the popularity of these fillers is that there is very little risk of allergic reaction as hyaluronic acid is found naturally in the human body.

Cosmetic Dentistry in 2005

  • The newest kid on the block in dental technology is the DIAGNOdent® laser cavity scanner. The device allows for the earliest possible detection and diagnosis of dental caries, identifying problems in tooth structure even in teeth that are superficially strong and healthy. Dentists can now treat cavities more conservatively while preserving more healthy tooth matter than ever before possible.
  • The American Academy of Cosmetic Dentistry (AACD) releases the results of its survey to determine "The State of Cosmetic Dentistry." Among the most interesting findings:
    • The average dental practice experienced a 12.5 percent growth in cosmetic production.
    • Of patients who ask about their cosmetic options, 96 percent are female.
    • The most requested cosmetic service is teeth whitening (29 percent of all cosmetic services requested).
    • Approximately 40 percent of the dentists surveyed had taken at least 21 hours of continuing education courses in the clinical aspects of cosmetic dentistry.
    • Of the dentists surveyed, 98 percent believe that the growth of cosmetic dentistry will increase or remain constant over the next five years.

The Internet: YouTube and the Beginning of the Internet Video Age

Inspired by the difficulty of finding video of Janet Jackson's "wardrobe malfunction" during the 2004 Super Bowl Halftime Show, three former PayPal employees launch YouTube.com in February. It takes a while for people to warm up to the concept of a video sharing website; according to the Pew Research Center, only 33 percent of Internet users will have visited a video sharing website such as YouTube as of December 2006.

The timing of Einstein Medical's entrance into video production could not have been better. By 2007, the number of Internet users that will have visited YouTube or another video sharing site will increase to 48 percent. Seven years later, YouTube has more than one billion active users a month, and virtually every marketing company out there offers some form of video product. Not many, however, can claim that they've been providing professional, custom video services since 2005.


Einstein Medical: New Media and Communications Products

The release of our Custom Video product coincided with the release of a sister product, the Einstein Website Media Center, which proves to be one of our most successful offerings in 2006. The aim of the product is to integrate three modes of communication - video, email, and telephone - into a central location. When users launch the Media Center, they have easy access to the doctor's video library and email address, as well as the ability to request a phone call from the practice via the push-to-talk feature, with an attractive user interface that can be seamlessly integrated into our clients' websites.

Another highly popular new offering is our Internet Call Tracking service. By assigning our clients' special 1-800 numbers that can only be accessed via their websites, they can now easily track how many calls are generated from their sites. Call statistics are accessible through their Einstein Extranet accounts.

In June, we add our own Media Center to the front page of our corporate website. Among the videos featured is a television interview with Robert Silkey discussing his insights into cash-pay healthcare marketing.

Cash-Pay Health Care: Free LASIK for Soldiers, the Reintroduction of Silicone Breast Implants, and High-water Marks for Dentistry

The elective healthcare industry continues to thrive, with cosmetic dentists reporting particularly impressive growth over previous years. In fact, the 5,500 dental practices that participate in the 2007 American Academy of Cosmetic Dentistry annual market survey generate an average of

.04 million in revenue in 2006.

Ophthalmology in 2006

  • The United States Army has provided free LASIK surgery to more than 35,000 of its active-duty servicemembers since approving the procedure in 2000. Now, as an increasing number of soldiers are preparing to head back to Iraq or Afghanistan for their second tour of duty, many are hoping to do so without their spectacles. According to Jaime Cavazos, a spokesman for the U.S. Army Medical Command's headquarters, the Army is expecting to perform between 10,000 and 12,000 LASIK procedures a year going forward at the eight refractive surgery centers located on Army bases.
  • LASIK is being performed increasingly often on new Naval recruits, as well. In fact, of the 993 midshipmen graduating from the Naval Academy in 2006, a remarkable 349 elect to undergo the procedure, courtesy of the U.S. Navy. "We get at least five times as many requests every year as we can keep up with," claims Commander Joseph Pasternak, an ophthalmologist at the National Naval Medical Center in Bethesda whose poor vision disqualified him from flight training in 1984.

Plastic Surgery in 2006

Fourteen years after removing them from the U.S. market, the FDA is once again allowing silicone breast implants to be sold to consumers. Specifically, the agency has approved silicone implants created by Mentor and the Allergan-owned Inamed Corp. after years of court battles (resulting in the eventual bankruptcy of Dow Corning, which emerged from Chapter 11 in 2004 after establishing a .35 billion settlement fund) and clinical tests. Dr. Daniel G. Schultz, director of the agency's Center for Devices and Radiological Health, stated that "from a scientific standpoint, the decision that we're making tonight is, in fact, in the best interest of American women."

Dr. Schultz finds no disagreement from Dr. Richard A. D'Amico, president-elect of the American Society of Plastic Surgeons (ASPS). "For us, it's a triumph of science," he says. "We've always felt that the science would bear out the use of the implants."

Less than a month before, health officials in Canada allowed silicone breast implants back onto the market for the first time in that country since 1999 after being convinced of their safety. The U.S. ban was put in place in 1992 not because there was compelling evidence of the implants' being unsafe, but because the FDA required further information about their safety. While the FDA allowed certain women to receive silicone implants as part of clinical trials, only saline-filled implants were commercially available to women who wanted to undergo breast augmentation.

Now women not only have more choices when it comes to augmenting their breasts, but are also being made more aware of the limitations of breast implants. The FDA and the ASPS are stressing that breast implants are not, and should not be considered, lifetime devices, and women who receive silicone implants should expect to have to replace them eventually. Women are also reminded that, if they opt for silicone implants, they should undergo regular MRI scans, as ruptures may otherwise be difficult or even impossible to detect.

The FDA limits the use of silicone implants to women aged 22 and older; saline implants remain available to women as young as 18. Nevertheless, the number of silicone implants used in breast augmentation eventually surpasses the number of saline implants by an enormous margin. While silicone implants are used in only 19 percent of the breast augmentation surgeries performed in 2006, they are used in 72 percent of the procedures performed just six years later, according to the annual American Society for Aesthetic Plastic Surgery (ASAPS) report.

Cosmetic Dentistry in 2006

  • The American Academy of Cosmetic Dentistry (AACD) reports that 2.68 million patients undergo approximately .75 billion in cosmetic dentistry procedures during the year. This represents an 12.8 percent increase in patients over 2005. The industry is predicted to grow a further 10.9 percent in 2007. It is not a bad time to be a cosmetic dentist.
  • According to the AACD report, the most performed cosmetic dentistry procedure is dental bonding, which generates roughly1.7 million in revenue, with 3.93 million teeth treated. 599,400 porcelain veneers are placed, generating roughly 1.9 million in revenue.
  • Dental Economics publishes an article entitled "Advanced Dental Technology: Don't Get Left Behind." Author Michael Healy urges dentists to embrace such new technologies as non-invasive laser techniques, non-surgical periodontal treatments, digital x-rays, and practice management software. "Not since the advent of intraoral cameras has there been so much excitement in the field of dentistry," he writes. "Yet many practice owners still hesitate to invest in [this] new technology…waiting to take advantage of these new technological developments can be risky business."

The Internet: The First Tweet and the Emergence of the Cloud

  • On March 21, Twitter co-founder Jack Dorsey made the most important Tweet ever: the very first one. While "just setting up my twttr" might not seem like the most earth-shattering message, but as the first of more than 300-billion Tweets sent through the end of 2013, it certainly sets a trend.
  • Although the term "Cloud" has been making the rounds among computer programmers for a while now, and Einstein Medical has been "in the Cloud" as a Software-as-a-Service (SaaS) provider since 2001, the launch of Amazon's Elastic Compute Cloud makes it official: the Cloud Computing Era has officially begun.

2006-Present: Einstein and the Cloud

During the Search Engine Strategies Conference in August 2006, Google Chairman and CEO Eric Schmidt tells host Danny Sullivan:

What's interesting is that there is an emergent new model…I don't think people have really understood how big this opportunity really is. It starts with the premise that the data services and architecture should be on servers. We call it Cloud Computing - they should be in a "cloud" somewhere. And if you have the right kind of browser or the right kind of access, it doesn't matter whether you have a PC or a Mac or a mobile phone or a BlackBerry or what have you - or new devices still to be developed - you can get access to the cloud…The computation and the data and so forth are in the servers.

It will still be a couple of years before the concept of the Cloud really catches on publicly, at least among those who understand it. By this point, Einstein Medical has been embracing the idea since the 2001 launch of our first Software-as-a-Service (SaaS) app, IMPACT. As ever, we have representatives at the 2006 Search Engine Strategies Conference, and we are pleased to have confirmation that our software model is gaining traction among some of the leading lights in Internet technology.

Since 2006, we have released dozens of innovative SaaS apps, in addition to placing all of our data in the Cloud. Our data is securely backed up on servers contained in a high-end, off-site colocation. This facility features:

  • Virtually impenetrable security , including video surveillance and biometric access
  • Massive, gas-powered back-up generators
  • Redundancy systems and protocols
  • Advanced cooling and fire-suppression systems
  • The power and bandwidth to ensure high-speed, reliable access 24 hours a day

The facility also provides real-time monitoring of all these functions and services to make sure that they run perfectly smoothly and that our clients never experience any of the consequences of system failures.


Einstein Medical: A Pact with the Estate of Albert Einstein

It's one thing to name a company after Albert Einstein, as a tribute to the genius of the father of modern physics. It's quite another thing for that company to obtain the intellectual property rights to the man's image and likeness. As far-fetched as such an agreement might have seemed in 1995, it becomes a reality for Einstein Medical in 2007. After a long series of negotiations and a thorough evaluation of our company and our internal philosophies, structures, and culture by the Einstein estate, we can now use Albert Einstein's image and likeness in our marketing, promotional, and other materials.

During the year, we make two major new products available to our clients. The first of these is our latest Software-as-a-Service (SaaS) app, our proprietary Image Gallery software. This breakthrough software, developed over countless hours by our in-house engineering team, makes it easier than ever for our clients to tag, organize, and display their before-and-after images.

The other product is actually a suite of Premium Gold and Platinum Video packages. As part of these packages, we fly a full professional production team out to our clients' practices, where they devote an entire day to shooting footage of the doctors, their teams, their offices, and their satisfied patients. Our clients receive fully produced and edited HD video clips in return, including the highly popular Web Story. The Web Story is a three-to-four-minute, HD-broadcast-quality feature about the client's practice, complete with professional narration and the sort of flow that engages viewers from beginning to end. These video profiles further distinguish our clients from their competitors, and us from ours.

Cash-Pay Health Care: Elective Procedures Are the New Normal

It is becoming increasingly clear that cash-pay healthcare professionals are no longer on the fringes of their professions, as more and more physicians are being urged to embrace new technologies in aesthetic medicine or risk missing out on an unprecedented opportunity to grow their practices. Patients aren't simply flocking to ophthalmologists, plastic surgeons, and dentists in response to the latest cosmetic fad. The cash-pay healthcare model is thriving, and the markets are experiencing steady, healthy growth. Elective health care appears to be here to stay.

Ophthalmology in 2007

  • In the April edition of EyeWorld, the official magazine of the American Society of Cataract & Refractive Surgery (ASCRS), a new technique called sub-Bowman's keratomileusis (SBK) is introduced as "the next K in refractive surgery" in an article entitled "The Evolution of Laser Refractive Surgery: Are Surgeons Ready for the Next Chapter?" The procedure entails the use of a femtosecond laser to create a much thinner corneal flap than in conventional LASIK, allowing for the preservation of part of the Bowman's membrane, a layer of corneal tissue located between the epithelium and the stroma. Proponents of the technique believe that it will be embraced by patients and, therefore, eventually by the entire industry.
  • Two years after purchasing VISX, Advanced Medical Optics (AMO) acquires IntraLase Corp. for 8 million in cash. This means that two of the most advanced ophthalmic technologies - the VISX CustomVue® wavefront-guided LASIK procedure, which is approved by the FDA in July, and the IntraLase® femtosecond laser, which allows for completely blade-free LASIK - are now united under a single corporate roof. AMO markets the combination of these two technologies as iLASIK, which is promoted as the safest, most effective variation of LASIK surgery yet. NASA agrees with this assessment, and in September, approves the all-laser iLASIK procedure for use on its astronauts.

Plastic Surgery in 2007

  • Cynthia Figueroa-Haas publishes the results of her study on the emotional effects of plastic surgery on women in the March issue of Plastic Surgical Nursing. Using the 30-point Rosenberg scale to measure self-esteem, Figueroa-Haas reports that, of the 84 women who participated in her study, the average score rose from 20.7 (pre-surgery) to 24.9 (post-surgery). There were also substantial increases in the average sexual function, sexual desire, arousal, and sexual satisfaction scores. Figueroa-Haas is careful to acknowledge that some women will never be satisfied with their bodies, regardless of how much surgery they undergo. "These are not ideal candidates for surgery and should seek further counseling to address their underlying psychological issues," she says. "But for women who seek improvements in certain physical areas, plastic surgery can be a very positive experience."
  • Although BOTOX® Cosmetic continues its reign as the most popular aesthetic treatment (2,775,176 performed), liposuction edges it out in terms of revenue generated (
    .065 billion versus
    .054 billion), according to the annual American Society of Aesthetic Plastic Surgery (ASAPS) report. The report also shows that the number of males undergoing plastic surgery is continuing to rise, increasing 17 percent over 2006.

Cosmetic Dentistry in 2007

  • "In 2007, the research, development, and use of oral appliances and oral surgery for the treatment of SDB [sleep disordered breathing] or other sleep-related conditions is gaining in popularity as well as acceptance" among dentists, writes Allison M. DiMatteo in the March issue ofInside Dentistry. In the article, she suggests that dental practitioners whose use of oral therapies to treat snoring, sleep apnea, and other sleep disorders was once considered "voodoo" are now pioneers of a trend that is helping to elevate the profession of dentistry in the public's eye. "With the advent of dental sleep medicine," states Mark J. Friedman, DDS, professor of clinical dentistry at the University of Southern California School of Dentistry, "we can save people's lives. You - as a dentist - by making an oral appliance could help prevent a stroke or a heart attack."
  • In Japan, researchers announce that they have successfully grown functional, natural-looking teeth from single cells and transplanted the teeth into mice. Using primitive cells injected into collagen, the research team grows teeth that are fully mature, containing dentin, enamel, dental pulp, blood vessels, and periodontal ligaments. This represents not only a landmark event in dentistry, but in all of medicine, as it is the first time an entire organ has been duplicated from a single cell.
  • "Don't we all do cosmetic dentistry?" asks Dennis J. Wells, DDS in an article published in the April edition of Dental Economics. Although the article largely focuses on the benefits of prepless porcelain veneers, he makes the point that all dentists have benefited from a "higher level of artistic training." "Thanks to great educational organizations such as theAmerican Academy of Cosmetic Dentistry," he writes, "we have developed a more refined understanding of smile design principles and how to apply them."

The Internet: Welcome to Web 2.0

  • Internet professionals are gravitating to the term "Web 2.0" to describe the high-level technologies that are making every aspect of the online experience easier, faster, and more rewarding for users. At the Web 2.0 Summit, Morgan Stanley Internet research analyst Mary Meeker informs an eager audience that we are now in two cycles in the Cloud Computing era: broadband and wireless. She predicts that "a new generation of Internet leaders [will] capitalize on growing access to fast Internet access on mobiles." AtEinstein Medical, our in-house engineers are busy developing our first mobile solutions, which will result in our innovative Mobile Gateway product and, eventually, to websites that are built to display beautifully on all devices, from laptops to smartphones.
  • During his keynote speech at Macworld 2007, Steve Jobs coyly states that he will be announcing the launch of "three revolutionary new products": a widescreen iPod® with touch controls, a new mobile phone, and an Internet communications device. "An iPod®, a phone, an Internet mobile communicator," he repeats. "These are not three separate devices! And we are calling it iPhone®!" Cue much applause, and the official initiation of yet another new technological era.
  • Around the world, millions of people spend millions of hours playing with Google's latest Software-as-a-Service (SaaS) offering: Google Earth, which is released in May. The public's response to being able to zoom in on images of their own homes is a mixture of intrigue, delight, and paranoia. It's fairly clear that Web 2.0 is intended to make the Internet a less anonymous, more unified worldwide community.
  • Even more importantly to our industry, Google launches "Universal Search," the most drastic change to its search model yet. The Universal Search system combines results from its news, video, images, local, and book search indices to produce the most comprehensive results yet for searches. While the system experiences some growing pains, it will clearly reward websites that feature original content of varied types - precisely the sort of content that we've been encouraging our clients to add to their websites for years.

2007-2010: Facebook vs. Google, Round One

Facebook Spurns Google, Google Courts MySpace

Throughout 2007, one of the hottest topics on the Internet is the competition between MySpace, the reigning King of Social Networking sites, and Facebook, the rebel upstart with an eye on the crown and a dagger behind his back. It appears to be a fair enough fight: although Facebook's numbers are growing rapidly - its membership will reach 50 million by October 2007 - MySpace has Rupert Murdoch's News Corp. empire behind it. And Murdoch loves MySpace, to the extent that the company's blueprint for its planned new headquarters in the far west side of Manhattan features as its focal point the "MySpace Pavilion."

MySpace also has the financial backing of Google, in the form of a three-year, 0 million contract that makes the search engine giant its exclusive provider of text ads and search. Google wants in on the social networking action badly, and its own attempt at a social networking site - Orkut - is popular in Brazil and India but virtually unknown in the United States. An alliance with an established social network at this point simply makes sense.

That alliance will not be with Facebook, however, much to Google co-founder Larry Page's consternation. In the fall of 2007, he believes that he has reached an agreement with Facebook execs that will allow Google access to the mountain of personal data that Facebook had collected from its users in exchange for a 0 million investment. Page is sitting on the Google jet, buckling up for the trip from Zurich to London, when he gets the news that not only is the deal off, but that Facebook has instead entered into the same deal with Google's archrival, Microsoft.

Page is understandably not pleased, especially at having such a large deal collapse so publicly. Undeterred, Google forms an alliance with MySpace and Bebo, another social networking site, with the intention of establishing a set of best practices that software developers will follow when creating programs for social networks. Between this alliance, called OpenSocial, and the 0 million that Google has put in the pockets of MySpace, it's pretty clear that Google is gunning for Facebook (notwithstanding the fact that Google invites Facebook to join OpenSocial, an invitation that is declined).

MySpace Gets Caught in the Crossfire

In the meanwhile, all appears to be well at MySpace. Although Facebook surpasses MySpace as the most visited social media website worldwide in April 2008, MySpace isn't hurting, at least not that anyone can tell. In fact, it has its peak month in December 2008 when its number of unique users reaches 75.9 million.

Behind the scenes, however, MySpace is in turmoil. In order to earn its 0 million a year from Google, it must meet strict page view quotas and devote a significant amount of space to advertising that its execs find distasteful, including an ad for an Internet dating site featuring the headline, "Want a Girlfriend? View Hundreds of Pics HERE!"

"When we did the Google deal, we basically doubled the ads on our site," Chris DeWolfe, co-founder of MySpace, tells interviewer Charlie Rose in 2009. "Remember the rotten teeth ad? And the weight-loss ads that would show a stomach bulging over a pair of pants?"

While MySpace is becoming more cluttered and littered with spam, Facebook is garnering raves for its clean design and rewarding user experience. According to a study by Anderson Analytics, Facebook has 77 million users by July 2009, 75 percent of whom claim that Facebook is their favorite Internet site. The same study shows that MySpace membership has dwindled down to 67 million.

MySpace attempts to carve a new niche in the social networking sector by turning its focus to entertainment, and music in particular. Despite its rebranding attempts, it continues to lose users, hitting a low point in 2010 when membership falls below 40 million. In what appears to be an act of desperation, MySpace radically redesigns its site in 2009, despite the fact that Facebook's own redesign prompted a "Petition against the New Facebook" that attracts 1.7 million users.

While the redesign and rebranding of MySpace do nothing to slow its decline, and might even hasten it, the 1.7 million annoyed Facebook users represent just a drop in that social network's membership bucket. According to an official statement issued in response to the "Petition against the new Facebook,"

The new…home page is one step in the continued evolution of the site, designed to give people more ways to share and filter all types of content, such as status updates, photos, videos, notes, and more. We are grateful to have 175 million people worldwide using Facebook…and we take their feedback very seriously.

In other words, Facebook isn't changing a thing. Why should it? By the end of 2010, the year in which MySpace membership bottoms out, the number of active Facebook users per month reaches 608 million.

Facebook's Actual Target: Google

As it turns out, the "Facebook vs. MySpace" rivalry was more of a mirage than an actual battle. Facebook's ultimate goal has never been to be King of Social Networking Sites - in fact, Facebook founder Mark Zuckerberg disputes the notion that Facebook even is a social network. Facebook's actual goal is to dominate the entire Internet, and that means toppling Google. MySpace is simply collateral damage in a much bigger war that is well underway.

While Facebook's initial strategy against Google might have been a sneak attack, that is no longer the case. In an article featured in the June 2009 issue of Wired, entitled "Great Wall of Facebook: The Social Network's Plan to Dominate the Internet - and Keep Google Out," Facebook actually lays out its four-step plan for online domination in explicit terms:

  1. Gain as many users who contribute as much data as possible, creating a "second Internet" that resides exclusively on Facebook's servers.
  2. Substitute the traditional search engine algorithm with a "social graph," in which users solicit their network of friends, coworkers, family members, and other acquaintances for information about goods and services, from where to eat to which plastic surgeon produces the best results.
  3. Make Facebook as accessible as possible from as many partner sites as possible so that users don't have to sign into their accounts to contribute valuable data to Facebook's "second Internet."
  4. Sell ads across all of its partner sites, using its wealth of personal data to provide perfectly targeted commercial messages.

The strategy is as brazen and brash as Zuckerberg himself, who is referenced in the Wired article as describing Facebook as "a once-in-a-century communications revolution." Google has "a top-down way" of organizing the Web, according to Zuckerberg. "You have a bunch of machines and algorithms going out and crawling the Web and bringing information back. That only gets stuff that is publicly available to everyone. And it doesn't give people the control that they need to be really comfortable."

Google is still stinging from what turned out to be a 0 million train wreck of a deal with MySpace. The giant isn't sleeping, however. It plans to stay on top and is better prepared for round two of its war with Facebook than one might think at the end of 2010.


Einstein Medical: Universal Search and the Expansion of Our SaaS Solutions

In response to Google's launch of its Universal Search system, Einstein Medical expands our range ofcontent-oriented Software-as-a-Service (SaaS) solutions. During the year, we release the first versions of our proprietary Content Management System (CMS) and Blog software. We hope that the ease and convenience of these software solutions will encourage our clients to publish new content more regularly, giving the new-and-improved Google the timely, relevant, and comprehensive content it craves.

Our initial Einstein CMS is designed in response to the more complicated content management systems on the market, such as the newly released WordPress Version 2.5. While many of these systems are powerful and feature-rich, they can also be confusing to the layperson. Our engineers produce a CMS that is as powerful as these systems, but far easier for someone who is not trained in HTML to use. For the first time, our clients have the potential to post new content on their own, as regularly as they wish, without having to have any knowledge of code or design. Most clients prefer to have our in-house writing team continue to develop their content, but they are also generally glad to have the ability to modify that content without having to purchase corrections through us.

The Einstein Blog is equally easy to use, and gives our clients the ability to publish content to their blogs and to their social media accounts, such as Facebook, which has evolved into a potent business and marketing tool. We emphasize to clients that, by posting content regularly both to their websites and to their blogs, and integrating that content with custom video and compelling imagery, they will be more likely to show up in Google's Universal Search results.

Demand for Einstein's products and services reaches an all-time high as cash-pay healthcare professionals rush to add video and other fresh content to their websites.

Cash-Pay Health Care: Weathering the Economic Storm

In September, the economic decline that began in December 2007 takes a particularly devastating downward turn. While the unfettered growth of the various cash-pay healthcare markets over the past decade comes to an end, the industry remains relatively stable, especially compared to the real estate and automotive industries. Millions of Americans seek out cosmetic services during the year as new techniques and technologies continue to become available.

Ophthalmology in 2008

  • In Budapest, Dr. Zoltán Zsolt Nagy performs the first cataract surgery ever to be aided by a femtosecond laser. According to Dr. Nagy, "the femtosecond laser in cataract surgery will soon be inevitable, especially in premium lens implantation…[the use of a femtosecond laser] not only makes the procedure safer but it decreases the amount of phaco energy…which is good for the endothelial cells."To perform the surgery, he uses the LenSx® laser system, which will become the first femtosecond laser to be approved by the FDA for use in cataract surgery in 2009.
  • In economic terms, times are tough all over the United States, and the LASIK industry as a whole is feeling the sting. Still, in an article that appears in the April issue of Cataract & Refractive Surgery Today, Jim Denning cautions LASIK providers not to buy too heavily into doom-and-gloom forecasts. While economic indicators are far from positive for the country as a whole, LASIK has technological improvements and shifting demographics on its side. "Femtosecond lasers, customized wavefront abberometers, and iris recognition have all incrementally grown the LASIK market," he writes. He also notes that Generation X is approaching the age - early 40s - at which the Baby Boomers initially embraced LASIK in the 1990s. "The market can be expanded," he concludes, "…by accessing patients with lower degrees of myopia and by attracting younger patients through savvy marketing."

Plastic Surgery in 2008

  • For the first time since the American Society for Aesthetic Plastic Surgery (ASAPS) began collecting data for its annual statistical reports in 1997,liposuction is not the most popular form of cosmetic surgery. This year, that honor goes to breast augmentation, with 355,671 procedures performed. During the two full years that have passed since silicone breast implants were reintroduced onto the market, plastic surgeons have performed 755,111 breast augmentations, 321,343 (43 percent) of which used silicone implants.
  • In a study published in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons (ASPS), it is predicted that more than 55 million cosmetic surgery procedures will be performed in 2015. "While today's economy reflects a slow-down in plastic surgery procedures, the specialty will weather the current decline in economic growth…," says ASPS President Richard D'Amico. "This prediction for 2015 is exciting." (While the plastic surgery industry has indeed weathered the financial storm, the accuracy of this prediction remains to be seen. It is worth noting that, in 2008, only the most pessimistic among us could have predicted just how badly the U.S. economy would continue to decline over the next two years.)

Cosmetic Dentistry in 2008

  • For years, dental professionals, scientists, and legislators have been debating whether the mercury contained in silver amalgam fillings poses any sort of health threat. While many cosmetic dentists have eliminated metal from their practices, others continue to assert that traditional dental materials have their place alongside modern porcelain and resin restorations. Although the agency classifies the mercury contained in amalgam fillings as a class I (low risk) device, it now acknowledges that there may be some potential hazards associated with restorations that contain mercury. As part of a settlement with Moms Against Mercury, the FDA changes its website content to reflect that mercury vapor is released when pressure is placed on amalgam fillings, which could make them dangerous to pregnant women and patients who are sensitive to mercury. These individuals, according to the FDA, "should not avoid seeking dental care, but should discuss options with their health practitioner[s]."
  • One of the biggest benefits associated with dental implants is their ability to halt the degradation of the jawbone that begins once a tooth is lost. Adding to the mounting evidence of this assertion are the results of a long-term study conducted by Zeev Ormianer, DMD, and Ady Palty, DMD, implant dentists in Israel and Germany, respectively. Reviewing the charts of 60 patients who had received a total of 267 implants, Drs. Ormianer and Palty find that there is "no discernible bone loss in 88 percent of the implant sites," with a mean follow-up time of seven-and-a-half years.

The Internet: The Continuing Rise of YouTube and the Mobile Web

  • A year after the launch of the iPhone (which BlackBerry founder Mike Lazaridis famously likens to a Mac computer stuffed into a cell phone after opening one up), HTC releases the T-Mobile G1, the first smartphone to use Google's Android operating system. TechRadar reviewer John Brandon rates the smartphone as "stellar," astutely adding that it "points to a future when a phone is as flexible and useful as the PC on your desk."
  • The public's insatiable thirst for online video shows no signs of slowing. The American Journalism Review publishes an article entitled "The Video Explosion," examining how print news organizations are integrating video into their websites in order to remain relevant. "While job opportunities in nearly every other newsroom category are shrinking," writes author Charles Layton, "jobs for videographers are opening up." Chuck Fadely, a former photographer who became a videographer for the Miami Herald, tells Layton that "the change in the industry right now is the most dramatic I've ever seen. Virtually every paper in the country is, if not diving head first, at least dipping their toes into video."
  • At the 2008 Web 2.0 Summit, Morgan Stanley Internet research analyst Mary Meeker predicts that YouTube will emerge as the second most-used search engine during the year. Number-one search engine Google surely won't object; the company purchased YouTube in 2006. It turns out that Meeker is absolutely correct in her prediction, as a ComScore report finds that YouTube processed 2.6 billion search queries to Yahoo's 2.4 billion in August.
  • Technically, ComScore places YouTube on the list of "Expanded Search Query" rankings, comprised of not-quite-search engines. Interestingly,MySpace ranks number two on this list (585 million searches in August), followed by eBay (434 million) and Craigslist (335 million). Facebook registers only 186 million queries, but the times are rapidly changing.
  • In a development that will change the way Einstein Medical's programmers, developers, engineers, writers, and designers approach websites forevermore, Google publishes its Webmaster Guidelines. Although many people in 2014 continue to claim that they "have no idea what Google wants," these guidelines lay out, in fairly precise detail, the do's and don'ts of creating a website. Much of the epochal document can actually be boiled down to a single common sense premise, a sort of Golden Rule of website development: You cannot go wrong by providing the best user experience possible. Serve the user's best interests, and the search engines will follow. In response to this, we begin scrutinizing and revising our own ideas as to what Search Engine Optimization (SEO) - a concept that we had helped to shape industrywide - should and should not be.


Einstein Medical: New Lead Generation and Monitoring Services

In the midst of the not-so-great recession, we focus our efforts on strategies that will help our clients maximize revenue by increasing and tracking the leads coming into their practices. Our first step in that direction is to add a new lead capture component to DocShop.com. While the directory had successfully directed millions of prospective patients to our clients' websites for more than a decade, there was definitive way of knowing which leads came in through DocShop.com and which came in directly through the website. While either type of lead reflects well on our marketing services, we want to make sure that our clients realize the true value of a DocShop.com listing.

Now targeted leads are sent directly from DocShop.com to our clients. Twenty-four hours a day, seven days a week, clients receive a steady flow of information about prospective patients, including their names, email addresses, and phone numbers. Combined with our Call Tracking service, the new lead capture system allows our clients to manage and monitor leads more efficiently and effectively.

Well, in theory, anyway.

In reality, most of our clients are far too busy serving their patients to keep track of their leads, entrusting that job instead to their staff members. As a result, lead conversion is highly dependent on the ability of these staff members to respond to patient enquiries and "seal the deal" by scheduling an initial consultation. We suspect that, in the case of many of our clients, some valuable leads are falling through the cracks.

To solve this problem, we launch our latest Software-as-a-Service (SaaS) product: the PrePatient™ Customer Relation Management (CRM) System. PrePatient™ gives our clients a means of gauging how effectively their staff members are communicating with and converting patient leads. At a glance, they can see who has contacted the practice, which services they are interested in, and whether they received a response from the practice. Ultimately, it enables our clients to track the return on investment of any marketing effort they deploy so that they know where to focus their marketing dollars going forward - and where not to.

PrePatient™ is the first lead tracking software created specifically for doctors, and it immediately becomes one of the most popular products we've ever offered. It remains one of Einstein Medical's flagship products to this day.

Cash-Pay Health Care: A Big Year for Implants of the Lens, Breast, and Dental Varieties

For the most part, ophthalmologists, plastic surgeons, and cosmetic dentists are surviving the worldwide recession, and the cash-pay healthcare industry in general is ready for a rebound in the new decade to come. In the meanwhile, implants are all the rage this year, with the FDA approval of the Tecnis multifocal intraocular lens implant, the rising popularity of the recently reintroduced silicone breast implant, and a study confirming the efficacy of immediate-load dental implants.

Ophthalmology in 2009

  • In January, the FDA approves the Tecnis multifocal intraocular lens (IOL) for the replacement of the eye's natural lens in cataract surgery patients. The IOL performs impressively in clinical trials, particularly in its ability to provide crisp, clear vision in low-light situations. Abbott Medical Optics, the manufacturer of the Tecnis IOL, emphasizes that the Tecnis is "uniquely designed for low-light vision" in its marketing materials, noting that patients "may comfortably enjoy everyday activities like reading a menu in a dimly lit restaurant, talking a walk at dusk, or even driving at night" after lens replacement surgery.
  • The April edition of Ophthalmology features the results of a comprehensive review of LASIK literature published between 1988 and 2008. Nearly three-thousand citations are reviewed, and the 309 strongest citations are collated into a database. Analysis of this database results in a statistic that has been much-repeated ever since: worldwide, 95.4 percent of patients who have undergone LASIK are satisfied with their results.

Plastic Surgery in 2009

  • The American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) are outraged by the surprise addition of a 5-percent elective cosmetic procedure tax to a healthcare reform bill being proposed by the Sentate. ASPS President Michael McGuire claims that such taxes "discriminate against women" and "the working middle-class." ASAPS President Renato Saltz says that the tax is tantamount to a "Soccer Mom" tax. Under pressure from these organizations as well as the American Medical Association (AMA), Senate Majority Leader Harry Reid removes the tax from the health bill and replaces it with a 10-percent tax on indoor tanning services.
  • According to the ASAPS annual statistical report, the plastic surgery industry isn't feeling the sting of the recession too badly, as the demand for cosmetic procedures in 2009 is only 2 percent less than that in 2008. For the second year in a row, breast augmentation is the most-performed surgical procedure (311,957), with liposuction coming in second (283,957).
  • Patients aren't skimping when it comes to plumping up their posteriors. While every other form of cosmetic surgery experiences at least a slight decline in 2009 over 2008, buttock augmentation and buttock lift both experience growth (37.3 percent and 24.6 percent respectively).

Cosmetic Dentistry in 2009

  • In July, the FDA issues its final regulation on dental amalgam, reclassifying the mercury used in fillings as a class II (moderate risk) device. It gives the same device classification to dental amalgam, which had previously not been classified.
  • Historically, the surgical placement of dental implants has been followed by a three-to-six-month period of osseointegration, during which the titanium implant fuses with the jawbone, essentially becoming part of the patient's anatomy. This has meant that the jawbone must be dense enough to support the implant post. In cases in which patients lack sufficient jawbone mass, they generally have to undergo a bone grafting procedure in order to qualify for implant dentistry. In recent years, however, immediate-load ("same-day") implants that usually do not require an osseointegration period or bone grafting have become more widely available. For the right candidates, solutions such as Nobile Biocare's All-on-4® offer stability even in minimum bone volume and a fully restored mouth in as little as one day, as well as the ability to secure a full-arch prosthesis on just four strategically placed implants. Not all dentists embrace this technique; however, a clinical study completed in September confirms the efficacy of the All-on-4® technique. Of 708 implants placed in 165 patients, 99.6 percent of the implants survived after one year. While conventional dental implant techniques remain the preference of many dentists, these study results demonstrate that immediate-load implants are a viable option for certain patients.

The Internet: Mobile Usage and Social Networking Continue to Rise

  • Once again, Morgan Stanley Internet analyst Mary Meeker presents her predictions for the upcoming year based on the current online trends, and once again, history validates her predictions. This year, she states that "mobile internet usage is and will be bigger than most think" and that "next generation platforms (social networking and mobile) will drive unprecedented change in communications and commerce."
  • Eleven years ago, Compaq purchased the domain altavista.com for .3 million, the first time in history that a domain had traded hands for more than
    million. This year, nine domains sell for at least
    million, led by QuinStreet's purchase of insure.com for a record million. Anticipating the potential future value in domain names, Einstein Medical secured a number of desirable cash-pay healthcare-related names in its early years. Now, we are making some of these available to our clients for purchase. Although none of our domain names fetch eight-figure offers, they quickly sell at between several hundred and thousands of dollars apiece.
  • It was 40 years ago that the first message was sent via what we now know as the Internet. University of California Santa Barbara student Charles Kline sends a seemingly cryptic message - "LO" - to awaiting students at the University of Utah. The "LO" is the first two letters of "LOGIN"; however, the system crashes before he can complete the word. At Einstein Medical, we are amazed to realize that we have existed now for 16 years, or 40 percent of the Internet's lifespan dating back to 1969.
  • Facebook 's monthly active user base reaches 360 million. Photo sharing site Flickr now hosts approximately4 billion images. In the U.S. alone, 12.2 billion videos are viewed per day on YouTube. The 1.73 billion Internet users out there are devouring types of media that didn't even exist when Einstein Medical first started building websites.
  • In a somewhat ironic twist, considering Mark Zuckerberg's stated ambition for Facebook to dethrone Google as the Internet's most dominant force, the most-searched term on Google in 2009 and 2010 is "Facebook."
  • Google introduces a new feature, Google Profile, which allows a user to create a personalized page with a brief bio, links to other social media profiles, and as much personal information as he or she wants to share. Users can control who can see their information, and the ability to create private profiles allows anonymity to remain an option - for now.
  • Further evidence of the lightning changes occurring to the Internet landscape: There are more blogs now than there were websites on the Internet in October 2006, by a score of 126 million to 100 million.


Einstein Medical: New Products for the New Internet

It's difficult for us to fathom how much the Internet has changed in just the past two years, let alone since we developed our first website in 1996. In her prescient 1999 Print article "Fragmented Future," Darcy DiNucci predicted a day when:

The Web will be understood not as screenfuls of text and graphics but as a transport mechanism, the ether through which interactivity happens. It will still appear on your computer screen, transformed by video and other dynamic media made possible by the speedy connection technologies now coming down the pike. The Web will also appear on…your car dashboard…your cell phone…hand-held game machines…

That day is fully upon us, and we are ready with a line of products that we have devoted hundreds of hours to developing. These include:

  • Our proprietary Lucid™ Content Management System (CMS): We release the initial version of this Software-as-a-Service (SaaS) app in late 2010, two years after the launch of our first-generation CMS. Like that CMS, Lucid™ is created specifically for doctors by dedicated experts who understand their unique needs; however, Lucid™ is even more powerful and feature-rich, yet simpler to use straight "out of the box." Our clients are able to add, revise, organize, and manage their content with greater ease than has ever before been possible with any CMS, including WordPress.
  • The Einstein Video Player 4.0: In conjunction with Lucid™, we release the latest version of our video player software, which presents high-definition (HD) video clips in immaculate quality. The SaaS app is easily integrated into our clients' websites and allows them to write descriptions and include transcripts alongside the video.
  • The latest version of our Blog software auto-publishes entries to our clients' Facebook, Twitter, and LinkedIn accounts, giving them the ability to generate fresh, original content on multiple platforms with minimal time and effort.

Not all of our new products fall under the SaaS umbrella, however. In fact, one of our most important new product releases of the year is a reimagining of a service that we had been offering before the SaaS revolution even began: the Einstein Medical SEO Audit. The audit entails a comprehensive analysis of a website, from its code, meta elements, and on-page optimization to an in-depth evaluation of how the site is performing against competing websites in the same market. Using Google's Webmaster guidelines and our own best practices as guides, members of our in-house marketing and content teams collate all of this data and hand-curate it into a report that averages in the dozens of pages. The final report is presented to the doctor who purchased the audit or a designated representative of his or her practice in clear, comprehensible terms.

The aim of the SEO Audit is to demystify Google and its search engine counterparts and give prospective clients a detailed list of what's wrong with their websites (and how it can be fixed), as well as what's right with their websites (and how it can be strengthened or maintained). These prospective clients can then do whatever they like with this information, whether that means working with us further or taking it to one of our competitors. There is no pressure, just honest answers and straight shooting.

The SEO Audit proves immediately to be one of our most popular products and, indeed, one of the most powerful educational tools about the Internet ever developed. It's a product that we are continually refining as the Internet evolves and as new technologies and challenges arise.

Cash-Pay Health Care: Full Speed Ahead in the Face of Controversy

There can be no doubting that the cash-pay healthcare industry has been a popular target of the media since the early nineties. This year, LASIK becomes controversial again when a former FDA advisor who once argued that the procedure was safe appears on the ABC television network stating that he would "absolutely not" recommend LASIK to anyone he cares about. In the meanwhile, people who type the phrase "plastic surgery" into Google are likely to be bombarded by stories about Heidi Montag's ill-fated decision to undergo ten plastic surgery procedures in a single day. As usual, the nation's elite ophthalmologists, plastic surgeons, and cosmetic dentists rise above the fray, focusing their talents on the millions of patients who continue to demand their services.

Ophthalmology in 2010

ABC News televises a controversial segment entitled "Hindsight 20/20: LASIK Surgery Now Unsafe?" The segment features Dr. Morris Waxler, who was part of the FDA panel that helped to promote LASIK in 1995. Now, when asked whether he would recommend LASIK to someone he cared about, Dr. Waxler replies, "Absolutely not."

The reaction from ophthalmologists throughout the country is swift and indignant. Trusted LASIK Surgeons (a directory that, in the interest of full disclosure, directly competes with DocShop.com) issues a press release on behalf of several esteemed eye surgeons denouncing the segment, as well as ABC's seemingly biased approach to the story. The press release notes that Dr. Waxler is not a medical doctor and has never performed LASIK. In addition, it quotes Dr. R. Doyle Stulting, who served as Chair of the Ophthalmic Advisor Panel for three years during Dr. Waxler's FDA tenure, as characterizing Dr. Waxler's current view of LASIK as "misinformed, unsupported by evidence, and lacking in balance and perspective."

The FDA is none too pleased with Dr. Waxler's statements to ABC News, either. In its own press release, the agency states its official disagreement with Dr. Waxler's claim that FDA officials "ignored" problems with LASIK when they approved the use of the excimer laser for use in the procedure. Ultimately, the FDA's stance on LASIK is summarized succinctly: "The FDA considers LASIK lasers to be reasonably safe and effective when used as directed."

Whatever Dr. Waxler's intentions, the effect of the story on the LASIK industry is ultimately positive, bringing the public's attention to the true, unbiased facts about LASIK - the benefits, the risks, and the results. The story also makes clear that prospective patients should entrust their surgeries to only the most skilled and reputable professionals usingonly the most advanced and effective technologies - and that the importance of thorough screening of potential LASIK candidates cannot be overstated.

"Sometimes I think, instead of asking, 'How many LASIK procedures have you done?'" says Dr. Penny Asbell, professor of ophthalmology at the Mount Sinai School of Medicine, "you should actually ask the doctor, 'How many have you turned away?'"

Plastic Surgery in 2010

  • For the first time in history, worldwide plastic surgery statistics are being made available to the public, courtesy of the International Society of Aesthetic Plastic Surgery (ISAPS). Perhaps not too surprisingly, more plastic surgery procedures are performed in the United States in 2009 than in any other country in the world. Slightly more shocking is that China comes in second on the list. The ISAPS report estimates that 17,295,557 cosmetic procedures have been performed by board-certified plastic surgeons around the globe.Liposuction is the most popular surgical procedure in the world, while BOTOX® Cosmetic and Dysport® combine to rank as the most popular non-surgical procedure.
  • Liposuction may still be the most popular cosmetic surgical procedure in the world, but it ranks second to breast augmentation in the United States for the third straight year, according to the annual American Society for Aesthetic Plastic Surgery statistical report. Of the 318,123 breast augmentation procedures performed, 62 percent used silicone implants, the first time that silicone implants have outpaced their saline counterparts since being reintroduced onto the U.S. market in 2006.
  • The FDA approves the Zeltiq™ CoolSculpting device for use in treating small, isolated deposits of fat from the abdominal region and the flanks ("love handles"). The device eliminates targeted fat cells by literally freezing them, and the CoolSculpting procedure is being marketed as a non-surgical alternative to liposuction.

Cosmetic Dentistry in 2010

  • The New York Times publishes an article entitled "When That Smile Is Too Perfect" which focuses on the latest trend among cosmetic dentistry patients: requesting porcelain veneers that are just flawed enough to look unique. According to the article, "The lifelike 'flaws requested by patients include rotating the teeth next to the center pair so they overlap a little; subtly discoloring veneers toward the gumline so it looks between-cleaning realistic; and adding grooves so the porcelain isn't oddly smooth." Master ceramist Vincent Devaud tells article author Catherine Saint Louis, "It's not in my fiber to do a white and perfect-looking smile…What makes a person desirable and attractive? It's not the symmetry; it's perfect imperfections."
  • The results of an American Academy of Cosmetic Dentistry (AACD) poll show that the average AACD member performed an average of 77 teeth whitening treatments in 2009. Certified dental assistant Shannon Pace Brinker states that one benefit of the high demand for whitening is that many patients who come into her office for whitening sessions become interested in other cosmetic dentistry procedures. "Our existing patients are saying 'yes' to other procedures after the whitening such as bonding, replacing amalgam fillings, and replacing porcelain restorations to match the whitening they have achieved."

The Internet: Entering the Golden Age of Online Advertising

  • Patients aren't the only ones turning to the Internet for healthcare information. According to a comScore study,81 percent of physicians online visited websites featuring health care professional (HCP) content. In addition, 75 percent visited general health content sites such as About.com Health.
  • For the first time in history, Americans are spending as much time on the Internet as they are watching television, according to a survey conducted by Forrester Research. This is not just true of younger people, either; according to the survey, people over the age of 66 are using the Internet approximately eight hours a week on average. That's just four hours less per week than the average person under the age of 30.
  • The Pew Research Center's Internet & American Life Project shows that people in higher income brackets are more likely to look for information about doctors and medical facilities online than those in lower income brackets. Specifically, 54 percent of survey participants who make more than ,000 a year have searched for information about doctors versus 32 percent of those making less than ,000. Likewise, 43 percent making more than ,000 have looked up information about a medical facility versus 30 percent of those making less than ,000.
  • Morgan Stanley Internet analyst Mary Meeker suggests that online advertising "may be entering a golden age, finally." The Internet offers advertisers a " billion golden opportunity," given that consumers spend roughly 28 percent of their media time using the Internet (versus 31 percent watching TV, 16 percent listening to the radio, and 12 percent reading print materials). Yet, only 13 percent of advertising dollars are being invested in Internet campaigns (versus 39 percent on television, 9 percent on radio, and 26 percent on print). Meeker further argues that now is the time for business owners to invest in their online marketing strategies to take advantage of the mobile explosion. Over the next decade, she predicts, the number of devices that can be used to access the Internet will increase tenfold, from one billion to ten billion.


Einstein Medical: Simplifying Social Media and the Mobile Internet

We strongly agree with Mary Meeker's prediction that online marketing is on the verge of entering a "golden age," and that social media and the mobile Internet will play pivotal roles in its evolution. At this point, however, there aren't a lot of great solutions available for doctors who want to embrace these exciting new media. So once again, where no great solutions exist, we decide to create them.

In the case of social media, the problem is largely one of perception. Many business owners continue to see social media as a waste of time rather than a legitimate marketing tool. Even those who do recognize its potential value to their businesses can't spare the time to manage their social accounts, let alone post fresh content every day.

Our solution to this dilemma is Social Broadcast™, a subscription-based service that makes it easy for our clients to establish a strong social media presence without having to take any time out of their busy schedules. Every business day, we provide subscribers with an interesting, informative post relevant to their specialties and distribute it to their Facebook, Twitter, and LinkedIn accounts. The posts are crafted to provoke thought and inspire response, generating the sort of organic conversations that send out the strongest social signals.

To create an effective mobile solution, we challenge our in-house engineering team to develop the latest addition to our selection of Software-as-a-Service (SaaS) apps. They respond with Mobile Gateway™, a program that puts the practice information that most smartphone users would be looking to access - phone number, address, map, email, and social media accounts - at their fingertips. Those who want to delve further into what the practice offers can access the full website with a simple touch of their screens.

While Mobile Gateway performs a valuable function, it also exposes a myth that is being perpetuated by many website developers, namely that businesses need to augment their existing websites with separate, custom-built mobile websites. Many doctors around the country are investing in these (usually expensive) mobile sites believing that they will be able to reach a user base that is closed off to their competitors who aren't "mobile ready." We assure our clients that Einstein Medical websites will display as beautifully on mobile devices as they do on computer screens, not because of any special technology, but because they are built properly.

Cash-Pay Health Care: And the Survey Says…

In recent years, ophthalmology, plastic surgery, and cosmetic dentistry organizations have become increasingly adept at measuring and documenting trends and growth within their specialties. There is more data available to cash-pay healthcare professionals and their patients than ever before, and much of it is readily available on the Internet to anyone who is interested.

Ophthalmology in 2011

  • An increasing number of eye surgeons are offering BOTOX® Cosmetic injections at their practices alongside LASIK and PRK. While the availability of BOTOX® Cosmetic in eye care centers may be a recent trend, ophthalmologists were actually the first medical professionals cleared to use the injectable treatment by the FDA in 1989, shortly after the name of the product was changed from Oculinum to BOTOX®. At that time, it was approved for the treatment of strabismus (better known by the general public as crossed-eyes) and blepharospasm (better known by the general public as eyelid twitching). Now many ophthalmologists are using the injectable to treat crow's feet and wrinkling around the eyes, adding a cosmetic complement to the rejuvenative effects of laser eye surgery.
  • Interest in laser cataract surgery - or "femto-phaco," as it is commonly referred to by ophthalmologists - is reaching fever pitch. Indeed, the 2011 annual meeting of the American Academy of Ophthalmology (AAO) features a full day's worth of presentations and seminars on femto-phaco, followed by two events devoted to the topic on "Cataract Monday."
  • According to a survey conducted by the Review of Ophthalmology National Panel, 71 percent of ophthalmologists consider custom LASIK their procedure of choice, versus 5 percent who continue to prefer conventional LASIK. Interestingly, when asked which procedure they would use to treat presbyopia in a 45-year-old patient, 36 percent respond with monovision LASIK, versus 28 percent who would recommend multifocal contact lenses, 18 percent who would use the ReSTOR® multifocal intraocular lens (IOL), and 6 percent who would use the Tecnis® multifocal IOL.

Plastic Surgery in 2011

  • The American Society for Aesthetic Plastic Surgery (ASAPS) publishes its 15th annual statistical report. Since the initial 1997 report:
    • The number of abdominoplasty (tummy tuck) procedures performed in the United States has increased nearly 340 percent, from 34,002 to 149,410.
    • The number of breast lift procedures has risen 539 percent, from 19,882 to 127,054.
    • The number of injectable treatments administered has grown an astonishing 3,920.7 percent, from 65,157 to 4,061,442 (with BOTOX® Cosmetic leading the charge at 2,619,739).
  • The American Society of Plastic Surgeons (ASPS) is collaborating with the FDA to create a national registry for breast implants. ASPS President Phillip Haeck, MD is confident that the registry will help to reduce unfounded concerns over the safety of breast implants. "For nearly 20 years American women were denied access to their choice of breast implants because of false claims and unfounded science," he says. "We are determined this shouldn't happen again."

Cosmetic Dentistry in 2011

  • According to a Kelton Global Survey commissioned by the American Academy of Cosmetic Dentistry (AACD), 48 percent of adults believe that "a smile is the most memorable feature after first meeting someone - more so than the first thing a person says (25 percent)." A further 75 percent believe that a flawed smile can interfere with a person's chances for a successful career.
  • A separate AACD survey of cosmetic dentists finds that "new technologies are cutting down patient office time at least 50 percent, increasing patient safety and making the whole dental process easier and more comfortable." Many of the respondents predict that there will be increased use of iPads and iPhones in dental offices as they make practice management, patient education, and displaying x-rays more efficient and convenient.
  • In 2005, the AACD found that interest in cosmetic dentistry was weighted heavily toward females. Six years later, the State of Cosmetic Dentistry survey shows that the scales are now considerably more balanced, with 40 percent of cosmetic dentistry patients being male.

The Internet: Social, Local, and Mobile

Social, local, and mobile media are becoming more intertwined with each passing year, leading famed venture capitalist John Doerr to coin a term to describe the trend: "SoLoMo" (Social, Local, Mobile). Nielsen and NM Incite collaborate to compile statistics on the SoLoMo phenomenon:

  • 51 percent of U.S. consumers were influenced by ads on social media sites that displayed which of their friends liked or followed the brand or service being promoted.
  • 18 percent of U.S. adults use their social media accounts to post links to videos, articles, and websites.
  • 39 percent of smartphone app downloaders used the Google Maps app.
  • 58 percent of smartphone app downloaders used the Facebook app.
  • 38 percent of Americans own a smartphone.
  • The average smartphone owner has 35 apps installed.
  • 44 percent of smartphone users visit social media sites via their phones.

By 2013, 61 percent of Americans will own a smartphone according to Pew Research Center's Internet & American Life Project. Of those smartphone owners, L.E.K. Consulting reports that 80 percent have used their smartphones to assist in their purchasing decisions through researching a good or service. Businesses that integrate social, local, and mobile media into their marketing strategies in 2011 quickly reap the rewards of their foresight.

2011-2012: Facebook vs. Google, Round Two

Facebook Closes In on Google

By 2011, Facebook has become a way of life for hundreds of millions of users around the globe. While the social network is more popular than ever with the younger demographic - 48 percent of 18-to-34-year-old users check Facebook as soon as they wake up - the truest gauge of its dominance is the degree to which it has permeated "adult" society. Indeed, nearly one-third of all Facebook users are aged 35 or above .

Facebook founder Mark Zuckerberg has made his intentions clear. He wants to dominate the Internet, and Facebook has been constructed as the vehicle that will allow him to do that. But dominating the Internet means dominating search - and that, in turn, means taking down Google.

As 2011 unfolds, that ambition doesn't seem entirely misguided. At the beginning of the year, according to Alexa, Facebook commands a 40-percent share of all daily Internet traffic, compared to Google's 48 percent. The hundreds of millions of active Facebook users around the globe are, unwittingly for the most part, contributing to an unprecedented database of personal information through their social interactions. Alone, those ubiquitous "Like" buttons that provide such a seemingly innocent, simple way of broadcasting one's preferences to the world get clicked on tens of billions of times each month. The "second Internet" that Zuckerberg had envisioned - the one that Google can't so easily crawl - is growing exponentially on a daily basis.

Not coincidentally, one of the most recent additions to the Facebook team is Paul Adams, who had been one of Google's lead social researchers up until he joined Facebook in December 2010. In explaining the reasoning behind his decision, he writes in his blog that "Google values technology, not social science."

Google Fires Back with Google+

One of Adams' last and most important contributions to Google was the concept of Google Circles, a sort of social filter that allows users to find and organize connections according to their real-life relationships (e.g., "friends," "family," "co-workers," "business contacts," "high-school buddies"). This concept is at the heart of Google's latest attempt to claim its share of the social media landscape, Google+.

Unveiled on June 28, 2011, Google+ represents the fourth social networking site launched by Google in a seven year span, Orkut, Google Buzz, and Google Friend Connect having been relative failures (although Orkut remains extremely popular in Brazil and India). Like Gmail when it was launched in 2004, Google+ memberships are initially by invitation only. Within a month, there are 25-million Google+ members; by the end of the year, that number grows to 150 million.

While impressive, this growth does not add up to an unqualified success for Google. The problem is that many people don't quite understand what the point of Google+ is, other than to very publicly challenge the supremacy of Facebook as a social network. "Nobody wants another social network right now," social media analyst tells The Wall Street Journal in an article entitled "The Mounting Minuses at Google+." "Google hasn't communicated what the value of Google+ is."

In the press, Google representatives express optimism. Bradley Horowitz, vice president of Google's product management, claims that "we're growing by every metric we care about" in the Wall Street Journal article. Most Web analysts agree that Google must have something up its sleeve, but at this point, no one is exactly sure what that might be.

Google's "Secret" Strategy Begins to Unfold

Behind the scenes, Google execs know that Google+ is not their endgame, but rather part of their opening gambit:

  • Beginning in April, long-time YouTube users are met with a shock when they try to log in to their accounts, only to be informed that they have to log in via a valid Google account. This is not optional. Although YouTube has been owned by Google since 2006, this is the first time that the company has so openly used the video sharing site as leverage to reinforce its dominance.
  • Also in April, Google rolls out the latest update to its search results ranking algorithm, the somewhat controversial Panda. The purpose of Panda is essentially twofold: 1) To encourage the development of original, high-quality content on websites, and 2) to make the artificial intelligence used to power the search results more "human." Indeed, Panda is designed to find the best possible results for users based on the feedback of human testers. These testers rated thousands of websites according to their trustworthiness, site speed, and uniqueness of content. While Panda exhibits its fair share of growing pains, it ushers in a new era of search.
  • Just three weeks before the launch of Google+, a post appears on Google's Webmaster Central Blog announcing that "Today we're beginning to support authorship markup - a way to connect authors with their content on the web. We're experimenting with using this data to help people find content from great authors in our search results."
  • Just days after the launch of Google+, the company announces that it will no longer support private Google Profiles. Users can either agree to go public with their full names and genders, or their profiles will be deleted on August 1, 2011.
  • In July, Nielsen announces that Google's Android has risen to the top spot in the U.S. operating systems (OS) market, comprising 39 percent of the market compared to second-place Apple's 28 percent. By November, Android's share of the U.S. market will be 43 percent. Google reports that, between July and the beginning of December, 2011, approximately four-billion apps were downloaded by Android users.

While Google's strategy may not yet be perfectly clear, its overriding message seems to be "You're either with us or against us." Nevertheless, much of the public continues to focus on Google+ and what appears to be a futile mission to overtake Facebook. A December 2011 report by Enders Analysis predicts that Google+ will "remain niche."

Facebook Goes Public, with Disappointing Results

On February 1, 2012, Facebook files an S1 form with the Securities and Exchange Commission, setting in motion its initial public offering (IPO). Thirty-three underwriters for the IPO, led by Morgan Stanley, JPMorgan, and Goldman Sachs, settle on a value of 4 billion for Facebook, which nets the company billion. Expectations are unprecedentedly high; as Morningstar analyst Jim Kraprel tells Reuters, "I think anything over [a 50-percent increase in the stock's value on its first day of trading] will be considered a successful offering - anything under that would be underwhelming."

Millions of eyes are on the NASDAQ on May 18, as 421-million shares of Facebook are made available at an offering price apiece. At the opening bell, shares sell for apiece; by the time the closing bell rings, that number has fallen to .37. In general, the reaction among both Internet and Wall Street analysts ranges somewhere between shock and disappointment. As it turns out, however, .37 is as good as it gets for Facebook shares in 2012.

In July, Facebook announces that it achieved a record revenue of

.18 billion during its first quarter as a publicly traded company; however, it sustained a net loss of 7 million. In August, the company admits that roughly 83 million of its 955-million accounts are fake. Weeks later, Facebook stock bottoms out at .58 per share.

Mark Zuckerberg is typically unfazed, or at least appears to be. In Facebook's S1 form, Zuckerberg wrote that "we don't build services to make money; we make money to build better services...These days I think more and more people want to use services from companies that believe in something beyond simply maximizing profits." In responding to concerns over the company's net loss, he points to an improved mobile experience for Facebook users as the path to a brighter financial future:

Facebook is the most used app on basically every mobile platform. So when we think about what we want to do right now, we want to increase the depth of experience in addition to just growing users. We want to not just have applications that people use, but also be deeply integrated into these systems as much as possible, and develop an ecosystem where other apps can be built on top of Facebook.

Zuckerberg denies rumors that Facebook is planning to develop its own mobile phone, stating that the current strategy is to work with existing operating systems. He points out that Apple's upcoming iOS 6 will feature tight integration with Facebook.

Interestingly, as Facebook's relationship with Apple becomes stronger, Apple's relationship with rival Google begins to sour, very publicly. The iOS 6 update does not include the highly popular YouTube or Google Maps apps that had been part and parcel of previous iOS updates. Google's response is to release an updated version of its search app for iOS, which features voice-recognition abilities that rival, and in some respects surpass, Apple's own Siri.

The battle for Internet supremacy may have begun as strictly business, but it appears to have taken a very personal turn.

The "Turf War" Heats Up

While Facebook seems to be stumbling, Google is promoting itself as a company reinvigorated by the new challenges that have arisen during the SoLoMo era. Just four days after Facebook's IPO, the company announces that it has completed its acquisition ofMotorola Mobility. The deal helps to fuel Google's excellent second quarter in 2012, with reported earnings of .79 billion.

Larry Page , Google's co-founder and CEO, continues to emphasize Google's value as a social resource, insisting that Google+ "is truly at the heart of our efforts to create a simpler, more intuitive experience for all of our users":

You should think of it in two parts. One is just our social spine. Once you're logged in and have upgraded to Google+, you're just using one Google, not a series of disconnected products…You can see friends' recommendations when you're using Google Play and you don't think about that as Google+, but it just comes from that infrastructure. And we're seeing a positive impact all across the web. Google users can now recommend search results they like, a goal we've had ever since we started the company.

The other part is the social destination, which is accessed on your mobile client or on plus.google.com. This social destination…is growing quickly…We are starting up a new community.

Many interpret Page's words as shots across the bow of Facebook, although he characteristically does not mention the social networking site by name. Even more notable is Page's continuing enthusiasm for Google+ despite the fact that it has been branded as a failure by many analysts. Google has earned a reputation as a company more than willing to cut its losses and move on; as soon as it's clear that a product or service doesn't have legs, it unceremoniously gets the axe. (RIP, Google Lively, Google Buzz, Google Web Accelerator, Google Squared, Google Base…)

However, Google+ appears to be sticking around, and while its membership numbers don't rival Facebook's, they're still impressive. By the end of 2012, there are more than 500-million Google+ accounts, and 135-million members who use Google+ at least monthly. In a post published to Google's official blog in December, Vic Gundotra, senior vice president of engineering, flippantly refers to Google+ as "the fastest-growing network thingy ever."

True to form, Mark Zuckerberg fires back, and he seems less interested than ever in Facebook's status as a "network thingy." His aim is dominance over search, a point that he makes abundantly clear at the 2012 TechCrunch Disrupt Conference in San Francisco:

We're basically doing one-billion queries a day, and we're not even trying…Search engines are really evolving toward giving you a set of answers. It's not just like "I'll type in something and show me some relevant stuff." It's "I have a specific question, answer this question for me." When you look at it from that perspective, Facebook is pretty uniquely positioned to answer the questions people have: "What sushi restaurants have my friends gone to in New York in the past six months and liked?" "Which of my friends and friends of friends work at this company I'm interested in…so I can talk to them about what it's like to work there?"

These are queries you could potentially do in Facebook if we built out the system that you couldn't do anywhere else. And at some point we'll do it.

The battle for Internet supremacy is developing into what Fortune writer Kevin Kelleher describes as "Silicon Valley's version of Freaky Friday: the aging web giant with touches of grey and the cocky upstart have reversed roles."

Or have they? In the Prospectus Summary that Zuckerberg included in Facebook's S1 form, he outlines the components of the emerging "Social Web":

We believe that the web, including the mobile web, is evolving to become more social and personalized. This evolution is creating more rewarding experiences that are centered on people, their connections, and their interests. We believe that the following elements form the foundation of the social web:

  • Authentic Identity. We believe that using your real name, connecting to your real friends, and sharing your genuine interests online create more engaging and meaningful experiences. Representing yourself with your authentic identity online encourages you to behave with the same norms that foster trust and respect in your daily life offline. Authentic identity is core to the Facebook experience, and we believe that it is central to the future of the web. Our terms of service require you to use your real name and we encourage you to be your true self online, enabling us and Platform developers to provide you with more personalized experiences.
  • Social Graph . The Social Graph represents the connections between people and their friends and interests. Every person or entity is represented by a point within the graph, and the affiliations between people and their friends and interests form billions of connections between the points. Our mapping of the Social Graph enables Facebook and Platform developers to build more engaging user experiences that are based on these connections.
  • Social Distribution . Over time, people are consuming and creating more kinds of information at a faster pace across a broader range of devices. The growing volume of information makes it challenging to find meaningful and trusted content and to effectively make your voice heard. Facebook organizes and prioritizes content and serves as a powerful social distribution tool delivering to users what we believe they will find most compelling based on their friends and interests.

Zuckerberg's Social Web model explains not only the ultimate aim of Facebook, but also the seemingly disparate elements of Google's 2011 strategy, including its support of authorship markup, the Panda algorithm update, the positioning of Google+ plus at the heart of the overall Google experience - virtually everything that Google has done over the past two years.

This isn't a turf war. This isn't a struggle between search and social. This is a race to dominate the evolving Social Web.


Einstein Medical: Entering the Era of "The Human Algorithm™"

In the four years since Google published its Webmaster Guidelines, our approach to Search Engine Optimization (SEO) has changed significantly. Many of the components that were essential to an effective SEO strategy in 2005 are by now either less relevant or altogether outdated. Although we had been instrumental in shaping many of these components, we are guided by Robert Silkey's philosophy: In order to move forward, there can be "no sacred cows."

In rethinking and redeveloping our SEO strategies, we realize that we have to cater to search as it currently exists while looking forward to search as it seems destined to become. It's clear that the Internet as we once knew it has morphed into something less cold and technical, something more intimate and intuitive. Facebook founder Mark Zuckerberg calls it the "Social Web." Einstein Medical President Ted Ricasa calls it "The Human Algorithm™."

In an October 2012 post to Einstein's corporate blog, Ricasa first uses the phrase to refer to Google's unfolding strategy, of which Authorship and Google+ are cornerstones:

When you participate in Google+, you are essentially giving Google permission to use your data in its development of a "human algorithm." The company laid the foundation for the human algorithm as early as August 2005, when it first filed a patent request for Agent Rank, a system in which original content would be associated with an author through a digital signature. Based on the content produced by that author, he or she would be assigned a reputational score that would be relatively difficult to maintain or increase, but easy to decrease. This reputational score would strongly influence the rankings of an author's published content, encouraging reputable authors to continue to produce excellent content and dissuading them from attaching themselves to substandard content. Agent Rank…set the precedent for Google Authorship.

He further notes that, while many people are nervous about the amount of data that Google has, and will have, access to, its "primary objective is to weed out the fakes, the snakes, and the sharks and, ultimately, to make the playing field more level for real flesh-and-blood people" like our clients. Anonymity is being discouraged through Google's attempts to reward real people for standing by the content they publish to the Web using their actual identities.

It soon becomes clear to us that The Human Algorithm is more than simply a clever way of describing Google's aspirations. It's an umbrella term that encompasses what the Internet has become and what it will inevitably be. No matter how the Web evolves, it will always evolve in the direction of becoming more human. Therefore, our approach to SEO must also evolve in the direction of becoming more human.

Although our SEO strategies are, and always will be, works in progress, our collective embrace of The Human Algorithm concept marks an important turning point in our website development philosophy. Contrary to industry wisdom, we begin to emphasize that such old-school SEO elements such as keyword density and intensive geo-targeting are of secondary importance to serving the needs of readers. And readers want content to be readable,scannable, comprehensible, and engaging - in addition to being timely, relevant, and comprehensive.

Of course, even in the age of The Human Algorithm, an effective SEO strategy comprises more than just great content, as fundamental as that component may be. With one eye on the present and one on the future, we expand our selection of products and services to include:

  • Google Authorship Setup and Management : Adding authorship markup to our clients' websites and linking that content properly to their Google+ accounts pays immediate dividends in terms of both rankings and click-through growth. In the process, we are able to reinforce our clients' brands and reputations as authorities in their fields. We find that, in general, prospective patients are more likely to click on a result when it is accompanied by thumbnail photo of the doctor, which helps to inspire trust and confidence and make results without such photos seem generic by comparison.
  • Social Magnet™ : Social Magnet integrates before-and-after photos, links to review sites and directories, news, blog posts, and other content into an interactive Facebook page custom-themed to the individual practice.
  • National Health News (NHN) Podcast™ : The NHN Podcast represents our first online audio product. Each podcast includes two professionally produced interview segments, a streaming audio player, downloadable audio files, and numerous other features.

Combined with our existing Local SEO and custom content services, we are confident that we have created a suite of products that will ensure our clients' success both now and in the future.

Cash-Pay Health Care: New FDA Approvals and Post-Recession Resurgence

Improving economic indicators are pointing the way toward a full-fledged recovery from the recession that hit nearly all industries, including cash-pay health care. Daily average consumer spending is at in 2012, the highest it has been since 2008. Patients are spending billions on elective healthcare procedures, both time-tested and newly FDA approved. In general, things are very much looking up for cash-pay healthcare practitioners.

Ophthalmology in 2012

  • On average, ophthalmologists are happier than most other types of physicians, according to the results of a survey conducted by Medscape. On a scale of 1 to 5, ophthalmologists responded with an average score of 4.03 when asked to rate how happy they are with their lives outside of work, compared to an overall average of 3.96 for all physicians. In addition, approximately 80 percent of ophthalmologists do volunteer work, compared to 68 percent of all physicians, while only about 1 percent of ophthalmologists smoke, compared to 18 percent of all Americans.
  • The FDA approves the enVista™ hydrophobic acrylic intraocular lens (IOL) from Bausch + Lomb. The monofocal lens implant is the first FDA-approved IOL with labeling stating that "No glistening of any grade were reported for any subject at any visit in the clinical study." "Glistenings" are tiny fluid-filled cavities that can form within IOLs, particularly hydrophobic acrylic IOLs.
  • Could glue one day make LASIK even safer? It's entirely possible, according to Stacy Littlechild, lead author of a Kansas State University study published in the June 2012 edition of Investigative Ophthalmology & Visual Science. The "glue" in question is based in fibrinogen, a naturally occurring blood protein, that is mixed with saline to form a transparent, yet extremely strong and sticky substance. The hypothesis is that this glue could one day secure corneal flaps after surgery, making them virtually invulnerable to dislocation due to trauma. Kansas State University Professor Gary Conrad states that there is no plan to study the glue further at this point, but "it's always on the tool rack as something that we could use."

Plastic Surgery in 2012

  • Silicone breast implants have been around for fifty years now. In an Aesthetic Surgery Journal article entitled "Silicone Gel Breast Implants at 50: The State of the Science," Dr. Mark L. Jewell identifies 1992 as the year that "brought the start of both evidence- and quality-based movements within plastic surgery" that would eventually lead to the FDA's decision to allow silicone implants to return to the U.S. marketplace in 2006 - a victory of "science, safety, and choice." According to Dr. Jewell, plastic surgeons "must actively demonstrate good stewardship of these beneficial devices and maintain and improve them in a hostile regulatory environment."
  • A decade after the FDA approved clinical testing of Brazilian manufacturer Silimed's ultra cohesive silicone gel implants in the U.S., the agency approves them for use in breast augmentation. Popularly known as "Gummy Bear" breast implants, they've been available in Europe since 1995 and in Canada since 2000, which led thousands of American women to travel abroad to have them placed. The implants will be distributed by Sientra, whose founder and CEO Hani Zeini is "elated" that the company "has successfully broken the existing duopoly [i.e., Allergan and Mentor] in the U.S. by offering surgeons and patients a new choice." This represents the first time that a form-stable implant - one that will not lose its shape - has become commercially available in the United States.
  • The improving state of the U.S. economy is reflected in the 16th annual statistical report published by theAmerican Society for Aesthetic Plastic Surgery (ASAPS). For the first time since 2008, more than 10-million surgical and non-surgical procedures are performed in 2012. Americans spend approximately billion on cosmetic procedures, with 6.7 billion of those dollars going toward surgical procedures. Breast augmentation edges outliposuction as the overall most popular surgical procedure (330,631 to 313,011), whileBOTOX® Cosmetic and other botulinum toxin type A injections remain the most popular non-surgical treatment ( 3,257,913).
  • The two surgical procedures that experienced the greatest year-over-year growth are vaginal rejuvenation (64.4 percent) and gynecomastia treatment (i.e., male breast reduction - 28.9 percent). The surgical procedure that has experienced the greatest growth since the ASAPS started publishing its statistical reports in 1997 is upper arm lift (812.9 percent), followed by breast lift ( 542.7 percent) and thigh lift (470.5 percent). During this span, facelift surgery and rhinoplasty have remained steady performers, withstanding trends and economic downturns to generate billions of dollars in revenue for plastic surgeons throughout the country.

Cosmetic Dentistry in 2012

  • The American Academy of Cosmetic Dentistry (AACD) commissions Kelton to conduct a "smile survey." Of the 1,018 U.S. adults who are surveyed, 45 percent believe that a smile is the single feature that remains attractive regardless of a person's age. By comparison, only 34 percent opted for eyes, while body shape, hair, and legs each received 10 percent or less of the overall votes.
  • The British government is cracking down on teeth whitening products used outside of dental practices, limiting the hydrogen peroxide content in such products to 6 percent. Legislation is passed after hundreds of complaints from people whose teeth were permanently damaged by "cosmetologists" and other non-dental professionals, some of whom were using whitening concoctions containing up to 40 percent hydrogen peroxide. Now, only registered dentists are permitted to use higher-concentration teeth whitening gels while the government considers requests that whitening services be banned outside of dental practices.
  • The popularity of zirconia as a dental material is continuing to spread. In addition to its strength and its uncanny resemblance to natural tooth enamel, it is proving to be extremely strong and durable in clinical tests. In June, the results of a five-year study conducted by Italian researchers at the University of Chieti are published, with the authors concluding that "results proved that three-unit posterior zirconia-based [fixed dental prostheses] were successful in the medium term for both function and aesthetics."

The Internet: The Rise of Pinterest and Continued Domination of Facebook

  • In August, one year after being named as one of Time Magazine's "50 Websites That Make the Web Great," Pinterest stopped requiring an invitation to register for membership. As it was, invitations weren't that hard to come by; in January 2012, the site attracted11.7 million unique U.S. visitors, crossing the 10-million monthly visit thresholdfaster than any other website in history, according to TechCrunch. By April, it is listed as the third most popular social networking site on the Internet in a report published by Experian, trailing only Facebook and Twitter.
  • More importantly for cash-pay healthcare professionals and other business owners, an October BizRate Insights study finds that 70 percent of Pinterest members use the site "to get inspiration on what to buy." By comparison, only 17 percent of Facebook users look to Facebook for such inspiration. According to Boticca.com, the average consumer referred from Pinterest spends 0, as opposed to by the average Facebook referral.
  • Mary Meeker has left Morgan Stanley to become a partner at venture capital firm of Kleiner Perkins Caulfield & Byers, but her reports assessing Internet trends continue to be the industry's gold standard. Her 2012 state-of-the-web report defines the latest generation of Internet users as "asset-light" and accustomed to purchasing goods and services on their mobile devices, "from hand to cloud and back." This generation has so much information at its fingertips that Encyclopedia Britannica has announced that, after 244 years, it will no longer produce print editions.
  • On October 4, Facebook surpasses one-billion active monthly users. That's the entire population of the United States times three.
  • More than 1.2 trillion searches are conducted on Google during the year. That equates to approximately 1.7 searches per man, woman, and child on the planet. The most searched phrase was "Whitney Houston," who died in February.
  • How important is it for businesses to reach out to mobile users? For the second straight years, sales of smartphones and tablets have exceeded sales of desktop and notebook PCs, this year by a ratio of approximately 2-to-1. In August, Adobe publishes the results of a mobile consumer survey, which finds that mobile ads presented in websites have a 42-percent click-through rate.


Einstein Medical: Celebrating Twenty Years of Innovation

It has been twenty years since Robert Silkey had the vision - that the nation was on the verge of a large-scale migration of physicians and dentists from reimbursed to cash-pay health care - that would result in the creation of Einstein Medical. We celebrate our twentieth anniversary by pushing forward full steam ahead, launching 146 new Lucid™ CMS websites during the year while continuing to invest significant time and resources in the development of innovative new products and technologies.

On the development front, our team creates one of our most advanced social media products yet in Social Beacon™, a ratings and review management tool that makes it simple for patients to leave positive feedback about a practice on a variety of social platforms. With Social Beacon™, an invitation for patients to rate their experience with a practice on a scale of one to five stars is included toward the bottom of each page of the practice's website. When patients award a practice fewer than four stars, they are directed to a feedback form that allows them to contact the practice directly with their feedback as to how their experience could have been improved. However, satisfied patients who award the practice four or five stars are directed to a page that gives them:

  • A single, convenient platform for accessing Google+, Facebook, Twitter, Yelp, LinkedIn, and Pinterest.
  • A step-by-step guide to using these social media sites, including how to create accounts for first-time users.
  • Simple instructions on how to use these sites to review and recommend the practice.
  • Clear explanations of how their positive ratings and reviews will benefit the practice.
  • Interesting facts and fun quizzes that are designed to engage and educate users, furthering the site's reputation as a great educational resource.

Social Beacon™ represents our most powerful reputation management solution yet, as well as one of our most powerful Software-as-a-Service (SaaS) apps. As with most of our SaaS apps, there is nothing quite like Social Beacon™ available to cash-pay healthcare professionals. As we have been doing now for twenty years, we identify a need among our clients, and we work toward the most convenient and effective solution possible.

Joining Social Beacon™ in our arsenal of SaaS apps is the latest version of our Photo Gallery software. The upgraded software is offered free of charge to existing clients, giving them even greater control over the uploading and management of photos and data. On the user end, website visitors can now:

  • Scroll effortlessly through a doctor's before-and-after photos using a convenient new slider tool.
  • Read case data, which is placed directly beneath each image for easy access.
  • View images in greater detail using an improved click-to-zoom feature

The software also gives our clients an opportunity to reinforce their brands through seamless integration of the Photo Gallery into their websites. Categories of procedures and photos of actual patients can now be beautifully laid out in a modern, fluid, open design.

Of course, our twentieth anniversary celebration wouldn't be complete without celebrating the many clients whose loyalty, faith, and goodwill have enabled us to reach the two-decade mark in business. To highlight some of the remarkable achievements of our clients, as well as the results they have achieved through the technologies in which they have invested, we launch our series of Success Stories. Beginning with an article on how weekly blogging has helped cosmetic dentist Clint Newman to grow his practice, these Success Stories prove to be among our most popular blog features while shining the spotlight on some truly exceptional healthcare providers.

Cash-Pay Health Care: The Industry Is Stronger Than Ever

People are availing themselves of cash-pay healthcare treatments in record numbers. While LASIK, breast augmentation, dental bonding, and other perennially popular procedures continue to attract millions of patients to practices throughout the country, the rise in popularity of such procedures as cataract surgery, buttock augmentation, and dental implant surgery is helping to bolster revenues in their respective industries. Economically, technologically, and otherwise, things are trending in a very positive direction.

Ophthalmology in 2013

  • The number of people undergoing cataract surgery is climbing each year - and that's a good thing for society, according to the clinical journal Ophthalmology. In a cost-utility study published in the journal's November issue, it is reported that cataract surgeries performed over the course of a year end up saving 3.4 billion, primarily in personal and Medicare costs, over the next thirteen years.
  • According to the findings of a Mayo Clinic study published in the Journal of Cataract & Refractive Surgery, the increasing number of cataract surgeries being performed per year can largely be attributed to the desire of 70- and 80-year-olds to maintain a good quality of life in their elder years. Ophthalmologist Jay Erie, M.D., senior author of the study, concludes that "our older population, or the aging baby boomers, are working longer, they want to be more active, they have more demands on their vision. That's why they're looking for surgery sooner - so that they can remain independent, remain active, continue to work."
  • The American Academy of Ophthalmology (AAO) has developed the first comprehensive, nationwide clinical registry of eye diseases, which is officially unveiled at the 2013 Annual Meeting of the Academy in New Orleans. The IRIS™ (Intelligent Research in Sight) Registry simplifies the process of adding and accessing data on such disorders of the eye as cataract, age-related macular degeneration (AMD), and glaucoma.

Plastic Surgery in 2013

  • Within a year of its approval of Silimed's ultra cohesive silicone gel breast implants, the FDA approves Allergan's Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implant in February. This represents the second form-stable implant - or "Gummy Bear" implant (a nickname that is not popular with many plastic surgery professionals) - to be made available on the U.S. market.
  • The Great Recession of 2008 appears to be over, at least if ones uses the annual statistical report published by the American Society for Aesthetic Plastic Surgery (ASAPS) as a gauge. For the first time since the recession began, Americans spend more than billion on surgical and non-surgical procedures during the year. More than 11.4-million plastic surgery procedures are performed, the highest number since 2007.
  • While liposuction and breast augmentation continue to battle for the top spot among popular cosmetic surgical procedures (this year, liposuction reclaims the crown, beating out breast augmentation by a score of 363,912 to 313,327), the two most surprising gains were in buttock augmentation and labiaplasty. Compared to 2012, 58 percent more buttock augmentation procedures are performed in 2013, and 44 percent more labiaplasty procedures are performed. Even the ASAPS is caught by surprise, stating that the procedures "have not previously been considered 'popular.'"
  • In October, the FDA approves JUVÉDERM® VOLUMA™ XC, the first injectable hyaluronic acid dermal filler that adds volume to the cheek area to be made available on the U.S. market. The treatment is marketed to patients who are interested in achieving a subtle lift without having to undergo more invasive plastic surgery, producing results that last for up to two years. JUVÉDERM VOLUMA™ XC can be combined with its sister product, JUVÉDERM® XC, which was approved by the FDA in 2010 for the correction of wrinkles around the mouth and nose.

Cosmetic Dentistry in 2013

  • According to the 2013 State of the Cosmetic Dentistry Industry published by the American Academy of Cosmetic Dentistry (AACD), dental crowns are the most commonly completed treatment in the field, followed by dental bonding, porcelain veneers, teeth whitening, and dental implants . In general, practice revenues are up, with the number of practices reporting revenues in excess of million having risen 5 percent since 2011, representing 13 percent of all participating practices. "Patients are spending more on cosmetic dentistry procedures," says AACD President Jack Ringer. "They want more than just a functional smile - they also want a beautiful smile, which is great news for cosmetic dentists."
  • During the year, the FDA approves the Solea CO2 laser system manufactured by Convergent Dental for both soft tissue and hard tissue procedures. It is the first laser system of its kind to receive approval for use in dentistry. "Based on my experience with the system," says Dr. Gerald Kugel, associate dean for dental research at the Tufts University School of Dental Medicine, "I fully expect that Solea will modernize the practice of dentistry in the removal of decay and helping to prevent it in the first place."
  • A dental implant that fights infection? Tolou Shokuhfar, an assistant professor of mechanical engineering at Michigan Technological University, and Cortino Sukotjo, a clinical assistant professor at the University Illinois at Chicago College of Dentistry, are working toward this goal. They are testing dental implants made from titanium dioxide nanotubes, a material that promotes bone growth, encourages quicker healing, and kills infectious cells. "What we're developing is a surface that's inexpensive and easy to make and which can speed healing in so many ways," Shokuhfar says. "It's very exciting to be working on a product that could make a huge difference in people's lives."

The Internet: The "Year of the Bitcoin," Netflix, and the Mobile Internet

  • According to broadband network solutions company Sandvine, YouTube and Netflix account for a combined 50.31 percent of downstream Internet traffic (i.e., traffic flowing to users' computers) during peak hours. Of that, Netflix gets the lion's share at more than 30 percent. In its own words, Netflix is "the world's leading Internet television network with over 44 million members…enjoying more than one billion hours of TV shows and movies per month." However, this nearly wasn't the case. In 2000, Netflix executives tried to broker a deal that would have given Blockbuster a 49-percent stake in the then-unprofitable company, and rebranded the Netflix website as Blockbuster.com. Blockbuster declined the deal. Thirteen years later, Netflix is the new Goliath of video, and Blockbuster announces that it is closing its doors.
  • Mary Meeker 's annual report on Internet Trends lists the top ten global Internet properties according to global monthly unique visitors. The top seven surprise no one; Google is on top at nearly 1.2 billion, followed by Microsoft, Facebook,Yahoo!, Wikipedia, Amazon, and Apple. At number eight and rising, however, is Glam Media, which was launched in 2003 as a social platform for consumers and rebranded in 2004 as a female-centric media company known for its network of fashion bloggers. Now the company operates not only fashion and glamour site Glam.com, but also Foodie.com, Tend.com, Ning.com, Bliss.com, and Brash.com. On its website, the company announces that it will undergo a "BIG CHANGE IN 2014," shifting its demographic focus to include men and its topic focus to include home, auto, and technology.
  • In December, Forbes publishes an article proclaiming 2013 the "Year of the Bitcoin." While the digital currency was first introduced by the mysterious "Satoshi Nakamoto" in 2009, it is only now earning the attention of the public at large. This is due in part to the March financial crisis in Cyprus, which results in many of that island nation's citizens rushing to their banks, withdrawing their money, and converting it into bitcoins. At that point, a single bitcoin rises in worth from to nearly 0. After a lull, the value of a bitcoin rises once again, this time to an astonishing peak of
    ,242 per coin. On the same day, November 29, gold plummets to
    ,240 per ounce.
  • Despite the newfound popularity of the bitcoin, many people have difficulty understanding the concept of a unit of currency that exists only in digital space, whether "in the cloud" or on one's own computer. As a result, the "Year of the Bitcoin" is marked by considerable trading and speculation, as well as increasing use on the black market to procure illegal goods. This latter trend is fueled by the fact that bitcoins can be used completely anonymously. On the other hand, transactions for conventional goods are relatively rare, as few merchants accept bitcoin at this point. The largest above-board transaction of the year is the purchase of a Tesla Model S in December for approximately3,000 worth of bitcoins. This high-point will be eclipsed in March 2014, when an anonymous buyer purchases a villa in Bali for more than 0,000 worth of bitcoins.
  • According to the Pew Research Internet Project,73 percent of all adults who use the Internet use a social networking site of some kind, while 42 percent use multiple social networking sites. Not surprisingly, Facebook is the most frequented social platform among adults, with LinkedIn a distant second.
  • How important has mobile advertising become? According to Digital Buzz, 57 percent of users claim that they will not recommend a business that has a poorly designed mobile website. One out of every three searches conducted on a mobile device has "local intent."
  • Which country has the fastest Internet connection speed? It definitely is not the United States, which trails such countries as Czech Republic, Latvia, Netherlands, and Switzerland. And it isn't Japan, which ranks a distant number two. It is South Korea, where residents enjoy Internet speeds roughly 65 percent faster than users in the U.S., according to a report published by Statista.

2013-2014: Facebook vs. Google, Round Three

The Battle to Dominate the Social Web

On January 7, 2013, Facebook adds a page to its website entitled "Introducing Graph Search." To Internet industry leaders, however, this represents less of an introduction to Graph Search than the first public iteration of Facebook's long-expected social search engine, as inevitable as Google's forays into social media had been. Facebook founder Mark Zuckerberg has been explicit in his intentions to launch a search feature that would draw from the social network's unprecedented collection of personal data for years, yet most Facebook users are unprepared for its repercussions.

Indeed, many Facebook users are shocked to discover how easy it will now be for people to access potentially sensitive photos and information that, while always publicly available, had been consigned to obscurity as soon as it had disappeared from the feed. Facebook's page dedicated to Graph Search gives entirely innocuous examples of the search in action: "People who like Cycling and are from my hometown," "Photos of my friends in New York," and similar inquiries. However, in a January 23 article entitled "Actual Facebook Graph Searches," programmer Tom Scott demonstrates how the engine can be used to produce highly controversial results. Among his searches:

  • "Spouses of married people who like [cheat-on-your-partner dating site] Ashley Madison"
  • "Single women who live nearby and who are interested in men and like Getting Drunk"
  • "Current employers of people who like Racism"
  • "Islamic men interested in men who live in Tehran, Iran"

Each of these searches turns up multiple results, although Scott conceals the identities of the people and companies affiliated with these results in his article. However, Facebook users - including spouses, employers, family members, and even government officials - now have the ability to conduct these and similar searches, and the results will name names.

There are those who suggest that Graph Search will force Facebook users to be more conscientious about understanding and wisely employing their privacy settings and to be more circumspect in clicking on the ubiquitous "Like" button. As consumer privacy expert Justin Brookman of the Center for Democracy and Technology tells Forbes, "The positive result of all this…is that people are becoming less and less stupid about information sharing."

Of course, not everyone is using Graph Search to dig up dirt on people. At a press event on January 15, Zuckerberg emphasizes the use of Graph Search to discover new things - movies, music, restaurants, businesses - based on the interests and reviews of a user's connections. He also acknowledges that it could eventually lead to an influx of new advertising revenue, but that as of now "we're just focusing on building a good experience for users."

During the press event, Zuckerberg also introduces the "Dream Team" behind Graph Search, Lars Rasmussen and Tom Stocky, both of whom are former long-time Google employees. At Google, Rasmussen was notable for co-creating Google Maps, while Stocky was a director of product, focusing on search, client, and travel products. "Obviously, [Facebook has] already changed the world, and yet there seems to be so much more to be done there," says Rasmussen. "And I think that it's the right place for me to be."

In addressing the press, Zuckerberg continually stresses that Graph Search is very different from web search and, therefore, not in competition with traditional search engines. However, he also announces that Facebook has partnered with Microsoft to deliver results not found in Graph Search via the latter company's Bing search engine. He describes Bing, which does compete directly with Google, as "a world-class search engine" and Microsoft as a company that "was more willing [than Google] to do things that fit with Facebook."

He adds, however, that he "would love to work with Google."

Google+ Becomes Less Niche

Like Facebook, Google is no stranger to criticism of its products and the motives behind them; also like Facebook, Google charts its own course no matter how choppy the waters. In November, the company makes public one of its most controversial decisions when it announces that anyone who wants to leave comments on YouTube must sign in with Google+ first.

Such strategies have allowed Google+ to become a powerful force in social networking, if still well behind Facebook. In October, Google announces that the number of active monthly users on Google+ has increased 58 percent since May, from 390 million to 540 million. Perhaps more importantly to Google, public perception of Google+ seems to be changing somewhat dramatically. What was once perceived by many as Google's folly is now being lauded for providing the sort of rich user experience that Google-the-search-engine rewards, at least among techies.

One such techie is Yaara Lancet, who compares Google+ and Facebook in an August article that appears on MakeUseOf.com. She rates Google+ as providing the best experience in terms of "interface," "friends," "posting updates," and "adding photo albums," while Facebook earns superior marks for "profile" and "controlling privacy." The two networks are tied when it comes to their chat services. Ultimately, Lancet concludes:

In almost every respect, Google+ currently offers the better experience out of the two rival networks, although Facebook does win in Profile and Privacy, which are pretty important.

The main reason most of us still prefer Facebook is simple: it's where people are. Why are people there? Probably because it was first. This is a recursive argument, because if we all move to Google+, that's where people will be. But it's not easy, and in the meantime, if you truly want to stay updated and have an audience, you will understandably stick to Facebook (I know I do).

It's hard at this point to argue that Facebook remains the undisputed King of Social Networking Sites, even as Mark Zuckerberg objects to the pigeonholing of Facebook as a social network. Then again, Bradley Horowitz, the vice president of product management at Google+, is equally adamant that his service is more than simply a social network. It is, rather, the engine in the powerful vehicle that Google has entered into the race for dominance over what Zuckerberg calls the "Social Web."

"The goal of Google+ is to make all Google services better, including ads," Horowitz claims, adding that Google+ is the social layer that provides a "coherent notion of a person" across these services, including search, Gmail, and YouTube. Coupled with its support of authorship markup, as evidenced by the prevalence of the thumbnail photos of authors that accompany many if not most first-page results, Google seems to be taking as much of a shot at the concept of Internet anonymity as it is at Facebook.

Whatever the case, Google's strategy appears not to be hurting the company's bottom line. Buoyed in part by its remarkably popular Android platform, Google overtakes Facebook-partner Microsoft in October as the world's second most popular technology company. Between June and October, Google stock rises a meteoric 30 percent per share.

2014 and Beyond: The Battle Is Just Beginning

Shortly after Facebook's disappointing IPO, Mark Zuckerberg pointed to an improved experience for mobile users as one of the keys to the company's future financial success. Since then, the company has moved away from html5 to native apps with improved speed and impressive usability. It has revamped its Messenger app in particular, recreating it as a robust private messaging system. In the second quarter of 2013, Facebook sells 8,400 mobile app install ads, driving approximately 46 million app downloads during that period. So far, Facebook's rebranding as a mobile-first platform has been entirely successful. Not coincidentally, the company's stock finally surpasses its IPO mark of per share in August 2013. In February 2014, the company's stock hits an all-time high of .92 per share.

In the meanwhile, amidst rumors that the company plans to invest heavily in gaming and continued development of its successful Chromecast video-streaming device in 2014, Google continues to stand by Google+ as the heart of its future operations. Indeed, Google+ now seems to be part of a larger effort by Google to survive the gradual erosion of its dominance in traditional search. Due partially to the proliferation of mobile apps, Google lost market share in search ads for the first time in 2012, while searches in general declined by 3 percent in the second half of that year.

Through Google+, however, Google has created an information hub that transcends social media as we once knew it, or at least thought we knew it. Even if Google+ is, as The New York Times describes it in an April 2014 article, a "ghost town," it is the base account for anyone who uses Google products, including Gmail, YouTube, and Google Maps. Regardless of how often people interact socially through Google+ or how public they allow their information to be, Google is able to track who they are and what they are doing across the full range of its services.

At this juncture, hundreds of millions of people belong to the two of the most powerful and comprehensive databases in the world; databases that are, in many ways, more detailed and insightful than those developed by government agencies. What Facebook and Google choose to do with these databases is yet to be fully understood, perhaps even by these companies themselves. You can bet, however, that the saga of Facebook versus Google is far from over, and that the future direction of the Internet in all its forms will be determined by how the battle unfolds.

Einstein Medical: Looking Back on More Than 20 Years

In 1993, when Robert Silkey first predicted the migration of physicians and dentists from reimbursed health care to a cash-pay model, there was no company like Einstein Medical in existence. Now, the online marketing industry that we helped to create is heavily populated with search engine marketers, social media gurus, and web designers, and they all want your business. Some of them are very good at what they do.

Of course, some of your competitors are very good at what they do, too. But you are in an entirely different class. You know that. That's one of the reasons you're looking for the best way to promote yourself.

We're also in a different class. We were there at the beginning of the modern Internet and cash-pay healthcare eras, and many of the concepts that are now core to search engine and online medical marketing are rooted in our history.

We were there when :

  • Yahoo! was in its infancy
  • The FDA approved the use of the excimer laser for PRK and later for LASIK
  • Microsoft had yet to develop a search engine, and later when their search engine was rebranded as Bing.
  • Google was born, when it became a search engine giant, and when it established its Webmaster Guidelines.
  • Plastic surgery made the transition from a niche market to a worldwide phenomenon.
  • MySpace was the King of Social Media, and when it was taken down by a brash upstart called Facebook.
  • "Smile Makeover" became a household term.
  • Online video evolved from its crude beginnings into the Internet's dominant medium.
  • The Mobile Web was first emerging and as it overtook desktop computers as the number-one means of accessing the Internet.
  • SaaS apps and "The Cloud" were unheard of outside of a community of techies.
  • Every major society affiliated with elective and cosmetic health care evolved into powerful, highly esteemed organizations.

We have been there through all of this and more, positioning ourselves at the forefront of our industry every step of the way.

2014: The Best Is Yet to Come

Now, we are proud to have the privilege of building a fruitful, prosperous future on more than twenty years of trials, tribulations, hard-learned lessons, and hard-won victories. Our ongoing growth and development have made the past few years the most rewarding yet. We are at the top of our game, and only getting better with each passing year.

At present, our corporate office in San Diego houses a team of 75 experts, each dedicated to his or her specific craft. Every member of the Einstein Medical team is as committed to producing quality results and working to ensure the success of your practice as you are.

In our office, we have:

  • A design team that focuses on creating websites that look beautiful and function just as beautifully.
  • A writing team that provides custom educational and practice-marketing content.
  • An engineering team that expertly codes our websites and develops new, innovative business apps.
  • A team of project managers dedicated to keeping everything moving along smoothly and communicating to everyone involved in a project.
  • Experts in quality assurance, customer service, and information technology.

By employing so many skilled professionals in-house, we are able to leverage the economies of scale better than any other company in the industry. You will be working with experts who:

  • Are fully trained in our systems and standards
  • Are highly knowledgeable about the procedures you perform and the technologies you use
  • Have devoted their careers to honing their talents at Einstein Medical rather than "playing-for-pay"
  • Are accustomed to working with prominent medical professionals and know how to tailor solutions to their unique needs
  • Communicate with each other face-to-face on a daily basis as they collaborate on projects

We don't have to bring our team members "up to speed" when a project is assigned. They hit the ground running. Ultimately, this allows us to complete your projects more efficiently, more effectively, and at a higher level of quality than any of our competitors possibly could.

In the end, we measure our success by the success of our clients. Every day, we strive to fulfill the promise of our mission statement through a marriage of art, science, and vision:

We create exceptional business solutions that enable cash-pay healthcare professionals to reach their full potential.

It would be our privilege to do the same for you. Get in touch with us today to find out how we can.


Einstein creates beautiful websites, and they are very knowledgeable about the latest SEO practices, so your website brings in new patients. The team easy to work with, and I always get prompt attention. They've been an excellent choice for us. Julie K.


Einstein creates beautiful websites, and they are very knowledgeable about the latest SEO practices, so your website brings in new patients. The team easy to work with, and I always get prompt attention. They've been an excellent choice for us. Julie K.

Einstein Medical

6825 Flanders Dr
Ste 110 San Diego, CA 92121

Open Today 7:00am - 4:00pm

More Info Directions (858) 459-1182

Social Accounts Sprite Icon Sprite

Einstein Medical

6825 Flanders Dr
Ste 110 San Diego, CA 92121

Open Today 7:00am - 4:00pm

More Info Directions (858) 459-1182


Einstein creates beautiful websites, and they are very knowledgeable about the latest SEO practices, so your website brings in new patients. The team easy to work with, and I always get prompt attention. They've been an excellent choice for us. Julie K.