Fern Carness (left) and Margy Imlay designed this fitting room to put women at ease.

Sometimes, if you want something done right, you have to do it yourself. That is precisely what 10-year breast cancer survivor Fern Carness found when she sought out postmastectomy products for the first time.

“I was in Los Angeles and I could not find a store that served my needs as a young survivor of breast cancer,” says Carness, who is a registered nurse and has a master’s degree in public health. “In fact, I ran screaming hysterically out of the first store I went into because the only option was a breast prosthesis that was stuck in the back of an HME store next to the rental oxygen tanks and the commodes. I said, ‘If that’s what I have to do, just kill me now.’ I refused to accept that, and I felt the industry had to take better care of me.”

As a health education specialist, a nationally recognized speaker in the area of women’s health, and the author of Wise Women Speak: 20 Ways to Turn Stumbling Blocks into Stepping Stones, Carness was perfectly suited to the job of changing the way the industry was treating breast cancer patients. Using her expertise in the health care field, she first helped friends start Intimate Image in Calabasas, Calif, about 7 years ago, and consulted as a trainer with the franchisers of Women’s Health Boutique in Houston about 5 years ago. With her input, those proprietors were able to create stores with a healthier, feminine, and youthful focus where breast cancer patient and survivor needs were concerned.

Then Carness moved to Portland, Ore, where she again found nowhere to shop for appropriate products. She could order from the boutiques she had helped create, but she wanted to fill the postmastectomy niche in her area of the country.

Last year she succeeded. Her business partner, Margy Imlay, contacted a friend who turned out to be an “angel investor,” and in September 2001 they opened the boutique shop Just Like a Woman in Portland.

“I had already had the business plan written for 10 years, so 6 months after we found our investor, we were open,” says Carness, who co-owns the shop with Imlay, a certified cancer exercise specialist. Both are Board for Orthotists/ Prosthetists Certified (BOC) fitters and health educators.

A Touch of Class
Just Like A Woman is a full-service lingerie store that stocks mastectomy and other women’s health products in addition to maternity items, hard-to-fit items, wedding lingerie, and regular lingerie. Since Carness and Imlay believe in a philosophy of treating women special, the store was designed with beauty and comfort in mind.

“Thanks to Margy’s eye for style and décor, the store is very elegant, filled with antiques and large dressing rooms fitted with feminine vanity tables, fainting couches, and freestanding mirrors,” she says. “And we researched healing colors so that the final product would be bright and cheerful.”

The dressing rooms also are extremely private. Customers can lock the door leading to the store and sales staff enter with different products and sizes from the back of the room. In addition, every customer who enters the store is taken to a dressing room and given a satin dressing gown to wear and a cup of tea to relax. Each salesperson washes their hands, and customers are measured with a single-use tape that they take home with them.

“These things are critical, because we often have women here with still-healing incisions, or infections,” Carness says. “It is crucial that we have an infectious disease control policy in place, and we want our customers to understand that there is a professional working with her.”

Products Paired with Empathy
The staff at Just Like a Woman encourage customers to come in before their surgery so they can help support the customers’ decisions to undergo the procedure, and so they can fit the customers for all stages of their mastectomy.

“When they come in before surgery, they can purchase a camisole, some educational material, even some guided imagery tapes to help them through the treatment,” Carness says. “Then, about 10 days to 2 weeks after surgery, we like to see them again and get them in a transitional bra. This is not yet a proper fitting, but it will get them out of the camisole so they can go about their [usual activities].”

Four weeks after surgery, customers are ready to be fitted, and the staff spends approximately 2 hours with each customer, walking her through all her options and making recommendations. Two weeks after that, Carness likes to see them again to make sure everything is going well with their fittings.

“That is the time I introduce them to swim forms, sports bras, bathing suits, strapless bras, and the things they need in order to meet the rest of their fashion needs,” she says. “Throughout this process, we continually give them support in making further treatment decisions. We understand what they are coping with.”

To help them cope, the store also offers ongoing classes on a variety of women’s health topics, such as living with lymphedema, breast self-examination, nutrition for women, the mystery of menopause, performing infant CPR, and how to get ready for a surgical procedure. The staff also does lifestyle-coaching support one-on-one with customers.

More Than Just PostMastectomy
While the store’s dollar revenue is greater with the mastectomy customers, they make up only about half of Just Like a Woman’s clientele. The next biggest group is large-busted women, followed by maternity clients, then women who just like the level of service. Regardless, all customers are treated the same, and no one waits on themselves—based on client preferences, the staff handpicks every item for them, and each customer is fitted according to her stage of illness, lifestyle, and body shape. It is that level of personalized attention that has been Just Like a Woman’s best marketing technique.

“Word of mouth has been fantastic for us and our referrals have been critical,” Carness says. “The store is still so new that I am learning how to market it. We know that newspaper ads do nothing for us, and we have spent a lot of money on print that was a waste. The doctors are very happy with what we are doing, on the other hand, and they have been very supportive in trusting us with their patients.”

To further assist its customers, the store handles all insurance billing, so that women are able to leave the store with all their products but without having to pay for any of it yet.

“We are getting [listed in] as many provider manuals as we can, though getting some of the insurance contracts has been challenging,” Carness says. “It is tough trying to set profitability standards while still looking at the huge discounting going on, but the insurance companies are very happy to have us here.”

In terms of business practices, one of the smartest things Carness says she did was put in a retail software program for inventory and customer management. “That brought about some incredible frustrations when we were first learning the system, but it really is paying off now in terms of speed,” she says. “We also have had a difficult time finding fantastic employees, though we are there now. But it took almost a year to find our crew of five.”

Profits Came Quick
So far, Just Like a Woman is faring well in the marketplace, too. Though it has been open less than a year, Carness says it has been turning a book profit since it was open for 90 days.

“We did have a lot of money to start, so we were able to make the store beautiful and to make sure it was fully stocked from the day the doors opened,” says Carness, who, along with Imlay, has yet to take a salary from the business. “I make my income from speaking and consulting, and I am running out of resources. It has been tough, but we are committed to this for the long-term.”

She is also committed to expanding the store in several ways. Carness and Imlay have two business ideas for the future, though neither is fully mapped out yet. “We would like to open five more stores in other small towns in the Pacific Northwest and run Just Like a Woman as a mini-chain,” she says. “And we would love to be able to put together a motor home that is fully stocked and that can make a circuit of more rural communities on a monthly basis. It would be nice to take our wonderful products and service to women in outer areas. However, both of those plans will require a new investor, and we do not know where that is coming from yet.”

For the time being, Carness and Imlay are happy that Just Like a Woman is able to serve clients in the community in such a specialized way.

“Breast cancer products have to be a separate entity from most HME. It is simply not enough to throw up curtains and a chair and call that your mastectomy section,” Carness says. “It has to be a total environment by women, for women. The fact that I have a medical background is huge, and the dedication that my partner brings to the table for making this place beautiful is what makes customers feel just like a woman when they come in here.”

For others looking to go into this niche, Carness says they should do their homework, and enter a new market with a humble attitude. “HME providers in this niche cannot be arrogant enough to think they can come onto the scene and be the best thing in town,” she says. “They have to recognize that everyone in this business is providing a valuable service.”

Liz Finch is a contributing writer for Dealer/ Provider.