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Hello, and welcome to "Beauty and the Biz," where we’ll talk with Anna Frants, MD, and how she built a thriving practice on Park Avenue in 2 years. Additionally, we’ll discuss the general business and marketing side of plastic surgery.

As always, I’m your host, Catherine Maley, author of "Your Aesthetic Practice – What Your Patients Are Saying." Furthermore, I’m also a consultant to plastic surgeons, helping them get more patients and more profits.

Presenting today’s episode titled, “How She Built a Thriving Practice on Park Avenue in 2 Years — with Anna Frants, MD.”

Indeed, what does it really take to go from fellowship to a fully booked schedule in a high-end Park Avenue practice—while juggling motherhood, surgery, and serious growth?

Presenting, Dr. Anna Frants. Specifically, she’s my latest guest on "Beauty and the Biz", and she shares how she strategically positioned herself to succeed—fast. Moreover, in our conversation, we discuss:

• First, the business mindset she picked up from the biggest names in plastic surgery.

• Additionally, why she chose a private-practice fellowship over academia.

• Furthermore, how she evaluated job offers and negotiated the right structure.

• Moreover, what it’s like to share one OR with three other surgeons—and make it work.

• Finally, how she handled being the “new kid” without stepping on toes.

In short, this is an insider’s look at the business side of practice-building that most surgeons never talk about.

Presenting, Dr. Anna Frants. Specifically, she’s my latest guest on \"Beauty and the Biz\", and she shares how she strategically positioned herself to succeed—fast. Moreover, in our conversation, we discuss:

• First, the business mindset she picked up from the biggest names in plastic surgery.

• Additionally, why she chose a private-practice fellowship over academia.

• Furthermore, how she evaluated job offers and negotiated the right structure.

• Moreover, what it’s like to share one OR with three other surgeons—and make it work.

• Finally, how she handled being the “new kid” without stepping on toes.

In short, this is an insider’s look at the business side of practice-building that most surgeons never talk about.

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 P.S. IMPORTANT NOTICE!

Don’t miss this rare opportunity to level up your coordinator’s skills and get instant access to the $5,000 Cosmetic Practice Vault for free.

This combo is designed to convert more consults and smooth out your practice processes —fast. 

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
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🎤 "Beauty and the Biz" Podcast
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🤝 LET'S CONNECT:

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P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Visit Dr. Frants' website

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

#nyfacialplasticsurgeon #parkavenuefacialplasticsurgeon #annafrantsmd

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to "Beauty and the Biz," where we’ll discuss if AI can help or hurt your cosmetic practice. Additionally, we’ll discuss the general business and marketing side of plastic surgery.

As always, I’m your host, Catherine Maley, author of "Your Aesthetic Practice – What Your Patients Are Saying." Furthermore, I’m also a consultant to plastic surgeons, helping them get more patients and more profits.

Presenting today’s episode titled, “Can AI Help or Hurt Your Cosmetic Practice? — with Clark Mackey.”

First of all, AI is everywhere.

But specifically, what does it mean for your practice?

To find out, listen to this episode of "Beauty and the Biz." 

Here, I talk with Clark Mackey.

Importantly, he’s a certified Google Partner.

Also, he has 20 years of digital marketing experience.

Together, we break down how AI affects plastic surgery practices.

Specifically, you’ll learn:

• First, how AI affects your website traffic
• Then, how it impacts patient leads and reviews
• Also, how it can save you time and money
• However, how using it wrong can hurt patient trust
• Finally, what tools you can start using this week

Clearly, this isn’t just theory.

Instead, these are real strategies.

Undoubtedly, they help you stay relevant.

Additionally, they help you grow.

Ultimately, they help you earn more.

 

P.S. Before you go, Clark made a free AI guide just for you. Now, grab it here: cakewebsites.com/ai

https://bit.ly/4hwXjkb

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Visit Mr. Mackey's website

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

#cakewebsites #clarkmackey #googlepartner

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to "Beauty and the Biz," where we’ll discuss how to regroup after a disaster. Additionally, we’ll discuss the general business and marketing side of plastic surgery.

As always, I’m your host, Catherine Maley, author of "Your Aesthetic Practice – What Your Patients Are Saying." Furthermore, I’m also a consultant to plastic surgeons, helping them get more patients and more profits.

Presenting today’s episode titled, “Regroup After Disaster — with Kate O’Connor, MD.”

Clearly, running a thriving practice comes with challenges. Surprisingly, few surgeons embody resilience like Dr. Catherine O’Connor MD, a facial plastic surgeon in private practice in Nashville, Tennessee, for the past three years.

Specifically, this week, on "Beauty and the Biz", Dr. O’Connor shares her incredible journey of leadership and perseverance.

Previously, she had leased a sought-after brick building on Music Row. Fortunately, when the opportunity to buy it arose, she jumped at the chance. Unfortunately, just weeks later, disaster struck.

Suddenly, a pipe burst on the top floor, flooding all three stories over a weekend. Consequently, water destroyed floors, exam rooms, and equipment. Immediately, her team scrambled for solutions.

Thankfully, here’s where her leadership truly shined:

• First, she acted fast, securing a temporary space. Patients continued receiving care with minimal disruption.
• Next, she empowered her staff, keeping the focus on recovery. At the same time, patient care remained a top priority.
• Finally, she found opportunity in crisis. The setback became a chance to improve operations while rebuilding.

Meanwhile, as if that weren’t enough, she’s also expecting her first child. Undoubtedly, she’s proving that resilience isn’t just for business—it’s a way of life.

Ultimately, Dr. O’Connor’s story is a powerful example of adaptability. Specifically, she shares key lessons from overcoming adversity and growing her practice—no matter what.

Certainly, if you need inspiration to tackle your own challenges, this episode is a must-listen.

P.S. Want help overcoming the obstacles holding your practice back?
Book a Growth Strategy Review today.

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Visit Dr. O'Connor's website

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

#nashvillefemaleplasticsurgeon #nashvilleplasticsurgeon #kateoconnormd

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Let’s face it. Times have changed. 

It’s way too competitive to be mediocre. It’s also way too costly to attract new patients so you can’t afford to lose them. 

I know you’re painfully aware of how difficult it’s gotten to convert prospective patients due to the insane amount of competition and information available.

This creates confusion and fickle prospective patients who know if
they don’t like their experience with you, they can always call one of your many competitors. 

However, this is actually an opportunity for you to step up and be better than your competitors, so they choose you.

But here’s the harsh reality…

It’s not enough to have a gorgeous expensive website do all the heavy lifting for you.

It’s also not enough to automate everything (even though that would be great). Chatboxes, Auto-responders, follow up funnels and artificial intelligence are helpful, for sure, but they have their own limitations.

Remember you are in the people business. People with credit cards who want to look good and feel great. People with emotions such as skepticism, fear, hope, trust or distrust.

These people who are using their own disposable income want customer service. They want to feel heard and significant. They want to know you care.

Chatboxes and autoresponders do not give them those warm, fuzzy feelings. People do.

So, in this podcast, I’m going to show you how to convert more cosmetic patients without spending more on advertising or hiring more staff or adding more technology.

Problem

Let’s first start with this question...

If you were to listen in on new caller leads your receptionist was handling, would you smile with satisfaction listening to her professionally credential you and book the consultation or….would you cringe hearing her lose the callers and hurt your image all at the same time?

When you ask your receptionist about it, don’t they often say the callers were just price shoppers and weren’t serious about moving forward?

And, Does  this sound familiar:

You do a string of consultations that you “thought” went well.

The prospective patients you met with were engaged and interacting with you.

You were sure many of them would book.

However, when you ask your coordinator how the consultations went, she tells you:

• "Oh, they had to think about it."
• "They were going on other consults."
• "They had to check their schedule."
• "They have to save up."

So now you’re either questioning yourself or your staff or the patients.

Is it something you said or did?

Is it something your staff said or did?

Are patients today ridiculous and you’re ready to throw in the towel?

It’s so deflating putting in so much time and effort, only to NOT get the result you expected.

So now you decide to either spent even more on advertising to get more leads or you fire your staff or you do nothing and hope next month is better.

Instead, here are some insights that should help:

Agitate

I have trained hundreds of receptionists and coordinators from around the world and here’s what I know for sure:

Every practice has money-losing holes in their practice bucket (some practices have more than others) and the most common are disappointing conversion rates.

And, even the most seasoned staff could use improvement. Actually, the seasoned staff has been around for the good times, when it was a lot easier to convert callers and consults so they may have trouble adjusting to this increasingly competitive landscape where they need to learn new skills and strategies to keep up.

Frankly, too often the staff is winging it. They just say whatever comes to mind and that leads to them talking too much and confusing the patient and a confused patient is a no so that’s not a good approach.

Because it’s astonishing to discover the reality of lost revenues leaking out of your practice that add up big time.

For example, if your receptionist loses 1 caller per day that was worth $2K and you multiply that by 5 days per week and 50 weeks per year, that’s a whopping $500K per year and let’s say you see:

• 12 consults per week
• 40% Close Rate = 5 Booked Procedures
• X 50 weeks per year @ $8K Average Procedure = $2MM

This sound good UNTIL you do the math on the other 60% who did NOT book.

That number of lost revenues is $2,800,000! Yikes! 

This is unnecessary and also easy to remedy.

Here is The #1 Tip to Convert More Callers

Prepare your staff to answer the caller’s question, “How much is it?”

So often, callers have only one question when they call your office and that is…

How much is it?

Oftentimes, you don’t tell them. Your receptionist says, “the surgeon must examine you first” and then you’ll get a quote.

That used to work before, but in today’ world with so much information available, that can feel evasive or defensive to the caller so they end the call.

Or, you tell them the price and they hang up, never to be heard from again.

Here’s a better approach…

The reason they are asking about price is because they are not considering anything else but price.

They have commoditized your services and “assume” they can get the same service and result no matter who they choose.

But maybe in the past, when they had chosen a cheaper alternative, they were dissatisfied because they had to wait, the staff was rude, it was painful, nobody seemed to care, they were underwhelmed with their result and their experience.  

So, it’s vital you educate callers what else they should consider that goes into it than just price BECAUSE they don’t know….until you tell them.

Prepare your staff to “Pre-Frame Before Price” by bragging about you and the practice BEFORE stating the price. Now the caller has more to consider than one price variable. For example,

• You’ve performed more than 4,500 surgical procedures
• You have a no wait policy
• You offer pain free treatments and/or
• 1st time callers get a special gift card or goody bag

If you have trouble coming up with your brag points, think of all the complaints you get, fix them and they become your bragging points to tell the caller.

And, here’s The #1 Tip to Convert More Consultations.

Set your coordinator up to be seen as “The Aesthetic Advisor” and NOT “The Closer”

When you buy a car at the dealership, you are often sent to an office to meet with “The Closer” to talk about the numbers and the terms.

It can be stressful because the negotiator may be pressuring you to add on tinted windows, leather seats, etc.

This is NOT a fun experience and can leave you feeling victimized, or you may just leave because you are uncomfortable with the set up.

The same happens in a typical plastic surgery consultation. The patient meets with the doctor and then is sent to “The Closer”, otherwise known as your patient coordinator, to discuss fees and dates.

The prospective patient has never met or talked to the coordinator; yet, they are expected to review the quote, agree to the terms and put down a deposit….all is a matter of minutes.

This is not a comfortable experience for either the patients or the coordinator. That’s why the patient so often says, “I have to think about it” or “I have to talk my husband.

A better approach is to set up a process so the patient and coordinator converse ahead of time so they have a chance to bond BEFORE meeting face-to-face.

You do that by sending a personalized welcome letter from the coordinator, then she calls to introduce herself and then sends text reminders using her name.

These several points of contact help the patient and coordinator bond ahead of time and that makes it a much more comfortable and effective consultation that actually books!

The Offer

If this has helped you see how nuances make all the difference in converting callers and consultations, you’ll want to check out The Phone Club for Receptionists and The Converting Club for Coordinators at www.catherinemaley.com for a lot more strategies to transform your coordinator into a confident coordinator who converts 30-50% more consults professionally and your front desk staff will convert up to 30% more callers within 48 hours using proven scripts and strategies.

Go to www.CatherineMaley.com for details.

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

 

#convertmorepatients #convertmoreconsults #convertcosmeticpatients

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and the future of cosmetic surgery.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "The Future of Cosmetic Surgery — with Erik J. Nuveen, MD, DMD".

While speaking at this year’s AACS conference, I heard a surgeon give a talk called “The Future of Cosmetic & Plastic Surgery: Consolidation and Success”.

He was saying how difficult it is for a new surgeon, oftentimes saddled with up to $500K in loans, to borrow more money to open their own practice or buy into someone else’s, when they enter the marketplace. 

He went on to talk about new hybrid scenarios that work well for the up-and-coming surgeon looking for autonomy and support, as well as the mature surgeon contemplating a profitable exit. 

Since this is a hot topic lately, this Beauty and the Biz episode is an interview I did with that speaker. It’s Dr. Erik Nuveen, a cosmetic surgeon running a multi-surgeon, 10,000 square foot private practice located in Oklahoma, OK; which is embracing the future of cosmetic surgery.

We talked about how he bought someone else’s practice (with a shoddy reputation) and built it into an 8-figure practice, while performing 2,240 surgeries per year. 

And, how Dr. Nuveen is using the art of consolidation to reduce redundancy and change the landscape of solo cosmetic practices.

Visit Dr. Nuveen's' website

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

The Future of Cosmetic Surgery — with Erik J. Nuveen, MD, DMD

Catherine Maley, MBA: Hello, and welcome to Beauty and a Biz where we talk about the business and marketing side of plastic surgery and the future of cosmetic surgery. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits. I have a really special guest today.

His name is Dr. Erik Nuveen. Now, he's a cosmetic surgeon, who is embracing the future of cosmetic surgery, in a multi-surgeon, 10,000 square foot private practice called Cosmetic Surgery Affiliates, and it's located in Oklahoma City, Oklahoma, which I've actually had a chance to visit this year for the first time in my life, and it was really nice.

So, this eight- figure, practice, which is embracing the future of cosmetic surgery, includes face, breast, and body surgical procedures performed by four surgeons in their two onsite operating rooms, which are fully accredited and AAAHC certified. Now, they also offer a plethora of nonsurgical treatments performed by many ancillary staff in their med spa, as well as online store that carries their own skincare line.

Now Dr. Nuveen and I crossed paths very recently. We were at the American Academy of Cosmetic Surgeons annual meeting in San Diego and Dr. Nuveen we were in the practice management session and after I spoke, then I listened to Dr. Nuveen's talk and his was entitled, "The Future of Cosmetic and Plastic Surgery: Consolidation and Success". So, this happens to be a really hot topic lately, so, I wanted to get his take on it because he's very immersed in it and like I said, he’s embracing the future of cosmetic surgery.

So, Dr. Nuveen, thank you so, much for coming on to Beauty and the Biz.

Erik J. Nuveen, MD, DMD: Oh, you're welcome. Thank you for having me. I appreciate it. It's an honor, it's always I don’t know, may, maybe it's a point of retrospect and, and life, but to, to hear the things that I've done is kind of weird to listen. It just you know, I started off when I was six and always wanted to do surgery.

My father was an orthodontist and oh, He straightened teeth, and that was wonderful to change the perspective and often the self-esteem of o often adolescences. But at the end of that, I was always frustrated with my dad because he couldn't fix their nose or their chin. Oh. And that's really where it started.

And you know, today after finishing, you know, 14 years after college and. And eight, nine years of residency and fellowships. And then 21 years of clinical practice, it's like a blink of an eye. And I, I know I, I sound like a broken record for us that are adding up some years, but what I think what's been kind of special about my situation is when I finished up a full formal fellowship and face end body cosmetic surgery in Salt Lake City, Utah.

I had also finished a year of cranial facial surgery at Toronto Sick Children's Hospital. So, I had a pretty unique bunch of skills and also medical and dental degree. Prior to, I did a total of two years of general surgery. So, it was interesting because I, I had also along the way had taken a little time to fly some airplanes and so, I figured, well, gosh, how can I involve myself with a hobby with a skill to help others and to improve the standard of care throughout the country?

And I, I, I take that statement very seriously. That was my objective and it still is to this day to try to improve each and every day. And I hope when I do exit. That it will be at the top of the game and, and I'm always looking forward to that because each day seems to be a better day. Oh. Yeah. Yeah. So, I, I finished my fellowship and I came to Oklahoma City.

I picked Oklahoma City because the cost of living here was very low. And the opportunity to start off day one in a 10,000 square foot facility that I purchased was not Something I could do in downtown Manhattan, right? Or other major metropolitan areas. So, I live about eight minutes from my office and 12 acres and nice countryside and quiet with coyotes and hawks and owls.

And it takes me 10 minutes to commute to see patients, and it's just been a fantastic choice. It is the middle of the country, so, fortunately I get to use my airplane and go and visit the ocean often. And so, the practice really started there in Oklahoma City and I took over a preexisting doctor's practice.

He was 71 and did exclusively breast surgery. And I saw an opportunity to expand that practice. And fortunately, God willing it did. And so, I purchased that practice from an individual, kind of the old school method, a handshake, a, a gratitude, and pat on the back and. And there I started and did —

Catherine Maley, MBA: Wait, were you in a different building? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yes. Yeah. From the, from, so, he was in a smaller facility and shared with an ophthalmologist oculoplastic eye. Mm-hmm. And that relationship couldn't have lasted too long. Cause I really needed to grow and I needed multiple operating rooms to do what I had set my heart to do. So, my, my plan from day one was to come into the community meet all the other surgeons that did similar things and.

And opened the door for growth. And ultimately, I, I set the bar high. I want it to be the most dominant practice in this region of the country. And I, I think statistically we've been able to achieve that. I do. About, can, can I ask you something? Yeah. Mm-hmm.

Catherine Maley, MBA: Out of curiosity, what exactly did you buy? How did this affect your understanding about the future of cosmetic surgery?

Because, what did he have that you wanted of value? Was that a shortcut to get into the community or what? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah, it's a great question. So, you know, there's an exchange in life, right? You know, you, you ask for, you have communication, you hope for a response. And in the relationship with the physician was this gentleman wanted to exit and I wanted to come in.

Mm-hmm. And he had a patient flow volume of about 750 patients a year. He did a very high volume of breast augmentation and he was very consistent year in, year out. He didn't offer almost any other procedures. So, I saw an opportunity there just in the patient flow volume to expand, and it did. So, we sent out letters to 6,500 pre previous patients and inform them of our expanded services and an opportunity to meet with me and.

So, the first month I was in practice I did 57 major surgeries and I've never slowed down.

Catherine Maley, MBA: Nice. And did you two, like were you feeding off of his credibility? Did he have to stay put for, for a while for the patients to get used to the transition or how did that work? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah, that's, that's a really variable answer if you're speaking to the general public on that topic because it's all about personality will determination.

Effort and I hope good counsel.  I think that's an often-overlooked commentary is you, you need to, don't, don't do things foolishly because you think it's the right thing to do. There's been other people there before you and you really should ask some good questions and don't be afraid to hear constructive criticism.

It's, it's very common to think that doctors have done very well in school and that that translates into financial or good decision making, and it doesn't always. So, we have to admit that first and foremost, have the insight that the others have been there and let's get some good advice. So, for, in my situation, I was taking over a gentleman's practice who.

Had done almost 20 years of exclusively breast surgery. So, we had a very long proven statistical track record, and I'm very data driven. So, I did a lot of spreadsheets and demographics, co, you know, cost of living, cost of employment, and the goals that I set for myself and my business, and kind of predicted in a business plan exactly what I thought would happen.

And it's actually remarkable how close I was over a 20-year period to exactly what I predicted. It's actually freaky weird. I was off by less than a hundred thousand dollars in, in, in all the categories, which is pretty, pretty amazing actually.

Catherine Maley, MBA: But did he stay put like did you two work together or did he pretty much exit and you entered? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah, I made a very thought-out contract. There were some issues related to his history that I needed to insulate myself from and isolate myself from. So, I did that legally. And he worked about two hours. And then he was released from that obligation. And then I took it from there. And at that point, I had come down two times during my fellowship met patients, knew I was on good, solid ground of communication and I was willing to take that gamble.

So, he exited immediately and I took it over from there.

Catherine Maley, MBA: So, again, out of curiosity because these are the kinds of things people want to know about. Yeah. If you're taking over somebody's practice who might have some reputation issues or maybe some bad reviews, do you, how do you handle that? Do you just change the name and hope nobody notices, or what do you do? How did this affect your understanding about the future of cosmetic surgery?

Yeah. Well, you over his website with his SEO of 20 years of rankings, or how does that work? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. You know, today's a different era. Yeah. You know, it's 21 years down the, down the road since then. But at that point we did surveys. We sent out surveys to patients. We asked local doctors, because I did communicate with every other plastic surgeon here in Oklahoma City.

Not always to the most welcome response, but they gave me enough ammunition, fuel, and, and energy to try to approach. The challenges and also received the benefit. And the benefit was just a phone number and a website and that. Statistical demographic that was reaching out was very consistent.

And even though there were negatives and I, I have yet to meet a doctor in the country that didn't have a negative of some sort. Right, right. There are risks and sometimes we take those calculated risks and I, I think if we're, we're a wise person, we're going to really investigate background checks histories, people, they're cavorting with their associations, their friends.

It was, my situation was abundantly clear. There were some significant challenges, and I have to say, if I asked 10 of my colleagues, they might have questioned my judgment, but I just looked at the demographics. There was, there was such strong patient flow and opportunity in that patient flow that I, I went for it and, and it was a good choice.

But how does that translate to other doctors? Excellent background. Listen to others, get experts, get lawyers, get accountants. You need to surround yourself by people you trust to the end. I mean, like people you'd give your kidney to if they needed it. You, you really have to have that level of faith because these people are giving guidance about your career.

And to take it lightly is a fool's errand for sure.

Catherine Maley, MBA: What would you say is one of the biggest mistakes made that now you look at back at now and say, gosh, I wish I had avoided that one. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Hmm. Well, I got to be honest with you, maybe I'm, maybe I'm just blissfully happy, but I can't think of a single significant mistake that I made at all.

I mean, it, I really, it, it has been an unbelievable career. Unbelievable. And. Sure there are things I'd, I'd regret taking on too. Challenging a case at too earliest stage in my career. Mm-hmm. I'm definitely guilty of that and thinking that maybe sometimes I have more answers to a problem than I. I rightfully should have.

Mm-hmm. And those can bite you. But you know, it's experience just leads you to those types of mature answers and inexperience leads you to immature answers.

Catherine Maley, MBA: So, how long were you in practice before you bought that 10,000 square foot building? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Oh, I actually bought it before I started, so, I, I, I had made some pretty savvy investments during residency and I saved up a great deal of money.

So, I had no debt. I paid off all my student loans and I had enough money to go in and, and pursue loans. And this was a different time. I mean, gosh forbid a person leaves a residency now with four or $500,000 of debt. I mean, they've got a doctor, doctor at a, at, you know, after their name and that used to buy you, you know, a million-dollar loan just for the handshake and a signature.

Those days are long gone. And it's really an interesting time, which really leads us to the issues of consolidation. For sure.

Catherine Maley, MBA: How did you know that you, were you, so, you knew you were trying to build an empire, like you weren't getting around like you, or were you thinking about renting it out to others? How did this affect your understanding about the future of cosmetic surgery?

Did you know you were going to fill that building up? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah, well, you know, my mom says things to that I'll quote often, and I know she'll listen to this podcast, so, she'll probably get a little teared in her eye. But when I was a little kid, my, my mom always said he's full of grandiose ideas. We'll see what happens.

Catherine Maley, MBA: Famous last words, huh? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah. So, I, I've heard over and over from people and I surveyed as many people as I could find. I went all over the United States, never spared a vacation to, to go to a surgeon and spend time with them. I mean, I missed, I. Almost 10 years of vacation because every vacation was used to advance myself and my career for my patient's benefit.

So, I I had a lot of information, a lot of experts out there, very famous people. I could just run-down a, a lengthy list. And they, the con the con consensus was a few things. No matter how big the space you get, you'll fill it. Just watch, it'll happen. And so, I took that to heart and came to Oklahoma where things were a little bit cheaper and started day one at, with 10,000 square feet.

And, and now we have another facility in Jacksonville, Florida that's going to arrival at, so.

Catherine Maley, MBA: Wow. And then when did you start adding other surgeons? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Hmm. Well, I was in practice for three years before I took our first fellow, and so, I would. Count that as my first experiment with having another full-time doctor with me.

And that was a great experience. And so, I've had. 15 fellows. Now we have one every six months now. Those fellows are all over the country from Seattle to Scottsdale to Park City and down in Florida. And so, that's been a great journey. I, I would say that is a really nice way to bridge the gap from independent practice to developing physician relation skills.

When you're isolated in a practice, there are some strengths that come from that autonomy, but also some weaknesses that develop and that dictatorial unilateral approach to decision making can be a very challenging problem in, in various social arenas. So, I would attribute that first step of growth to fellowship training and devoting oneself to the education and betterment of someone else is, is a, is a really true altruistic art.

Mm-hmm. So, I would say there, now my first associate was 2007. So, I was in practice four years and took on a gentleman for two years. We knew his pathway was to leave, but we were fortunate to have him for two years, and that gave me another stepping stone towards longer term relationships. And I, I'm still learning to this day.

I don't have all the answers. I. But I will say that there, I think there's three categories of doctors you work with. There's a doctor who's very skilled, very capable, and very good, and is just trying to bridge that gap of independent practice from residency, for example. And they're strong enough and good enough that they're going to try to fight it and do it, do it themselves.

Some of those doctors will see value in associating with another doctor and others will not because they're so, capable and skilled. That's one type of doctor and they take a different approach and a different mentality and a different communication style. The next doctor is a doc. Our doctor is a doctor, is completely on the other end of the spectrum, and that's a doctor who doesn't want to own anything, doesn't want to run anything, and just wants to show up.

And they literally don't want to manage. Even the thought of management is, is just makes them almost sick to their stomach. And those doctors are really interesting because you can almost plug and play. You can have a system do consultations, plug in the doctor, minimize their interaction. Quite honestly, because often they're not the most robust in their skillset and succeed very well because if they show up and are happy to do two or three surgeries a day, I mean, they're thrilled to go home.

And maybe that, that term that sometimes confuses me work-life balance, which I don't have. That, that's the third type of doctor. The intermediate doctor is the doctor that I really strive for. But I'll take anybody, I mean, I, I'm not going to say that we have a specific type of doctor that we're looking for because honestly, all of them can work well.

It just. Listening to them, understanding them and respecting their skillset and their what they're really looking for in their lives. So, that intermediate doctor is a doctor that wants their input heard. They want to be respected. They want to add to the quality of the practice or the contribution factor they want to contribute.

Yet they don't want to overly be involved with the bills. And negotiating contracts with anesthesia departments, it's just not what they want to do. So, those are the three kinds of broad-based categories of doctors I deal with, and all of them can be appreciated and all of them fit into a system. You just have to respect their differences.

Catherine Maley, MBA: And, acknowledge them. Because I think a lot of doctors aren't aware of which box, they fit in. Mm-hmm. Because some of the doctors actually, some of the I'll just generally speaking, yeah. The younger patients don't, or the younger doctors don't know anything about business and they've never had to come up with patients in a marketing plan and paying bills and being at risk. How did this affect your understanding about the future of cosmetic surgery?

Yeah. So, they come on a little strong and not be naively, you know, and then there's the older doctor who might be burned out. But, but not willing to relinquish control so, that there's nothing easy about that. I'm sure you take your time, you know vetting these people, right? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah. It, it's, it's really interesting.

It, it's a, it has to be thought of, in my opinion much more fragile than a marriage. I know there's analogies often made, but. I mean, it's pretty easy to get out of a business situation, and it's, it's much more financially challenging to exit a marriage having been there. So, I, I, I would say that identifying egos who needs to be praised?

What, you know, what are their love languages? I mean, it's truly a tort of force of intellectual psychological assessment and appreciation on both sides. I mean, we have to respect each other. We have to show that respect, but constructively, we have to give guidance. I mean, it's really awesome. I mean, talk about fulfilling.

I mean, this type of, of business relationship is just amazing.

Catherine Maley, MBA: Well, I've seen some practices that are a true democracy. Mm-hmm. They meet, but they meet every week. They have the same values. They have honed this. Mm-hmm. I know a practice who has kind of like a coach and the coach keeps everyone on task. How did this affect your understanding about the future of cosmetic surgery?

Mm-hmm. Just in case things, they don't want any big problems that are factoring and they're not talking to each other, so, they really take it seriously. And, and they have a beautiful, profitable practice. Mm-hmm. And then others are just a dictatorship. They just, they. They hire some surgeons and they say, I'm running the show. How did this affect your understanding about the future of cosmetic surgery?

You just show up and, and appreciate that, and that's it. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Right. Right. Yeah. And, and yet there is room for all. I mean, there's enough to go around. Mm-hmm. And the greediness and, and the you know, to, to think that you're the only one to do it. The only way is just foolish.

Catherine Maley, MBA: So, I've been doing this for a long time and I've never heard the same story twice. How did this affect your understanding about the future of cosmetic surgery?

You know, there's no one way to do this. That is for sure. I'm just loving all the creativity that is coming about, that's evolving and that's why we're talking about this. But yeah, if I'm not mistaken though, when I was listening to you speak, do you have 39 staff people? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Let's see this week. And that's a, that's a, a laugh, but also the truth.

It does vary quite a bit. We have. We have one person two people kind of exiting. We have three coming on. That's normal. That's a normal week. So, we have a very open-door policy. I say the same thing every year at a Christmas party. I say, listen guys, whenever you want to leave, it's perfectly fine with us.

Don't ever feel like you got to be the last one in the, in the building. I just thank you for coming. Thank you for being a part of our employment. And just have a good time and leave whenever you feel darn good and ready. Don't, don't feel bad. And I kind of keep that same philosophy in the office. We tell people when they're hired, listen, we're, we're here in this life for a certain amount of time.

You may be here for a long time; you might be here a very short time. Don't ever feel bad about it. Always address things up with honesty and forthrightness. And if things aren't going well or you're seeing things differently, we need to hear about it. Let's just be open about this. Immature adults. And so, we do have a fair amount of turnover in our office, which is both financially challenging and functionally challenging.

So, we've chosen kind of a redundancy and an overlap in employment that allows kind of a rotational cycle of employees. So, I have a set of employees that I work with primarily. Of course, I like to call them "The A-Team", but. They're really just a group that, that has piled around with me, knows my habits, knows my mannerisms, and we work really well together.

So, we work together three days a week. We, we typically do 12 hours a day, three days a week. And we start at six 30 and yeah, usually finish around 7 30, 8 o'clock at night and no, I take no lunch. So, talking about work-life balance. Yeah. I'm not the model of that. I love my work, love my work. I make no excuses about it.

I am no balance whatsoever. Work, work, work. Because I love work and I figure I want to work. And if I die at work, that's okay with me.

Catherine Maley, MBA: Okay. Good attitude. Do you, hopefully you give them lunch, right? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yes, yes. As what's required. But I, it's so, funny because you know, people of personality types, they tend to congregate.

We like to hang around with each other and you know, we have a certain type of humor and we have a certain type of music we listen to. And it tends to be that these young ladies work their living butts off. Cause they love that I do. Nice. So, we're all, it's like a bunch of pigs and mud. I mean, we all love rolling around in it.

So, they take very little launch, often don't take lunch, they'll snack on something. They kind of mop about it, but they also are kind of proud about it and mm-hmm. So, my little set team is they're amazing and I'm very happy for, but we're just one small part of the big group. We have a, we have a big administrative group.

We have a very big IT division, which. I mean, I, I could just talk for hours about just our 13 different IT groups that we work with. It's craziness.

Catherine Maley, MBA: And are you planning, do you go for patients all over Oklahoma? All over the nation? All over the world? Well, where, where are you going with that? How did this affect your understanding about the future of cosmetic surgery?

Where are you? I mean, are all these, like the, those breast dogs, was he getting all those just in Oklahoma City? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah. The so, the, my predecessor, the person I purchased the practice from was, was a, a, a very unique individual. He decided to basically do the Walmart service, so, he did, it was $2,800 cash breast augs saline only, cash only.

And he did four a day, five days a week. So, that's not a bad business model. No, no. He did very well financially. Mm-hmm. You know, there, there were some unscrupulous issues and there were some, some financial misappropriations that occurred.

Catherine Maley, MBA: Well, the cats only probably was a hint there. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah, yeah, yeah, yeah. So, Anyway, but we don't run our, our business like that. So, our, our business is, you know, absolutely to a t run properly. And, and so. What is our recruitment? Honestly, we try to focus on the central Midcentral United States. We do get patients, word of mouth, friends, et cetera, that come from all over the country.

We have a very large military presence here in Oklahoma, so, we have a lot of people that relocate to Japan, Germany, Italy those are the big ones, and all over the United States on a different military basis. So, that has been a big area of contribution to the practice success. But really, I, I think it's been 21 years of, of tremendous service and being available to the patients.

I, so, 21 years ago I made my own website. Mm-hmm. I did it over Thanksgiving. Weekend it cost me 25 cents. Nice. And I started something I'd never heard of and I did, made an online form entry and completely, there was no HIPAA and so, they just sent me pictures. And so, I was getting, you know, pictures of people, body parts from all over the country all the time.

And I was inundated. So, I had never heard of anybody ever doing this before. And you know, of course things have advanced to all the encryption and HIPAA policies and now almost everybody has an online form entry system. Mm-hmm. But you know, 21 years ago it was unheard of. I certainly never heard of it.

Catherine Maley, MBA: Oh, that was a big deal 21 years ago. Good for you. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Oh yeah, we were doing 20, 25 cases a month purely from, without ever visiting with a patient. The patient would come in from out of town, we'd see him the day before, we'd do the consultation, then we'd do the surgery the next day. So, yeah, it was just I have to say that that concept came from a, another doctor who I met in Connecticut, and he was doing that for wisdom teeth removal.

And just inundated. And I thought, hell, why not try that in our business? And sure enough, it was a, a tremendous boost.

Catherine Maley, MBA: That's how I've grown my own business. I always looked at all the other industries and I said, how can I adapt that to our industry here? And it's all y all you have to do is be a little creative and say, how could we do that here? How did this affect your understanding about the future of cosmetic surgery?

And yeah. Now you also have an online store, a skincare line. You have your own skincare line with an online store where they can shop. I'm always curious about that. Is it a good profit center? Is it a pain in the neck? Who's doing the fulfillment? You know, I never, I, I'm not a fan, but, but does it work? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: I mean, yeah. Well, first of all, I, I think you have to have a passion for whatever element of the practice your endeavor might be. So, for me, I'm a surgeon. I do surgery morning, noon, and night. I hire people that have passions for things that I don't have a passion for. So, I have an aesthetician that does all the aesthetic services.

I have two nurse practitioners. That primarily do non-surgical things and supervise my clinics. I have a skincare person that deals with most of the retail services. Is it a profit center? Sure. It makes a profit. You know, I mean, it's probably 50% margins on everything we sell, but, you know, as far as a comparative, I mean, just to use real numbers and I hope that's okay.

I'm always very transparent about, about the practice. You know, selling $10,000 a month of skincare products is, you know, that's $5,000 a profit. That's pretty darn good for buying hamburgers and shoes for your kids.

Catherine Maley, MBA: I'm okay with that. As long as you don't lose focus on the big-ticket items. I find that the vendors or sta like estheticians take it very seriously, but I just, I watch the balance of how many are, how much of your resources are going into that when it becomes only one or 2% of your overall revenues good. How did this affect your understanding about the future of cosmetic surgery?

That money have been made. Easier or elsewhere, or that, that's my only comment there. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: You have. Yeah. Yeah. It's a very, it's a very good point. And you know, some of the consulting services will focus on the quote, the, the money left on the table, right? Yes. That's the common statement. Well, you're leaving money on the table, right?

I mean, that's a term that I just want to choke people out for. Because you're absolutely right. If you have no passion for it, if you have no business doing it, please don't do it. Yeah, you're going to waste energy, time, frustration, managerial nightmares, legal liability. I mean, I could go on and on. If you are really good at something, I think you should do it all the time.

Because you're going to make much more money at it. You're going to enjoy your life. And I don't worry one bit about my skincare related services, because I've got a young lady who loves it. So, there you have, yeah.

Catherine Maley, MBA: I mean, I practices try to train everyone on how to sell skincare and I just think I don't get that. How did this affect your understanding about the future of cosmetic surgery?

I just, I think there's a better use of your time. Regarding, you're doing a lot of non-cervical as well. You have a full-blown med spa, right? Because isn't your, is your philosophy more patient for life or one and done? Or where are you at with that? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah. God, you know, so, right now I, my practice and I as 90 plus, 90% of the overall surgical volume, I do about 2,240 procedures a year.

So, it's almost mind boggling. But I did surgery. Yeah. And so, I, my focus is all there. So, but what would be ideal? If I were to step back and walk into this office as a businessman, which I like to do mentally. I would look at the colors, I would look at the smells. I would look at how I'm greeted. I would see what, what the door presentation is.

I would want to hear the music on the speakers and you know, is there a TV on and what's playing on it and what's being presented. Are there menus of services? What are the services that this offers mm-hmm. That this office. Offers, how is it displayed? Is it displayed on the wall? Is it displayed electronically?

All of these things that would go through my mind if I walk to the office. And it's interesting because even though I, I suppose I'm in the position of c e o, I don't fulfill all of those. Things that I've just told you, there's always room for improvement. There's, and that's undyingly interesting to me, that there's always room for a person's improvement and the practice improvement.

Now, if I were to say in a more ideal situation for, so, I do about 90 major faceless and facial restorations a year in, if I could ideally, Play out for you. What I'd like to have, I'd like to have an introduction. I'd like to have a credentialing period. I'd like to discuss their goals. I'd like to hear from them for 10 or 15 minutes.

I'd like to a, evaluate them and like to give recommendations based on their goals. Now a quote is rendered, but I'd also like them to meet with an aesthetician because as part of the comprehensive care of this patient is not only. Pre-operative preparation for it in many cases, like laser skin reserving, but the post-operative maintenance, it, it is a really important, integral part of, of ideal patient care.

So, it's not just a surgeon comes in, cuts, walks out of the room and never sees the patient again. That would be the, the most cur method of maybe managing the patient. But really ideally that's what I'd like to have. Do I fulfill that each and every day? No, I don't. I, I think if I were to walk in as a consultant, I would say, boy, you really need to kind of systematize that process each and every day to have that integration that I think is more ideal.

Catherine Maley, MBA: Well, as a, coming from a perspective of the cosmetic patient, once they've invested in themselves on one body part, they will move on to another body part. And especially if you help them with that. So, I think you, you, you have a patient there for life psychologically, you know? Yes. Once you get that bug to look good or feel good and all of that. How did this affect your understanding about the future of cosmetic surgery?

Yeah, usually it's not a one-time thing for the patients and nor should it be for the practice, you know? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. The loyalty of patients within the cosmetic surgical field has been well documented. I mean, the average patient is like five procedures over a lifetime. If you can maintain them for a lifetime.

I wish only at five. Yeah, that's, yeah. Way over that. If you look at you know, lifetime income from that, you know, our average price point per procedure is just about $11,400. And so, I mean, that's not something we should shy away from. And we also know that the cost of acquisition of new clients is much more expensive than the preexisting ones.

So, it just, in every way it makes sense to establish and maintain an ideal relationship. But it really starts from. From the moment you meet them, being very direct, very honest, very, very open, and also expressing limitations. Just being a human. I mean, sometimes patients forget that just because you went to school for a long time, you don't have all the answers.

And reminding them that, that humbly, I think, is really important. Have you noticed a

Catherine Maley, MBA: change in cosmetic patients from even, I guess maybe pre-social media to now or pre-internet to now? Like, how do you see them now? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Hmm. Well, I, I, I'd say I'm a little bit biased by my current position in maturity of practice.

Probably 55, 60% of my patients, maybe even slightly higher are previous patients. Nice. So, that's, that's advises me because they already know me. They already trust me. They, you know, their daughter, their aunt, and their grandma came. And so, that's a, that's a no-brainer. You should seal that deal. That should be pretty easy.

It's the new clients, the new acquisitions that are, are Our, our have changed, evolved quite a bit of course during free money time and low interest rates. And, and COVID was, you know, the heyday for cosmetic surgery. I, I've rarely met a practice that didn't show a significant increase because of time available for recovery, but also Liquidity was very high.

Yep. And so, that period is, is certainly changing right now. And we see, seen a macroeconomic tightening throughout the country and all the practices that I deal with. And, you know, you, but it, it's a want and not a need. And thank goodness for that because having weathered housing crisis 2001 bombings there's a, you know, little dips that you take, but.

People want what they want and they'll put off their needs. They will not put off their wants too long. Mm-hmm.

Catherine Maley, MBA: I agree. So, I want to switch gears a little bit because Sure. You've grown this incredible empire. And then I want to talk about the talk that you gave about the future of cosmetic and plastic surgery and the consolidation. How did this affect your understanding about the future of cosmetic surgery?

So, can you go ahead and, and can you just like a brief talk of what your thought was? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Sure. Well, thank, thank you for, for listening to the talk. I appreciate it. Okay, so, five years ago. I sat down and I thought, you know, I'm not getting any younger. My practice has become a, a behemoth and it would be very difficult to sell the practice to an individual for what it's valued or what I'm told its value is I.

And so, I was really struggling with that. So, I thought, well, maybe I could fractionate it, break it down to shares, and maybe five doctors could split it up, and that would bring me some revenue towards an exit. But honestly, it still wasn't anywhere near what the actual cash flow and ongoing value of the practice was.

So, I got really frustrated with that and I, I can I Spoken, met with a lot of people from many different industries, auto industries tech industries all over as many people as would listen to me. And so, my, my grandma always said, if you want to want to learn something, just call. And so, I called CEOs from every website I could find.

It's amazing how many of them were interested to spend just five minutes with me and tell me about you know, it was like I was a kid in, in high school asking on a school project. And so, I learned and learned and learned, and I realized that where the value in the future of our field, in my opinion, is in reducing redundancy.

That was really the central theme. If you think about every garage, you drive by in the United States and it's open in the summer, you'd see a weed whacker and a lawnmower and a trimmer, and gosh forbid they're sitting there like 98% of the time not doing anything. What a waste of money when one community could very well buy a set of lawn, a lawnmower, a tremor, and rotate it throughout the community.

Catherine Maley, MBA: There you go. Perfect. That's a great idea. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah. I think of it that way and. Yeah. And in our business, that's exactly what we do. Almost every small boutique type practice has an office manager, maybe a person in charge of, so, social media, front desk girl, and an accountant. And, you know, maybe that's the size that they're, they're comfortable with.

But my practice had grown so, big that I had, I have, you know, five departments. I've got department heads in each department and ins, subordinates within those departments. And we have department meetings and, you know, it's all very corporatized and just everything was just going that way. So, the more information I got, the more I realized that I, I could very.

Quite honestly, I could very easily just go to a private equity consolidated group and just sell my practice. But what I did was I looked at all the available options and there were very few, and still are, very few actually that have gotten to a point of consolidation. And I realized there were a few significant weaknesses and I spent, I.

Almost 2000 hours. That's no exaggeration by the way. 2000 hours. I documented all of it. I, during residency, I was very obsessive, so, I documented every hour I ever did during residency. And so, I have that all written down. So, I figured, you know, I've got to keep this up. So, I documented all the time, I spent on the phone, at conferences, at meetings with private equity groups.

And I learned a great deal and what I learned was the private equity groups often contributing some form of financing. So, they consistently wanted to take. Plastic elective surgery and Shoe Hornet into the models that they knew. And those models were gastroenterology, ophthalmology, dermatology, insurance-based accounts receivable.

Their due diligence process was very foreign into a cash-based system. They didn't even understand that we were prepaid for surgery, you know, a month in advance. It was just, Whoa. Where's your accounts receivable?

Catherine Maley, MBA: And there's no accounts receivable. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. None ever. So, I had, I was really like walking into these people that I felt I was the ignorant one, but they had absolutely no understanding of what I was talking about.

So, it was actually, I saw that as a great opportunity to, I mean, I always love somebody who's willing to listen to me, so, I had a great. Time kind of going through so, many different groups, speaking to different levels, all the way up to CEOs of these private equity companies, and just hearing what was pleasing to them and what they were scared of.

Hmm. What. Oh my gosh. I mean, the list could be very long. Key operator dependency issues. You know, if there's only one doctor in a practice, how can you show me on a, on a cash-based system that your 90 day and one 20-day revenues are going to be there when I'm used to waiting for accounts receivable for 120 days?

So, they, they want security.

Catherine Maley, MBA: You know, and this, and they want predictable revenues and how you say that in our industry, you know? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: That's right. And all you can do is say, well, I've been in businesses 21 years and it's gone pretty well. Yeah, right. So, I just kept on telling them that, listen, look at the books, look at the data, look at the, the, the cash system is, you know, a 40 to 60% profit margin.

You guys are arguing over 13 to 17% in dentistry. I mean, it makes no sense to me at all that you're wasting all this time with dentistry when you've got a cash cow right down the street. I mean it just over and over again. And then one day I got a call back from one of the CEOs and I was in the Atlanta airport at the time, returning from a, a meeting with another private equity group, and he said, Erik, We like what you've been saying, we've been really talking about it, and we want to meet with you and your group.

So, that was, I mean, I, I almost cried. I've been telling you my hair stood up in my arms. I was like, yes. And finally, it took me four years to hear that type of response that I was hoping for. And, you know, speed ahead and the tides are turning. There's certainly a tipping point. Of familiarity, understanding, and acceptance.

And the world of cosmetic elected plastic surgery is filled with people that make a great deal of money compared to the average person, and they're very autonomous. And this is a tide that's going to take a long time. But that's okay. The, we're, we're in this for the long haul. This is a 10-year project.

This is not a one-year project. This is a 10-year project, and I really came up with that idea with a lot of my buddies in construction. And when they look at a thousand-acre plot, they're not thinking about, you know, one year, they're thinking about 10 years in building schools, community parks restaurants, everything.

That's a part of urban development. And I just thought that's, that's the kind of approach I want to have in this industry is a 10-year plan. I. So, really that led me to some partners with some colleagues I've known for 25 plus years. All of them that are surgeons. Were business people. Yeah. These are all other surgeons that have been extremely, you'd know all their names if I mentioned them, but I won't mention them because they didn't give me an approval to do so, but they're very well-known people that you would know immediately.

And people that after conversations, just like we're having, came to the realization that the future is very strong when you consolidate. Mm-hmm. The strength, and this really comes from the relationship I've had with my wife and my. Fellows and my partners are that we are always stronger together than you are separately.

Always, always. And once people get that mentality shift accepted, they go, ah, I get it. So, we can have one accountant for the entire system. That's one cost. We have one c e o, one procurement expert, one person that's saving us 20% on. Allergan or Galderma just 20% right there of negotiating power. When you've got a 50 million a year cash flow company and you sign exclusive contracts, you're going to get tremendous buying power, strength, and it, it's just over and over again.

I could go on and on, but I, I hope that's exciting for the viewership.

Catherine Maley, MBA: And are you consolidating the HR, the hiring, the managing? Because I find absolutely the surgeons, the number one challenges staff. Mm-hmm. They, they are. So, especially after post covid, they're so, done with staff. Like they're, yeah. How did this affect your understanding about the future of cosmetic surgery?

You know, is, does it include that? Because I can see a lot of practices thinking, oh my God, if I could get this off my plate and get back to doing what I like to do, which is surgery. Yeah. I'd be a happy clam right now. And I'm, and they're, I'm not. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah, yeah, that's exactly the type of person that we're looking for.

And you know, to kind of make this segue a little bit the goal is to have 50 practices that are like-minded, utilizing a centralized call center, centralized HR, centralized procurement. The buying power of, you know, 150 million a year company is just puts you into a totally different league, right?

We want doctors to maintain autonomy if they want to. So, we offer a number of different avenues to try to become partners, and it has to be a partnership. There are people that just want an exit plan and we provide that exit plan. There are people that want administrative roles and responsibilities.

There are people that want equity in a growing and very rapidly growing corporation that pays dividends. And so, we have avenues for all those different types of people, and we have avenues for people that just want to show up and work. I have a couple people right now that, so, we're constantly interviewing.

We're constantly evaluating practices, and you always learn something from that. Those, those communications.

Catherine Maley, MBA: Are you involving private equity or is this a physician led consolidation? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Actually, the answer is yes and yes. Okay. Ultimately in order to fund the growth if you study almost every other industry, there's a reason that loans exist.

Yes. I mean, why, why not just put it on your shoulders? Well, because honestly, there's a point of growth that you need acceleration and you need to get through a, a bridge, a gap that costs money. And it's, it can be a pretty substantial amount. So, the initial phase of development is a minority partnership with private equity where we maintain 80 plus percent of ownership and all decision-making rights exclusive of a few constraints with utilization of funds.

That are appropriate to any financial term, to any company. And but it is a board run by through and about physicians.

Catherine Maley, MBA: So, the board is made up of decision-making powers by physicians and the business people are also on that board? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yes. They have one seat at the board, at the table. They do have some.

Again, you know, lots of details, but ultimately decision-making powers of specific hiring roles. Veto powers do exist, but they're extremely limited due to the minority position.

Catherine Maley, MBA: Gotcha. I'm doing, it's a miracle though. I've worked with, I mean, when I get in when there are more than three surgeons in a room, we have a tough time making a decision, so, Yeah. How did this affect your understanding about the future of cosmetic surgery?

You know. Good, good for you, because I can't imagine all of them coming. How does that work? Can you get a decision made? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Yeah. Yeah. Well, I, I think, again, it all goes back to what I tried to form formally kind of describe, you have to have this mental shift. It's not about me anymore. Yeah. It's about the entity.

It's about growth. It's about the quality of consistency of quality of care. Mm. Mm-hmm. And I think those words play very strongly amongst even egocentric physicians. Mm-hmm. So, but getting that shift from me, me, me, Now I have a two-year-old and he's constantly saying, mine, mine, mine. And I just, I got to take a video of it because it reminds me so, much of the first time I meet with a doctor who's got been a very successful doctor in there.

They've got these barriers that are so, visible. I mean, you can just palpate and trying to get through that to, to a level of, of greater understanding that this is a societal shift. Hmm. You can either sit back and wait, or you can be a part of it. If you join early, you're going to be in a position of more directorial involvement, right?

You're going to have a higher equity value. And what happens if you look at the math and its pretty simple stuff. I'm, I'm the, not the smartest guy in the world, but I do work hard. So, if you look at the math, it's really simple stuff. When you add practices to a group, it becomes stronger. When you exit, meaning when you sell it to a larger fish.

So, a small fish is eaten by a bigger fish, and that's the principle at hand here, is that a private equity group comes along and says, this is a prosperous company. They're running very efficiently. They do good business. I want to buy them now before they get too big and too expensive. And then there's an equity transition.

And then that doctor can consider, do I want to cash in my equity or do I want to stay on for the next? Bigger fish that comes along and it's just a pretty simple process, but you have to buy into it mentally. You have to understand that ultimately, it's not about the individual practice anymore. It's about the opportunity to take best practices from each location and formulate the best practice.

Mm-hmm. Because I can tell you, after spending so, many years and so, much time with all these other practices, there are some things that fall way outside the standard of care. And it's readily available, and I'm very research oriented. I, I'm constantly studying and I don't really do much else except fly airplanes.

So, for me I, I love trying to find out, you know, what is the enhanced recovery after surgery, what is the fastest way to get a patient home? What is the most efficient way? What is the safest way to reduce DBTs and blood clot formation and complications after surgery? That is just thrilling to me, and having that energy and enthusiasm and being able to transfer to multiple practices.

I mean, I, I mean, I don't know what to say. This is the greatest life ever. Okay. I would love to have that. So, when I can find people with similar, like-minded ideas, then we, we blend pretty well. And the decision making is always about what's best for the patient because the financial returns will come, they will come as a result of running the business properly, running it ethically, morally, keeping track of every dime appropriately and, and always best practice for the patient.

Catherine Maley, MBA: So, because this is a business and marketing podcast, I have to ask about the marketing. Yeah, sure. Is the branding now a big name, like your name is Olympus Cosmetic Surgery, is it now like Dr. Smith Plastic Surgery by Olympus? Mm-hmm. Or how does that work? And then who does, who does the patient attraction now? How did this affect your understanding about the future of cosmetic surgery?

Does everyone have a big ad budget and the, the front office handles all the, how does that work out the advertisement? How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah. Well, it, it's always evolving. The current situation is that all the practices are independent, but we're consolidating our services. Gotcha. Now, I, I do view in that 10-year time plan that I've told you that there will be a central theme, a central title AEN, a central logo.

We have our subgroup; we have our website related to Olympus cosmetic surgery group. Brett's really in the stages. For information for future acquisitions or partners to find us. So, it's not a centralized advertising platform. It will be there's no question that's inevitable, but right now, in each individual location, we're trying to find the most successful practices, and they're successful for a reason.

Mm-hmm. Because they've proven their methods successful in their region. So, if they're dominating, we don't want to rock the boat and dislodge that, that dominance from that area, just because we think we know better.

Catherine Maley, MBA: Right. Yeah. Okay, that's a good idea. You know what, I want to wrap it up. Now. I normally, I'm afraid to ask, you know, because I like, I usually like to ask tell us something we don't know about you. How did this affect your understanding about the future of cosmetic surgery?

So, if you can't say that you fly planes, because we already know that. What, what's another one? Cause I'm, you are a very interesting person. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Well, I don't know. I appreciate that. Well, gosh. I would say if I were to, to say the thing that, that you know, I, I, I say it all the time. I'm not, not the smartest guy in the world, but I do work my ass off, and I mean that at a much deeper level than I'm, I'm, I'm admitting I, I think that the.

Interest and the passion that I have for studying humanity is, is unparalleled. I absolutely love every moment of this life, and when I go, it'll be just fine with me because I've lived a full and complete one. But just the, the interactions between highly intelligent people, investment bankers, a private equity group, leaders, I mean, These people, if I were a little kid and somebody said, someday you're going to be hanging out with all these people that went to the best schools in the country, and were top of their class in every way, and you're hanging out with them and you're doing pretty well.

I'd say no way. You know, so, it just, the, the passion has is there for me. And I, I would just say if, if I could surround myself with people with equal or similar passion as I know you have in your field. I mean, gosh, I've, I've known you for like 25 years I think so, yeah.

Catherine Maley, MBA: So, I needed to be in this field to hang in there.

Erik J. Nuveen, MD, DMD: Yeah, yeah, yeah. And so, you have to have that undying, never say die, never quit. Passion that is, is, is, is palpable. So, other know, others know it and, and I somehow have been blessed with that gift. So, thank you for allowing me to say that.

Catherine Maley, MBA: Congratulations, and thank you for your father for being an orthodontist. How did this affect your understanding about the future of cosmetic surgery?

I had braces a million years ago, and I'm so, grateful it was a life changer. Looking back now, if I hadn't had braces. Oh my gosh. That would be a different story, you know? Yeah. So, Dr. Nuveen, how can people get ahold of you? I'm sure there's plenty of surgeons who are interested in your business model. How did this affect your understanding about the future of cosmetic surgery?

It's very unique and I, and I find it's very multifaceted. It seems like it, you don't have a, a process in ink right now. It's a multiple flexible fluid process because you're evolving right. How did this affect your understanding about the future of cosmetic surgery?

Erik J. Nuveen, MD, DMD: Yeah, that's a good way to look at it. There are some rigid elements that you can't hear from due to the relationships.

Mm-hmm. But we're always learning and we got to have that attitude. I mean, if you look at some of the other groups that have attempted to go down this pathway, they've really had some terrible problems. And, and, and actually it's been a wonderful lesson because you look at what they've done and you're like, well of course that wasn't going to work.

You know, lifestyle lift. I mean, I could go down the road. There's, there's been probably 10. That are examples of just poor business practice or lack of transparency, or a lack of partnering. True partnering, it's an overused term. It's one that you really have to focus on is it's got to be a partnership and people have to see eye to eye in the relationship.

So, yeah, we'll continue to learn and evolve with the people that want to join us. My, my contact is probably best just as I give to my patients each and every day. Gimme a call. Give me an email. My email is fxfaces@yahoo.com. fxfaces@ yahoo.com or call my cell phone. But also, you can Google, you can get me there as well.

My, my telephone number's openly published. It's (405) 550-7522.

Catherine Maley, MBA: All right. Well, it has been a pleasure having you on Beauty and the Biz. I really appreciate it. I'll see you again at a conference coming up. Looks like you're traveling. Everyone's traveling again.

Erik J. Nuveen, MD, DMD: That's fantastic. Yeah. Yeah.

Well, yeah, I'll tell you any, anytime if there's another in interesting issue you'd like to discuss. I, I do lots of other things un unrelated to this topic, but other business things with many different startups and techs and stuff, so, I'm always interested.

Catherine Maley, MBA: Thanks so, much.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how Dr. Nuveen understands the future of cosmetic surgery.

If you’ve got any questions or feedback for Dr. Nuveen, you can reach out to his website at, csaok.com.

A big thanks to Dr. Nuveen for sharing his vision on the future of cosmetic surgery.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “The Future of Cosmetic Surgery — with Erik J. Nuveen, MD, DMD".

 

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how Dr. Kontis is the 2nd female president of AAFPRS.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "2nd Female President of AAFPRS — with Theda C. Kontis, MD".

I had the privilege to interview Dr. Theda Kontis, a facial plastic & reconstructive surgeon in a private, multi-surgeon practice in Baltimore, MD.

Dr. Kontis has been very active in the American Academy of Facial Plastic and Reconstructive Surgery for the past 30 years and was recently elected to serve as the AAFPRS president, making her the 2nd women to hold that title. 

We talked about her vision for the Academy under her presidency and the challenge of juggling her duties there, while also managing a big practice with multiple surgeons and lots of staff. 

She also shared her opinions on private equity, the change she has noticed in cosmetic patients’ attitudes, as well as staff tips to keep turnover at bay.

Visit Dr. Kontis' website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

2nd Female President of AAFPRS — with Theda C. Kontis, MD

Catherine Maley, MBA: Hello, welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and how Dr. Kontis is the 2nd female President of AAFPRS. I'm your host, Catherine Maley, author of "Your aesthetic practice, which your patients are saying", as well as consultant to plastic surgeons, to get them more patients and more profits. Now, I'm very excited about today's guest.

It's Dr. Theda Kontis, who is the 2nd female President of AAFPRS. She's a facial plastic and reconstructive surgeon in a private multi-surgeon practice in Baltimore, Maryland, and the name of the practice is The Aesthetic Center at Woodholme. Now, Dr. Kontis completed her residency and fellowship. At Johns Hopkins and is currently an associate professor there as well.

Now, her bestselling textbook, "Cosmetic injection techniques", is in its second edition and has been translated into five foreign languages. She's also authored numerous, and I repeat, numerous research and review articles, book chapters, editorials, as well as conducts research clinical trials. Now, Dr. Kontis has been very active in the American Academy of Facial Plastic and Reconstructive Surgery for the past 30 years, and was recently elected to serve as the AAFPRS President, making her only the second woman to hold that title.

Dr. Kontis, welcome to Beauty and the Biz, and congratulations on being the 2nd female President of AAFPRS.

Theda C. Kontis, MD: Thank you so, much Catherine, and thank you for inviting me. It's quite an honor.

Catherine Maley, MBA: Absolutely. Let's just talk about that for a minute, because I didn't realize you were the president right this minute. I thought it was you were still president and elect.

I'm sorry. So, how busy are you juggling that plus your practice, plus your family? How's it going? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Well, I never could have done it if I had little children, but luckily my daughter's all grown and in medical school. So, it's, it's quite a challenge. It takes a lot more time than I thought it would, but it's really fun.

It's fun to be involved and to be able to make changes. And I've been a member of our academy for many, many years and sort of came up in the ranks and it's fun to give back.

Catherine Maley, MBA: Good for you. I mean, that's putting a lot on your plate. Is there a lot of travel involved or nowadays is it more Zoom? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: It's all Zoom it Recently our marketing firm.

Actually, had me do all these Zoom meetings with magazine editors and they used to take the president to New York City and go in a car and go from one desk to another. And it was fun, but it was not very productive because, you know, how many offices can you go to in a morning, you know? And I could have six.

Meetings in the morning on Zoom. So, it was fun. I, I really enjoyed doing, they call them desk sides and working with all of the magazine editors and it really is fun to get the word about being facial plastic surgeons and to trust your face to a facial plastic surgeon to get that word and that message out is, it's fun.

Catherine Maley, MBA: Oh, that's fantastic. So, let's just talk about your practice. And I noticed when I was doing some research when I met you a long time ago at the meetings and then I was in your office, you had two surgeons, and now I see you have three surgeons. So, what's the makeup of your practice in today's world? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: I joined my fellowship director.

Most everyone has heard of Ira Papel, of course. And Ira was my fellowship director. I was his first fellow. I finished in 1994, and the deal was Ira said, I will train you and then I want you to join my practice. So, when I joined Ira, we had a very small operating room with one nurse who did everything, and we had three secretaries.

Now we have 25 employees. A big operating room, a minor procedure room, about 10 nurses, and we hired a body plastic surgeon who was one of the Hopkins residents who rotated with us. And so, he was a good match for our practice. But we don't when, when people. Have a body plastic surgeon join their practice.

Sometimes they limit them and say, you can only do tummy tucks and breasts and all the face stuff you need to give to me. But Ira, and I thought that really isn't fair to him because if he does a body work on someone and they want him to do their facelift, It's not fair for him to say, well, sorry, but I can't do it.

So, he does everything and it's a really good match. So, the three of us get along great. He's, he's buying into the practice now and it's, it's, it's been good. You know, you have to choose a partner that like a marriage. And the two guys I'm partners with are really, really good. Marriage.

Business marriage people.

Catherine Maley, MBA: Right. Well, you're all, you also are very mild mannered and reasonable, so, I bet that helps a lot. But you also probably share the same values. Are you still doing reconstructive and research and cosmetic? Like what's your, where are you spending your time? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Mostly cosmetic. We all do mostly cosmetic.

We do some reconstruction with cancer. Skin cancer reconstruction. And the research bit sort of comes and goes. It depends. If there's a project that is that we're asked to participate in, we'll do that. We have a great coordinator. You know, it's so, important to have somebody who just takes over.

Like you always say, you know, someone who you don't have to think about. Well, we have someone who does that and so, she just runs everything and we fill in the blanks. And so, I love doing clinical trials. I mean, if I could stop doing all my regular work and just do clinical trials, I probably would because it's fun.

But you know that that mix of things really makes every day just different and exciting.

Catherine Maley, MBA: Nice. And then where are you at with the surgical versus non-surgical? Is it a priority in your office? Do you have that? Like patients for life mentality where they go up and down the ladder, they start the surgery, work their way down to non, go to non-work, their way up to surgical.

What, how did you feel about that? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Well, let me backtrack a little bit on that. When I joined Ira, IRA is a rhinoplasty guy and when I joined him, I actually said, are you sure you want another facial plastics person in your practice? Because we're going to be competitors. Basically. We're going to be fighting over the same patient.

And he said, no, no, that's what I want. So, I, I thought, you know, I will never be the rhinoplasty person in the practice. Am I okay with that? And so, the answer was yes, I was okay with that. So, then the next question I asked myself is, how am I going to. Distinguish myself, separate myself from Ira, like why would someone come to me?

So, I finished in 1994, and that's just when Restylane and Botox started coming out and I thought, I can master this. I can be the injectable person. And so, I wrote a textbook on it. We did courses on it. So, that became my niche and. That way Ira. Ira does injectables and I do rhinoplasties, but he's known for rhinoplasty and I'm known for injectables.

And my injectable patients are patients for life. You know, they love you, they trust you, they appreciate your artistic eye, and when they're ready for something, I'm the person they ask. Is it time for this? Is it time for this? Fillers aren't going to do it for you anymore. You need this. So, it, it's absolutely a gateway and I think that the general plastic surgeons years ago made an error in judgment on saying, We are the surgeons.

Other people should do the injectables. And I think that was a mistake that if you don't do injectables and you don't get good with that, you're missing a nice chunk of patients who love you, who want then to move forward with bigger things

Catherine Maley, MBA: Oh, there's such a balance there. I've seen it every which way where the surgeon says, no, I'm just going to let it go.

I just, I'm, I just want to be in the OR. But then you hire nurse injectors, so, I'm sure you have, you, you have several nurses there. Do you have them doing the injectables at all the, the surgeons are doing? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: No, and that's how we distinguish ourselves in the community. Mm-hmm. That the doctors do the injections.

Catherine Maley, MBA: Nice. All right. And are you going to stick to it? Like have you noticed it's taken you away from the surgical or not? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Not a bit. Okay. Not a bit. But I'm busy. I mean, I see 35 patients a day and some of those are injectables and some of those are people who want to talk about surgery. And you know, I can't tell you how often I'm injecting someone and they start asking me questions about surgery and it becomes a cosmetic consult while I'm injecting them.

So, You, I can't imagine not doing injectables or passing it off to someone else when I have their ear. I can't expect a nurse who is doing the injections to say, you know, this really isn't going to work for you. You, it's, you're at the point now where you need a facelift. They're not going to say that.

They're going to say, you know, I think you need six syringes rather you're four. Yeah.

Catherine Maley, MBA: Yeah. So, what are all these staff doing? You've got 24 staff and a lot of nurses, what are they all doing? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Okay, I have well, secretaries obviously I have a skincare and laser division as well as the surgical side. So, we've got three estheticians.

We've got three laser nurses. So, we've got that side of the business running with skincare, with selling products. The, the Allergan company does a review of metrics to comparison benchmarking. And our aesthetician is off the charts in selling products, so, they, they really have it down and skincare is such an important mesh with cosmetic surgery.

You've got to, to change the skin quality to get the best results. So, we've got estheticians, we've got laser nurses, we've got or two ORs going all the time. So, we need nurses for recovery, nurses for the, or. Two rooms going. So, that's a lot of staff.

Catherine Maley, MBA: Yeah, that is a lot of staff. Any staff tips? I don't know if you had the dip, like others, you know, the post covid.

Did you have HR issues or any tips on managing staff pre Covid or PA post covid? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Well, yeah, the, the staff really sort of laid the law down with us and said, you know, we could go to Wendy's. And make X amount of dollars an hour and you're only paying us this, so, what can we do? You know, we had to give everybody, everybody got a raise to get them up to this competitive with Wendy's and Burger King thing, you know?

So, so, yeah, they sort of held us hostage with that. But they all stayed through covid. They all stayed. They knew we were getting the PPP loans to save them, to keep them with, with income coming in to save their jobs. We didn't lose anybody.

Catherine Maley, MBA: Nice. Nice. So, just out of curiosity, does Wendy still pay like that or can you now like what? How does this relate to you being the 2nd female President of AAFPRS?

You can't take money away from his, can't take away him a raise.

Theda C. Kontis, MD: Yeah. So, what are you going to do? I mean, the cost of living's terrible, you know? So, what are you going to do? Yeah. We are so, busy you know, all the practices around the world that do cosmetic surgery are, you know, going crazy. Yeah. So, you know, it wasn't a hardship for us to give them a raise and probably they, you know, it was the right thing to do.

Yeah.

Catherine Maley, MBA: One thing I have learned or I keep hearing the staff will not work at overdrive for very long. They need fun. They need acknowledgement. They need recognition. But they can't live in a pressure cooker every day. Do you, do you feel that or do they, is that the feedback you get or how do you keep it at least calm, you know, in, in the middle of a storm when you're so, busy? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Well, we fired the one that was the pressure cooker actually. Good for you. Now there's, and that was the mistake, you know, higher, higher, slow fire. Fast. Well, we fired slow, which is a bit of a problem. But there's always a disruptor. There's always something that everybody's upset about. And it was that one person, and we needed, we knew it, but.

This person was very productive. And you know, sometimes they hold you hostage because they're such good workers. It's like, oh, we don't want to let them go because they're so, good, but they're driving the rest of the staff away. So, after a few people leave, then you realize that this is just not going to work.

They've got to go. And so, once you get rid of that person, then everybody's happy. And the, the doctors set the tone. Hmm. You know, and we, they know, our staff knows that they're appreciated. They know that they're valued. And we treat them with respect. And so, I don't think there's anybody in our office who doesn't want to come to work in the morning.

Catherine Maley, MBA: Very nice. Talking about that. I've even been with practices where it was the office manager who was the drama queen and just 80% of the staff left before the surgeon did something about it. And it's just so, easy for me on the outside to say, get rid of her. But on the inside, you have so, many uncertainties about it.

Fear about it losing somebody who's productive, but doesn't it always happen the minute they're gone? You hear the feedback, oh my God, why didn't we do this sooner? Oh, I should have done this. You know, I mean, this has been fantastic. It just, I don't know what the right answer is, except when your gut is telling you that something's not right.

I would say just address it sooner rather than later, you know? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: You know, we all tend to have employees that we think are not replaceable. Right. But they are, and that is part of the issue that we think, how can we let this person go? They do everything well, they're replaceable.

Catherine Maley, MBA: Yeah. I would say though, one of the biggest errors is not getting that employee's intellectual property down on paper. How does this relate to you being the 2nd female President of AAFPRS?

You know, if they know everything and they set themselves up for that, by the way, they need to be irreplaceable in their own minds because it gives them safety. We've all had that employee, God knows I've had it too. And that person becomes so, ESHA can't even be sick for a day. And you're like, oh my God, what would I do?

I fall apart. And, and then you don't, you know, when it happens because then it's going to, it's going to blindside you. So, I have learned, get all this. Get all this on paper, get it in videos, get SOPs, standard operating procedures get checklists do not let them walk out the door being the only person in the practice who knows what's going on. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Absolutely true. And when we let this person go, part of what we had her doing is sort of teaching other people how to do what she did which was not rocket science, you know, but we sort of, Moved her around and had her show people things. And I think she saw the writing on the wall. But to have your staff be able to multitask is so, important.

Never have one person who does one thing and they're the only ones who know how to do it, because they do hold you hostage. And they're done that.

Catherine Maley, MBA: Yeah. Give me like running a practice as long as you have, first of all, the surgeons themselves. Any tips on how, how three surgeons can work together harmoniously? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Well, they all listen to me, which is good.

Catherine Maley, MBA: Are you kind of like the deciding factor if it's pretty much, pretty much there? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: My two partners are very calm, easygoing. They don't get riled up about anything. I'm the more emotional one. I sort of take charge of things and I tell them, look, it needs to be boom, boom, boom.

And they say, okay. So, the, it's not a power struggle. We all. Feel comfortable enough to disagree with each other if we need to. But it's just a very respectful, nice group and so, many times you hear of people joining another physician and it just doesn't work out. And I think it's too much of everybody trying to be the boss trying to Dominate one or the other not agreeing about things.

And then what do you do if there's two of you, you know, you're at an impasse. But my two partners are just easygoing. Easy to get along with guys. And I. Just works. I'm very fortunate.

Catherine Maley, MBA: Yeah. I don't hear this very often, so, please enjoy that. You know? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Yeah, I do it.

Catherine Maley, MBA: It's not always that way. I do think it's true when you have two alphas in the office that just.

Can't work one. It just, one has to be the alpha and one has to be the go along or stay out of each other's way. Like you do the marketing, I'll do the admin, like something like that. Like tight boundaries perhaps. But I'm just glad it's working for you. That's fantastic. Now, are there any plans to. Grow anymore or there's been so, much talk about exiting, like how do you exit these practices? How does this relate to you being the 2nd female President of AAFPRS?

It seems to be changing very quickly. There's a lot of talk about private equity coming in and taking over. Any thoughts about that? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: I don't know of one person who has sold to private equity who said, this is the best thing I ever did. Oh, no. It's terrible selling out to private equity because you've made your baby, you know, and now you're going to give your baby away, but you still have to be parenting for a while and you're watching somebody else take care of your baby.

And it's horrible. Because it all suddenly becomes about the money and it's not about, your staff does not benefit from it. The only person that benefits is the physician who got their millions of dollars for their practice, and we're not going to do it. We, our exit strategy's going to be different.

Ira’s older than me. Ira’s going to eventually, in a few years start phasing out. We hired on Emile Brown, our body guy as part of the, the next generation. He'll eventually take over the practice after I leave. We're looking now at somebody to replace Ira, somebody who has rhinoplasty knowledge, who can sort of.

Fit into Ira’s practice model and sort of take that going. So, our way of keeping the practice going is to have a succession plan. Mm-hmm. If I were in practice by myself, I, and getting older, I think that probably selling out to private equity is. Maybe a good thing. You get your golden handshake and then you leave.

But it's just, it's a really tough thing on your employees who, you know, we love our employees and, and employees aren't happy once the practices get sold. Mm-hmm. So, it's people can do it either way, but I like the way that we've chosen, I'm not going to make millions and millions like I could sell out my practice, but I feel better about it.

Catherine Maley, MBA: The one thing that I find interesting with the private equity is they'll consolidate some of the tasks that you don't want to do, like. HR benefits contractual agreements you know, they can pull the resources and get you a better rate on, you know, the, the cost of goods. That part I find interesting.

It's the part when the people get involved and who could, who controls the shop. You know, like all of a sudden now the staff who does the staff work for the, the surgeon or the private equity group or that part? It's a little fuzzy, but it's really exploding. Like, it, it's all, it's all I'm hearing about right now, so, I don't have an, an opinion on it yet.

I don't know enough about it. All I know is the more people, the more cooks in the kitchen, the more complicated it gets. And I don't know, can you know, can you lose complete control over it? Or can you still have piece of, because one of the things about surgeons, you're, you're in private practice for a reason, otherwise you'd be in the, in the university still, you know?

Yeah. So, then to take that away and say, okay, I'm just going to work for you now, I think that's more difficult said than done. If you've been running your own show. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: I don't know. I'm telling you, Catherine, find, find the people that are happy. They sold out. Okay. They're going to be hard to find. I predict that.

Catherine Maley, MBA: Okay. That's really interesting. Okay. I'm taking a poll. I'm taking a silent poll out, an informal poll of is this a good idea or not? Because I feel like some of this makes sense, but then what's the other side of it, you know, that I don't, I don't know yet. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: I don't have an opinion yet, so, so, I have a, several dermatology friends have sold out.

Okay. Yes. One of them said that all of a sudden there was a new practitioner in her office working with her. Never met her, didn't know anything about her. I don't know if she liked her or not, but all of a sudden, they hired somebody and now she's working side by side with this new person because she has to work in her office a couple years before she's out.

Yes, yes. Another staff member in another practice said to a patient, oh, Dr. So-and-so, she's not the boss anymore. Oh, we don't work for her. We work for so-and-so company. And you could tell that they were really bitter about it. Hmm. So, patient, patient care goes down and, you know, we pride ourselves with patient satisfaction and the things we do to coddle our patients.

Mm-hmm. That's not coddling. Mm-hmm. So, I don't know. I think it's a bad idea.

Catherine Maley, MBA: Right. I do know another, a Mos surgeon and he, but he was pretty burnt out. He was running a big operation and he was more than willing to let the res go. So, in his case, he's like, yeah, I'm still on board, but I'm just, I just do my surgery and leave.

I'm not involved anymore. And, but I think he was at that point. As you do when you get older, you're like, I don't know how much fight I have left in me. You know? So, I think it just has, you have to really watch the variables of this, and you have to know yourself. Are you going to be okay working for someone else? How does this relate to you being the 2nd female President of AAFPRS?

Are you going to be, okay? When your staff looks at you like I. What'd you do? What happened here? You know? Right. That's the part I worry about the staff saying, I don't work for you anymore. Like what? Right. What the heck? Like that, ah, that's not a good culture at all.

Theda C. Kontis, MD: But you, you lose autonomy, like you said.

We go into this to have our own practice, to have autonomy. Right. So, your most surgeon may lose his most tech and they'll say, sorry, we're going to hire so-and-so to do your tech. Well, they're not any good. They're not doing a good job. I'm not happy with them. Well, sorry, that's what you get. You know, and then, you know, it's like working at an academic center.

You have no, you're stay over what you do. Full circle. Yeah.

Catherine Maley, MBA: Yeah. All right. Let's talk about the more fun stuff, and that's the marketing. I want to congratulate you on the incredible outside signage. You happen to get approved on your building. You cannot try by your place without seeing that. How did you ma Nowhere else can somebody have big signage like that on the outside of their building.

So how did you, I know, how did you manage that? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Well, I love to negotiate. Okay. I took a course and learned negotiating and I love it. And I buy all the cars in the family because I love negotiating. So, when we, when we Went into our building, which was 20 years ago, they did not allow any signage on the building.

Yep. So, we had a 10-year lease. So, the urologist moved in above us about maybe seven years into our lease and put a big sign up. Chesapeake Urology. It's like, wait a minute. Now it looks like we're working in the Chesapeake Urology building, and I did not like that. So, when our lease renewal came up at 10 years, I said, you know, we want to sign up too.

And they said, well, Chesapeake has the whole floor. I said, well, we are taking over this other suite next door for our skincare and laser side. Said, that's basically the whole floor. And they said, all right. So, we used the build out money that they gave us to buy the sign, so, it cost us nothing. Yes. So, then when Dr.

Brown joined us, we need a bigger sign because there's three names now, not two. So, now we're much bigger than Chesapeake Urology. So, it's, it's wonderful.

Catherine Maley, MBA: And you, and you got your names on there too. Names on the building. Yeah. You are like celebrities. Your local celebrities at this point. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Yeah, yeah. People say you can't drive by without seeing our names, so, that's good.

And aren't you on like a major thoroughfare? Yeah, pretty. It's in a big shopping area, so, there's a lot of traffic going around. A lot of traffic.

Catherine Maley, MBA: Yeah. Yeah. Oh, that's fantastic. Let's talk about the patients for a second. Do you, what difference do you see now in patients, cosmetic patients that you didn't see before, and how are you handling that? How does this relate to you being the 2nd female President of AAFPRS?

Like their, their tastes and demeanor or how they, how they work with you. Talk about negotiating. Having the negotiation skills is probably brilliant in today's world.

Theda C. Kontis, MD: Well, it is, it does help. I tell you, Catherine, it's really, I've had this conversation already twice today. Oh. People are angry.

People are angry. They're unhappy. They, you know, in nine 11. When nine 11 happened, we all bonded together. Everyone was nice to each other. Everyone was help you do anything you can to help someone else. Covid pushed us all away from each other, like, don't stand next to me. You could infect me. And we were away from each other for so, long.

People have forgotten how to be nice to each other. So, there's this, this undercurrent of anger and unhappiness. With an overlay of social media telling everyone they have to be perfect. So, throw all that into the person that's sitting in our exam chair. You've got someone who wants a perfect result who's already angry.

And it's, it's really, I find the patients today very difficult to deal with. I have a rhino I saw a rhinoplasty patient like took they're splint off. Oh. And they said, when do I get my revision? Oh my God. So, so, I'm entitled to a revision and I'm ready for it. It's just, it's mind boggling. I've had all these one-star reviews recently.

Either I've become suddenly a horrible doctor. I got one that the patient wrote that 17 years ago they had surgery with me and the staff was rude to them and they were unhappy with their results. I had to write now getting, I had to write back. I had to write back. I really don't understand why it's taken you 17 years.

To write a comment like this, I wish you had at least come talk to me so, we could figure out what the problem is. Good for you. But 17 years, they're going to start writing one-star reviews. That's insane. I, I don’t know, I, I don't get it. But it's a very interesting question that you ask because people are very different right now.

They're hard to please and it's just a different mindset.

Catherine Maley, MBA: Well, some surgeons now are even videotaping the consultation. They're videotaping the all of the consent forms like it's gotten. That feels so, defensive. Like that can't be building a great relationship if you're videotaping people. But I don't know what the answer is.

You know? Do you protect yourself or do you just hope to God these people are reasonable? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: You know, it's all, you have to protect yourself. I'm not videotaping consents. You have to trust your gut. You know, so, many times if, if the staff doesn't like a patient and I don't like a patient, it's probably better not to operate.

You know, we always say you never regret not operating on someone. Right. And that is so, true. It's, it's a tough world right now, and social media has not helped.

Catherine Maley, MBA: Are you actually active on social media? And if so, like, are you spending any of your time there, your personal time there? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: I had patients tell me, you've got to get on Instagram.

So, I got on Instagram and I realized that it was such a waste of my time that I just, I'll post some things periodically just to let people know what's going on. But it doesn't really bring me patience. So, you know, I think if I were a young person starting my practice, I think you have to be in social media.

But I think somebody who's, you know, I've sort of peaked in my practice. I don't think I need social media at this point.

Catherine Maley, MBA: I'm with you. I, I know I'm older, so, it's not that I don't care. It, it's that I don't care enough to spend my time doing it. So, I have my staff work around, work around me to get it done.

And I would say that for some surgeons, they have embraced it. Wholeheartedly. And it does attract patients because they have the right attitude. Like they, they want to do it, they enjoy it, they, they like it. Right. And, but I would say if your heart's not into it, there has to be a better way for you to spend your time than I don't even go on there. How does this relate to you being the 2nd female President of AAFPRS?

I can't, I'm not allowed to go on there. I'm one of those A c D or O c d or whatever the heck they're called. Oh, is that right? Oh my God. 30 minutes. I'm gone for 30 minutes. I, I, I don't even know what happened around me, and I just think this is not a good use of my time. It's not good for my mental health.

So, I stay away from it, but I, I see how it can help. Rhinoplasty though, I would just say generally speaking, they're the toughest patients already. Gosh, to add social media to that as well. I don't know. I do, you do a lot of revision rhino, because a lot of surgeons don't even do the revision Rhino anymore, and then some do it, but they charge a whole lot for it, but it's a lot more risk there. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: So, what are your thoughts about that? Well, you know, you tell a rhinoplasty patient, I tell them there's no such thing as a perfect, perfect rhinoplasty. Do they hear you? When you say that? I was just going to say, it goes in one ear and out the other, and then postop. You say, remember I told you there's no such thing as a perfect rhinoplasty.

I had mines done. I can tell you six things wrong with it, but it's better. They don't want to hear that. So, y you know sometimes a little bit of filler. In a rhinoplasty, patient can just make a good rhinoplasty, a great rhinoplasty. So, I do offer that to people sometimes. I do revision rhinoplasties on patients who've had rhinoplasty elsewhere.

I do revision rhinoplasty on my own patients when they're not happy. What are you going to do? You know, most of the time we try to do it under local. So, that it's not a huge financial loss. Mm-hmm. But some people need anesthesia, so, at least most of the time you can get them to pay the anesthesia. But, you know, sometimes they're so, angry that's the last thing you need to do, so, you eat that cost.

So, you know, sometimes you lose money doing rhinoplasty surgery. Mm-hmm. So, it's, it's a tough surgery and a tough practice to have. I can't say I have to revise eyelids or facelifts or, you know fat OS very often, but boy, rhinoplasty, I mean, there's a standard revision rate that people just, they want perfection and they want it more now than they used to.

Catherine Maley, MBA: For sure. I had a rhino and I was super happy with mine, but as I've gotten older, the darn the scar under my nose started showing more. And I thought, this never ends this aging process. It just, it's, my face is just constantly shifting. But then so, then I goes to my laser people and I say, can you just laser this darn thing? How does this relate to you being the 2nd female President of AAFPRS?

And psychologically I feel a lot better. I think that's what a lot of times the patient, they just want you to do something. Exactly. Yeah, that's my little tip there.

Theda C. Kontis, MD: And that's the nice thing about fillers. Mm-hmm. Cause they say I just, every time I look in the mirror, I just see this, well, we'll put a little filler there now you don't see it.

“Oh yeah. It's better.”

Catherine Maley, MBA: So, so, what's your theory about patient retention? Are you into the “one and done” or patient for life? What's your feeling on that? Patient for life? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Patient for life, absolutely. It's a silly thing to one and done because they love you. And they trust you and so, they're going to keep coming back.

And I mean, that was the beauty of Botox is that they had to keep coming back. You know? So, that's why you have to have, in my mind, you have to have a filler practice. To have people coming back and as they age, they need more filler and then they're going to need surgery. And if you want to have an aging face practice, that's the way to do it.

And then they are happy and their friends come in, you know, all my new patients give me names of two or three people that I've operated on who say, oh, I really like how so-and-so looks. That's why I'm here. So, that's how you grow your practice.

Catherine Maley, MBA: I call that the long tail patient. The aging face is just a beautiful patient retention strategy because she has other friends just like her who need your services, they care a lot more about your credibility and your credentials and your reputation than some of these younger folks do.

They're just more financially. You know, secure. And they're more reasonable it seems. Absolutely. So, they're the ones who but they're the ones who typically will return, refer, review on, approve your photos. How are you feeling about the before and after photos? I'm also doing it in personal study on this one.

How do you get patients to approve their before and after photos? Do you ask yourself; do you have the staff ask? Do you hope they just offer? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Okay, so, this is my routine. Okay. When we do consent for surgery, I ask them if I can show their pictures to other patients, yes or no. And if I can put them on the internet, yes or no, and we circle it and they initial it.

And so, now I have a record of it. Sometimes they'll say, well, just my eyes, if you're doing my lips, or you know, don't show my whole face. Okay, fine. Then after six to eight weeks after surgery, we do their after pictures and I print them up and give them their after pictures. Nice. And I have, I give it to them on photographic paper in an envelope, and staple to the outside of the envelope is a letter from me thanking them for trusting me with their surgery.

And saying, by the way, if you're happy, please write a review, because I'll bet you read reviews about me before you came to me. And maybe 1% of people write reviews, but it does help because they're happy. Now if the results aren't that good, obviously I don't ask them to write a review or if they're mad or something.

But most of the time I ask someone for a review. Some of the time they write a review, but giving them their pictures. Is huge because I don't just hand it to them. I say, now look here. See how you had this hoodie here. See how that's better? See how your eyelids are more symmetric and your brow now is above your bone.

You look brighter. Let me hold your picture far away. See how your eyes look bigger? And I show them what they need to see because they don't see what we see. For good point. So, it's really important. Don't just hand them the pictures, but actually explain their results to them. So, you know this a little bit that you see here, that's probably going to get better.

We'll take pictures again at three months and we'll see. So, I give them their pictures, I ask them for reviews. And then if I think their pictures are really, really good and I do want to show them, I'll ask them again. And sometimes they'll, they'll change their minds.

Catherine Maley, MBA: I think you're doing the best you can is when you ask yourself personally, they'll say you yes, you way more than they'll say it to the staff.

So, I think you're doing all the right things. I have always said give your patients their photos. They need their photos, they want them, they're going to show them. Even somebody who is absolutely private, they will still show them to at least three of their favorite people, you know? Absolutely.

Yeah. And nobody remembers what they used to look like unless you show it to them. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: So, Let me tell you that has, just giving them their pictures has made unhappy patients happy. I agree. You know, I don't really see a difference. Well, look at this. Wow, I looked like that. I had no idea. You know, they, because they think they're going to look like someone else.

There's this, this thought that if they have cosmetic surgery, it's going to completely change their look. Right. And they say, well, no one noticed. Well, what did people say? Well, they say that they, my hair makes me look younger. Well, they noticed. They just don't know what they noticed. And that's a great result.

And then you show them and they get it. Hopefully.

Catherine Maley, MBA: So, true. So, what do you think in today's world, what would you say is one of the biggest challenges of being in a cosmetic practice or running one? Or keeping it competitive. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: What would you say is the biggest challenge in today's world? I think it, it's dealing with these angry patients.

I think that there's a lot of body dysmorphic. Mm-hmm. And we are terrible at, at figuring out who has it. We've done a study that showed that we all think we're great at it and we're terrible at it. I think there's a lot more psychopathology. And, you know, we have to be really, really careful with treating our patients because they, they will sometimes threaten you with bad reviews.

Mm-hmm. You know, if you don't give me my money back, I'm writing a bad review. And it's, it happens. I've had it happen and I'm sure everybody listening has had it happen. It's terrible. So, the patients today are very, very challenging. And I think that you have to go with your gut. If you have a bad feeling about a patient, try not to try not to operate on them or, or treat them.

Catherine Maley, MBA: Or if your staff has a bad feeling too, I would listen to them because they oftentimes treat you differently than the staff, and you just want to know as much intel as you can before you say yes to that patient. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Absolutely. My staff has, has a code at the computer where they put a lot of stars. Yeah. And wonder, that means they don't like them.

Catherine Maley, MBA: And it's so, funny, I always say, don't you have some kind of a code like a for angry, like a big a with a circle on it. And that tells we got a hot one here. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: A lot of stars. No one knows what stars mean. They think it's good.

Catherine Maley, MBA: That's really brilliant too. So, back to ps. As you, as the president, is there like one big like one big issue that you were trying to address during your presidency? How does this relate to you being the 2nd female President of AAFPRS?

Is that too old?

Theda C. Kontis, MD: There, well, there's always. A lot of issues. Our academy itself has an issue with transparency. Mm-hmm. So, I'm working really, really hard at increasing the transparency of what we do, because we do so, much, but people don't know it. So, I'm doing videos, we're doing more e-blasts. We have a Facebook group.

And still people don't know what's going on, you know, I mean, we've done everything but smoke signals, you know? But, so, trying to get people more in the loop. And then what is really kind of fun is advocacy. We're writing, right now, we're working with UnitedHealthcare. They've developed a policy that is really not in the best interest of the patient, so, we're working with them to try to get the policy changed.

So those are some of the big things we're working on.

Catherine Maley, MBA: That must be an act of God, huh? Changing policy. How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Can't imagine. Yeah. Oh my gosh. Yeah. And, they're very good at not communicating and making it impossible to communicate with them. It's, it's really how they hide behind everything. So, yeah.

So, it's a little bit at a time, but we're making some progress.

Catherine Maley, MBA: Good for you. So, I want to wrap it up now, and I like to wrap it up with this last question, which is tell us something we don't know about you.

Theda C. Kontis, MD: Well, that's a very fun answer because you were not going to believe me. But the thing that you don't know about me is that I am ticket number 664 for Virgin Galactic, and I will probably get my space stride in about 2026 or 2027.

Catherine Maley, MBA: No kidding. That is amazing. Really?

Theda C. Kontis, MD: Yeah. I bought a ticket.

Catherine Maley, MBA: I did not see that coming Dr. Kontis. I know, I know. Is there rude to ask? How much is it? How does this relate to you being the 2nd female President of AAFPRS?

Theda C. Kontis, MD: Oh, it's a lot. A lot. It's a lot. But you know you work hard your whole life and you think, you know, what am I going to get out of all this work other than just the satisfaction of taking care of patients and, you know, I have a nice car and I have a nice home and you know, what do you need in life?

But that's a dream that I've always had and I thought, you know, I'm just going to do it. And I asked my husband if it was okay with him if I bought a ticket and he said there's no way he's going. But I did. And I'm really excited about it.

Catherine Maley, MBA: Okay. You win for the most unusual answer. Oh, wow.

Good. My Lord.

Theda C. Kontis, MD: Thank you.

Catherine Maley, MBA: Doesn't that give you something to look forward to?

Theda C. Kontis, MD: Oh, it does. And part of the training is that we got to do this zero-gravity flight. Oh. Where we, you go on this airplane that does parabolic flight, so, it goes up and then when it comes down, you're weightless. Oh. And so, you get to feel what it's like to be weightless and they do that for you so, that when you finally go to space, You can unhook your seatbelt and be weightless, but it's not the first time and you can actually enjoy looking at the earth from space and you know, you've already been weightless.

Catherine Maley, MBA: So, unbelievable, that was fun. Unbelievable. Okay. Wow. If anybody has any questions for you or would like to contact you, how would they do so?

Theda C. Kontis, MD: They can email me: tckontis@aol.com.

Catherine Maley, MBA: About the AOL.

Theda C. Kontis, MD: I'm old.

Catherine Maley, MBA: Might want to Gmail.

Theda C. Kontis, MD: I know.

Catherine Maley, MBA: What's your website? ACW or something?

Theda C. Kontis, MD: www.ACWPlasticSurgery.com. Mm-hmm.

Catherine Maley, MBA: Okay. Dr. Kontis, it has been an absolute pleasure. I will never re forget this. Yeah, now I think I need a really big goal because I didn't, I wasn't thinking that big. Okay. And then thank you so, much for being here. I will see you at an upcoming meeting, hopefully, and enjoy your presidency.

Congratulations.

Theda C. Kontis, MD: It's always a pleasure, Catherine. Thank you.

Catherine Maley, MBA: Thanks so, much.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how Dr. Kontis is the 2nd female President of AAFPRS.

If you’ve got any questions or feedback for Dr. Kontis, you can reach out to her website at, www.ACWPlasticSurgery.com.

A big thanks to Dr. Kontis for sharing her wisdom as the 2nd female President of AAFPRS.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “2nd female President of AAFPRS — with Theda C. Kontis, MD".

 

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📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how to Dr. Katz has 50 lasers and devices.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "50 Lasers and Devices — with Bruce Katz, MD".

Non-surgical rejuvenation is a big deal.

The global non-invasive aesthetic treatment market size was valued at 61.2 billion in 2022 and is projected to expand at a compound annual growth rate  of 15.40% from 2023 to 2030. (Resource:  Grandviewresearch.com)

And, the most popular non-surgical procedures are Botox, Fillers, Fat Reduction, Skin Tightening, Skin Care Treatments.

So, I thought it would be interesting to have Dr. Bruce Katz, MD on the Beauty and the Biz podcast.

Dr. Katz is a board-certified dermatologist who practices dermatology, cosmetic, and laser surgery in Manhattan, Queens and worldwide.

Dr. Katz is a leading innovator and researcher performing clinical trials on advanced laser technology, cosmetic surgery, body contouring & dermatology.

We talked about the plethora of non-SX technologies entering the marketplace and what else is coming down the pike. Very exciting!

He also had great advice for those buying technology, so you actually make money from it (that was promised from the salesperson) ;-)

Visit Dr. Katz's website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

50 Lasers and Devices — with Bruce Katz, MD

Catherine Maley, MBA: Hello everyone and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and how Dr. Katz has 50 lasers and devices. I'm your host, Catherine Maley, author of "Your Aesthetic Practice — What your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits.

Now, I have a very special guest today because he's not a plastic surgeon, but he is a dermatologist and has experience with 50 lasers and devices. And it's Dr. Bruce Katz. He's a board- certified dermatologist who practices dermatology, cosmetic and laser surgery in Manhattan, Queens, as well as worldwide. Now, Dr. Katz is a leading innovator of advanced laser technology cosmetic surgery.

Body contouring, research and dermatology. He has more than 50 lasers and devices and has been treating more than 95k patients for their aesthetic needs. That's a lot. Dr. Katz is the director of the Juva Skin and Laser Center, and also the Juva Foundation Research Center that has been performing clinical studies for more than 20 years.

As a matter of fact, they have participated in over 70 studies. Dr. Katz, welcome to Beauty and the Biz.

Bruce Katz, MD: Thank you Catherine. Pleasure to be here. Thank you.

Catherine Maley, MBA: So, would you just start us off by telling us describe your practice practices and the services you provide? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know, we're a cosmetic dermatology practice and we do a lot of fillers, toxins, a lot of laser work, body contouring work.

I was one who introduced Smart Lipo here in this country about 20 years ago now. And you know, we also do a lot of clinical research on all kinds of different technologies, whether it's lasers. We did actually the recent F D A trials for dify, the new toxin. We do filler studies as well. And also, you know, laser and body contouring studies too.

And then also we do big pharma type of studies on acne, eczema, psoriasis, and all kinds of you know, medical dermatology as well as cosmetic me, cosmetic dermatology and, and cosmetic surgery. And also, I I'm a clinical professor at the Icahn School of Medicine at Mount Sinai here in New York, and I lecture nationally and internationally.

Catherine Maley, MBA: Dear Lord, do you ever sleep? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Oh yeah, once in a while.

Catherine Maley, MBA: God. Okay, so, I, you know, I'm always curious to find out how can you manage the dermatology practices? I've done a lot of work with them because a lot of them want to take advantage of all of the quantity of people they have and turn them from medical to cosmetic, so, I'm very familiar with that.

But one of the challenges is it's such a busy practice with so, many people in it. Are you focused on like, how do you focus on medical and cosmetic and then don't you also do Mohs. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know, I focus mostly on cosmetics. I have associates who do Mohs and also general dermatology. We do a lot of skin cancer work too.

Yeah, so, you know, my colleagues do the other type of more diverse procedures in medical dermatology and skin cancer work. And I focus mostly on cosmetic dermatology and cosmetic surgery, as well as laser surgery too.

Catherine Maley, MBA: And then the clinical studies, are those also done under the same roof as the cosmetic and the medical, or do you need to spread that out? How did this impact your expertise and procurement of 50 lasers and devices?

I don't know how much space it takes to do that, but…

Bruce Katz, MD: Well, we have three full-time people just doing our research at our center, and we have a large center in midtown Manhattan, about 5,000 square feet. Oh. So, we, we know, we also have a big area for our research studies too, which obviously you need, if you're running 10 and 12 studies at a time.

Catherine Maley, MBA: Wow. Just out of curiosity, you mentioned that new doxy, I think it's called. Mm-hmm. How, how long does it last? Because we, people who love our Botox, the, our biggest complaint is, well, you know, could it last longer? What's the, what's the scoop on that? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, the Scoop, Catherine, is, it does last longer, usually six to eight months, and I saw that in the clinical trial.

So, I don't think there's any question about it. I mean, it could vary in some people, but I think on average, you know, at least six months, some people even up to nine months in fact.

Catherine Maley, MBA: Good. Well, keep, keep researching that. We need it to last longer than that too. All right. I just feel like I'm constantly getting my Botox done. I'd like to. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, now you can try something a little different. That'll last for certainly, certainly a lot longer.

Catherine Maley, MBA: Is it available now worldwide? I mean not, not worldwide, but like easily distributed to everybody or is it still out there in the general distribution. Specifically? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know, we were, we were one of the, we were part of the group that was, you know, introduced to it initially.

Mm-hmm. You know, I guess to, you know, just try it out. Make sure there are, you know, no issues. But there certainly weren't, and now I think it's available around the country.

Catherine Maley, MBA: Oh, terrific. All right. Now let's get back to, you run a pretty big boat there. You've got two locations, a lot, it sounds like three locations. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: A lot of people. actually, four now.

Catherine Maley, MBA: Oh Lord. Okay, so, how many staff?

Bruce Katz, MD: Well, we have about 45 people, you know, between the four offices now, so, it keeps us busy. But you know, we we're really organized, so, everything runs really smoothly. And we have a great team of people. My administrative people as well as our clinical team are great, our research team as well, and that's really important.

As I'm sure you know you know, you're in a consulting business, you know, your staff is what really makes your practice and. You know, the front office people are the face of your practice, so, they're really important as well. But you know, we have regular meetings. I think that's, that's imperative to communicate regularly.

And, and that's why we have a very smooth operation, I think.  

Catherine Maley, MBA: That's amazing. And you're absolutely right. I don't understand why there aren't more regular meetings. Just catching up with everybody and getting everyone on the same page. It just, it saves so, much time and hassle with miscommunication. How did this impact your expertise and procurement of 50 lasers and devices?

And when you're not communicating, the staff will make stories up. You know, they did. They're, they're trying to communicate without you, and that's never a good idea. How did you find how. Didn't you have any trouble, like post co covid, post covid trying to get the right people in place. Have you had any issues with that or what's your secret to hiring the right people? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know, we had a great team, you know, even before Covid. Mm-hmm. But we did lose some people as a result. And it has been a little difficult getting new people to come in. But, you know, we try a variety of different ways to do it and, you know, often asking our current staff if they know people, friends or family as well.

And somehow, you know, we do get those people in. Mm-hmm. And fortunately, good people who manages everybody.

Catherine Maley, MBA: There's no way you're doing that. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, no, I have a great, you know, front office manager and clinical manager. We also have, you know, great people in our, in our clinical staff as well to manage back office too.

So, it all works, you know, very well.

Catherine Maley, MBA: Well, let me ask you to get the right people, right, but you, I mean, I would think you have different profit centers set up. Like you would have one for cosmetic, one for research, maybe one for Mohs. Is it like that? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, that's true. We sell, sell products in our, in our practice as well.

That's another area. And we have person who supervises that.

Catherine Maley, MBA: Yeah. I'm going to ask you about that, but where I'm getting to is, are you still, so, are your kind of in silos? Like are, are those teams working separately or are you trying to develop this big mission statement and vision where everyone's under one roof all working together as a big team?

Or is it siloed? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, it's, it's, it's a little bit of both. In fact, I mean, we have one obviously great team that works together, but we have individuals that are responsible for certain areas. You know, one person is responsible, say for the products, and making sure that we keep the right inventory.

Another person is responsible for billing and, you know, making sure, you know, bills get paid. And also, you know, accounts receivable. So, we have these different. Buckets that, you know, people focus on and are responsible for. And then also in terms of research, we have a manager of our research, our research director, and he is responsible for making sure that the studies are done properly and that patients come in, subjects come in and come in regularly.

So, it, it's, you know, pretty well-oiled machine I'd say.

Catherine Maley, MBA: Very nice. You had mentioned skincare and I noticed online you have your own skincare store. Mm-hmm. Give me your thoughts on that. Has it been a revenue stream? Has it been okay? Has it been a great idea? Like, where are you at with that? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Oh, it's certainly a, a very substantial revenue stream.

We use Shopify, which, which is a great technology to help us with that. And You know, it's, we have a variety of different private label products and also other, you know, proprietary products that we promote as well. It depends on, you know, what we need, which, you know, what, what products we think are best in their class, and we go for that, whether it's private label or proprietary.

You know, we always want to find the best products, the newest and the most advanced that will give our patients the best results.

Catherine Maley, MBA: So, that's really interesting what you're saying because most practices say, oh, I'm selling, I, I have a skincare line. And I say, well, how, how's it going? And they say, well, the staff won't sell it.

And you're saying you're not even necessarily marketing to your own patients. You're, you went Shopify, you went to the world like are you on Amazon, kind of thing. Like can they find you on Amazon? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: No, we're on Google actually. We're not on Amazon. Google has also, you know, promotion of, of products.

You know, we don't want to be, you know, I think Amazon is a great venue, but you know, patients can call. Our office or email us and we send them products. You know, we have clientele all over the world, so, you know, they can come to the office to pick up a, you know, a product when they run out.

Mm-hmm. So, we have a great team that just deals with taking care of product sales and making sure when people need more of those products, that we send it to them and, and they, they get it. They don't have to worry about going to Amazon or elsewhere. So, it's very easy for them.

Catherine Maley, MBA: Gotcha. Do you, do you think though, that most of the revenue is coming from your current patients who know you, or have you put enough into Google, I don't know if you're doing PPC or some kind of advertising, to get the public in general to buy it? How did this impact your expertise and procurement of 50 lasers and devices?

Do you know?

Bruce Katz, MD: I say the majority is our own patients. Gotcha. Okay. We do have some people who call us who, you know, may have heard about their products from friends or family. Mm-hmm. But I say the majority are really just from our patient population. We don't really try to sell. To the public. Generally, as you know, that's a very competitive space and the margins are extremely razor thin.

So, and I don't think it's really an area that we can compete in, to tell you the truth, because all the big brands, you know, have a lot more marketing Cloud than we do that.

Catherine Maley, MBA: That's why honestly when I see doctors putting a whole bunch of money into their skincare website. I just say, you know what, let's, let's just, just, if you want to be practical about this, when I look at your revenues by procedure, it's never been more than 2% of overall revenues.

You know, skincare is never more than 2%. And I say, let's just put it in perspective though. If it's 2%, then spend 2% of your time and your staff's time. And your resources on that, but the rest, you know, go somewhere else where there, where there's more money to be made. It's so, competitive. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Oh, I think you're absolutely right, Catherine.

From what I've heard, I mean, I could be wrong, but even from what I've heard from Dr. Lines or quote Dr. Yeah. Lines that are carried in Sephora. Yeah. Or in Bloomingdales, or. Other, you know, retail places. Yeah, I hear that. They, they find it very hard. They have to pay for all their own marketing in, in those stores.

They have to have their own little sections that they have. They have to hire their own people. And I would think that, you know, the profits are extremely thin for all the effort that goes into it.

Catherine Maley, MBA: Exactly, unless you can somehow hook up with the pharma group, you know that you need a pharma budget, frankly, in today's world.

Right. Get that to happen. Yes. So, regarding any mistakes you've made, like, because you have been around a really long time and you've done it all and you've worked with vendors, you've worked with pharma, you've worked with PR agencies, you've worked with a bunch of staff like, and all the research that goes into.

That's a whole other world as well. Like what, what would be your advice to others who maybe are thinking about doing research but also doing their own private practice? Is it viable to try to do both when you're like a solo practitioner? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: You know, that's a very, that's a very important question that you raise and I think, I think you know, a lot of my success over the years, And you know, we are always looking to introduce the newest technologies to our patients and we get a lot of media attention for doing that.

But where does it come from? And it actually comes from the research we do. And a lot of people don't understand that. But if you come out. Say with, you know, you, you're doing research on a, on a new technology, take Taxify for example. So, you know, that was, you know, really a breakthrough technology compared to the other toxins available.

Cause it lasts a lot longer. You know, we did the clinical trials, the f a trials, we were one of the sites that did that. So, we are first to market as a result because we have the experience. People don't come to us because they hear that. You know, we've treated 40 patients even before it was FDA approved in the clinical trial.

So, that gives us a lot of credibility, right, right away. And then the media. Calls us because they know we have experience and we can talk to them about how it actually works and how does it feel for patients? Does it feel any different? Does it act any differently than other toxins? So, by doing the research, and I, and I can repeat this for so, many other technologies that we've introduced over the years, Catherine, you know, Cul, for example, another breakthrough technology, the first to build muscle of any body contour in treatment.

Well, we did the F D A trials there. We've done many studies on cul, cul neo, and other technologies in that, in that sphere. Smart lipo. Also, as I mentioned earlier, I was the first to do that. I introduced it to this country and did the first FDA trials for it, and we got huge media attention. As a result, and that helps our practice.

But it all came from the research, and this has been true of other technologies we've used over the, that we've done research on over the years. And then, you know, we use also for marketing and PR.

Catherine Maley, MBA: I used to do a lot of pr well, decades ago because it was so, new and, you know, new and it was just so, new and, and nobody knew anything or much about it, the consumers didn't.

And it was very easy to call. I could literally pick up a call, pick up the phone, call the station manager of my local radio or my ro local tv and then I'd say, okay, what do you think about this story? And they'd be like, Sounds good. Maybe next week, you know, call me back. And nowadays you, there's nothing else to say.

So, the secret is because you have so, much PR on your website and you are definitely the innovator and the thought leader and your, I can see why the media would go to you because of the research. You didn't just pay to play. You didn't just get a PR company and say, okay. Give me, get me some pr and they'll be like, well, what's our topic?

Like, what, what can we, what does the all the PR people or the media channels care about is what's new for their audience. Exactly. And the only thing that's new is what you've been researching. So, you have the, you're on the front line there. So, that's, that's the secret. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Good for you. Oh yeah. Well, that's, and that's given us a lot of currency.

Another example right now is M Face, that's the new technology for facial lift and building muscle on the face as well. Another similar to M Scope, but for the face, we just did an interview. It'll be coming out tomorrow on Hollywood Life. That's you know, a big website. They get 30 million eyeballs every month.

Mm-hmm. And all, cause you know, I, one of the people at Hollywood Life tried it out at our office. And they had great results. So, they wrote a story about it. And that gives us a, also a lot of exposure for this new technology as well. And that only came out in the last few months. But that's very important, very important to be first to market.

That really Right. Gives you a big advantage compared to your, your competitors. And again, it just comes from the research.

Catherine Maley, MBA: But the holy Grail for us women who are aging, especially women, men too, but you, you know, you can only have so, many facelifts and, or you don't want a facelift and you just, you're, you're afraid or whatever.

If that really, honestly, does it really work? Like, are we talking. Noticeable results are so, subtle that you wouldn't notice, like, oh yeah. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: No, you see, you see noticeable results. No question about it. Great thing about it. Also, it's non-invasive. Mm-hmm. It's a 20-minute treatment. You do four treatments, you know, once a week, and people love the results.

I mean, they, they can see it right away.

Catherine Maley, MBA: No kidding. And is the last thing, how long. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know, we think it'll probably last at least a year. Oh, okay. As have the other mco treatments. And then, you know, you probably do maintenance once or twice a year. The 20 minutes each time is pretty easy. Right, because painful.

Yeah.

Catherine Maley, MBA: Okay. Sometimes I have watched a lot of these where you have to have multiple treatments. Like remember sculpture, you had to have three treatments. The patient journey is tough because the patient journey was you have a sculpture treatment. Then your face is fairly puffed out, like you have some swelling and you look fantastic.

Then it goes away. Then you have to go back and get another one. Then it layers onto that and again, you have a beautiful. Affect treatment and, but then it goes away. Then the third one, you know, supposedly builds that up. The problem is, is half the patients won't get through all three. You know, so, that's one of the issues is the, I love the non-invasive, but there's a cost to that, and that is time, you know, and repetition.

So, it's just, I just find this so, fascinating. Like, what are you finding in the industry, like surgical versus nonsurgical? How much has that changed in, in the world, you know? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, I think you know what really talks to that is the fact that a lot of plastic surgeons are now doing these treatments.

Right? Right. Because obviously they know people want try dose first. You know, we know surgery does. You know plastic surgeons do great work and their results are amazing, but a lot of people, you know, particularly women today who are working, you know, juggling, you know, family life and the workplace as well, find it really hard to do surgery when, you know, they may be just having early changes.

They may be getting a little bit of jowling, a little laxity of the neck, perhaps, you know, some, you know, looseness around the eyes. And they're not ready for surgery. So, what do they do? You know, they want to have these treatments that are non-invasive, no downtime. 20 minutes to half an hour each. So, it's very easy, you know, I mean, we're in Midtown, so, our patients find it very, very easy to come to us.

We're on 56th and Park and you know, they could just jump in at lunchtime, have these treatments and go right back to work rather than taking off two weeks after a facelift or, you know, other major plastic surgery procedure. And they, you know, not, are not necessarily ready for that. Mm-hmm. And even if they see a plastic surgeon, They'll be told that as well, that, you know, that little bit of Jing or a little laxity of the neck doesn't warrant a deep, plain facelift.

Mm-hmm. But you know, plastic surgeons now are offering these non-invasive treatments cause they realize instead of losing that patient, say, well, you're not ready. You know, chow River, dci. You know, we can offer you something in the meantime like evoke, which is another type of radiofrequency technology to tighten the jowls or tighten the neck or another, you know, m face treatment to give you a lift to the face where you may be getting a little bit of a droop.

And they don't lose the patient. They keep them in their practice until they're ready for a facelift and then they see that plastic surgeon. So, you know, it's not, you know, one or the other anymore. It's really a combination of doing both. You offer people, you know, early on with the early changes, non-invasive, even though they have to come in several times for the treatment, they're fine with doing that because they're not losing any time from work or their family.

Mm-hmm. And I think that's a reasonable approach.

Catherine Maley, MBA: And in, and in addition to that, after you've had a facelift, it never stops. The aging process never stops, and nobody wants to go through it again if they don't have to. So, if these treatments, you can get that patient at the beginning when they're just thinking about surgery, but they're not ready yet.

The, they're worth thousands of dollars to you while they're thinking about it. Then they, even if they have the facelift, they're worth many thousands afterwards. Trust me, I'm this patient. Well, that'll keep coming back trying to keep that facelift in order, you know? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Oh yeah. It's so, right. And also, I think by starting early on with these noninvasive, you can actually delay having a facelift because you're stimulating collagen.

The changes aren't, you know, as dramatic as they would've been had you not started with the noninvasive earlier.

Catherine Maley, MBA: Yeah. Just out of curiosity, I feel like I'm doing a consultation with you. It, it used to be, you know, I was around for therapy and the other one, Thermage, and just her, the pain threshold was ridiculous.

Has, have they done anything about that? Has the new technology become less painful? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Oh yeah. Well, those, those technologies are really old technologies, Catherine, but the new ones are not painful. They feel mostly like a warm massage I'll take that, have much more advanced, you know, energy sources.

Mm-hmm. So, you don't have the pain that you would from the whole therapy particularly. That was, you know, I tried it early on when it first came out and I felt the pain. They were treating my face. I felt the pain in my feet, how intense it was. But and also, You know, with homage it's not as painful, but you need to have, you know, a technician working on that person for 40 minutes.

You know, with the pandemic in the last few years, a lot of people who came into our practice didn't want someone working on them cause they're concerned about getting sick. So, these certain, these particular companies like BTL in mode, they developed these hands-free technologies and sign was sculpture as well.

They develop these hands-free technologies, so, we just put the applicators on their face, their neck or their body, and walk out of the room and the patient can sit there, they can read emails, they can listen to music, read a book, and, and not, they're not in pain, but they don't have someone hovering over them for 40 minutes and worried about getting sick.

Yeah. So, that's been a major. I think sequela of the pandemic, which has been very positive because it also is very beneficial for the practice. You don't have to give up one of your staff to perform a procedure for a half an hour or 40 minutes when you can just put on the equipment, the applicators, walk out of the room and let them do something else or treat another patient and not have them only devoted to one patient for 40 minutes.

So, saves you staff time as well.

Catherine Maley, MBA: Aren't you? It's shocking how far the technology has come. Mm-hmm. Just so, many options now and then they, they're trying to do this, do it yourself at home. What do you think about that? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know, those, those technologies are so, dumbed down. Yeah. Because, you know, you know, the companies don't want people to get burned or scarred.

Right. They really have very little benefit and, you know, from laser hair removal to skin rejuvenation with l e d light. Or the helmets to grow hair. You know, they're all, they're all so, you know, modest. In terms of benefits, I would say they may work a little bit. But it takes many, many sessions, you know, hours a week to do these treatments.

So, most people eventually give, give it up. It's the same ideas, you know, you know women when, when hair coloring came out in the pharmacy, so, women could buy, and guys also, they can buy their own hair coloring. Hair coloring. Do it at home. Save money, not go into the salon. What happened? Well, you know, eventually they got stained all over their bathrooms and, you know, splatter everywhere and they went back to the salons and had it done in the salons.

So, you know, they, patients who come back after trying these things at home come back to our offices and realize that, you know, even though they have to spend some time in our office, they get much more beneficial effects and more efficacy as well.

Catherine Maley, MBA: So, it sounds like the theme is tightening, you know, like it's, it's tightening.

Would you, the research you're doing right now, is there anything coming up the pike soon that you could tell us about or down the road? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: I can't tell you about it, but there are, I could tell you that there are things definitely, you know, coming up the turnpike and they keep getting better and better, you know, more efficacy with minimal downtime.

Shorter treatment times as well. So, there, there's new technologies coming along all in a pipeline.

Catherine Maley, MBA: And that's what we're all looking for as a consumer patient. No downtime, no scarring, no pain. Oh yeah, that, that's, that's what we need because we're also darn busy. I, I don't have a week, I don't have a week to take off and hide anymore, you know, if I can get up and running again in a day.

That's the, that's where the money is. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Yeah. Oh, yeah. And I can tell you, you know, right now about one new technology for tightening, please. That is just coming out and it's called Micro Corine. It's actually by a company called Cires, and it actually takes away tiny little pieces of skin without causing any scarring and with minimal downtime.

So, it's actually removing tissue, you know, up till now. The way we did skin tightening was basically trying to stimulate collagen to tighten the skin. Mm-hmm. But we didn't remove skin, you know, aside from surgery now we actually can take away tiny little discs of tissue, almost microscopic, without causing scarring.

And as these little wounds heal, the skin tightens. So, that's a whole new technology. And you know, some say it can actually take away as much tissue on the face as a facelift does.

Catherine Maley, MBA: No kidding. Yeah. All right. When's that going to happen? Because I need, I need that.

Bruce Katz, MD: We'll be getting that probably in the next month.

Catherine Maley, MBA: Oh my God. That soon?

Bruce Katz, MD: Test out. So, I'll let you know and you want to come in, check it out.

Catherine Maley, MBA: Please. I'll be right over. Yeah. Even though I'm California, you're in New York. That would be worth the trip over. All right, so. Lately I've been talking to a lot of surgeons who have been around a long time and they're contemplating their exit strategy.

And I just want to, I, you may be or may not be, but I'm just hearing so, much about how do you exit from this industry profitably, you know, and comfortably. Mm-hmm. Now are you the mindset you're going to stay until the bitter end? Are you going to. Do you have a plan for exiting? Are you going to sell to private equity? How did this impact your expertise and procurement of 50 lasers and devices?

Like what? Any thoughts on that that you want to share? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, I can tell you, you know, my former partner, Dr. Alexander Fisher, was also a very famous dermatologist. Mm-hmm. And he worked till he was 91. So, I have a legacy to fulfill here, Catherine. So, check with me in about 15 or 20 years. I'll let you know.

Catherine Maley, MBA: That's why you're exercising. Yeah, keep that. Keep stay on that electrical machine.

But do you have any, like, just regarding the business side, do you have any advice for the newbies coming up, or guys who've been in solo practice and they're just trying to figure out how to grow or how to scale? Like let's say they're tired of medical and they want to get more into the cosmetic side.

Any advice for any of them on how to not just enter the market, but how to position yourself in the market to your benefit? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: You know, I think it's really important to become expert at one procedure at a time. Mm-hmm. That's the best way to start some. Mm-hmm. Some young doctors try to do a variety of different things and they don't really do any particular thing really well, and that doesn't really help grow their practice because patients may not be completely satisfied.

So, they don't talk to other patients. I think, you know, that's, that's the first thing to be doing. You know, one, learn one thing at a time, get expert at it, and then do the marketing. You know, we do a lot of social media. We have seven different platforms that we, we market on social media. Our Instagram if people want to check it out, is @JuvaSkinAndLaserCenter.

Catherine Maley, MBA: You're doing a good job on that. You've got a nice following going. So, are you putting that time in? I mean, you're in there, but you can tell you're not. I mean, you're not spending a lot of time. No, no. Preparing it. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: I have a person who does great job with that. And she runs all those sites. And then she also works with our in-house marketing person, who also does a great job.

And, you know, we do a lot of videos, as you know. Yep. As your specialty, I'm sure. Yeah. Telling, you know, docs to do lots of videos or procedures they do, talking about new technologies or what's new in there, in their particular practices. So, we do a lot of work there and also, Helping to develop a, a network a marketing.

And I think a media network is critical. So, once a young doctor starts out, they should try to develop relationships with people in the media. And, you know, I just fell into it many years ago because of the new technologies that, you know, I was coming out with and. 20 years ago when I camp with Smart Lipo, I had People Magazine approached me about the story cause they happened to be at a meeting.

I was lecturing out in London and I had a five-page spread on in People Magazine about Smart Lipo. And I had patients coming in from all over the world for the next two or three years to do, you know, liposuction. So, but you know, trying to curry. Relationships, develop relationships with the media is really important because like you mentioned earlier, you know, I think the media, people call it Feed the Beast.

They're always trying to feed the beast, you know, talk about new stories, you know, scoop their competitors cause they're competing as well as, as doctors are competing against other doctors, while media people are competing against other similar outlets To get to the newest stories out first. So, by creating a media network, which, you know, fortunately over the years we've developed, so, when we come out with something new, I can just call them or I say, come in and try it.

Say how you like it. And then they decide if they want to do a story about it. I don't pressure them, I want them to, you know, give an honest appraisal and not say, this works when it really doesn't. And I don't want to ever present a technology that doesn't work to a media person. Cause you know, They're not going to do a, a good story.

And if they do a good story about it and it's really isn't effective, patients are going to come in and be unhappy. So, you want to be honest with the media. Don't ever try to, you know, put something over them about a technology that you're just trying to promote, even though you know it doesn't do very much.

Mm-hmm. Because they'll figure it out and, and you'll end up getting negative feedback as a result.

Catherine Maley, MBA: How important is the Mass media pr. I'm from before the, the good, the goods, like the TV and the magazines and the newsprint versus the new world today of digital. Have you changed your approach on PR and media now that everything seems to have gone online? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Oh, yeah. You have to make, make a big change. I mean, you know, years ago, I'd say probably even five or six years ago, still the most effective media was tv. And, you know, we did a lot of tv. I was on the view all the time. Mm. You know, the Today Show, good Morning America, CNN, and that gave us huge exposure, right?

People coming from over the country, internationally. But in the last five or six years, that's pretty much dried up. I mean, TV still works if you know, if you're lucky to get that. But it's been harder and harder because they're not doing. That many cosmetic stories anymore, and they're leaving it more to their.

They're digital out outlets. So, some, you know, whereas the View may have done a lot of cosmetic things years ago, and we would actually do live procedures on the view, we would treat sunspots with a laser or do a laser resurfacing on someone live on, on the show. Mm-hmm. But today, you know, they may do a, a video of it on their, on their website or on their, you know, Instagram.

But they don't do it on their, on the actual program anymore. So, it's really digital, you know, and social media. I mean, that's really where it is, where it's at today.

Catherine Maley, MBA: In terms of marketing, how much of your own time is spent on social, creating that content? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: I don't really create any of it. Good. I just have our, our, our people do it and they do a great job.

You know, they ask me to do videos and I'll do videos. I'm always happy to, you know, to talk about the latest things. And I encourage them to do stories about, you know, what's new in our practice, what, what we're doing, you know, that's interesting. Or we're even talking about, you know, how to, I'm going to do a video tomorrow on how to make the change in skincare from winter to s to, you know, warmer weather.

Of course, that's, you know, something that a lot of people contending with right now as the weather gets warmer. So, it's not always about just new things that we're doing, but also things that are important to our patients in terms of their own lifestyles. There's,

Catherine Maley, MBA: In today's world, I almost think if you're going to play the game, especially in the jungle you are in in New York you almost have to have a marketing team.

You have to have somebody who understands digital, somebody who understands social you know, someone's got your website covered and that content because your website you have a killer website with tons of content on it. And that doesn't happen by accident. Somebody's got to do all of that, you know? How did this impact your expertise and procurement of 50 lasers and devices?

Oh, yeah. Yeah. I mean, wouldn't you say you have more a bigger marketing team now than you ever did before? Because it's so, mandatory to be everywhere.

Bruce Katz, MD: Well, certainly, you know, in terms of, you know, adding digital and social media. Yes. Mm-hmm. But we've always had, you know, someone doing our marketing. I mean, that's, it's like any other business in a competitive field, particularly in a market like New York.

Everyone has to do that. Yeah. But you know, it's, I think it's also important to mention that you can't just. You know, hire someone to do it or let them run with it. The doctor has to also be, you know, in communication, you know, we meet once a week, sometimes even more frequently. I meet with my, not only my research team, but also with our marketing team and making sure that, you know, they're, we're all on the same page.

They give us a review of what they're working on, and before anything goes out of my office, I review it. So, nothing goes out to the media. Nothing goes out in social media or e-blasts without me or one of my associates who, you know, are providers in a practice reviewing things because sometimes marketing people may not get it right, and you don't want something to come out that's inaccurate or misinformation or, you know, not true.

So, you know, it's always a point. You can't just say, run with it and not be involved. The doctors have to be involved too. That's very important.

Catherine Maley, MBA: But then you have the public coming at you when you do pr and you have a big name out there and you throw a big net out. Now you have to deal with the response to that.

And have you found that the patients are a lot different in today's world? A lot flakier like I've noticed like for example, plastic surgery, they can have 1100 leads. I just saw this the other day, 1100 leads and. All, you know, the journey from the time they call to the time they come in, to the time they have their console, to this time they say yes was 12.

So, they went from really 1100 to 12 paying procedures. And all I can say is that's a lot of work. Talk about a needle in a haystack to find the, the 12 that wanted to give you money. Do you, are you finding that yourself that there's a lot more quantity but not as much substance? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: You know, I think it's probably truer in plastic surgery because you're talking about much bigger ticket items.

Yeah. Whereas here, you know, in, in dermatology, you know, someone comes in to have a Botox treatment. First of all, we tell them, you know, if you don't like it, it doesn't last anyway. So, you don't have to worry about committing to a procedure that you have live with for forever. Right. And it's, you know, a few hundred dollars.

So, it's not a terribly expensive procedure that they have to really. Think about for months at a time. Whereas on a facelift or a breast dog or lipo, you know, people will, will spend more time considering it. I find that to be the case in my liposuction patients. Mm-hmm. You know, they'll come in, we'll do an evaluation, a consultation, examination, and then they may take, you know, a few weeks to decide.

Mm-hmm. But then again, you know, We could also tell when people are just shopping, right? And, you know, we know that that's not going to be a, you know, we're not going to close that deal. So, I think you have to just, you know, put your emphasis on ones that are realistic and more likely to, to close. And then also make sure that your staff follow follows up.

You know, I have, I, I know, you know, not just plastic surgeons, but dermatologists who see patients for cosmetic procedures and never follow up. With them if they don't make the appointment right away or if they don't make it, you know, don't call back. So, it's important to have a person usually, you know, it's ours.

Or cosmetic care or surgical coordinator who does the follow up and tracks it on a sales spreadsheet. And now does certain, you know, touch points over, you know, two or three times after that visit, after two or three, you know, contacts. If they're not interested, you just. Say dead end, but, but it's important to do the follow up because sometimes people may not have un understood something correctly in the consultation, or they weren't clear about, you know, what, what, what's really involved in terms of follow up and, and recovery.

So, by having someone follow up that might actually change the, the nature of their, of their opinion, and then they actually close on the deal. And they make the appointment and have the surgery. So, I think follow up is, is as important as you know, the actual consultation for sure.

Catherine Maley, MBA: Now, what about the competition in your world?

It's been. Fairly commoditized. I mean, the patients think that they can get Botox anywhere or they can get laser treatment anywhere. Do you deal with that? Or you're so, you know, you're so, branded that you don't have that issue. Like people go to, you just, they're going to pay what they, they pay whatever you want because they, because it's you.

Do you have that issue where you're losing patience to the competition, you know? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Not really. I mean, I think in New York they, you know, there obviously are, you know, the non-doctors who are doing these procedures in spas. But you know, I think it's so, busy overall and I think, you know, we also, you know, our, we, we don't have.

A real cutthroat competition with be between dermatologists and plastic surgeons, or, you know, between dermatologists and dermatologists. We all get along really well. We, we talk to each other. You know, you've been in our meetings where it's multidisciplinary and our plastic surgeons, facial plastics, oculoplastics, and dermatologists, we're all buddies.

We lecture together we do research together. I re do a lot of research on cosmetic procedures and laser procedures with plastic surgeons. Very well-known ones as well, and we all get along really well, so, and we refer to each other. So, I just had a re referral from a plastic surgeon today because someone had a bad procedure and asked me to evaluate them.

And vice versa. And I'll refer, you know, to plastic surgeons for conditions I may not want to treat or I don't feel, you know, we have the right treatment, they need surgery. So, I know it's different, other parts of the country where, you know, there are turf battles like that. So, but you know, I think, you know, for the most part patients come to us and they have treatments that are appropriate.

And we don't really lose them to non-physicians.

Catherine Maley, MBA: Yeah. Good for you. And lastly, I wanted to ask you about your podcast. Are you still doing that? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: We do it, you know, periodically. I just have been so, busy lately. I just haven't had a time with, you know, doing the videos and social media and tracking those things and lecturing.

I was just in Hawaii, lecturing in Miami, going to Phoenix next week. Mm. So, it's just it's like you mentioned earlier, it's hard keeping track of everything. But you know, It's all fun. We still have a great time. What we're doing, it's, I don't consider it work. I, I'm always looking forward to getting to the office every day and we're really blessed to be in this industry where we have so, many new things happening and never becomes routine.

You know, there are new things happening, whether it's in plastic surgery, dermatology, lasers, fillers, toxins. It never gets boring and that's really an amazing position to be in. So, we are very fortunate.

Catherine Maley, MBA: But the nuance there is it doesn't get boring because you stay in the game. You are not just sitting in your office, you are everywhere.

You know, you're still playing games. Yeah. Everywhere, everything and learning all the new technologies. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: And all at once.

Catherine Maley, MBA: But but I mean, you're, you're, that's how you keep it interesting. You know, you're, you're really learning what is going to happen in the world. Like how do you see this playing out as an aesthetic patient? How did this impact your expertise and procurement of 50 lasers and devices?

Like, do you see it changing dramatically where we're not going to do surgery half as much as we used to, or how do you see this? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Well, you know with all due respect to my plastic surgery colleagues, we all know that that's coming. You know, that it's going to be less and less invasive over the next few years.

And to the point where, you know, I don't think. People with extreme, you know, loose necks or jowls down to here you know, boobs down to here also are not going to need surgery. They're going to still need surgery. But for people who don't have as severe changes and because people are starting a lot younger to have these non-invasive preventive treatments, even we see kids.

In their twenties are getting a little tiny wrinkle. Rico, they're come in for Botox. We call it rejuvenation. Yeah. Which is actually, you know, some people say, well, that's a, a little bit ridiculous. But it really isn't because we know muscle movements continue over time. So, those lines are going to get deeper and deeper.

And eventually I've had patients come in and say they want to have Botox when they have ingrained, etched in. Lines in a frown area or horizontal forehead lines and you do Botox and it doesn't do anything because they're etched in. And there's no way, even by relaxing a muscle that, that, you know, that wrinkles going to go away, or those wrinkles are going to go away.

So, they need to have laser surgery or, or regular surgery. So, by coming in earlier and earlier, they're going to need less and less invasive treatments later on. So, there'll be a few patients who need. Facelifts and brow lifts breast work, you know, that may continue to be the same case, but also even body contouring.

Mm-hmm. We see it already, you know, there's less numbers of liposuction cases, and we see that in my own practice because we're doing noninvasive fat reduction, noninvasive skin tightening muscle toing, non-invasive muscle toing, cellulite treatments, so, there's less need for the invasive procedures.

So, I think that's going to continue and it's going to get even more advanced and more effective with less and less downtime.

Catherine Maley, MBA: Right. I mean, it's so, good for the consumer. Not so, good for the plastic surgeons probably down the road, but, mm-hmm. I've also heard a liposuction that's going to be done by robot, you know, robotic lipo.

It's like, what? How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Yeah. Well, that's, that's possible. Yeah. I may don't even need liposuction at all if we can take away fat. Well, that's a good point. One area which we're getting to now. With Nia, we can take 30% of the fat layer away in four treatments, which is more than any other technology out there.

Only cause they, they combined with, you know, they two energy sources. So, it's getting there every day. So, it's more, more exciting and a lot more fun. But the plastic surgeons are never going to starve, you know? Yeah. They're going to be taken, you know, up with all these. Noninvasive procedures too. So, whereas their surgery may reduce in number, in number of procedures, they're going to be offering these noninvasive treatments to offset the lack of surgery if they're smart.

Right. Which I think they are. And they're doing that already. So, I know that is the case

Catherine Maley, MBA: for sure. So, we're going to wrap it up. Why don't you tell us something we don't know about you.

Bruce Katz, MD: Something you don't know about me? Well, you know, I have I just had two twin grandsons. Oh. Excited about just a year ago.

They're the loves of my life right now. Are they identical? Two little boys. Twin boys, fraternal twins. So, that's something people don't know, but you know, that's really exciting, and you know no one will be able to steal away my social media director. You know, why?

Catherine Maley, MBA: Why?

Bruce Katz, MD: Because she's my wife and she does a great job with our social media.

She's a graphic designer and she does all the social media. So, that's something that people may not know.

Catherine Maley, MBA: I say this all the time, marry “smart”. If you, if you're going to be in business, Mary Smart, you look at that, push your wife to work and she stays in the practice. And who better represents you than your wife? How did this impact your expertise and procurement of 50 lasers and devices?

She knows you definitely, she knows you what you like, what you don't like. That's such a great idea. Anytime you can get your wife to, to run the show. In the practice.

Bruce Katz, MD: Absolutely. And she goes to all the meetings. Also, Catherine and Yeah. Does some videos and all our, you know, colleagues at the meetings know her.

All the companies know her because they all follow her on our social media. We have the CEOs of major cosmetic companies, filler companies that follow her on social media because that's how impactful it is.

Catherine Maley, MBA: Yeah. You have something to talk about after 40 years of being married or whatever. How did this impact your expertise and procurement of 50 lasers and devices?

Bruce Katz, MD: Exactly. Right. Exactly right.

Catherine Maley, MBA: I know your website is www.juvaskin.com. J u v a. And if somebody wanted to get ahold of you, how would they do that?

Bruce Katz, MD: So, I'll give you, first of all, our Instagram handle is @juvaskinandlasercenter, Juva Skin and Laser Center, and my phone number is (212) 688-5882

Welcome to call anytime.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how Dr. Katz has 50 lasers and devices.

If you’ve got any questions or feedback for Dr. Katz, you can reach out to his website at, www.JuvaSkin.com.

A big thanks to Dr. Katz for sharing his experience on using 50 lasers and devices.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “50 Lasers and Devices — with Bruce Katz, MD".

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how to Dr. Chernoff performs 700 – 1000 surgeries per year.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "700 – 1000 Surgeries Per Year — with Gregory Chernoff, MD".

Some surgeons have two locations usually about an hour apart. They do that to capture a bigger market share than they can with only one office. 

However, this week’s podcast guest performs 700 – 1000 surgeries per year in his two practices located in two different states that are 2,200 miles apart.

My latest Beauty and the Biz podcast guest was Dr. Greg Chernoff. He’s a cosmetic surgeon in private practice in Santa Rosa, CA AND Indianapolis, IN. 

We talked about how he manages his time so he can do surgery every day in 2 different parts of the country AND sit on several medical, scientific, and editorial advisory boards, while maintaining his health and marriage. (Hint: He loves what he does and he invests in outside counsel).

Dr. Chernoff also talked about the latest technologies to watch for that will revolutionize the aesthetic industry (Hint:  Regenerative innovations).

Visit Dr. Chernoff's website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

700 – 1000 Surgeries Per Year — with Gregory Chernoff, MD

Catherine Maley, MD: Hello everyone and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and how Dr. Chernoff performs 700 – 1000 surgeries per year. I'm your host, Catherine Maley, author of "Your aesthetic practice — What your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits.

Now, I'm really excited about today's guest because I've known him forever. It's Dr. Greg Chernoff who will be sharing how he performs 700 – 1000 surgeries per year. Now, he's a cosmetic surgeon in private practice in Santa Rosa, California, which is maybe an hour up from where I'm at now, and he performs 700 – 1000 surgeries per year. He's been in practice for over 30 years. He's authored several papers and studies from his extensive research, and he's given over 700 lectures and teaches his innovative techniques to surgeons all over the world.

Now, he sits on several medical and scientific advisory as well as editorial boards, and he's a member of several medical societies. He also gives back to Survivors of Violence Foundation that helps men, women, and children who have injuries and scars as a result of violent acts, abuse, illness, or birth defects.

Dr. Chernoff, welcome to Beauty and the Biz. It's a pleasure to have you.

Gregory Chernoff, MD: It's a pleasure to be here. Catherine, as you mentioned, I've known you for a long time and your quality as well has been unwavering, so…

Catherine Maley, MD: Thanks for that. I really appreciate it. Now, a lot of people don't know you. You came from Canada and I'm always fascinated with Canadian medicine because it's very different from our medicine down here. How does this relate to you performing 700 – 1000 surgeries per year?

But you're more innovative. I think you're more bureaucratic, but almost more innovative as well. So, what brought you, how did you get here from Canada? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: So, I did my medical school in Canada. I did my residency in Canada, and then after residency you can do one-on-one training years called Fellowship. So, I, I initially came to Indianapolis and did a microvascular breast body fellowship.

And then after that came to U C S F and did a facial plastic fellowship. I returned Indianapolis opened my practice there. And two years after that my, my fellowship director of Larry Schrock died too young at 58. Oh no. So, he had operated the day before he died, I was asked to come back to, to take care of his post-op patients.

So, I came back with the intention of keeping his practice open so, that they'd have something to sell. I, I knew the patients, and so, most of them said, well, why don't you buy it? So, that was over 30 years ago. So, it's really, it's given me the, the privilege of doing what I love the most, and that's operating every day.

Between Indianapolis and Santa Rosa, we do upwards of 750 to a thousand cases a year. So, it just gives us a great volume of, of nice people to take care of. In addition, 2020 5% of. My practice has stayed dedicated to research. We continue to be alpha, beta test sites for majority of the, of the laser energy companies in many of the cosmetic and drug companies.

So, when we do studies, it gives us a great bell curve distribution of, of all the different skin types. Probably 40% of my practice in, in Indiana is African American, 30 to 40% in, in the North Bay would be Asian, Mediterranean, Hispanic. So, Just a nice bell curve of people to take care. So, how

Catherine Maley, MD: do you, how do you manage a practice when you're there half the time and do you have like extenders who are keeping it going and keeping the money in with the non-surgical while you're somewhere else doing surgery and, and how, how are you managing that? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: So, you, you really couldn't do multiple locations first and foremost without a, without a business plan. And without financial advisors, the key being for whom you listen to. Because I think the, the, the biggest problem with most doctors is that most doctors think they're good business people, but they're not.

And the, the more frightening part is they don't know what they don't know, right? So, we have a, we have a great business plan, second and second, and tied to that are, are great people around me. Julie has been my, my office manager and office nurse for 30 years in Indianapolis. Annette's been my operating room nurse for 30 years in Indie and, and in Santa Rosa.

We have a, we have a, a tremendous lineup of people who, who really take good care of me. I take very good care of them as well as just like family. But I think that's the key is surrounding yourself with people who always have your back and, and in return you always have their back as.

We're having that kind of longevity.

Catherine Maley, MD: Honestly, most of the top practices I work with or know of, there's usually that, that continuity person there, that one who has been there from the, from the beginning through thick and thin, they know it inside and out, and the trust level is over the top. How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: Yeah, definitely Julie. I always tease people at, when I give OC, I tell them from a business standpoint, the first thing that they need to do if they're starting is to find their Julie in their office. Julie for me has been the sister I never had, and I'm the brother she never wanted.

Catherine Maley, MD: So, how much are your, I mean, I know you're doing crazy amounts of surgery is like, is that a good revenue stream for you to have both the surgical profit center for you, but then the non-surgical with you extend is that. How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: No question because as, as part of your business plan, it has to be what, what will happen when you decide that you are, are ready for your exit strategy. And in, in this day and age patients you know, one step back, as you know, through the years that there's such a difference between taking good care of patients and just doing things to people.

But patients these days in the aesthetic realm, they, they appreciate one stop shopping. So, our patients know that they can come to us if it's for a little mole that they want biopsied. If they have unwanted pigment, if they have if they want to improve the tone, quality, clarity of their skin, a above the, the, the shoulders if they have unwanted fat, cellulite, skin laxity, poor muscle tone below the below the neck as well.

They like to know that that we offer. And it, it's really nice. Remember with, with all of these machines, there's always a gm Ford Chrysler. Nice. And so, having, having your story because again, it's all, it's all about what you portray in, in your book to patients. And so, having good reasons why you are using whatever you're using.

But in the exit strategy, if you looked at our p and l's monthly, you know, surgery, you know, my patient coordinators keeping me in the operating room eight hours a day is definitely what, what secures paying the bills. But we haven't downed such since the non-surgical volume is really just in the, in the pure profitability.

Standpoint. But, but both if, if run properly or are very strong profit centers to a practice.

Catherine Maley, MD: You know, I'm very curious though, how do you handle the consultations because you're very streamlined and process oriented. You always were. And it still takes you to do these consults somehow, unless you don't have to do them. How does this relate to you performing 700 – 1000 surgeries per year?

Is somebody else doing them for you? Are you doing virtual? Are you just doing them quickly? Consults and surgery? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: So, having, having stars that are patient coordinators both in, in both of our practices. So, our, our system is really time tested. A patient contacts our office for information and it's our patient coordinators that give them the initial information.

They, they bring the patient in first to meet with them. So, that we can find out definitively what a patient's goals are if they are a non-surgical candidate versus a surgical candidate. We do the computer imaging for them. They get educated not only in what they're seeking. My coordinators highlight my accolades, and then if we have if we know that a patient, because there's a lot of tire kick.

Pardon the expression also that come in thinking that surgery might be neat, but they think a facelift should be $500. So, I, I, I don't need to, to spend my time with those patients. But if a patient is pre-qualified, no different these days than if you're. Buying a house many times, you can't even go and see a home unless you are pre-qualified.

Mm-hmm. So, if you know that a patient is, is, is pre-qualified financially, emotionally, then they, then they meet me. So, I, I meet most patients now after they already have their deposit in for surgery. Patients who want to meet me before that we're fine with that. I think Covid was an excellent eyeopener to show us that many patients are happy doing, doing Zoom consultations.

Mm-hmm. It saves them time as well, and in their process of deciding whom they want to take care of them. So, we really have the streamline now such that I meet our patients once, once we know they're, if not already on the schedule, if they're ready to commit.

Catherine Maley, MD: I will add a caveat though. How does this relate to you performing 700 – 1000 surgeries per year?

The reason you're able to do that is because you've got such a well-rounded and balanced website, you have positioned yourself as the expert. And I tell doctors this all the time. When you're at the meetings, make sure your person's there taking photos of you at the podium, in the hallway meeting. How does this relate to you performing 700 – 1000 surgeries per year?

Really well-known surgeons, you know that's pr, whatever you want to call it, pr, marketing, whatever. It, when I was on your website, all I could think of was he bothered to take the time to show how greedy is, but you're bragging in such a sophisticated, professional way, and that's how you do it. That's why I can, I'm sold on you before I've met you, and I can live off of a Zoom 15-minute console call. How does this relate to you performing 700 – 1000 surgeries per year?

To, to just put icing on the cake. That's how you do it. How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: You know, our best, our best source of referral is always another happy patient. Mm-hmm. And so, we, mm-hmm. We enlist happy patients to talk to perspective patients. That vote of confidence goes a long way. And really, you know, when I. When you and I first started at this, many of the things that we do now, we wouldn't have dreamt that we would've had to do.

I employ a, a full-time social media graduate and you know, I, I employ the full-time photographers, full-time web people whose, whose jobs are, are, are never ending given the, the changes in Google formulas and whatnot. So, times are always changing and if you're not willing to change with them and spend the money to do that, then, then you'll get you'll get.

 

Catherine Maley, MD: So, going back and forth between Indianapolis and Santa Rosa. Not an easy feat because Santa Rosa is a lovely town, but it's outside of SFO. I mean, I, I, it's probably about an hour. Are you flying private by any chance? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: No, I'd I'm just I'm just a few hundred million short of affording 40. No, we've, we've stayed, we've stayed commercial.

Okay. But it's all, it's all in the planning. I'm, I'm also blessed, you know, I think another key. To success. My, my wife Jill was with Roche for 15 years before we got married, but she really oversees the running of both practices. She, she is responsible for my schedule. All of our, you know, our, our schedule is mapped out during the, the end of the third quarter for the following year.

Our flights. We're all booked. So, we typically fly into, I used to keep a car there, but it's actually cheaper now just to rent a car for the week. It's nice you get to drive vehicles. You might be interested in buying at later date. So, it's really, and we, and we know the timing as, as you and I know, if you if, if we land at non traffic times at SFO. I'm to my front door with, you know, within an hour.

If you land at bad times, it's three hours. So, we, so, we know when to fly, when not to fly, and that's just, that's just, I've done it for 30 years. It's just part of life now and my, my way of preserving my health as well as I promised myself, I don't do any work on the plane. That's my time to read enjoyable or watch a movie.

And that's some downtime where, where people can't get ahold.

Catherine Maley, MD: Oh, that's so funny. The plane for me is my quiet time and that's where I do my best riding. Yes, exactly. Because I'm sitting still with nobody bugging me. Exactly. On that. Yeah. So, because you've been around a long time, just give me one big mistake that you really learned a lot from that others could avoid making. How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: Not having a, and that, that's an easy, you know, fine, because you can break your practice down into it. It's a given, it's a given that we're here to take good care of patients, but we're also a business. Yeah. And, and if you don't run your practice as a, as a business, then you can, you can waste a lot of money and lose a lot of money.

And so, my, my biggest mistake as, as I alluded to at the start, was thinking that I knew everything that I needed to know about the business of running a practice. And now, and now I, I have a business advisory board, if you will, comprised of, of CPAs, accountants, business people. And I have to write a pledge that I will listen to them.

And many of the things that they advise me to do aren't what I want to do, but I, I listen to them and it turns out to be right. So, so, younger docs starting out really need to first define for themselves who are they? What do they want to practice? Do they want to be in an academic setting? Do they want to be in private practice?

Do they want to be a solo practitioner? Do they want to be in. In a group do they want to stay exposed to research? Do they want to be just surgical or have a, a non-surgical limb, which then also involves expenditure in buying, you know, most of the machines that you look at buying or, or are all upwards about, you know, they're all like buying a nice car.

They're all upwards of a hundred thousand dollars to. And you would, you have to also look at your return on, on, on investment with, with those. So, that was probably the biggest mistakes that I made in my first decade because when we finished, so, I was, you know, between fellowships and whatnot, I was, I was upwards of 300,000 in debt with student loans.

And because there's such a delayed gratification, you, you really come out gung-ho thinking, I have to do everything. I have to do everything tomorrow. The first thing you need to do for tomorrow is start saving. Mm-hmm. And so, a, a, a proper business plan that keeps your, your expenditures as low as you can, while you can still you know, operate your practice how you want to, is really important.

But, taking the time and, and, and young docs should do that through their residency as, as you become exposed to more. Things. And I think it's really important to go to all of the different academy meetings, that there's a, as you know, our, sadly our, our meeting industries in such dire need of consolidation.

La last year I did a hundred hours of C M E talks. And, and, but there's, so, that means for, for people looking, there's, there's such tremendous information that's being offered at these meetings, both in the scientific limbs and the business limbs. So, that those things, companies like yours that, that are, that are so, valuable in, in guiding the way you've, you've watched so, many people do well, but you've watched so, many people not do.

And so, you, you're a, you're really a, an encyclopedia of knowledge for someone who's looking to become successful as they start. So, but, but starting with a plan, starting with a budget and, and adhering to those I think are, are very important. Plans change as times change, but, but the essence of who of who, who a person is also shines through in their practice as.

Catherine Maley, MD: Well, you have such a good vast perspective on this industry because you've been a surgeon in solo practice. Then you've had two locations, then you had, I think you even had a third location. Then you work with the vendors, you work with the medical societies. You're very involved in the industry. What would you say to surgeons who maybe are just stuck, like stuck in a rut or they're so, confused that they're like ready to give up, or that it is just not fun anymore? How does this relate to you performing 700 – 1000 surgeries per year?

Like any suggestions for how do you, how do you gain footing in this industry being the uber competitiveness and just all the advances in technology and so, How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: As, as you alluded to, the you know, all of the things I, I I'm humbled by, by what I've been able to accomplish in 30 years. But there are days that I say that even though that I still after 30 years love what I do, I realize that all I do is what I do.

So, it's, it's an enormous time investment to be in solo practice, to also be involved in, in research. But if some, if someone's stuck you know, there, there are many docs. Just like me, who are always willing to talk to people you know, I, I was blessed and, and always being trained by people who, who believed in sharing their knowledge both medical and non-medical.

So, anyone is always welcome to, to reach out to me with specific problems and, and we're always happy to help. People, and I think that's, talk to people who've been at it for a while. And be open. Be honest. Hang, hang your ego on the door, and be willing to, to admit what your shortcomings are and really go with what your strengths are.

Most docs haven't reached the point of, of finishing a residency start. Go into, you know, looking into how they want to practice. If, if they haven't been in the higher percentages of, of IQs and, and, and willingness to work hard. But towards the end of education, I think that's when a lot of people hit a wall and they get very discouraged because they do have, they do have choices you know about which, which road.

And you may choose a road to go down and I that, I did that a few times too. You may choose a road to go down and, and realize that that's not. Right avenue for you. It's okay to change t and to change course midstream. I think some of the most miserable pe people that I've met in my life are people that are doing things every day that they don't like to do.

Sure. Life's too short to live that way. If, if, if you realize that you're not doing something that you have a passion for, that you, because patients will pick up on that as well. It's still my, my nicest compliment every day is when patients say, gosh, by talking to you, we can tell that you still really love what you do.

Mm-hmm. And I, I think that makes the consultation very genuine as well.

Catherine Maley, MD: Would you have any advice for somebody who's like, let's say they, they like research in academia, but now they're ready to make some money, so, now they want to go out into the regular world. Do they go solo? Do they try to buy in with, you know, with somebody else's practice? How does this relate to you performing 700 – 1000 surgeries per year?

Or, you know, that new trend now is all this private equity going on? Do any thoughts on any thoughts on where we're heading here as a solo surgeon? Where are you going to go with this? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: Yeah. Th those are all, all excellent questions. And I think you know, most, most physician multi-doctor practices that have been successful are usually doctors that started together.

I think most, I think most doctors, if they're not in an academic setting, most doctors would like to be out on their own. Mm-hmm. And so, if a person has the inkling that they want to be out on their own, then they should do what I did. And that's Go to a bank, take out a loan. Mm-hmm. And start, you know, and, and start on your own.

And, you know, there are, there are always you know, older guys like me who are looking for new associates. Mm-hmm. I think the, the formulas, the formulas have changed for doctors looking for associates. I think most, most docs who bring on an associate now would require a young doc to take out a loan, do a buy-in right away, away, because we've, there's been many stories of, of young docs coming into practices only to, to abscond with patient lists and.

You know, and, and open up, down, down the block. I think that's one thing that's, that's a across the country, non-competition clauses are weakening. In, in many states, you'll see more, more doctors protecting their established practices by having younger docs buy into them and then, and then earn, you know, earn their, their buy-ins.

Al also then over, over time.

Catherine Maley, MD: But then should there be a honeymoon period before you have a buy-in to make sure you have shared values and vision? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: I think a lot of that is built, a lot of that is built into, you know, the, the, the early, the early contracts. I think, I think younger docs need to also appreciate, though it's, it's not easy to start your own practice.

Patients these days with the internet, they have many choices about where they, about where they can, they can go. So, there's benefits. To younger docs in joining established practices. I think they, they can be mentored into excellence that, that way there's benefit also, and by, by older docs bringing in younger docs to carry, to pick up the baton.

The, the, there's a lot of private equity firms. I think, you know, this really started in the dermatology professional. Where dermatology practice started getting bought up. The doctor was offered a certain percentage in cash, but then the ability of putting some, keeping some equity in the company and for the larger equity company to buy up again, so, to see some profit off of that.

As well. So, those, there's a lot of those formulas around, but I mean, those, those equity companies are looking for more established practices that would, you know, it, it wouldn't be, you know, looking for a, for a, a multiple of, of, of, of earnings. So, you have to have a track record before a private equity company would, would really consider you in that regard.

And as part of that, you have to have clean. You can't have, you can't be running your practice as your own private bank account. As well. You have to show profitability for equity companies to be interested. But I think young and that, that's, that's also a, a positive for young people coming out of training is that they have many options that they can know, that they can look at.

Think you also have to if you're going to. Be in the field of aesthetics. Look at what your primary specialty is, and you have to decide, am I going to be an aesthetic doctor, non-insurance base, or am I going to keep a certain, you know, a, a certain percentage of my practice in the insurance area? Which, which, which can always act as a, a backup if, if times, if, if the economy worsens.

Although I think this is interesting. You know, before Covid I would've been booked on average, you know, eight weeks in advance. I'm, I'm booked here. We, here we are in coming up in April and I'm booked through September, October for many things. So, I think with, even when times get bad, people will always spend money on themselves, and that's what we're seeing with Covid.

Maybe people aren't traveling as much, so, they're spending more on themselves or their house.

Catherine Maley, MD: Oh, I think, I think cosmetic rejuvenation has become a way of life now. The stigma is almost gone. Social media helped that a lot. Social media also hurts it, like everything. There's a 50 50 to it, but I just think no problem with the demand here. How does this relate to you performing 700 – 1000 surgeries per year?

My problem with insurance is it's hard to dabble in it when everybody else. Eating, sleeping and drinking cosmetic, and then you're doing some insurance. And the, and the cosmetic is kind of a hobby. It can't be in today's world, it's just too competitive. And I think you need pretty extreme focus on something. How does this relate to you performing 700 – 1000 surgeries per year?

But I want to talk about that because, Normally in today's world, I say, you know what? Get really good at a few things. Don't try to be everything to everybody but somebody like you who's so, into research and you love the new technologies you offer. Talk about an umbrella, like you talk about a one-stop shop. How does this relate to you performing 700 – 1000 surgeries per year?

Like you offer everything and all the lasers and the injectables. And you're from Canada and you have all the latest like, you know, everything that's happening, like coming up with fillers and non-surgical. How do. Do you think it's a good strategy to provide everything for everyone, or is that difficult to manage? How does this relate to you performing 700 – 1000 surgeries per year?

What's your feeling on that? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: If you're, that's an excellent question. If you, if you have the desire to, and you can break down surgically and non-surgically, if you have the desire to be head to toe surgically, you have to have the appropriate training. Certainly. And you have to, I think most surgeons know what they do best.

Mm-hmm. And I that, that's a better you know, Operate and do the operations that you know you're good at because it only takes, it only takes one unhappy patient. Mm-hmm. I always, I always tease young docs and, and tell them, since most people still don't want folks to know that they've had anything done.

Right. If you make one person happy, they may tell two or three of their friends, but if you make one person unhappy, they have the potential with one bad review of telling millions of. So, you really, you know, stick to, stick to surgically what you do best. Stick to, you know, offer non-surgically, you know what because you can go to all the, the academy and, and, and, and you have lists as well of what you know are the most popular nonsurgical therapies that are people are looking for.

I think first and foremost, and this was advice that was given to me as well in starting, is first pick where you want to live. Mm-hmm. Cause if you go, if you go someplace that you know you want to live, that you're happy living, number one. And then number two, if you do good work and you're nice to people, you'll be busy no matter where you go.

And you'll be happy because you're living where you want to live, you're doing what you enjoy doing. And, and still to this day, the most gratifying part for me every day is watching how the smallest changes for a patient have such a dramatic effect on self-esteem. Mm-hmm. That's really the, the, the gratitude that our patients display to us every day by just the, the smallest of changes that is so, so, gratifying.

You know, once you can make a list for yourself of what you want to offer. You can really map that out in a way that can also become profitable.

Catherine Maley, MD: You mentioned patients and what's your take on how, how different is the patient demand now than it used to be? And how have you molded your consultations to that? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: I think we, we as aesthetic providers have to really show a tremendous amount of tolerance these days because the internet has become such a double-edged sword. Every day I meet patients who've read an article and they know more than I do after 30 years now. And so, it's always, you always have to listen.

The other, the other thing that that more docs need to practice at getting better at is listen. And not talking it it's still our job to listen to a patient as it relates to what has brought them through your door. Then it's our job to give them information relating to what it is that brought them through the door in a manner such that they don't think that you're trying to sell them right.

Any, sell them anything. And, and that that's the, the artistry that's involved in, in the consultation process as well is if, if a patient really senses that you're engaged with them. Once you walk in that room or if you're on the zoom that, that they have your, your, your total attention and that you're really engaged in, in the problem for which they're seeking your, your help.

They'll get the sense that you really want to help them and not just do things to them, but it is very, you know, I walked into one of, one of my consults to a, a 60'ish year young lady, and she was holding two papers and, and she said to me, just like this, I want to make sure that you're going to do my facelift just like this.

Great. And so, it would've been, it would've been easy for me to, to tell her what I was really thinking. Yeah. But again, I, I, I helped her see how that, that really probably wasn't the best tack for her to, to take upon first meeting her surgeon.

Catherine Maley, MD: They have gotten very demanding. They're very educated, they're very demanding. How does this relate to you performing 700 – 1000 surgeries per year?

And you know what I've learned as a, as a consultant, I say to the doctor, you've got to decide who you are and get grounded in your values and your own vision. Because when the public's coming at you from every which way you can try to acquiesce to that or you can say, no, no, no. Here's how we do it. How does this relate to you performing 700 – 1000 surgeries per year?

Here, here, here's what I'm comfortable with. And then let the rest go. Because dealing with the public is exhausting, isn't it? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: So, to that lady, I took my current textbook on facelifts is four is four three that you wrote the book on page volumes. And I, I said, wait, right here, I'll be right back.

So, I went and I got the textbook and I brought it in and I put it on her lap and I said, we're going to do this differently now. We're going to do your facelift with you awake. I'm going to talk you through it and you're going to do your own surgery. And so, her mouth o opened and he thought about it and she said, “I get your point”.

Right people. It's so, I, I, I think if you, you know, pa patients have to know that they're coming to see you because you, you are the expert. You are the person who will take good care of them. You'll listen to them. But there comes a point where you, where you have to draw the line in the center. You wouldn't say to your cardiac surgeon who's just said you needed quadruple bypass, just do three minor arteries or two minorities and I'll be fine.

Catherine Maley, MD: So, how are you in today's world with marketing? Like you were always a really good marketer before, but you did it usually through patient education then I really, I mean, this was many decades. You were doing the patient education events before everyone else was, and I thought that's how to do it. How does this relate to you performing 700 – 1000 surgeries per year?

Like you don't have to sell anything to anybody. People want to look good, help them understand what it takes for them to look their best. It's, it's a no-brainer, but how much of your practice nowadays is marketing versus just good old patients coming back for more and referring their friends? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: I think both, both are, both are still equally important, you know?

Mm-hmm. You, you and I could sit down and, and, and show a beautiful equation on the value of one happy patient. Mm-hmm. Cause one happy patient. One patient may start coming in, doing fillers, doing Botox. That will transcend then to maybe some laser work for pigment fine lines. Then as time goes on, they, they see that the gravitational diss.

That they are, that they are now seeing, as well as their volume loss, their loss of elasticity is, is now warranting surgery. So, they may start with doing their eyes, their brows, their liposuction, whatever, they're happy, then they tell a friend or two, then they're ready for something else. So, so, one happy patient when you meet them is worth hundreds of thousands of dollars in, in in the end.

So, protecting that. Is, is very important. So, there's that aspect of, of marketing through meticulous results. Mm-hmm. And then there's, then there's the dollars that you never like spending. We still do public. I think public seminars have been very, Valuable over the years because you can, you can extend information in a, in a very non-intrusive, non-threatening way to, to people.

And, and you can waste a lot of money on, on ads you know, on print ads. The internet is still a very valuable resource that if you, if you know how to play the, you know, the different equation game It all adds up, but, but you really, I think to be successful, you really have to do it all.

You, you can't just, you can't just focus on, on one avenue of, of, of marketing. And, but, but again, my, my greatest recommendation to anyone is to hire someone like you because that's what you, you know, that's what you are there for is to, is to educate and, and to help people be a.

Catherine Maley, MD: Well, and not to waste so, much money. How does this relate to you performing 700 – 1000 surgeries per year?

Yeah, I, it's shocking that they won't pay for my services yet. They'll give it to some PR company that works, what, five grand a month for eight months and you got what from it? You got something in Toledo, Ohio, like some kind of like that, a magazine nobody reads. And I think, what the heck? You know, that's. How does this relate to you performing 700 – 1000 surgeries per year?

I just, I'm on, I'm into marketing in today's world. Smart marketing, you know? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: Okay. Because I've, I've wasted a lot of money on companies that grossly overpromised and even worse, under delivered. And so, you, you, you really have to, there's so, many, as, you know, shysters out there who. You know who, who talk, talk a good story, but, but you know, provide very little inner turn.

Catherine Maley, MD: Yeah. Well, you're really up on the technology because you're on all those advisory boards and you're out there in the world like what's happening. Because half of us, remember when I, when we first started, you surgeons wouldn't even dream of injecting Botox. Like you were like, are you kidding me? I am a surgeon. How does this relate to you performing 700 – 1000 surgeries per year?

And then you really came around full circle and said, no, no, I need to grab that patient. You know, so, now I do injectables as well as surgery, but like I know you're very involved in regenerative medicine. Yes. So, what's coming down the pike? Like, what else do we need to look good and feel great? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: I think we're seeing more; you know, we're seeing more people.

I'm really seeing two, two distinct new peaks. In, in my practice. We're seeing younger people. A lot of the, you know, the, the generation Z patients, the generation X patients coming in c as well. With healthcare being what it is, I'm seeing many more 70, 80, 90-year-old patients coming in. With sometimes letters from their family doctor saying, don't discriminate against this patient because of their chronological age.

They're the biological age of someone much younger. And these elderly folks come in saying, you know, I don't feel my chronological age, but yet the person that I've seen in the mirror doesn't match how good I feel in my heart. So, if you have a safe way of helping me, I'm really interested. So, both of these subsets come.

Seeking what I refer to as preventative aesthetics. Mm-hmm. As compared to corrective aesthetics. Remember the, the three signs of aging. The only reason that anyone comes to someone like me is, is three reasons. Number one is the gravitational dissent of their muscles, both above the. Above the shoulders and below the shoulders.

And for gravitational dissent, there're really no surgical options at a point for which the patient, you'll do the things for them and they'll go, wow. The second reason they come to us, it's all these non-surgical reasons, volume loss. So, all of us lose fat in our faces in the mid-face. Lower, lower third, and this is where the injectable fillers are.

Fat transfer. There's, there's nothing. And then the third sign of aging is the loss of tone, quality, clarity of skin. And this too is where, where many of the non-surgical treatments, the fractionated CO2 systems, the needle rf treatments that they've never been better, but the whole field for, for 30 years, we've been involved in, in the fields of cellular medicine, regenerative and stem cell therapies, medicines is going to change so, much in the next decade.

The whole field we, we've been involved very highly in, in the field. Called exosomes. Exosomes are the tiny little articles that all of our cells communicate with. And they're packed with growth factors just as your own p r P is, but your own p r p is your age, whereas a memal stem cell exosome is, is very robust with growth factors.

And so, there's the therapeutic side of exosomes. They can improve the tone, quality, clarity of skin. They have such a tremendous, because they're loaded with, with regenerative and healing factors. They can help us in wound care and scar therapy. But the whole field of biogenetics and epigenetics we, we know what genes now are responsible for what features in in the body.

Exosome Diagnostics. There'll come a day where you and I can spit in a cup or pee a cup, and based upon the exosomes that our own body is secreting, we'll be able to detect disease states before the first cells even hit an organ. And then exosome therapeutics will be able to load at your own exosomes with disease fighting, fighting drugs will, you know, disease states like melasma like hypopigmented disorders will have very specific treatments coming up from these that are personalized based upon your own.

Your own gene. So, the whole field of gene therapy isn't that far away. There're some great companies we work a lot with some companies at Purdue at Stanford, that, that are involved in, in innovative genetic therapy so, that the field is so, exciting and I really envy people that will be around for.

20 to 50 more years because they'll be doing very different things. Not even today. I, I do very little how I did things 30 years ago, right? And, and, and very little of what I did even 15 years ago, both surgically and non-surgically. Mm-hmm. All geared to give better results, to have healing times. Quicker for patients as well.

So, the technological advancements that we've seen since I started, and it'll continue to see will really be jaw dropping for, for providers and for patients alike.

Catherine Maley, MD: Well, I've been using every technology that they had introduced because I'm going to say, I'm going to fight this aging process forever for as long as I live. How does this relate to you performing 700 – 1000 surgeries per year?

It's why I'm in this industry, although I should probably be more, more interested in the genetic stuff, you know, because I, I don't think, I don't know if I have great genes, but it'd be nice to, you know, I. I already feel really good like everyone else; I feel great. I can't believe I'm the age I am and I don't want to, How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: You and I are both 90 and look how good people.

Catherine Maley, MD: That's right. And so, if you could hurry up and research a little faster, we can get to one 20 looking good. So, what is driving you, where do you get this motivation? Because I'm pretty sure you're not sleeping a lot. When you're doing 700 sur, like a thousand surgeries a year, what the heck? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: What, what's, and I, I really say this from the bottom of my heart. A any my mother was a high school teacher who, who really believed her, her favorite saying to my brother and I was, don't, don't, don't settle for mediocre because there's, there's mediocre all around us. And so, I've always, I've always been driven to, to be my best.

And that that really hasn't changed. And it really, but like I said, I, to this day, I genuinely, without hesitation or reservation love what I do every day.

Catherine Maley, MD: Ah, that's so, nice. Now tell us something we don't know about you? How does this relate to you performing 700 – 1000 surgeries per year?

Gregory Chernoff, MD: Cooking is still my hobby. And so, that's the, what's your specialty? You know, I, with our, with our foundation for survivors of violence, my wife and I put on two charity barbecues.

Last year we cooked for 250 people in our backyard. So, that's still, holy cow. Still, still a hobby. I still play. I used to play hockey. My arthritis doesn't let me. I still love golfing and, and other sports as well. So, there, there's, there's no end to doing things like that in spare.

Catherine Maley, MD: Well, you're probably still cleaning up after that barbecue. Dear Lord, that's a lot of people in your backyard, so, alright. If some, if somebody wanted to reach out to you, what would be the best way? I know your website is called www.ChernoffCosmeticSurgery.com. Is there any way they can or, or, or just www.DrChernoff.com?

Gregory Chernoff, MD: They can also reach me on my email. Just Greg@DrChernoff.com, Greg@DrChernoff.com. And I'm happy to communicate and share, share anything that I've learned over the years.

Catherine Maley, MD: Oh, thank you so, much Dr. Chernoff. I really appreciate it. I'm glad we could catch up. Hopefully I'll see you at a meeting coming up soon and that'll do it for us today.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how to attain 700 – 1000 surgeries per year.

If you’ve got any questions or feedback for Dr. Chernoff, you can reach out to his website at, www.ChernoffCosmeticSurgery.com.

A big thanks to Dr. Chernoff for sharing his wisdom on how he performs 700 – 1000 surgeries per year.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “700 – 1000 Surgeries Per Year — with Gregory Chernoff, MD”.

 

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and insights from Grant Stevens, MD.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "Insights From Grant Stevens, MD".

Dr. Grant Stevens is the who’s-who of plastic surgeons and one of the most trusted voices in beauty, and will have lots of insights to share. He's a board-certified plastic surgeon who is the founder and medical director of Marina Plastic Surgery by Athenix and Marina Med Spa in Marina Del Rey, California.

Not only is he the past president of The Aesthetic Society, Dr. Grant Stevens also actively speaks, writes, researches, teaches, consults and participates with national and international medical societies, journals, hospitals, universities, industry, pharma, PR outlets and even government. 

This week’s Beauty and Biz Podcast is my interview with Grant Stevens, MD where we talked about:

• Insights on new business models available to those who want to simplify
• Insights on equity deals to invest in to shore up your financial future
• Insights on how to differentiate from everyone else 
• Insights on how cosmetic patients have changed 

You may need to listen to this Beauty and the Biz episode several times since it’s packed with pearls on how to market, scale and exit a cosmetic practice. 

You’ll hear how differently Dr. Grant Stevens thinks about business, marketing and the plastic surgery industry.

Visit Dr. Steven's website

Enjoy!

Catherine Maley, MBA

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Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

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"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

Insights From Grant Stevens, MD

Catherine Maley, MBA: Hello everyone and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and insights from Grant Stevens, MD. I'm your host, Catherine Maley, author of "Your aesthetic practice — What your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits.

I am absolutely thrilled with this episode because I have Dr. Grant Stevens, who will be sharing his insights. Now, he's a board-certified plastic surgeon, who is the founder and medical director of Marina Plastic Surgery and The Institute, a medical spa in Marina Delray, California. Now, he's also a medical director of Orange Twist Brands, offering multi-location non and minimally invasive aesthetic treatments, as well as chairman of the USC Marina Aesthetic Surgery Fellowship and the director of the USC Division of Aesthetic Surgery.

Now, Dr. Grant Stevens is the "who's who" of plastic surgeons and one of the most trusted voices in beauty and who will be sharing his insights. He has the longest CV I have ever seen because he actively speaks, writes researches, teaches consults, and participates with national and international medical societies, journals, hospitals, universities, industries, pharma, PR outlets, and even government.

Actually, I had Dr. Grant Stevens on my podcast right as the pandemic was... It had kicked in, but now they sent everyone home. So, I was able to catch him for a minute on the podcast and a lot has happened. That was several years ago. So, we're going to hear what's new and his other industry insights.

So, Dr. Grant Stevens, welcome to Beauty and the Biz. It, is an absolute pleasure to have you back and to share your insights.

Grant Stevens, MD: Thank you very much, Catherine. I really wish my mother had been here again. Once again listening to that introduction.

Catherine Maley, MBA: That's very well, I'll say, well, it was really difficult to condense it because you have been around. Wow. Good for you. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Yeah. Yeah. Wonderful career.

Catherine Maley, MBA: So, let me ask you this because today I did a lot of research on you and I see a lot of things have changed. So, let's just start with your practice. When I knew you, you had a very, you know, healthy, busy practice and you had quite a few people. So, tell me what is your practice like today and where do you fit into that? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, thank you very much. And hello to everybody. First of all, my practice is in Marina del Ray. It's Marina plastic surgery in the Marina med Spa, and it's been there for about 33 years and we've enjoyed a wonderful time. And we have a fellowship and aesthetic surgery fellowship that's gone on for over 20 years, actually in conjunction with U S C and also Jay Calvert and the Rocks Institute.

So, it's the Marina Rocks USSC Fellowship, which we're right now in the process of changing to the Los Angeles Aesthetic Surgery Fellowship because we're incorporating more of the LA based surgeons. And you asked about what I'm doing and what my role. And some people mistakenly think I've retired. I certainly have not retired.

I'm working as hard or harder than ever, but I actually am not doing surgery. And you mentioned orange twist. We are so there's orange twist is another endeavor, and that's a number of med spas. By the end of this year, we should probably be up to 30. We're looking all around the country, building and acquiring.

And that's all non-surgical medical aesthetics and it's called Orange Twist. However, the most exciting news I can share with you is that a company out of Texas called Lattice Work Capital, which has been around for 25 years, doing various rollups and other consolidations in the medical business, from veterinary to ophthalmology, to dental all sorts of different subspecialties.

They have 25 years’ experience. And they came to me and asked me to be on the board. Of their aesthetic rollup. And this is a couple year or a little over a year ago. And with that in mind, I looked at some of the opportunities because I was working very hard with engaged technology and some other things that will come up a little later today.

And I decided that I would go ahead and go and partner with them. And with that in mind they, they called the aesthetic portion of their business. They called it a phoenix, although I think by the time this airs, it will probably be called something else. And it's through lattice where capital and we are acquiring other top flight plastic surgery practices and around the country and only going for the very best and providing a fantastic patient.

An employee experience in the field of aesthetic exposed surgical and non-surgical. And as a board member of that company, and I always kid people, I say I sold my practice to myself because I took back a lot of equity and I really want to build a, the number one national brand in the country of aesthetic plastic surgeons.

So, Marina plastic surgery, alive and well. The senior surgeon there is Dr. Justin Perez. All of the employees are still there. Everything that you remember is still there. And in fact, I'm swinging by there tomorrow. I'm down here right now in Manhattan Beach, and I'll be there at the office tomorrow.

Check on things and see everybody. I'm actually going to get a little dify in my forehead. Wrinkles, you can see I need it. And then I probably have a Cyan laser in a couple days BL and Halo. So, I'm still very much involved and I'm still a consumer of the product.

Catherine Maley, MBA: You're still drinking the Kool-Aid.

I knew there was a shift on your website because on your website you very strategically marketed him, Dr. Perez as the medical director and you were after him as the founder. And I thought interesting, because you're transitioning, you're keeping that credibility because he needs your credibility. He can't stand on his own at the moment, I don't think he's much younger.

I mean, is that, is the goal though, for you to walk away and, and have him take it? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Yeah, well, certainly Dr. Perez could do whatever he wants to do. He trained at UT Southwestern. He was my fellow for a whole year in the number one aesthetics fellowship in the country. He then stayed with me and worked alongside of me for a couple years, and now he's the director and running Marina plastic surgery.

And, and I assure you that he could do it on his own. However, we are great friends and colleagues and we share, and obviously I have a little experience. I've walked the path a little longer than he has, and we have a great time. Hey, let me share with you. He is going to do my eyelids this time. Oh my God.

He's going to be my surgeon. Not only is he injecting me and doing my laser this week, but this summer is going to tidy up my eyelid. So, I trust him as my surgeon and I could go to anybody obviously, but he's so, and he's such a great guy. He's running that, that office within the whole Phoenix structure.

But like I said, it may well not be called a Phoenix by the time you air this program.

Catherine Maley, MBA: Well, lately on the podcast, that's all we've been talking about is private equity and plastic surgery. So, just to be clear, because it sounds to me from what I, the little bit I do know every deal is different. It depends on how much you want to give up, how much the, the business people want to do.

So, for typically you're going for the economies of scale for one thing, right? You're trying to do group discounting or group special pricing. Is that true or is that one of the objectives? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Are you talking about the acquire or the seller?

Catherine Maley, MBA: The business side, the business people who are going to take it, the private equity people, is their goal to roll you up so they have stronger buying power.

So, now you decrease your, like, hard costs. Is that one of the objectives? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, that, yeah, that, that is one of them, but that's not the main objective because what's the main objective? There are plenty of buying groups. It's, it's the efficiencies, first of all, the back-office efficiencies the running of the office, so all the support and of the office, the marketing, the HR, the employee relations and so forth, and their experience.

Like I mentioned, the company I'm with, with Gladys work, they have 25 years of successful rollups. One of my concerns, and this will come out at the Aesthetic Society meeting at Hot Topics, which may have already happened by the time you play this, but. I actually looked at 13 different groups, and I know there's a few more.

And there will not be 13 groups in a couple years, most of them will fail.

Catherine Maley, MBA: And why is that? Because I can see, but just from my, my looking out, you know, outside looking in, there's so many variables involved, so many egos, so many pieces to that thing. And I don't know how you're controlling it when it's in different locations, different people.

Who has the decision making? Who doesn't? That, that was, that's my take. Like why wouldn't they make it? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, first of all, as I mentioned, this is not a new phenomenon. This has been going on for 25 years with other subspecialties. So, if we look back and we study what's happened in previous verticals, in previous specialties, and we study what's happened, Then you ask why do they or why will this fail?

And, and it won't fail entirely. There'll be successes and there'll be cannibalization. Some will be bought by others at different valuations. But there will be some people that pay too much. There'll be some that can't deliver what they say they're going to deliver. There will be early retirements because people will see the money and they'll retire and, and, and the, the revenue stream will evaporate.

There'll be a number of reasons why they don't pan out and deliver what they're promising. I hope they're all successful. I'm not trying to be heavy downer here, but it can't possibly be 13 different rollups. And in fact, I'm told there's a couple more coming down the pipes, which doesn't surprise me because private equity wants to get in this because they've made tons of.

On other verticals. When I say a vertical like dentistry or pediatric dentistry or cardiology and so forth, they're veterinary, as I mentioned, renal dialysis centers and so forth. And I've studied, I went back and studied the previous models and looked at and interviewed people. I interviewed a couple pediatric dentists who did a three-time recapitalization and their final out was a 14 x.

They had a wonderful exit, foreign excess of the cash they had, and that would be one of the best models I saw.

Catherine Maley, MBA: But, but why has nobody ever done plastic surgery until now? My thought, is it insurance versus cosmetic? I haven't heard of this until a couple years ago now. It seems very popular. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Okay, so let me go back.

It's funny you say that. I attempted a roll up in 1998 with 31. With 31 practices and I took it to Wall Street. We went public and it was called the Plastic Surgery Company. It was 1999. Good for you. How, what happened? And we had 31 practices and more than 31 physicians. But I learned the hard way that managing plastic surgeons was much tougher than herding cats.

As Harvey Zim used to say. It was very difficult. And as I said, we could give a key to a burning building with the plastic surgeons in the building and say, that's the door. Here's the key. Let yourself out and save your life. And they would argue with you that it's not the right door, not the right key, and so forth.

But what we didn't have was private equity. Equity, and we didn't have the knowledge, the backend knowledge. And that's exactly what's going to happen to some of these other groups. I learned the hard way. Mm-hmm. We survived and did fine. Dennis Connan and I did it. And you know, Dennis from the industry and we learned a lot.

And I said to Dennis at the time, if I ever come to you and say I want to manage plastic surgeons again and do a roll up, I want you to shoot me. Well, then I call him and I say, you're never going to believe what I'm about to do. But it's totally different. It's totally different now because the physicians are giving up control of their practice, and that's a key thing they didn't with the previous one.

And that's good and bad, but they will follow the directions of the, of the parent company. In some of the programs, they have more control over others. Right. I think they're going to learn very quickly that that's probably not a great idea. PLA surgeons are independent, physicians are independent, plastic surgeons are very independent.

Mm-hmm. And they're tough to manage. Mm-hmm. But again, Catherine, as I mentioned, this has been done many, many times before, successfully in other fields. And I think what we're seeing here is now the interest in non-surgicals, especially captivates a lot of money people and private equity and, and people want to get on board the aesthetic boat if you will, or train because it's growing at an exponential rate.

And I don't blame them. I don't, that's why I'm on board. I mean, that's why I rolled a lot of my value into equity. Mm-hmm. And why I encourage my colleagues to give it a look. We're, we're going to be talking about it at the hot topics section of the Aesthetic Society meeting and comparing in contrasting some of the models.

And there's not one model that fits everybody's right. There can be many models, depending on the age of the doctors, how many doctors there are what their goals are, you know, what their tolerance is for having people manage them or their staff. There's just so many variables, and I hope they're all successful.

Catherine Maley, MBA: Because one, you, you need commitment though. You, you need them to stay put, right? Like, like for five years at least to make it work. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, so, okay. So, they're men. As I mentioned, every time you ask me a question, there's going to be a variation of the answers. Yeah, for sure. Some of the models are three years.

Some of them go out to five, some go out to seven or infinity actually. Mm-hmm. But if you leave in less than three years in general, you're going to forfeit something in the way of e or more. So, there's not one size of fits all. So, if you, there's as many models as there are companies

Catherine Maley, MBA: For sure. If you were to talk to a surgeon, like the biggest benefit for a surgeon to roll up with this, with a, with a private equity firm, what is it?

Is it to let go of the admin part of their practice and just do surgery? What's their benefit? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: It entirely depends on the age of the surgeon, what their practice is like now, and what they want out of their practice and their life. It's, there's not one size of fits all. Once again, if you're a young surgeon, it might be effective practice management and professionalism and branding and marketing and taking the headaches of running a business out of their hands, allowing them to do what they're best at, which is surgery.

That's one. If you're a senior surgeon in your final third of your life, it allows you to monetize all the work you've done and actually get a healthy multiple that you're not going to get anywhere else. Mm-hmm. Certainly, have to stay around a while. And the middle, sort of a blend of both. So, it's not one size fits all.

And when people say to you, they have the answer, they know, trust me, they don't. There's many, many scenarios here and there are many ways we can actually adjust it for the needs of the younger. I always talk the first, third, second, third, third, third of their practice. Mm-hmm. And it can be, and they can make more money, both even for practice efficiency on a day-to-day basis, as well as have a program extra strategy.

Catherine Maley, MBA: Mm-hmm. The one, the two things I was wondering about with these groups who pays for the patient attraction, does it now become the, the business side of that to, to do all the marketing for you? Or a lot of the groups, they still say to the practice, no, you still do what you do. You still build your practice market the way you've always done it.

But now doesn't it have to be co-branded? You know, like how, how do you divvy up this marketing part? Like where are these patients coming from? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Again, Catherine, once again, same answer. It's as different as there are different practice model. Some are centralized entirely and they only do a central brand.

Some allow the practices to exert their influence. Like for instance, marina plastic surgery is still marina plastic surgery. Yeah.

Catherine Maley, MBA: Well, that's how I noticed this. It said marina plastic surgery by a phoenix. Right. An old, interesting. Yeah. So, you are full branded a little. It's little though. It's subtle, right? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: It's co-branding and eventually as we get bigger, we'll probably have a national brand, but we're still allowing people to have their own local brand. Mm-hmm. And to the extent people want to do their own unique marketing, that's fine. But one of the values of this is we share best practices. Mm-hmm. So, if somebody in another locale who's part of it shows us what they're.

And they're involved in, say, patient financing with patient Fi or subscription services with, with dax, I mean, excuse me, with Privy. And they're doing great. They will share that because now you have partners coming together on quarterly meetings and sharing best practices is nobody can have all the answers.

This allows sharing of the best practices and then incorporating that around the country and maximizing the return and having partners and learning from one another, not just surgical technique, but in this case business management, marketing, and all the various other parts that are outside of the OR.

All right now practices or some models. Take all that off the. Some, some just come in and they just run it and then the doctor goes to work and does surgery and so forth. That's not what I'm doing. It's not what we're doing, and that it's not what most are doing. And most plastic surgeons don't want that kind of model.

But there are some that are that way. I can tell you I looked at them. Mm-hmm.

Catherine Maley, MBA: Well, what would be your advice then? Choose carefully, you know? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Yeah. Again, it would be, it would depend on the age of the surgeon. Mm-hmm. Well, private equity's not interested in hiring a young surgeon just fresh out, unless they're in an established practice.

I would, I would let, let me talk to the people that understand the second, third, or third-third of their practice. Yeah. Yeah. Look carefully. But in my mind, the biggest mistakes people are making, and we're going to talk about this, is that they're, They're falsely thinking that all the management schemes are equal and that somehow that they all be successful.

Mm-hmm. And I don't understand how they can think that when you study the other subspecialists, the other verticals, if you one studies veterinary stuff, or derm or dentistry as I mentioned these other, and you study what happened 10, 15, 20 years ago. Mm-hmm. You see that a lot of people got burned.

However, some did not. And the ones that did not have the best management ches, they have the best, the, the best business people and they partner with the physicians, be they veterinarians or dentists or whatever they are. And learning from the past helps the people now and in the future. Right. I mean, why would you repeat something that failed?

And that's what I see. I see a lot of naive plastic surgeons that I feel sorry for. They're just going for either the highest multiple, and they don't understand that that's not really the big strategy here. Because in a year or two, they're going to be out on the street or they're going to, the whole thing will be, well, what will happen, it'll be acquired.

We'll be re-roll up at a much lower multiple. Hmm. I just would be very cautious, be very thoughtful, be very analytical. The other thing is you don't need to be paying these bankers so much. I see these guys hire all these bankers, which I mean, it makes sense to have one, but they're paying way too much for them.

I don't know. The bankers hate me for saying this. And I have the bankers on my program and they're my friends. But some of the plastic surgeons are getting gouged by bankers. Sorry, bank.

Catherine Maley, MBA: For the surgeons, are they looking for predictable revenue streams? What would make the business people want to take over a practice? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

What are they looking for? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: They're looking for that delta. They want to. Pay the surgeon. They want that EBITDA and they want to drop the revenue, drop the expenses, and raise the revenue. And that delta is what they're looking for. They want to run more efficiently. It's, it's an old model. It's not new.

This is not new. This is ancient. They're coming in with economies of scale that you mentioned on acquisition of product, but way more than economy of scale and product. It's running the business like a business. Right. You know, I started that whole thing called the business of plastic surgery years ago.

And you've actually been involved in that also. And I remember when I first gave a talk called Staying ahead of the competition, I was roundly booed and so forth. Because I said, you're all business people. Then they disagreed. I said, yeah, you are. You're just bad business people and profit's not a four-letter word.

And you may remember I gave that talk profit's not a four-letter word. And I pointed out it funds philanthropy. It funds sitting in that chair. It funds your kids' education, it funds your. And so forth. Then without a profit, unless you're a silver Spooner, you're not going to be successful. You're not going to be able to help your family, help the needy and so forth.

Go on mission trips. So, if it is in fact not a four-letter word, then shouldn't we get the most profit? And shouldn't we run our businesses as business people, not as frat rats? I mean, I looked at businesses when I rolled them up in 89 and 90, they were being run and they still are like fraternity houses.

And, and it's unbelievable to me. I'm a businessman and I'm a surgeon and you know; it turns out you can be both. And I know that was really tough for people to swallow. I'm happy that now it seems that people have gone full circle and they understand they are in the business of aesthetic plastic surgery and aesthetic.

And they want efficiencies and they want help in the back office and marketing and sales and all the management issues in HR and everything that every business in America has. So, that's where the rollups are going to help the doctors.

Catherine Maley, MBA: Is the point of the roll up to eventually then just sell it to somebody else for even a lot more equity? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

But then who would that somebody be? Is it just some more business? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, you know, some are, some are established just to throw off cash and distribute it back. The shareholders. Mm-hmm. Some, I can think of a couple that come to mind. I'm not going to identify any of them, but, and some are clearly in the business of growing and then recapitalizing and then maybe recapitalizing a couple times and then ultimately then selling out.

But the ones that are getting involved right now who tell me, oh, we're going to do this in sell out in three years. Right. I know they're... No question. That's the biggest path to failure to start a new business and say your goal is to sell in three years. Every business school textbook says that. And, and if you look at startups, the people that make the money are do not startup companies with the idea of selling.

Catherine Maley, MBA: So, I'm from the Silicon Valley. I live very close to it, and I was down there for a year and I was in the middle of the, I started in 1998 and I left in 2000 to start what I do now, because I thought, you're all crazy. Nobody, you're all just here to start something and, and pull out the money and leave.

And all of us were, you know, millionaires on paper and we, it was over overnight, it was gone. And I was working for a startup that was burning through so much money and nobody had a. Just so it was so interesting to watch that, but you really have to know business and some where you're going with this.

And now I tell the surgeons, you're not only in in the world of business, but you're also in the, in the game of marketing. You've got to market yourself. And they're still fighting that as well. Like, why should I have to market myself? And I think it's just, I think the surgeons are the most sophisticated of all medical societies because you've been kind of forced to be, but even then, you're, you're kind of behind that until you realize this is a business that includes the marketing.

That's why this podcast is business and marketing. That's how you grow this thing, you know? Mm-hmm. So, tell me about Orange Twist. How is that different from Phoenix? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Okay. Very different. So, Orange Twist was started by Clint Can, Carnell and myself were the co-founders, and it's a Dr. Light approach to med spas.

And we started with one and then we went to fi. We then we went to 15 and now we're going to have 30 by the end of the year. And what we provide are the non-surgical and minimally invasive type procedures that do not require a physician on-site. We have medical directors and say I am not the medical director of Orange Twist anymore, but we do have medical directors of the individual sites.

And a general medical director overall. So, we have medical supervision, we have Orange Twist University. We train our staff. We emphasize quality and safety, number one. But a lot of patients don't want to go to a doctor's office. They want to drive in, get out of their car, walk into the Starbucks and go right next door and have their Botox or the Dify or their RHA or whatever filler, Restylane.

I don't want to endorse one over the other. They want to have their aesthetic experience and it might be a laser treatment, it might be hair removal and so forth. There's the whole myriad of things, not surgery. So, the key thing, it's non-surgical there. It's not, it's on the first floor you can park in and walk in.

So, it's the friction. We've taken the friction out of the experience you're easy to do business with and patients come in and, but they're not patients, they're clients and it's. Sort of like going to your hairdresser. Although I always say to the staff, you know, you're not hairdressers, you are practitioners and, and you know, their hair grows back but sometimes doesn't.

So, but the experience for the consumer is very approachable. It's very simple. And patients love it. We also offer subscription services so that patients are on a subscription. They come in, they get their every three months neuromodulator, or in the case of Dify, every six months, neuromodulator, maybe every year or nine months, they're filler.

Maybe they get one to two BBLs a year and so forth. So, now they come in and they have convenient payments that are taken from the credit card every month. It's, it's seamless. It's no different than Netflix or your iPhone payment, or your gym membership, or your car payment. Mm-hmm. And so forth. And patients love it.

They absolutely love it. They send their friends and we're growing by leaps and bounds.

Catherine Maley, MBA: So, who owns this thing? Are you taking over med spas that weren't doing well or they just didn't want to run it anymore and they're all on the first floor? Like how do you know they're on the first floor or they're all over the country, right? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: You're talking about the buying, the purchasing one. We build most of them. I mean, he would —

Catherine Maley, MBA: oh, you're starting from scratch. You're just built, because I know another surgeon in Texas that he, he's a facial plastic, but he owns a med spa and then he brought you on board. I'm just trying to figure out like, how, how is that working? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Are you going after the plastic surgeon or the facial plastic surgeon who has a me spa or a med spa that's struggling or a brand-new building like you just said, like how's that business model? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: So, as I mentioned, we build most of them, de Nova. We acquire some that fit our model. You're referring to Steve Camp And he's not a facial plastic surgeon?

He's a plastic surgeon. He's not facial. Oh, okay. He did an aesthetic fellowship with Dan Mills. Yes. He's a very friend. Dan and Sarah are fantastic people and have a great practice. And they came to us and we built that de novo with them. Oh, gotcha. They were our practice; they were our partners and they're running a great business.

And there were a few we acquired here in the LA area, but they had to fit our model. You know, they're, you're not getting in an elevator. You're not hopefully paying for parking. Certainly, you're not, it's not there's not a lot of friction. We want to make it simple. Just like Starbucks. We want to make it, you don't pay for park for parking when you go to Starbucks, and I'm not sure you've ever been in a Starbucks on a second floor unless it's in another business.

My point is, we put them conveniently next to gyms and other areas where people have high traffic beauty salons, Starbucks, I've mentioned that a few times. That's actually one of our areas we look for and other. High traffic areas where people can just go from one experience into another. Mm-hmm. People want to have the beauty experience.

So, no, we're not looking for failed established practices at all. That's not at all the model. Mm-hmm.

Catherine Maley, MBA: So, that's in, so is there, are you the owner, is there a board of directors? Is it also private equity? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: We just had an infusion of 40 million last Monday. Of course, there's a board of directors. There are many investors and owners.

It's a thriving business, Catherine. Yeah. It's, it's a, there we have, it's a thriving multimillion dollar business. Mm-hmm. That has valuation, a high valuation. I mentioned we just had someone put another $40 million into it. So, yeah, it's. They're a number of owners, if you will, because they're all investors.

Catherine Maley, MBA: Right. Okay. You're busy, you've got a Phoenix, you've got Orange Twist now, are you still doing your podcast? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, I am, I'm, I'm not doing much with Orange Twist. I'm certainly supporting them and I'm one of their, I'm helping with some of the medical stuff and I'm, I mean, I was just on the phone with c e o today and the chairman of the board yesterday, so, but I'm not actively working with Orange Tri because I'm so busy with various other things, including my podcast.

But more importantly, I'm the chairman of the board of Engaged Technologies. And today is big news because today we announced we have a press release that Engage Technologies and Apex merged, the official merger was announced today. So, we so you know Terry Ross and Isaac Mosley, they have a P X.

Which is a practice management tool, which includes a, a dashboard and a number of KPIs and a lot of management skills and training on the part of dairy. We merged with engaged Technologies. What did they do? And, and I mentioned I'm not, I'm the chairman of the board. I'm also the chief medical Information Officer and so forth.

So, that's keeping me very busy. The technology of Beauty is the podcast and I'd love to plug it. You can watch a new episode every Tuesday. We have over a hundred episodes. Last week we had Carrie and Jason from Allergan. Tomorrow we are. Today we had Dustin Suits from Revance. We've had pretty much every single c e o and chairman of the aesthetic space.

I mentioned we've had a hundred. I could run through it with you. It's a really fun prod podcast. I get to interview the movers and shakers of the beauty business and learn a lot from every one of them. We film it in a studio we have here in Manhattan Beach. It plays every Tuesday. It's on YouTube and all the other podcast feeds.

It has videos, well as audio. We have three cameras. We have a whole film crew editing editorial staff. And it has been incredibly successful. And what, what audience are you attracting? Well, it's really fascinating you asked that because we have a mixed audience. Because we have so many industry people.

It's fascinating to me what's happened. It's morphed. So, we have a lot of industry viewers. We have clinicians, especially entrepreneurial clinicians for sure. We also have people that are looking for jobs in the beauty business, which I never expected. And some of the companies are using the content to push it to their sales staff as well as to potential applicants.

So, someone was going to interview with Dennis the other day, and this person, Dennis Conan, and this person watched Dennis's show. I didn't even know the person, and they called and thanked me because they had some insight into what he was all about. And that has now happened a number of times. And it was something that Max and I max is my producer and director, and he has influx marketing along with Adam.

And we, when we set out, we weren't exactly sure what our goal was, but I was interviewing Richard Gonzalez, as you know, the, the head of AbbVie. And who that bought Allergan. And I got to the, for, I was fortunate enough to meet him off camera and talk to him when he took over and bought Allergan. And he is the chairman of the board and the CEO, and he runs everything with Abby.

And I said, Hey, can I interview you so you can get to know the people in plastic surgery? And my mantra was already, as you know, the, the, the technology of beauty that's been across my, my wall since 1987. And I own that. It's trademarked. I own the technology of beauty. And so, I named the program the Technology of Beauty and, and Rick Richard Gonzalez was my first guest.

And we had so much fun. I said, Hey, let's do this again. So, lo and behold, we started bringing other people. We got a studio, we got cameramen and sound people and editors, and it's just been so much fun over the last three or four years now. Excuse me. And we've learned a lot. I learned something from every single guest.

Yeah, me too. It's incredible to me. We interviewed Eddie Yune not too long ago. He wrote the Super Consumer and he also wrote The Snow Leopard. And if you haven't read the Super Consumer, it's an amazing book and it relates right to what we're doing in aesthetics. I hardly encourage you to. And Eddie came and he presented some fascinating marketing information.

Like what did you know? That people that make generators, companies that build generators sell a lot right after a natural disaster, you'd expect that an earthquake, a flood. Of course, people run to the local Home Depot or wherever you buy a, a generator. I must confess I have one because I lived in Southern California.

I've been through earthquake, but. Did you know that when there hasn't been a natural disaster that their sales plummet? Not unexpected. Cause they're asking you to, you know, shell out, I don't know, five to 10,000, whatever it is, to buy one of these things and stick it in your garage and hopefully you'll never use it.

Right? Right. Okay. Well, they came to Eddie asking about marketing advice. He's a consultant. So, what he did was very creative. He started looking at what people do that have generators. So, let me ask you something. Do you have extra refrigerator freezers in your garage? Do you, so you don't have a generator.

Do you take an excessive number of. Yes. Okay. So, it turns out people that buy generators, number one, they all have more than one refrigerator freezer. And Tuesday in the garage they have backup freezers or they, they, and they keep frozen food out there. So, that's number one, predictor. Number two, they buy a ton of vitamins.

So, then if you want to target your marketing, instead of geo-targeting like we do, you just for that com, for those companies, they targeted people who purchased these refrigerators, freezer, extra second and third, and then vitamins. And there were other collateral things. And in the book, he lists a ton of them.

And 20% of the people consume 90% of our product. Again, 20% of our patients consume 90% of our product. And if we can identify who those 20% are and market to them, we're way better off. And Eddie was on the show, but we've had bankers, we've had CEOs, we've had some. A few doctors, not many. We've only had a handful of doctors, and they are, again, to be on, you have to be a mover and shaker of the beauty business.

But we've had some docs on and they're big-time aesthetic surgeons and medical people. Mm-hmm. And it's great. I encourage you to check it out. We have a website. We also have Instagram page technology@beauty.com.

Catherine Maley, MBA: Gotcha. You mentioned marketing, and I want to go back to that because you have such a well-rounded background in all facets of aesthetic medicine. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

What's working in today's world for at patient attraction? What, what has been working that you know about or you? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: It's so great you asked me that because this weekend I worked on this last weekend I worked on my talk to the residents and fellows coming up. They've asked me to talk about that.

It's going to be a kind of a morphing from staying ahead of the competition talk. Mm-hmm. But you know, Catherine. Too much time is spent talking about just the peer marketing. The number one way to get patients is to be the best surgeon and physician you could possibly be and take the very best care of the patient sitting in your chair right now because that person will tell her sister or her family or her neighbor, and there's nothing better than word of mouth marketing.

We have gotten so distracted by the other digital, which I'll talk on, but we've gotten so distracted that I see a lot of young people just jumping around on TikTok and not thinking about the fact that at the final analysis, if you don't deliver the very best services, the safest and best surgery or non-surgical aesthetic services, I don't care how much marketing you do, you will fail.

It starts with the best surgery and, and medicine and being the best. After that, it's, it's communicating with your patients and then they will communicate with their friends and family and then you expand. And then it's building a website and have me before and after pictures, and then of course social media and we can talk about, you know, in the old days it was Facebook, then Instagram, now TikTok and others, and we can debate it all day long.

We can talk about the target audience. If you're looking for facelifts, it's Facebook perhaps, although now that's moving down. Anything we talk about today be antiquated tomorrow. Right. Except that, except my first premise. Patient care, quality and safety will never be antiquated. And the biggest disservice I see are these people jumping around like a bunch of non-knuckleheads and thinking they're going to track.

A bunch of patients and they will, short term, they will, but long term, if they're not delivering the goods, their history, and I've seen this over and over again. I remember when the internet was new and I performed my first webpage in 1994 and I remember being told by Harvey Zuru, patients will never find a doctor on a computer.

And that's the quote he used. And that's when he heard I had something called a webpage. And my first webpage I built in November, 1994 and it was three pages and I did it myself. And then I went on to build tons more. And then obviously had people helping me such as Ryan Miller and, and Max and Adam and so forth.

And that was the mainstay of it. And I still believe that's the lifeblood because it, that's where you can put the "before and afters" as a library and that's really what people want to see. But of course, that's not the whole answer. You need to have a social media presence. There's no question. And I'm, and I'm suggesting that everyone does that.

And at this point, having someone help you with it is probably essential to tell you the truth. One PR one surgeon can't do it.

Catherine Maley, MBA: Yeah, I agree. I think you've got to have that person walking around with the iPad and, and videotaping you the day in the life of a surgeon if they want you involved in that, because you guys are so busy to add this social media to it. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

And some of the surgeons who come on my podcast, they'll spend two to four hours a day on social media, and they're getting a lot from it. But on the other hand, their staff is worn out trying to come deal with all these, they're not leads their inquiries, you know, or whatever you want to call them. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Yeah. In today's world, I think you've got to triage what's coming at you. You know, because when the public's coming at you, wow, your staff's going to get burned out from the all the crazy, you know? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Yeah. Handle that. And it's a moving target, and it will continue to accelerate. The movements will not stop.

And we can't even imagine what's going to be out there next with AI and all kinds of things we're going to be seeing.

Catherine Maley, MBA: Yeah. AI's really interesting. I tried it myself and it wrote some pretty darn good blog posts. I was really surprised. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Isn't that incredible? I had it do, I had one of them doing one of my slide decks just to see how close it was.

The one I built. Yeah. And you know what, I got some great ideas from it. Mm-hmm. And I put it in my slide deck.

Catherine Maley, MBA: Yeah. I was, and then I think now Google's not going to appreciate my writing anymore because I live off of content. You know, I write a content a lot and now they're going to, they're not going to value it like they used to because they're going to think everyone did the ai and I think, where are we going with all of this? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

This is crazy, but interesting.

Grant Stevens, MD: R2-D2 is going to be writing all of our content. Yeah.

Catherine Maley, MBA: All right. So, I wanted to talk about competing because you are so good at differentiating and that's how you compete. You just differentiate yourself from everybody else. Would you please explain the “Marina Man Land”. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Oh, “Marina Man Land — Where a man can feel good about looking great!”

So, you know, historically men have occupied, occupied about 10 to 15% plastic surgeons of busy plastic surgeons practice for an aesthetics. And it varies. I know it can be less than 10, I know it can be over 15, but that's sort of the sweet spot. You can look at what the Aesthetic society might say, and I'm not sure the exact number they'll give you year to year, but that's kind of the range.

But I was convinced that that number could expand. But it was going to take a new way of thinking. About aesthetics and the male and the male's, a unique creature. And when I started with Cool Sculpting in 2009, if you could believe that I brought it into the Med Spa. And then I looked at my experience in 12.

I looked at the experience of 10, 11 and 12, 2000 10, 11, 12, and I learned a number of things and I wrote it up. It was published in August of 2013, the Aesthetic Surgery Journal. And what I found was that 74% of the people that came in my office in the first three years to for Cool Sculpting, had never been to Marina Plastic Surgery.

They had never heard of me. They'd never been there. I thought, well, that's kind of interesting. It's kind of a magnet. And they all wanted to lose a little fat. And then we drilled down lower further, and we looked at those people and we said, have you ever had anything aesthetic at all, including a medical grade facial?

And 84% had never had any aesthetic procedure. So, not only were they new to my practice, they were new to what I do for a living. And then I drilled down even further. And guess what? 41% of them were men. Huh? So, then I interviewed on Paper, 200 plus Men. I had over 200 responses, and I asked them what they liked and what they didn't like about being in my office.

This is before Man Land. I asked them, you know, what would stop them from coming? What would encourage them from coming in? Of course, we got the smart asses that, you know, would talk about, you know, beer, tap beer, and you know, topless women or whatever. We got all the crazy answers. But when I drilled through it, There were some absolute trends and consistencies guys hate sitting on couches.

Oh, amazing. This is almost like Eddie Yoon stuff. They love chairs. Yeah, they love leather, they love the smell of leather. They hate the smell of this fufu stuff That was pump pumping into my established reception area with all these women. Because I had been very successful with my model and I wasn't targeting men, but the men came in for CoolSculpting because I was running it on ESPN.

And the ESPN guys Mason and Ireland were talking about themselves getting it. So, I got a bunch of guys in the Lakers show and so forth, and that's what grew my men. But then I got a chance to find out what they wanted. They wanted a combination between a sports bar and a, a cigar lounge. They wanted flat screen TVs in every room.

They wanted to smell leather. They wanted to sit in chairs, not couches, and on and on and on. So, I decided, guess what? I'm going to build Marina man land like Disneyland. And it's the same fun where a man can feel good about looking great. And so, with that in mind, I put a flat screen on every single wall of every single structure of every single room, including the restroom.

I also put a standup urinal in the restroom, and I ran the Sports Illustrate bathing suit edition on the restroom television over the urinal, 24 hours a day it never turned off. Scantily clad bathing suit, bikini women from. Sports Illustrated? No. Topless, no. Cause it was all approved by Sports Illustrated.

And there's a little side story to that. We did it in darker colors, we did it in wood, we did a lot of leather. And I actually put together a proprietary smell that I pumped into the space because one of my thesises actually, when I, I was an experimental psychologist actually, and I studied olfactory stimulation as one of my oh my, one of my papers, actually, one of my research areas was the, the effect of olfactory stimulation.

So, I put together the smell of leather and cigars and one other proprietary smell that I never revealed, and I still haven't. I got a company to put it together and we pumped it in every single room except the bathroom. Mm-hmm. And., I remember I put pictures up in all the rooms with, with women and, and guys doing all kinds of fun stuff.

A lot of motorcycles and sports and horses and guns and all kinds of male stuff. Mm-hmm. And I brought my mom in before I opened the door. I didn't let a single woman in before I opened the door. I built this and no females were in it. I brought my mom in; she made me take down two of the pictures.

Okay. And that was fine. Okay. And we're good to go. And then we opened the doors. Now the amazing thing, not even men love it. And we had, you know, it was amazing. God rest us soul Larry King came all kinds of people. I just thought someone, I, I think it was on says Charlie came, you can fill in the blanks.

I had many of my friends and neighbors. Who came in and checked it out and loved it and loved it. How much free PR did you get from them and they, how much, what, how much free PR did you get from Oh my God, they did a thing on the, on the morning news show where what's her name? Harvey channel nine.

She was there the whole morning. They starred the news show in the morning and they kept cutting away for two or three hours. They cut away back to Marina Man land where a man can feel good about looking great. I had a rule, no one could say the name of MML without saying the tagline that I invented.

So, that's why I say it because I, my staff will go crazy if I don't say that when I say the name of M n l to. But we had so much media coverage actually when Larry came, Larry King came in one morning about nine in the morning to the regular office and said, Hey I understand you've got a s special place for men.

Can I see it? I said, boy, I'd love to take you, but I'm kind of tied up. Let me take you briefly and then my staff will take you around. I got a full office of patience. I took him back there. He would not stop talking about it. He couldn't believe I had a ural. He couldn't believe I had the sports illustrator thing.

I had so much fun with people just wanting to come in. And then lo and behold, they wanted Saturday hours. Then they wanted beer, then they wanted to smoke cigars. And of course, we can't do that. And I couldn't serve beer. But guys smuggled it in to have cool sculpting. And when I found it, of course I disposed of it.

But my staff would say, the guy back in such and such room, he's drinking beer out of a whatever. And I'd say, dude, you can't do that, man. But it was so cool. And guys would sit around in their leather chairs and the number one question was, Hey dude, what are you in for? It was like, it was like a prison, but it was what you in for.

And I also played a lot of pre and post-op stuff because the wives sent them enzyme sometimes and the guys would watch stuff that they didn't know could happen. A lot of guys are not as well versed as women and they would say, Hey Doc, what happened on that patient? Back in on, I we had photo books there.

It was absolutely incredible to me the naivety of so many men. They might be there to lose a couple inches with cool sculpting, but boy, they morphed into surgery like you wouldn't believe. One quarter in 2015, 51% of our patients were men of, of the coast company. It was unheard. The baseline was 10 to 15%.

As I told you, it was 41% in our first three years and one quarter we eclipsed 50%. We went to 51. We didn't do it after that. But that was the one quarter yeah, marina Man land. It was a ton of fun building. We kept morphing it. It's a ton of fun now. We got tons of media coverage. Yeah. And I'd love to talk to anybody who has questions about it.

It's, it's a big deal.

Catherine Maley, MBA: Yeah. It was really cool. What do you think about the patients today? How much have they changed from, let's say pre-social media? Have they changed much? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Oh, yeah, they changed a ton. So, so how, A couple ways. So, as you know, the average age is going down mm-hmm. In general, and we have released some statistics on that last week.

So, the average age of a consumer getting a non-surgical has dropped 10 years in like two. That's one big difference. If you look at a picture of a person from 10, 15, no, 20 years ago, a 50-year-old person compared to now, or even better yet, a 70-year-old person today versus a 70-year-old person 30 years ago.

Mm-hmm. It's remarkable how different they look. Mm-hmm. And a lot of that is aesthetics, but not, not all. I mean, skincare, it's health, overall health and wellness. So, we have people come in saying in the, well, I did years ago, say, well, I'm 65, this is my la I'm going to have a face that, but I'll never be here again.

I remember hearing it over and over. I saw an 83-year-old woman on March 22nd, 2020, no, 20 March 21st, 2022. And I know that because I walked in and I announced I had just done my last surgery. Yeah. And she turned to me and she said, no, that's not true. You're going to do my surgery tomorrow. I said, no, I'm done.

I just did. My friend's daughter, you'll have to talk to Justin Perez about it. She said, Nope, you're going to do my surgery tomorrow. I said, ma'am, I'm sorry. Sorry kids. I said to Maria, what, who exactly is this? So, she said, you know, you don't remember, but over 20 years ago you did my first surgery. It was my breast augmentation.

And then about 10 years later, when I was 70, I told you, this is my last time. And I, you did my tummy tuck and you didn't touch my bra. Oh. And my facelift, you did my tummy tuck and facelift. And I told you with certainty that I would never be here again. And now I'm 83 and I'm here. And I, my face looks great.

My tummy's still flat. And she picked up her blouse, she pulled up her bra and her breast fell down and she said, these puppies, this is her. These puppies need to be lifted and smaller. 83. She then turns to me and says, I'm sexually active. My husband and I want you to do this, and I care about how I look.

And you were her and you were right. You told me. I would always care because if I cared at 60, I'd car at 70. If I cared at 70, I cared 80. And that's the difference in the consumer. They're the super consumers.

Catherine Maley, MBA: And I can assure I'm in that group. My vanity knows no bounds. Every time I say I'm not going to do something, I hit that age and I completely change my mind and say, no, no.

I'm, I need another five years getting used to this “Getting older”.

Grant Stevens, MD: Absolutely. I'm doing my eyelids this year and I'm turning 70 this year. So, there you go. You know we're going to go down kicking and screaming. We're the boom. We are not. It's going to fade away into the sunset. Yep. You know, we've got Keith Richards and Mick Jagger and Bruce Springsteen ahead of us.

Mm-hmm. And we are not giving up hear It's, and you know that's when you're talking about differences, there's part of the differences. Yeah. We're not tolerating the, we don't, we know we're getting older, but we're not going to look older. Well, we're going to try our best not to. Yeah. Stay in shape, eat good food work out, have a healthy lifestyle, and have plenty of aesthetic services.

Non-surgical for the most part. Yep. And then every now and then have a little nip and tuck and that's the difference. And that's my game plan. Yep. That also creates the other thing, I built a private door to my big office for the stars and for the people that were embarrassed, guess what? In the last decade, it had cobwebs.

No. Used it. Even the stars didn't use it. Mm. And I rattle off the names of tons of them, and they didn't use it. They didn't care. They were signing autographs for God's sakes. And they're on social media. It's crazy. So, the privacy thing that the stigma of having aesthetic plastic surgery or aesthetic cosmetic services, it doesn't exist anymore.

Catherine Maley, MBA: Yeah. I have no qualms about saying all the, oh my God, I've had so much done. It's crazy. And I'm 65 and I don't want to look like my grandmother at 65. I just, I can't get there. I'm, I'm going, I'm going kicking and screaming with you.

Grant Stevens, MD: Yeah. Why don't you pull a picture out of your grandma at 65, take it and put it side by side with you in marketing this talk and say Steven said, you are not your mother.

You're not your grandmother. Exactly.

Catherine Maley, MBA: Okay. I'll do that. I'll do an Instagram post as well on that, and I'll tag you.

Grant Stevens, MD: because My sister-in-law did that recently. She took a picture of her grandma, same age of as, as this woman is, and it was so funny. I swear to you, they're the same age and you look at them and the other one looks 20, 25 years older.

It's crazy.

Catherine Maley, MBA: Right? So, to wrap it up is there, like, if you were going to give, cause this audience is basically surgeons and residents and fellows and it's more b2b, let's say. What, what advice would you give, not just the newbies, but people who have even like some of the surgeons who have been practicing for 20 years saying, what has happened here? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

I don't know where I'm going with all of this. Any advice for them to stay in the game because some of them aren't tired? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, obviously I touched on some of it and I still believe, I still believe. That we are physicians, the surgeons first. I still believe the crux of it, the core of it is being the best physician and surgeon.

But I know that's not where you're going with this. You're talking about sort of practice success and marketing success and so forth. But I, the number one thing is that but also home, the road less travel. I have a T-shirt and I have a whole mantra that always be yourself unless you can be a pirate and, and then always be a pirate.

And what I mean by that, and I didn't make that up. I read it. Okay. And I, but I use it. It's on t-shirts, it's on mugs, it's everywhere.

Catherine Maley, MBA: All I can think of is Johnny Depp right now. So, where are you going with the buyer thing? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Yeah. Well, I am certainly a pirate and so is it's funny. So, is Eddie Yun, and I didn't even know, used that pirate analogy till we got together.

If you do what everyone else does, you are bound for mediocrity. So, the toughest thing, especially surgeons and physicians, they're, they're not the most creative people and they do follow rules and that's good. And we want our doctors to follow rules and we want our doctors to be safe, number one. But it turns out you're asking me what advice I give my fellows, and I have all 40 fellows, about 39 or FO 40.

First be safe and, and, and, and the best surgeon, but think outside the box. Think of ways that other people haven't done it. Don't do it the same way I did it. Don't do it the same way your neighbor does it. If, if you do, that's fine, but. It's a guaranteed of mediocrity and it's a guarantee with one of —

Catherine Maley, MBA: Have you always thought this way, this open? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

You are so entrepreneurial and open-minded and creative. And that's not normal for surgeons. You, you, you had to be pretty conservative and go by the books when you're becoming a surgeon. But then you have to ship gears and now be creative and that's, can you make that shift, you know? How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Well, I've always been an entrepreneur.

When I was four years old, I had a tomato route When I was five years old, I had an egg route. When I was seven years old, I had a paper route. When I was nine years old, I had four paperboys working for you. For me, I mean, and so forth. I've always been an entrepreneur. I just happened to love science and people.

And I went to med school and I came from a degree in psychology because I really love people and art and. I recognize because I interview all the fellows, I in residents, and I recognize I'm a unicorn. I reco. So, I call myself a pyro. But I'm telling you right now, these are the best and brightest people that I see.

These plastic surgeons and Platy residents are so much brighter than I ever was and at am and they need to think outside the box and not be afraid of it. Not be frightened by it. Again, start with best patient care and then think of ways in which they can put themselves on the map. You know, the other thing is the golden rule.

You know, your mother taught you before you went to, to in kindergarten, if you're fortunate enough to have a mother. Some of us weren't. I did have a wonderful mother, but do unto others as you would have them do under you, right? So, if you live by that credo, And you're a great surgeon. You just, everything follows thereafter and you'll be criticized for sure.

I remember I was criticized for my seminars and for all kinds of crazy things I could go into forever. But, but I, you asked for advice. My advice is think outside the box. Do creative things. Hey, and if it is TikTok, God bless you. Let it be TikTok. That's just not my gig. Right. And I'll, I'll respect the fact that that's what you chose to do.

And you'll get a bunch of patients, but then you better take great care of them because number one, they're getting home and tell their sister. And if you screw up, they're going to tell their sister. And bad news goes way faster than good news. The other thing is, you know, I'm not sure how much these guys are and gals are taking business school, but.

It takes a lot more effort to get a new patient than to keep a patient in the practice or the dry cleaners. It's oftentimes said it's seven times more expensive, sometimes eight. I've heard 10, but it's a big multiple. Yeah. So, keep the patient in your practice for God's sakes. Don't keep patients for life.

Don't just be a breast dog guy and just rotate and go around round, round, round. Keep them in there. Keep them in non surgicals. Even if you specialize, say in breasts or whatever, bring them in for non surgicals. Get someone else to do body or face, but keep them in your practice. It's far cheaper than acquiring new people.

That is a key part of being successful in.

Catherine Maley, MBA: I'm so glad you said that. That has been my main message for the last 23 years, working with plastic surgeons, patients through life. It's cheaper, easier, they convert better. They give you that patient flywheel. If you get it right, it, there's no more, you're not advertising 10 times what you need to because you've got the patients doing it for you. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

I'm just glad you said that. Thank you. And so, for the last question, tell us something we don’t know about you.

Grant Stevens, MD: I love my doodles. I have three double doodles. I have tuxedo, I have blaze, and now I have little Gucci. Tuxedo is a double doodle, which is a cross between a golden doodle and a Labradoodle from American hunting doodles in Portland. One of his little nephews is Blaze and he has Tuxedo is named Tuxedo because he's a white spot here in his chest.

And he looked like a tuxedo when I first got him. And Simeon Wall gave him to me. Dr. Sin Wall gave him to me as a gift. Can you believe that? Did you want another dog? I had so many dogs up at the ranch. I never even dreamt of having another dog. He said on a Sunday, go down to Alaska Air Freight. I'm sending you a puppy as a thank you.

And I said, Simeon, I live at the beach. I don't need another dog. I have dogs. I've got 31 Labradors up at the ranch. I don't need a dog. He said, just go get it. It's Jelly's brother. I fell in love instantly. And Tux has been my sidekick, along with Aaron. Aaron Stevens, I might add. And, and Tux has been our sidekick only.

And then we got Blaze. And Blaze has the blaze pattern of horses. Of those of you who are who know horses, blaze is the white face and the white chest. And he's lovely. And he's tux is nephew. And then finally, recently we got Gucci, the first girl in the, in the deal. And Erin wanted Gucci. She fell in love with Gucci online, called up Scott Ferrell, who owns American hunting doodles.

And we were blessed to have Gucci. And she's down here in Manhattan Beach and she's in the Puppy Academy here in Osa Beach. And the other two are up waiting for me to go back to Sun Valley. I'm living in Sun Valley most of the time. I'm. Beach here temporarily to see a couple people and do a little business with companies, you know.

Catherine Maley, MBA: Okay. Well congratulations. I didn't realize you got married.

Grant Stevens, MD: Yeah, well, we're not married. Oh, no. We have the same last name. She changed her name and we're domestic partners for now. We haven't had wedding yet, but we just got Enough is enough. And so, it's Erin and Grant Stevens, and we're so happy.

And we'll announce when we have the marriage and the wedding.

Catherine Maley, MBA: I think you had to tell Google, because you know what happened when I was researching you today, I just put in like, grant Stevens, MD Surgeon, California Grant, Steven's wives, and you have four wives. You have photo. Yeah, you have four wives.

One of them was your old you know practice manager and then the others, I think. I don't know. But anyway, it looks like you had four wives, so I, you might want to tell Google that. How dare you. There's only Karen.

Grant Stevens, MD: Okay, let's be perfectly clear. My practice manager was never my wife. Let's get that clear.

Catherine Maley, MBA: Well, Google doesn't think so.

Grant Stevens, MD: Well, I'm going to go check out and find out. So, I did have one wife before. Right. And a wonderful marriage. And that ended like for 30 years, right? 34-year months. That's a good run. Good for you. Yeah. Wonderful. And then I'm in the second phase and then I was working with and, and getting to know Erin and we've been together for many years now and so forth.

And we are domestic partners and we will be getting married and we couldn't be happier.

Catherine Maley, MBA: Ah, well Congrats you have Yeah, go ahead.

Grant Stevens, MD: I've seen that about Google, but I'll go on as soon as we're done right now Cause I, I've never had, I, I've only had one. My, I don't have four wives.

Catherine Maley, MBA: I know. I was offended for you.

I said, this is, this is misinformation. But anyway, I just, I'm, I'm so pleased to see how you have transitioned because that's what a lot of the surgeons I hang around with, they're trying to figure out what do I do now? Like what do I do with this practice that I'm kind of ready to wind down, you know?

And look at all the options that, I mean, I hope everyone's clear that they have so many options. They can work with industry, they can work with business, they can work with vendors. They can do real estate. There's a lot of things you can do. You don't just have to be a surgeon anymore. So, think outside the box. How does this relate to this episode’s title of “Insights From Grant Stevens, MD?

Grant Stevens, MD: Right? And the, you asked about advice number one. I would check out Engage Technologies. It will help. What is that? Well, hold on. And number two, I would use Patient five for all your patient financing. And number three, I would use subscription aesthetic services, the best of which is Privi, P R I V I. That is.

Without a doubt, the very best you get paid the very next day after you do the services, you don't chase down the patients, you will double your, your volume and double your patient revenue. I can show you from the Hi MD experience, I'll be talking about this to the Aesthetic Society and in octane in Nashville and, and other meetings coming up.

It, it will change everything in your practice. Okay.

Catherine Maley, MBA: That's enough of that. You're the only one who's been allowed to promote stuff, so we're okay. Yeah, we're a clean podcast here.

Grant Stevens, MD: That's fine. You asked me what I do and I help them. They're going to hear me talk about it anyways. For sure. You can cut it out if you want.

Catherine Maley, MBA: No, no, no, it's fine. Alright, well thank you so much Dr. Stevens. I do hope to see you someday. I'm, I'm just —

Grant Stevens, MD: So, hopefully get the next meeting?

Catherine Maley, MBA: Well, that's not going to happen, but maybe the next, next one. So, everyone with that I'm going to wrap up Beauty and the Biz and Dr. Stevens, if somebody did want to get ahold of you, what's the best way?

Grant Stevens, MD: drstevens@hotmail.com. drstevens@hotmail.com or stevensgrant13@gmail.com. They don't like Hotmail. My daughter gives me grief about being on Hotmail.

Catherine Maley, MBA: I have not heard Hotmail in a long time. Yeah, but I'm glad you went Gmail eventually. So, good for you and thanks again for sharing your insights, Dr. Grant Stevens.

Grant Stevens, MD: They both worked. They both get.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on insights from Grant Stevens, MD.

If you’ve got any questions or feedback for Dr. Stevens, you can reach out to his website at, www.MarinaPlasticSurgery.com.

A big thanks for sharing his insights from Grant Stevens, MD.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Insights From Grant Stevens, MD”.

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

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📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and my 10 top practice pearls.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "200th Episode — 10 Top Practice Pearls".

Time really does fly. I am so excited to record this 200th episode of the Beauty and the Biz Podcast. 

Four years ago, the Beauty and the Biz Podcast was created to talk about the business and marketing side of plastic surgery, and it’s been a great ride. 

It’s fascinating to hear how every practice is unique and runs differently because each surgeon is different in their beliefs, perceptions, understandings, and past experiences.

This week’s Beauty and the Biz podcast is a compilation of the 10 Top Practice Pearls I gleaned from my guest interviews that you will find thought-provoking and even mind-bending. 

Thank you so much for following my work and enjoy!

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

200th Episode – 10 Top Practice Pearls

Time really does fly. I am so excited to record this 200th episode – 10 top practice pearls of Beauty and the Biz. Four years ago, the Beauty and the Biz Podcast was created to talk about the business and marketing side of plastic surgery, and it’s been a great ride.

It’s fascinating to hear how every practice is unique and runs differently because each surgeon is different in their beliefs, perceptions, understandings, and past experiences.

The majority of surgeons I interview are in solo practice, so they have the freedom to build and control their practice as they see fit.

However, there’s a flip-side. It can be a lonely existence. You live in your own myopic world with no one to bounce ideas off, so you can easily lose perspective and waste time and money guessing what to do next to grow your practice.

There’s also a lot of fear around financial failure. Even though you’ve had years of training to be a surgeon, you have not had equal amounts of training on running a business, leading a team, managing staff, working with fickle cosmetic patients, and marketing yourself in an uber competitive marketplace.

That’s why the Beauty and the Biz Podcast came about. It’s a resource for you to learn from others who have been there and done that. Their challenges, opportunities, insights, mistakes, and wins.

I did the Top 10 Take-a-Ways from the FIRST 100 podcasts on episode #100, that you may want to go back and listen to since it’s full of good stuff, so I went through the last 100 podcasts and pulled out 10 more Top Practice Pearls and here they are:

Top Practice Pearl #1:

Build a Brand You Are Proud Of

Branding is how you present your practice to the world. It’s how you build connection with prospective cosmetic patients. It’s the way you’re seen through their eyes, which is a key point in my 10 top practice pearls.

It’s your persona. It tells prospective patients what to expect from you in terms of quality, service, results, and price.

Branding is more than just your logo and website.

It’s your story. Who you are, where you came from, why you became a surgeon, what you stand for, as well as your core beliefs and values.

It’s your vision and your mission statement on your website that you and your team actually live by consistently.

It’s your reviews, social media, before/after photos and your streamlined processes.

It’s all facets of your practice representing you including your location, office, furniture and details count: It’s Your hair, clothes, shoes, as well as your staff’s hair, clothes, shoes and so on.

The point is to be who you want to attract. If you don’t want price-shoppers who haggle with you, invest in your own high-end brand to attract high-end patients. It’s that simple.

Top Practice Pearl #2:

Don’t Hope for New Patients – Market for New Patients!

A successful cosmetic practice is not happening by accident or by luck. They are doing something to make that happen. In today’s competitive world, top practices execute many strategies to attract new patients, which is a key point in my 10 top practice pearls. For example….

They enhance their online presence by updating their website look, making it mobile friendly, adding social media buttons and B/A photos and videos. They consistently add fresh, updated content that is informative, entertaining, and compelling because that’s how you increase your digital footprint on the Internet.

They open their mind and embrace new marketing strategies such as Instagram Reels, YouTube Shorts and Facebook Lives since video is hot!

They have a marketing team of 1 or an agency with a good video editor they meet with regularly to plan and create content, so they are active on social media.

They may even start a podcast and/or patient webinar to educate consumer patients on their services.

And reviews, B/A photos and referrals are a priority. They focus on their patient relationships and the journey the patient has with them because they realize that’s where reviews and referrals come from.

BTW, the surgeons who have thousands of before/after photos on their website got them because they asked the patients themselves. Typically, 1/3 said yes, 1/3 said yes with restrictions such as don’t show their face or only show them in the office and 1/3 declined.

The top practices typically have an ad budget and plan since organic SEO has become more challenging, so they need to advertise. However, they watch those numbers carefully to be sure they are at least breaking even, since they can make it back with valuable patients returning, referring, and reviewing.

Top Practice Pearl #3:

Automatic Marketing System

The top practices use marketing automation to map out automatic marketing plans with funnels, email automation, SEO, landing pages, opt-in forms and follow-up sequences to handle incoming leads more efficiently, which is a key point in my 10 top practice pearls.

They realize this is a numbers game and not all leads are equal, so they get help setting up technology to triage and respond accordingly.

And they also train their staff and hold them accountable on their lead gen process, so staff is clear where they fit into the system. This also frees up their staff to focus on priority leads and great customer service.

Before I go on, I want to comment on these first 3 pearls. Branding, advertising and marketing cost money. Hiring enough staff and the right staff costs money. But surgeons hate to lose money.  So, they skimp in these areas and wonder why their competitors are doing better. The answer is because the top practices invest in their growth and hire the best they can afford. It’s a mindset shift worth considering.

Top Practice Pearl #4:

Get Good at the Fundamentals

The biggest problem holding you back might be your narrow focus on "getting more leads". You might be throwing a ton of money at SEO, google AdWords, social advertising and directories OR you’re spending a ton of time creating content for your Instagram and Facebook followers.

Yes, it’s exciting to get lots of leads and comments but here’s the kicker…Leads are only one part of it.

These leads need to be converted because if you can't monetize these leads, then you're throwing money down the drain, , which is a key point in my 10 top practice pearls.

The top practices know this and focus on all 5 key areas to attract and convert patients. That includes:

• Lead Generation
• Converting callers into appointments­­­­
• Converting appointments into procedures
• Ensuring the patient is comfortable throughout the process and gets a good result
• So they become a raving fan who refers, reviews, returns and shares you on social media

That’s how you build a practice flywheel that keeps your practice humming along, so instead of buying a new $150K laser and hoping new patients flock to it, you fix your phones and train your coordinator to convert consultation to give yourself a $500K+ raise because you are not losing high value patients trying to give you money.

Top Practice Pearl #5:

Surround Yourself with A-Players

Staffing issues will be one of your biggest challenges when running a cosmetic practice. Miss hires cost you a fortune in time, money, sleepless nights, and bad mojo in the office, , which is a key point in my 10 top practice pearls.

On the other hand, (1) A-Player will produce more than (3) of the miss hires so the top practices spend more time finding, training, and retaining top producers than fiddling with those who are not up for the challenge.

They get the right people on the bus and in the right seats, they give the right tools to do their job quickly and efficiently and they hold them accountable with metrics and evaluations.

They make it a priority to develop a positive culture that employees enjoy and are loyal to, because a negative culture creates angry or frustrated employees, poor communication, lack of passion, and staff feeling underpaid, overworked, and unappreciated.  

They treat staff as a revenue-generating asset, rather than an overhead cost because they know their staff is their differentiator. They also acknowledge and recognize their staff with perks, bonuses, and fun.

Top Practice Pearl #6:

Predictable Revenue Streams

The top practices realize the value of cosmetic patients who want to look good today, next month, next year and for years to come, , which is a key point in my 10 top practice pearls.

So, While surgery is their main focus, there is much money left on the table when that patient is treated as a “one and done” rather than as a “patient for life”.

It’s getting too confusing, expensive and time intensive to constantly refresh with brand new stranger patients, so the top practices offer a loyalty/rewards program to nurture their patients to return, refer, review, approve their B/A photos and share you on social media with their friends and followers.

This gives them a competitive edge because it costs a fortune to attract a new patient and almost nothing to keep that patient loyal to you without spending a dime on advertising.

BTW, I can help you with that so let me know.

Top Practice Pearl #7:

Embrace Change

The top practices are not only good with change – they embrace it. They see challenges as opportunities to learn and grow. To improve their practice and better their best. To learn new skills, , which is a key point in my 10 top practice pearls.

To take calculated risk, but plan for the unknown.

They face many challenges, but they keep their optimism that the future will be good and that gives them strength to tackle problems.

They are adaptable and able to abandon their old ways in favor of where the world is moving, i.e., they go digital and embrace social media and video.

They believe they have control and the power to shape their destiny. They depend more on themselves than on the whims of the world.

Top Practice Pearl #8:

Lead the Team

There’s a popular business quote from Peter Drucker that says,

“Only three things happen naturally in organizations:
friction, confusion, and underperformance. Everything else requires leadership.”

The top practices know that success starts at the top. They take responsibility for their wins and their losses and look at failure as feedback and keep on going.

They have passion and love for what they do and are driven to build a successful practice.
They push themselves and their staff to excellence.

They study leadership principles and lead by example.

They are decisive and communicate clearly and meet regularly with their team to talk about their vision, values and goals.

They celebrate their wins, while acknowledging and appreciating their team.

They collaborate with their team and see this as a group effort since they can’t do it alone.

Note: Every top practice I have interviewed on Beauty and the Biz is giving back. It makes them feel good, it gives their staff a bigger “Why” and it’s also good for their brand, which is a key point in my 10 top practice pearls. Just saying.

Top Practice Pearl #9:

Resilience is a Skill

Resilience is defined as the capacity to withstand or to recover quickly from difficulties and challenges through mental, emotional, and behavioral flexibility and adjustment to external and internal demands, which is a key point in my 10 top practice pearls.

The surgeons running the top practices have resilience. They have bounced back from all sorts of setbacks including partnerships breaking up after working together for years, having long-term office managers abruptly quit, rogue associate causing drama in the office, embezzlement, frivolous lawsuits, illness, hurricanes, build-out permit delays, and it goes on and on.

But no matter what, they get back up, dust themselves off and get back at it. They know this is just a part of doing business and they keep their focus on the end result and solutions. They also turn to their trust advisors, colleagues, and friends for guidance.

AND LASTLY,

Top Practice Pearl #10:

Streamline, Scale and/or Sell

The top practices use their business and marketing skills to set up an efficient money-making machine that runs smoothly. They streamline their processes and have others manage the practice while they lead the way and oversee the numbers, which is a key point in my 10 top practice pearls.

Then they scale to have predictable revenue streams that are transferable. They set up profit centers and bring on other revenue producers to build value and revenues that are not dependent on them.  Because the surgeons in the top practices are thinking ahead.

They ask early, “How do I get off this treadmill and get my equity out when it’s time?”

They plan to have enough money to retire WELL and not have to step down in their lifestyle.

But oftentimes, their income is their lifestyle. Their assets become their wealth.

But they discover you make it on equity – not on income so they find investments that build their equity that is NOT dependent on them.

The current trend is private equity coming into plastic surgery practices and consolidating administrative areas such as payroll, HR, benefits, hiring, negotiating purchasing contracts for economies of scale and so on.

The practices that join the group build up their value by decreasing their overhead costs and streamlining their processes for increased efficiency, so they build equity to secure their future.

Stay tuned since I’ll have more guests on Beauty and the Biz talking about this, so you know your options.

And there you have it!

the Top 10 practice pearls I gleaned from the surgeons I interviewed in the last 100 episodes.

Thank you so much for listening. I appreciate your interest and I’m working on the next 100 episodes so be sure to subscribe.

And, of course, please contact me if you could use some guidance OR, if you are looking for unbiased strategies to grow your practice, check out the www.CosmeticPracticeVault.com guaranteed to get you more patients and profits,

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on my 10 top practice pearls.

And if you have any questions or feedback for me on my 10 top practice pearls, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “200th Episode — 10 Top Practice Pearls”.

 

A special thanks to all of my guest speakers over the past 100 episodes!

103 Kristi Hustak, MD https://kristihustakmd.com/

104 Philip J. Miller, MD, FACS http://www.drphilipmiller.com/

105 William P. Adams, MD https://www.dr-adams.com/

108 Michael T. Somenek MD https://somenekpittmanmd.com/

108 Troy A. Pittman MD FACS https://somenekpittmanmd.com/

109 Randy Waldman, MD https://www.waldmanplasticsurgery.com/

112 Dr. Andres Gantous https://www.torontofacialplastic.com/

118 Dr. Marco Pelosi III https://pelosimedicalcenter.com/

120 Dr. Angela Sturm https://drangelasturm.com/

122 Dr. Stanley Okoro, MD https://www.georgiaplastic.com/

126 Frank L. Stile, MD, FACS https://www.drstile.com/

135 Harvey Cole, III, MD https://oculusplasticsurgery.com/

137 P. Daniel Ward, MD https://www.wardmd.com/

139 Edwin Williams, MD http://www.williamsfacialsurgery.com/

141 Lauren Umstattd, MD https://faceleawood.com/

143 David Mandell, JD, MBA https://www.ojmgroup.com/

146 Robert Singer, MD https://www.primeplasticsurgery.com/

147 Joe Niamtu, DMD https://www.lovethatface.com/

149 Lionel Meadows, MD https://www.meadowssurgicalarts.com/

151 Brock Ridenour, MD https://www.ridenourplasticsurgery.com/

155 Mark Beaty, MD https://www.beatymd.com/

157 Michael Persky, MD https://www.drpersky.com/

159 Carlos Mata, MD https://www.naturalresultsaz.com/

161 Bradford Bader, MD https://www.baderfacialplastics.com/

163 Sheila Barbarino, MD https://barbarinosurgicalarts.com/

164 Diana Ponsky, MD https://www.drdianaponsky.com/

166 Charles Boyd, MD https://www.boydbeauty.com/

167 Paul M. Parker, MD https://www.parkercenter.net/

168 Jeffrey Spiegel, MD https://www.drspiegel.com/

170 Sam P. Most, MD https://med.stanford.edu/drmost/about-us/meet-dr-most.html

171 Jennifer Levine, MD https://www.drjenniferlevine.com/

172 Alexander Rivkin, MD https://westsideaesthetics.com/

173 Steven Camp, MD https://www.campplasticsurgery.com/

175 Kristina Zakhary, MD https://facialcosmeticsurgery.ca/

176 Lamar Rutherford, MBA https://excellenssolutions.com/

177 Jason S. Hamilton, MD https://blacknosejob.com/

178 Thomas P. Sterry, MD https://www.drsterry.com/

179 Giancarlo Zuliani, MD https://www.zulianimd.com/

182 Jeremy Warner, MD https://warnerplasticsurgery.com/

186 Burke Robinson, MD https://www.robinsonfps.com/

187 Lawrence B. Keller, CFP https://www.physicianfinancialservices.com/

188 Jason Pozner, MD https://www.sanctuarymedical.com/

189 Ryan Neinstein, MD https://neinsteinplasticsurgery.com/

190 Gregory Mueller, MD https://drgregmueller.com/

192 Nicholas K. Howland, MD https://howlandplasticsurgery.com/ 193 Sam Lam, MD https://www.lamfacialplastics.com/

194 Lisa Marie Wark, MBA https://www.lisamariewark.com/

195 Jason Bloom, MD https://www.bloomfacialplastics.com/

196 Emily Hartmann, MD https://www.beautyeternalchico.com/ 198 Jeffrey J. Segal, MD, JD https://byrdadatto.com/ 

199 David Kaufman, MD https://www.thenaturalresult.com/

 

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how outsourcing is trending.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "Outsourcing is Trending — with David Kaufman, MD".

There is a trend happening in our industry to outsource the parts of your practice that you don’t enjoy doing such as:

• HR
• Benefits
• Management
• Inventory and so on

Its popular in other industries to consolidate these tasks for increased efficiency as well as economies of scale to decrease overhead costs.

This week’s Beauty and the Biz Podcast is an interview I did with David Kaufman, MD who is a board-certified plastic surgeon in private practice in Fresno, CA.

He is in the process of transitioning his practice to allow him to focus on surgery versus the business side of surgery. 

He explains what he gains and what he loses when he hands off this part of this practice and how this outsourcing is trending amongst cosmetic practices.

So interesting…

Visit Dr. Kaufman’s website

Enjoy!

Catherine Maley, MBA

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Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

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"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

Outsourcing is Trending — with David Kaufman, MD

Catherine Maley, MBA: Hello everyone and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery. I'm your host, Catherine Maley, author of "Your aesthetic practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits.

Now I have a really special guest today. He was on here before, but he came back for a new topic on how outsourcing is trending amongst cosmetic practices. It's Dr. David Kaufman. Now he's a board-certified plastic surgeon in private practice in Folsom, California. And for those of you who know, it's near Sacramento, California. So, he's been on Beauty and the Biz before.

But this time we're going to talk about a new trend that we're calling private equity and plastic surgery, and how those two fit together. Dr. Kaufman, welcome to Beauty and the Biz.

David Kaufman, MD: Thanks for having me back, Catherine.

Catherine Maley, MBA: Sure. So, let's just start with, just describe the, your practice that you have right now in Folsom. How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Sure. So, we have a, a primarily cosmetic practice. It's basically full service, aesthetic surgery. So, we currently have three surgeons under roof. I've been here for 16 years. My associate, my senior associate's been here for five. And then we just brought on a new surgeon a few months. So, like I said, now there's three of us.

We have a med spa that does really pretty well. We've got two nurse injectors and an esthetician. And then we have two operating rooms. We have a 13,000 square foot building and you know, we're just living the train here in California.

Catherine Maley, MBA: Yeah, me too. Yeah. So, I didn't realize you brought on another surgeon. How has this factored in with your understanding that outsourcing is trending?

Good for you. Wow.

David Kaufman, MD: She's great and she's a she, which is a differentiator. You know, I think for us that was a nice gap in our practice that we didn't have before.

Catherine Maley, MBA: And are they associates, as in contractors, partners, what? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: They're employ, they're employed surgeons, so, they're employees.

Catherine Maley, MBA: Gotcha. Okay, so, let's talk about private equity.

This subject keeps coming up and I'm so, glad you are in the middle of it and you can help under help us understand it because I'm hearing different stories about it and what, what is private equity and how does that fit with plastic surgery?

David Kaufman, MD: That's a great question and that's hopefully what we're here to talk about today.

So, certainly that's a trend in plastic surgery. Our practice recently underwent a, what I call a strategic partnership, where we joined another group of practices. They have private equity backing, so, we're not directly contracting with private equity, but there are certainly some practices out there now that are being acquired by private equity groups to roll up practices and then create some economies of scale.

And obviously the private equities plan is to then sell them again, hopefully for a profit. You know, if I look at my personal situation, I turn 57 this week. Oh, by the way, ha. Happy birthday, Catherine. You too. And then, you know, if you look at historically the exit strategy for plastic surgeon is not great.

Typically, you know, plastic surgeons who to close down their practice or sell their practice to a junior associate for what might be, you know, one EBITDA or even less. You know, if you look at what private equity brings to the table, they're certainly bringing in. To take some equity off the table, but they also have a much better sense of how to run a business.

At this point, we have 35 employees and, you know, we're now a big business. We're not just a little mom and pop shop anymore. And our hope, at least in our perspective, is to be able to draw on the experience of these larger firms to consolidate HR, consolidate payroll, improved purchasing, create some economies of scale, and really take a small company and.

Run like a, a big, more efficient company. So, what turned me onto this was actually when I listened to your podcast, I heard Dr. Singer and he's actually the group that I ultimately ended up joining. Okay. But certainly, in medicine, these rollups I've worked across dermatology, across GI, across cardiology and, and others.

So, this is a thing. It's happening and even with a pretty tight debt markets transactions are still, still happen.

Catherine Maley, MBA: Let me just ask a stupid question. Is this a roll up business? Are you selling your practice in, in essence, are you selling your practice to private equity? So, then they build it up for you so, then everybody can roll up all of these practices and then sell it again like, and then you all leave with money, right? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: So, there's different strategies, of course, but at a very basic level, if a private equity firm comes. They will acquire part of your practice, there's going to be an expectation that you will stay on and re retain some equity. The goal then, though, is to aggregate profitability because let's say your practice has a profit of $1, it's really not worth that much on the open market.

Mm-hmm. If your practice has a profit of $10, that becomes more interesting to bigger private equity firms and your multiple of EBIT, it becomes. So, you know, the goal is to aggregate practices, to create greater EBITDA, to create efficiencies across the different practices and then create a much more interesting platform to purchase for another group.

Or in theory you could go public, but you know, I think the second private equity play for bigger firms is probably the most likely play.

Catherine Maley, MBA: Gotcha. By the way, he's saying EBITDA, just in case you don't know what that is. It's earnings before interest taxes and amortization. Yes. And that becomes really important, that word, when you're trying to create value for somebody else. How has this factored in with your understanding that outsourcing is trending?

Yes. To buy. So, is this your practice buying into here? Here's why I say this. I do real estate syndication. And the way you do those is a bunch of people who have extra money, they get together and they put in like how much they want, a hundred thousand, 200,000 for, and somebody has found the property.

There's going to, it's apartment rentals. So, somebody has found this property with two or 300, 400 units, and they can't buy it on their own. So, they get a bunch of investors together. We all put in ours. And then they buy it and they manage it and we're passive income, so, we're not involved. They make all the decisions, but when it's comes time to sell it, then we all get our money back, hopefully, and then a whole lot more with it, or it's affinity.

We try to hang onto that forever as a cash producing asset and then we never leave, you know? Right. Because well, we get our money back. Is it like that or is it something?

David Kaufman, MD: I wouldn't say it's like that. Okay. So, in this instance, and in most instances of, at least my friends that have done this, they sell some interest in their practice and they retain some interest.

Ah, the goal, of course, is to continue producing and creating value to the overall company. And then when the company sells, I eat that proverbial second bite of the apple. What's called rollover equity would be even more valuable than it's at the time of the original transaction. Most of these transactions are structured in that you roll over 20 to 40% of your purchase price.

And the reason why they do that is, you know, in plastic surgery you are the value. It's not like a management company where a manage management or a manager could be. I can't be replaced very easily and I'm not irreplaceable, but there would be a lot of value out loss if I left. So, the goal is to take some equity off the table with a cash and close, but then, you know, build a company so, that the role of equity becomes also a very valuable consideration down the road.

Catherine Maley, MBA: Gotcha. So, why would a surgeon want to do this? Let's do the pros and the cons. Why would you want to? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: So, the pros are, you know, there's a lot of pros and granted, I'm fairly new into this, you know, we've only been acquired two months ago. But if you look at the things that you know specifically, we don't like doing as most plastic surgeons or office managers or practice managers, HR, payroll, buying you know, all the things that really are not sexy or interesting, those can all be aggregated into a central.

Office or essentially, you know, the backend could be shared through practices. There’re also economies of scale. You know, if I buy one implant, I might get it for $800. If I buy a hundred implants, I might get it for $400. So, there's certainly an economic consideration to increasing purchase power.

Catherine Maley, MBA: Would that go also with the injectables? With all the Absolutely. Pharma companies? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Yeah.

Catherine Maley, MBA: So, we would consider you one big client of theirs then, because you'd be under the umbrella of a bigger…?

David Kaufman, MD: Right. So, we become a corporate account as opposed to individual account and the buying power is meaningful.

Gotcha. And you know, even if you reduce your costs 10 or 15%, you know, over the course, Many dollars, it becomes meaningful. So, you know, if you could take a, a company and increase its profitability by 10 or 15%, just that in itself I think is a win. What else? You know, the, the world of plastic surgery is always uncertain.

You know, we are a luxury item and to some degree there will be some economic headwinds that we face occasionally. And I think doing a transaction like this for someone like me who is. More senior in their career, takes some equity off the table and gives me some financial security. So, that should things go, you know, very downhill.

Mm-hmm. Some of the equities off the table, so, there's some value there. And then, you know, ultimately my goal, and I think most surgeons’ goals are that when we aggregate our efforts together, we improve our own practices and, and those of others, so, that when a second bite happens, if that happens, It becomes a, you know, a very valuable transaction.

So, you know, it's nice to have a little bit of security up at the upfront, and then hopefully there's some meaningful upside on the, on the back end.

Catherine Maley, MBA: Well, I'm also thinking is does that. When they take over some of this HR and the inventory and all of that, does that mean you cannot hire two or three more people to do it yourself?

So, you're not managing it, you're not hiring for it, and you're, you're not spending money on that kind of labor cost. Is that a benefit or is that part of what you're trying to do here? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Certainly, that's the, the hope we haven't gotten there yet because at this point, you know, our integration into the parent company is requiring a fair amount of.

You know, the goal, of course, is to centralize a lot of the stuff that we currently have employees to do. Mm-hmm. And frankly, even if I can offload Kate, who's my wife's and office manager's plate that would be a win too. And I think that's going to happen because, you know, these, these functions are definitely being taken offsite.

Catherine Maley, MBA: Okay. Now, who is managing or who, who does the employee work for?

David Kaufman, MD: So, The employees, in my case, work for the parent company and my parent company is Prime Plastic Surgery. Mm-hmm. So, my former employees are now employees of Prime Plastic Surgery, as are the other surgeon’s practices who have been acquired.

Catherine Maley, MBA: Do you see that as an, I'm just going to be devil's advocate here. I've talked to some of the doctors at Stanford, let's say, and Stanford, they're not employ, you know, they work for Stanford, they don't work for that doctor. And then you have to hope that that staff is okay with that. You know, you don't need to hear them saying, you know, I don't work for you.

Like, can you imagine that happening? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Well, you know, I think that then becomes an issue of leader. You know, I'm still the leader of this practice. I still make, you know, most of the decisions. Obviously, if there's something critical, I would ask for input from the parent company, but for the most part, our day-to-day existence is very similar as it was previously.

You know, we still have the same surgeons, we still have the same teammates. They didn't install someone in here as like the new practice manager? They did or did not? They did not. Okay. You know, we have historically been a successful practice, at least by, I, I don't know, however you want to find success. And I think we've been reasonably successful.

We want to maintain that. So, you know, we don't want a cultural shift. And that was something that I carefully investigated before we made this transaction is. You know, we have a successful practice with a very wonderful staff. And I was assured that I would still be able to make decisions about compensation bonuses and things like that to make sure that people still have, you know, the right focus and incentive to provide great care for our patients here.

Catherine Maley, MBA: Did you have any resistance to the staff or anybody thinking, oh, what just happened? Did you, how, how did you handle that? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Well, we had basically a, a screw up. We announced that we were going to do this transaction almost six weeks before it happened. We thought it was going to happen sooner than it did, and for, you know, some number of reasons it didn't happen as quickly as we thought it did.

So, at first there was a lot of anxiety because change brings anxiety. Yeah. But I think as time passed people realize that, you know, they still come to work, they still take care of patients, they still work with the same people that. Benefits were very, very similar to what they were previously, and that their work really isn't that different.

It just, you know, the, the person who signs the check now is different. So, we've lost no employees. I think we have very good buy-in from them in terms of still focusing on great patient care. And so far, so good. Okay.

Catherine Maley, MBA: So, why wouldn't you want to do this? Yeah. Like, gimme the, the, what's the negative? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Yeah. It's risk. You know, you're, you're doing a deal and you're getting into bed with people. You hopefully, you know, but you never know until probably years down the road. So, you're going to give up some autonomy and that's not always easy. Ultimately, you'll have to play in a sandbox with other people.

You know, the parent company may have ideas of how to do things and you may have ideas of how to do things and somehow another, you need to reconcile those and that everybody is happy enough.

Catherine Maley, MBA: Like do they stay out of the surgical side and then you stay out of the HR side? Is it like, can it be that like line in the sand?

Can it be like that? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: I'm sure any agreement is possible. I don't imagine that some bean counter's going to come in and show me how to do surgery. But you know, I think they probably have ways that they want to do inventory or HR sort of thing. But again, you know, we're only two months into integration and we're trying to figure some of this stuff out.

Catherine Maley, MBA: Hmm. You know, you, I know this was your second go around. You had tr you had actually almost closed with a different group. Can you just talk about that for a second? Because I really want the audience to hear what, to watch for sure. What, what are the yellow flags or what could go wrong? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: So, the first go round, we went out to market, had some suitors.

We went through management meetings and ultimately, we chose to enter into a letter of intent with a private equity group out of Chicago. And we lawyered up. We got all our documents ready to go. We had gotten to essentially within 10 days of close, it was going to be a very different structure. It was more the traditional private equity purchases, some portion of our practice.

In that case, it was going to actually be a minority interest they were going to buy and we were going to be the platform on which to go out and acquire other practices. Mm-hmm. It's unclear to me exactly what happened, but in the. When we got very close to sort of consummating the deal, they didn't follow through on what they were supposed to do and the deal blew up and we were done.

It was incredibly disappointing. There was four to six months of efforts negotiating management meetings, onsite meetings you know, in excess of a hundred thousand dollars of legal costs, not to mention the time. And in the end, you know, I was smarter. But, you know, I had nothing to show other than, you know, a couple of bumps and bruises and a little bit of a, a little bit of an experiential learning.

Catherine Maley, MBA: Yeah. D was this like, so, with the lesson B, don't be the first, like, join a group, like join private equity that's already been in the game. Is that this, the, the point to that. How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: I think it would've worked had we gotten across the finish line. I think it depends on what you want. I think if you, in that case, we are going to be the platform on which to build other practices.

Right. And I think that is an enormous amount, amount of work as opposed to being an add-on, which we are now. Because being an add-on, you know, the, it's already working right, and we're just integrating ourselves into that as opposed to sort of creating the. But it sort of depends on where you are in life, what your ambitions are, how much time you want to dedicate to it, because, you know, being the platform and building out the infrastructure is enormous and that should not be underestimated.

So, you know, that's sort of what the private equity firms are there to help with. But ultimately, if you're the first, you're going to be doing a, a lot of work.

Catherine Maley, MBA: Right. So, what's the private equity? How are they looking at this and why? Why plastic surgery? Because they never went there before. They went with derms. How has this factored in with your understanding that outsourcing is trending?

Like derms were just obvious to them. They had a lot of volume. They could com commoditize it. Like why? Why does plastic surgery look interesting to them now?

David Kaufman, MD: Well, I think the other markets have proven to be successful and now I think they're moving into this space. I think they've been very successful in dermatology, certainly in dentistry.

Gi. And I think that, you know, the world is now accepting that plastic surgery is just a normal part of life. Mm-hmm. And, you know, look at plastic surgeons. Not many of them run their businesses exceptionally well. And here's a chance for an equity group to get in there, inject a little capital and operations, and improve, improve profitability.

It's a little bit of a beta test now because there haven't been too many plastic surgery groups that. Hit it big, but like, look at Air Sculpt, they're a, you know, I think there's 17 or 20 lipo center sites and they're valued in the 700 million. It's absurd. So, you know, I think it's, it's a real thing and the firms are interested.

I think it, as more and more practices are acquired and aggregated and hopefully exited will prove a successful model and even create more.

Catherine Maley, MBA: So, I, I like to follow the money. That's kind of my thing. Sure. So, a plastic surgeon who's doing really well, but is so, tired of the running of the practice, they would buy in or the other way around, the PE would buy into them.

Who's buying into whom? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: So, the, the, the cash flow was from the PE firm to a strategic partner to a practice or directly from the PE firm to. Plastic surgery practice, but understand, you're, you're basically selling some of your EBITDA to the private equity firm.

Catherine Maley, MBA: Gotcha. So, it's not like, you know, there is transaction, there's, there's value being traded for cash, who decided what the value is? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: So, that's a good question. And if you look at how practices are valued mm-hmm. You look at what your EBITDA is, and as you mentioned, earnings before interest, taxes, and amortization. That's essentially what your annual profit is. Okay. You then take away from that what your ongoing salary is going to be.

So, let's say I'm making $10 a year and I'm going to make $2 a year. The EBITDA that I'm selling is $8. Okay. So, then that EBITDA is multiplied by some multiplier, and that in the plastic surgery world could be probably as low as three or four to as high as maybe 10 if you've got a super robust practice.

Mm-hmm. And that's called your. Total enterprise value. So, let's just say for ease of numbers, you've got eight of saleable EBITDA and your multiple is 10. Mm-hmm. Your total enterprise value is now $80. That's the value of your practice. Mm-hmm. Then that value is sort of parsed up into three parts.

Those parts are the cash should close, the rollover equity, equity that we talked about before, and then there's sort of a middle grounds, which is. Earns. Mm-hmm. So, those are monies that are paid as long as your practice continues to perform and those levers can be moved up and down. Like the more rollover equity, you would be willing to put in, you might be able to squeak your multiple a little bit higher.

Mm-hmm. You know, if you want a lot of cash on clothes, they're going to crank down in the multiple because, you know, there's more flight risk of you just leaving and leaving them high and dry with a practice that doesn't produce. But that's, you know, that's sort of a nutshell of how practices are. I think in general it's a very good idea to go out and get an outside quality of earnings evaluation so, they can actually look at your practice an expert can, and run the numbers so, that when you go to market, you know you're not going to market with some inflated or completely ridiculous estimation of your own.

Catherine Maley, MBA: Do the private equity people, do they understand our industry or is it, one of my issues is although everyone says my business is different, we all say that my practice is different. But business is business for sure. But how much creativity do you still have on your own, like for marketing or branding?

Like who are you now? Are you brand, are you still branded? Is. PE company branded. How's that working? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Yeah, so, that's a great question and I think it, again, it depends on who you work with. So, there's a company out there called a Phoenix, which I'm sure you're probably all, at least on the West coast familiar with.

Mm-hmm. They brand their practices as the athe group of plastic surgeons. Mm-hmm. The one I'm with is different. We maintain our own branding, so, just like hotels, like you might stay at a, a Kimpton by Marriott. Mm-hmm. Well, my practice is my practice name. Part of the practice network or something like that.

So, we allow, or we're allowed to maintain our own branding because I think we have a lot of brand equity in our area. We don't want to scrap that. Mm-hmm. But there is some co-branding with the parent company, so, that way, you know, someone takes a look, they, they understand that we are part of a bigger group.

Catherine Maley, MBA: And then are they paying for the marketing efforts of everybody? How is that going? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Well, ultimately, since they're the owners of the company and all the money is theirs, both in terms of income and outflow. Mm-hmm. In theory they are, yes. But we still largely control what we're doing from a marketing standpoint.

That's one of the things that we're working on collectively in terms of how to optimize our marketing. So, we now have a central VP of marketing trying to coordinate some of our efforts, look at be best practices, track the data, and see what's successful and hopeful. You know, disseminate best practices and try and minimize the ones that have historically not worked.

Catherine Maley, MBA: Okay. So, they bring the, the value that they're bringing to you is like business people. They're bringing you the, the market, the VP of marketing, the VP of inventory, the v, like they're, they understand the, the numbers part of a practice. I just find this so, interesting. It's a lot of players involved. Like is it, is there like a board of directors?

Yes. Or…? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Yeah, there is. And you know, most of us who have put our practices into this group have a seat on the board so, that we have some say in how things are done. Yeah. But you know, the goal. Taking a bunch of small practices and turning them into a big practice with economies of scale efficiencies and best practices across the platform with the goal of when it's time for you to exit.

Catherine Maley, MBA: Because they don't need you there for a year. They need you to stay put.

David Kaufman, MD: Right, right. So, in my particular deal, I have a few years of turnout. So, it's not like I got a big pot of cash and walk, I could walk away. Mm-hmm. Like, I'm, I'm tied to this both because I have financial ties, but also, I really want to see this through.

Like, this is something that I think could be transformational within plastic surgery. Right. And may change the landscape. And I think if we do it well, it could be the model for, you know, many years to. You know, if you screw it up, then you know, it's just crash and burn and that's no good, but it's going to take some effort.

And, you know, I'm, I'm committed as I believe the other people who have joined this group are committed.

Catherine Maley, MBA: Well, you joined a good group with you know, I mean, Robert Singer is solid, you know, he's, but now like, like let's say he's getting older, you know, how, how do you step out of this if you need to or want to? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Yeah. So, in theory, after. Earnouts. Mm-hmm. I would still have equity in the overall company and if I wanted to work less, I could, because I would just earn less because I still have a salary based on production. But I would just write off into the sunset and, you know, hopefully our group will start a fellowship because we have these multiple locations for fellows to learn through multiple different surgeons and locations, how things are.

Our hope then is to take those fellows and backfill the people that leave. We'll see how that works. Cause this is all very new and mostly conceptual. Mm-hmm. But it, I think there's something to be said for a, a fellowship that has five or six different practices to draw from, from in multiple different geographic locations.

And then of course, you know, we'll be looking at them and hopefully they'll be looking at us. And if we find a match, if it's time for someone to leave or another practice is ready to bring on another associate, that will be a perfect person to quit in.

Catherine Maley, MBA: Well, you know, with the trends, the way they're going, you can't be a fellow with a million or two extra to invest in some practice you know, to buy somebody else's practice.

So, that actually makes a lot of sense because those days it's not going to happen. Usually if they had one or 2 million, they'll just open their own place, typically. But if you let them get into a, something like this, I assume, They're walking in without an investment, maybe being, making an investment.

However, that also holds them back from equity. They probably don't get equity for a while. So, is that also one of the points? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: So, certainly there's zero risk to onboarding and for a young surgeon who is right out of training. It's a great opportunity to both learn aesthetic surgery, because historically residency practice, the residencies have not been great at training in that regard.

Mm-hmm. You know, at that time in your life, typical, typically people don't have a whole lot of money to buy a practice or buy a building or build an OR. Right. And then the goal is, you know, if a, a younger surgeon joins and over the course of the first few years shows promise or commitment, you know, Trying to craft some ways to create equity or at least phantom interests for you know, younger surgeons to keep them committed to the long-term success of the practice.

Catherine Maley, MBA: Okay. And then would you want more and more practices joining? Is that helpful to have that big economy, scales of economy, however, or economies to scale? However, is there a point of getting too big and getting lost in all of this and imploding? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Sure. Well, I think that the answer to that, Growth is always well usually desired.

Mm-hmm. Certainly, we need to work out the kinks of onboarding so, that as PR new practices are integrated in, they're done in such a way that it's not disruptive to the practice, so, that they don't take a hit on the way in. I don't know what the exact right number is for a target to either, you know, sort of go up for a second offering or consider public.

My sense is in the, you know, the 30 to 50 million of EBITDA, so, once you aggregate to that level, that big, that puts you on the radar of big PE firms or maybe even considering, you know, public offerings. Mm-hmm. But you know, we're not anywhere near that, but we're working in that drip general direct.

Catherine Maley, MBA: I just thought of something for you to make this work, somebody like the centralizing has to know the numbers.

Yes. And they have to consolidate and know they, they need data. Yes. Is everybody going to need to be under the same EMRs? Yes. Phone systems payment plan, all of that is, will all of that be consolidated essentially? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Well, we, we are already on the same EMR. Okay. Some of the practices have use of the MR than others.

And that's one of the things that certainly the IT department will work on is bring everybody up to speed. So, there's similarity across platforms. I believe we're all running on the same accounting system. Oh, the same bill pay system. So, that's truly a centralized company with essentially, regional offices as opposed to just a bunch of people strung together on quick.

Catherine Maley, MBA: Right. That would be confusing.

David Kaufman, MD: Yeah. Well, they, they have a, in my opinion, at least from the feedback I've gotten from Kate, an exceptional chief financial officer and, you know, there's a, there's a lot to keep track of. There's a lot to keep track of for sure.

Catherine Maley, MBA: Is, has this been like a part-time job for you?

A full-time job? What kind of time goes into it? How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: Well, I would say that my lovely wife, Kate, it's been all consuming because she runs our practice and she's always made it. So, you know, I just have to operate and, you know, see patients and she takes care of making the machinery work around us. Mm. So, it's been an enormous undertaking on her part, for which I am deeply, deeply in depth.

But no, it's, it's a you know, it's been a lot of. But I think we, I hope that we see the light at the ender of the tunnel, which is efficiencies that take a lot of the crap that she doesn't like to do off her plate.

Catherine Maley, MBA: Yeah. And make them. Not everyone married as well as you. You know, others are really stuck in the middle of all of this drama that goes on in the office.

And if you, I mean, most surgeons I talk to would like nothing more than to do surgery and nothing else, you know? Yeah. And not deal with this. So, this is a new option for those who are really looking for a way to not exit so, much as to just. Shift things. So, you're just a lot happier doing what you like to do, and I'm not bogged down with what you don't like to do. How has this factored in with your understanding that outsourcing is trending?

David Kaufman, MD: You know, there's a lot of merit in what you just said and you know, I think there's, there's something, something there.

Catherine Maley, MBA: Well, Dr. Kaufman, it is always a pleasure talking to you. If anybody wants to reach out to you, how would they do so?

David Kaufman, MD: Sure. My cell phone is (650) 387-6066.

Email works, david@thenaturalresult.com, or certainly you can find me on the internet.

Catherine Maley, MBA: All right, and his website is the natural results.com or is it one result?

David Kaufman, MD: Singular. Singular.

Catherine Maley, MBA: You only get one result. Yes. www.TheNaturalResult.com? Yes. All right. Thank you so, much. I really appreciate it. And let's see what happens.

I mean, this really makes logical sense. It's the matter of, I just my 2 cents. Know your business partners. Intimately because you are going to be in a relationship with them for a very long time. Things can go sideways. Make sure you're with somebody who can negotiate and debate nicely without going to war.

You know? I mean, what, what, what do you think, what, what, what, what would you be, what would be your advice to others who go into these kinds of partnerships?

David Kaufman, MD: Well, I would say work with people that you generally like, because there will be difficult decisions that need to be make at some point in concessions that have to be made for both sides.

And having someone that is a reasonable and has the big prize in mind, I think that's critical. So, we're at the, the, you know, the early stages of this and I'm very excited the way, see it, how it turns out. And I'll certainly keep you posted as, as things progress.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on outsourcing is trending.

If you’ve got any questions or feedback for Dr. Kaufman, you can reach out to his website at, www.TheNaturalResult.com.

A big thanks to Dr. Kaufman for sharing his insights on the fact that outsourcing is trending.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Outsourcing is Trending — with David Kaufman, MD”.

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

#surgerypracticeoutsourcing #outsourcingistrending #trendsinoutsourcing

📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and reputation management.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "Reputation Management — with Jeffrey J. Segal, MD, JD".

At the medical conferences I speak at, there’s usually a talk about reputation management and how to keep %*@^ from hitting the fan and ruining your name. 

So, I invited one of the country’s leading authorities on medical malpractice and reputation management to update you on how to stay out of trouble and keep your reputation as stellar as possible. 

Jeffrey Segal, MD, JD is a board-certified neurosurgeon, but he’s also an attorney and partner at ByrdAdatto law firm. He's also a reputation management expert. Dr. Segal focuses on keeping doctors from being sued for frivolous reasons and to minimize the need for difficult reputation management.

On this week’s Beauty and the Biz Podcast on reputation management, Dr. Segal and I talked about:

How to protect, preserve and manage your reputation online

How to spot trouble early so your reputation management take far less effort

How to handle patients with mental health issues who can cause havoc with your reputation management and a lot more…

Every surgeon who has done enough surgery has or will experience patients who become problems, so this episode gives you strategies to help with your reputation management.

Visit the website of Jeffrey J. Segal, MD, JD

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

Reputation Management — with Jeffrey J. Segal, MD, JD (Ep.198)

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and reputation management. I'm your host, Catherine Maley, author of "Your aesthetic practice, which your patients are saying", as well as consultant of plastic surgeons. To get them more patients, more profits and better reputation management. But today's talk is a little different.

We've got a very special guest who’s an expert at reputation management. His name is Dr. Jeffrey Segal. Now he's not only a board-certified neurosurgeon who trained at Baylor College of Medicine. He also just happens to have graduated from Concord Law School. So, he's also an attorney and he's also a partner at ByrdAdatto law firm, and a reputation management guru.

So, Dr. Segal launched a company called Medical Justice in 2002, and Medical Justice is the physician-based organization focused on keeping doctors from being sued for frivolous reasons and to help with their reputation management. That's why he's on here. This is becoming more and more of an issue. So, Dr. Segal also founded eMerit to help doctors protect and preserve their reputations and teaches reputation management, particularly online.

Now, Dr. Segal has established himself as one of the country's leading authorities on medical malpractice, online reputation, and reputation management, and I hear him talk at the meetings all the time. He's a really popular, he's got such a popular topic because it's a hot topic, and it probably always will be. So, Dr. Segal, welcome to Beauty and the Biz.

Jeffrey J. Segal, MD, JD: Hey, Catherine, thanks for allowing me to participate.

Catherine Maley, MBA: Absolutely. Just out of sheer curiosity, how does, how does one go from a neurosurgeon to an attorney and reputation management expert? Because that didn't take a couple minutes. That took years and years to become one, to then become a lawyer, and that took a whole lot of time to then become more entrepreneurial.

What was that path like? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Well, it's interesting because I did not intend that to be the case, and it's like having that conversation with your parents and your wife, how that happened. In between, I was in biotechnology, so, I practiced as a neurosurgeon for a decade. Perfectly happy doing that. And then I had a son who became ill.

He's better now, but I took a year off. We moved to North Carolina to seek services for him, and I became persuaded that a certain set of pharmaceutical compounds might help him. And in that process went to where they were on a shelf, university of North Carolina licenses, compounds, raised money, and started a biotechnology company.

So, if. Knowing what I now know, I probably would not have done it, but we're able to move these compounds pretty far along from preclinical to phase two, get the company sold to a medical device company. By then, a number of years had gone by. Question was whether I can go back to practicing neurosurgery.

I thought since so, many years had gone by, it'd be a challenge to per, you know, to reasonably persuade a passion to go under the knife, even though I'm arrogant enough to believe I could do it. I'm not sure I had these, the persuasive skills to do that. So, I formed medical justice and got a law degree along the way.

So, in some sense you could just say, I'm confused. Another sense you can say I'm a lifelong student.

Catherine Maley, MBA: You're probably both, right? So, the thing about frivolous lawsuits and subpar reputation management: How did that come about? Because you wouldn't have had that issue as a neurosurgeon, but you certainly would as a solo practitioner, plastic surgeon.

So, how did you segue into that world? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Yeah, it's a great question. I actually did have it happen to me as a neurosurgeon. Oh. And I was sued one time for what I perceived to be a frivolous reason. The single expert who testified against me had actually been expelled previously from our professional society, the American Association of Neurological Surgeons.

Why? Because he was delivering frivolous testimony. Yet, even though he'd been booted out of our professional society, there he was on the circuit making a very handsome living testifying, saying one thing on one coast, saying the exact opposite on another coast, but his core competence, He had good communication skills.

He could speak well to a jury, so, he was in demand. In any event, I, he had never seen or done the case at issue, but it didn't stop him from running his mouth. The case was dismissed about two weeks before trial. I never felt as if I lost won anything. I just felt as if I lost less and I thought there has to be a better way.

So, we started medical justice as a way of holding proponents of these frivolous lawsuits accountable. In one sense, what do we do? We sue lawyers that inappropriately sue doctors. And more broadly, over time, we've expanded our mission to deal with all types of conflicts. Goal is to deescalate a conflict.

I mean, by the time people get to lawyers. There's a lot of conflict in the background. And there are, and in fact, this is probably a good segue to talk about, well, what kind of conflicts are there, what types of, what types of Sabre rattling takes place and well, all types. The, it typically gets started with yelling, screaming, or nasty emails.

Somebody doesn't, somebody says they don't like how they were treated, for example, that's the lowest level. Or they could put a nasty note on the internet. They can file a complaint to the Board of Medicine. All of that requires no effort whatsoever. They could sue you in small claims court. They could hire a lawyer to send a threatening demand letter or they can sue you.

So, a gazillion ways for a conflict to take place. That's the bad news. The good news is there are ways, if you are attentive, To the process to head this off at the past before there's litigation, before there's a nasty note on the internet before they even start yelling at you. There are plenty of ways to identify trouble before it shows up at your door and avoid this before it creates a headache.

Catherine Maley, MBA: I'll tell you being a cosmetic patient myself and just, and just being in this industry for decades, I have noticed that a lot could have happened at the beginning to prevent the drama happening at the end. And let's just talk about patient selection, in terms of reputation management. I know so, many surgeons, and I don't know if it's arrogance or just.

Whatever, but they don't want to say no to, to the surgical procedure or the money or whatever, and they always think they're going to be able to handle it. Even if staff is saying, I don't know about this one, I'm not feeling good about that. Can we just start there? Like, what? What can they do to just cut it off at the beginning? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Yeah, so, the first thing is to select your patients carefully. It's a cash pay business. There's this tendency to want to get everybody through the door. Nobody will ever have on their epitaph. I wish I had done one more patient that that epitaph does not exist on a gravestone. So, be. There are a handful of patients you not only should say no to, you must say no to.

They're not great candidates for surgery. You may believe they have a cosmetic problem or an aesthetic problem that you can solve, but that's not their underlying problem. If a patient comes in there and says, Hey, look, I just want to take three or four years off. I just want to feel better. That's probably a good candidate for a procedure.

If a patient comes in and says they're struggling to put food on the table and a roof over their head and they're struggling financially, or if they believe that the procedure will shave off 30 years, or if the procedure will save their marriage. Not a great candidate. Those are people who have expectations that cannot be managed.

You cannot manage those expectations. The best thing to do is to say no. And the other thing is that there are. Cash pay businesses where patient will have a particular budget and you say, I can't do that for you, but I can do something at 10% of that cost. But you know, in your heart of hearts, it's not really going to do what the patient wants.

They'll be back, they'll believe, they will have believed that somehow, they're getting a permanent solution when they're only getting a four-week solution. Expectations aren't managed, just don't do it. I'm telling you that the amount of extra revenue that you get for that one patient will pale, pale in comparison to the headache that you will experience.

And I've often said that in with the benefit of hindsight, if you had known that this particular patient would cause this much agony in your life, would you have paid them? Would you have given them a check in advance of seeing you to stay out of your practice? Hundred percent of practices say yes, I would've paid them.

I'm still waiting for the one to say no. I probably would not have paid them to stay away. No, they, they will, they will tear your soul out and they'll rip out. You know, your, you know your desire to practice medicine right at your bone marrow.

Catherine Maley, MBA: Do you have a professional way to tell a patient No, because I have found these patients are still going to slam you online when you say no, you know, is there a w the right way to do it without them giving you a bad review about it? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Maybe, I think I, I'm going to say upfront that even if, first of all, you should be capturing feedback from patients so, that if you get the inevitable bad review, it's not a showstopper, it's not going to destroy your practice. In fact, I will argue having an occasional negative review amongst a C of positive reviews is actually a good thing.

I think it's actually better than having a hundred percent positive reviews. Why? Because it demonstrates authenticity, credibility, et cetera. If you have a hundred percent five-star reviews, let's say you have 500 five-star reviews and just says, great doctor, love you, you know, there's no meat to the review it.

It looks like marketing material, but having an occasional negative reflects reality. The public knows you cannot make everybody happy. The Ritz Carlton doesn't make everyone happy. The public wants to see how you can solve a problem. So, if you have an unhappy patient and you've at least work to try to solve their problem, you can tele telegraph that in a HIPAA compliant way.

Good for you. I think you're better off now when you get that negative review. You don't feel like sending flowers and chocolate to that patient. Of course, but you should. You probably should. Only because I think holistically it's, it's helping you. But anyway, back to your very good question. How do you gently.

Give somebody the boot, if you will, you know, without being offensive. And I think the way to do it is to validate them. Say, look I'm not disagreeing with your, you know, with your treatment plan, what you're requesting. I just do not believe I will be able to meet your expectations. I'm not suggesting no one will be able to meet your expectations.

I just don't believe that I can meet them. And I. I just want you to be happy. I want you to be happy, and in doing so, I don't think it would be a good idea for me to take your money, ultimately go through a procedure and you not be satisfied or happy. Now, that will work with most people. There are, there's a small subset of patients who do not have a core aesthetic problem.

They have a mental health problem. Mental health problem may be something like body dysmorphic disorder, just to give this a, a name and there it's a body image problem. It doesn't matter what they see in a mirror. They don't. They experience a different image. And when you operate on somebody with body Dysmorphic disorder or B D D, you're actually doing them a disservice.

I mean, arguably it's malpractice, but I would just say, you know, more, more charitably, you're doing them a disservice. And the proper thing to do is to refer them to a healthcare professional, mental health professional who deals with body image problems. As an aesthetic practitioner, you do what you know how to do.

But let's say for example, a patient came in there and they had, they had a kidney stone, or say they had chest pain. You'd send them to a urologist for the kidney stone. You'd send them to a cardiologist for chest pain. You would properly refer. Then if you can identify, if you can make a presumptive diagnosis of something like B D.

D. Having a preexisting relationship with a mental health professional that you can gently pass the baton over to for additional screening. You're doing them a favor. And in some sense, you could say, I'm not saying no forever. I'm just saying no for now. I just want you to be screened and be evaluated by somebody that I know, somebody that I trust, and they can give you a clearance.

But if you've got a good screening tool for b d d, being able to gently. Get them referred to the proper individual in many senseen. I mean, you were really doing them a favor. Will they write you a bad review? Typically, they will not. Can I promise? They will never write a bad review. No, I can't. But I, I can tell you that if you, you do the right thing most of the time on balance, you will be better off than operating on that passion or just kicking them out the door and saying, I can't help you.

Catherine Maley, MBA: Just good luck with that. But now that we have social media, I see every day I, I don't know if it's B, d, d or whatever you want to call it, but the outrageous big boobs, big butt, little waist, huge lips. Is that b d, d or is that just, what is that? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: You tell me. Yeah, so, I, I'd have to plead ignorance there. I'm in North Carolina.

I don't see it as frequently as perhaps you do on the West Coast, but, but you know, I've been to Miami and I've definitely seen it there and I can, I can tell a trend and every three or four years the trend changes so, that it's something else. I think you just got to do what you do. Okay. If, if the patient wants something that is outrageous, they'll eventually get it done.

There's always somebody who will do it. Even remember Michael Jackson was able to find a doctor to put him to sleep at night and ultimately put him to sleep permanently. But you don't have to be that. You don't have to be Michael Jackson's doctor. You, you, you just do good work., you'll have a good practice.

Don't feel compelled to have to do outrageous things just to, just to keep the lights on. Most people are reasonable. I, I know sometimes it's hard to believe that, but most people are reasonable and want reasonable things. And if somebody's pushing the envelope to get you to do things that you're not comfortable, things that you think are not within the standard of care, just say no.

Because if you, if you do say yes, sooner or later, you're going to get burned. I, I, is it b d, d? I don't know, but I know it's not something that I know that most practitioners should stay away from. Let's just talk about, you know you know, putting in breast implants that are ginormous. Okay. It's possible that there will never be a complication associated with that, but it's just physics.

You're putting in a, a mass under the skin or under the muscle. And if the skin or muscle has to stretch, Beyond what it's capable of doing, and it outstrips its blood supply. I can tell you with a hundred percent certainty what's going to happen, that the skin is going to slough off, the implant will be exposed and it's going to get infected, and then the implants are going to need to be removed.

Now, they may not have liked their breasts beforehand, but I can assure you they're not going to like having a giant gaping hole in their breast without any mass in it. I think to, to me, that's a worse outcome. But all you can do is what you can do. You can try and persuade them based on the best evidence and your judgment.

And if you say no, maybe they'll go somewhere to say yes. But I, I, I know that you can't beat physics a hundred percent of the time. That much I'm confident of.

Catherine Maley, MBA: So, what about the patients who schedule surgery, put down the deposit, then change their minds, cancel the surgery. Now they want their deposit back.

The date can't be filled, or they're scrambling to try to fill that date. Who I realize that's the patient's problem, you know, they caused that. However, what's the best way to handle that? Because of this online situation. You know, they'll, they'll be online saying, I can't get my money back. The guy stole my money.

How do you handle that when a patient reneges on what they've… How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: This is a challenge, and I have changed my opinion on this over time. If you had asked me 15 years ago, I would say a deal is a deal. You basically stuck your deposit down. That's. I scheduled you for surgery. I wasn't guaranteeing you an operation.

I was guaranteeing you a slot on the schedule, and I honored my end of the bargain. I'm keeping the money. So, that was Jeff Segal me speaking 15 years ago. I've changed my mind. I've changed my mind over time because here's what I think happens. I think if you're dealing with a significant sum of money here, you're putting the patient in a bind.

The bind being that. Are being forced to choose between Forfeit Inc. A large amount of money. Let's say it's $10,000 just to make this a round number or have a procedure. They don't want to have, have a procedure. They don't, an elective procedure they don't want to have. And what I've seen over time is that if you push them into that situation, They'll ultimately have the procedure.

They're not going to forfeit the money, but that's when the fireworks begin. They'll have the procedure. You will have done what you, what you, you know what you said you would do. You honored your end of the bargain. Then they're going to. Tell you how horrible you did the job. They don't believe it, but they're going to tell you how horrible a job was and they're going to demand their money back.

They're going to demand their money back or slam you on the internet. So, as unsavory as it is to just swallow hard and let them go, I would probably most of the time give them their money back. Now, I think it depends on the situation. If it's, if the patient has a good reason for. For canceling the procedure and if they gave you adequate advanced notice and you could potentially fill the slot.

I'm saying just do the, be good, be a nice person and give it back, particularly if you can fill the slot. Okay. Because really you haven't been injured, you haven't been harmed, and you're just trying to be nice and do the right thing. If they have a medical event or a life event that took. And it looks like they really do want the surgery down the road.

Just ask them gently, you know, would you like to postpone this at no charge? And we'll do this when the dust is settled. You know, it sounds like you're going through a lot of life stressors right now. This is an entirely elective procedure. You don't have to have it done. But if you think you want to have it done, we'll just go ahead and, you know, keep your funds you know, stored away and we'll, you know, we won't raise our rate for you because typically we will.

Raise rates, you know, twice a year, once a year, and we'll honor our end of the bargain and flesh that out. But if they basically just say, look, it's the day before the surgery I'm canceling. Do I have a reason? No, I have no reason. I just don't want it. What don't you understand about that? And that's a nasty individual.

Okay. And do you really want that as your patient? I mean, I, I think you're probably better off not operating on that individual and just flipping it around and. Giving them the cash back. I mean, to me, deposits are mostly there to get people to commit to a date and it serves its purpose. It gets people, it puts something on a calendar.

So, when I say I'm going to, I plan on going to Europe, to me that's a wish. It, it has no substance whatsoever. Once I stick that on the calendar, that baby's real, I'm going, I know, I'm going ticket. Yeah. Once you buy an airline ticket, it's real. Now, you know, if I, I can change my mind and I can cancel the flight as, as I just did for my wife the other day.

So, now she's got x number of months to go ahead and use those dollars for something else. But I mean, over time we've hotels and airlines have kind of figured out how to find that nice balance between the two, at least holistically. You may get screwed on a particular patient, but. In aggregate, I think you'll be better off by adopting that philosophy.

Catherine Maley, MBA: Well, here's another thing that can go sideways. You've had your surgery and now you as a patient, you get this bill and it's for another thousand dollars for or, and anesthesia because the doctor took longer than expected. I personally, Thought, why is that my problem? Like, I'm the patient, he's the expert.

Why am I paying for him to take longer than he said he was going to? Do you have a comment on that? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Yeah. I don't disagree with that. With your interpretation of that, I mean, look, in the elective space people are looking for. One shop pricing, they're not looking for surprises. If it's an insurance world, it's not really your money.

I mean, let Blue Cross manage that, not my problem. And once you've hit your deductible, it's just break out the champagne, all of everything done, you know? But I mean, if, if indeed there's going to be extra fees related to taking more time, Then the rational argument is, well, do I get money back if the surgeon was fast, if the surgeon was faster and only took half as much time, because I was simple, do I get a refund?

And we know the answer to that. The answer is that a big no. So, if I, I think the proper way to do it is to try and work with facilities and other professionals who are willing to accept fixed. With the understanding is that you are already arbitraging this, you have more knowledge than the patient and you're in aggregate.

You're going to come out ahead. Mm-hmm., if you basically say, I'm going to accept the risk of the case going longer, I'm just going to eat it. But you know in your heart of hearts that you're benefiting by the case going. If you could stuff in more cases good for you, you, you've actually benefit. So, I, I think barring extremely unusual circumstances, you're probably better off eliminating surprises to patients.

Nobody likes a surprise. I know. I don't like a surprise, you know, when I get a letter from the I r s, if it doesn't have a check in there for me, I'm, I'm not happy. That's an un, that's an ugly surprise. And even if I do get a check and I'm not expecting it, that's also an ugly surprise because if you cash that check, You're going to get hosed a year from now.

So, my, my larger point is try to eliminate surprises for those in the cash pay business and you'll eliminate future headaches for yourself. Oh, and let me tell you another thing. Avoid billing patients for $24 and, and 32 cents. You know, it just pisses people off Now. Particularly if they're not expecting it.

I've seen people sent to collections for under $25. I don't get that. I don't get it because if the patient is unhappy or suffered a complication and they, they just ate it and they learn to live with it, that's the, that's the one thing that rubs salt in their wound. It's, it's a, it's an unforced error.

You don't need to do it. If you've got a $24 bill with a hangover, write it. Just write it off.

Catherine Maley, MBA: Here's the next surprise that comes up. The patient has their procedure. They're not happy with their result. The doctor agrees and says I’ll; I'll do a tweak in the office if possible. Mm-hmm., if he can't, he says, I'll, we'll go back to surgery, but you're paying the OR and anesthesia and I, I will forfeit my feet again.

The patient says, why am I paying? It's, you know, you are the expert, you did it. You can see there's a problem. And I know that's murky because sometimes the doctor can't see there's a problem. But oftentimes there really is. I mean, he did he, he does need some kind of revision to be made. How, how tricky is that?

Or is it more black and white than it seems? Because I, as me, as a patient, if I see something's wrong, I mean, but I'm reasonable too. What if it's a reason? Revision? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Yeah. So, the answer, I'm going to give you a lawyerly answer. Okay? It depends. Every, every doctor is different. Every patient is different.

Right? Here, I would say if you're going to do a revision procedure where you waive your professional fee, then. You do want to spell out in advance who is responsible for anesthesia and the facility. Okay. And try that. That's a trial balloon. See how it goes. If the patient thinks that's reasonable, they'll sign off on it.

Get them to sign off on it. Get them to say, here's the deal. The deal is this. And most of the time they'll say yes, but not always. Then you got to recognize who is that individual that is going to need something more just to solve their problem. Do. Would I roll over? I probably, I might, I might. I'm actually thinking about myself at that point.

I'm thinking about do I want to go to World War III over a modest amount? And. Or do I, will I eat some of that fee even partly because I already received a large amount of money from them in the first place. Now is it as much? No. But is this really going to change my financial statement at the end of the year?

No, it's really not. And if I'm already psychically invested in this particular case, and it's starting to raise my blood pressure at this stage of my life, I'm going to opt to decrease my blood pressure. It's not going to bother me One. But that's me. I, again, if you had asked me 20 years ago, I would've given you a completely different answer.

I would've gone to war.

Catherine Maley, MBA: The, the reason patients will go online, typically, I'll just say in general because I talk to them all the time, is because nobody fixed their problem. They had a problem, nobody heard them or listened to them or did anything about it. How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Repeat what you just said. That's the most important point of this conversation.

They did not feel listened to. They didn't feel listened to. Listen to them. If you listen to them, they'll give you the answer still. Sir William Osler said, the patient will deliver the diagnosis to you, and here it's the same thing. It's a communication issue. If you stop talking for a moment and you start listening, they'll tell you their perception of what they believe the problem is, then you've got a question, can you solve their problems?

In my estimation, Once you've listened to them, you've already, you've, you're 90% of the way there to solving their problem. You may have to go a little bit more and some problems cannot be solved. I, I don't, I agree. Not every problem can be solved, but where else do you get 90% success rate? I think that's pretty good that those are pretty good odds.

Catherine Maley, MBA: When you do know it's not your best work and the patient knows that too, like everyone knows that but you don't want to do it again. You're, you're kind of done with it. What is the easiest way to detangle? I personally, I like the refund idea, the one with, and you agree not to disparage me? Yeah. In any way, shape, or form.

Is that still the best way to handle that? Or what is your approach? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Couple ways to do that. That to me is tried and true, meaning that patients unhappy. It may not be your best work. It could have been the patient, you know, biology. Biology, and it is what it is. But being open to the idea in the cash pay field of giving the patient their money back.

You give, you, get, you give, you get. So, what do you want from the patient? I want a release. I want two things. No legal mischief, no online, mechi. 99% of the time, they think that's a pretty good deal. And they'll say yes, and you become a beneficiary of that too. And the reason I say you become a beneficiary if you're seeing a patient 12 times post-op and you see the name on the schedule and your sphincter tightens up because of your nose coming in during the day.

That eats into your longevity, you're going to live a few minutes less the more, more of those experiences that you have. So, in, in a sense, you're paying for longevity and we, I mean, to me, that's the cheapest way to live longer and live well longer. So, yes, you give, you get, it's got to be a nice crisp release.

And a good release is typically five pages long and, and we, we have those available. Something you can also. If you could potentially have the patient seen by a colleague of yours that you trust. If you think the patient is not malignant and they're a reasonable human being, but you believe, or both of you believe that the trust that is necessary in a good doctor-patient relationship is gone, you can offer to say, look, I know that our relationship.

As good as it could or should be. But I'm open to sending you to somebody that I trust and I'm hoping you'll trust him or her too. And I, I can get you on their schedule, you know, to be seen as s a P. That often also helped. Now, they may say, any friend of yours is an enemy of mine, and they don't want to see that person.

But by and large, you. You're coming up with potential solutions, you're solving a problem here. Can always fall back and giving the money back. But sometimes if you can kind of keep it in the fold with people that you know and trust every, you become a beneficiary of that, and hopefully it solves their problem and they're happy to.

Catherine Maley, MBA: So, what about arbitration? Because I think egos get involved and it gets overblown and a third party that could smooth things out makes sense to me. When do you, how does all that work? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: The arbitration? Okay. So, there are a couple ways to think about this. One is, I'll call it informal mediation and then arbitration.

Let me explain the difference. So, sometimes the love is lost that the doctor and patient really do not want to talk to each other any longer. They don't like each other. It's a bad marriage and they need to divorce, but they need to separate amicably. So, sometimes hiring an attorney like me, because I will do this, I will reach out to the patient.

I'm not formally mediating. I do represent the doctor, and I do tell them that, but I'm a person who will actually listened and validate what is obvious. I mean, if a patient had an infection and they had an unexpected complication, I'll just acknowledge the obvious they're unhappy with how this turned out.

Why would, why wouldn't, why would they be happy with that? I mean, it makes no sense to, to perceive otherwise, and hopefully we can negotiate a detant a way out. Perhaps how to give the patient summer all of their money back. Or we even had it where the doctor will donate to a charity so, that something good comes out of this instead.

So, there are a thousand ways to come to an amicable resolution. So, that's that one bucket. The other bucket, arbitration is more formal. Arbitration is an alternative to court. Arbitration is alternative to court. So, why do I like arbitration? A court is, so, what is arbitration? Arbitration is. The sides agree to resolve their dispute informally in a private setting, typically with a retired judge, and it'll be private and binding.

It'll be private and binding. So, why do I like that? Well, to resolve a case in the normal system in a court, it's public. Everybody can see it. They can read everything. And when you're dealing with an aesthetic case, I mean everybody benefits by this being private, at least I think they do. It's faster, typically because it's less formal, typically costs less, not always, but typically it's less expensive to go through.

And it's binding, meaning that you can't appeal it. So, when the decisions in the decision's in with court, you never know when it ends because you can certainly appeal it and there could be no end to this stuff, at least, you know, no conceivable and to the process. So, I'm a big fan of arbitration and while I, it clearly benefits the physician, the doctor, the provider.

I also think it benefits the patient. I think everybody benefits from this.

Catherine Maley, MBA: So, let's say the patient wants to, let's just talk about reviews, because reviews are going to be the being of every plastic surgeon's existence. And I, I feel for them because nowhere else on the planet can you complain about somebody with no recourse at all.

And the doctor. You haven't? I don't know. It's just, it's so, unfair. Because most of the time the surgeon is not, their intent is fine. They have no ill intent. And you're getting bashed online for things you can't fix. You can't get it down. You can't. Although just recently on the West coast there's a federal lawsuit against a surgeon who was filling around with the reviews.

And I hear this a. Either they're having their staff write good reviews or bad reviews for the competitors, or they're paying right the reviews for all unnecessary… How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Here's the deal. Here's how I would do it. Look, if you're a high performing practice doing great work, there are ways to get honest reviews and they're mostly going to be positive from your patients.

But don't filter reviews. It's called review getting. Have as many patients as you're possible, participate in the process, have it so, that it's done at the point of service. I'm making a plug. Our organization does this stuff with the merit. We're not the only one that does it. But aggregating reviews from your patients, not filtering them, not getting them, you will be perceived for the most part, for what you are as long as you get them up there.

You will get an occasional negative review. It's inevitable everybody gets it. As I told you earlier, having an occasional negative review is actually better than no negative reviews as much as you.

Catherine Maley, MBA: I tell doctors this all the time. I say your three hundred and thirty-six five-star reviews. Is so, inauthentic.

I wouldn't trust that at all. How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: So, plus, who's going to read 336 reviews? People read 10, 15 reviews. They may ask to read the lowest one. Great, get to the lowest one, and then see if there's a HIPAA compliant response. Did the doctor or the provider take the high ground? Did they try to solve a problem? Do they look to be reasonable?

Why the patient is trying to identify if they become the complainer, will their problem be solved? And that's all they're looking for. They're looking for insurance or reassurance and typically it's, you can provide it, you can solve that problem.

Catherine Maley, MBA: Yeah, well a lot of times too because we patients, we love to look at the one-star review and see what happened.

And a lot of times that one star is so, chaotic you can tell it's not a balanced. Person who's writing that review. So, that's handy. But otherwise, if the reviews are just, he made me wait forever like, I hope that's your worst review. Like, he was so, busy. He, you know, I got two minutes with him.

Like, that's a, that's still a really good review. How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: It is because how does it get positioned? So, if he made me wait, it means, look, I spent as much time as needed with a particular patient and after the patient before. Had a crisis or had additional questions. I gave them the benefit of the doubt. I gave them extra time, just like I'll give to you.

If you become that patient, you turn a negative into a positive. If You know, if they say you only spent 10 minutes or not enough time, you go the, the, the, the subtext is that you're so, many people want you, you're in demand. The public must know how great you are. So, not all of these are really bad. I think the things that are manageable, if there are money issues, you just.

Put down a statement, which is our patients sign off on the expected amount they will pay in advance. And if there's if there's a disagreement, they’d they need to do little more than come to our office and we'll fix it. I mean, it's, it's the type of thing. If it's in writing, you're just honoring what's in writing.

It is what it is. I think if they're just unhappy, and I said, Segal's a butcher. Yeah. There's only so, much you can do with that, but. You know, if the patient, for example, had an infection you turn a negative into a positive, you say something to the effect of the infection rate for this particular procedure is, 2%.

In our practice it's 1%, so, it's less than the national average. However, patients are not statistics. A patient either experiences an infection or doesn't, a hundred percent or 0%, but regardless, we'll stand by our patients and try and fix them until they're satisfied, something like that. And so, what have you done with that?

You're basically. Acknowledging the obvious that infections do happen, that in your practice it's lower than the national average. And number three, you'll do your best to try and make it right. That's per that's a great answer, by the way. And by the way, There's no violation of HIPAA in the way I just described it.

Catherine Maley, MBA: Mm-hmm. You know the big ones that end up usually on TV or something, it's when the doctor didn't respond they told them they'll be fine. We'll they'll be fine. Just get some rest and days go by and then it becomes a very big issue. So, a lot of this can be prevented, but what's the, what's the most frivolous and the least frivolous?

Do you have any like, like extreme example? How does this tie in with reputation management?

Jeffrey J. Segal, MD, JD: Oh my God, for the most frivolous, there's so, much attention to that. My, here's my favorite case with the frivolous lawsuit, and it's not an aesthetic case. Okay. But hopefully you'll bear with me. So, a. I believe in this case it was a urologist and a small town performed a vasectomy on a particular patient.

And a year later, the patient's wife became pregnant. Okay? A year later, the patient's wife became pregnant. The male comes back and is livid, is saying that the vasectomy didn't work. Now, by the way, the postoperative sperm count was zero, and in rare cases it does happen where the, the vast deference, which is tied off and cut.

Come back together. It, it does happen. But that's not what happened here. What happened here is that they lived in a small town and everybody knew that the patient's wife who got pregnant had a lover on the side. So, this was a lawsuit, and until they were able to get a paternity test to demonstrate it wasn't his child.

This was a, this was a lawsuit and I would argue a frivolous lawsuit. So, that's one of my favorite cases. I, I typically ask the audience if they have a hypothesis as to how this might have happened. You know, when the. Patient's wife became pregnant after he had a vasectomy. Is there a hypothesis as to how this could potentially have happened?

I can't believe she let it go that far. Oh, I know. and it was a small town and basically the doctor said to everybody in the town who knew she was seeing, you know, there was no mystery here. And we, but they, I guess the patient, the husband was the last to know here in terms of. Least frivolous cases. Look, if a patient has a complication, that's an unexpected outcome for them.

And to them, that's a big deal. I think one thing to pay attention to is this, that much of the aesthetic world is cash pay. And if you've got a Blue Cross policy, they exclude cosmetic procedures. So, what happens if the patient ends up getting a local infection? What if the patient gets a local hematoma?

It depends. Blue Cross may not pick up the tab for that. So, if the patient has an urgent problem goes to the er, they may or may not pick up a tab. I will tell you we had one client. I would say this wasn't pretty decent outcome. The patient was operated on, I think in Southern California and then went up to Washington State and developed post-op day number three, four, developed a hematoma, breast hematoma.

And so, the doctor says, look, just go to the er, just get it taken care of. She goes to the ER, phone call, doctor comes in, finds a hematoma, removes it done under general anesthesia. Blue Cross would not pay for it. They basically said, this is a complication of a procedure that we don't. We're not covering it.

But interestingly enough, this the anesthesiologist or the surgeon did a pregnancy test on the patient just to dot all their eyes and cross the T's and to everybody's shock, it was positive. So, the patient was pregnant I guess newly pregnant at the time she was going to be put to sleep. So, the argument that we made was.

Because they wouldn't pay the anesthesia bill. So, the argument was that, well, look, they weren't just taking care of mom, they were taking care of the baby. Anesthesiologists were taking care of the embryo or the fetus, and they accepted that appeal. So, they, they bought it, meaning that there are ways to do it.

And in addition, if the patient has a systemic illness like sepsis or a pneumothorax, Something that's potentially life-threatening. Typically, on appeal, they will pay for it. But be careful. If somebody has just a local infection and they are sent to the ER and now the I C U and they've got tens of thousands of dollars, this could be a potential challenge.

So, I, I tell people, look, if people are spending their last. On a particular procedure and they truly don't have the resources to weather a potential storm, just be careful because they're going to be looking you to make that payment. You know, if they can't, otherwise they'll have to file for bankruptcy.

Catherine Maley, MBA: For sure. Well, we're going to wrap it up. I don't know how you're a lawyer. I was going to be a lawyer for about a minute and I realized how negative it all is. Like you have to live in that mindset of what could go wrong. And I didn't. So, I went into marketing instead. I thought that was a lot more positive and fun.

But good, you know, you're probably doing God's work there. So, good for you.

Jeffrey J. Segal, MD, JD: I try to maintain a sunny disposition. So, my, my feeling broadly is that I'm here to solve a problem. Not to say no. Good for you. I typically say my feeling is ye, so, I, I have two ways of saying something. I could say no because, or yes.

If no, because, or yes. If I try to say yes, if more often than not.

Catherine Maley, MBA: Good for you though. Good mindset. So, how can others get ahold of you if they do have a little issue and they'd like your 2 cents out?

Jeffrey J. Segal, MD, JD: I'll give you my email address, so, it's jsegal@medicaljustice.com and my office phone number is (336) 691-1286, and you can just look us up. at medicaljustice.com. It's one-word medicaljustice.com. We've been at this now for over two decades. Every time I think we've seen it all, I'm proven wrong, but we have worked with over 11,000 practices across the country over two decades, and lots of problems to solve.

Lots of conflicts, but the good news is most of the time things go smooth.

Catherine Maley, MBA: Oh, that's all. That's a lot of problems to solve there. 11,000. Holy cow. But thank you so, much. I appreciate your time, and I will see you at a conference coming up soon, I'm sure. And everybody, thanks for joining us. And if you haven't already, please subscribe to Beauty and the Biz and share this with your staff and colleagues and anyone else who's interested in the frivolous lawsuits because they're going to happen.

They're just going to happen, period.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on reputation management.

If you’ve got any questions or feedback for Jeffrey J. Segal, MD, JD, you can reach out to his website at, www.ByrdAdatto.com.

A big thanks to Jeffrey J. Segal, MD, JD for sharing his tips on reputation management.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Reputation Management — with Jeffrey J. Segal, MD, JD".

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

#reputationmanagement #manageyourreputation #plasticsurgeonreputation

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how to think your way to success.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Think Your Way to Success".

Every single thing ever invented began as a thought…

• Caves became houses
• Horse-drawn carriages became cars
• Media became the Internet and on and on

And, as an aside, what’s really trippy is the ideas for those things and others, like the iPhone, kindle, and social media were always there, but nobody thought them up yet. 

Look at what’s happened to the aesthetic industry….several different neurotoxins have been introduced, lots of different fillers and the technical advancements keep on coming!

It all starts with a thought so for this week’s Beauty and the Biz Podcast, I talk about why thinking is an overlooked skill, why it’s important and I give you strategies how to think constructively.

I “think” you will get a lot out of this ;-)

P.S. If you know it’s time to invest in you, your practice, and your future, please check this out:

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

Think Your Way to Success

Catherine Maley, MBA: Welcome to Beauty and the Biz. Discover how to grow your practice with effective cosmetic patient attraction, conversion, and retention advice. From author, speaker, trainer, and cosmetic practice, business and marketing coach, Catherine Maley, MBA.

Hello and welcome to Beauty and the Biz, where we talk about the business and marketing, and how to think your way to success.

Plastic surgery. I'm your host, Catherine Maley, author of “Your Aesthetic Practice, what your patients are saying”, and consultant to plastic surgeons to get them more patients and profits; as well as coach on how to think your way to success.

Today's podcast episode is called “Think Your Way to Success”. So, while consulting with plastic surgeons since year 2000 and interviewing them on my Beauty and the Biz Podcast, I have found the most successful think differently.

And the good news is it can be learned. So good thinking is a skill worth practicing. It can generate revenue. Solve problems and create opportunities. It really can change your life. However, it's different thinking than the kind you did to become a surgeon. Your training was based on science and specific techniques taught by others before you.

Now, this structured thinking was crucial to you becoming a great surgeon, but not so helpful. When trying to become a successful business person. So, you need to think differently when you run a practice, lead a team, manage the business, and compete in a crowded marketplace. But have you ever heard the saying; thinking is hard work if you want to think your way to success.

That's why so few do it, So when you take the time to become a better thinker, you are investing in yourself. So, I'm going to give you 11 strategies to help you become a much better think. Here's number one, feed your mind with good stuff. So good ideas don't typically just happen. You search for them to get the mind juices flowing so you find good ideas by reading books, reviewing trade magazines, listening to podcasts like this one, and spending time with other good thinkers to expose yourself to thoughts you haven't thought before, but ideas come and go quickly. So, you want to jot them down immediately in order to think your way to success. Keep paper in pen handy, or add ideas that come up to your iPhone notes.

Now, I personally get lots of ideas when I'm walking my dog and listening to podcasts. So, I text them to myself and then I transfer them to my file of ideas that I refer to.

Now, here's number two on how to think your way to success. Schedule it. Life will keep you focused on the busyness of your day, so there's no time to stop and think unless you make the time. So, block the time on your calendar just like you do for new patient consultations. That's how important this is. This can be. One hour per week, one day per month, or a couple of days per year.

Grab a pen and paper, find a quiet place with no distractions, and then ask yourself really good questions to get the ideas flowing. For example, you could ask, how can I increase my revenues without working harder? Or how can I enjoy managing staff and building a more productive culture? Or what skills could or should I learn to help me grow my practice?

Now here's number three on how to think your way to success. Find your thinking place. Everyone is different. So, notice where you are and what you're doing when the best ideas come to you. It can be in the shower, the car, the park, while you're jogging or flying or cooking or falling asleep or whatever. Now just go to these thinking places more often, and your mind will condition itself to think of more ideas more often.

It's that simple.

Now, here's number 4 on how to think your way to success. Journal for more clarity. If you like me, find it challenging to sit quietly and wait for thoughts to come to you. Here's a strategy I've used for years, so I have a folder on my desktop called notes and they're labeled by each year. Now I ask myself a question. I set the timer for 10 or 20 minutes, and then I just type, and frankly, I type faster than I hand write, so this works better for me.

So, at first, I'm just kind of typing and babbling, but then my brain starts to slow down and focus and it starts opening up, and the babble turns into thoughts. And some of those thoughts turn into an idea. Now most just clear my mind, so I feel better getting certain thoughts off. But I've gotten some of my best ideas that have grown legs and made me money.

So, you might want to give this a try to think your way to success.

Now here's number five on how to think your way to success. Share if your idea affects anyone else. Think it through before sharing. So, ask yourself., if you believe it has merit and you have confidence in it, that it could make a difference. If so, present it to others to get their insights and feedback.

Sometimes though, when said aloud and discussed, you realize it's not that great of an idea after all. But other times, the feedback you get back grows the idea to something worth pursuing and getting excited about to help you think your way to success.

Here's number six on how to think your way to success: Take action immediately. A thought is just a thought until it's executed to think your way to success.

So, ideas come and go on how to think your way to success. So, if you have a good one, immediately act on it to keep it alive. For example, you think of a good idea from pondering the questions above, and that is to hire a patient liaison whose primary responsibility is to follow up on the leads coming in, so you take the next step. And let's say that is to have your office manager write and place an ad for this patient liaison.

Now, if you need help with that, like how to execute it, you can get all those details about how to hire from visiting www.cosmeticpracticevault.com. Now, in the vault, I lay out exactly how you find the right person, how you train and motivate them, and then how you hold them accountable. Just saying.

Now here's number 7 on how to think your way to success

Thinking is a learned skill. Becoming a good thinker is a discipline that you can get really good at By practicing. Just open your mind, be curious, ask why, and how. A whole lot more often, such as, why do we do this task? Or how could we do it better? Or could we do something else instead that is faster, cheaper, easier, or more.

Now here's number eight on how to think your way to success: Think big picture.

It's so easy to get caught up in the minute details versus the overall bigger picture when thinking your way to success. An example would be you reminding your staff regularly that customer service. Is more important than double booking and making patients wait. Instead, you figure out how to avoid no-shows in the first place so you don't have to double book.

For example, you can charge a consult fee or at least reserve their time with a credit card while when they're booking. Um, and you can even text multiple appointment reminders and so on. Get a lot more creative about how to. Good customer service rather than the opposite.

Now, here's number nine on how to think your way to success: Always be learning good thinking, in order to think your way to success.

Surgeons stay open to learning and growing for a lifetime. Even though they spent many years learning to be a surgeon, they realize there's more to it than that. They now have to learn to be a good leader, manager, and marketer to stay.

Now, here's number 10 on how to think your way to success. Listen to the experts. You can get a Reader's Digest shortcut education just by listening to others who have been there and done that.

The specialized experts have already done the heavy thinking on a certain topic, so you don't have to, which helps you think your way to success. For example, you can spend 40 hours on the weekends learning the latest marketing hacks, or you can pay an expert in plastic surgeon marketing to customize a proven marketing plan for you. So, for example, if your time is worth at least a thousand dollars an hour, which it is, and the consultant charges 10 grand, that's a savings of 30 grand and you'll have an actionable plan to execute.

Doesn't that make more sense to think your way to success?

And the last one is, number 11 on how to think your way to success: Think big.

This is different than thinking big picture to think your way to success. This is more like 10 times in your efforts and results To make that happen, you would have to think. How could you do that? It will expand your mind and your thinking. So, for example, if you currently bring in 1 million a year, thinking big has you asking yourself, how could I bring in 10 million instead?

Now, whenever you ask your brain a question, it has to give you back an answer, which is key on learning to think your way to success. So, listen and take notes when the ideas come, and some of those ideas will be something like, raise your prices or bring on more service providers who have big following. Or train other surgeons on your innovative techniques, and that's just to name a few examples on how to think your way to success.

If you sit still long enough, the answers are within and they will come to you. So, to wrap this up, I wanted to leave you with a few quotes to bring the point home. Ralph Waldo Emerson said, everything begins with a thought. John Locke said, what we think determines who we are, who we are determines what.

James Allen said, our thoughts determine our destiny. Our destiny determines our legacy. Now, my own advice that I learned from Wayne Dyer, the spiritual guru, is if you change the way you think about things, the things you think about change. Gosh, that is so true. So that wraps it up for me. If you haven't already, would you please subscribe to Beauty and the Biz and then of course check out www.cosmeticpracticevault.com.

It's got everything you need to know about the business and marketing of running a very specific successful plastic surgery practice.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how to think your way to success.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Think Your Way to Success".

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

#thinkyourwaytosuccess #successfulthinking #successfulplasticsurgeons

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to "Beauty and the Biz," where we’ll discuss building a world-class team. Additionally, we’ll discuss the general business and marketing side of plastic surgery.

As always, I’m your host, Catherine Maley, author of "Your Aesthetic Practice – What Your Patients Are Saying." Furthermore, I’m also a consultant to plastic surgeons, helping them get more patients and more profits.

Presenting today’s episode titled, “Building a World-Class Team — with Manuel A. Lopez, MD.”

Indeed, what does it take to run a thriving plastic surgery practice with 50 team members?

Specifically, Dr. Manuel Lopez, a facial plastic surgeon and founder of Advanced Aesthetics Lopez Plastic Surgery and L Spas in multiple areas of San Antonio, Texas, believes the answer lies in one simple but profound principle.

Simply put, it’s not about making money—it’s about providing world-class patient care.

Now, in the latest episode of "Beauty and the Biz," Dr. Lopez dives deep into the systems and leadership strategies that drive his success.

Specifically, here’s what you’ll learn:

• First, How Leadership Sets the Tone: He ensures everyone feels heard and valued.
• Then, The Secret to Hiring Rock Stars: He sets clear expectations during the interview process.
• Afterward, Processes Over Profit: When issues arise, it’s usually the process—not the people—that needs fixing.
• Finally, Motivating Staff: A productivity-based pay structure creates accountability.

Ultimately, Dr. Lopez isn’t just growing his practice. Instead, he’s building an environment where both his team and patients feel supported every step of the way.

P.S. Are you ready to uncover the hidden opportunities in your practice? My Practice Growth Review is designed to help you fine-tune your people, processes, and patient experience to uplevel your profits.

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Visit Dr. Lopez's website

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

#manuelalopezmd #drmanuelalopez

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and blending plastic surgery with wellness.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Blending Plastic Surgery with Wellness — with Emily Hartmann, MD".

The healthier your patients are, both physically and mentally, the better their outcomes and the less grief you have to deal with.

So, you can either hope your patients are fit or you can proactively help them get to sound body and mind, so they have a smooth journey before, during and after surgery.

This week’s Beauty and the Biz episode is an interview I did with Dr. Emily Hartmann, a board-certified plastic & reconstructive surgeon in private practice in Chico, CA, where she was born and raised.

She takes the sound mind and body philosophy to a new level. After suffering from her own health issues trying to juggle being a wife, mother, surgeon and business owner, she needed a new approach for herself and her patients.

Here’s what we talked about:

• The downside of tackling medical school, marriage and babies all at once
• How the COVID lock down helped her prioritize
• How her approach to addressing ALL of her patient’s mind, body and wellness issues has grown her practice kingdom quickly through word of mouth.

Visit Dr. Hartmann's Website

P.S. If you want to attract more cosmetic patients, check out my latest resource to help:

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

Transcript:

Blending Plastic Surgery with Wellness — with Emily Hartmann, MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and Dr. Hartmann’s wellness package with surgery. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits. Now I have a very interesting guest today who has made a success of blending plastic surgery with wellness.

It's Dr. Emily Hartmann. She's a board-certified plastic and reconstructive surgeon in private practice in Chico, California, where she’s been blending plastic surgery with wellness. So, I'm in Sausalito. She's probably two hours away from me. So, she was born and raised there, which is probably how she founded because I don't know where Chico is. And she's owner of Beauty Eternal Surgical Practice, as well as, Beauty Eternal Medical Spa, and also, the Medical Director of the Eternal Wellness Spa, offering holistic services to support the mind, body, and soul, and thus, blending plastic surgery with wellness.

Now, Dr. Hartmann is a graduate of Georgetown University's School of Medicine. She did her residency at the University of Wisconsin Madison and her aesthetic surgical fellowship at an ASAPS credentialed University of California Keck School of Medicine. And she practiced in Marina Delray and Beverly Hills.

So, she has several publications under her belt and summer Along the way, she found time to get married and have three kids. Yikes. So, Dr. Hartmann, welcome to Beauty and the Biz.

Emily Hartmann, MD: Thank you So, much. It's an honor to be here.

Catherine Maley, MBA: Thanks So, much for coming. So, tell me this quick journey. I like to hear the journey between fellowship and solo practice. How does this relate to blending plastic surgery with wellness?

Was it a jig jag or did you go straight to it?

Emily Hartmann, MD: I went straight to it. I knew I had my sight set on coming home because I, my kids were young and I just wanted to be closer to family and I love the idea of serving my community once I realized I wanted to do more aesthetic surgery and breast reconstruction.

So, it just really. I bee lined over here.

Catherine Maley, MBA: So, did you have to start from scratch? Did you buy a building? Did you rent a space? How'd that happen? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: So, I found a partner and a guy in town who was in private practice, solo practice, and he was incredible in terms of letting me come in just 50 50. Kind of hung a shingle with him as we expanded to new buildings and we opened an, an operating room a quad, a s f, and Medicare approved operating room as well as a med spa.

So, he was very, Open with me and, and was able to give me a platform to spring from very quickly once I was in practice.

Catherine Maley, MBA: Is he a plastic surgeon? Yes. Yes. So, when you two came together, what was the agreement was, were you his associate, were you partners? Were you Completely two different? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: We were partners 50 50.

Oh. And yeah, it was pretty incredible. So, I just had, he had the, the, the worth of what he already owned. And So, I just bought in 50 50 with what I brought with me, and then we built from there.

Catherine Maley, MBA: And was like, was the goal to have him and you come in or like, what, what was up, what was his motivation for adding another surgeon, especially somebody young with not, without a following?

What was the benefit to. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well probably his retirement plan that I would slowly kind of buy him out and he would have an exit strategy. So, I, you know, he was a, he's a very a very kindhearted person, just enjoys having camaraderie around him. And I think that was part of it too. We just kind of —

Catherine Maley, MBA: That's unusual, right?

Yeah. I mean, had you known about him or had he known about you? Like, did he also, grow up in a community and like what was your, what were you bonding over? It's weird, right? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, I think we bonded over plastic surgery mostly, and that I wanted to be in Chico. So., I woke up in the middle of the night and thought, oh my gosh, I need to look at Chico as options.

Maybe I want to work in Chico. So, I started calling around So, that there were five plastic surgeons in town and he was just So, open and kind. And., we'd had some good conversations back and forth, and then it just went from there. He had a great business manager who then contacted me when I was in fellowship and she, she came down interviewed cause I was working at, with Grant Stevens at the time.

Wow. And she toured the practice and I just said, I want to, I want to do what Grant's doing. I want to build the dream and bring ev watch everything come to fruition. And so, She did it.

Catherine Maley, MBA: That's seriously amazing because not everyone thinks like ran Stevens. He's an anomaly for sure. So, you were hanging with these big thinkers, like he's such a big thinker.

And then you're coming back to Chico and I'm sure that them, the plastic surgeon you were going to join. I just like, did he know you had big. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: I shared them with him. Okay. And he was, he wanted me to, Just succeed in whatever it is that I, I needed to fulfill, have my own sense of fulfillment. Mm-hmm., he was very happy in his practice the way it was.

So, I just brought more elements, more energy. You know, we, we bought a cool sculpting machine almost immediately, and he was, he was excited, I think for the new experiences.

Catherine Maley, MBA: And then how did you enter the marketplace? Because were you just feeding off of his patient list? Was he already doing some pretty good marketing?

And then he said, oh, by the way, you know introducing, you know, how did, how did you step into the marketplace? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: So, he had been here for 12 years before I, I came along. He already had a pretty good footing though. He was predominantly a hand surgeon and a reconstructive surgeon, and, Really, I started from scratch.

He was not doing much in the way of marketing you know, outside of local magazines and such, but didn't have really a strong website or anything, so, So, that was I, I essentially was starting from scratch and building from, I just started taking, you know, call at the hospital and whatever I could do.

It was a very stressful time. Mm-hmm. Trying to, Get through my board's experience and then I had small children at the time. It was, it was a really intense, intense time. And my, the person I was in practice with he was very understanding and supportive. It was a good, it was a good relationship.

Catherine Maley, MBA: And then is he still in practice now? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: He is, and we have separated. Okay. Practices. Honestly, I, I had this massive experience when Covid happened and I just, I just realized that I needed to make a dramatic shift in what I was doing, and I really was better off by myself. Mm-hmm. and he understood. We're still great friends and I, you know, operate, we still operate out of the same or.

He just, you know, has a big heart and is excited for me to fulfill my dreams, but we are definitely kind of going in different directions.

Catherine Maley, MBA: Well, I would think if he's recon, you know, is he's doing mainly hand surgery and you're probably loving cosmetic. You're probably loving both. Like how are you balancing that?

Because if you were hanging with Grant Stevens, you, you know, he, he, he's got it all going on over there. So, how were you? Did you like cosmetic or did you think you were going to be reconstructive and then cosmetic really got ahold of you? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, So, in residency all you really see is reconstructive. And that's really what I remember.

My brain was, you know, I was going to do peripheral nerve, I did a lab year and then I just really had. I was starting to get this big realization around my fourth year of re residency that I needed more in terms of interactions with patients and also. The whole research thing didn't jive with my what my sense of purpose was.

I didn't really get that, the fulfillment that I was hoping for. And So, that started to change me. And I actually started to interview attendings around me about their lifestyle and what, you know, what kept them up at night. And it was just a, a lifestyle that I think was not for me. And then I started doing a rotation with aesthetic surgeons.

And I was started to see some really neat stuff going on, and, and they just seemed to have the, I'm just, the private practice world seemed to have So, many opportunities for me to think outside of the box that it really just pulled me in.

Catherine Maley, MBA: But you hadn't been thinking about that until way later, right?

Like a lot Actually that's not true. A lot of surgeons never even think about it until they're 10 years in at the hospital and they say, this cannot be the way we do this. You know, and they like, So, you, you get these revolutions whenever you get them. You know, this might be the actually a good time for us to talk about why you're on this.

So, this is how you got on my. I happened to I don't know why I, I, I just can't get enough of this industry. And So, of course I signed up for this 7:00 AM on a Saturday morning. Beautiful. The Aesthetic Society had a great webinar with the women and it's about burnout. Mm-hmm., and I just couldn't miss that because, you know, you guys are really like gosh, I mean, you're doing the, the job of a lot of people in one, So, I loved your story.

So, could you just, let's just talk about burnout for a minute. Cause nobody ever talks about it. Everyone's fine. Everyone's doing great. Everything's great, you know, and I love when people are authentic. So, j could you just go into your story a little bit of how you got to that? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Absolutely. Thank you.

Yeah. So, this. This whole process has been constant episode of rediscovering myself and when you get through residency, well, medical school, residency, fellowship, and you're just doing all the things that you feel like you need to do, and then you get into being an attending. And a young attending in a new practice, new location, I really didn't feel like I knew what I was doing.

Everything seemed to be just So, challenging and it wasn't what I imagined. I think I had all these expectations that were really unmet. It was hard for my spouse as well because he was. Thinking that everything was going to be easier after training, and then we buckle down, then, you know, everything's going to open up in this, and the, the, the, the lights will be brighter and money will fall out of the ceiling.

none of it. True. So, there was a lot of pressure on me to, to make things work. And I. Doing it. I was in survival mode. I was, you know, showing up for my kids and showing up for my patients and showing up for my family, and I just, over time showed up for myself less and less. And then I realized that I, I was starting to have some.

Some health issues and really some mental issues. I mean, I, I had started I developed an anxiety disorder in medical school, So, that was something I was already grappling with and had kind of managed.

Catherine Maley, MBA: But then what does that mean, an anxiety disorder? Like what does that look like? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: It looks well, it manifested as panic attacks.

When I was studying for my shelf exams in medical school and I had to see a psychiatrist, I could, I had terrible insomnia and, and I needed heavy medication

Catherine Maley, MBA: So, that, opened the door for the…? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: The route of panic attacks and anxiety to be more sort of, it creeps up every now and then. And So, I had developed methods of coping, but they weren't exactly healthy.

So, then Covid struck, and I had all this time to sit and think to myself as many people. and I started to meditate. I started to read books that were, seemed to like, kind of come to me divinely. Mm-hmm. And one of the main books I read that really had an impact on me was Mind Over Medicine by Alyssa Rankin.

She's a very prolific author. I'm not sure if you're, if you've heard of her.

Catherine Maley, MBA: I'm going to mention her in the notes then. Yes. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Mind over medicine. She is just fabulous. She actually lives in Marin near you. Oh yeah. She's, I'll get her on the podcast. Oh, she's amazing. So, Alyssa Rankin is an OB-GYN not practicing any longer, as she had experienced her own burnout.

And from that fallout, she developed this system of tuning into your internal wisdom. and there she has this whole methodology, and a way to prescribe yourself what you think you need. And it's beautiful. It's a beautiful way to prioritize your needs and realize that what you've been conditioned for doesn't have to be that way.

You can think outside the box, you can write your own rules. And that was very empower, empowering to me. And I realized that I wanted to create a, I wanted to create something very special for my patients and. What came to me was this idea of mindful plastic surgery and putting together my love of wellness and my love of l embodying all the other modalities that can impact patients with plastic surgery and.

Took out big pieces of paper and started drawing on the walls and became extremely directed in my vision. And that's when I decided to break ways with my partner, move o physically offices, and I not looked back.

Catherine Maley, MBA: So, what did you create? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: So, it's now a year and a half old as our brick and mortar has opened.

And it is a two buildings plastic surgery and a meds spa. And then across the parking lot is my wellness center where I have. A whole host of complimentary services, hypnotherapy, which we use to prepare patients for surgery. My hypnotherapist has a beautiful pre-op program that patients see him two months prior to surgery and they start to flood their system with positive affirmations.

It is the most beautiful.

Catherine Maley, MBA: Can they do surgery without anesthesia? Thanks to him. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, like, like a hypno-epidural. There, there, there are, there are. We, we haven't really ventured into that yet, but there hypnotherapy is extremely powerful. Mm-hmm. People know it a lot from the hypnobirthing and how impactful that can be, where you dissociate completely.

And it's, it's pretty incredible what the mind can do. So, what, when I, when I first started putting this together, my main goal was to tackle anxiety leading up to surgery for sure.

Catherine Maley, MBA: It's a big deal. I deal. Cause I'm training coordinators, you know how to get people to a Yes. And what they're forgetting is people are scared.

oh, it's So, scary. You know? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Mm-hmm., we also, carry a lot. Stress and trauma and different ways of managing it. And a lot of people just bury it deep down and then surgery comes along. And, you know, it's interesting. Patients have a tendency to, they just don't, they don't think about it in the way that it.

It's like a huge life experience. Mm-hmm. and that sense of vulnerability and lack of safety, that feeling can all of a sudden manifest all of this anxiety. Mm-hmm. and tension and fear, and we know going in to surgery when you're like that harder to manage from an anesthesia standpoint and a pain management standpoint, but then after surgery, they're tense, they're anxious, they are harder to rationalize with.

They're just, they're, they're tricky because they're con, their mind has sort of captured them and So, that we know a lot, many studies that show an. Complication rate in patients who have a higher anxiety rate prior to surgery. So, it, it's just been revolutionary. I also, do not tend to prescribe narcotics, or at least I try to avoid it.

And by doing this, I prescribe herbal supplements prior to surgery that our anti-inflammatory. And then supplements after surgery. This, this also, has completely changed the way, you know, my patients walk in, they're very clear. They've got very little bruising, very little swelling. And this is definitely stepping outside of the box for plastic surgery.

Mm-hmm., you know, we, we are trained to hold all our herbal supplements prior to surgery because Right. Who knows what's in them and it could cause bleeding and some have more compelling evidence to increase the risk of bleeding. And some, you, it's, it's largely vague. Mm-hmm. So, in searching for, Well, in my county, the issue with opioid abuse is, Through the roof.

Mm-hmm. So, I have to be extremely careful. I feel as though being a good warden to my community, I, I just don't prescribe them on the front end. And I always tell people, I will give them, if you need it, you know, you get my cell phone number and if you need it, I'll, I'll prescribe them, but I don't dole them out without real care and consideration.

In addition to that, we have reiki, which is energy healing. Reiki is a very beautiful experience that is hard to explain until you have the experience yourself. But essentially someone who is trained with reiki uses their hands on your body in certain areas and they just spend time shifting your energy, trapped energy, stuck energy, childhood energy traumas, and Realign you.

Catherine Maley, MBA: I'll just give you my Reiki story. I, okay. I'm like Irish Catholic from Chicago, like we don't believe any of this hooey. But cause I've lived in northern California So, long, I'm, I'm a firm believer now. However, I'm in graduate school, we had to do this weekend getaway, and I have always jogged forever and I have a pulled hamstring and I've had it forever.

The girl from India, of course, knows Reiki and says, I can take care of that for you. And she doesn't touch me. She just does some weird thing gone forever. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: That wow. Crazy. Wow. Yes.

Catherine Maley, MBA: I'm a true believer.

Emily Hartmann, MD: Wow. That is a wonderful story. I hear, I, I hear So, much of that just in, you know, until you feel it and experience it yourself.

It's kind of hard to convince people. Yeah, it is life changing. It is. So, we have reiki, we have my nurse practitioner who's in charge of all the wellness programs, she, she actually spends three sessions with my surgical patients, getting them ready for surgery. So, she, it's amazing. She talks to them about things that I, you know, we don't have time to talk about.

Things that are important to the surgical experience, like getting your environment ready, reducing inflammation, reducing stress and, you know, breath work and breathing techniques. She's, she's just incredible. So, that is my goal in terms of optimizing patients for surgery. And we also, offer, you know, massage, lymphatic massage and facials and function similar to a day.

Catherine Maley, MBA: Holy cow. Alright, So, the way the office is set up, you have one building with the plastic surgery and the med spa. Mm-hmm., the non-surgical, the surgery is done in another building that you two are sharing. The other surgeon is sharing. How far is that from your office? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: It's about a five-to-10-minute drive.

Catherine Maley, MBA: Oh, nice.

And then the park across the parking lot is the holistic center. Yes. Right. So, alright, those are a lot of moving parts there. So, how many, how many staff is involved in all of this? Like how and, and how many are revenue generators?

Emily Hartmann, MD: You know, we have about 20 staff. Two of those are nurse injectors who function in my med spa.

They do the lasers and injectables, and they're very gifted human beings. So, those, those are my co providers. Mm-hmm. And So, yeah, we have about 20.

Catherine Maley, MBA: Well, you jump right. You've invested in the lasers, you've got your buildings, you have your or holy cow. How's it going? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, I appreciate you saying that because it feels like we always need to be doing more, but, but I've come to a point where I want to, now that I've realized the dream mm-hmm.

I just want to spend time making it better. And I, I feel like we, we keep having people call. We, we don't have a microneedling RF device yet. We don't have this, and we don't have that. We have a lot of things, but I, I, I really want to be experts at what we deliver and I want to focus on the patient experience because when, when you get So, bogged down with all these different facets, it's easy to.

To lose sight of the purpose, you know, the main.

Catherine Maley, MBA: And it's not, it's not always more is better because if you had too many variables, you absolutely lose the patient experience quality part because there are too many things going on. Too many people work there, too many patients are in there. You're there for too many different things.

I personally love the idea now of more concentration on the patient experience, So, they return, refer, and review, than constantly trying to get a whole bunch of new people. Looking at all your different services and I just think that's a different kind of game to play. You can do it, it's just complicated, you know? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Right. Yes, yes. And you know, creating your own definition of successful, you're right. To me, I, I would rather have a really in-depth conversation with a patient and discover that plastic surgery really isn't for. You know, they need to go focus on, you know, managing their traumas or leaving their abusive husband.

You know, plastic surgery isn't going to make you feel better. May, it might make like, You know, in the, when you first go in and talk about it, and people think that it's like getting a haircut, it's going to suddenly make you feel lighter and better about yourself. But I have to be really careful with the tools that I have been, you know, I have developed, I, I'm acutely aware of how.

How selective I need to be and that not everyone is a good candidate, but unless you take that time, it's really easy to miss those things. So, for me, I would just much rather let those patients go mm-hmm. and pull in and focus on the ones that You know?

Catherine Maley, MBA: I feel like are really need the investment at every medical conference I've gone to.

There's always that topic of I wish I had followed my intuition. I wish I knew this was going to be a problem, but I thought I could handle it. There's always the unhappy patient's story there. Do you have any tools you are using to get you to identify those red flags before you get into deep. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, My number one method is I schedule enough time with my consults that I really can talk with them about what brought them in.

And I always ask the, the difficult stuff. You know, that's, and I don't let spouses in because I just wanted to focus on the patient mm-hmm. And So, I, you know, I dig deep into understanding what brought them in. And that takes time because you have to kind of first establish trust. And So, I think that's the best way to the best way I've found to, to find those red flag patients.

Other ways are, of course, just paying attention to how they interact with your staff, and that can be a real. But it's, it's tricky. It's tricky.

Catherine Maley, MBA: What are, what are the tough questions you would ask them that would help you indicate something might be off? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, I always want to know what do they think they're going to accomplish with plastic surgery?

And I'll tell you, it's the people who don't have solid firm answers that raise my red flag. You know, people who come in and, and they just, they can't really explain what they need. They just say, I just want you to look at me and tell you what I need. Tell me what I need. And I'm like, Oh yeah. Versus the, you know, mother of 3 42 comes in as like, take off this extra skin.

And I say, yes, Mm-hmm. So, it's the non-descript kind of sad and or overly energetic, but have a hundred things that they want to do. They're just not quite as focused. And those patients

I have to really give pause.

Catherine Maley, MBA: Okay. You know, that's interesting. You say you don't have the husband come in. I actually want the husband to come in number one because. Don't they always say at the end, every woman blames it on her husband. I have to talk to my husband about this. I can't, I can't give you an answer.

I have to talk to my husband. And I'm like, what is with this, with this husband thing? I'll put the husband our boat without telling you or asking you, So, whatever. But I then I say, okay, then let's bring the husband in because he can also, be a red flag if he's the one doing all the talking and she's just sitting.

I think that is really helpful to know because you start asking, well, why do you want to do this? And he answers for her, that's really good intel too. So, you're doing it the other way, you just, you know, don't even want the husband involved. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Yeah. Yeah. And it depends on the situation, but when I first meet someone, I like it to just be us.

Catherine Maley, MBA: That's a great idea. How do you somehow introduce them to the holistic side? Because it sounds like everybody is going to have a holistic slash surgical experience with you. Is that right? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: For the most part the everyone is signed up to meet with Lauren. She is. The one who spends a large amount of time with them.

And So, I know that they're going to get that introduction, but when I'm talking with them and I'm going through the process, I just introduce it as a normal part of our experience. So, I, I say we have a pre-op hypnotherapy program. It's essential for managing your anxiety and optimizing your outcomes and, and increasing.

Level of satisfaction after the surgery, and it also, reduces the sensation of pain. Everyone is like, oh, okay. And that the you know, I just, I basically just work it in like I would anything else?

Catherine Maley, MBA: And is it part of the package? Yes. Is it, it goes, it's included in the., but what about the lymphatic massage?

Because that can also, often be a little stickler because a lot of the practices just do the, the surgical procedure and then they refer out, you know, to somebody else to do the lymphatic massage. And some of these groups are charging the patients, you know, your patients several thousands of dollars. How does this relate to blending plastic surgery with wellness?

And how are you working that part out?

Emily Hartmann, MD: We just bundle it all in and So, it's a requirement. Obviously, I can't force them to show up for their appointments, but it is, they've paid for it, So, it is a part of their package and that way they're not paying for multiple things, but everything is sort of, is all inclusive.

Catherine Maley, MBA: I love that idea. Thank you. Good for you. Because you know what you're, that's how you're differentiating yourself as well, because others aren't doing that. I'm trying to think though. Somebody like me who's type A is like, oh, blah, blah, blah, blah, blah. Like, can we just get on with this? But I also, love the head the mind stuff, you know, So, I'd probably be okay.

I, I want the hypnosis. I think that sounds fantastic. And then I love the lymphatic massage, So, maybe, I mean, have you had any resistance to it? Are the patients loving having that full package? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Man, they, they're, they're loving it. I've had some interesting resistance to it, just to kind of random reasons that they don't like massage.

One patient who has a bad experience as an adolescent and So, they don't like people touching them. And I said, oh, yes. No problem. That makes sense. But we have hypnotherapy that can help you. So, it's a, you know, you know, it's customizable, but it's generally something Yeah. That, that people are excited about.

It is So, beautiful to go from this experience because we, breast reconstruction can also, you know, use the services have this experience where you're, You know, this very emotional difficult time. And to be able to walk over to the wellness center where everyone is, is on board with your healing, everyone understands versus going to another place that's off brand and they don't know you.

You have to explain yourself. This is an a, a relationship that we are establishing with patients that carries through this. Beautiful. Oh, sure.

Catherine Maley, MBA: Let's go back to the staff again. 20 staff or a young surgeon is insane actually. How are you, how did you, did you study leadership and management? Did you get a killer practice manager who's handling this for you?

Like what's the secret to handling all of that? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Thank you. I'm So, glad you asked this because this is my secret weapon. My business manager is insanely good at her job. So, she has a medical business consulting, or excuse me, a medical consulting business. Mm-hmm. and called Medical Business Solutions.

And So, she and her staff do all the HR and, and hiring and firing the sticky stuff. Yeah. I, however Do not. I am. I like to be involved. I like to be a leader. I like to, to set the vision and I'm, I'm, she doesn't treat me like just a money generator. She really brings me in and she is, she actually builds me up as a leader and I lean on her quite a bit.

She, I just went to a leadership meeting for the Aesthetic Society. And So, she supports me in trying to be the best leader that I can because it doesn't come naturally to me.

Catherine Maley, MBA: Nobody, nobody's a born leader. It's a learned asset. Some people are more innately attuned to it, you know, it's learned. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Yeah, but it's, it's really, it's So, rewarding Once you can have this functioning body of people who are growing and learning and, and propelling forward with the same vision and you can set back and watch people find their own zone of genius and you don't have to do everything. You can just kind of let them take the lead and, and.

It's just, it's a beautiful process. So, I've grown a lot. I've learned a lot. It was blood, sweat, and tears, but it's been wonderful.

Catherine Maley, MBA: Would you say staffing is the biggest challenge or what would be your biggest challenge? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Well, it's interesting for me personally, staffing and turnover. You know, I had the, an amazing nurse practitioner who then had to get engaged and married and be happy No.

And then move away. And So, those, those kinds of unexpected things, I'm just kidding. I'm very excited for her. But those unexpected things, those shifts are of course, challenging. You know, I've got such a strong team that we can lean on each other. So, I think the staffing stuff doesn't bother me as much as what?

What really is tough for me is to hold firm to. What I need to maintain my mental health. Hmm. That is a, I'm constantly being squeezed, and not by anyone's intention, but it's just the nature of the beast. Mm-hmm., I naturally want to show up and say yes and do all the things so, I, I'm constantly kind of reexamining where we're at and, okay, I need to re reestablish my boundaries.

I need to see the wipes of my kids' eyes in the morning. I need to kiss them goodnight. Good. You know, at night. And I have all these phys, these, you know, I do things that keep me sane and maintain my anxiety because I'm the one running this shit. So, I affirm me personally, that is the, a very big challenge that I, it takes a lot of discipline and self-awareness.

Catherine Maley, MBA: And you need to learn that now for the next three decades because every surgeon I know who had developed bad habits now have to develop better habits in their fifties because their neck is killing them, their back's hurting, their E. Everything hurts and. And, and their attitude's getting bad. Like, if I have to do one more liposuction case, I'm going to kill myself, you know, it just, it starts numbing.

So, I'm So, glad you're developing good habits now. How are you finding the time to meditate? I have tried to meditate for years, and, and I know it's So, good and I, I struggle with it to sit still. I, I, if there's some, some kind of like jogging meditation, I would be better off. Or like, if I could meditate on the treadmill, I'd be like, I just like to. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Actually, there is. So, So, today I actually did a walking meditation and it was synchronized to my steps and it was a really beautiful, I'd never done a movement meditation of that. It was like a guided meditation. So, there, there are methods for people who are not sit stillers. Mm-hmm. But I still. Still, you know, running is definitely a movement meditation.

But there is something magical about sitting there still. And I, I, Lisa Rankin talks about this, that the things that are sometimes we are the most resistant to are exactly what we need. So, I mean, that's always helped me.

Catherine Maley, MBA: I can do 15 minutes. I used to be able, yeah, I was doing four and now I'm up to 15, and I can do that fairly comfortably.

On the weekends I can go. 30. Whoa. But after that, I'm getting itchy. I just, because I'm really, I know what's going on in my head and I get all the messages that I'm, that I'm, I know when I'm, when I'm, when I'm open to it and when I'm not. Like I, I just, I feel like I've spent enough time with me that I, I, I understand a lot of that already.

Boy, I, it's So, important to stop, like stop and stop thinking. Stop thinking, stop. The monkey minds us. All that stuff going on. I just, you know, it's hard to do in this world today. Yep. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: It is. I was just reading Michelle Obama's book. Mm-hmm. The Light We Carry and she talks about picking up knitting during Covid because she was ordering stuff on Amazon and she thought, okay, I'll, I'll order some knitting needles.

And she taught herself to knit, but that, that she had never. Done something. Like that with her body that wasn't So, like, you know, intensely using her brain and now, and she just knits, she's knitting up a storm because it really brought her this sense of calm and peace and home sense. Mm-hmm. And I just thought, there you go.

There's a meditation.

Catherine Maley, MBA: I, yeah. Yeah. I knitting’s not going to happen probably, but I, I do a lot of journaling and you know how they always say with journaling, oh, you must do, you know, pen and paper. Hand and paper. You know, you've got to hand. And I thought, no, I don't. Every time I try to do that, I resist it because my handwriting is atrocious.

Oh. And I can, I can't write as fast as I can think, but I can type like nobody. So, I type and it is So, meditative for me. I just, you know, like the thoughts of the day, you just type them out. I get it all down. I do it every morning. That is my. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Right on. That's amazing.

Catherine Maley, MBA: All right, well then thank you very much for that conversation,

Cause as you get older too, you say, who says you have to do that? Like I, I question a lot more than I used to. I used to just be like a good soldier and I know you were too, and you're probably your worst critic and you push yourself more than anybody else pushes you. Have you gotten a handle on that and you're feeling like you have a better control over your life? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Most definitely. Most definitely. And I have the freedom to push back and to create those boundaries that I've, I've never had before. This is a really, really incredible time for me. And that's not to say that the, those like, So, it's interesting I, if you start reading. Mm. Masculine and feminine and, and things of that nature.

You know, plastic surgery was built on, the masculine medicine was built on the masculine, and there are certain ways that we, you know, that we learn that are very masculine. And So, I. Once I realized this and I started to I stopped wearing a white coat, I just started to like, kind of slowly break down some of those just automatic or auto automat automatic reflexes and.

Decide what, you know, what was best for me? It, it was a real game changer. It was a real game changer. So, we're, we're very stuck in our, our routine. Oh, what's interesting, I know what I was going to say is this idea of a morning routine and, and of this, these check boxes. And if you don't do this, you know, everything isn't going to be just perfect that day.

It's a very masculine way to approach your day. And So, I, I love that you said this because I, you know, there was a time when I was very check boxy and, oh, I'm going to have a morning routine and a meditate. It doesn't work that way. We are cyclical beings and every day is different. Every week is different, every month is different, and phases of the moon are different.

It is a really, it's a really, it's a very freeing sense to have that realization. And say, oh, okay. That's why it feels So, impossible sometimes because I don't need to do that right now.

Catherine Maley, MBA: Well, I, I love podcasts. I'm sure you do too. And I'm constantly listening to the men, like these internet marketers who just crush it every day.

And I think I have become a man. I just, you know, I have got to chill and they take cold showers. Okay? I take cold showers and it's just So, habitual. All of this. And then I think I'm kind of lost if I don't do it. And that's even worse. Because then I think really, I mean, is it, seriously, Catherine, you, you know, you're not conquering the world here.

You know, I'm just conquering my corner of the world. But. Back to you. I think you're amazing. Thank you. So, you have, I'm loving your business idea. You've got these three entities, you've got 20 staff, you've got a great group managing it for you, which absolutely, you should be the leader in the visionary and somebody else should be in the weeds.

You cannot do what you're doing and be, do the Knickknack, all that. Just not healthy now. So, tell me about the revenues though, because you have. This is a big boat to float. So, how are you keeping that steady stream of patients to cover the overhead and are you losing any sleep over that? Is one group making more than the other group or do you find that if things slowdown in surgery, it seems like the meds spa will pick it up, or the holistical, like any of that going on? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: It does seem like this really interesting yin yang happens when one is down. Things just seem to compensate and I think that's the beauty of having a diverse practice that it will now the wellness. Center is the youngest of the, of the situation that we have going on. And that is definitely still we're just, we're just So, fresh and new and the revenue stream is not as robust as it could be, but we're, you know, it's, it's getting better and better every day.

So, that one is, is sorry. It's getting So, dark where I am. Fine. That one is a. You know, we're just, I, I have, I hate to say low expectations, but it's just really starting to take off and they're doing such a beautiful job, but word of mouth in my area is So, important. So, we're, we're just chugging up the mountain.

Yeah. Year and a half in.

Catherine Maley, MBA: Yeah. How important is social media to you to grow that practice? Or what marketing channels are you using to make sure everyone knows you're there? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: So, our, we still rely heavily on social media for followers and you know, people seem to. Kind of start following for a few months and then decide to make their consultation and then they'll start messaging us in social media, you know, getting gearing up for that.

And, and that still seems to be holding strong. I, I wasn't sure when we first started if social media was going to be as important as it is down in Southern California, but still it. Still a great way for people to get acquainted with who, with our philosophy. Mm-hmm.. So, that is definitely important. I, the, the largest number of new patients come from our website.

Catherine Maley, MBA: Okay. And are you doing SEO and you're keeping up with content, that kind of thing? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: So, our website is also, new in formation, and we are just starting to really make tweaks to it, to, to enhance how well it conveys our brand. But these, these things are So, much harder than I realized.

Catherine Maley, MBA: And they take longer and they cost more than you think and Yeah. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Oh, my goodness. Yes. Yes. But we just hired a marketing director in-house, So, she is We're really excited, excited about that So, that we can start really changing the website and making it more of our own as we had someone outside of our, outside of our company build it. So, So, that's exciting.

Catherine Maley, MBA: That's also, a big question. Do we bring it in-house So, we can control it? Do we outsource it and hope we can manage it? There is no right or wrong answer for that other than trust your vendor. Treat them like their staff. Communicate with them a lot and tell them what you expect. Don't make them guess.

Meet with them regularly. Tell them what you're like, what you're not liking, and don't wait until you're mad. You like, you're angry at them and they're like, what, what, what's wrong? Probably do a podcast just on outsourcing, because frankly, that's really a, a good way business model is if you don't have to do it in.

And you don't have to manage people and they can, it's just getting rid of some of this stuff. So, you can focus on the patient experience rather than the external marketing experience. It's the way to go if they're, and then they're the five is to go with it, you know? Exactly. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Yeah, exactly. I found experience of with the, with the web designer I found it.

The person that we used was very good. It was just, it was hard to communicate with them because they had So, many other accounts that it, I felt very impersonal. So, that's the only thing I would say to it. Otherwise, I was happy to have someone outside just putting it all together with their expertise.

But then, you know, the finished product I felt really didn't convey our message, but I think that was probably a result of, Of me still not owning that message yet, because it was a couple of years ago when we started building that website. Mm-hmm. So, it's been an interesting evolution, but I, I feel as though all things settle out in time.

Everything feels like it's not happening quick enough. But in reality, 10 years down the road, I'm going to look back on this time and, and chuckle a little bit about the experiences, but I'm enjoying watching things happen in real time. And they always turn out better and different than I could have ever hoped for.

Catherine Maley, MBA: I love your tagline. Can you tell us what it is?

Emily Hartmann, MD: “If it's important to you, it's important.”

Catherine Maley, MBA: I love that. That's really, it came off very genuine when I, when I opened up your website. It's like, if it's important to you, it's important. And I thought, oh, she hears me. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Yeah. Thank you. I, I that's just something I always say to patients who are.

Concerned that they're not making a good decision or they feel bad about, you know, financial burden on their family and whatnot. And, and I just always bring it back to if it's important to them, that's all that matters. It's So, simple.

Catherine Maley, MBA: So, far you're like a year and a half in or a couple years in.

What's your, like, what would be your advice to anybody else that's still new, you know, coming out? What, what would you do? Would you do this again in this big way? How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Oh, well, you know, hindsight's always 2020, So, it's So, challenging. But I would, I would, I wish that I had learned to listen to my inner voice sooner. And I wish that I had been more observant of the lifestyles of other plastic surgeons and, and really rather than trying to copy them, learning why they do what they do, but then, Listening to myself and digesting it and figuring out what works best for me.

I didn't learn that, learn early enough, but, you know, it's what gives us the depth of understanding for other humans. So, I don't regret it either.

Catherine Maley, MBA: You're learning an awful lot at the young age. You're, you really are, you're, you're way ahead of the game, as far as I'm concerned. So, tell us one thing we don't know. How does this relate to blending plastic surgery with wellness?

Emily Hartmann, MD: Oh, well, I became a black belt in Taekwondo when I was 17, and I'm, I am still practicing Taekwondo. I just went back to it two years ago and it has been such a wonderful and refreshing way to re, re find my power again and power through my body, and also, had, Be silly and make a fool of myself, Good for you.

Yeah, yeah. With people who just encourage me and want the best for me.

Catherine Maley, MBA: So, it was great. So, if you and your husband are walking down a dark alley and somebody approaches you, does your husband step back and let you handle it? Or what? How does this relate to blending plastic surgery with wellness?Emily Hartmann, MD: Yes, we do talk about that.

Catherine Maley, MBA: Yeah. Honestly, I go have at it. I'll hold your coat.

Yeah. Anyway, I'm going to wrap it up now. Tell us how can somebody get ahold of you who would like to hear more about you? And by the way, what's your website?

Emily Hartmann, MD: The website is www.BeautyEternalChico.com. That's c h i c o.com. and the easiest way to get ahold of me is through email. So, EmilyHartmann, make sure there are two ends at the end of that @mac.com.

That's m a c as in Macintosh.

Catherine Maley, MBA: Gotcha. Gotcha. Okay. Thank you So, much Dr. Hartmann for being on. I really appreciate it. And everybody, if you've got any comments for Dr. Hartmann or myself, you can certainly leave them on my website at www.CatherineMaley.com. I'd also, appreciate if you subscribe to Beauty and the Biz.

Do you have an Instagram account that they,

Emily Hartmann, MD: you want to mention? Yes. @BeautyEternalChico as well. Oh, there you go. Okay.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on Dr. Hartmann blending plastic surgery with wellness.

If you’ve got any questions or feedback for Dr. Hartmann, you can reach out to her website at, www.BeautyEternalChico.com.

A big thanks to Dr. Hartmann for sharing her story on how she’s blending plastic surgery with wellness.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Blending plastic surgery with wellness — with Emily Hartmann, MD".

 

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📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how Dr. Bloom achieved steady growth in just 3 years.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Steady Growth in Just 3 Years — with Jason Bloom, MD".

There is nothing easy about growing a new practice from scratch or even maintaining a growing practice, let alone achieving steady growth in just 3 years….no matter how old it is.

There are too many factors in the way of making steady growth in just 3 years:

• Uber competition, which can stifle steady growth in just 3 years
• Advanced technology, which can deflate steady growth in just 3 years
• Fickle cosmetic patients, which can hinder steady growth in just 3 years, to name a few

This week’s Beauty and the Biz Podcast is one surgeon’s story about how he opened his solo practice and grew it quickly from scratch and attained steady growth in just 3 years.

Dr. Jason Bloom, a board-certified facial plastic & reconstructive surgeon in private practice in Bryn Mawr, PA, focuses on facial rejuvenation, rhinoplasty, non-surgical treatments and hair restoration to help fuel the steady growth he's attained in just 3 years.

We talked about how he grew his solo practice and made steady growth in 3 years by being in the right location, hiring the right staff and taking good care of them, and how he networks to create a steady flow of referrals.

There are lots of pearls in our discussion.

Visit Dr. Bloom's Website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

Steady Growth in Just 3 Years — with Jason Bloom, MD

Catherine Maley, MBA: Hello everyone and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and how to create steady growth in just 3 years. I'm your host, Catherine Maley, author of "Your Aesthetic Practice — What your patients are saying", as well as consultant to plastic surgeons to get them more patients, more profits, and to learn about getting steady growth in just 3 years.

Now, today's special guest is Dr. Jason Bloom, who’s an expert at achieving steady growth in just 3 years. He's a board-certified facial plastic and reconstructive surgeon in private practice in Bryn Mawr, Pennsylvania, and has steady growth in just 3 years. Now, in regards to him creating steady growth in just 3 years, he focuses on facial rejuvenation, rhinoplasty, nonsurgical treatments, as well as hair restoration. Now, Dr. Bloom attended the University of Michigan Medical School and then completed his residency in Otorhinolaryngology neck surgery at the University of Pennsylvania, before embarking on attaining steady growth in just 3 years? He also, then did a fellowship program at the New York University Langone Medical Center, also before attaining steady growth in just 3 years? Now, Dr. Bloom has authored more than 40 journal articles and book chapters, and speaks at medical conferences all over the world. He continues to teach residents, sits on medical advisory boards and performs research studies as well as clinical trials.

Dr. Bloom, welcome to Beauty and the Biz. I’m excited to speak with you on how you’ve created steady growth in just 3 years.

Jason Bloom, MD: Well, thanks so, much for having me. It's a pleasure to see you and to be on this.

Catherine Maley, MBA: Thanks so, much. So, I always like to start with how, what was your journey to private practice before you started making steady growth in just 3 years? Because it's never a straight shot, is it? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Yeah, I mean my I, I've kind of had a little bit of a roundabout way to my own private practice.

So, when I was doing my fellowship at NYU in 2009, 2010 I. Came out of my fellowship and I actually joined a dermatologist in the Philadelphia suburban area, which is ki actually where I am now. But I joined his practice and he did only non-ablative lasers, but was a very big name in the space.

And he used to joke that I did everything in the office that caused blood or smoke. So, I did all of the ablative lasers, all the injectables and all the surgery. And we are still friends. It worked well. I was with him for eight years. But what happened was after you know, I was a surgeon, facial plastic surgeon in a dermatology office, and he was a cosmetic derm.

He and never took any kind of insurance or anything like that. My surgical practice just began to get so, busy that it was hard to run facial plastics practice out of a, a derm practice just because, and even from a support standpoint. So, whether it was surgical coordinators or booking things and seeing patients and follow up, it was, they weren't equipped in their office to do that.

And so, you know, I actually found a dermatologist to come in and work for him, and we separated very amicably and I opened up my own practice strictly facial plastic and reconstructive surgery practice in the Burma area not far away. And. That was about three and a half years ago. I have since brought on some nurse injectors.

I have a junior partner who works with me. She is a facial plastic surgeon and it's been great ever since. So, that's kind of, it's onwards and upwards at this point.

Catherine Maley, MBA: Nice. Let's talk about the location you chose and how that might impact you in attaining steady growth in just 3 years? It looks like you're kind of in a strip mall kind of retail area. Yeah. I, I love the thought of that, like the, what are the pros and cons of that because I pro it looks like you're on the ground floor as well.

You have your own building; you have your own big name on that center versus being in a hospital on the fifth floor. So, how did you choose that? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: You know I love having first floor access. It is so, nice. Patients walk. I mean, we have tons of parking patients walk in right from the parking lot.

They see our name, they see our sign, and yeah. And there's actually a lot of kind of, let's say a. Traffic and influence in the area. My neighbors in our kind of in our shopping area are a, a very busy salon, a very busy nail salon. And then across the straight street and aesthetic orthodontics, there's a dentist’s office.

There's a lot of kind of people who are interested in aesthetics, all kind of funneling in the same area. And so, when they, maybe they're coming in to get their hair done or their nails done and they see bloom facial plastics, they see it's, ooh, what's going on there? Not like we're accepting like walk-ins, but it does kind of like it's great in that we get that kind of cross traffic and people, it becomes kind of front of mind when they see our name on the...

Catherine Maley, MBA: I love that idea, in terms of steady growth in just 3 years. I think you picked the right location though, and the right clientele and the right high-end neighborhood because I've watched others do it, but then they're like next to Chipotle or TJ Max or something, and it, it doesn't have the same feel to it, so, I, I love your location. I think it's great. How has this helped you in attaining steady growth in just 3 years?

Do people ever come in and just walk by and say, I, I just?

Jason Bloom, MD: We, we, we see people like walking by, and also, we see our patients that are coming in for example, like PA patients who we've operated on or stuff. This, this is a very busy hair salon, very busy nail salon. And we also, work with some of these you know, with these companies and do kind of co-op marketing in terms of like the orthodontics.

We have their cards and their brochures in our office, and they're offering $500 off Invisalign. And we, and, and for example, if they send a patient for a lip lift or lip injections, then you know, they, and because they. You know, our pamphlet in their office, we give them a discount. So, any of the local businesses that are kind of in our direct area, we like to do kind of marketing things on.

I remember when some of the injectables were doing it, it was a new indication for like hand filler. And with the nail salon we, you know, any new patient that they saw that they had our brochures at the nail salon. Any patient that they referred got $50 off hand filler because they were coming in and getting their nails done.

And they say, oh, you know what? My hands are looking a little bit kind of deflated, or I can see the veins. That was a new patient they were sending us. You surely know how; how important it is to get patient referrals and how much those patients are worth. Mm-hmm., certainly doctors pay for patient leads.

This is more than, you know, I'm more than happy to give $50 off treatment to come in my office when it was sent from them.

Catherine Maley, MBA: It's a lot cheaper than finding an internet stranger patient, to help with getting steady growth in just 3 years, that's for sure. Okay. And they're much more likely to convert. So, I, you know, I think that's a great idea. One idea that, I will tell you somebody else, we both know this facial plastic surgeon, but they they're not in your area though, but they do the tchotchkes, you know, they do the, like the lip gloss and the pens and they just hand it to all the salons and just say, here you go.

And so, in case, because a lot of times these are great alliances, they just don't work out because you have to nurture these relationships and they're busy with their own practice, your business trying to figure out yours isn't on their priority list. So, I love to come up with what else can we do where nobody else is involved, like humans aren't involved other than there's a big bowl with your name, with all of, with your name in it, you know, and they can just take free views out of it. How has this helped you in attaining steady growth in just 3 years?

So, it's a thought.

Jason Bloom, MD: Yeah. And, and, and, and actually we kind of encourage all of these kinds of local businesses. We see a lot of. Of their employees as well for treatments and things. And we offer them steep discounts in order to come into our practice so, that, you know, they see certainly more patients getting their hair done or their nails done, then we can, you know, handle in a day.

So, if they're sending people and they said, Hey listen, we went to Bloom facial plastic surgery and I got some toxin and some filler, and they're recommending us, that's like, that's huge. So, we offer discounts to their employees and, you know, not to send us people, but you know, If they're happy, then they will send us people.

We're not, you know, so, it's been, it's been a great kind of back and forth that we've had.

Catherine Maley, MBA: Yeah. Have you ever done one of those parking lot tent events, you know, where you all get together and you all invite your own patients and then everyone, I mean, have you ever done some, it's a big deal though to, to put that together? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: We did. We did actually. We usually, So, every year when we celebrate our anniversary, which is in the, in September of our practice we do kind of get a tent. I have like a taco truck come, I have a the, the Mr. Frosty, Mr. Softy truck comes, and then we invite everyone to come out and just kind of like, get free ice cream, get some tacos, enjoy themselves.

Mm-hmm. And then also, when, when the orthodontist across the across the parking lot, who is a good friend of ours, when they moved into the space, we kind of had a welcome to the neighborhood party, same kind of idea.

Catherine Maley, MBA: Yeah, the I, when, a million years ago when I got into this, I lived in San Francisco and I was a marketing consultant and I would get plastic surgeon’s gigs at alliances.

So, they would give talks at high-end boutiques, hair salons all of that stuff. And it was, it worked great. It was a lot of work though, to coordinate the darn thing. But the point was we had a da a patient list, they had a patient list we needed to get in front of their patients. So, the doctor would pay for the marketing.

And in those days, we would send out postcards. Like they were really fun, big postcards, eye-catching. And they worked very well in today's world. I don't know, I wouldn't do that, but, but so, the surgeon it cost him maybe a thousand. Like we had refreshments and the postcard mailing, no big deal. And we got in front of all of their patients or clients, and that's how boy, that was, that worked like a charm for many years. How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: That's, That's fantastic. I mean, yeah. Who would, who wouldn't love to get access to? You know, more patients get in front of them, have people see you, meet you. Yeah. That's fantastic.

Catherine Maley, MBA: Well, especially when they're, they're almost referred, like their credibility. We, we got rid of the trust problem because there was already so, much credibility built into it.

So, when the surgeon showed up, it didn't feel like a, a sales thing. It felt like an educational event. and everyone was so, comfortable and I just, those worked so, well that I, you could still do it in today's world, you would just have to tweak it. You know, the marketing channels are different and the trust level is so, different now.

Like you'd really, that's why I like going with who already knows somebody that you could know, that they could introduce you to. It just makes your life so, much easier when you know those patients who show up with you, like, who are you? Like who, who are you? You don't want, you don't want a do that all day.

You want the patient who says, oh my God, you are so, funny on Instagram. Or, I love your family, you know, isn't that fantastic? Like, is that what happens a lot for you? They show up saying, I feel like I know you. How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Patients feel like, well, yes, because my Instagram is very unique. My Instagram, I actually.

Craziest. This sounds, I do it all myself. So, I have one account which has almost 18,000 followers and bought that one, but that's the account. I actually, it's uniquely me. It has my crazy sneaker collection of Air Jordans. I put my kids on it. I put your trip to Israel. My, yes, my, my, my trips, my vacations, as well as my before and afters for patients and things going on in our office.

We also, have a separate bloom dot facial dot plastics. Oh, I'll check that out. And that's like my office one. And we do have someone, I'm kind of like monitoring it, but we do have someone doing that because it's hard to do both. But I'm, you know, I worry is that if someone did take over my own account, the D RJ Bloom account, it's just like, it loses that authenticity.

I feel like there's something that. People know it's me because it's like kind of this self-deprecating, funny guy out there, like putting these things up. Mm-hmm. And I think to kind of pass that off, I, I think with lose a little bit of that it hasn't gotten too overwhelming. It certainly is hard to do.

Catherine Maley, MBA: How much time is it taking you per week? How many hours do you think? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: I mean, oh gosh. I mean, I would probably say 10 hours a week I spend on this. And so, it does, I mean, it, it takes a lot of time, but in the end I kind of enjoy doing it. I like interacting with everyone on it and they get a real sense of me and my personality.

And actually, just this like past week, I posted something about Mike the top nine, you know, posts from 2022 from last year. Mm-hmm. And when you look at the posts, The vast majority, like seven of the nine posts were more about lifestyle things and my family and my sneakers and things, and maybe one or two were about surgery and my surgical results.

And it just shows you that like what people respond to the most mm-hmm. are they want to see that kind of more personal side rather than strictly before and after’s and, and you know, it just makes you step back because I'm like, oh, people want a see my facelift results and they want a see my rhinoplasty results.

But like, the people have spoken, you know, it's like, it shows that they really want a see you from a more personal side.

Catherine Maley, MBA: It's just, I think you need both though. I think you've got to keep, keep showing the social proof, the social proof of, I mean, you're doing a good job of that, which certainly helps with attaining steady growth in just 3 years? But before and after photos, patient testimonials, patient videos are amazing if you can get them like you interviewing the patient afterwards or doing the nose reveal or they patients love that kind of stuff.

Totally. But it's so, true nowadays. What's the first thing we., we Google somebody or we just Google anything, and then we see someone's name. We don't go to your website. We go straight to Instagram and, and people, and like a lot of these surgeons are fighting it. And I used to fight it too. I thought, this is silly.

What a waste of my time. But for a surgeon, it's not for b2c, it's brilliant. For b2b, it's not as important, but I still have to be there too. Everyone does. We all have to be on social media and if you are not, you're definitely missing out on a whole group. And you can't say it's just for the little kids. How has this helped you in attaining steady growth in just 3 years?

It's, I mean, we're all on it now, you know?

Jason Bloom, MD: Yeah. I mean, I, I, I have been kind of selective in terms of my social media outlets. Like I'm not on TikTok and I'm not, I mean but, but some of my friends who are facial plastic surgeons have done extreme extremely well on that on that. But I am on Instagram.

That's kind of like my biggest platform. Mm-hmm. Interestingly, I have a website. I love my website. Love it. I think they did a fantastic job with it. But when people come in and are like talking about before and after’s and they want a see before and after’s, I, I don't even, like, I haven't up, I need to be better about updating my website and sending, but I update my Instagram so, much more frequently and sometimes I'm just sitting in a console with a patient and they want a see before and afterwards and we just like, scroll through the Instagram and I'm saying like, Ooh, see this, this is very similar to your case.

This is what I would do in this case. And we can look through all the pictures and then they, they can go and I'm like, you can please feel free to refer back to it. I put everything up there, all the different views and they, they feel good about it.

Catherine Maley, MBA: How are you getting so, many before and after photo approvals?

Because so, many surgeons still say, my patients are private. The minute they say that, I know it's not the patient, it's not, it's the surgeon's belief that, that that's true. It's not, it's not true anymore. I mean, I How are you doing it? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: A couple ways. So, first of all, doing a lot of surgery, So, when you do a lot of surgery you know, if one out of 10 like says yes, then that's great.

And so, yes, I operate three days a week, eight hours a day. And I do a lot of surgery. So, my n the number of before and after’s I can pick from is larger, right? Mm-hmm. And then the one thing that I always do is I ask personally. Yeah. Like, I'm the one asking that's the secret, and I say, listen, you look great.

I'm so, I'm happy that you're happy. Mm-hmm. and. And, and, and sometimes, you know, they'll say, you know, they, they, they'll tell me, and, and, and sometimes they're like, yes, I'm, you can post it. I'm happy to do that. We have them sign, photo, video, consent and sometimes they say, you know what? I don't want a be on your Instagram or your social media, but if a patient comes in the office, you can show, show them.

And so, you know, I'm grateful that patients even let me, you know, show other patients. But I think that personal ask, rather than having a staff member do it, is really, that is patients know that you, that you care and like that this means a lot.

Catherine Maley, MBA: Yep. Actually, a lot of them are flattered that you want to use their photos. How has this helped you in attaining steady growth in just 3 years?

So, you asking makes all the difference in the world and it's still a numbers game. Even if only three out of 10 said yes, that adds up so, quickly. Totally. And you know what? I would do, get anything you can if they say, you know what, I'm happy to have you show them in the office, get an iPad for that group, you know, and put them all on there.

And while that patient's sitting around a cosmetic patient is stewing a lot during this journey, give them that iPad and keep them in front of all those photos. How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Yeah, certain, I mean, the, the other thing is there is the, I've, I've had this too, and this kind of has happened with like the younger generation getting rhinoplasty and things like that.

And well two things. Number one Of the younger people, like consider it like a badge of honor. They've said, what? Why am I not on your Instagram yet? And, I said, well, I didn't, I didn't know you wanted to be. And so, those kinds of people are great because they actually are excited to like, put it out there.

And some and some kind of like want the content. And what I mean by that is I've done some influencer surgery before and they want to like put their reveal videos out there and, and I never. Ask until, but they're like, oh, I want a, like, some ask, will you film footage in the or, or you do this. And I'm, I'm happy to do that for them, but I always let them make the first kind of move and say, oh, I want a put this out there.

I'm going to post my reveal video, I'm going to post my experience. And then I say, would you mind if I use those photos or can I share your video? Mm-hmm. And they're usually, they like, want the content for their own, like, outlets. So, how does that process start?

Catherine Maley, MBA: There are some influencers who literally have a PR group who call you and say, do you want a do a deal? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: I, I have. I have. I've seen it all. Yeah. And being in practice for 13 years, I have had so, I did somebody's nose probably about five years ago now, and. She, it was originally started through a direct message and she direct message, direct message me. I un I, like, unfortunately, I, I had no idea who this person was.

It's like a young influencer with millions of followers on YouTube and so, she's like, oh, can I come in for a consult? I'm interested in a rhinoplasty. Mm-hmm. And I said, sure, call the office, make an appointment. And she's like, well, I don't necessarily live in your area, but I might be in this area.

She grew up kind of close and can I come in on the weekend? And then I looked at her Instagram fine and I was like, Hmm, okay, I might want a see this person on the weekend. And I actually came in on the weekend mm-hmm. I saw her, especially with her, with her mother. And she loved and I said, this is what it is, the whole thing.

And she called up Monday book surgery and I didn't say anything about it.

Catherine Maley, MBA: She didn't ask for any favors? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Not Nope. Until two weeks prior she said, you know what? I think my followers would like to see this. Can we film some stuff in the operating room? And I said, yeah, and, and, and ac and actually I didn't, and I didn't ask for anything and she didn't ask for anything.

Mm-hmm. and I am not a fan of giving discounts or you know, free surgery in exchange for this stuff. Like I understand now knowing, and when and when she posted her Reveal video. Mm-hmm. Okay. Which was one week after her surgery, she posted it at 6:00 PM by 6:00 AM the next day, it was seen already by 1.5 million people and it was.

It blew up. And I realize now, h the power of this mm-hmm. But I've also, seen the other, I've seen people come into my office, literally a girl who's 18 comes into her off my office with her mother and said to me, I'm a social media influencer. Mm-hmm. And I said, hi, I am Jason Bloom. Nice to meet you. And we go through the consult.

She was also, interested in a rhinoplasty. And at the end we give her the price for surgery. Mm-hmm., she looks at it, looks at her mom, looks at the price, stands up and walks out. And, and then I was like, okay, well that's, that's what it is. I don't owe you anything other than a good result in surgery and you don't owe me anything.

And this woman's, this girl's mom called back like, Two weeks later and she called my office manager, surgical coordinator and said, yeah, she's doing a bunch of things. I think Dr. Bloom really should, the word they use is collaborate. Okay. You know, Dr. Bloom really should collaborate with her. And my surgical coordinator comes in and she's like, what should we do?

I said, you know what you should do, send her the quote for surgery again and tell her these are the dates we have available. And she did that. Two weeks later she booked surgery. Oh, nice. What? I didn't offer her anything. She didn't, and, and, and if this is a private thing, surgery, I'm not going to post anything.

And you know what, afterwards she posted it all because she was interested in using the content on her own on her own pages. And then actually I asked her, would you mind if I shared this? So. It's all happened organically. Mm-hmm., but I feel like I don't want a be responsible or contractually obligated for anything.

And I certainly don't owe them anything other than, and I don't want them to owe me anything other than a good result. That's what I owe them, is I want a get them the best result possible. I have seen friends of mine have four-page contracts with, you must mention these things and you must use these hashtags and, and ex in exchange for procedures and, and it's just, that's just not me.

Never happened.

Catherine Maley, MBA: So, the girl, so, the, the, the girl who blew up your account, the one that with the 1 million followers, did she come back and want anything from you? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Never. She never has. She's had multiple surgeries with other people too, and she still will po she's posted, she regrets some of her other surgeries and she said she never regrets her rhinoplasty.

It was always great. She has over 10 million followers on, on YouTube and about four and a half or 5 million followers on Instagram. Isn't that crazy? Yeah. And if you, I mean, and you can look at my Instagram and stuff. You can find her. She's on there, but like, she still texts me all the time, says I love my nose.

It's like my five-year nose anniversary, you know? Oh, that's so, cute.

Catherine Maley, MBA: But you know you have a challenge though because of what you're doing. You've got the young rhinos, the older facelifts, then you have the men hair transplant. How are you marketing to three very different groups? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Yeah, I mean certainly, I think.

Well, Instagram and social media has been hugely popular with the, with the younger generation. Obviously, this is the 17- to 20-year-old rhinoplasty patients. Additionally, my name is very good in the area. I mean, I, I would say even better than my Instagram is the word of mouth that I get and referrals from.

And I, and I'll, and I'll tell you one other, my, my biggest area of marketing that has kind of grown my practice over the past 13 years. But yeah, men are hard because men aren't necessarily on Instagram and following this. So, I have. You know, treated friends of mine with hair transplants, and I have a hair care company called Hairapy Hair Care.

Oh, good for you. And so, you know, I, you know, treated my friends and they refer other friends and then kind of surgery. You know, facial rejuvenation surgery where I used to say, where I used to see the majority of patients in their late fifties to late sixties. Now, I, the vast majority of my patients getting facial rejuvenation surgery, and that's like face neck lifts and some eyelid work is in their early fifties.

Yeah. So, I think over the past five years, it's kind of slid up at least five years in terms of the age. Mm-hmm. And, and they're still very savvy with social media and Facebook and so, they do see me on there. I'm, I do some, some news pretty frequently, so, they see me on TV once in a while.

But I would say my, my, my greatest marketing over the past 13 years has been the word-of-mouth and. Because that's hard to do as you know, those are the best patients, but the hardest to get, right? Mm-hmm. So, I am a train and, and this is like a little bit of my secret, and what I've done is I've been a trainer for Allergan and Galderma and Revance, and I work with all these companies.

Mm-hmm., and, and, and interestingly the dermatologist, we, that was kind of how we opened, was that, you know, I was with him for eight years and he used to say, why are you training these nurses and why are you training these dermatologists? They're your competition. Mm-hmm. very, very, very shortsighted. Mm-hmm.

And what I've done over the past 13 years is I only train derms. I only train PAs. I only train nurses. No plastic surgeons and no one who works for a plastic surgeon. And you know what? I'm a good guy. I go in there, show them exactly what I do. I train them. I train tons. I love training local, local, regionally.

I love training dermatologists and these big med spas. And you know what? When they have a patient, because they can, they're, they see, like, I mean, I've become friends with all, all of these people. And when they have a patient who needs their facelift, like who think they're going to send it to, mm-hmm., are they going to send it to someone who they've never had any relationship with?

Who's they? They who? You know what? They've never seen their before and after’s. They haven't. They're like, you know what they say? Why don't you go see Dr. Bloom? Whether they book with me or not is that's then my issue. Right. But they say, why don't you book a consult to see Dr. Bloom? He does good work. I see him on Instagram.

He's come here. He was nice. He showed us, you know, like you might like him. And so, I get more referrals from my friends who are dermatologists and nurses and injectors and PAs in my local community. Mm-hmm. than anyone else. That is my number one source of marketing for the past 13 years, and I continue to do it and not for the money I get from Galderma or Allergan or Revamps to do the training that is pennies compared to the amount of.

Referrals and networking that I do at each of these events. Yeah.

Catherine Maley, MBA: Are the vendors though, are they helpful with pr? Because I used to tell people, you know, the best thing to do with big pharma money because there's a lot of pharma money there. Hang out with their PR department, they can get you a lot of, or have they or have they not or…? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Yeah, I mean I've done some, I'm, I mean I've done national PR stuff with some of the companies and yeah, it's a lot of work sometimes for, you know, very little benefit.

And for me, I would, I mean I did like a, I mean, years ago I did like a town and country event with Allergan and we were up on the stage and, and doing this and they put it in Counter Country Magazine and it was on their website and like a bunch of different things. And like to me, honestly, when I look back at it, I would rather do an event.

One of my friends who owns a big med spa who has nine nurse injectors and sends me more people than doing a national event with one of these companies through their PR department, because it's just patients, you know, the patients that I get one patient coming in from California to have their nose done versus 20 that I'm sent over the course of the next couple months from the other.

It's just it. I just don't think it has the same. I would much rather local, regional things with people I trust and care about rather than a big national event that involves time and energy and I just don't see the same, you know, reward on the backside. And my reward is surgical patient referrals.

That's what I want a see.

Catherine Maley, MBA: So, you're doing only surgery, but you've got a lot of other revenue generators are in your office. So, how are you set up staff-wise? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: So, great. Great question. I use, I mean, I built a lot of what I do based on based on injectables and I've converted a lot of them to surgery over the course of the next couple years.

When I opened my office three and a half years ago, I brought on a nurse injector who I have since trained in like to do what I do and she's now a trainer for Galderma. I, for the last two years, I'm no longer taking new patients for injectables. Hmm. I'm busy enough and, and, I'm trying. And I tell them, listen, they can see what I did when I'm talking about like, go see my nurse injector, she's great.

She injects me. I was like, she sees exactly what I did at last appointment. Some people still want me to do their toxin even. And I'm like, okay, no problem. Happy to do that. But I want a encourage my nurse injector. I just hired another nurse injector to come out part-time. And then one of our estheticians was in nursing school and she has and she has now finished nursing school, so, she'll be slowly learning to inject over the course.

So, we should. My partner who injects on, and she's a facial plastic surgeon and she's still about 65% surgery and about 35% injectables. Mm-hmm. We have my full-time nurse injector and then potentially two newer injectors. Who, that I want them doing the majority of the non-invasive aesthetic work.

Catherine Maley, MBA: So, you believe in surgical versus non-surgical, keeping it all under one roof. How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Right? Totally, totally. And, and I'm, I, you know, and it's certainly easier to get in to see one of my injectors and it is to, for me, I only am in the office itself two days a week. Mm-hmm., cause I'm operating. Tuesdays, Wednesdays and Thurs Tuesdays, Wednesdays, and Fridays.

So, I'm just only in the office two days, So, to get a, a patient, you know, you can't tell a patient that comes in today that the next time they can see me is in September, you know, or in October. It's just, they'll be, they'll, they're gone. So, you need to offer them options or else see they're, they're not, they're, they're not.

And, and not just options, but options. Who you trust and options who you've, you know, who you've trained. Mm-hmm. Both of the new nurse injectors, who, well, one of them, again, new to my practice, she's been a nurse injector for 10 years and one who is newer, both of them. I want them to learn how I do it.

Yes. And so, they're, they're shadowing for the ne, I mean, one is shadowing for about six months, and she's coming in on days. She's not even working. Coming into the rooms with me, with my nurse, injector, with my partner, seeing how we do it. W you know, making the, you know, the diagnosis and saying, okay, we're going to use this product here.

Why? Mm-hmm., and I always ask, that's my favorite question. Why? Why are you using that product? Why are you using that amount? Why are you going there? Why are you starting there? Why are you using a cannula? Why are you using a needle? Because I like, it doesn't matter necessarily, as long as you have a reasoning for doing these things.

I want them to develop their own why. And it's as, and it could be like, I'm doing this because you did it, and I think that makes sense to me. Mm-hmm., but I want it to kind of click and make sense to them if they're going to be doing it.

Catherine Maley, MBA: And it's so, important that you're both on the same page on that. How has this helped you in attaining steady growth in just 3 years?

There have been practices who have hired nurse injectors and two weeks in they realize this injector overfills every time. And it's because they came from a commission-based position and, and it didn't match with this practice at all. They were all about natural results and they had, they looked like loo bird people going out of there with the filler and they had to stop it immediately because it was hurting their brand.

It was hurting their relationships.

Jason Bloom, MD: Catherine, if you knew how long it took me to like hire one nurse injector and then a new person coming in, there's a lot of. There's a lot of, a lot out there, let's say. Mm-hmm. and I am extremely conservative and, and totally non-confrontational, and I just want patients to be happy.

Mm-hmm. and I mean, that has to go a lot with my philosophy. Like I, I mean, I certainly do take before and afters for surgery, but I don't take pictures for injectables. And I, I can explain why, but I, I just wanted someone to fir, first of all, I wasn't inviting someone into my practice. Unless I saw consistently that they were producing natural looking results because, and they, I mean, as crazy as the sound, they couldn't look crazy because we all see those people who maybe they're great injectors, but they look a little bit strange because they're overfilled or they're doing too much.

And, and I just want someone who is going to look natural, do natural results because that's what I'm trying to convey. And you know, patients ask, sometimes they say, oh, like where did you get that in a good thing? It's like, wow, where did you get that? That looks good. And then there's also, where did you get that?

That looks a little crazy. I don't want a go there. So, I never want that ladder situation. So, yeah. And, and, and by having them see what we do, I think it kind of reinforces that kind of, this is what we do, it's a natural result. That's what I'm looking to put forth.

Catherine Maley, MBA: Yeah. Any have you had any staff issues like everybody else or how's that going? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: You mean like staffing in general? Just hiring people? Yeah. Yeah. fortunately. I've never had someone leave my practice for, I mean, other than one was, she was Canadian and she her visa was up, so, she had to go back to Canada. One went to medical school, one went to PA school, so, okay.

Those were the only three people that have ever left my practice and, and for bigger and better things, you know, like I would never hold something, somebody back. Interestingly the pa is graduating PA school in June and I hope to have her back in my office. As a surgical pa I want her assisting in the operating room and doing pre- and post-op surgical stuff, so, hopefully she'll join our practice back.

Catherine Maley, MBA: So, what's your secret to hiring and keeping them. Taking good care of your employees? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Being a good person, like, I, I, you know, it, it's, it's every day we're there. I, I buy lunch for the office and just like keeping it light and mm-hmm., you know, we just have a good dynamic. And when you hire someone, you really, and, and this is what I say, and like, I'm like, when I'm hiring even for the front desk, I'm like, I just need to make sure that your vibe with our office mm-hmm.

before I hire you. And it's just, we have such a positive, good vibe in our office. Like, I've been super lucky over the past three and a half years. It's like, it's literally like a family. I, I, I'm, I'm with these people. As much as my family members, right? I'm in the office, I'm in the operating room. And so, kind of creating that family type environment.

And it sounds kind of hokey, but it really isn't. Like that's, that's the kind of vibe we got, we have there. And you got to kind of, I just respect every one of my employees. They respect me. They know they can call me about any situation, talk to me personally about any situation at any time of the day or night.

Catherine Maley, MBA: Well, good for you because it starts at the top, so, you're doing something right there. So, kudos I saw on Instagram, I think you had a patient who was like a Sep and she, two years later, but, but what's that? What's her story? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Yeah, I mean, she worked as a medical assistant for a dermatology practice and I.

She was referred to me through that dermatology practice and I did her nose and just like in our, you know, doctor-patient relationship as she was really happy, you know, I kind of found out she was, you know, not as happy where she currently was. Mm-hmm. and we were looking for medical assistants and aesthetician and she's both, and I brought her into our practice and she's been fantastic and she's been our medical assistant ever since.

And she is also, aesthetician in moving into some aesthetician roles as well.

Catherine Maley, MBA: But has she been a good referral source or at least a good walking, talking testimonial for the patient's visiting? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Totally. I mean, she's rooming pa, she's rooming patients and you know, she'll sense maybe like a patient who's like nervous mm-hmm.

and they're coming in for a consult and she's like, you know what, you're going to be great. Dr. Bloom did my nose. Mm-hmm. And again, she looks natural, she looks good, she doesn't look crazy. And so, that kind of reinforces our brand and what we do and what better to have someone in our office. I've, I mean, Anne, I've done surgery on another front desk person.

I did her nose. I've done different kind of procedures like face tight and things on some of our estheticians. So, I love treating some of our office people because they trust it shows trust. Mm-hmm. shows that the results are natural and they're kind of walking, talking advertisements for all this stuff.

Catherine Maley, MBA: I always say it's an investment. All of you who think, what? I'm not paying for that. You're missing the whole point. There's nothing better to a cosmetic patient that walks in and says, oh, I don't know. Should I do this, shouldn't I? Well, I had it done and I can tell you my story, really. Let me see. Like, do where are your scars?

What's going on? Like, how was it, you know, nothing better. I, I can't imagine, I can't imagine any better investment than having those walking, talking testimonials. It's good pr it's also, good team building and some of the surgeons have like all those r rules about it. I think that's what happens when you come in into it with that.

Fear of, you're going to screw me. You're going to, you know, you're going to get surgery and walk away, and then you haven't signed all these documents. I think that's where it gets crunchy and yeah. How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: I mean, we, there's no doc. I mean, obviously they get a discount, they still pay for surgery, right? They discounted surgery and they have to be with our practice for at least a year prior to getting surgery, with the exception of someone who had surgery.

And then I bring into our practice. And the, those are, you know, those are just but you know, that's, that's from a surgical standpoint. Mm-hmm. But certainly, I encourage, encourage every one of our staff, get toxins, get fillers, get lasers. You can talk about it. Get as much as you want. I never charged them for it.

There are only two things that they have to. Number one, you do it after hours. Yes. You ask our nurse injector, you ask me, I'll stay late, come in early. We're happy to do it, but not in the crazy flow of our office day. And the second thing is, if you, you know, all these companies offer free product for the staff.

And I say, get it in advance. You want your lips done, get the syringe in advance, we'll do it done. Never charge you. You can do it, you know, whenever you are ready to do it. So, those I do.

Catherine Maley, MBA: Yeah. Yeah. It's, it's so, it, there's, it's all good. All of that is good. It's free for you. It takes a little of your time.

It makes the staff so, happy. And actually, I, when I write ads for practices, one of the perks I write is cosmetic treatments. Cause that's why we want a be in this industry, you know? We want stuff done. Exactly. What would you say is like the biggest challenge of running your own solo practice? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Oh gosh, the biggest challenge.

You know, I'm not the greatest business person and I've had to learn a lot. How'd you learn it? I have some like fantastic mentors in the business sense. Edwin Williams is, ed Williams is, he's incredible. Your friend and, and one of my best business mentors. And I, you know, I, I didn't do his fellowship, but I would, I mean, I, I feel like I did his business fellowship in learning so, much from him and calling him

And I've been on his podcast and we talked about how, kind of like stuff that we, we talk about. So, I consider him huge mentor of mine and kind of like getting a small group of people who you really trust around you who are smart and an accountant, a financial advisor, and people who you trust to kind of help you.

Mm-hmm. And I, I said, listen, I am, this is my first time doing it. I need your help in doing that. And then and we kind of like starting out, I did everything at, at, you know, Everything myself. And then, then I had, you know, my office manager and she was my surgical coordinator and office manager. And then we hired a surgical coordinator to kind of like allow her to do more of the nuts and bolts of the business kind of stuff and more of the HR stuff.

Mm-hmm. And then my surgical coordinator can focus more on the patients and the booking surgeries and the scheduling surgeries and getting patients ready for surgery. So, like, as we grew, as we kind of like grew into our practice and, and felt more comfortable with what we were doing, we added staff to offload some of the responsibilities where at the beginning we were doing everything and it.

For, to pay someone to do that. You know, we're lucky that we, we do well as a practice and, you know, I pay people to make my life easier and to make my office manager's life easier so, that she can, focuses focus on things that are important to the business and not kind of be bogged down with other things.

But I remember, I mean, just, you know, like going back to the, what, what we kind of opened this with was when I was at the derm office and I wanted to book a surgery. Guess who was doing that? You were, right? I mean, I was calling the operating room. I was writing the pre-op scripts. I was doing all meeting with the patient's pre-op.

I was taking all the pictures. I was making sure that they got their EKGs. I was doing all of that, and I was killing myself, literally. And I didn't have this point. And that was one of the things, why now my life is easier because I have someone to help out with that. But I mean, these are newer things.

As the practice grows, you get people to help with these kinds of things. And it's all, it's all growing pains, but you can't be, I would say the one thing that I will say is you, you can't at the beginning be unwilling to do it yourself. Because none of its easy, and you got to be willing to go out there and make the calls and book the cases because no one's going to do it for you.

You have to do it as you're growing or else, you know, like you, you can't be a pome being like, oh gosh, I need someone, you're just starting a practice. Oh, I need someone to do that. You know, it's like, right, no, you can do it

Catherine Maley, MBA: It's just, it's worth it, or they try to be cheap about it and hire this one person and they have to wear the 14 hats because you don't want a do it.

But then you burn that person out and they leave and you're, and now you're really screwed. And so, there's such a balance between how to pay, pay for time, because all we have is time. And it's like, do I do this myself? I mean, there's always, in business, there's always that rule. If you're supposed to be making, let's say 2000 an hour, you should be doing nothing under 2000 an hour task.

You know? And if you look at it logically like that, and you think, oh my God, why am I doing. The 40 things that you do, that you probably should be doing, you know because you, you're cheap because you don't want a pay somebody else to do it. But then again, on the other hand, then you also, have to manage other people and hope that they're doing what you think they're doing.

Yeah. So, that's why business is so, important nowadays. You've got to figure out the business side of this, by the way you ran. Right? That, by that, what are you talking about? You have a hair club; you have a business hair. What, what was that about? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: Yeah. So, very entrepreneurial of you. It's, it's, it. Been about six years in the making.

I was approached by some friends who, some of them, so, two partners. One is kind of a Q V C alum is a rep of some products and has done multiple marketing kind of things. And product representative product representation of brand representation at QVC, which is about 30, 45 minutes from my office.

Mm-hmm. And one of his friends her father who passed away was founded a company called Hairapy Hair Care years ago. I don't, I mean, some people have heard about it. I mean, it was in like Walgreens and c v s and Rite Aid, and it was a big company. And interestingly her dad had all of these patents and formulas.

For hair growth and, and hair care in shampoos and on all of these different ingredients. And when he passed away it was just kind of sitting there. And interestingly, so, the three of us got together and she's like, I would wish, you know, we could take something with these ingredients that we call BioDapt eight.

It's eight ingredients that we have patents on and, and the formulations. And why can't we like reformulate it and make like a shampoo that helps with hair growth and thickening your hair and a conditioner and some serums. And that's what we did. And we started about six years ago. We are now sold in doctor's offices and direct consumer on our website, under the name Hills.

No, it's, it's called “Hairapy” Haircare. So, it's like “therapy”, but it's “Hairapy”. Mm-hmm. Hairapy haircare. And it's been great. We're going to, we're planning a bigger launch this year, but a lot of my friends in the co in like the facial plastics community and plastic surgery and derm community have now carry it in their office or you know, direct patients to their website.

It's very easy. We have serums, so, just serum once a day that matches your skin type because, so, there's a, a normal to dry, a normal to oily and a sensitive, and people are like, well, I, they're like, no, no, no. I'm not talking about my skin. I'm talking about my scalp. I. Does your skin stop at your hairline?

No. Right. So, if you have oily skin, guess what? You have oily scalp. If you have dry flaky skin, you have dry scalp. And if you have sensitive skin, you probably have sensitive scalp. So, we use these formulas actually, and we've done great clinical trials showing improved thickness in the hair, improved styling, improved volume, and, and also, like again, I like if I'm invested in the company and I'm, I'm part of it, I give it to my friends and say, listen.

let me know what you think. My fellow who is postpartum was having a lot of shedding and postpartum her hair loss. Mm-hmm. She uses this and she just said the amount of shedding she has is so, is so, much less. She loves the way that her hair looks much thicker afterwards. So, it's been really exciting and it's just kind of like one of those fun things that I've done.

And because it benefits my patients —

Catherine Maley, MBA: But wait a second. That's a whole other company and business that you're doing. So, are you going B2B or B2C? Are you trying to sell it on QVC, direct to consumer, or how are you marketing this thing? How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: So, our, our marketing is do we do direct to consumer through our website?

We, we offer it at our practice. Other doctors, it's right now only like my doctor friends who have kind of reached out to me or who do, like, for example, when I see a patient who is getting p r P injections or P r F injections or hair transplant, we just roll it in to that package. Right? So, oh, you're interested in hair.

We go through the whole thing. Our non-surgical surgical hair restoration. And then as part of it, we. We want, I want you to start on this and if you like it, you can continue to buy it off of the website. Additionally, we have kind of, you know, doctors don't necessarily like to take up shelf space in their office with these products.

So, we offer kind of affiliate programs where they give the patient our website and they have a special code, the patient enters it, and then basically they get 10% of every sale that the patient makes linked back to their office. Gotcha. And, and although we have huge connections at QVC, QVC is not the place where we want this because the margins that they take are very steep and it's just not right for our practice at this, for our products at this point, maybe in the future.

But yeah, we'll see where it takes us. We're going to kind of do a little bit bigger marketing launch in 2023. Well,

Catherine Maley, MBA: I'll tell you the reason you do QVC is because it gets the attention of the big boys. How has this helped you in attaining steady growth in just 3 years? There's this woman who, she's, I don’t know, 25 years old. She wrote a book on it and she had this concealer you know, facial concealer.

And she was Just trying to, you know, get it out there. Anyway, she got on QVC, the profit or the margins were awful. However, L’Oréal ended up buying her company for a billion dollars. Right?

Jason Bloom, MD: Yeah, I mean, that would be nice. I, I will tell you where we're working right now is that some of the companies have, you know, I have some relationships over the past 13 years with some very high ups at many kinds of device and injectables companies as well as skincare companies.

We've had conversations, many of them like it, we're talking about partnering with some of them not to buy the company, but to potentially, you know, shampoo, conditioner and serum isn't like, there's not. Companies doing that out there. So, it's kind of a new thing. And, and this year, hair is the last year, a couple of years.

Hair has been really exciting. And so, we've been in talks with some companies, so, who, who knows.

Catherine Maley, MBA: Good kudos to you because if the plastic surgery doesn't work out. How has this helped you in attaining steady growth in just 3 years?

Jason Bloom, MD: I'm not giving that up. I'm not giving that up. Yeah.

Catherine Maley, MBA: Alright. And then my last question, well actually, do you have any words of wisdom for anybody who's I not even just coming out in the world, but just being out there right now, all of the crazy going on. How has this helped you in attaining steady growth in just 3 years?

Any, any words of wisdom for how you're doing just fine?

Jason Bloom, MD: Yeah. I mean, I, I, I think the key is to surround yourself by good people and be good to those good people. So, you know, when I, when, when I started out with three employees like I had my office manager, I had an MA and I had well really an office manager, an MA that was like, there was three of us.

And then I and then I hired a front desk person and really, we started out with, with two and then three employees for a little bit of time because and, and just make sure you bring in good people and you interview them and, and you know, like that they're just not necessarily that they're great.

You know, you want them to be good workers, but they're good people. Like their hearts are in the right place and they support you and believe what your mission is, and they believe in you that you're going to do a good job. And then from that, take care of those people as, as the owner, as a boss because you know, I mean, and that of those three people who started with me, I've operated on family members of theirs, I've operated on some of that, you know, it's just like they believed in me in what I could do, and they believed and they trusted, you know, my results.

They trusted what I was doing. And, and in exchange for that, I've always been very good to my staff and the people that I've surrounded myself with.

Catherine Maley, MBA: Kudos to you because it'll save you so, much time, money, and hassle and sleepless nights. How many, how many, I mean, staff tr problems can just wreak havoc on your mental health. How has this helped you in attaining steady growth in just 3 years?

You know, you, they're the ones that waking you up at two in the morning and you're like, really? I mean, why, you know, why can't we all just get along?

Jason Bloom, MD: I, I remember one thing and I, I'll say my, my father is an oral surgeon and he's 74. He is very close to retirement, but I don't think he's, he's, he's not, he's not ready to retire yet.

But he used to say, he's like, The surgery is the easy part. Yeah. He's like, it's, you know, this staff problem and this person calling out and this person's calling, you know, having an issue with this person. And, you know, this thing's breaking. He's like, that's what gives you gray hair. And so, I, I just remember him saying that.

And it's true, you know, like we get to go into the operating room and, and, and we do what we do and we, you know, we, we love it and we know how to do surgery, but the hard part is everything else behind the scenes.

Catherine Maley, MBA: I couldn't agree more. But now I don't want a forget what is with the sneakers. You have sneakers everywhere.

If you everybody, well by the way, what's your website? Because people should go to your website. You look on your website, you have this gorgeous office, and then it has like a sneaker, it, it has as like a statue and it has sneakers in art. And I thought, what's with the sneaker thing?

Jason Bloom, MD: Yeah, I mean, I, you can probably see in the background there that I have, like, those are all piece, those are all like sneaker things from patients who have, like, I love Air Jordans.

I have a collection, actually, I'm here in my home office and I have a sneaker closet of hundreds of Air Jordans up here. Really? And you've, it, it, it's kind of been leaked a little bit on my Instagram, so, it's out there. But yeah, I mean, I used to wear, prior to the pandemic, I used to wear a suit and tie mm-hmm.

every day to the office. And now I am scrubs. Sneakers and that's like kind of, I expressed myself with some cool sneakers and now patients like call in. They like say, Hey, what sneakers does he have on today? They love to see me wearing kind of like these cool, outrageous sneakers. And then they like, buy me things like, this is some, there was like a mosaic back there that was made of like one of my sneaker posts on Instagram that, that a patient made.

And just some like cool things. So, it's kind of become a little bit of my personality quirky.

Catherine Maley, MBA: It's, it's unusual and at least you have a space for it because usually it's the woman that takes up all the closet space. And in your house, it must be you.

Jason Bloom, MD: Yeah. Well, this is upstairs in my home office, so, it's far away from me, it's from my wife's my wife's closet.

Catherine Maley, MBA: Is she okay with your fetish?

Jason Bloom, MD: Yeah. Well, you know what? She used to be like, oh my gosh, this is crazy. And now and now when like a person comes to our house and she's like giving them a tour, showing them around. That's, that's her far she loves, that's her favorite part. She loves to show them the sneaker closet.

Catherine Maley, MBA: That's crazy. Good for you. That's interesting. I did not see that in your personality. Usually when I see you at conferences, you know, everyone has their game face on at conferences. That's why I love these podcasts. You know, you're actually a real person. You're you. That's a really quirky, that's so, funny.

I saw it on Instagram. I saw the, I didn't realize there were hundreds there. I, you definitely look like a lot, but. Okay. All right. Well thank you so, much Dr. Bloom. It has been a pleasure. I hope to see you at a meeting coming up soon because now that we're back in action and everybody that's going to wrap it up for us today, if you would so, kindly subscribe to Beauty in the Biz if you haven't already, and if you have any questions for Dr. Bloom, how would they get ahold of you?

Jason Bloom, MD: I mean, the best way is I told you I do my own social media. Yeah. www.instagram.com/drjbloom or www.facebook.com/bloomj. Reach out to me on social media. My Instagram is probably the easiest way.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how to create steady growth in just 3 years.

If you’ve got any questions or feedback for Dr. Bloom, you can reach out to his website at, www.BloomFacialPlastics.com.

A big thanks to Dr. Bloom for sharing his experience on attaining steady growth in just 3 years.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Steady Growth in Just 3 Years — with Jason Bloom, MD”.

 

 

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#steadygrowthcosmeticsurgeon #steadygrowthplasticsurgeon #steadygrowthaestheticpractice

📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and the pros and cons of nurse injectors.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Pros and Cons of Nurse Injectors — with Lisa Marie Wark, MBA".

Is it worth it to bring on a nurse injector to grow your cosmetic practice? 

The answer is….“maybe”.

This week’s Beauty and the Biz Podcast is an interview I did with my colleague Lisa Marie Wark, MBA. 

Like, me, she is a practice management consultant for cosmetic practices, and even founded and operated the first luxury medical spa in Las Vegas years ago. 

Here’s what we covered:

• Her experience hiring and managing nurse injectors
• When do the numbers make sense to bring a nurse injector on board?
• Are they an employee or independent contractor and much more…

Hiring a nurse injector can be the best decision you make to grow your practice or the worst nightmare if things go sideways. Learn what to consider and watch out for in this episode. 

Visit Lisa Marie Wark's Website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

Pros and Cons of Nurse Injectors — with Lisa Marie Wark, MBA

Catherine Maley, MBA: Hello, welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and the pros and cons of nurse injectors. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", and consultant of plastic surgeons to get them more patients and profits. Now, I have a special guest today that's a non-surgeon, and I'd like to introduce you to Lisa Marie Wark, MBA.

Now she's a practice management consultant just like myself (as in an expert on the pros and cons of nurse injectors), and she's focused on business develop. Best practices as well as marketing. And she's even created and formulated beauty and wellness products for our industry. Now, Lisa Marie founded and operated the very first luxury medical spot in Vegas, and we'll ask her more about that.

And then she's also, a very sought-after speaker at the medical conferences. She and I have been sharing the podium for years, like all over the us and now we're going international. So, Lisa Marie also, supports many nonprofit organizations within her community. And she's interested. Now, this is really interesting.

I don't know. This was so, random. She reads and speaks Japanese fluently, so, we'll ask her about that too, along with the pros and cons of nurse injectors. So, Lisa Marie, welcome to Beauty and the Biz.

Lisa Marie Wark, MBA: Oh, Catherine, thank you so, much for having me. I'm Beauty and the Biz. I'm an avid follower and I listen to your podcast religiously. So, big fan. And also, I'm a big fan of you as a consultant in the plastic surgery space.

You've been around for a while and I've learned a lot from you.

Catherine Maley, MBA: And that's the pleasure of this. Like I love hanging around with the competitors and some of them don't like it, and you and I just get along very, very well and I love sharing ideas and nobody has the market on all the ideas, you know?

And frankly at this point there are probably not many new ideas. It's who can put them out there creatively and. And get people's attention and get people fired up, you know, for this industry. So, there, I don't, there's plenty for everybody, quite frankly. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Absolutely. Absolutely. And you know, I think a lot of times too when we get clients, it's the clients that resonate with us.

And that's why they choose us because we have different styles and, you know, that's what makes us, you know, unique and also, be able to work together and to lean on each other. So, yeah, no, it's, it's wonderful to be a peer of.

Catherine Maley, MBA: And that was a really good point. Not everybody jives with each other.

Yeah. So, so, you would, we definitely have different personalities and so, that's a really good point. So, before I get off course, how in the world did you learn Japanese? The rest of us, usually we learn Spanish or I learn French. How did you go to Japanese? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: You know, in college, in undergrad, I went to Willamette University in Oregon and I was in the Japanese dorm and I had a Japanese roommate.

And so, every day she would come in and she would actually knock on the door before she'd come into our room and her name was Como. And I said, Como, you don't have to knock on the door. This is your room too. And she would say, oh, okay. Thank you so, much. Then she turned around, come back, and knock on the door and I thought, ok, I need to learn Japanese.

So, I studied Japanese for seven years, lived there for three years, and then I got my M B A in international management emphasis to East Asian Japanese techniques.

Catherine Maley, MBA: Nice. And you were also, a news reporter, right? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: I was. I was. I've had nine lives. Who's counting? Yeah. I was a financial news anchor in San Francisco.

Up the street from you? Yeah. Yeah.

Catherine Maley, MBA: All right. I do. That is on my bucket list. I've never been, I want to go to Tokyo and I would, I'm assuming I'm like going to be the tallest person ever. Oh my gosh. You would be. You would be. You would be. I love, I, I love the culture. I love how graceful they are. I love the food.

Like if I could eat sushi every day, I would that it is clean eating. So, was it, did you love the food while you were there? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: You know, I did. I got tired of fish; you know? Yes. If you went to a, if you went to, you know, McDonald's, I mean, they have McDonald's there and you were to, or like, you know, you're American and sometimes you're like, you know, I could just use a Big Mac.

but unfortunately, the Big Mac would taste like fish. So, you'd be like, ah, just doesn't, it's not like America, but I love Japan and I obviously was treated very differently because of what I look like. You know, there's not a lot of, well, I had red hair, if you can believe that back in the day and people would come, I'd be sitting on the train station and.

Feel people touch my hair that I didn't know. And I just, you know, it was very awkward for me to have that happen. And then people would come up and ask me if they could take my picture Oh, wow. And say, well, I don’t know. You, you know, what are you using this for? And they said, ah, you know, you're, you're an American, you're a foreigner.

We want to take pictures of you. So, It was a very different experience. I loved every second of it. I climbed Mount Fuji, if you can believe that, and taught English to homestay moms and to executives at N E C in Panasonic. And. The different Japanese companies and you know, I also, went to Tokyo International University.

There, I was going to get into their Becca program, which is a prerequisite for learning Japanese fluently enough to get your M B A over there.

Catherine Maley, MBA: I know somehow you went from that to our industry and we're glad you did. And that was like what, 15 years ago and you opened, you founded and opened your very first, the very first medical spot. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: I did, I did back in 2005. You know, it was funny. I went to San Antonio to a medical. It's a medical spa. That's what, I can't remember the name, but it was this wonderful conference and I still know people from that conference today. And what I loved about the whole concept of medical spas was that it created that spa environment, that relaxation, that calming experience with medicine.

And it reminded me of. Meets West, right? Where, you know, a lot of eastern practices, medical practices are, are very they're just very calming and, and everything is about, it's, it's not so, sterile and cold. And so, I thought if we could bring that together and marry that together people would love to, you know, come in and they'd get their facials.

And then we did injectables, and then we did hormone replacement therapies. So, it was the first one in Las Vegas. Wow. And how long did you own it? We were in business until 2011, and then I decided to, you know, start a family and, you know, move on to my next season of life. So, that's, that's how, that's, that's how that ended.

And I started consulting and loved consulting. I went around with a wonderful architect who worked for the spa at. At Spanish Bay and at Pebble Beach Lodge and the Grand Yle. And he actually got into creating more like villas and overnight you know, care facilities for plastic surgeons. And so, he was help building those out back then, and I was writing his feasibility studies and making sure we were within.

Catherine Maley, MBA: Gotcha. So, the reason I brought you on is because we want to talk about nurse injectors. What is happening is, I'll tell you what, what happened, why this all exploded, was the surgeons always wanted to do surgery and. I, I've known the surgeons forever, and I thought your customer service is terrible.

Like, they wouldn't answer the phone. The staff wasn't friendly. The waiting was out of control, and it was just ripe for the taking because the patient with a credit card was not going to stand for that. They wanted service to go with these high prices. And the surgeons just, it's, they, it wasn't their focus.

Like they didn't want to do injectables, they wanted to do surgery. So, that was. Such an opportunity for somebody to develop this medical spa concept, and now it's completely, you know, taken over. So, then the, the now the surgeon has to say, okay, some surgeons have embraced injectables and they love doing them.

They like doing them themselves. They love building that relationship. Some surgeons say, I still don't want to do injectables, but I don't want to lose the patient either, right? Cause this one and done. If you're around for a while, you realize, wait a. This one and done can't be a good business model either, right?

So, that was creating this this vacillating, should I get a nurse injector, should I not get one? And in some practices, they've done such a great job that nurse injector's bringing in a million or two and she's well worth the money in other practice. They're just complaining the whole time saying, oh my God, I'm giving her so, much money for what?

So, that's what we're here to talk about. And you know so, much about it because not only, you know, do you consult on it, you actually experienced it. Right. So, in your own, what was your own experience when you opened up your medical spa, when you were going to bring in a nurse injector? On what criteria did you. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Well, the criteria for me, because I'm not a doctor we had a medical doctor at the time and a supervising physician. We also, had a visiting plastic surgeon that would come in and do consults. So, what I needed is someone that is a, either a nurse practitioner or a physician assistant. I didn't feel comfortable with a registered nurse just because the Nevada.

Require you to have a doctor that should be on site if you're a registered nurse and you are doing any type of injectables. So, my first experience with this was hiring a physician assistant and a nurse practitioner. One Nur the nurse practitioner was actually experienced. While the physician assistant was a newbie and she was trying to gain experience in injectables because she, and like a lot of these you know healthcare providers, mid-level healthcare providers, they.

They are looking to make money. They're looking to make money in injectables and create a following and then you know, take that following from your practice. And so, that was the first time that I, you know, really was around what the politics, right, of hiring someone, having them come in, interface with the patients, do the procedures.

And then the question was, whose patient? Are they, because a lot of times the, you know, PA or the nurse practitioner will say, well, really that's my patient. I've been injecting that patient. That patient comes to me, that patient's going to follow me if I leave this this medical spa or if, or practice.

And so, you really. It was really a quandary at the time as to, gee, you know, how do I protect my business from losing patients when the, when the injector walks out the door.

Catherine Maley, MBA: So, that's the big question. When you bring somebody on board, are you trying to bring an experienced person that has a following?

Because I love that idea. If you can make it work and get the right person, what a great team, because she just brought an influx of patients to you and. So, so, you haven't, oh, you know, there's your marketing for the year. You know, she's got, she's brought the whole group with, however, on the other hand, she's one of those people who knows everything and she, she thinks she's the boss and she doesn't do well.

You know, w you know, working under a doctor, so, what do, what do you think is better? Do you hire or do you hire a brand new one and, and they're green and you hire and train them yourself and, and then hope they catch on and hope they're going to ejector because they have no experience. And you can't afford, in today's world, too, you can't afford bad results.

You don't need any Guinea pigs. You know, your patients don't want to be Guinea pigs you know, training somebody else. So, what, what's what, what would you suggest bringing on a newbie or an…? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Well, it really depends on the type of practice, right? So, we talked in the beginning, we talked about plastic surgeons.

They start their practice and a lot of them aren't as busy as they'd like to be in the, OR doing surgeries. So, to supplement that income, they start doing, you know, non-invasive procedures like injectables. And so, when they first start out, the injectables are some money that's coming in. Their or is not at full capacity.

So, they bring in someone that, well first they don't bring in anybody in, right? They, they're doing it all. Then they start to realize, listen, I need to bring someone in because I don't want to be doing injectables. I'm a surgeon. I belong in the OR. So, you can either have someone who comes in as a newbie, but when they come in as a newbie, you really need to.

Protect the practice. And that means that they need to know that the patients that you're feeding them, meaning feeding the, the injector that those are the practices patients. And how is that, like how do you how do you explain that to the injector is you say, well, Who, when you think of the patient, who is the patient paying?

Is the patient paying that injector or is that patient paying the practice? And just that answer alone is going to tell you it's the patient, the patient belongs to the practice. The second thing that, that when you bring in an injector, even if it's a newbie or an experienced. Is, you know, what kind of social media policy are you going to implement at that time?

A lot of times you see plastic surgery, you see medical, any type of medical spas, they, they allow their injector to have their own Instagram account and the Instagram followers, well, that hurts your... Because that should be under the umbrella of your practice. So, whenever I would hire an injector, regardless if they had a following or not, I would make sure that the social media is under.

Let's say, for example, Smith Plastic Surgery, it'd be Smith Plastic Surgery injectables. So, there is no question as to who those patients belong to. So, going back to, is it a, is it a newbie or is it someone who has a following? Well, that just depends on how much money are you willing to spend. A lot of practices when they first start out or when they're getting going, they can't afford to pay.

400,000 a year. To an experienced with a large following injector or starting at 40 to $60 an hour for a, a registered nurse that's a lot of money. For, for a, for a practice, for a, for a medical spa. So, you really need to look at, well, am I going to pay that person? On a base pay. And what does that mean?

What are the job descriptions and the roles and responsibilities of that employee? Or are you going to have it as an independent contractor? Are they just coming in and you're doing a 10 99 form and you, they log in the hours that they've spent with you, they send you, they give you an invoice, and then you pay off that invoice.

So, there's many different ways to set up an agreement with an injector, but always make sure that your practice is being protected.

Catherine Maley, MBA: I highly recommend when you are bringing somebody on board, have them sign an NDA or a non-compete, and the first thing somebody says is, well, you can't hold those up in court.

It's not, that's not the point. The point is, is if they're not going to sign it, they're telling you right now. They're, they're, it's a yellow flag, a red flag, whatever color you want, That's, that's a clue that they're not thinking the same way you are. And I would also, have them sign the social media policy.

And that means everybody, all photos are watermark and all posts go to this practice. She can't have her own, she's not building her practice on your. You know, in your name. So, or it has to all stay together and if she won't sign, he or she won't sign those two agreements. Then I would say it's a no-go because it'll be, it'll, if it goes sideways.

That kind of stuff gets ugly. Exactly. You know, and you don't need that negativity. But, you know, a lot of this, you do have some responsibility. If you hire the right person, you've got to take care of them and respect them and make them feel part of the team. Because I've talked to plenty of nurse injectors and they feel used and abused and the, the ones that aren't happy, you know, so, it goes, it goes two ways.

I would, I would hire slowly. I also, what do you think about hiring the competitors? Like when the nurse comes to you and says, Hey, I work for your competitor, but I. I'd love to come over to you. How, how would you handle that? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: You know what I it's always a red flag for me, and I'll tell you why, because obviously, or not obviously, but you really need to look and see if they've signed a non-compete clause with the other doctor and.

If, if, let's say, if they have, and they haven't told you about it, you don't need that bad blood between another doctor or another practice. You, we all need to, you know, be amicable, work together, so, to speak. There's plenty of business out there for all of us, and so, we want to, you know, we, we want to be on the up and up as opposed to.

You know, doing something shady and taking on an injector that signed a non-compete clause and an n d A agreement was someone that, that you know, and is, is a neighboring plastic surgeon or medical spa.

Catherine Maley, MBA: And a lot of times if I were the surgeon, I would pick up the phone and call the other surgeon and Oh yeah, one-on-one and just say, you know what?

I just want you to know Susan was in here looking for a job. What's up? You know? Yeah. I, I would just I would be that transparent in today's world because you can head off an awful lot of drama at the front end rather than at the back end when you have to deal. Just a lot of bad blood. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: That's true. That's true. And you also, have to make sure they have active licenses. A lot of times they'll come in and they'll say, oh yeah, I've done this and this and this. Okay, well let me see your license. And it has to be in good standing just to protect yourself. There's a, I mean, sadly there's a lot of. People out there that will say anything, you know, really to get the job, but you really need to do your due diligence as an employer and really find out, okay, you know, did they sign in noncompete with someone else?

Do they have a good standing? Is there license active? You know, you really need to make sure that those references have are clear. Sometimes you need to even to do a background check. In fact, I recommend background checks. Anytime I hire someone.

Catherine Maley, MBA: I'll tell you a story about that. I was consulting with a group in, I'll just say Texas cause it's big enough that nobody will know what I'm talking about.

And she was a nurse injector there for a couple years. Really resisted my consulting, very much resisted it because I was digging in and asking questions. And long story short, it turns out she had, she had called Allergan a year ago and changed the accounts. So, all of the money that Allergan gives back to the practices was going into her own account.

By the time they found out they were 200 grand out. Oh, and he the surgeon actually pressed charges and somehow, they're still, it was like pending forever. And she had the audacity to get a job with the competitor right there in the neighborhood. And I don't, and the competitor was also, a little on the shady side, I guess.

So, they were meant for each other, but. That surgeon lost so, much sleep over that and so, much negativity and what a shame, like. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah. Well, it's a shame because you start to invest in that, in that employee or that independent contractor, you start training them. You start you know transferring institutional knowledge about your, your practice, about your medical spa, about your organization, and.

It becomes a waste. It all becomes, you know it, it just, you, you don't get that return on your investment. In fact, you lose money as the moment you find out something like that because they're taking all of that out the door.

Catherine Maley, MBA: Well, another tip would be everything should be set up as a profit center on, on its own because they were such a big practice.

Nobody was noticing. The money was missing because they had a lot of big numbers going. But if they had practiced like a silo, like the injectable silo, the skincare was a silo. The lasers were a silo, they would've caught that much faster. Oh, oh yeah. I highly recommend that. Yeah. Let's talk about pay because it is all over the board.

It matters where you live. It matters what your overhead is. A, a nurse here in California is a joke. It's ridiculously expensive versus maybe, I don’t know, somebody. I don't know, Oklahoma, I'm sure it's very different. Correct? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah, no, it's all over the place when it comes to, you know when it comes to you know, compensation.

Catherine Maley, MBA: Absolutely. So, there are so, many different scenarios, but the major ones are usually number one, you either hire them as an employee and you just pay them an hourly period. Right. And they get perks. Cause some of them, like the employee perks, some of them actually are looking for stability. Because they, they've tried to do this on their own.

They've tried to be this, the traveling injector, and it doesn't, it's. Sexy as it seems. Yeah. So, a lot of them are just ready to settle. They want to find a home, they want benefits. They want to just do their nine to five, but make them full-time, that kind of thing. Okay. So, they're employee, right? Another way is to make them an employee but give them less of a base pay and then give them some incentive to go above and beyond that. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Right, right. And so, so, you can start, okay, so, first of all, you can start with just a commission, right? And I recommend that a commission, when you have an experienced injector, who has a, a, a large following, right? Because you are only going to, you are only going, she's only going to get her commission based off of the money she brings in off of the revenue.

The injector generates, right? So, when, let's say, let's say just for example and this is a very low number, but let's just say she brings in your injector, brings in 10,000 a month, right? And let's say you, your, you're base monthly commission based off of a hundred thousand is 18%. So, right there, she's getting 1800 a month, and this is 10,000.

Listen, people can make that in a day, less than a day, $10,000 on injectables. So, right there, right, she's, her annual commission would be, you know let's say $22,000, right? That's her annual commission. Now, let's say sh you have an injector that does 30,000. A month. So, you're looking at the annual revenue generated as 360,000 a year.

Right? So, let's say you increase her, her monthly base commission to 22%. Now you're looking at, she's making 6,600 a month just based off of commission, and her annual commission is about 80,000 a month or 80,000 a year. So, it all, I mean, You know, it, it's all negotiable is what I'm saying. But the, but what we really want to be careful is, is that we don't want to give 40, 50% commission off of.

Generated revenue sales, right? So, you don't want to say, I will give you 50% or 40% off your gross commission because someone has to buy the products, right? Somebody has to buy the office supplies, somebody has to pay for the overhead, and usually that's the practice.

Catherine Maley, MBA: You know what when it comes to the money part, because sometimes the doctors get caught up on, I've heard this over and over, I'm going to pay her six figures.

No way. Like all they see is that six figures. But if she was bringing in a million. That that's 10%, that's fine. You know, like, just keep remembering. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: There's a, a, a math problem there, there is a math problem. You want to stay between 18 to 23% on any type of gross commission generated from the revenue coming in.

That, that, that, that injector generates you don't want to go over 25%, otherwise it's not sustainable. It's just not sustainable for the way I…

Catherine Maley, MBA: You know, the way I look at it, just generally speaking, when it's all said and done, when you know your costs, you know, your fixed costs, your variable, your commissions, when it's all said and done, if you can keep 25% profit margin, you can't make 25% any more, any, like in the stock market.

So, if you can make it there, because your business is still probably your best business investment, you'll make then I would say it, it's a go. Yeah. If it's anything under that, I would say, You don't need the hassle. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: No. And then, and then you got to think about it too. Let's say you do a base pay. So, let's say you're going to give someone $50 for them coming in.

I would, their commission, I would have between two to 4% commission based on the revenue that comes in. So, here again, we're looking at numbers, right? But let's say you work 24 hours a week on $50 an hour. Your, your monthly salary is going to be over 5,000 a month. And then if you, let's say you generate $30,000 in revenue, you're going to at 4% your base monthly commission's going to be $1,200.

So, add that you're going to hit 14,000, so, your total, total compensations are almost $80,000 for your base pay and your commission. and was that part-time? That could be 24 hours a week.

Catherine Maley, MBA: Mm-hmm. So, yeah, that's part-time because one of the issues I have with the part-time in today's world, you're just trying to get really good at this because it's so, uber competitive now.

You're going to win if you are. A smooth-running operation than if you're not. A lot of money is lost in the processes or lack thereof, right? It's so, difficult to build a team and a smooth operation when people are coming and going, like when they're. They're not there all the time. And team building's really tough when one person's, the prim donna who comes in just twice a day, twice a week, and then Jackson leaves and then the, and they, they're not building a team effort.

So, and I don't know what the answer is. I'm just trying to give the variables. What kind of practice are you trying to. And can you do it with part-timers? And I will tell you it's way more difficult to do it that way. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: It is, it is way more difficult. You can have someone that's, let's say is your sole injector.

And a client that I've had had the, the injector had the L l C, the injector bot. All of the products. Oh. And then, and then gave that plastic surgeon a percentage, right. Of what she brought in. Well, she obviously brought in a million, and then she gave him 400,000 and she kept 600,000. Right. So, and he, and, and the whole thing is he's like, well, I want to build, you know, a bigger injector.

You know, I want to scale my inject, you know, my injector. And she was like, why? What's the point? I'm making good enough money. I don't need to, so, it you, your kind of, there is that, you know that mark there where they lose the incentive. There's no more incentive to build the business. So, you're kind of stuck.

Catherine Maley, MBA: How interesting though, that she, she paid for everything. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: She, yeah, she was a pa and she paid for the, she paid for it all. He didn't want to worry about it. And so, she, and he fed her, all of her patients and, and then she put it under her LLC. Okay.

Catherine Maley, MBA: Very interesting. I would just say where a lot of it goes sideways is the doctor's not watching the money. How does this relate to the topic of the pros and cons of nurse injectors?

So, Oh, yeah. I just wouldn't take that car blanche. Oh, okay. Thanks for the 400. Like, I, and, and he, it was almost like a gift, you know, I, yes. That I just would never. Abdicate the accounting, you know, just, yeah.

Lisa Marie Wark, MBA: No, you have to count your pennies as a physician, even when you don't have time. You really have to.

Catherine Maley, MBA: I mean, yeah, somebody has to because you've got to know, is this a profitable system that we're running here? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah. Your bookkeeping, your accounts receivables. Your accounts payables. Yeah.

Catherine Maley, MBA: Yeah. That's the only way to do that. So, that's really interesting. What do you think about Who's medical? If somebody comes in, like a nurse comes in, that who's liable? How does this relate to the topic of the pros and cons of nurse injectors?

Like how liable is a practice for a contractor or like a…?

Lisa Marie Wark, MBA: Right. You know, a contractor needs to, they need to carry their own medical malpractice, right? Because no matter whatever happens, That patient is going to go after the doctor for sure. They go after the deepest pockets and they will go after the, the injector.

They go after both. But I recommend that the injector has also, insurance to help you know, protect the, protect the, the providers.,

Catherine Maley, MBA: Would you say most of them do, and should you be asking that during the hiring process? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yes. Yes, you should. You should be asking for that, especially if they're an independent contractor.

If they're an employee, it's under the preview or the purview of the Of the physician.

Catherine Maley, MBA: Do you think a lot of them are covered?

Lisa Marie Wark, MBA: Personally, I don't think that, I don't think they are. I don't think they are.

Catherine Maley, MBA: I've never heard of it.

Lisa Marie Wark, MBA: Have you seen it? I don't think they're, I asked for it. I asked, I said, well, what's your medical malpractice?

Oh, well I need to get that. Yes, you do. Yes, you do. Yeah. Interesting.

Catherine Maley, MBA: Yeah. What do you think about the injector? Who's the traveling injector in the area and she works for three different competitors? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Oh gosh. It's, it's, it could be a big Hornet, you know, nest if, if something happens, you don't, you know, it might be a great thing at first, she's going to a salon, but, You know, she also, needs to make sure that the medical director knows exactly what she's doing, where she's going.

The medical director needs to sign off on her charts. It depends on, is it a nurse, is it a pa, is a nurse practitioner? It can be messy in all these different places just because. Well, if they're using an E M R it might be easier, but back in the day when they would have all these charts and then, you know, they'd have to leave the charts there because you really can't take the charts everywhere because you don't want anyone to get into, you know, for HIPAA violations or anything like that.

But I prefer you just stay in one location and if you grow out of that location, then you can have a second location and, and hire someone else to, you know, help you with injecting.

Catherine Maley, MBA: So, we're, we're probably being really negative because, but we want the audience to know that you want to watch out for this because it can be the stickiest relationship.

You have it. Well, next to bringing a partner on, you know, that's another Yeah. Yeah. But my tips would be, hire slowly. Yes. Time. Really know who this person. Mentally, psychologically, reputation, credentials, all know them well. I definitely would do back background checks. I'm shocked at how many shady people there are out there. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Oh, a hundred percent, yes.

Catherine Maley, MBA: I mean, I've seen some people on mugshots.com for God's sakes. You know, so, I don't know why. Yeah, How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: I know. I shouldn't laugh. I mean, I, I believe you. It's, we're, we're very naive and you know, a lot of physicians and my father's a physician they don't learn business in medical school.

Right. So, they're very trusting people and that's a good part about them. And then it's also, can be very dangerous for them in.

Catherine Maley, MBA: Well, and, but they're also, not at all interested in business typically. So, they'd rather abdicate that whole thing and hope it all works out fine. And they just want to know the bottom line, you know, how much did she cost me?

Yeah. So, I, but you know, so, you have to take some responsibility for that. So, I would say the ones that I have seen work the best. Yeah. I will just do this. The ones that work the best, they're full-time. They have very clear. Tasks very clear. It was all done in writing at the beginning. This is what I expect from you.

They signed the non-compete, even if it weren't going to, they signed the non-compete, they signed the social media policy. They were they're told very specifically; all watermarks go on all our photos. We own the patient, obviously, that you can't hold everyone to it, but the more that's discussed upfront, but then treat them like a team.

Don't treat them, don't treat them differently. Don't treat them like a pre-Madonna either. You know, like when they start calling the doctor by his first name because they think they're, you know one-on-one with the doctor. That I would say those are some of the signs. They won't sign anything. They resist anything in the office, like team meetings.

They won't show up for team things. They won't show up for trainings or meetings. They leave early. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Yeah, all of that is red flags. If you have someone that works like that in your office, and I don't care how great of an injector they are they're just not a team player. They don't belong in your, in your, you know, practice it, it creates.

it really creates some kind of toxic work environment because everybody else is going and everybody else's team building and everybody else, you know, is really trying to, you know, make the practice the best that they can possibly do. And then when you have someone who doesn't want to join the meeting or leaves early, comes in late, that's, you know, that's unacceptable.

You, it doesn't matter who you are. It doesn't matter if you're the injector or if you're the esthetician or if you're the front office person. We all are a team when it comes down to it, and we all rely on each other. And to have a Pri Madonna in your office really is a strain on the other employee.

Catherine Maley, MBA: I'll give one last tip that I have learned through my own experience. Yes. That injector needs to know that all arrows point to surgery. A lot of the injectors never, they, it's their patients, they protect their patients, but a really good injector works as a team with the surgeon and she or he is the funnel to the surgeon.

So, when I show up in a practice, I want in-house. in her treatment room, and it's all about surgery. Like and the patient who's waiting for their Botox or filler to be, you know, prepared, they look over at a digital photo frame and they see tummy tuck, breast dog, breast lift, mommy makeover. And they're like, what?

So, today they're there for filler tomorrow they could be there for tummy tuck and that. Injector needs to have some type of paper trail. I personally like paper trails. So, she could have a cute little comp card. A comp console card. Yes. And, you know, and she hands it and because the patient looks over and says, wow, can you tell me more about that tummy tuck?

And she said, I can do better. We have we charge the doctor, it costs, you know, $200 to see him for his time, but because you know me, I can get you in there for free. So, here's a comp consult card. Perfect. And literal., there's a paper trail straight from that cord that injector to that surgeon, and now we know that she's working as a team member.

And then the doctor can always give the patient back again to the, to the injector. Like it's such small thinking, thinking, no, no, no, I'm going to keep everything with me. That's not how you work this. You know, a good surgical patient will go up the ladder, back down to nonsurgical, back up to surgical, back down to nonsurgical. How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Absolutely. I mean, if you think about it, just like when you say abdominoplasty or liposuction or whatever that patient might be inquiring about, it's, it's imperative for you to refer that patient to the surgeon for many reasons. One that's, they want that result and then that surgeon should refer back to the medical spa, for example.

And let's say do maintenance like m sculpt or cool sculpting use machines that can help maintain the surgery. So, it, it works together. It's not just one, it's not just one procedure over another. for sure. Yeah. And there's also, one other thing that I forgot to discuss about, about injectors is that if you were training an injector and you were doing all this advanced training, which we all know is not, Inexpensive.

It's very expensive to train, especially advanced training. I am, I, I like to implement an aesthetic educational agreement with your injector, and essentially what that means is saying that if I invest in training for you to have to know advanced techniques and to be able to. You know, do I don't know, Russian lips or P D O threads, you are obligated.

The injector is obligated to stay an amount of time with that practice until that training investment has been paid off. So, I think that's a really big we don't really talk about it, but I know like a lot of injectors, they want all this training, training, training, training, training only to walk out the door.

Right. And, you know, you really want to keep them there.

Catherine Maley, MBA: And, but it's the same thing with that. If they won't sign it, that's a big sign. If they will sign it, it could still go sideways. But at least you, you set the expectations ahead of time, you know? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Exactly, exactly.

Catherine Maley, MBA: Better all the way around. Yeah. So, that pretty much wraps it up. How does this relate to the topic of the pros and cons of nurse injectors?

Do you have any final words or anything else you want?

Lisa Marie Wark, MBA: No, I don't, but it's so, great to see you and I, I put a light on me because it just got dark, so. See me. I don't know if you notice. No, I saw that. Oh my God. Is that me in there?

Catherine Maley, MBA: No. I've literally been on these zoom calls where it was getting darker and darker and I'm sitting still and the light is way across the room.

I'm like, I can't get over there. I don't and I just started talking faster. So, Lisa Marie, thank you. So, much for being on. How can people get ahold of you if they want to learn more? How does this relate to the topic of the pros and cons of nurse injectors?

Lisa Marie Wark, MBA: Sure. Okay, so, you can go to my website, www.LisaMarieWark.com. You can email me at lisa@lisamariewark.com, or you can call me.

It's (702) 374-1944.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on the pros and cons of nurse injectors.

If you’ve got any questions or feedback for Lisa Marie Wark, MD, you can reach out to her website at, www.LisaMarieWark.com.

A big thanks to Lisa Marie for sharing her experience on the pros and cons of nurse injectors.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Pros and Cons of Nurse Injectors— with Lisa Marie Wark, MBA”.

 

 

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#nurseinjectors #consofnurseinjectors #prosofnurseinjectors #lisamariewark

📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and 6k B&A Photos and Just for Men.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "6k B&A Photos, plus Just for Men — with Sam Lam, MD".

One of the biggest complaints I hear is the reluctance of patients to share their B/A photos. 

I used to believe that too. Until I met surgeons who have thousands of B/A photos of their patients on their website, on their social media and on Ipads in their office.

How is that possible?

Why can one practice collect thousands and others can’t?

In this week’s Beauty and the Biz Podcast, I let Dr. Sam Lam answer that question for us. 

Dr. Lam is a facial plastic surgeon with 20 years of experience in private practice in Plano, TX. He focuses on face and hair transplantation, and still manages to collect lots of social proof from his happy patients, willing to share. 

Here are other topics we talked about:

• How to grow a “Just for Men” component to your cosmetic practice
• How he grew his own 600-video library and use it to market his services
• How his building differentiates him from his competitors (gorgeous)

Visit Dr. Lam's Website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

6k B&A Photos, plus Just for Men — with Sam Lam, MD

Catherine Maley, MBA: Hello, welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and 6k B&A photos and “just for men” . I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and profits. Now I have a really special guest today.

It's Dr. Sam Lam. It's Samuel Lam, but I just love his name. Sam Lam. Can't miss that. Now, he's a board-certified facial plastic and reconstructive surgeon with 20 years of experience and in private practice in Plano, Texas where he's from actually. He also has a lot of experience with 6k B&A photos and “just for men” .

So, Dr. Lam completed his undergrad degree at Princeton and his medical degree at Baylor College of Medicine. Then he trained for six years in head and neck surgery at Columbia University. In New York, and then he completed a fellowship in facial plastic and reconstructive surgery as well as hair restoration and a "just for men" component to his practice.

Now, Dr. Lam has written over 250 articles, book chapters, and eight major medical textbooks, including the first textbook series on hair transplantation.

So, Dr. Lam lectures. Hair transplant courses all over the world. He's been featured on CNN, CBS, ABC, Fox, and many other media channels. I met him many years ago. He's been on the podium forever around the world talking about marketing. He's a really good marketer, by the way. So, we're going to dive into the business side of your practice and learn more about 6k B&A photos and “just for men” .

Dr. Lam, thank you so, much for joining me.

Sam Lam, MD: Thanks, Catherine. I appreciate it. I'm glad to be here.

Catherine Maley, MBA: Oh, that's fantastic. So, why facial plastic surgery and "just for men"? I always wondered that because when I was growing up, I never heard of facial plastic surgery. I heard of plastic surgery, but how did you land on facial plastic surgery? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, it was it was actually during my otolaryngology residency that a guy gene Tardy, who was my mentor, ed Williams' mentor, and he came in a very patrician guy, very well dressed, and he started talking about rhinoplasty. And I'm an artist at heart. I paint every day and. I just like, wow, this is beautiful.

I mean, my whole life is driven by beauty, and so, even now, 20 years out, I'm probably one of the few guys that do, does his own injections as well as his own surgery. Because I just, I'm just passionate about all of it. I, you know, for me it's, it, it took me from a position where I was doing the same procedures over and over again, and then now every, every patient is different than.

Catherine Maley, MBA: Okay. So, how, what was your, just quickly, what was your journey from, you graduate, you did your fellowship, you're out, and how did you enter the marketplace and establish a "just for men" component? Did you go to a hospital? Did you go solo right away? How was that journey? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, I had a very nice cushion, and unfortunately from the business side of, of things, it's, it's, it's obviously not something everyone can get.

I, I was literally in and not figuratively, literally my dad's toilet. So, my dad was a family doctor and he had a toilet that I, I needed, I needed. I have an office, so, he took it out and that was my office. So, it was very nice because I lived at home. I wasn't married and, and he basically they covered, my staff, covered everything.

And I was in a very small office for a fam, you know, family doctor in, in Richardson, which is an area that has mainly Asians. I trained a, a few months after my fellowship to learn. Asian cosmetic surgery and the Asians came in and they said, oh, this guy is affordable, which is perfect for me. And other people that were that, that, that were not Asian, were like this guy, I, I, I don't think he can know.

He knows what he is doing. So, I started with him for a couple years. My mom, who was really a Is ne was never a developer, that she is the brains and the vision and the trust in me as a person that I'd even trust and built this at the time was 27,000 square foot wellness building that became 45,000 square feet.

And that's another thing we can talk about, but she really, I would love to take credit for it, but she's the one that built that. And. That's how that in about two years morphed into an amazing, insane center that I would love to take credit for, but I can't.

Catherine Maley, MBA: By the way we're going to talk about it, but you have to go on his website, Lam facial plastics.com and check out the tour.

It's quite impressive and especially the "just for men" component. Yeah, it's right up there with like one of the best I've ever seen. So, how did you divvy up the services? Because are you still doing recons? At all? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Not, not anymore. I, I leave the reconstructive on my website only because its, people love to see that the song, there's a little tag of warning of, yeah, it could be a little graphic.

And I, when I started my practice I said, look, and when I didn't have a lot of rhinoplasty before and after is I said, look, I can put a nose back on the face. And they go, okay, so, I'll, I'll do, I'll let, I'll let you do my nose. So, no, not a lot of recons anymore. You know, some keloids and things like that.

But mainly it's cause —

Catherine Maley, MBA: Then how do you divvy up your time and with your "just for men" component? Because you are getting so, well known for Rhino, but you also, do bleph. I'm, I'm sorry, for hair transplant, right? So, you do a lot of hair transplantation, then some rhino, then some facelifts. How are you? Divvying N And you do your own injectables.

So, how do you divvy up your time? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: So, the way that, that my, my, the, the way the work, the way that the week works is I, I, Monday and Wednesday are my big hair days. So, I do either one big strip or f u e case, then one big one on Wednesday, and that's in the morning. I'm usually done. If it's, if it's a strip procedure, I'm done about 10 30.

If I'm doing an f u e, I'm done about 1230. I, and then I in the afternoons will be consults, injectables, small procedures, blepharoplasties, little things in the office, whatnot. Tuesdays and Thursdays are my big face days. I do either a facelift rhinoplasty fat graft, bluff, whatever may be bigger procedures on those two days.

Thursdays, I may switch out with a hair or I, or vice versa. I may fill in a hair a face on a Thurs on a, on a Wednesday. So, these are just, there's a little bit of flexibility. And then the afternoon's the same thing, small procedures. And then Fridays are my non-surgical days. I usually don't do any big surgeries on that day, and I just, I just, the day just fills in, to be honest with you.

I just go back and forth a little bit here and there and run back and forth.

Catherine Maley, MBA: Do you have a preference for the procedures you like the most, in regards to your "just for men" component? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: I love it all. I, I love it all. I mean, you know, I just, everything is for me is creative and fun and I just, the way, you know, for me, I find that people. They oftentimes surgeons give up the injectables.

They, you know, I understand that from a money perspective, you get someone else to do it, it makes sense. But I love it and I find that there's so, much overdone fillers and great facelifts and that it, it doesn't look right or vice versa. You get really good fillers in bad surgery and doesn't look right.

So, I look at myself as sort of Apple, Inc. I mean, I control the end-to-end user experience. So, I, my patients look good when they come out. I only, things I don't do is like I p l and you know, microneedles and stuff like that, but anything that requires an artistic eye and control, I, I do it all.

Catherine Maley, MBA: So, your business model, you've got with your "just for men" component. Yeah. 45,000 square feet of facility. That is remarkable. It's got. More than one water fountain or water flow thing. Oh, dear Lord, if the place is gorgeous, but somebody has to pay for all of that. So, as far as I can tell on your website, you look like the only revenue generator. Who, so, who's on your team helping you make money? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, for my, for my center, it is mainly me, to be honest with you. It's probably not the best business model, but it's a business model that works for me because obviously I know people do better with 10 injectors and everything. Now I have people that do all the non-invasive little small things as we talked about.

There's a lot, I've got a lot of lasers. They do all those things. I don't do any of the. The little laser things, but the vast majority of the revenue comes from me. Now, there are things like, we do this thing called hair stem, which basically it's an infusion therapy instead of p r p that helps with stimulating hair.

There are a lot of little things that are, I, I can't even name so, many little things, but they do all that. But the vast majority of the profit still comes in mind from my hands.

Catherine Maley, MBA: How, how can you, your overhead must be insane and also with your "just for men" component. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, let me clarify. The 45,000 square feet is not mine. I have about 10,000.

Okay. So, so, I've got a, a spa that I, I lease to that's, you know pretty large six, 7,000. I've got a. A huge salon that's across the way. I've got a dentist; I've got a marriage counselor. I've got a person that does eastern cupping medicine. I've got these med suites that's about 6,000 square feet that, that has Ayurvedic medicine hair systems.

I've got, I can't even think of it. There's so, many different things.

Catherine Maley, MBA: So, those are all tenants. Okay. So, are you the owner of the… How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Yes. Yeah. And they're tenants.

Catherine Maley, MBA: okay. So, that's actually an incredibly interesting business model, with your "just for men" component. But do you have any control over any of them, or are they just, because I look at them as alliances.

They're a beautiful feeder to you, to what you're doing, or are they, has it turned out to be like a reciprocal but not? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Not as much as, so, I tell, you know, from a business perspective, I tell. Young people coming into this, don't overfocus on that being such an essential element. There are a few reasons. So, first of all, we're all in it for ourselves.

We're driving ourselves. And so, yeah, I send people there. They send me people. I wouldn't say it's necessarily more than from external sources. And then of course, if you've got a salon in your, your space, other salons may feel like, oh, I, they're not going to send me people or vice versa through, so, it's not necessarily.

The most beneficial relationship. I look at it as just a long-term equity play to exit. And, you know, a lot of people are trying to sell their business in a way. I don't even have to. I can retire in my building. So, so, that is, I, if you look at it from a long-term equity play, it's great if you worried about trying to cross feed each other.

Yeah. Okay. But it's not correct. I, and then, and then I, I made some mistakes along the way. I, I owned the Jose Bar Salon that was in my place, and I didn't revenue a lot. And it was great because in the sense I, I learned never to do that again. And I learned that I'm, I just, it's not my blue flame.

It's not the area that I. I'm good at. I don't own the time to manage it, and I own the spa. I, I didn't make much money on the spa. And, and so, now that someone else is, that owns like eight centers in Dallas, they do it. And, and, and when I was initially starting, I was worried about having a. You know, having someone else doing Botox in my building now I've got multiple doing it.

I don't care because I, I've established myself and my med spa offers it. It's, I don't even own the med spa. They, they do their own thing. If they don't refer to me because of it, I'm busy enough right now that I'm not so, worried that I, I'm looking this, that I own the building or my mom owns the building.

To be honest with you, it's, it's, it's to be clear and, and, and the future, I'll own it, but that is something that doesn't worry. That is so, interesting.

Catherine Maley, MBA: So, you don't have to manage these people. They all have their own separate LLCs or whatever. So, when you sell. Yeah, you are not, you can't sell all of it. How has this impacted your understanding of 6k B&A photos and “just for men” ?

You can only sell your piece of the practice and everyone else, all the —

Sam Lam, MD: No, no. So, this is not a condo. It's not a condo. It's a, they're, they're rent paying rent, so, they don't own any of this. I, I, I will own the whole building and the real estate, everything. So, they're, so, when someone purchases it from me, they're buying everything.

They're not having to worry about condos at.

Catherine Maley, MBA: Interesting. Wow. That's, wow. Do you have any plans, like how I, you're certainly too young to even think about exiting, but do you have any plans? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, yeah, I mean, eventually what I want to do is sell out and I'll rent from, I'll rent from the owner, you know, because and I'm fine with that, you know, so, I, my exit is not, I'm not, so, I'm, I, I'm not so, worried that I have to exit my business.

I, I make enough revenue from what I do. I'm looking at the building as my. Right. I the real estate. Right. It's the, it's the real estate, right?

Catherine Maley, MBA: There's, there's so, much equity and built up in that after all those, all after years go by. My gosh. Yeah. I think that's a brilliant idea. How has this impacted your understanding of 6k B&A photos and “just for men” ?

By the way, the real estate, just like McDonald's, it's not about the hamburgers, it's about, but I also, but I also, tell people too, an —

Sam Lam, MD: Are we talking about the business side or is that, have I dive too fast into that? So, the, so, the, the, the thing is, I would, I, I would caution people when they hear that to say, oh man, I'm going to go get this big building and I'm going to do all that. The, the, the very honest truth is you can do really well.

By investing in something else. You don't have to; you can invest in some other real estate. You can invest in some other business you don't have; it doesn't have to be yours. A lot of doctors have this mental idea and including me that we have to own where we work. I think if we can divorce the concept and say, look, if, if it works for you and you got the prime place to where you want to be and it all makes sense, do it.

Otherwise, don't worry so, much. Even if you lease or rent for 10 or 20 years, if you're making good revenue here and you've got a better business proposal somewhere else to exit on, do that.

Catherine Maley, MBA: I think they get such peace of mind from it. I know just being a homeowner, I just have a lot of peace of mind that nobody can kick me out.

I control my destiny there. And it's like a little ATM machine if you ever need it, cause the equity's there. So, I see why they do that and be, especially in today's world, I don't know how many young guys can join you and buy you out. I mean, I don't like who's going to buy you out. I you. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: That's, that's exactly the case.

And so, that's why I'm not quite as worried about that exit, which is a different mindset. You know, my, my building is my exit. It's not, now, of course, I'm going to have someone come in and groom and, and build into the thing, or maybe it goes to VC at some point. I don't even know. But right, right now I'm not so, worried about that exit as, as important as, as the other component.

Catherine Maley, MBA: What about the surgical center? Is it, is it as big of a deal as the office looks like? How many suites do you. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, so, for, for the surgery center, I started with only one because it was for me. And so, what I do now is I have sort of two And so, let me explain what sort of means I do. One of the rooms is I, I build for my hair, hair, hair transplants.

I don't need general anesthesia for it. It is completely med Gass ready to go. And so, what happens is I have a, a plastic surgeon that does body work does some face, but he basically does like 99% body work. And he comes in and the days I do hair in that, in the hair room, he uses. The surgery center to do the body stuff.

And then, you know, if in the future if I get busy enough or I want to exit on that, or I want to sell this as a surgery center, then I can easily, basically, it's ready, it's, it's ready to get it's gassed. I just need to put in a general anesthesia machine to do that if someone wants to do that. So, As a separate entity, as a profit center, profit center to sell that out.

Right now, it's not built in for that. It would make a lot of sense. I did have discussions with the plastic surgeon to come in as a tenant and, and to buy over time some shares on the surgery center. You know, a lot of physicians are very risk averse. They just don't see that as something that makes sense.

But it's a no-brainer for me for where he was going to come in and do that. But, you know, it's, I, I'm not sweating it, you.

Catherine Maley, MBA: So, that plastic surgeon, your business arrangement with him, is it, is it completely, he rent some space and that's it? Or do you have a, a relationship? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: No, he just comes in and uses my, my center and so, I, he is just using dead, dead air, so, to speak, you know?

Gotcha.

Catherine Maley, MBA: Yeah, I mean, I, I've, I've seen it go both ways. I've seen the surgeons who have put millions into a multi suite or thinking that the surgeons in the area will come to him, you know, to come do surgery there. That was way more difficult than they ever expected. They had, they had to go out of their, like the plastic surgeons wouldn't come, so, they had to go with orthopedic surgeons or, I mean, they, they scrambled, you know, to build a time there and it was just one more big headache that they had to manage.

So, I've just heard such mixed reviews, like sometimes they were sorry, they ever got involved and they should have just kept it small. Like any thoughts about…? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: You know, I mean, to be honest with you, you need to have good people working around you to help you. So, if you are going to do that, the problem with cosmetic work is you don't, it, it, you don't make money on that from a surgery center.

You need, if you really want to make money on a surgery center, you need insurance. And the problem with that, that's a whole different level and it depends on what level you want to take it. A friend of mine does bariatric work. He's got a great surgical facility that does all the insurance stuff.

For him, it makes sense because he does insurance. But if you're a cosmetic guy. I, I think if you are, unless if you want to go into the surgery center business, then you got to go into, from an insurance perspective, if you really want to put plastic surgeons together, too many egos going around. There's no compensation at the level of a, of a surgery facility.

It just makes no sense to me.

Catherine Maley, MBA: Well, I did watch somebody in California many years ago. He, he was, 6 million building the place out as he's building California. Took away all the insurance for breast reduction and workers comp and all of that. It just changed overnight. And he's like, crap, what am I going to do?

And that really hurt a lot. And then somebody else came in and decided to do all the transgender. Yeah. And in California, I couldn't believe this, but they were. Transgender patient was insured by up to a hundred grand for, you know whatever it is whatever you call it. Gender…? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Gender, affirmation, surgery.

Catherine Maley, MBA: Yeah. Yeah. And it, it's a huge business, so, It just depends, you know, like where, where you want to go with that. But it did, it completely destroyed his cosmetic side. Mm-hmm., because it's a completely different world. It's a different patient, it's a different emotional background. And it, it, the two did not gel at all.

But when you just take that piece of it, the transgender part of that, I've watched some practices just crush it. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: There's, it's so, many, there's so, many right answers and wrong answers to everything.

Catherine Maley, MBA: Yeah. Yeah, for sure. So, do, do you plan on ever like, bringing in another person? Another? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: No, no. I, I actually have the physical space for it now.

I just don't have the bandwidth. The problem, honestly, several things. Number one is staffing has been a nightmare the last two years. Just trying to make sure that I'm, I'm having. Staffing for me has already been very difficult. So, until that part of the equation is solved, the answer is no. The other thing to me right now is you know, there's, I, I need to find, I think, you know, ed always told me, ed Williams always told me, he says, don't bring someone on board unless you're willing to slow down.

Yeah. Or exit on it. And I'm not either one. I, I really love what I do and I, I don't run a crazy business where I have to. I am running all over the place, but I, I don't do, I do like two to three transplants a week, two to three major surgeries a week, and a ton of small ones. And then of course, a ton of injectables and I'm happy, so, I just don't have the room or bandwidth to have someone come in right now, you know, maybe in the future for sure.

Catherine Maley, MBA: But it sounds like also, you're trying to do work-life balance. You know, you're not, you are not going to kill yourself doing this. And, and I'm so, glad you know that because some do. And., I don't know if this made them any happier, but they're grinding, you know, they, they, they've been grinding for 20 years, so, you know, the answer's whatever's right for you. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: For sure. Absolutely.

Catherine Maley, MBA: Yeah. Gosh. All right, so, we have to talk about actually, let's just talk about staffing for a second. Sure. It has been universally. The biggest issue ever. It always was an issue like, isn't staffing like your biggest challenge of running a practice, but now due to whatever has happened in the world, it's just gotten so, difficult to find people, not find people, good people you know, who want to work and who are dedicated. How has this impacted your understanding of 6k B&A photos and “just for men” ?

So, any tips on what has been working for you?

Sam Lam, MD: I have an amazing director who manages all this, first of all. So, I don't and of course it's, the thing is she's so, well connected in the community. She finds a lot of friends. Of friends. Of course, that's the best way to get people here. But that's not even enough.

It's too still too dry. Of course, indeed has worked really well for us. But there is no easy way to do it. It is, it is a slog. And I, I, I wish I could give you a good tip. That would be a pearl. No, there isn’t.

Catherine Maley, MBA: It's, well, didn't everybody, I think half of the state of California left because we're so, crazy here right now.

And a lot of them went to Texas. So, did you feel a big rush of. Californians coming over. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Yeah. I mean, from a real estate perspective, they've all come here to take over homes and things like that. So, from a business perspective, it definitely has, has helped us. I mean, I think that everyone has felt a really good plus, I mean, not everyone, but a lot of people have felt a really good plus during the pandemic time.

But now as inflation soars and everything else is going up, there's definitely been a drop in the last six months. And I think things are trending and not in a good way. Everything's a cycling. I mean, I, I'm not so, worried long term. People want facelifts. People want hair transplants and, and it's just little bumps in the road, you know?

Catherine Maley, MBA: And it is cycles. We were both around for the recession and the comeback and all the crazy that goes on, but it's very cyclical. It just is. So, let's talk about marketing, because I used to say, Hmm, how do, could you possibly differentiate yourself from everybody else? Number one, your building.

Killer. That is unbelievable. How long did it take to build that thing? Two years. Right. I it's amazing. Did you have that vision, like the, and you call it something like the Wellness Center, right? How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Well, you know, I had a vision for the Wellness Center, but I, it really, I, I, I would love to sound like an arrogant person and to come up with this, but my mom.

Is an amazing business person and you should interview her. Not me, I guess. No, but she, she really, honestly had a lot of trust in me to do this. And we built a lot of the stuff at a time where, you know, like right now, building is built, anything is crazy. I mean, it's, it's, you don't, you want to, you know, buy low and sell high.

I mean, I, of course, if someone's building right now, go for it. It's, it's, it's great. But my God, it's, it's a tough time. And we just built at a very low time. I mean, the land was dirt cheap here. This in 2001, you know, it was just after some after nine 11 there was some depression. The marketplace.

The Tomans who owned the mall across the way that has had been up and down and still up and down. Unfortunately, right now with Covid post, post Covid, they wanted to, to get rid of stuff and, and so, it, we just be, we're just very lucky that Texas has, has grown so, much. But the thing with real estate too, is that it, it's not a surefire bet.

It's not that just because. You think, well, it's real estate, it's real. And then you're, you're going to grow. Not every area grows, you know, and not everything multiplies in huge degrees. So, there is risk with that, you know? But we are just very blessed that the area we chose was like amazing. It's the, the huge corridor of growth right here.

Catherine Maley, MBA: For sure. I did own some single-family homes in Austin, Texas. Yeah. Before, of course I sold at the wrong time, but I, I, it was there's no money in that, quite frankly. They, there was no equity like you can build out here in California. Like, like it just, and it was difficult to manage, but I just remember thinking, wow, this place, it's so, dirt cheap to buy real estate away from California.

Sure. But then when you sell, well now they're the place, I mean, actually one of the houses, like the houses were They, during Covid, they jumped up to like over 400,000 in what I had bought it for. And it's like, gosh darn, I didn't see that coming at all. But here was the big, the big one for Texas is they get you on the property taxes.

Oh, of course. Like my property taxes like tripled one year and I thought, wait a second. I didn't account for that. And so, it just didn't, financially it didn't make sense, but do you find that. Because somebody's got to pay for all of this stuff somewhere along. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Yes, yes. No, property taxes are terrible in Texas.

There's no doubt. Get someone to negotiate it for you. That's pretty obvious. I've got, I've got, someone negotiates my commercial. I've, and the same guy negotiates my home and everything's negotiable. So, Nice. That's good. That's actually a good rule for everything. Everything's negotiable,

Catherine Maley, MBA: Sure. By the way, what's your commute like from your home to you. How has this impacted your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: In the morning, it's eight to 12 minutes and home it is 12 to 30 minutes, and it's, it, the 30 minutes has really gotten crappy now because sometimes I just deal with traffic. I never had to deal with that. I don't know what's going on, but I, I you know, Tony Robbins calls it no extra time or net and I learn languages when I drive home, I do audiobooks and I, fortunately, I, I mean, I, I can absolutely concentrate and learn a language, but I don't like wasting time.

So, I, you know, I don't even feel the commute.

Catherine Maley, MBA: I, I just think a as I get older commuting, commuting has become, I, I, I won't do it. I just, I, I just, I think it's not good for your peace of mind or your productivity or your just your, I just, it's just so, nice. I mean, I, I've noticed also, surgeons will start moving closer. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: There's a book by Jonathan Hy called The Happiness Hypothesis. Oh, he said that it's an actually, the farther you live from your, it's directly related how f farther you live from your workplace. And the longer your commute, the less happy you are.

Catherine Maley, MBA: Isn't that true? Although, you know, now we all listen to podcasts all the time.

I can listen to those all day long. I still don't like be being forced to sit still. That that's my, I'm just too a d d about that. Anyway. So, so, regarding marketing, you were, you were one of the very first people I ever met who got into video. Yes. And we were at the medical conferences, been going to those for years.

And you always had your camera up there, and I thought, good for you. And you were, you got really good at it, and you were the only one doing it. And then now the whole world has jumped in and they're doing it. But how much did that help you to be at the still? All of that? Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: All of it does. All of it does. I, I think that, you know, I'm definitely not the leader anymore of this, of this space.

People are doing great work that I, I'm not doing that, but there's no doubt that on a daily basis it's the it's the videos, the podcasts, the just patience getting to know you. I mean, just, you know, you, you know, and the great thing is lecturing and filming your own, I film my own lectures.

That's been huge thing. People just go, oh my God, this guy is such an authority. But I come across pretty good on, on stage. And so, you know, if you're, if you're not a good lecturer or you're nervous or something, then of course that is not good. But, you know, I feel very, people feel authenticity as you talked about as, as you've, as you have talked about that, that is an important element and there's just a connection.

So, videos are still critical, you know.

Catherine Maley, MBA: So, what's working for you? I, your Instagram looks fantastic. Your YouTube channel looks fantastic, although on YouTube it definitely looks like you're doing hair transplantation. Yeah. Like are, are you, is it meant to be that, like are you trying to, I can't tell if you're like trying to get away from facelift and Rhino or, or like putting all your eggs in the hair. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: You know, it's, I, here's the thing from a lecture perspective, I, I just, what happens is in the world of lecturing, you get boxed into a certain category and you like, am I, am I doing huge advances in necklaces? No. I'm following what Mike Nig is doing with network. And so, I, I get podcasts about that.

I talk about it, but I am not, I don't feel comfortable going on stage and say, look, I've innovated something. Whereas with hair, I am always on podium. You know, I have written now so, many books on hair transplant and I just am having another one come out next year. So, for me, I think a lot of it may read that way because of the academic stuff.

But the one thing that I will. Is that, you know, with long tail strategies of just putting videos up there, people are searching stuff and whatever comes up, they fi figure that's what you're, what you do. And so, I'm not so, worried about a composite location where they have to follow you, but when someone follows, finds something that I, for example recently I've been doing a lot of osteos and people find me because of all my videos in osteo.

They don't care how to do hair. They don't care how to do a facelift, but they find me because they're looking for the word osteo. They're looking for the word bone on the forehead or boney lesion on the forehead. And, and so, I think that if so, long as I keep throwing different things out there, it's great, but sometimes, you know, there's a lot more stuff about hair because I have a lot of, I do a lot of hair and I'm always on podium.

Catherine Maley, MBA: I know well there's something else you do that's really smart. I look at websites and digital presence from the consumer point of view. And if I was somewhere and I saw I wanted to talk about a facelift, and when I click on facelift, when you show up, you send me to a web page. That's all about facelift and it has everything there.

It has to be before, after photos. It explains things. It has diagrams, it has many videos of you. It has video testimonials about facelift. You are not making me click all over the place. I don't have to go to galleries, then I have to go to video testimonials. Then I have to go to learn more about the procedure.

It was all there on one page and I don't, I tell everybody, you guys make this easy for the consumer. Give them what they want in one shot because they're not going to click like they used to, you know? So, boom, whoever's doing your website, I think they are doing it. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: That was my idea. Go. Brilliant. So, the recent thing I just recently did is I, I had shot about it a couple years ago.

What are I call virtual consultations where I just, I basically the same thing I say every day. And now I move that up to the front of the page because that's really the, you know, where people want to know, like, what is the procedure, what's the recovery, what's the, what's the risk, what's the limitation?

What are the goals? Anyway, so, I, I've now flagged that as my top one, and then everything follows from there. And I. And the other thing I've done with before and after is, which I've tried to do is people. They don't want to go to a new page, they want to scroll. So, what I've done with my before and afters is I have one page scroll for like if it's rhinoplasty or whatever it may be.

You just keep scrolling down and in that way you don't. You, if you want to stop, you stop. And then what I've done with the before and afters is they're swiping left and right. So, now you basically, what's a tap it? The swipe didn't work as well, but you, you go through all your videos and everything related to that one patient on, on a horizontal bar and then vertically.

There. It's all in that one category. Of course, I've also, got subcategories. So, if you're looking for ethnic hair restoration, ethnic rhinoplasty, whatever it may, that's specific, you'll, you'll go into, dive deep into that category as well, besides a general one. But that whole, you know, finger left to right and depth and down has also, been helpful.

Catherine Maley, MBA: Oh, that's fantastic. By the way, you have 600 videos, but 6,000 before and after photos and more patient video testimonials than I've ever seen. How are you making that happen when everybody else says, oh, my patients are so, private, they won't talk about this. How? How do you make that happen? Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: So, first of all, I, I'm a good salesperson, so, I'm the one in charge of it.

So, basically what happens is the way I first look, I have the patient, I have the staff put up the before and after for me, before I walk in the room, if it looks mind blowing, I'll walk into the patient's room and say, wow, you got to see this before and after. It's amazing. So, they'll see it and then I'll ask the, just like, if you want to date a girl, if you don't ask, you don't go out with her.

So, or a guy, whatever it is. So, I, I asked the patient, would you. Mine to, to do this. And if they say, well, I don't know, usually at that point I ask the simple question, is it privacy? Or what is, or what's the reason? If they say it's privacy, I, I don't, I don't push a testimonial, whatever it may. So, let's say they say yes.

So, then from that, yes, I go to, I go to, well then you do a video, will you do a review? Will you do all these things so, I can capture all of it and then use it in all different platforms? If it is a no, it's a privacy issue, then I ask. When you do review, can I use part of the image? How about what if I, if it's autoplasty, can I black out your face and just use the ears?

Can I do you know, if it's a hair, can I just do the hairline? Can I just do the eyebrows? Can I just do the eyes? Can I do the nose with the eyes blacked out? I try to negotiate what privacy allows and., if it goes toward the, yes, I can use it before and after is of course, the natural question I just mentioned is can I shoot a video?

And they'll usually tell me, they may tell me, no, I'm not ready. I don't accept that. I, I will, what I do is I just take, now I just use my phone and I take a little plugin thing with a wired mic to the us to the, the lightning cable. Clip it on them and put it on cinematic modes. So, the backgrounds.

Hold it up this way and just. So, I'm ready to roll because, and I, and I tell them this, I say this is the way I coach them. I'll say, pretend I'm your best friend, Susan, or whatever your best friend's name is, and I'm scared to do this procedure. I'm interested. I don't know about it. Talk about why you wanted this done.

What is, you know, how, what was the experience with the staff? What was the experience with the surgery? How was the discomfort recovery? What did you feel about it? What do you think about your results? How's it changed your life now? And I said, you can say all that, or you don't have say any of it, just.

Don't worry about it. And if you forget something I will crop it, cut it, and do, and they never forget. And if they do, then at the end, let's say, they'll say something and then I, I stop the filming and then they say, oh man, you know what? I forgot. I is, I, I wanted to say how lovely your patient coordinator was.

She just really made me feel, I said, okay, hold on sec. I'll take the, the phone. I'll say, okay, start with this. Say, you know, I forgot to mention something, and then say what you want to say, and then I'll just splice it on iMovie and I'll stick in a before and after onto my thing and just upload it myself.

Catherine Maley, MBA: Now the big Pearl there is you ask, you ask, you don't delegate or advocate you, you ask. The patient's much more likely to say yes to you than somebody else in your practice, and you're making it very easy for them to do that. I will tell you though, people who are not used to video, they, they get scared when something is put in front of their face.

So, I would try to come up with, I don't know, maybe like a big whiteboard with five things like. This is what the pain is, what I was in, like, the pain I was in. This is why I chose Dr. Lam. This is why you're going to want to choose him. This is what my journey was like with the staff and the, and the surgery.

This is how great I feel now, and I wish I had done it sooner. If you could somehow, like give them a few pointers. In other practices, what they've done is they a, they're interviewing them. So, they'll, you know how when you do an interview, the. Reporter says, so, I'm going to ask you, oh, so, how did you hear about Dr.

Lam? And then I say, oh, I heard about Dr. Lam through da da da. So, a lot of them just need some coaching that they're just scared, you know? So, you know, if you can help them with that, but whatever you're doing is working because I've never seen so, many video testimonials. Very good. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: You know what's interesting is that they, they tell me they're scared and they need a script or something, and they never need one.

They just go for it. Yeah. And it's really interesting that, and the other thing I'm worried about with any pointer pointed stuff is if their eyes dart off. Yeah., like they're reading a script. Right. Cause I really want them to be focused on that. And I tell them, look, the thing that makes it easy is I'll hear that.

I'll hear the complaint that, Hey, I'm nervous I don't do this. And I'll say, Pretend you're talking to your friend. I love that. And I will edit it. Don't worry about it. Just keep talking. Just tell me and I'll say, you know what, and this is the other thing I'll say, I'll say, it can be 10 seconds. It can be 10 minutes.

Talk about whatever you want to talk about. I've given you some ideas. If you don't want to talk about the recovery, don't talk about it. Talk about. You know, what did you pretend you're having a conversation with your friend. You don't need a cue card for that. Just say, you know, why did you want this done?

And how has it changed your life? And those are the words I say, how does it change your life? And then that usually gets them clicked in and they're so, emotional about it, they'll just go off. And what that fear level is, it goes away. Yeah. You know?

Catherine Maley, MBA: Yeah. What's the timing on that? Because I have watched practices wait too long.

Yeah. There's a, there's a, a sweet spot when a cosmetic patient has been transformed and they're totally emotionally attached to it. And then there's the point where they, they, they're used to it now, and so, the emotion is gone or the passion like it was there. Is there a certain time. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: The timeframe is always, and I, and so, let me explain, is like, you know, sometimes a patient doesn't follow up with you, so, what you thought was going to be a good time is not.

And people want to see a patient a day out, they want to see a week out, they want to hear from them all over the time. So, when I, if, if I like the before and after, that's usually one. If, if I, if. That's usually one of the catalysts that I have. The other catalyst is just thinking about it, thinking, you know what?

This is a really personal person, let's just do it. Or if the person's from out of town it's like, let's just shoot it right now. And, and sometimes what I'll do is like, I had a guy this week, I, I just put on a hair transplant one, I remembered him doing a video, so, I already got the consent. I already knew he; he was comfortable.

They already told me how great the experience was. So, I went and he was six months out. He had a lot of hair growth at that point already. So, what I, when did I shoot the first one? A day after the procedure. And so, when did I shoot this one, six months out? I could shoot another one at, at one year. So, that same patient is giving me at least 2, 3, 4 testimonials.

So, it's endless, you know? And then that is a great long tail because it gets spa smattered all over the, the.

Catherine Maley, MBA: For sure. The and the reviews, do you handle that the same way or do you do that differently? Are you, are you asking for everything all at the same time? Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Like, I, I. I usually do, my staff usually handles a review.

I, I don't, I'm not necessarily a hundred percent happy with the way that I'm been taking the reviews, to be honest with you. So, I can't a hundred percent advocate it. But we use a little doctor.com thing where they type in a little review and I don't know if I don't even, I haven't checked my case, I probably should…

Catherine Maley, MBA: But if you have like two 50 or something, you have a good rating. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Yeah. Good. I don't even know, to be honest. That's terrible to say that because I should know everything, but I. Check it because sometimes make a bad one or whatever in there. Right. You know, and I just, I don't, you know, I, people ask, you know, how do you, I have one guy ask me, he said, how do you., you know, handle like a bad review.

I said, look, I, I don't read it. I just live my life and do good work. And then there's going to be a bad review. And those give more authenticity to the whole thing. But you know, it's going to happen, you know?

Catherine Maley, MBA: I want to ask about marketing for different target markets because that's getting more and more difficult to be the best at a rhino, the best in a facelift, the best at hair transplantation.

How do. How do you figure out the branding of all of that? Because you can, when you specialize, you can charge more. People will come in from all over the world because you're the best at that one thing and you've done that really a good job with that, with hair transplants. But is that what you wanted?

Or how do you market to the young rhino patient, but then turn around and market to the man who needs hair? Then how do you turn around and the more mature woman who needs a facelift, those are such different target markets. How are you handling. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: For me, it's always been the video because as I said, people, it's Google just sticks them up there and then when you see a 36-year-old deep necklace.

People relate to it and whether it's on Instagram or somewhere else, but people just, they, they, they relate to the story. They relate to the before and after they relate to the person, and then they just find more like that their brain naturally proclivity, you know, has a proclivity to find people like themselves.

So, that's one thing. And you know, I divide my website into those, those ethnic divisions. Know African rhinoplasty and, you know, all those key terms and African hair or I don't even remember now. Yeah, it's like traction, alopecia, black hair loss. So, I have all those, those ethnic and gender divisions on my website, but then I lump them.

So, I've got all male, all female. And I try to split all that up and then I've. Ron, I have a rhinoplasty website. I've got a hair website; I've got a face website. And you know, soon I probably will develop a, a, a facelift website. But those micro sites that I know now is not as in, in vogue, but people want to see your specializing something, so, that helps as well.

And then they're universal truths, things that just make it different. Like with, with hair. I have a, a joint commissioner credit facility, so, I knock them out, so, there's no. And, you know, I talk about their experience being better off, of how, and just I think the key is if you don't, if you're not good at speaking, public speaking, no one is to start, right?

You're nervous the first time you're on stage. I'm, I was nervous the first time on, on stage. Just keep doing it. And the more comfortable you get in front of the camera just talking and not worrying about what you're saying. And you may flub and you go, oh my God, I forgot to say that. I'm going to say this.

People feel that authenticity and they connect with you and they want. You become this kind of pseudo celebrity and then they walk in, they feel comfortable with you, and that's the real connection. You can have as many before and afters and, and no videos. You can have as much text and then without the video connection.

People need to connect with you before they come and see you. Of course, you have to have before and afters. You have to have great before and afters, not average ones, but you need to connect and there's no other way to do it than with you. The voice is going.

Catherine Maley, MBA: I believe with everything going on with SEO and Google and apple and privacy and all of that.

Video is. The way in today's world to market. So, anybody who is afraid of video, I always say just do it at home. Just get the phone in front of you and the iPad in front of you. Get used to it, like find your voice. When I was much younger, I knew I was going to be a public speaker. I couldn't even say my name without forgetting it.

And I went to Toastmasters for one whole year, every Tuesday. I went to Toastmasters in a loving group who like never criticized. We were all always very positive with each other. And that's where I found my voice and thank God, because I wouldn't be where I am today if I had not gotten over that public speaking fear.

Totally. And so, it's, it's totally surmountable. You just have to do it, you know? I agree. I want to talk about the, the mindset part. When I first met you, and I don't know if you'll remember this, but it was probably 15 years ago and it was a Greg Morgan Ross meeting and it was in at Stanford and in California.

And you were a very different person then. And you were, I, there is no nice way to say this. You, the, the impression I got was so, you were so, arrogant. I think you literally said to. You don't know who I am, you know, like one of those things. And, but you are a great dancer. And, and then I hadn't seen you for a couple years.

Next thing I see, I've never seen a surgeon transform as much as you had. You had lost a ton of weight. Yeah. You, you had a whole new aura about you. You were smiling and engaging and I almost didn't recognize you. And then you gave a talk and it was about, The old you and the new you, and it had to do with you had some bad reviews, you know?

Yeah. Do you want to just tell that story because that was amazing. You just became this amazing, beautiful person. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: I mean, there's so, many components to evolution, right? Because I, I, I've evolved over 20 years of practice and, and also, my life. And you know, when you're, for me being Asian, I, I was picked on a lot as a kid.

I got a lot of fights as a, as a teenager. Not proud of that. But you know, in the eighties was a different time. I think today there's racism is much more subtle. It's, it's very un under undercurrent rather than, than, than. Than basically in front of you. So, I think I had, I dealt with a lot of inferiority complex about being an Asian male, my sexuality, my, you know whatever it may be.

And that confidence sometimes comes out as that in that lack of confidence comes out as arrogance when it's not meant to be. And also, he is, you know, a young person trying to prove himself that doesn't know his, his salt pushes, pushes the, pushes things very hard. But yeah, bad reviews. Humble you.

I had a guy that I. Did a hair transplant on and at six months he had poor growth. Back then it was even before regenerative medicine that was available to try to build faster growth. And he just said he was going to sue me for a quarter million dollars and he was going to put a sign, sign outside and post against everything.

and I made a lot of bad judgment errors at that time. I first ha let my staff handle this situation, which is a mistake I should have handled myself, and I know ways to, to circumvent that better now, not a hundred percent obviously, but that was one of the issues. So, it just, it, it humbles you when you get slapped in the face and you start to realize, hey, you're not all that, and.

You know what people's opinion of you are going to fluctuate. They're, they're going to think you're great or not great. And, you know, it's, it's not it's not about you. And, and, and, and many, many issues with that in terms of weight loss. The, the honest truth is just, I, I lived in New York and I walked all the time and ate like a New Yorker.

And now you get moved to Texas and I ate like a Texan and I, and it was bad. I ate a lot and I, and it was, you know, I just got fatter and fat. But it, that was, I think all of it is just this evolution of finding yourself men mature later than women. I think, you know, there's a, a component where I didn't get married.

I mean, I didn't get married until my mid to late forties. And you know, still trying to find myself, I don't think I was the right. Spiritual, psychological emotional, physical level to get married. Whereas I think women are, are much more mature than men faster. I have kids now. I, I have four and a two-year-old in my early fifties.

And I, I'm, you know, it's great. I, I was watching the Sebastian Maniscalco thing. He says, he calls it lay and play where he lies down and, and basically as the kids run over, that's basically me because I'm old and tired. But I think a large part of this is humbling yourself, you know, and realizing that that life is fun.

You know? It is, it's incredible and it's, and, and the other thing that's really important you know, I'm, I'm a spiritual person. I believe God has given us a lot of this stuff. You know, when, when we're arrogant, we think we have so, much talent it, it's not the truth. I mean, to be honest, like I told you, look who built this.

I could easily say like, I built it, I did it, I did this. I didn't, so, why should I say that? Because I didn't. And the, the truth of the matter is we are given so, many opportunities, like with hair. Great example. Amina Vance, who came into my life, and he, she was ed Williams she sorry, Ed's coordinator was Susan Sullivan.

No Ed's hair transplant coordinator at the time that he was doing a lot of hair said, you got to meet this one, I mean, advanced when you go back to Dallas. And I said, okay, whatever. I met with her and, and, but it, it turned out to be this amazing relationship over 20 years. Now she's like semi-retired, but she's working on this new book with me for next year because we are an amazing team and, and you start to realize stuff that you suck.

and if you are transparent with that suckiness to the people around you, they know it already. You know, it's, it's, it's obvious. And if you try to pretend that they don't know, then it's even worse Just. Know what you suck at. And for, for, for her and me, we're very different. And my wife and I are very different in, in really good complimented ways.

I'm a really good visionary. I'm really good at artistic design and understanding big pictures. I know where I. Need to get better. I, I can write really fast. I, I, I, I wrote my last book in literally two months. I shot a hundred videos for this book and, and, and over four months all with no, no time at home, away from my family.

It's all done very, very efficiently in microseconds of time between patients. But I'm really bad at looking at quality control, little details like what Amina's done, even with this textbook, for example, is come back and, and just shredded it. I mean, the last book chapter on recipient migration, I thought, I was like, this is amazing.

She like shredded it, redlined it, put a new image, diagrams like, wow. So, the point of this is that we're given all these amazing relationships that in our life that make us look really good. Like, Hey, I'm the hair guru, right? I just. Lifetime Achievement Award. They've only given 20 some awards out for this golden fall.

I got it. But you know what, it's because I've got an amazing team around me that has made me look amazing. It's, it's not just because I'm all that in a bag of chips. So, I mean, those, that's, that's a long and short of it, you know.

Catherine Maley, MBA: But didn't you also, take up like yoga and meditation and it like what I did a lot. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: You know, for me it was very if, yeah, my spiritual journal journey is another story, which is really interesting. So, I can dive into that for a little while. You know, seeking for what's. Real at the end of the day. Right. So, for me, yoga meditation was a huge part of my life in my mid to late thirties, early forties.

And then if you want to hear something weird, I I'm, I, I really had no faith in God at nothing. I, in my early forties, I was trying to run this marathon, this half marathon, I was sick and me. Tenant said, you know, you got to meet this guy. Like, well, whatever, I'm sick. I don't want to meet this guy.

So, I, I, and he says, no, he, he doesn't, I doesn't mind come his come, you know, come meet. They're fine. So, I was lying down in this treatment room. I, my, my, I was down, face down and his partner, his like business partner was doing acupuncture on me. And then it turns me over around and he's, he's, he's this sort of like Catholic monk type of guy.

I don't know what he is, but he, he's putting the needles in me. and I immediately started crying for 90 minutes. I said, God, have mercy on my soul. Wow. And I was, I, I was a Christian growing up, but I lost my faith in college. I was a history major. I saw man's inhumanity, man. So, I was seeking something spiritually to fill that void.

And for me it was yoga meditation for many years. And then I became a Christian again, I guess, or however you want to say, it returned my faith, not by any volitional effort. It was, I believe God came into my life because I was. I was I just believed it was like lightning struck and that occurred in my mid-forties.

And so, it's that journey of, of that spiritualism helps me, anchor me, and I think it's something I've always wanted. And I saw it through different avenues and things and then, and God, that, my God that came to me transformed me, not by me. So, that's, that's the spiritual side of things.

Catherine Maley, MBA: That's amazing. God and I are really tight. I don't know how you get through life without having that foundation. There are just too many things that I don't believe in coincidences anymore., sure. But a lot of that takes maturity because you've tried every external thing on the planet to make yourself feel important and significant.

And eventually you, I think you just finally get there and say, you know what? It is what it is. I, I hope you like me, but if you don't, I'll, I'm okay with that because it's just too hard to keep singing and dancing for everybody else, you know? I agree. So, congratulations. I have, I have watched you through the years going, what happened?

I, I want whatever he got, because you can tell you're so, comfortable with yourself now, and that's all it was. It was just insecurity. That's what we're all doing, you know, fighting our insecurities. And I thought, oh my gosh, he has just, I've never seen anything like that before, so, I really appreciate. So, I always ask at the end like, tell us something we don't know about you.

You really were a great dancer. H where'd you learn that? And then this art, you're not kidding that your art is serious art. So, tell us about that. Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: It's my passion. I was, it, it, I was, I was doing a lot of abstract work. Now I'm recently doing one because my wife has asked me to do it, but I've always been.

Fascinated with, with art and design and museums and everything. And initially when I did my first textbooks, they just, the, the publisher said, look, hey, I, too, to get the book deal signed. I said, I'll do my own drawings. And I didn't know what I was doing and I finally did it all digitally and they came out okay.

But in the last few years, I started to really move from abstraction and started to trust my hand. And I've dived deeper and deeper into rep representational work. And every morning I get up, I work out and I paint before I go to work. And it's this part of this if you will call the meditation side.

It's a meditative part of my life and it is amazing. And I encourage all of you guys to, to paint. Now, I don't know. I love it. And I, I, I learned it through YouTube during the pandemic. The pandemic was great because I spent that time watching some YouTube videos and learning and go to Patreon. If you haven't done Patreon, It's not well organized, but it's, it's, it's, it's YouTube and Patreon are ways to learn everything.

My God, I learned all my artistic techniques through that.

Catherine Maley, MBA: Are you selling your artwork? Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: No, but I recently donate. I was the chairman last year for this Dallas County children's advocacy center, which is to help with child abuse cases horrible child abuse cases in Dallas County.

And I was the honorary chair with my wife. And, you know, it's, it's an art for advocacy where they. You donate you, you people, artists donate pieces and I said, I'll donate my piece. And I've never, and it was great because I never met all these community of artists, but bam, I made, I made friends with those artists and my piece sold like in five minutes for max bid, which is you can buy it for twice the whatever.

They, they forced me to cap it. 10,000, I sold it 20,000. So, so, I, I sold that, if you will count that. But it, it, it, it all goes to charity. So.

Catherine Maley, MBA: Holy cow. Somebody buy for $20,000? Is this reflected in your understanding of 6k B&A photos and “just for men” ?

Sam Lam, MD: Yeah. And so, next year, this, this year, excuse me, this is 2023. Now I'm going to do a 10-foot piece that my goal is to do this on the live auction.

So, out of 80 pieces, they allow five for the live auction. They turned me down last year. My arrogance said that I should be on the live auction, but this year I'm going to really, I said, I told them, look guys, I've sold this thing in five minutes, and even all the other artists said, Bottom told me this was like the best piece they've seen.

So, my goal is I, I already have the vision of how I'm going to do this 10-foot piece. It's going to be, I'm hoping they will say yes. It, it's based on the, the, the curatorial committee to say yes or no to it. It's 10 feet tall. 10 feet wide and five feet heights, two canvases, five by five. It will be what I'm planning to do is these children that have gone through the suffering, they it's an idea from what this woman did last year.

I'm going to have them work on and paint the backgrounds and the, the acrylics so, you'll know that what you're hanging in your room has been touched by the children that you have touched by buying this. Because the money goes, all, all goes to them. And so, then I'm going to do a, a web and network with birds and flowers, which I've painted a lot.

and those can be realistic. On the abstract background, it's going to be called hope, or Hope Eternal because that's the symbolism of the flight and the symbol of the, of the flowers blossoming because you know what? A child has been sexually abused and physically abused and it's just horrific that this is, that you are going to hang that in your home.

That will show, show this, you know, flight and blossoming. So, that's sort of mine.

Catherine Maley, MBA: Wow. Well, you know what? If plastic surgery doesn't work out for you, you can always fall back on this.

Sam Lam, MD: I don't know. I'm be a starving artist. I hate to tell you that.

Catherine Maley, MBA: So, we'll, we'll wrap it up now, but is there any closing comments about 6k B&A photos and “just for men”  or how can people reach you?

Any advice for others coming up?

Sam Lam, MD: You know what be passionate about. Don't. If there's something you don't like, don't do it. You know if, and that's if you love it. Don't, don't let someone else tell you not to do it. Carve your own way. Like I was a history major in college and people thought, why'd you a history major?

Well, trans, trans, you know, Steve Jobs talks about if you hadn't seen the Steve Jobs when he talks about connecting to odds backwards yeah, it's a great, I always tell to people to watch that because I didn't know that could actually allow me to write books so, fast. And it, it just follows your heart and your passion.

Just do what you like. Don't worry about someone else telling you that you suck or you're stupid and you shouldn't do that because. You know, if you love it, you're going to be, you're going to get better at it. And, and that's, that's, those are my parting words, you.

Catherine Maley, MBA: Well, that's fabulous. Thank you so, much Dr. Sam Lam.

I hope to see you at a meeting soon. Yeah, and that'll wrap it up for us. For Beauty and the Biz, if you'd be so, kind to subscribe to Beauty and the Biz so, you don't miss future episodes, that'd be terrific. Please share this with your colleagues and staff. If you've got any questions or feedback for me, you can always leave them at my website at www.CatherineMaley.com.

Dr. Lam's website is at www.LamFacialPlastics.com.

Sam Lam, MD: Plastics with an s.com. Yeah. plastics.com it would be Dr. Lam, DrLam@LamFacialPlastics.com.

Catherine Maley, MBA: Gotcha. Alright. Righty. And then if you want to DM me, you can reach me at Catherine Maley, MBA at Instagram. What's your

Sam Lam, MD: Instagram handle? I've got many, but if you want to follow my art Yeah.

Which has nothing to do with business. It's @SamLamMD. I, I post every day a new piece of art. If you want to follow my facial, it's @LFPDallas as in Lam facial plastics, @LFPDallas. And my hair is @HairTX and then my skincare is @OvaSkinCare. @OvaSkinCare.

Catherine Maley, MBA: Dear Lord, do you ever sleep?

Sam Lam, MD: Six hours.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on 6k B&A photos and “just for men” .

If you’ve got any questions or feedback for Dr. Lam, you can reach out to his website at, Visit Dr. Lam's Website.

A big thanks to Dr. Lam for sharing his experience on 6k B&A photos and “just for men” .

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It's guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I've gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let's grow your cosmetic revenue.

-End transcript for “6k B&A Photos, plus Just for Men — with Sam Lam, MD”.

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

 

 

#b&aphotos #drsamlam #samlammd

📅 Schedule your free 30-min strategy call with Catherine

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⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and transforming patients and yourself.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Transforming Patients and Yourself — with Nicholas K. Howland, MD".

When you’ve spent years training to become a surgeon, your fortitude and character were tested big time. 

But that’s just the beginning. Then you had to have enough left over to go into practice and grow a sustainable business that takes good care of you and your family. 

That is no easy feat.

This week’s Beauty and the Biz Podcast guest is Dr. Nicholas Howland, a young board-certified plastic and reconstructive surgeon practicing in Draper, UT for the past 5 years.

Dr. Howland looks at plastic surgery not as vanity, but as transformation and self-empowerment for his cosmetic patients and by extension, he learned about "transforming patients and yourself".

He’s walking his talk since Dr. Howland also went through his own transformation this past year by divorcing, being a single Dad, losing 60 pounds and working on his mental game to become his most authentic self. 

We also talked about:

• Dr. Howland growing up in Salt Lake City as a Mormon and the values he gleaned, even though he has since left the church;
• How he entered the crowded Utah marketplace and found a unique hybrid practice situation to join that works with his personality; and 
• How he’s an independent contractor with freedom to build his own brand, while also growing equity for his future and not having to worry about the day-to-day HR and office issues.

He really does have a nice set up!

Visit Dr. Howland’s Website

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

Transforming Patients and Yourself — with Nicholas K. Howland, MD

Catherine Maley, MBA: Hello everyone and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and profits.

Now, today's guest is Dr. Nicholas Howland and he's a young for certified plastic and reconstructive surgeon practicing in Draper, Utah at the largest private practice group in the area, and he knows all about transforming patients and yourself. And we'll talk more about that, but this is what I find really interesting. He was born in Utah and before pursuing his medical career, he fulfilled a two-year church mission to St. Petersburg, Russia, where he was the lead interpreter and coordinator for volunteer efforts in the world-renowned Hermitage museum. You have to Google it. It is the most unbelievably huge ornate building I've ever seen. So, we'll talk more about that.

So, Dr. Howland went to medical school and his residency at the University of Texas Medical Branch in Galveston, and he's presented at over 20 local and national meetings, as well as published several abstracts, journal articles, and book chapters, all before social media grew his practice.

Now, he has a great introductory video on his website at Howlandplasticsurgery.com. He actually has two and one is, and I think everyone should have an introductory video (remember, he knows about transforming patients and yourself), like get to know me kind of thing, where he's talking about cosmetic surgery that he performs. But he is, or was also, talking about taking call at six different hospitals in the area.

So, we'll have to dig into that and see if he's still doing that. So, Dr. Howland, welcome to Beauty and the Biz. It's a pleasure to have you.

Nicholas K. Howland, MD: Thank you Catherine. Thank you, and thanks for calling me “young”. I appreciate that.

Catherine Maley, MBA: Sure. Well, I'm getting up there now. Now you're, everyone's looking pretty young to me. So, how did you, you're in the middle of Utah, and social media grew your practice.

Oh. First, I have to talk about the Russian thing. I happen to be reading. I love Russian spy novels for whatever weird reason, and I'm in the middle of one right now. Now it's winter and the way it's described, I'm literally freezing reading. This book is so, intense in Russia. How cold is it?

Nicholas K. Howland, MD: Well, it depends on where you're at in the country.

I mean, you go, if you go south to like Rusto Nanu, which is on the Black Sea, it's a tropical climate. But where I was in St. Petersburg, we I lived in St. Petersburg for about one out of the two years. And then the other year I lived in a very small town called Petroski, which is, here's St. Petersburg, here's the North Pole. And Petroski is this little lake town, right? A little closer to the North Pole than St. Petersburg. And I was there in the middle of winter and the coldest I ever saw was 40 below, and I remember it was 40 below because you know what? 40 below and Fahrenheit. No, it's 40 below and Celsius.

That's where the two graphs meet. So, 40 below is the same in both Fahrenheit and Celsius. And you walk outside in that kind of temperature and you immediately take a breath and every bit of moisture in your body immediately crystallizes all of the moisture in your nose. Any tears on your eyes, everything just immediately is frozen.

But I, I loved my time there. I, I spent two years there for a church mission. And we loved the people, loved the country. The history is incredible and fascinating. And I, I still haven't gotten a chance to go back there, but that's on me.

Catherine Maley, MBA: But if you were interpreter, that means you spoke Russian and you must have spoken very well and fluently if you were in charge of that.

How in the world, I don’t know, one person in America has said, Hey, I think I'm going to learn Russian, especially in terms of Transforming Patients and Yourself.

Nicholas K. Howland, MD: So, while I was there, I had been there for about a year and a half, and this was in 2003. And in 2003, St. Petersburg celebrated their 300-year anniversary as a city. And president Putin, he was still president at the time.

He put in billions of dollars into renovating St. Petersburg for this celebration. So, they, I mean, they repainted the whole city. They restored a lot of old churches and buildings and one of the things that they were anticipating was several hundred thousand, if not over a million visitors coming through the Hermitage Museum in a period of about a month.

So, it was just going to be packed for this whole month-long celebration of St. Petersburg. And they needed English speaking interpreters to be stationed throughout the museum to be able to tell people like, Hey, the Rembrandts are this way, or If you want to see Michelangelo go this way, or The bathrooms are that way.

And for whatever reason, the church missionaries got put in charge of that project and I got tapped as the lead for that project. So, I had to over several months give, we had over a hundred missionary volunteers who spoke Russian, but also, English. And then we had over a hundred native Russians who spoke fluent English.

And so, I had a group of over 200 people where we organized and trained them on the museum so, that throughout that whole month they could be stationed throughout the museum and guide people. So, every day for about two and a half months, I was taking little small groups on private tours throughout the museum so, they could acquaint themselves with it.

Taught them what we were going to do during this big celebration. And that's really where I developed a, a really strong love of the arts. I mean, you spend, so, The Hermitage is the second largest museum in the world.

Catherine Maley, MBA: Do you have any idea how many square feet It's, cause this thing is massive, and I’m sure that’s helped since social media grew your practice.

Nicholas K. Howland, MD: Oh, I'd have to go look.

I mean, it is, is it like football fields like. Bigger. Yeah. I mean, it's, it's composed of five buildings. The Winter Palace, which is where the, the czars used to live is one, is the kind of recognizable building. It's, it's like a, like a green color. It sits right on yellow Square. And that's kind of the entrance that everybody recognizes, but it's actually five massive buildings that host some of the most incredible art in the world and some of the most recognizable art in the world.

And walking through, just over and over, I really developed a love of art and the classics there.

Catherine Maley, MBA: And, and just out of curiosity, is it a dangerous city? Because this book makes it sound like everyone's a spy and you can't trust anybody and everyone's ripping you off. I mean, is it, is it what, what is Russia?

Like, just your observation and how it relates to Transforming Patients and Yourself.

Nicholas K. Howland, MD: Russia is a city as, as a country that's really been damaged by its history and by its leaders. There is, since the Iron Curtain came down, there still has not really developed a middle class. It's a very kind of two class system, especially in St. Petersburg where you have the ultra-wealthy and then everybody else.

The people that are, are great. They're, they're, they're kind, they're loving and they're great people. They're a little untrustworthy because of their history and how they've been treated. But once you kind of get in their home, they'll give you the shirt off their back and would do anything for you.

I, I, I love it. What's, what's interesting is my brother, He served a church mission to the Ukraine. And so, he and I with world events as they are today, actually having friends who are, are now at war with each other. And it's, it's a hard thing to watch especially when you know and love people on both sides and you have to your heart goes out to these people who really are at the mercy of, of leaders making, you know, choices that we may or may not agree with.

Catherine Maley, MBA: I wouldn't mess that. All this, my lord. So, back to our vanity world how, how did you become a plastic surgeon? Did you grow up with plastic surgeons (before social media grew your practice) when you left the church?

Nicholas K. Howland, MD: First of all, I'm going to, I'm going to correct you right there because my approach to plastic surgery is a little. It's not about being Vanity.

I do not believe that plastic surgery has anything to do with vanity. I think plastic surgery, I think it can, and I think there are people who utilize it that way. But for me in my practice, plastic surgery is one of the most self-empowering things that a person can do for themselves when it's done for the right reasons.

And so, you and I talked a little bit about this when we met in Miami, which I have my own podcast called The Naked Patient Podcast. And that's what we kind of talk about on there is removing this social stigma of plastic surgery being this horribly vain thing that that people only do to kind of satisfy their own vain desires,

Cause I don't think that's what it's about.

Catherine Maley, MBA: Hmm. Okay. We don't agree on that. But carry on because what, whatever. Prompt somebody to want to look good and feel good. I'm all for that because my opinion is we're all just trying to be happy, period. We're all just trying to figure out what the heck we're doing here on, on earth and how can we enjoy it Today I want to buy a new car and that's going to make me happy.

Tomorrow it's plastic surgery, the next day it's a boyfriend or husband. Like, it's just, we're always bopping around. So, I love that we, we can do whatever we want. That's the greatest part about being human beings. You know, we, and we, we ebb and flow, you know, so, yeah. However, we get there, it's become super-duper popular, and how that all relates to Transforming Patients and Yourself.

Nicholas K. Howland, MD: Yeah, absolutely. Well, well I'll tell you how I kind of came to that belief. Cause that really is the mantra that kind of drives me in this practice. When I was going through medical school and then residency, I remember. I, I had a, a dinner with this. He was a, a friend and we went out to dinner with some other friends and he was asking me, you know, what I was going to go into, this was around third or fourth year of medical school.

And I told him, you know, I think I'm going to do plastic surgery. I think I really love plastic surgery. And he didn't ask me another question. He just looked at me and he says, Ugh, what a shame. And I was like, I'm, I'm sorry. And he says, I just, it's such a shame that healthcare has become the way it is, that you've got to go into such a vein and, and horrible profession in order to make any money these days.

And I'm like, hold on a second. I really like plastics surgery. And that was the start of it. And then even later, we, I got into residency and my mom would call me pretty regularly. and she would say, did you do good plastic surgery today or did you do bad plastic surgery today? And in her mind, if I was doing cleft lips and pallets or you know, even massive breast reductions, she would, she would justify then I was doing good plastic surgery.

But if I was doing rhinoplasties, breast augmentations, facelifts, I was somehow doing bad plastic surgery and that was coming from my own mother. So, I had to reconcile that somehow in my life. I had to make that make sense or else, I mean, I, I, because I wasn't going to agree that I was just doing this profession to make any money and that there was a good and a bad side of it.

And that I was choosing the bad side because I knew I wanted to go into cosmetics. So, for me, the way that I reconciled that is I just realized that they're not different. For I, I think, and I have seen a breast augmentation change a woman's life just as significantly as a cleft lip or cleft palate change some kid's life in Guatemala.

And that may sound like a really harsh comparison, but that is true. And that's because plastic surgery is such an individual thing and it can be so, self-empowering for that person. That thing that, that's why I believe it's not about vanity. So, when you do it for the right reasons, it's taking that whole vanity thing away and it becomes about empowerment.

And that's why I love plastic surgery. And that's, maybe that's just how I reconcile it in my mind, but I truly believe that, and that's the approach that I take with me.

Catherine Maley, MBA: So, at family reunions do you guys talk about it? Are you the black sheep? Are, is everyone okay now? Like, how's your mom doing?

Nicholas K. Howland, MD: Oh, listen, she's, she is, heard me tell that story countless times. and Oh, yeah. Yeah. She, and she knows, but she, I think has come over to my side where she feels like, you know what, you're, you're right. I, plastic surgery really can change lives and is more about, can be about self-empowerment and not about the way that we have pushed this as a society.

And that's not just, you know, social media and influencer's, faults. We as plastic surgeons have pushed this as a vein profession and something that, that's not empowering. And you know, I think that we have a responsibility as plastic surgeons to, to improve the way our field is perceived.

Catherine Maley, MBA: So, when you left Fellowship and it's time to go out into the marketplace, what were your choices and how did you decide what to do and then what did you do before social media grew your practice?

Nicholas K. Howland, MD: So, for me, I had gone to a meeting in, I think it was in San Diego or Dallas. And it was, it was actually about the business of plastic surgery. And they had some guys talking about how to, how to run a business because you don't get a lot of that in training. And I'm trying to remember who it was that gave this talk.

He's, he's, he's out in California. Really like him. Doctors. What's that? Doctors? Yeah. He's a plastic surgeon in California. I just, I can't, I'm blanking. What's that? Paul?

Catherine Maley, MBA: Nasa, the guy, he has a program now. Everybody wants to do what I do. I'm a consultant, plastic surgeon. He's the business of marketing and now everybody wants to do that, in terms of Transforming Patients and Yourself.

Nicholas K. Howland, MD: No, I'm blank. I'm blanking on his name and he'll, you know, I'll come back to it. But he had this idea that he used when he went out into practice and he, he wrote a letter to every board-certified guy and said, Hey, I'm coming out there to practice. I'm not necessarily looking for a job, but if you have an opportunity, I'd love to hear about it.

And he said he got two responses back. He got one guy that said, there's no room for you here. And he got another response from a guy that said, sure, as long as you stay on this side of town. And I heard that story and I thought, I'm still going to do that., I think, I think that still sounds like an opportunity and.

Salt Lake City is still kind of this underdog or, or at least perceived underdog in plastic surgery. We, at one point, were the number two or number three spot per capita in the country for plastic surgery. Right. And it's kind of, it always kind of shifts, but, but Salt Lake is always up there near the top.

We have a ton of plastic surgery here and a lot of plastic surgeons. So, I was training in Texas. I had gotten divorced and my ex-wife had moved here with our two kids. And so, I knew I was coming to Utah. And I did what this guy had suggested. I wrote a letter, I looked up every board-certified guy, wrote a letter, said, Hey, I'm coming out there, let me know.

And in two weeks I had 14 offers. Nice. And a lot of them were older guys looking for me to buy their practice. You know, they wanted me to pay them. One 2 million to buy their practice. And those ones I wrote off immediately. But then there were a few that were from guys looking for partners and the contracts they offered were different.

And the one group that I found that I ended up joining is, is a kind of a hybrid practice model. So, our group is called Premier Plastic Surgery, and there's four of us in the group. And we office share, we share expenses with of our nurses. We have the same office manager, but within that umbrella of Premier plastic surgery, we all have our own individual pc.

So, Hal Plastic Surgery is its own entity within Premier Plastic Surgery. So, I'm the sole president and employee of Hal Plastic Surgery. I do my own marketing. I run my own social media, but I'm also, under this premier plastic surgery group through which we buy our implants. We buy our products for our med spa.

And as a and as a group, we also, save a little bit on our malpractice because of that and. So, I get a lot of the benefits of a group practice, but I still get to enjoy the freedom of an individual practice where I'm doing my own marketing and I'm creating my own brand. And that's all independent from this group.

And I've loved it. I, I don't think that there's a model that, that I have seen that works better in my, in my opinion.

Catherine Maley, MBA: Alright, so, how do you divvy up the expenses? Is it done per surgical hour or whatever? Cause this is one area where you can get into trouble when you're working with a bunch of surgeons when social media grew your practice.

You're using the OR more than I am. Why am I paying for, how have you worked that out? Because it can be troublesome, as it relates to Transforming Patients and Yourself.

Nicholas K. Howland, MD: So, the surgical center side runs a little bit differently. So, I'll get to that in a second. So, on our clinical side with Premier plastic surgery, Everything is split uniformly down the middle.

We all get a bill a stack of bills at the end of the month, and we're splitting those bills 25% across the board. And on the surgical side though if I'm, I'm an independent contractor with Premier Plastic Surgery, so, I go into the surgical center and I have a contracted pricing as an owner with the surgical center that I pay when I use it.

And so, it's really based on my use. Your kind of still eat what you kill, and that's it. A couple years into the, into my practice, I was offered the opportunity to buy into the surgical center as well as the medical spa, which I did. And so, I now am one of the four owners of the surgical center as well as the Med Spa.

Catherine Maley, MBA: So, all four of you are the owners. Partial owners of the Med Spa and the surgical center. You don't have outside surgeons coming in? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: It gets a little complex there, We, we are in a building where there are nine plastic surgeons in this building, and only four of us own the Surgical Center and the Med Spa in my group, premier Plastic Surgery.

Three of us are the owners. The other owner actually is an independent private, or, sorry, a solo practice, but he's in the building. Hmm. And so, that's where, that's where it gets a little convoluted,

Catherine Maley, MBA: Okay. As long as you got a good accounting system, you know, taking, you're tracking all of this, you know. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Oh, yeah. And so, with, with the four of us owning the surgery center nine plastic surgeons in the building that, that use it. Plus, we bring in some orthopedic surgeons. We bring in some podiatrists, some urologists. I mean, there's probably about 17, 18 surgeons. That use the, or we've got four ORs. It's a quad, ASF surgical facility.

And works great.

Catherine Maley, MBA: So, what would you say gimme the pros and the cons of working in this, this hybrid practice idea, I think is almost your best bet no matter how you look at this, because you still have the freedom to do your thing. Because one of the biggest issues I have seen after 23 years is one guy wants to be the alpha and the other guy has to be the number two.

And it just, the egos don't usually mesh well that way. So, in your case, you don't need a line in the jumble. Your ha you're all for doing your own thing. And so, what would be the pros and the cons of. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah, I'll tell you exactly what the, the hardest part for us right now is, and it has nothing to do with our model.

It has to do with o only one of those owners of the four of us is actually the landlord of the building we're in. Gotcha. And that's where any problems that we run across come up is when the landlord makes a decision that favors the landlord and not the partners of the practice. And so, the solution to that, which is something we're working on, is having a building where everybody shares equal ownership in the land, in the building.

Because otherwise the practice model runs almost perfectly. I mean, I, there's, I don't need to be the Alpha and nobody else strives to be the Alpha because they have their own practices and brands. My brand is Howland Plastic Surgery, premier Plastic Surgery. Is this. Nice group model that we put up a billboard for and, and we'll put some ads in a magazine here and there so, people know, oh, that's the group I go to.

But the brand I'm building is Howland Plastic Surgery because, because I'm the brand.

Catherine Maley, MBA: One of the issues also, that comes up is Premier Plastic Surgery is, it's not a little practice, it's a very big established, you're the largest group in Draper, Utah. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: So, we're the largest group in Utah outside of the university.

Catherine Maley, MBA: Okay. When leads come in, they don't all say Dr. Howland, they sometimes just say Premier, like, I need to, how do you divvy up leads that come in arbitrarily. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: We have a front desk staff that's very well trained to be diplomatic. They also, know the surgeons who kind of like certain things. So, a couple of the partners.

Don't like liposuction. And so, if somebody calls and they don't know the surgeon that they want to go to those two, those doctors that don't like liposuction aren't recommended. And we've all kind of created our own little niche in terms of what we like and the front desk staff know which surgeons prefer which cases.

And, and, and that the other thing I'll say to that, that was one of my big concerns coming into a group. I had had a friend who joined, a guy whose wife ran the practice, and it was a year in before he realized, oh my gosh, she's giving every single lead to her husband, obviously. Yeah. And so, that was a concern for me.

And I, I asked the office manager Hey, how do we divvy this up? And she said, you know, you'd be surprised. She said, most people who call here, Aren't calling saying I need a plastic surgeon. Most people who call are calling because they looked up Dr. Howland or Dr. So-and-so, and that's specifically who they're trying to get an appointment with.

It is few and far between. For somebody to call up and say, I want a tummy tuck, Kuya got Gotcha. And that's getting even more prominent in today's age of social media. People are looking up year before and after’s, they want to come to you. Nobody's looking up a group practice before and after’s not looking at the surgeon and then calling up and saying, well, gee, the group looks good.

Send me to somebody in there. No, they, they know the surgeon. They're trying to get in to see.

Catherine Maley, MBA: That's why there's such a debate about what to name your practice. I, in today's world, you've got to get your name in there somewhere. Like you're the brand. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Absolutely.

Catherine Maley, MBA: And I, and I, I hear you. Like, I know when you're ready to actually, you wish it was something else, but at the moment to grow this thing, it takes your name. How does that relate to Transforming Patients and Yourself ?

So, I, I don't know what the answer is there, but I do know things work better when, when you when you brandish your name and people get to know you well.

Nicholas K. Howland, MD: …And I'll tell you what, I'll go, go back to those guys who were trying to sell me their practice at the end of their career. For whatever reason, among doctors that, especially plastic surgeons, the idea that your practice is worth anything when you retire.

That's gone. plastic, this is, you are not a dental practice. Nobody's staying committed to the plastic surgeon they go to when he retires, and they're going to go in and see the guy he brought and replaced you. No, like you are the brand. The only thing that's worth any money at the end of the day is the building you're in and the dirt it sits on.

And so, that's why that landlord issue is so, important for, for me, is I know at the end of the day, my practice is not going to be worth a thing because it's me. I'm the brand. So, I better be invested in the real estate and the building if I want to have anything to take away from my practice. At the end of the day,

Catherine Maley, MBA: I certainly agree about the real estate and I would also, keep an open mind to the med spa.

That's your best bet for reoccurring, predictable revenues because asthma, your name is not on that as much and it's much easier transfer over and a doctor will buy. Something like a predictable revenue stream from a med spa than they will from another surgeon who has patients that may not be a fit for him at all.

So, I think that's where your next best asset is. The med spa. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah. That I would absolutely agree with.

Catherine Maley, MBA: So, are you still doing how much cosmetic, how much insurance? Where, what's the point? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: That's, that's kind of morphed over the years? You know, I, I still followed that old model. You know, we, we talked earlier where about me taking call and I, I did that old model where you just take, call everywhere you can.

I did a lot of hand trauma and a lot of facial trauma and built up my cosmetic practice slowly. And that still works. When I say slowly, I feel like it built up pretty quick with social media, but, The I, I only in the last year have stopped taking any insurance other than some passion surgeries that I really enjoy doing.

And so, now my mix is probably a 90 10 mix of cosmetic versus insurance cases.

Catherine Maley, MBA: Oh, interesting. And does anyone else in the practice do insurance or are you pretty much cosmetic all the way there? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Pretty much cosmetic all the way. We will be bringing on another junior partner here shortly. Especially since I've transitioned out.

He'll ideally come in and take some insurance cases and that, that's kind of the model we've followed. Where the new guy comes in, he practices that old style of eating, what he kills, taking what insurance he can, and then growing his cosmetic practice until he's busy enough where it's time to take on another junior partner.

Catherine Maley, MBA: What I'm noticing after doing this for decades is the patience. Has dwindled to a, a lot less because in the before you'd have to grind like that for years. And now it seems like there's, the patients are, there's no patients now they've got, they want it now. They want it now. Sure. So, they do all the, all the recon and the, and the e n t and all that for about a year and say, okay, I'm, I'm done.

I'm not doing this. And that's been, it's, it's problematic because on the one hand you're saying, oh yeah, insurance is great. And on the other hand, nobody wants it because you can't make any money. You know, that's, I any advice for that for people coming out saying, I'm not doing, I'm not call, you can do this without doing call.

Can you enter the marketplace? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yes, you can enter the marketplace without doing call. And I see guys do it all the time. How, how do they do? I, they establish a social media presence as, as quickly as possible. They provide good results and they treat their patients well.

Catherine Maley, MBA: …And they take out a massive loan to cover office staff lasers or like I, is that what they're doing? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I'm not sure if they are. I, for me, I didn't have to do that. The way my, you know, the way that this was set up is I took out a, I established a line of credit and I think I dipped into that line of credit twice. I bought a computer and a white coat, because that's all I needed. They had everything for me.

Here. Desk was here, furniture was here, the nurses were here, everything was here. And I needed some help with that first month for cost of living. After that I was, I was earning enough to, to maintain my cost of living and to pay my bills. But I think there probably are guys who have to either take out loans or take out a line of credit if they're not doing any type of insurance cases or their contract is different.

I, you know, I have a friend who joined a cosmetic practice, doesn't take any call at all. His contract was a guaranteed salary. And then he, anything that he earns past that guaranteed salary, he gets to pocket a percentage of it. And I, I think a lot of those contracts exist where it makes sense to do that and not have to take call.

I'm partial to the independent contractor contract. I think when you're, when you're giving a percentage of those cases away to a partner, golly, that sure breeds a, a, a difficult relationship. Right. Especially if you start earning a lot and you're like, why am I paying this guy a percentage of these cases?

So, for me, I just think doing that independent contractor agreement and saying, I'm going to, I'm going to buckle down for a few months until I'm busy enough is the best way to go.

Catherine Maley, MBA: Well, I, I hang around mostly with the more mature surgeon who's trying to figure out how to exit profitably. Mm-hmm., and they'll, they'll guarantee a salary for about a year and, and that's not going to, that's not an open wallet forever because he took the risk.

And that's what they say to me. I took all the risk. I'm the one who put down all this stuff at the bank. I'm the one who had to go through hell to grow this thing and this guy walks in and says, oh, oh, what do you got for me today? You know? And so, there's some resentment already before everybody even starts. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Exactly.

Catherine Maley, MBA: Exactly. Yeah. So, I always say it, all of this in writing when everyone's still happy. You know, just like a divorce, like do it when you're still in love. Cause there's just so, many ways to go sideways on that. And I don't know how, you know, they want you to buy their practice because they want to walk away with some money, but you're saying, what am I buying?

And that's why I think you've got to own some land here because at least you've got the land in the building. And the rest is just gravy, I guess, you know? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah. So, one of the things, one of the things that we have done in our group that I think is, is, is helping so, two years in, I bought into my into the surgery center in the med spa.

And the reason I did that is I was, that wasn't supposed to be an option for me until five years. But one of the partners retired earlier than everybody thought. And when he retired, he said, okay, I'm out. Buy me out. And they hadn't really thought that far ahead. And so, they did an evaluation and they ended up paying this guy out.

And I'm sitting there going guys, you're all about the same age. I'm not about to take out a massive loan when you all retire, to pay every one of you off. So, we either figure this out or else I'm going to be fine in another practice. And so, what we did is my, my buy-in for the ownership in the surgery center, in the med spa was assuming the loan that they took out to pay that guy off.

And the way though that we structured future buyouts is we had an insurance guy come in and we all now have a, basically it's a, a universal life policy that will have a set cash value amount at our retirement age. And when. Want to retire, that policy becomes your buyout. You've got the cash value of it, which we set really high, and you can then retire and say, great, I will take my cash value policy and I will now walk away.

And so, older guys in the practice have to put in more money for their premiums because they're older and closer to retirement. For me, my premiums towards that policy are not too significantly high, but I know that I'm going to have a nice cash value nest egg at the end of retirement, and I'm not going to have to worry about having somebody buy me out.

Catherine Maley, MBA: What happens though, if you wanted to leave earlier? Is there a clause that says you get the piece of whatever you've put in already or do you lose that if you...? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yes, you can. Yes. If you leave early, you can take your policy. And it's because they're, they're individual policies under an umbrella.

Catherine Maley, MBA: Gotcha. Now is there, by the way, let's just talk about staff for a second. This, I'm surprised you don't have any staff issues because usually on the morning there's a dictator, at least there's some clarity, like everyone gets it because there's this one personality you're dealing with. But when all of you are working solo or the staff still has to work together as a team. How does that relate to Transforming Patients and Yourself ?

Yeah. How does that work out? Like who do they listen to or...?

Nicholas K. Howland, MD: Brittany, her name's Brittany.

Catherine Maley, MBA: Office manager? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah. Get, and we had, so, it's now Brittany. It used to be Stephanie. And that is one of the biggest lessons I've learned in five years is find, I, I am, I cannot manage. People around the clock. I've, I'm like most surgeons where I want to come in, do my cases, go home and not deal with drama, not deal with, you know, nurses arguing or not doing their job or staff having issues.

And so, you've got to find an office manager that can run that ship and you pay her every cent she's worth because, or him because it will make your life. And so, for us, that's, that's Brittany. She does, she does everything. She manages each partner's individual day-to-day stuff that they need, and she manages all of the nurses and any staffing issues that we have.

And we have regular meetings with her where she says, here's where we're at, here's what we need to do. And she makes life a thousand times easier.

Catherine Maley, MBA: I would just make sure she doesn't burn out. Because that's a lot of responsibility. Oh yeah. Yeah. I would, wow. I would, I would take good care of her, those people. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Well, well, and we'd take very good care of her. And those people are hard to find. We, we had, like I said, we had Stephanie and then Stephanie moved out of state and we needed somebody else. And we went through we went through two more before we were able to find Britney, who has been fabulous. God.

Catherine Maley, MBA: Yeah. That's why I say hang on to her, because especially in today's climate, it's been very difficult to find good people. That'll stay, you know? So, yeah. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Well, that's, that's been my mantra as one of the owners as you, you pay your good people what they're worth. And we have very, very little turnover.

And I think it's because we, we keep our good people and we pay them what they're worth.

Catherine Maley, MBA: So, in your five years, just gimme one mistake that you made that you wish you hadn't, but you learned from it. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Okay. This one is, I, I still don't think this was a mistake, but, it's not a mistake. It's feedback, you know, but I definitely learned a lesson from it.

And so, I came, this one's a little bit topical based on Utah and the culture here. So, that two-year church mission I served was for the Mormon Church, the Church of Jesus Christ, the Latter-Day Saints. I grew up that way. I grew up here in Utah. I'm no longer a member of that church. But a large part of the community here in Utah still.

And so, a lot of the marketing around here, not just plastic surgery, but marketing in general will oftentimes cater to members of that church. In Utah. It's a very common phrase to hear people say the church, and you're just supposed to know that they're talking about the Mormon church. I remember when I moved to Texas and I said something like, oh, I'm a the church.

A friend of mine was like, what church?? What are you talking about? But here in Utah, everybody knows what you're talking about. So, I had this idea for a billboard that I thought was brilliant. The Salt Lake City, l d s temple was undergoing construction and was under all this scaffolding. And that temple is a huge part of the Salt Lake City skyline.

Like if you, if anybody shows you a skyline of Salt Lake, that granite temple with the six spires and the big golden angel on top is going to be part of that skyline. And so, when I was growing up a, a thing that parents and church leaders and people would always say to me is, your body's a temple. Your, your body's a temple.

Don't do anything to your body that would, would, that would damage it. Because that's a temple. That's the house of God. And so, I, as I kind of reconciled plastic surgery in my mind, and I'm going through residency, It's really bad to tell somebody, Hey, you need plastic surgery? Go, you're looking, you're looking a little rough.

You should get some plastic surgery. Like that's a terrible thing to say to somebody where temple is not looking so, good. Exactly. But I think it's just as damaging to tell somebody, Hey, you're going to have to deal with those size, size H breasts. Or sorry, you can't have any plastic surgery because your body's a temple.

I think that's just as harmful. So, the billboard was a picture of the Salt Lake temple with under the scaffolding and the billboard said, God's remodeling his temple. Isn't it time to remodel yours with how? And plastic surgery underneath. Oh my.

Catherine Maley, MBA: Oh, my goodness.

Nicholas K. Howland, MD: Still, I think hilarious and brilliant. I still will take credit for that.

Catherine Maley, MBA: What was the blowback and our house, how quickly was the blowback? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: For the first couple days, I, I knew I was going to get some, some of the church blowback, like people are very sensitive about the religion. I, I knew that was coming. And so, for the first couple of days though, it was mostly positive. People were laughing, people loved it.

And I was really happy. And then somebody who had a pretty sizable following on Twitter, got on Twitter and went on a rant about how I was body shaming women. Oh, okay. And I tried to rep reply, be like, no, no, no, you're, you're missing the whole point. This is the opposite of that. I'm saying it's bad to tell somebody, get something done.

It's just as bad to tell them they can't. Like, this is the opposite of body shaming and. It just, its people clung onto that negative image. And I started getting one star review bombed, and people started coming after me on, on social media. And I spent days where I just was, was up looking at every comment.

And I had this, I, I was trying to respond to comments and I finally realized I can't respond to comments. These people are just here to, to make a mess and to be angry. And I molded over for several days and I finally the local news came and did a story on it. And I, I finally, when, when the local news came, that's when I was like, you know what?

We're just to appease people. We're just going to take the billboard down. I heard all

Catherine Maley, MBA: PR is good PR, no? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Until you get one star Google review.

Catherine Maley, MBA: Phone ring with people who wanted plastic surgery. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I have seen a lot of. Patience come to me specifically because of that billboard. Right? A lot of people saw it and said, oh my God, I love that guy.

I want to go see him.

Catherine Maley, MBA: He's got a great sense of humor. I think he's probably real. Like, look, I, I would just look at the numbers. The numbers tell you everything, you know. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Well, I would say, I would say I've probably had just as many looks at that and say, I don't want to go to that guy, And so, the I to this day, wish I wouldn't have taken it down.

I, I had a friend call me the night before. I had already made the decision to pull it, but she called me the night before and she said, here's what you do. She said, you get on the news show tomorrow and you say, Plastic surgery is about self-empowerment. That's what I believe. That's what I practice.

And I am proud of plastic surgery and I'm not going to be shamed into taking this down because we need to take away the shame from plastic surgery. That's the whole problem with the world today. And I wish I would've done that. I just, my, my two, I was only two years in practice. My Google reviews couldn't have handled that probably.

Catherine Maley, MBA: But How long, how long was it up? How long was the billboard up? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: A week. One week.

Catherine Maley, MBA: Oh kidding.

Nicholas K. Howland, MD: Yeah. And those are expensive, right? Yeah. I mean, it's here, it depends on where you're at here in Utah, but billboards run anywhere from one to 3000 bucks a month. But don't you have to sign a contract? Yeah.

You're on a contract and so, we just changed the ad. Oh good. It was a, it was a, it was a digital board and so, we just changed the look of the ad and put something else up.

Catherine Maley, MBA: You know what, but you were a little new, so, maybe that was a lot of critique for, you know, still being pretty fresh at this. I still, I think it's very cute and it's a good idea.

I think you could have gotten some good PR from it if you had, could have gone on to do the empowerment. But I will tell you, the media loves the negative, so, they could have turned that around on you. So, like, you think you're want to talk about empowerment and there's a good chance they would've Gotcha.

You know, so, you're, yeah. But actually I, I worked with this practice I won't say who, but he was also, religious, but he was more Christian and he had Bibles in each exam room and I told him, look, you're either talking religion here or you're talking. Body transformation, but you can't do both at the same time.

This is, it's making me uncomfortable. And I, I'm Catholic, like I, I love God, but this is not the time for us to be talking about Bibles, you know? You know what I mean? Like, I, I was in Utah and I went to the, the church and I was fascinated with it that they were marrying on a Tuesday afternoon.

There had to have been 50 couples getting married, and they were all under what, 18 or something. But I was fascinated with it. So, good for Mormons. You know, they've got everyone, they're, they're clean living, no drinking, no smoking, I mean, good for them. I don't know how you get people to do that, but you're the most productive state I've ever seen. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Well, I feel, I feel very blessed to have been a part of that culture. Yeah. You know, people will ask me all the time when I'm telling I'm from Utah, if I'm Mormon and I actually will say, even though I don't belong to the church anymore, I will say I am because those are my people. Those are my culture.

I'm very grateful for the, the le the lessons I learned for the values that I have because of that. But I also, love being able to speak both sides here. Like a patient comes into my office and if they are a member of that church, I've, I've been there. I know what those thoughts are and what they're dealing with.

Somebody who's not a member. I know what that's like mm-hmm. And so, I can speak to that too. So, I feel like those experiences in my past have given me such an advantage here to be able to speak to both sides of the coin with my patients.

Catherine Maley, MBA: For sure. So, let's talk more about marketing, because I love that you're only five years out. How does that relate to Transforming Patients and Yourself ?

There's no way you are marketing like your father's generation did. So, how did you enter the marketplace? It sounds like you, you went to so, well, you, well, you tried the billboard result. Well, you found, you forget that one out. But did you go into the print ads or did you go straight to social? How, how did you put your marketing?

Nicholas K. Howland, MD: Well, I didn't, I didn't have a lot of money and so, I I do, I still think billboards work. And I still do billboards. My, my face has been on the side of I 15 for ever since I got here.

Catherine Maley, MBA: Do you keep updating it because you look dramatically different than you? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I do. I do. And yeah, it's, it's changed, my appearances changed quite a bit, especially just in the last year.

Catherine Maley, MBA: But do you want to talk about that? Because I almost didn't recognize you when I saw that introductory video on your website. I thought, that's not the guy I know! How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I know I need a different, I need a different one. I've lost 60 pounds in this last year.

Catherine Maley, MBA: And good for you. Any, any weight tips, weight? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I went through I did the 75 hard challenges.

Catherine Maley, MBA: Love, love, love, love, love. I listened to him. I just listened to him this morning. I love Andy Sela. He's my main. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah, it was a great start for me. And so, I now at least have a, a, a base to work with, you know, and I got down to a weight that I'm happy with, and now I'm working on kind of building some muscle.

And this last year was a real journey for me. I kind of got out of a toxic relationship and r really focused on myself a lot this year and on learning to love me, and it's changed every aspect of my life. Both my self-worth, for me, my ability to be a dad with my kids and even into my work life, my ability to be a good surgeon and a good boss and a good leader.

All of those things have changed just by me focusing more on myself and taking care of.

Catherine Maley, MBA: For those of you who don't know, 75 hard is program put together by this internet kind of guy named Andy ela. And he's in St. Louis? No, he's in Missouri somewhere. Maybe it's St. Louis. And so, he, he, it's, he's all about mental toughness and he's another one who lost like a hundred pounds.

And the thing is, is for 75 days you learn discipline. It's all about discipline and getting to know yourself and controlling yourself, controlling your emotions. No drinking, no every very disciplined diet you have to read twice a day. You have to exercise outside twice a day for 45 minutes no matter what.

And I think, and I think about him all the time because I'm very disciplined. I exercise like a, like I am disciplined. I even take the darn cold showers. I'm waiting for them that to make me a multimillionaire. It hasn't yet, but I'm going control my mind more than I let my, you know, I'm going to control my brain and I'm not going to let control me.

So, this 75 hard I. I just never wanted to go that far. But, but I intermittent fast all of that, I just, it is brutal, wasn't it? Like, didn't you, I mean, it's a game changer, isn't it? For 75 days, you're so, gosh, darn disciplined. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah. You're, you're locked into it. And for, for me, I thought that no drinking was going to be the hardest thing.

But it actually was the water. You're, you have to drink a gallon of water every day, and as a surgeon, you don't, you don't normally scrub out to go to the bathroom, Wow. So, when you're drinking a gallon of water a day though, you have to. And so, that was one of the hardest things for me. But it was such a good, it, it's, it's a way to develop habits.

You know, doing anybody can do anything for 75 days. It's not going to suddenly just change you, but it helps you create habits that you hopefully continue to stick with to this day. I walk for 45 minutes every morning. That was my outside workout that I would do every day, would be a 45-minute walk outside and every morning I still, I get up and I take that walk and that's kind of where I meditate and get my day started.

Catherine Maley, MBA: Oh, so, interesting. That's good. So, back to the marketplace. So, you have the billboard and you're doing social media? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I, the billboard, I do. I, I started doing a lot of Instagram and Facebook and I started by posting a lot of videos of my cases. That's become more difficult to do as a, as a marketing ploy.

The algorithms have started pushing those down or shadow banning those people for showing graphic content videos. When I started doing that, they, they didn't, and those became wildly popular. People want to see surgery and action. You can still do those and you can, and videos still get a lot of traction, but you just have to be careful how you're posting them when you're posting them and making sure you've got the appropriate kind of filters on there.

Like, Hey, this is a graphic content video. For me, I'll tell you the secret to my own social media is you need to be interesting. And so, the only things you should be posting are things that are interesting about you. And because again, remember the whole. The whole point of, you know, my belief in my success is you are the brand.

And so, take five things that are interesting about you, the brand, and that's all you post. So, for me, I sat down and I thought about this and I, because at the time I was throwing anything at the wall, I was doing literary book quotes. I was doing stock photos of people having plastic surgery and saying, BBLs are great.

And just, it was, nobody was stopping and liking it. Nobody was commenting on it. Nobody cared. It didn't engage you. And so, The five things I came up with for me that were interesting. I'm a plastic surgeon. That's pretty interesting. And so, I post plastic surgery content, whether it's before and after’s or videos or education.

I post that. I'm a single dad with two kids. That's unique and interesting. I love to hike, so, I post about hiking. That's unique and interesting. I love to travel, so, I post anytime I'm traveling and I love cooking and I love wine. And so, I post videos of me cooking or, or wine that I'm enjoying, and that's it.

I don't post anything else. You scroll through and that's all you see on my feed. There’re no stock photos, there's no book quotes, there's no hang in there posts. It's just those five things and I if, if you don't have an engaging post, don't post it. I am a firm believer in posting only engaging content.

Sometimes that'll be more than once a day. Sometimes that'll be twice a week.

Catherine Maley, MBA: And you do it yourself or you have a team that does it? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I have, I, it's a mix. I'm the one who finalizes and posts everything. I do have some content they call them content curators because I actually get the content and then say, Hey, I need you to create a before and after, or make this into a TikTok.

Be, and I've tried bringing on people who could run the whole social media. Nobody has your vision. Nobody is going to take it and run with it the way you want to. And so, you're constantly just like, Ugh, why'd they post this? Why'd they say this? I, you, you just, that's got to be a thing that you do. I, it's, it's a good, and it's a blessing and a curse.

It's good and bad.

Catherine Maley, MBA: I do know some surgeons though, who have a marketing team, but they meet with them every week. They go over the content. The, the best part is they've got that videographer in there all the time, taping or recording the. You know, the day in life of a plastic surgeon. And then if you can get a good editor and somebody who understands social media well it's the Gary Vanerchuck thing.

One, one video becomes 96 pieces of content Right person to do that. Cause that certainly makes your life a lot easier. And it's really engaging content too. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Yeah. Those, those are hard to find. We're, we're slowly kind of building that team, but that's kind of, we, we started from the bottom. And, we're slowly building that team.

Catherine Maley, MBA: Now I saw your Facebook and I didn't see YouTube and I didn't, and Instagram was private. Is that just me? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: You're looking at Howland Plastic Surgery. You need to go to Dr. Nicholas Howland. Hi, the Catherine.

Catherine Maley, MBA: I, God, I, I'm like, there's no way he's doing, cause it said, you know, I've got a lot of videos. How does that relate to Transforming Patients and Yourself ?

And I thought there's no way he put that under private. Why would he do that?

Nicholas K. Howland, MD: Ok, Dr. Nicholas, how’s the Instagram as well as the TikTok? My YouTube channel is sparse. We're starting to put my podcast content onto the YouTube channel. And we'll use that more.

Catherine Maley, MBA: So, let's talk about your podcast. Cause I know a lot of surgeons who have started one and they usually get to.

Four and say, this is way too much work. I don't want to do this anymore. And so, I always say, you know what, before you even jump in, decide are you and commit, are you going to do it or you're not going to do it because you can't do it once a month. It's got to be consistent; it's got to be interesting. And thank God I have all you surgeons to, you know, interview because it's a lot of work to pound this out every week.

So, for sure we're probably with yours. And I love the name of yours to make it patient. You, you're, you're very, you're very good at inline. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Well, listen, this, this came about really just in the last six months. I had a patient who was talking to me, she'd been through three rounds of body contouring after losing 300 pounds.

And after the last round of surgery, her husband pulled her aside and said you're still ugly and I miss you when you were heavy. And that. That was a blow to her. And she was talking to me on the phone about this and said, you know, I just, I'm struggling because I'm feeling guilty about my bariatric surgery.

I'm feeling guilty about my plastic surgery. She said, but I've never felt better about me in my life. And she says, I don't know how to deal with that. And I said, that's actually more common than you think with weight loss patients. Let's, we should do like an Instagram live or we should do an interview or something.

And literally it just kind of hit me. I was like, hold on. This just needs to be a podcast where we talk about that human element of plastic surgery. There's surgery, podcasts all over the place where you can talk about what to expect and what surgeries do, what and how the pain was. I want to dive past that.

I want to get into the actual emotional side of plastic surgery. Did it change your life or did it not change your life? Wasn't it. Empowering, or wasn't it? And I want to hear both sides. This is not a rah rah, Dr. Howland podcast where people come on and talk about how great I did. No, I want, I bring on complications, I bring on patients who I know are not happy with their results.

And that was, that was how it started. And so, I brought in patients where we were going to talk about their plastic surgery and then it's kind of morphed into everybody who comes on as a patient of mine. But really, I just want to hear good stories. And sometimes it's plastic surgery adjacent.

Sometimes we don't even talk about their surgery. Like I had my sister on who has had plastic surgery, but she has this really cool story where she met her fiancé during Covid. They dated for 18 months online, and then he moved around the world to meet her and get married. Oh. And they meet before they got married.

They, the first time they met was for two weeks in Hawaii, and that was March, 2020. Oh man. And then the world shut down and they, he lived in Australia. She lived in New York, and so, they dated online for the next I talk to you.

Catherine Maley, MBA: Boy, I've been to Australia. That's a 24-hour airplane. Airplane ride. Wow. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: So, they, they only had met for two weeks and then they dated for 16 months online and decided it was worth it.

And now they're married and they just had their first kid.

Catherine Maley, MBA: Oh cow. That's a great story. We love stories. I mean, I, I'm a marketer and the first thing you learn is stories are everything. We remember stories. We were, we were told stories. As kids bring on the stories and bring the emotional element that one of the biggest issues, I see in practices is they're so, logical about the surgery.

Now this is what's going to happen and this is what, but nobody's talking about the emotional side. Like, why are you having this? Anything going on in your life? Like, what's prompting you to do something about it now? And then grab the story afterwards. So, what do you think, you know, has this transformed your life? How does that relate to Transforming Patients and Yourself ?

Has it been a game changer? I, that's what we all want to know.

Nicholas K. Howland, MD: Yeah. And so, that's, that's all we talk about. And I don't do hardly anything other than set aside. I set aside a block of time once a month to go down to, there's a, a podcasting studio. And they've got, it's all set up. I pay a small monthly fee where they've got cameras set up recording equipment.

I schedule my people; I knock out five or six interviews in half of a day. And then we release and they, they do everything. They cut it for me, they edit it for me. They upload it to all of the podcast channels for me. They even will create small snippets of clips from the podcast that I can use for content on my social media.

And it, for me, I, I think it's helping my practice from a business standpoint, but it, I don't care. I don't this podcast. Does not need to make money. For me, it's hell, it's a, it's helping me become a better surgeon because I'm connecting more with my patients and I think it's very cathartic for my patients to come on and talk about their experience.

That's what makes it worth it for me. If this thing blows up and becomes the next Joe Rogan podcast, awesome. It's not going to, but it might be the best when it gets to that point., if it, if it also, only gets my patience to come on and that's it. I, I'm still happy. It's still worth it for me. And so, that's the other thing I would tell anybody looking into doing a podcast, you have to go into it for the right reason.

If you're And that reason cannot be to make money cause the podcast. This is not a money-making endeavor. No. The podcasts that make money are few and far between.

Catherine Maley, MBA: So, how difficult is it? How do you ask a patient, do you want to be on a podcast? Cause most of the surgeons still have trouble asking for before and after photos

So, how are you, how are you getting them to agree to full on podcast? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I, let's say a connection. You, you, you build a connection with your patients that's beyond the money surgery exchange. And so, if I know somebody has a unique story or if I am, am talking with a patient and they tell me that emotional side, I'll just like, Hey, I would love for you to come share that on the podcast.

And sometimes I get stuff that is just completely unexpected. Like, I had a, a gal come on my podcast just last week and I saw her in my office for her three months, which is when we do their pictures and we then turn them loose and we see them every year. And I came in to see her after she had gotten her pictures and she was just sobbing and I, what's, what's wrong?

And she said, you know, I just, you need to know that this is like the culmination of this long road I've been on. I lost all this weight. I was in a very abusive relationship and this has just really helped me see the me that I knew existed. And it was really beautiful. And I just said, I would love for you to come share that.

Will you come tell me that story on my podcast? She said, absolutely. So, she shows up and that was all I knew about her. I didn't know anything about A lot of my patients that come on there might be friends or they might be somebody who I know their personal life or they might be like locally famous and so, we'll put them on.

I knew nothing about this. And she came on and started sharing her story. She was in a very physically abusive relationship. She decided to leave the relationship and the day she decided to leave was July, 2020. In the middle of Covid, she put her two kids in the car. She went in to tell her husband that she was leaving and he shot himself in front of her.

Oh my God. And I had no idea that was coming. And so, I'm silent on this podcast and she, nothing. But she goes on to tell the most beautiful story of healing and kind of learning who she was and forgiving him and raising these two boys and becoming an advocate for suicidal awareness. and plastic surgery for her was, was like putting a bow on the present.

She said like it was the cherry on top to finally see all of the work she had done on the inside. And it was such a validation to my message that plastic surgery is empowering, that I, I couldn't have asked for a better, a better messenger to come on the podcast and share that. And that's, those are the stories that I look for.

Catherine Maley, MBA: For lead generation then. Would you say social media is your best lead gen piece or podcast is your best lead gen piece where from I would always word of mouth and social media is a very close second. Can you track it? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: So, tough. It's, it's hard too, for sure. I, one of the things that I do is I personally engage with all of my messages on Instagram and social media.

So, you're, you're not talking to a nurse or a coordinator, you're talking to me. And that's a helpful way of tracking. But other, otherwise, and, and there are algorithms built in where we can see if a patient, you know, got to my phone number or website through Instagram or through TikTok. But otherwise, it's tough to say, yes, this is exactly where this person came from.

Catherine Maley, MBA: Right. Do you find, though, on Instagram, I find I personally just working with practices, I find that the Instagram people are have more sticker shock than others. I don't know if it's because they, they're online a lot and they think like, you know, Boobs or two for one. And like, I don't know if it's that kind of thing, but do you find that, that they're more price sensitive than somebody who came to you from word of mouth, let's say? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I haven't, I'll, I'll have to look at that. I haven't noticed that where I've said, oh, these, that's the way it's going to be. Utah is a little bit unique in that we've managed to keep our prices really competitive across for, for, in terms of across the rest of the country. Mm-hmm. And so, we get a lot of out-of-town patients who fly here because it's cheaper to fly here, stay here, have your surgery here, than to actually stay home locally.

And I think that's a, a, a unique part of Utah that's allowed that to happen and allowed plastic surgery to be what it is. For sure.

Catherine Maley, MBA: I didn't realize we are way over time, so, let me just ask you gimme, gimme. So, well we've learned a lot already, but give me one thing that we don’t know about. You already, we know you like hiking wine.

All my favorites of the 75 hard. So, what don't we know? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Oh boy. I, I, I kind of bear it all out there. One thing I would tell you that, that you don't know is I. And it, this, this last year, as I said, has been sort of a journey. And so, I have an entire half sleeve of a tattoo planned and I've started part of it.

And this is kind of one of my newer tattoos that's, oh, let me see if I can turn it for the camera. Oh my gosh. And this is actually the skyline of Salt Lake that we were talking about. Mm-hmm. And there is the Salt Lake Temple right in here and the Wasatch Mountain Range. And I've got more coming along this arm.

And that's all kind of a homage to this journey that my last year has been for myself.

Catherine Maley, MBA: All right. So, where are you going with this? It's going to, so, far it's one, one body part. Is it moving around? How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: Is it, is it, it'll all be just that left arm.

Catherine Maley, MBA: Oh. Why do people do that? Why don't we put them all in one spot?

I don't understand tattoos. I have enough freckles to deal with. I can't have any more spots on me, but well, so, you put them all in one place. How does that relate to Transforming Patients and Yourself ?

Nicholas K. Howland, MD: I, I, I am I, I think individual people put them where they, where they want. Yeah.

Catherine Maley, MBA: So, interesting. All right, so, just to wrap it up, do you have any words of wisdom for the new people coming out or trying to figure out where they fit into this marketplace? How does that relate to Transforming Patients and Yourself ?

Any, any words of wisdom there?

Nicholas K. Howland, MD: Yeah, just be authentic. Just be you, you are the brand. Be you, be authentic, and you're going to be successful. I mean, you're come out, you're a board-certified plastic surgeon, you're well trained. There's, there's very little difference between board certified plastic surgeons.

And so, the thing that's going to set you apart is you be authentically you. That's the only thing that's going to set you apart from everybody else.

Catherine Maley, MBA: Oh, what words of wisdom. That is so, darn true. So, how can people learn about you? Because I, I understand the website is Howland plastic surgery.com. Mm-hmm. What was the Instagram?

Nicholas K. Howland, MD: Go to Instagram. It's @DrNicholasHowland is the handle. Same for TikTok. Same for Facebook. Those are the handles that you'll find most of my content on. Listen to The Naked Patient podcast. I, I think it's actually the naked patient colon beyond the operating room, but it'll, it'll, it'll come up if you just look up the naked patient.

And come, come see me in Utah. Let's go skiing.

Catherine Maley, MBA: Oh, wow. Have you gone up this year? Okay. Yeah, you're in the right place, that's for sure. Alright. Thank you so, much. I really appreciate you being on Beauty and the Biz.

Catherine Maley, MBA:  Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on transforming patients and yourself.

If you’ve got any questions or feedback for Dr. Howland, you can reach out to him at, HowlandPlasticSurgery.com.

A big thanks to Dr. Howland for sharing his experience on "transforming patients and yourself".

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Transforming Patients and Yourself — with Nicholas K. Howland, MD”.

 

 

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how you want more cosmetic patients choosing you.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Want More Cosmetic Patients Choosing YOU?".

If you want more cosmetic patients choosing you over your competitors, you don’t rely on luck. 

You make it happen with the right mindset, proven strategies, and consistent execution that attracts new patients to you. 

But first, think about the confused cosmetic patient. They have a problem with their appearance, and they want help. But who is the best provider for them?

And who can best address their emotions of fear, uncertainty, doubt and worry. 

Somehow, you have to get across to them that choosing you means they will get a result that makes them happy, and they will not regret it.

So why are they going to choose you? 

The answer to that question is where the money is made. Please give it considerable thought.

You have the skills to alter someone’s appearance, so they look better and then feel better and more confidant as they move through life.

That’s a tall order because it’s extremely personal. That decision is full of emotions: fear, uncertainty, doubt and worry.

Somehow, you have to get across to them that that they will get the best possible outcome for their particular concern, and they will not regret it.

In this week’s Beauty and the Biz Podcast, I lay out (3) specific ways that help cosmetic patients choose you.

P.S. Get the answers you need now and for the rest of your career. It’s guaranteed to give you results or your money back. 

Click Here www.CosmeticPracticeVault.com

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

Want More Cosmetic Patients Choosing YOU?

Catherine Maley, MBA:

Let me ask you this…

In your own life, how and why did you choose a certain accountant, financial advisor, dentist or contractor?

Typically, it’s because you researched online. They had a nice website and good reviews.

Or you heard about them from your friend, family member, neighbor or colleague who had a great experience with them. That provider gave them great service, was easy to do business with and did good work.

They trusted that provider to take good care of you and solve a problem you have and that’s why they referred them to you.

The same goes for cosmetic patients choosing you. Except that it’s multiplied due to the nature of your services.

You have the skills to alter someone’s appearance, so they look better and then feel better and more confidant as they move through life.

That’s a tall order because it’s extremely personal. That decision is full of emotions: fear, uncertainty, doubt and worry.

Somehow, you have to get across to them that that they will get the best possible outcome for their particular concern, and they will not regret it.

So, here are 3 ways for more cosmetic patients to be choosing you:

1.Specialize – You Can’t Be Everything to Everybody

I know you want all the business you can possibly get your hands on, and for more cosmetic patients to be choosing you, but that is not how you grow your name and reputation.

Getting very good and well known for a particular procedure has so many benefits.

It helps you focus and get a lot of experience with that procedure. Your results are better when you do something often versus periodically.

Patients start talking about you to their social circle whenever that procedure comes up. That could be their immediate friends and family, but also their facebook groups and social media followers.

You become synonymous with that procedure and are seen as the expert. That’s your free advertising. Your referrals will grow. The demand for your services will grow. You’ll raise your prices because the “right patients” will pay more for specialized services.

Here’s what you do to make that happen, so that more cosmetic patients will be choosing you…

Find a niche in your marketplace and cater to it. Sometimes this happens organically but, usually, you have to create it and then grow it, so more cosmetic patients will be choosing you.

This is the vital piece….define your specialized procedure and target market by defining the criteria of your perfect aesthetic patients. That includes

Age

Gender

Zip code

Lifestyle and hobbies

Interest groups defined by associations or memberships

Occupation-based such as lawyers, professionals, stay-at-home moms

Ethnic/religious groups

Life events including marriage, babies and divorce

Now that you defined WHO, HOW to get in front of them is the next step.

Cater to those demographic groups. Join clubs they belong to. Attend events they attend and speak at association functions they are involved in. 

Locate your office in the same vicinity.  Become one of them.  They will see you as the only choice for them because they are familiar with you and more cosmetic patients will be choosing you. 

The beauty of catering to a certain demographic is the referral base that grows from it.  Like-minded people spend time together, work together and play together.  They will talk about you to their friends and family and grow your word-of-mouth faster than you ever could on your own. 

Now build an arsenal of social proof to build trust with other prospective patients who are also looking for your specialized services, so more cosmetic patients will be choosing you.

That includes an updated website, lots of reviews and plenty of before/after photos that reassure would-be patients you are the only choice.

But go a step further… Publish clinical papers, write a consumer book or free guide, and let your non-competing colleagues know you appreciate their referrals.  You might even grab the attention of the media who wants to interview you or showcase your talents in their next issue or episode, so more cosmetic patients will be choosing you.

To make this more practical, here is a Case Study of how a surgeon Built Trust Through Specialization

A plastic surgeon with 10 years of experience in a hospital setting decided to go out on his own. He wanted to return to his hometown and practice in an affluent suburb; however, it was saturated with other plastic surgeons, and he was late to the marketplace.

Even though he could do face and body, he knew he would drown in “me too” services to compete. So, he decided to focus on rhinoplasty.

His website focused on it, he wrote papers on it, spoke at conferences and public events on it, and got involved in the community.

He hired a PR agency specializing in digital marketing to help spread the word. He received offers to be interviewed, speak and be an expert guest on blogs, facebook groups and consumer webinars.

He also reached out to his fellow plastic surgeons and let them know his focus was on rhinoplasty and not body work.

He is now 5 months booked out and couldn’t be happier.

But this also includes a Warning: Specialization Takes Time and Courage

This approach takes an unwavering decision to commit and stay the course for the long run. It was crickets for two years and he wondered if he was going to make it.

You have to pull from deep within to trust yourself and your skills and NOT waffle. You decide, put the flag in the sand and stay focused. Basically, you burn the boats so you have to succeed because you don’t have another plan.

Another surgeon wanted to grow his non-surgical side of the practice as well as his surgical side so he became the “Go To Expert” on repairing silicon lip injections.

In his area, this was a big deal to a certain population who had this problem so he treated a couple of the women and they referred him not only to their friends and family but also raved about him in their private facebook groups.  

Now he enjoys a steady stream of new patients who come to you for a lip treatment and then stay for additional services, treatments, procedures and products.  And then, they will refer their friends and so on.

2.Build Trust Using Your Branding, so more cosmetic patients will be choosing you

Start with your marketing efforts that create your brand .  How many aesthetic patients have you not attracted due to your poor marketing materials and lack of unique branding?  More than you think. 

A new aesthetic patient who has not yet developed a relationship with you has to go by clues as to who you are and what you value. 

They will look at your materials or assets to help determine that.  Even an aesthetic patient who has been referred to you will solidify that referral by observing your personality through your marketing tools and branding.

So, it is your logo, tagline, website graphics, content, pricing, ads and your social media that tells them who you are, which will help for more cosmetic patients to be choosing you.

It’s also anything else connected to you that builds your brand.

It is your hair, shoes, clothes, and demeanor.  It is your staff’s hair, clothes, makeup and demeanor.

It is your office furniture, lighting, ambience, décor, towels, and products in your restrooms.

It is the smooth flow of an aesthetic patient’s experience while visiting you and going through the process. It’s your follow up.  It’s all the details that make up your brand for more cosmetic patients to be choosing you.

3.Build Trust by Building Rapport

If you take the time to build trust with your aesthetic patients, they will stay loyal to you and refer their friends to you for years to come.

Aesthetic patients go to service providers they like.  Again, think about the service providers in your own life – your car mechanic, your hair stylist, your accountant – all get your business because they have a good relationship with you and that counts as much as the service they provide.

You build trust with your aesthetic patients by developing personal rapport with them and having integrity in the eyes of your aesthetic patients, so more cosmetic patients will be choosing you. 

You build personal rapport by finding what you have in common with your aesthetic patient.  It could be your kids going to the same school or you are both from the East Coast or whatever. 

People like people who are like them so look for the commonalities, so more cosmetic patients will be choosing you.

And, you build integrity by saying what you believe to be true, by giving your aesthetic patients the best reasonable result possible and by doing what you say you’re going to do. 

Your aesthetic patients want to know that your recommendations would be the same if you were talking to your own family member and that they are not just the next procedure for you.

The bottom line is trust.  Your aesthetic patient must trust you emphatically.  They must believe and be reassured that you are the best choice for them.

And that’s how you get more cosmetic patients to choose you.

For more branding, business and marketing strategies that grow your cosmetic revenues, check out www.cosmeticpracticevault.com.

It’s the WHAT and the HOW that sets you up for success…

Because If you want to build a practice your competitors envy, you can’t rely on luck. You do it with the right mindset, strategies, consistent execution and outside counsel who has a bigger perspective to help, so more cosmetic patients will be choosing you.

The cosmetic practice vault is your playbook you turn to when you’re stuck or stagnant or need a new plan, or when new staff come on board.

 Here’s what’s included:

24 training videos with courses and powerpoint slides packed with tips, strategies, and graphics

10+ Hours of mind-expanding content

44 Business Strategies

85 Marketing Strategies

77 “Swipe & Deploy” graphics

44 Proven Scripts to convert, follow up, write ads, and conduct staff interviews

So, it’s your resource standing by whenever you... 

• Need more leads or better leads from more quality cosmetic patients
• Differentiate yourself from your competitors
• Need more effective advertising strategies
• Want to see at a glance how you’re doing
• How to cross promote ALL of your services so you never hear, “I didn’t know you did that”
• Want to hire A-Players who have your back
• Hire new front desk staff to convert more callers to appointments
• Need your patient coordinator to convert more consultations
• Need a social media strategy, and a whole lot more

There’s no fluff. I took everything I’ve learned from my 23 years of working with hundreds of cosmetic practices and testing what works and what doesn’t, so more cosmetic patients will be choosing you.

This was truly a labor of love and a ton of work went into it so please visit www.cosmetic practicevalue.com and let’s grow your cosmetic revenues. 

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on “Want More Cosmetic Patients Choosing YOU?".

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It's guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I've gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let's grow your cosmetic revenue.

-End transcript for “Want More Cosmetic Patients Choosing YOU?”.

 

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#wantmorecosmeticpatients #getmorecosmeticpatients #howtogetmorecosmeticpatients

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how Dr. Mueller became "The Surgeon Inventor".

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "The Surgeon Inventor — with Gregory Mueller, MD".

Most plastic surgeons see a problem and complain about it or wish it could be easier, faster, more precise, etc.

A rare surgeon sees the same problem and invents a solution for other surgeons to benefit from. 

That’s what my Beauty and the Biz Podcast guest did. 

 

Greg Mueller, MD is a board-certified plastic surgeon running a busy Beverly Hills practice during the day and inventing at night and on weekends.

He is best known for www.MyEllevate.com, a minimally-invasive neck lift contouring procedure that was bought by Cynosure, as well as ICLED Surgical Suture System, a light-guided technology and the oVio360 Imaging System. 

We talked about the herculean effort it takes to bring a new product to market and the many pearls he learned along the way. 

Visit Dr. Mueller's Website

P.S. On Monday, I talked about fixing your phones so grab my 5 Phone Fixes Guide guaranteed to increase your phone conversions by 30% within 48 hours.

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

The Surgeon Inventor — with Gregory Mueller, MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and how Dr. Mueller became The Surgeon Inventor. I'm your host, Catherine Maley, author of "Your Aesthetic Practice — What your patients are saying", as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today's special guest is very special because he became The Surgeon Inventor.

It's Dr. Greg Mueller. Now, he's board-certified. He's a plastic surgeon in Beverly Hills and he's been there since 1998 and became The Surgeon Inventor. Now he's also an inventor and this is the part I'm very excited to talk to him about. Dr. Mueller invented the ICLED Surgical Suture System, formally called The Guide Surgical System, and it's a light-guided technology for cosmetic surgery and he's also invented the oVio360 Imaging System.

Now, Dr. Mueller is best known for MyEllevate, which is a jawline contouring procedure that offers the convenience of minimally invasive technology with long lasting results. Now in 2021 Cynosure purchased the MyEllevate necklift procedure. So, let's find out more about that. Dr. Mueller and for becoming The Surgeon Inventor, welcome to Beauty and the Biz.

It is such a pleasure to have you. I've tried to get you on for a while, and thanks for coming.

Gregory Mueller, MD: Oh, Catherine, thank you. And it's such a pleasure to be here and I'm excited to talk about you know, the innovations and my practice here in Beverly Hills and any questions you might have for me. So, let's let it go.

Catherine Maley, MBA: So, it's the inventor part of that. Cause most surgeons, I'll just say generally speaking, they're a fairly, like a finite, linear kind of thinking group. And in your case, you've got to be pretty creative to be inventive and to become The Surgeon Inventor. How in the world are you coming up with these ideas?

Gregory Mueller, MD: You know, Catherine I grew up in Nebraska and it was the fifth of five kids, the youngest, and our household was chaotic.

They. Five kids born in six years. So, I was kind of an independent guy. The last one, the youngest one. And so, I was always a tinkerer. I was always like looking at things. I was kind of like the little nerd inventor. And I remember when I was a little kid, my mom, I would watch her go down the stairs to check the washer and dryer and then she'd, you know, they wouldn't be done.

And then she'd come back upstairs and it was this total waste of time. So, I rigged up this whole light and buzzer system for my mother, and that was my first invention. So, I've always been the type of person I can look at something and say to myself, is there a better way of doing it? And I would say that's probably how MyEllevate was born.

I was looking at necks and I just thought, you know, there's got to be a better way to do neck surgery that's less invasive, and that's where it.

Catherine Maley, MBA: But then where did the plastic surgery fit in on your road to become The Surgeon Inventor? Because if you were a kid tinkering around, it seems like you would've gone with engineering or. Sure. You know, something like that.

Gregory Mueller, MD: Yeah. No, no, no, no. It's, it's such a good question. So, I you know, I always wanted to be a doctor. Ever since I was a little kid. I grew up in this little town called Oola, Nebraska, 5,000 people. And we just had I think we had four family doctors and a surgeon. And so, as a kid I always wanted to be a doctor.

And my mother, she was the scrub tech for the general surgeon. So, I would go up to watch them do surgery sometimes. And I thought it was pretty cool what they did, like fixing a body and things like that. And even when I was in college at University of Nebraska, I entertained the thought of becoming an engineer or maybe an architect, but I found those to be kind of isolating and I love people so, much.

So, I thought, you know what? I should stick with medicine. And so, I just kind of, you know, had this whole pathway for surgery and that's how it all started.

Catherine Maley, MBA: So, now you're a surgeon in Beverly Hills who became The Surgeon Inventor. I might add, and we'll talk about that a little later. So, you're doing surgery and you're literally, half of your brain is doing the surgery and the other half is trying to figure out how to make it easier, better.

What, how did, how did that come about as you became The Surgeon Inventor? The MyEllevate?

Gregory Mueller, MD: Yeah, so, you know, I finished at U S C in 1998 and went into practice here in Beverly Hills. And you know, right off from the start I just thought, you know, the neck procedures I felt were pretty invasive and some of the patients didn't want to have a big invasive procedure.

So, in my mind I was just thinking. There's got to be a way to sew the neck muscles and to kind of smooth the area underneath the jawline without surgically opening the whole thing up. Because with neck surgery, that's what adds the complexity is when you make an incision under here and then you're cutting around the ears, you're lifting up all the skin, and the only reason you're doing that, especially in the front of the area, is to see the muscles to sew them.

So, I thought there's got to be a way to sew the muscles without directly opening the. And that's where it all began. And that was way back, that was like back in 1999 to 2000 when I started thinking about it.

Catherine Maley, MBA: And then how long did it take you to actually do it to become The Surgeon Inventor? Sure. And make sure it was really something effective.

Gregory Mueller, MD: Yeah, yeah. So, you know, I, I would do traditional open neck procedures and, and facelifts and necklaces and so, on. And then back in like early two-thousands, I started placing my endoscope in just to look at how things looked underneath the skin. Because I thought maybe I could endoscopically, you know, sew the muscles together, because I knew that, you know, people were doing endoscopic brow lifts, which I was as well then.

So, I thought, wow, maybe we could do an endoscopic, you know, neck muscle surgery. Well, when I was looking with my scope, this is back in 2005, I noticed that the skin was attached to the underlying muscles with all of these liga. And I recognized that those ligaments were pretty strong and they were always present even after doing liposuction.

So, then the thought came in my head, wow, I could, I could wrap the sutures around those little ligaments and use that as an anchor. And then when I had my scope in there, I could see the light through the skin. So, I thought, Wait a minute. If I had a sewing needle that was illuminated with a thread attached to it, then I could look at the skin on the outside, see where it was going.

If the light faded away, I knew I was too deep. Or if it was just nice and yellow, I knew I was right in the nice fatty layer, which I needed to be. Then I could use that as my directional guide. And so, that's how the whole idea was born, was looking to endoscope and studying the area underneath the skin.

Catherine Maley, MBA: Was that your other invention as you became The Surgeon Inventor? The, the.

Gregory Mueller, MD: No. Well, yeah. Oh yeah. That's, you know, the I C L E D kit. Mm-hmm. IC means I see you with my eyes like IC and then l e d light. So, the surgical kit is, it's not an endoscope, it's basically just an illuminated sewing needle and thread. And so, that tiny little sewing needle, we pass it underneath the skin and the doctor looks at the light shining through the skin to determine exactly where they are.

Catherine Maley, MBA: So, do those two go together or do you just, is MyEllevate including that light or can you do it without it? How does that relate to you becoming The Surgeon Inventor

Gregory Mueller, MD: Yeah, so, you, you can't do the MyEllevate procedure without the light because you need the light guidance to accurately place the suture material right onto the muscle, and that's the whole cornerstone of the technology is being able to use light guidance.

To deliver the suture material right onto the muscle as opposed to just passing a probe through the skin. It's very unpredictable. So, you wouldn't know if you were too deep, if you were too shallow. And the whole key to the success of the procedure is accuracy and, you know repro reproducibility. So, that's how the light works.

Catherine Maley, MBA: Now, how much do you consider that minimally invasive, but there is a, an incision. Has that helped you to become The Surgeon Inventor?

Gregory Mueller, MD: Yeah. Yeah. So, it's, it's minimally invasive, meaning that everything's done through little needle punctures. And if there's fat to be removed with liposuction, then we'd make a tiny little stab incision with a 15 blade.

And those are very small scalpel blades, so, those would be considered tiny little stab incisions or incisions. But they're so, small we don't even need to put a stitch in them. But the suture system, the MyEllevate. Place through tiny a little bit smaller than two-millimeter punctures, and none of them need a stitch.

They heal within just a few days, which is really cool.

Catherine Maley, MBA: The patients must love this, which must have helped you to become The Surgeon Inventor.

Gregory Mueller, MD: They, they love it. I'm, I'm telling you, I just saw someone today who she's on the red carpet. You know, this is Beverly Hills and you know, she was just horrified of the idea of having incisions around the ears and she came in at the right time, because MyEllevate works for somebody who's just starting to see some aging underneath the chin.

And so, we all use a laser to tighten the skin. I love using precision TX, which is a laser. Pass into the skin. So, now she can have a procedure without any detail, tale, signs, and a quick recovery too.

Catherine Maley, MBA: So, who's the best patient demographic for this? You said who's just now feeling it like they're not facelift candidates, but there's something going on.

Like how do you decide who, to help you become The Surgeon Inventor? Who's good For face or for like MyEllevate versus, I don’t know, skin tightening or a face.

Gregory Mueller, MD: Sure, sure. No, and that's, it's a really good question. So, if you think of MyEllevate, let's just think of it as a minimally invasive, percutaneous, light guided way. A lot of words to sew the neck muscles.

Okay. So, in a person who's just starting to show some signs of aging, it's a great way to sew the neck muscles by lifting and shaping them. Without opening the neck. And we would combine that with a laser to tighten the skin envelope. Or we could use radiofrequency, or we could use something like J Plasma or Renu Vion, or we could use Vaser to tighten the skin.

Now, in my practice here in Beverly Hills, the majority of my. Practice are facelifts and neck lifts, so, I still would remove skin around the ears, but I never opened the front of the neck, which is great. I always use MyEllevate to address the muscles, so, MyEllevate is really a way to address the muscles underneath the skin.

Without having to open the skin. So, it can be combined with skin removal or non-kin removal, or in a younger patient you can reshape somebody's neck that they inherited from their parents. That's not real desirable. You can give them like this new snatch jawline.

Catherine Maley, MBA: Wow. So, how did you present this to your patients to help you on your way to become The Surgeon Inventor?

Or did you, did you bother? Did you tell them that you have a different way of doing a neck lift? Cause some of this is patient education too, isn't it? Aren't you trying to explain? Well, I don't, you don't need a full open, you know, face lift. You just need a little something, something like, how are you explaining that and how does that relate to you becoming The Surgeon Inventor?

Gregory Mueller, MD: Sure, yeah. In, in the over 15 years of development of this technology in the very beginning you know, I had patients who complained about the little incision under the chin, and so, after I'd studied the area with the scope, I figured out that I could attach a suture onto like a rod, just a, you know, a normal surgical rod that you'd use in the operating room.

And I was able to just, Lace, the back part of the neck area without having to open it all the way back. So, the patients were very willing. They said, oh, that's great. If you don't have to open it all up, just use that. And then over a several year period, it just advanced where eventually I was able to lace it all and then we published a paper in the Aesthetic Surgery Journal in 2012, and that was using just the solid rod without a light on.

And the revision rate was like 15%. So, that's a lot, right? You know, you don't want to have 15% of your patients have to come back for a touch up. Nothing bad happened, but you know, they just didn't have like perfect results like I want. So, then that's where the light guidance came in. That's where I realized we have to have the light.

So, we got our F D A clearance for the light, and that was in 2009. So, from 2009 until today., everything is done with the light guidance and now the revision rates are less than 5%. So, it's pretty.

Catherine Maley, MBA: That's fantastic. What's the learning curve like? Cause it sounds complicated. What is it like and how did that help you to become The Surgeon Inventor?

Gregory Mueller, MD: Yeah, it's, you know, what if a surgeon is expert in the anatomy of the neck, which is key, right?

Because we want safety and we want our patients to be well taken care of. That's the number one criterion for someone who's going to perform MyEllevate. Then the second one is the surgeon has to be knowledgeable and experienced. And doing liposuction of the neck. So, the, my elevator is, is performed in the exact same location as liposuction is, and that's what makes it so, safe.

Because we're not down around the nerves, we're actually on the top of the muscle, which is safely away from the nerves, which lie deep to the muscle. So, any surgeon who is skilled in surgery of the neck and knows how to do liposuction is a great candidate. The learning curve is fast. Usually if surgeons do five to, you know, five to 10 procedures, they feel very, very skillful and very confident in their technique.

So, that's, that's the nice thing about it. It's a quick learning curve.

Catherine Maley, MBA: Huh. I'm fascinated with that. I should have known that before I had my neck lift, which would have also helped you on your journey to become The Surgeon Inventor. That's alright.

Gregory Mueller, MD: But see, we might use MyElllevate to address the muscles underneath, but you look amazing. So, they did a great job. They did a great job.

Catherine Maley, MBA: Well, it's the, like, if the facelift starts going, is it like a post base look kind of thing as well, where you're just trying to do touch ups to keep it all? How does this relate to you becoming The Surgeon Inventor?

Gregory Mueller, MD: Yeah, so, you know there, there's, there's actually four different patient groups who are great candidates for MyEllevate. Younger, genetically less desirable neck contours.

We can change that. Then the sort of the middle group, those are the ones where a laser will tighten the skin or radiofrequency or, or plasma. Then the third group is those are the patients with the facelifted neck lifts and in the fourth group you just brought up, that's the patient who's had a prior face lifter neck lift because the neck is usually the area to go first.

Is pretty resilient and lasts a long time, but the neck skin is thin and everything hangs underneath the jawline. So, MyEllevate's a perfect way to prolong the results and do like a little jumpstart on a prior facelift or neck lift.

Catherine Maley, MBA: Okay. Good to know. I might need to, yeah.

Gregory Mueller, MD: All right. Come to Beverly Hills.

I would love to take care of you.

Catherine Maley, MBA: Don't be surprised when I show up. Yeah, so, so, this is the part I'm really interested in. You can have a great idea, but selling. Selling an idea to another surgeon. A surgeon to a surgeon. It can go both ways, in terms of becoming The Surgeon Inventor. Either they trust you implicitly because you're also a surgeon, or they can't stand that you thought of something and they didn't, so, there's some resistance or they just don't want to make a change.

How did you market this, or how did you introduce this to other surgeons?

Gregory Mueller, MD: Yeah, that, that's like a great question, Catherine. I will tell you. It was hard. It was really hard and I'll tell you why It was hard. It was hard because it was so, expensive. Oh, you could, to go through the FDA and to get patents and trademarks because you know you need to protect it.

Once you had this investment. You've got to protect it. So, you've got to do those things. And then to go through the F D A, it's, it's a very expensive process. We set up our own manufacturing process here in California, so, our factory is about 50 miles from Beverly Hills, right here in California. And literally, I was down there on the assembly line.

Making sure that each person who was putting it all together was trained to do it perfectly because it's a medical device. So, the time and effort and money that went into it are just unbelievable. And that was something I did not really understand. So, that's. One big part of it. Then the other one is, is getting surgeons to, to open their minds to think about a different way of doing things.

Surgeons by nature, which is a good thing, we're very conservative and we're very safe. You know, we don't want to take risks with our patients. We don't want to. Experiment with a patient. And we usually do what we were trained to do in our training programs. That's like our foundation. So, it was enormously difficult to push the cart up the hill to get surgeons to see that it was a viable alternative and to get them to actually try it.

So, it, it's tough. It's very tough. And you know, you've got to publish papers. You've got to find reputable surgeons who believe in it, who will talk about it. It can't just be from you. Because every surgeon thinks, you know, they look at you and they're like, well, of course he thinks he believes in it. He has money in it, and he wants to make money.

And it's not about that. It's about. Getting something accepted in the medical world, which is conservative by nature and getting surgeons to adopt it. And, and it's, it's been quite a journey and I, and I feel like we're just, you know, over the hump of that sinus Assure has helped a great deal. But it, it's, it's been amazing to just see the naysayers now are becoming believers, which is so, cool.

Catherine Maley, MBA: How many years did that take from the time you decided to introduce it to others, to now how many years was it and how did that help you to become The Surgeon Inventor?

Gregory Mueller, MD: Yeah, the journey originally was introducing what was called the trampoline Plasmo plasty. I wasn't very good at branding back then because no one could ever remember that name. But anyway, that was the original name was a trampoline, floop Plasty, and it was a more complex procedure where we created like a shoe lacing underneath the jawline.

And it was hard to teach honestly. You know, I had mastered it by the time we were teaching it, but we didn't really beta test it with surgeons, which was a wrong move. We learned. And so, no one could really learn the trampoline or remember what the name was. So, we published our paper, which had a 15% revision rate.

So, you could imagine surgeons were just like, Uhuh, I'm not interested. So, I spent the next decade. That paper was published in 2012. We just got another. Very important paper accepted in the Aesthetic Surgery Journal in 2022. So, there you go. There's your 10 years describing the MyEllevate procedure.

Now we're at a less than 5% revision rate and a very high patient satisfaction rate. So, a decade, Catherine, it took a long time. And was this self-funded? No, no. It was self-funded in the beginning. Yeah. When I came up with the idea here in my head back in 2005, my neighbor is a patent lawyer and he said, how convenient.

Yeah, I know that helps. He said, you better file your patents before you ever even hire an engineer. So, I actually filed all the patents in December of 2006, and then I hired a biomedical engineer and told him my idea for the tools and he was the person who could, you know, put them on paper and eventually, Add 3D images.

Oh yeah. And, and that's what we did. And I self-funded it until 2008. And that was when we were getting ready to apply for f d A clearance. And that's when I realized, oh my God, this is so, out of my league. Lots of money. We have about 20 investors who stuck with me the whole way since 2008.

Catherine Maley, MBA: Wow. Okay. That’s very interesting too. So, you know, when it, it sounds like when the government gets involved, the budget increases, which may or may not help with becoming The Surgeon Inventor. Oh yeah. Maybe that's your boundary there.

Gregory Mueller, MD: Yeah, yeah. I, I think if somebody has an idea and so, on, it's, it definitely, you, you definitely, as, as surgeons, you know, and, and we make a good living and so, on.

But it, it's a very expensive process. We're talking millions and millions of dollars, not hundreds of thousands of dollars, millions and millions of dollars to get it to where it was. When we sold it to sinister in August of 21.

Catherine Maley, MBA: So, you have this this procedure that you have down, your patients love it. You love it. It's good.

Do you just call like your best buddies that you have and say, you know what, I've got this, this new procedure that will help me to become The Surgeon Inventor. Let me show it to you and then come on by and take a look at it. Like, were you beta testing just one-off doctors or it sounds like you did the papers. Did you also then get on the podium and start talking about it?

I'm still interested in how do you build credibility. In this industry that's a really tight knit group and tough to open up to, you know?

Gregory Mueller, MD: Sure, sure. Yeah. What we did is we did all those things. We, you know, got podium time and, you know, that was sometimes our company, we would sponsor a meeting, so, we would have an exhibit there.

and you know, they have non c M E talks so, you can, you know, get on the podium and, and you can present to a group of surgeons. And we did that just to kind of assess the level of interest. And then there was a meeting out here that's a meeting in the spring where we did our beta testing. So, we, we were a major sponsor of the meeting and right here in my office, in the surgery center, we had live surgery as part of the.

And so, that was a great way to bring some of those surgeons into the operating room. And what we did then is we really paid attention to their feedback. We had them fill out questionnaires about what it was like to watch the procedure, where they saw there were deficiencies in us explaining what we were doing.

And then we used all that information to help us shape a training program. And then I would do cases here and we would invite surgeons from the community just to come by if they wanted to just see it. And that was hard, you know, because surgeons are busy, you know? So, to get somebody to come over even for an hour is not an easy thing to do.

So, it was kind of friends, like you were saying earlier, friends and surgeons who, you know, that I respect and they respect me, would come over and look at it and then we'd get feedback from them.

Catherine Maley, MBA: So, now, so, you're doing that in Beverly Hills. How were you able to scale, in terms of becoming The Surgeon Inventor? And move this throughout the —

Gregory Mueller, MD: Yeah, I think probably a big step for us honestly, was we, we knew that there, there are two surgeons who are, are major KOLs and, and you and I have talked about them and I, and I, I know you know them, but Barry de Bernardo, who's a plastic surgeon up in Montclair, New Jersey, and Jason Posner, who's down in Boca Raton at this current time.

In the world of plastic surgery, they are known as folks who really have a grasp on new technology. They, the industry likes to go to them to talk to them about where they think things will fit. So, so, we arranged a meeting where I could meet with them and, and we went down to my partner in the company.

He's not a physician, he's a movie maker. He and I went down to San Diego. To the Aesthetic Society meeting, and we met with Dr. Posner and Dr. D Bernardo at 7:00 AM or maybe it was 6:00 AM before the meetings even started. And I had my laptop and showed them before and after’s, showed them a little surgical video and they seemed interested.

And then the next step was I went to Boca Raton and Dr. D Bernardo was there, and Dr. Poer, and we did some cases together. You know, I kind of walked them through it and they loved. They loved it. And so, then they were just wonderful in, in helping us kind of shape, you know, how we would get it introduced.

They both, you know, became consultants for the company, but I think that was a, that was a key step. That was a giant leap right there with them because you have to get it out of your realm into the realm of people who are known as people who are good at looking at new technologies.

Catherine Maley, MBA: Mm-hmm. and well, and the plastic surgeon's world is different than the facial plastic surgeon's world.

That's different than the cosmetic surgeon's world. So, do you tap into all, or are you just focused on plastic surgeons, or who do you, what kind of surgeon do you have to be to perform MyEllevate, and how does that relate to you becoming The Surgeon Inventor?

Gregory Mueller, MD: Yeah, so, I, you know, the two major groups for sure are the plastic surgeons, my group, and then the facial plastic surgeons, because we identified those groups as the most proficient and expert at surgery of the nac and, and the ones that would be, you know, safe and well-trained with a great foundation of education.

You have to be realistic and realize that there are other surgeons who are doing necklaces and facelifts and liposuction of the neck. So, we kind of hand select and, and seek out surgeons who might be oculoplastics because they're, you know, they're very well trained as well in anatomy of the neck. And then also dermatologic surgeons and, you know, just like everything.

There are great plastic surgeons and not so, great plastic surgeons. There are some oculoplastic surgeons who are great, you know, and some who aren't or whatever. So, we really try to vet and find the ones who are proficient in this area, because we want safety and we want efficacy. So, we started out in the facial plastics and plastics world, and then once you're out there and you're on the podium, And you get some facial plastic surgeons doing it and they love it.

Then they get, you know, they, they may speak about it on the podium, which is very effective because it's not my voice. It's another person's voice and that's how you make it go. And that's kind of how it's happened. It's been very organic that way.

Catherine Maley, MBA: Well, it was organic, yet you were able to scale enough to get sin assures you know, attention to become The Surgeon Inventor?

Yeah. So, how did that happen? Cause that was your big coup, wasn't it?

Gregory Mueller, MD: I mean, yeah. Oh yeah. So, it was. It was crazy, you know, because we were, we had beta tested at the meeting here in Los Angeles, so, we knew we had a training program that would work. We fixed a few little glitches in it and we thought, okay, it's Showtime.

And we had Barry de Bernardo and Jason Posner. We had some great podium time at meetings that were coming up, and then the little thing hit us called the. And so, it was like early 2020 and we're like, oh no, we're finally ready. And you know, it's been over a decade and now this is happening. And I remember calling my partner in the company Ted Galliano, who makes movies, and I told him, I said, I think we should just shut down the manufacturing and conserve cash.

And he said, no, no., he said, and he makes movies so, he understands big productions. He said, oh, no, no, we need to manufacture a lot of kits. Get them on the shelf because he said there's going to be a supply chain shortage. So, he said, this is the time to do it. And the factory, they were so, happy because we were the only company who were building up.

even though the, you know, the world was shutting down and that was the best thing we ever did. And what we did is we, we did like a virtual launch. So, we had these Zoom meetings because we knew doctors were not working full-time. We knew they were at home. We knew Ed, the culture was switching to Zoom. So, we had these webinars and we had them, we had this cadence going where we had something going every couple of weeks at the same time.

And we built this following. And then we, we had developed some nurse trainers who would actually go and help the doctor with the kit to teach them how to use it. And so, we were able to do virtual training, do live surgeries that we would, you know, show on Zoom like you and I are doing right now. That was enough where doctors saw it, saw they were interested, and then they would buy the kids and the nurse would go to their office and help them with their first two cases.

And, and it worked. We had 30% growth in revenues every quarter for six quarters. Oh my gosh. 30, 30, 30. Oh yeah. So, it attracted the attention you can imagine of not just Cynosure, but three other major companies and, you know, through non-disclosures. They can't say who, but anyway. We, we were negotiating with all of them and we were doing all these little, you know, meetings and, and whatnot and signed Assure.

They were the first ones who threw a proposal out and said, we don't want you to talk to anybody. And so, So, we could've, we had a quiet period and, and that's how it all came to be. And, and, We've vetted the other companies, but we felt sinus was the best match for us because they knew that this technology had to have a slow introduction.

It had to be done in the right way where we chose the right surgeons and trained them.

Catherine Maley, MBA: I think it would be that the quality control. Yes. Cause the last thing you need is bad. You know? Bad stories out there. Bad, bad reviews, people complaining that would be bad for becoming The Surgeon Inventor.

Gregory Mueller, MD: Yeah, and you know, we've seen it, I mean, I know you've seen it in your lifetime and so, have I, where a new hot technology comes to market and the company over expands and they don't really train well, and then suddenly you've got bad complications.

So, we knew that was not the model we wanted to follow. We wanted to follow a slower buildup, you know, which is kind of hard, you know, because everybody's in the business, you know, especially corporations to make money. But I loved it, that sinus. Sure. They totally were on the same path as us and they continue to be, which I love.

Catherine Maley, MBA: Yeah. Now, when you sold to Cynosure, do you come with that package or how does that work and how does that relate to you becoming The Surgeon Inventor?

Gregory Mueller, MD: Well, I come with it sort of, no, no. So, I'm totally, so, the company was, or the technology, the, MyEllevate technology was completely purchased by Sinus Assure, and that was a clean deal. And so, I no longer run the company or anything, which is such a wonderful.

But I have a separate deal with Sin Assure, which was integral to the whole thing going through where I'm a consultant for the company, so, I just consult for Sin Assure. And the deal was some cash up upfront and then some shares and Sin Assure overall, and then the company. Our startup company gets some royalty payments along the way, depending on performance, and there's some milestones.

But I'm not directly tied to it anymore, which is great. But I am a consultant and it's to my benefit and to the company's benefit that I help them, you know, and shepherd it through. So, that's all part of the deal.

Catherine Maley, MBA: Wow, good for you on becoming The Surgeon Inventor. How long from time that they, that you ta that you got on their radar to the time you all signed, how long does that.

Gregory Mueller, MD: Oh gosh. The due diligence process with, with them was about six months. That was the quiet period. So, it took so, much time and Oh, it was intense and I'm so, glad we did everything by the book. I'm just so, happy with that. And I can remember along the way because we had people who would come and go, who would, you know, consultants, regulatory people.

So, me of them were not as like above board or like, you know, What I want to say, conservative about everything as we were, and we would always insist that everything would be done by the book because when the due diligence came down, everything was checked into. So, I'm very happy we did that along the way.

So, I would say from them talking to us to the sale of the company was about. 10 months. Wow.

Catherine Maley, MBA: Yeah. And you're tied up for that time. You can't talk to anybody else so, that you need that to work to become The Surgeon Inventor, right?

Gregory Mueller, MD: Yeah, that's right. Yeah. So, we, yeah, we just continued on doing what we were doing and you know, we just had to, it was a quiet period and we couldn't really talk much about it.

The quiet period was towards the end, you know, they, they did a lot of sorts of upfront checking on things. So, I would say the quiet period was maybe three to four months. Something like, Or we could not talk to anybody else about it. We couldn't tell anybody that we were in process with sinus or we just had to like lay low and tell people we were just going to keep doing it on our own.

Catherine Maley, MBA: So, that's fantastic. So, wasn't taking up your time while becoming The Surgeon Inventor?

Gregory Mueller, MD: Yes, I was a slave to it and you know, I didn't even realize, but you know, right when we sold the company on August 4th, 2021, and I can't even tell you from August until December last year, which was 21, my income rose so, much. From just working here, I never realized how much opportunity loss I was experiencing until that big hungry horse was like taken out by sinus shirt.

I just didn't realize, you know, because you, you're so, distracted when you're running a company like that. It is a major full-time job and then you try to run your practice, which is also a major full-time job. I, I'm so, happy that we sold it. It's unbelievable.

Catherine Maley, MBA: Well, it was 10 years coming or 20 years, two, eight until 22 on your road to becoming The Surgeon Inventor?

Gregory Mueller, MD: So, yes. A good 14 years. It was time, Catherine. Oh my gosh.

Catherine Maley, MBA: Yes. So, so, then let's talk about Beverly Hills. You have a practice that facilitated you becomng The Surgeon Inventor. How did you, how many hours were you able to work there? Like, how are you, were you swinging this because Beverly Hills, it's not like you're in Ohio where you're the only surgeon.

You know, you're in the middle of Beverly Hills and it can't be more competitive and those people are eating and sleeping and drinking plastic surgery and now you're kind of dabbling cause you're, you know, you know, tapping through both. How did you handle that on your journey to become The Surgeon Inventor?

Gregory Mueller, MD: Well, I, I think the, you know, the way it all works is if I had invented something that was non-plastic surgery industry, I think that would be a different story because that would've been a huge distraction and I think the practice would've suffered tremendously.

But since I'm the end user of the technology and my patients who are right here are benefiting from it, it was kind of cool because the two worlds were together. Very much collided. So, running a medical device company, perfecting a technique and technology and treating my patients with that same one, which attracted a lot of patients because patients loved it, that I was an innovator.

They loved it, that I didn't open the knack. So, I think that's what kept it all going. and they knew, I mean they all knew it was in my blood that this was my big thing that I was doing. So, they knew I had obligations outside and they stuck with it and they were just so, and they were so, proud about the whole thing too.

There, it's like a family for me here. So, everyone supported, which was great, but I'm so, glad now I'm not doing it well.

Catherine Maley, MBA: I kept hearing MyEllevate cause I met all the conferences and I'm like, what is with is me. And then your name was attached. I went, oh my God. I had no idea and how it helped you to become The Surgeon Inventor. I did not.

Gregory Mueller, MD: Two and two together.

Catherine Maley, MBA: Fine. Not for a long time. So, what advice would you give to another surgeon who, you know, who thinks this is a good idea when, when you have a good idea that may help them become a “14-year overnight success” or similar? Sure. Any, any advice or any mistakes you made that you would tell somebody you watch out for?

Gregory Mueller, MD: Yeah. I, I would say that the major things that I learned from this are number one.

It takes twice as long and twice as much money to get to where you want to be. So, you need to be patient Number two it's, it's a huge opportunity taker because as surgeons, you know, you know, we are paid really by time, you know, because our time in the or, which is very. And if you're doing things like a startup company on the side, you're missing out on some major income in the or.

So, I think recognizing that it is going to be very expensive and you're going to have a lot of opportunity loss is very important. And then probably the biggest lesson I learned was the beta testing. You know, being a surgeon innovator. By the time you get something to where you think it's ready for market, you will have mastered it.

But you have to remember that your audience, which are other surgeons, they know nothing about it. So, you have to be able to get into their shoes and do some beta testing and get feedback from them, and use that feedback to help you fine tune the procedure because it can be as elegant as ever. But if you can't teach it, there's no commercial value to it at all.

Catherine Maley, MBA: So, true. So, do your, in your practice, is it, are you doing basic, do you do body and face or are you pretty much just focused on the face now to help you become The Surgeon Inventor?

Gregory Mueller, MD: Yeah, I used to do everything. But you know when, when I started not opening the neck, the word got out and people would send their friends because they loved it cause they didn't have scars here and they love their.

So, mainly above the shoulders that's probably 90% of my work. And then 10% would be, you know, like some lipo sculpting or things like that.

Catherine Maley, MBA: And then how did you for in Beverly Hills just how do you market yourself in Beverly Hills? How the heck do you stand out amongst everybody else to become The Surgeon Inventor? Any tips on that?

Gregory Mueller, MD: Yeah, I mean, I, I'm a little bit older than the younger social media savvy surgeons, you know, because they, they, you know, I look at their Facebook and their Instagram, they have like a hundred thousand followers. It's like, I have 5,000 which I think is a lot, but, you know, that's bigger than my hometown.

But they, but I think. Being a good doctor and taking good care of my patients and listening to them. And also, you know, I'm not a big social media person. I'm, I'm not really good at it, you know, and that's not where our patients come from. But I think just taking care of patients and especially taking care of them if they have a problem.

You know, no surgery is perfect, no surgeon is perfect. And I think some of my best referrals, in fact I know this have come from patients who've had a complication because I was there for them. You know, and they know that. And you know, a lot of people have had other things done and their doctors they had before.

Just kind of didn't show up, you know? And I think that's a big thing. And, and being in Beverly Hills, yes, there's a lot of us here, but I think being a good person and looking after your patients and realizing you are human and there are going to be little stumbles every now and then, but, you know, helping the, helping your patients out when they have a little problem, I think is key.

Catherine Maley, MBA: Yeah. Do you miss Nebraska, in relation to you becoming The Surgeon Inventor?

Gregory Mueller, MD: I'm so, glad I'm from Nebraska. I think it's a great place to be from and I love going back every year cause my family is there. I just think if I were in Nebraska and I came up with a surgical idea people that are more conservative, I think they would've said like, oh, he's kind of a kooky doctor.

And you know, maybe that's where it would've laid and it would've been done. I feel like in LA and California, I feel like. This is the technology capital of the world. California is. So, I feel like I am blessed that I'm in this city and that I have friends who make movies and who make a lot more money than I do who could see the potential of my dream, you know?

And were willing to support it. I think I would've had a harder time in a more conservative environment. And I feel like that's Nebraska's a more conservative place, you know? And so, I, I do, I love it out here because of that, and I think it's, it's helped me realize my dreams.

Catherine Maley, MBA: Well, you had a lot of time to think on how to become The Surgeon Inventor, you know, when you live in Nebraska there's probably, you have a lot of downtime as a kid.

You know, there's not a lot going on. Probably, so, you just got to think more often.

Gregory Mueller, MD: Oh, but Catherine, remember I was building the washer dryer action indicator for my mother. So, I've always been a little bit of a busy bee!

Catherine Maley, MBA: That and have that other oVio going on, which helped you to become The Surgeon Inventor. So, because you're not going to stop inventing, are you, is there always going to be a little project going on behind the...?

Gregory Mueller, MD: I mean, it's expensive. As I told you earlier, that's one of my teaching points of this whole process is realize it's twice as much and takes twice as long.

I have the imaging system, the oVio360 Imaging System, which I'm very proud of, and it's very related to MyEllevate and, and I'll tell you why. When we published the paper in the Aesthetic Surgery Journal in 20., when I was assembling the patient's photographs for that paper even though I was very mindful and was trying to make sure they were all standardized, they're just not.

When you've got a camera and you're holding it and your nurse might take them one day and you might take them the next day, the angles are a bit off and stuff like that. I was so, frustrated with that. So, I built a camera for myself, basically putting the camera on a boom. And putting the backdrop on the other end of the boom and a little lazy Susan in the middle, so, who just rotate around the face or the body.

And I did that so, I could, number one, always have standardized photographs, but also so, that I could really study this neck procedure to perfect it. As I was building it, I thought, wow, a movie camera would be better on this boom, because then I could look at motion, you know, and see how when someone smiles, how the facelift alters the face, or with breast implants, how the breast implants move when someone flexes their peck muscles.

So, I built the first camera and my investors for the neck procedure for my. Remember I told you they make movies. They saw that camera and they said, oh, we'll pay to develop that. And I was like, oh my God. I built the camera for myself, not to be commercialized. And they're like, we've never seen anything like it.

So, that's how oVio was born. And they said, we will pay to develop it. And we did. And we. You know, my partner in the company, he was president of post-production at Fox which is the big movie studio here, and he hired one of the engineers who did some of the engineering for Avatar to really perfect the camera system.

So, the one I have in my lobby here is so, beautiful. It's, it's built out of air aircraft, aluminum, and it just sweeps around the patient and whisper quiet and it does these beautiful images. So, That's my other invention and we're you know, right now marketing and selling those. I'm a consultant for that company.

I don't manage that company. I learned right from the MyEllevate that I don't want to run a company; I need to run my practice because this is where I love to be. So, I do consulting for the imaging company, which is really fun.

Catherine Maley, MBA: Boy, have you evolved on your journey to become The Surgeon Inventor? Dear Award dear. Good for you. You know, just congratulations.

I've just been watching you; your career and it's just been amazing. I, I just, I wish I had a hidden idea myself, and I just, I, I do, but they're never like consumer, like I, I like to prefer to do things very complicated, you know, that like only a hundred people need, you know, I need to go, I need to find something big, big, big.

Yeah. So, my last question What? Tell us something we don’t know about you.

Gregory Mueller, MD: Wow. What you don't know about me. What would I say? I love to travel. I'm certainly loving teaching MyEllevate now because I get to travel the world. I just got back from Australia. This morning I was on with Dubai, and I'm hoping to go there early 23 to introduce MyEllevate to the Middle East, and then we'll be off to Singapore and then China after that.

So, I, I just, I think. What people don't really know about me is how much I love to travel and how much I have not traveled this far in my life because I've been working so, much. But I'm, I'm excited about that part of my life and you know, there probably will be another innovation down the road.

But, you know, I think the main thing is I love doing plastic surgery. I'm more excited about my job today than I was when I started 25 years ago.

Catherine Maley, MBA: That's…not everyone can say that. Good for you and your path to become The Surgeon Inventor.

Gregory Mueller, MD: Yeah, and I think it's a, due to a couple things, I think because for so, many years I was doing the startup that it was, it was quite a distraction and it just feels so, good.

And so, you know full of serenity to be able to just focus on taking care of people and not have all this interference of worrying about cash flow with the startup company and this engineer quit, or that person quit, or the factory's not working right now, I can just really focus. So, I'm, I'm, I'm just loving my profession right now and love my family too.

I'm really close with my family. That's another thing that, you know, I spend a lot of time with them and I don't know, I'm just excited to see where the next chapter takes me.

Catherine Maley, MBA: Right. Well, you are busy with being The Surgeon Inventor and it's so, nice. I hope to see you at some of the meetings coming up now that we're back again, right?

Yes. If other surgeons want to get ahold of you, what's the best way to do?

Gregory Mueller, MD: Yeah, I think that the best way would be to you know, I'm on Instagram, I'm a little bit addicted, even though I'm not good at it. And my Instagram is @TheNeckDoctor, and it's all one word. People can direct message me on Instagram.

That's a great way. Or they can just call the office here in Beverly Hills and the number here is (310) 273-9800. That's a great way to get ahold of me. And other than that, it's just I'm easy to get in touch with. Okay,

Catherine Maley, MBA:  Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on “The Surgeon Inventor”.

If you’ve got any questions or feedback for Dr. Mueller, you can reach out to his website at, DrGregMueller.com.

A big thanks to Dr. Mueller for sharing his experience on becoming the surgeon inventor.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It's guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I've gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let's grow your cosmetic revenue.

-End transcript for “The Surgeon Inventor — with Gregory Mueller, MD”.

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

 

#thesurgeoninventor #cosmeticsurgeoninventor #gregorymuellermd

📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how to charge a lot / give a lot.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Charge a Lot, Give a Lot — with Ryan Neinstein, MD".

How do you charge up to $75K for a tummy tuck?

That’s what I asked this week’s Beauty and the Biz Podcast (link) guest Dr. Ryan Neinstein.

He’s a plastic surgeon in private practice in NYC, in a gorgeous 6K square foot office above the iconic Bergdorf Goodman store with views overlooking Central Park.

Dr. Neinstein’s answer….”We charge a lot. We give a lot.”

He went on to explain his hyper focus on the patient experience and aftercare that his patients gladly pay extra for.

He walks his talk by employing 30 full-time staff who assist him in surgery, offer concierge services, drop off garments, pick up prescriptions, visit post-op patients and anything else that makes patients feel special and cared for.

His entire team thinks “relational” vs “transactional” and he gave lots of great tips for developing a practice culture that is fun, inspiring and profitable.

We also talked about HOW:

• His marketing efforts keep 3 plastic surgeons busy
• What he focuses on that allows him to charge more
• How he “rules but not reigns”

Dr. Neinstein shared his pearls and philosophy with good takeaways.

Visit Dr. Neinstein’s Website

P.S. If you are NOT getting the consultation conversions you want, there’s something your coordinator doesn’t know. I’ll train her to be a converting rock-star within weeks.

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

Charge a Lot, Give a Lot — with Ryan Neinstein, MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and how to charge a lot / give a lot. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying" and consultant to plastic surgeons to get them more patients and more profits.

Now today's guest, this Dr. Ryan Neinstein, and he’ll discuss how to charge a lot / give a lot. He's board-certified by the Royal College of Physicians and Surgeons in Canada. And a faculty member at the Lennox Hill Hospital in Manhattan. Now, Dr. Neinstein is in private practice on the Upper East side of Manhattan where he specializes, speaks and writes on the topic of modern body sculpting techniques and liposuction safety standards. He’s also very savvy on the topics of how to charge a lot / give a lot

He also serves on the Safety Committee for the American Society of Aesthetic Plastic Surgery, also now known as The Aesthetic Society. So, Dr. Neinstein, welcome to Beauty and the Biz. It's a pleasure to have you.

Ryan Neinstein, MD: Well, Catherine, thank you so much for having me. I'm very much looking forward to this and I have been following your work for quite some time, so it's an absolute pleasure to talk to you today.

Catherine Maley, MBA: Oh, glad to hear it. Now, how did you go from Canada to decide to come to America to the most incredibly competitive area in the United States? How did that happen, in regards to how to charge a lot / give a lot?

Ryan Neinstein, MD: Well, you know, I've always been in search to learn from the best, and after my amazing training in Canada and general surgery and plastic surgery, I came to New York to learn cosmetic surgery.

I was lucky enough to be accepted to the fellowship here where they, Uber was very limited and tough to get in. And when I landed here, I immediately fell in love, the culture of America. I fell in love with the people of New York and I knew that I wanted to spend the rest of my life.

Catherine Maley, MBA: Wow. That's great. Did you meet your wife here and how does that relate to how to charge a lot / give a lot?

Ryan Neinstein, MD: Yes, of course. My wife is a fitness instructor from Connecticut. We actually met on a yoga retreat in Nicaragua, of course, and the love story has continued since then.

Catherine Maley, MBA: Aw, that's very sweet. Okay, so we'll talk more about that later, including how to charge a lot / give a lot. Right now, we're going to talk about business because ok, you're very young and from what I can tell, you're building quite a little empire over there with all of your expertise on how to charge a lot / give a lot.

And so, I'm trying to figure out where are you going with that? It looks like you've got two other surgeons working with you. What are they? Are they associates? Partners? How are you set up? Because it is Neinstein plastic surgery.

Ryan Neinstein, MD: Correct. And you know, I've always loved the team atmosphere. I played competitive sports growing up.

I played competitive sports in college. It always, you know, it always drove me to be the best version of myself working with others in a competitive environment. And you know, I've recruited Dr. Chris Bundaberg and Dr. Anna, Steve and we all, so Dr. Steve just does breast surgery and Dr. Vanderberg is like me.

We are a hundred percent body and breast surgery. We do nothing from the. We have three people who are a hundred percent focused on the same procedures, and it provides a lot of intellectual inertia. We're able to do research projects. We're able to have a big infrastructure and team, which means we're giving a better experience to the patient, both in the operating room after the operating room, and in total.

So that team environment with a hyper-focused mentality creates an inertia to a better. They're associates of mine.

Catherine Maley, MBA: Gotcha. And it is the goal to keep adding more providers, or where are you going with that in regards to how to charge a lot / give a lot?

Ryan Neinstein, MD: So, I think, you know, this is it. So, we built the space. Like I always say, you know, I like to think of them, what's the magic?

And then work backwards. So, the magic to me was the space. It's, you know, almost 6,000 square feet on top of Bergdorf Goodman overlooking Central Park. It has enough space for two operating rooms. I think three surgeons work well at two operating rooms. We work backwards, and I think the biggest. Thing that I'm always concerned about is this undisciplined pursuit of more, and we're not looking to grow.

We're not looking to bring on more providers. We're not looking to grow more offices. We want to keep maturing and being better at what we do. Focus, focus, focus on patient experience. So, there is no. Future for another office. All the future is, is just enhancing and increasing the capabilities and abilities that we have right now.

Catherine Maley, MBA: One of the biggest challenges of surgeons is working together. And I find personally the dictatorship seems to work better than the free for all or trying to have everybody agree on something. I've just, the, the groups I've worked with where we've tried to make decisions together as a group has on the topic of how to charge a lot / give a lot.

Not been great. Egos get involved. All sorts of things get involved. How well does it work for you? Number one, how did you find the right people to come on board? Did you, do you have tips for how do you find these people that you're going to have to work with 24 7 and get along for years to come?

Ryan Neinstein, MD: So, these are all good things.

Number one, I think it's important that there's someone who rules but not reigns. That's a quote from the late Queen Elizabeth. So, there's a difference between someone being the leader and someone being a dictator. So, in my office or in our office, I take the leadership role from the operations outside of the, or the organizational structure and the operations point of view.

And that's something that my associates. Me doing something I take great pride in. That's something I, you know, I use mentors and consultants from around the world to help me continuously improve the culture. And that creates a frictionless interface between me and our other surgeons. And we're all, we have a common goal, you know, we want to work together to provide patients with the best experience.

So, in that sense, you know, They have autonomy in the, my, my associates have a unique amount of autonomy for being an associate for how they grow and develop their own practice within the practice. And I talk about, you know, using Frick as an example. Frick worked with Carnegie, right? And Frick has his own museum here in New York.

You know, Steve Bald. My, for Bill Gates and Steve Ballmer owns a basketball team. So, you, you can create immense success within a bigger organization and use that structure and foundation that a leader that you believe in trust and can create. So, I don't think you need a dictatorship, and I also don't think you need everyone to be equally weighing in on every aspect.

When we have a northern star and a moral compass that we're all agreed upon, someone can take the lead on.

Catherine Maley, MBA: But what happens when you need to make big decisions on how to charge a lot / give a lot? Things like, what are we going to do with the profits this year? How are we going to divide them up? Are we going to put them back into the practice? The big decisions on how to charge a lot / give a lot, how are those made?

Ryan Neinstein, MD: So, everything you know, I do believe in a meritocracy and. Merit is not all about revenue generating. You know, there's, especially in medicine, the quality of the outcomes is not about how much revenue's generated. It's like, how happy are the patients. So, we have multiple street tiered levels of key performance indicators that help, you know, our bonus and cost structure.

Catherine Maley, MBA: And then how do you divvy up responsibility on how to charge a lot / give a lot, you know like the, the one woman she focuses on breast, you two guys are focused on body when the leads are coming in, like, does she ever want to do anything other than breast or the boundaries are so set with you. You have, you three have this so figured out and dialed in that there's never an issue with leads or I'm getting more than you are getting, or she —

Ryan Neinstein, MD: Oh, I think when, when someone says never or always, they're probably lying.

You know, we have pretty clear goals for each of us and what we like to do. And you know, we do a lot of these hybrid cases where Dr. Steve does the breast and I'll do the tummy tuck and because they want that expertise at both level, and that works really well. But primarily, you know, Dr. Steve's breast surgeon, she has all the, you know, world class training and breast surgery and likes to do complex breast surgery, and she primarily focuses.

So, if someone is interested in doing, you know, a big body procedure in breast, we usually will have two surgeons involved and they'll get a, a, a particular expert in each side. Mm-hmm. And is it complete? 100% cosmetic? A hundred percent cosmetic. But you know, yes, I'd say so. Sometimes, you know, even though it's cosmetic, we're still helping people with skin cancer, lumps, bumps, rest reductions, things.

Catherine Maley, MBA: But when you've got three surgeons who need to stay busy, that takes some, some leads and automation and lead generation processes, so, correct. Who's, who's the marketer there to help with how to charge a lot / give a lot?

Ryan Neinstein, MD: I, I mean, we all contribute. So, the way we look at, and I, you know, what do they say about marketing? Half of it works. You just don't know which half, but.

What we listen, we have a clear, concise message, right? There's a lot of clarity with what we do. You know, I, when you go on a lot of plastic surgeon's website, you know, they're an expert in non-surgical and surgical rejuvenation of the face, breast and body, and you're already like, I don't understand.

Right. Ours, you know, ours is super clear. Breast surgery, body surgery, basically like with 360 tummy tucks and breast surgery. That's it, you know, and any combination. So, the clarity is key in terms of putting out the message. Number one, we're very, we're very strong with our blogs and we like trying to do bottom of the funnel blogs versus top of the funnel.

Top of the funnel is more building audience. Bottom of the funnel are people who are really looking to convert into a. And they're ready to go. So, we do a lot of blogs based on things people are actually searching for. How do I pick my breast implant size, mommy makeover recovery. That generates a lot of trust because you're getting real organic information.

That's one. Two, it's through social media, both Instagram and TikTok. We have a very consistent, serious message about how we present what we do, and we're all about telling stories, you know, it's not just like, look how great I am. It's this. We make. We try to think of ourselves as hero makers. The patient's the hero.

We want to show this story because we want people to recognize themselves within that. And they say, she's just like me. She's just like me. I have the same struggle. I've been down that path, and you guys are able to provide a solution. So, through blog and online, creating the content through social and then through our PR and the various media outlets, which creates the links and the back.

We're able, you know, to get the word out. And luckily, we're in a high-density area. I mean, there's 20 million people in the New York area.

Catherine Maley, MBA: Yeah. There's no shortage of , would be patients for sure. Do you all go use the same website to help with how to charge a lot / give a lot or does everyone have their own social media account, or is it all —

Ryan Neinstein, MD: Oh, we have, we have one mother mothership website and we all have our own social media, but we're all kind of, we have the same coherent message within.

Social media and everyone's saying the same thing every day. And with the overlying, with the, with the foundation of the mothership of the location, the team altogether.

Catherine Maley, MBA: And then speaking of the team on how to charge a lot / give a lot, how, what kind of numbers, how many people are working under you?

Ryan Neinstein, MD: We have about 30 full-time. Oh, And we're expanding.

So, I mean people, a lot of surgeons don't understand. Listen, we are about the patient experience and that requires support staff, and I'm talking nurse practitioners. I like the maturity that comes with the master's level. You know, we run two ORs. I have a 10-person surgical team. I mean, we're, we're more staffed than the hospital.

Yeah. And from an admin side, you know, I think we provide a concierge service that the Ritz Carleton across the street would be jealous of. And I don't think that there's any, we have no limitations in growing support staff for our patients. We have people who run around town 24 hours a day, seven days a week, dropping off garments, getting anything, they want from a pharmacy.

It's a full-service operation and I, I would just keep adding more support, more support, more support. Patients deserve and want access, deserve and want support.

Catherine Maley, MBA: Well, I commend you for that in regards to how to charge a lot / give a lot. Everybody tries so hard to work with at least amount of staff as humanly possible. If they go on vacation, the whole thing falls apart.

Cause they're so lean already. Good for you for pulling that off and. I'm sure you're charging accordingly though. I did notice on your website, and I love this it said like FAQs, how much would be a tummy tuck? Well, it's anywhere between 20 and 75 grand, you know, and I thought that was really good because obviously it's a huge range, but it totally told the segment who you are in terms of how to charge a lot / give a lot.

You're, you're not going to be the two for one er kind of guy, you know?

Ryan Neinstein, MD: Well, listen, we charge a lot. We give. Well, I think it goes hand in hand.

Catherine Maley, MBA: I don't, I think you've got to go both in relation to how to charge a lot / give a lot.

Ryan Neinstein, MD: Yeah. About 30% of my patients are out of state and out of country, and we give a lot. It's an, it's an incredibly mature relationship with the doctor and the patient.

It's not transactional. We're all in, you know, we visit the patients every day that are across the street in the hotels. We have these long-term relationships. It is not a transactional factory, I don't think. There's nothing, anything wrong with that for the, you know, certain people that's the way they want to have their surgery and that's fine.

We are, I know what over the years, patients that we love, we love to work with want, and they want all of the, the experience in aftercare. And to us, that just means a big, committed team of, you know, passionate, caring people.

Catherine Maley, MBA: Now, I know you're big on teamwork and I'm sure building culture. Yeah. Any tips on that for how to charge a lot / give a lot?

Because I would say that's probably the biggest challenge of almost any practice are the people. It's tough managing people, especially if you're a surgeon who never was taught any of that leadership and culture and all of that. Now, where do your tips on it and how do you learn it

Ryan Neinstein, MD: Well, you have to find mentors. I don't think you can go a straight line in life without a ruler. And you need to find mentors who can help you go from being smart to wise and also understanding that you'll, there's never, there's no end point on wisdom. So, to me, smart is, you know, you can read a lot of books like when we all Finish school.

We're very smart. Everyone's smart. We can read lots of books on business, we can read lots of books on HR, but wisdom is that traveling and actually implementing all that. So, you got to just keep asking questions, keep trying anything with the team, you know, with your people. It's, you got to seek first to understand if you want to be understood.

So, you got to get to know your team and you have to create, like, we have a, we have a core values. So, to come work on our team, it's not for everyone. We set the core values. Hey, everyone here believes in these four things. Number one, they're going to be an expert in what they do. So, whether or not you want to be.

You know, a scrub tech or a nurse or a front desk, you got to be an expert coming in. Number two, you got to be a lifelong learner. We have Book of the Month Club. Everyone has to take a course every year. Everyone has to keep getting better. This is not a check-in checkout. Number three, you have to graciously share what you learn.

We have. 30 people learning things every day. You got to be walking around and sharing them. There's no hiding knowledge. Number four, you have to accept feedback, okay? So, you have to be willing to have all these checks and balances, but when you have 30 people moving in the same direction, all in the same page, that's the culture here.

And it's a really culture that it's patience first, employees, second profits. Third, never lose sight. Patients, employees, profits. That's the algorithm. You can't go the other way. You got to take care of the patients. You got to take care of your team. And how often are you meeting? So, we do a full like town hall meeting once a month.

And then the individual teams, the clinical nurses, the surgical nurses, the admin, the patient coordinators do weekly meeting.

Catherine Maley, MBA: I don't know why people don't do that to help with how to charge a lot / give a lot. You'll save yourself so much time and grief if you'll check in 30 minutes a week versus waiting till everything goes sideways.

Ryan Neinstein, MD: Yeah. That, that doesn't happen.

I mean, each, each clinic, each team texts and has a meeting once a week. The leaders from each of those team check in once a week, and then we have a town hall once a month.

Catherine Maley, MBA: No, I understand. Yeah. But I mean, you have to meet the, the people working together have to meet at least weekly to check in with each other, which helps with how to charge a lot / give a lot.

And then there's the big meeting where there's more division and, and where we're going.

Ryan Neinstein, MD: A hundred percent the front. Yeah. The, and I also think it's important. Everyone knows everyone and everyone knows everyone's name and everyone knows what they do. The front desk knows who the nurses are. The nurses know who, you know, the administrators are.

there's nobody working in silos. It's a free-flowing communication.

Catherine Maley, MBA: Have you had any issues with staff since Covid, pre Covid, post Covid, in terms of how to charge a lot / give a lot?

Ryan Neinstein, MD: No. Listen, I think you're always going to, some people are always going to have life experiences outside of work that impact their, you know, ability at work. And, you know, we try to do our best for each and every one of them to help them along.

Catherine Maley, MBA: What's been one of the biggest business mistakes you've made in relation to how to charge a lot / give a lot?

Ryan Neinstein, MD: So, I think my business biggest business mistake was not getting a big, a big enough space early. I kind of did that, you know, renting very small and slowly renting, but the actual costs, not just in the time of all of the maneuvering and moving between offices and only going up like couple hundred square feet.

Every time with the new furniture, the legal work on the leases, and, you know, it, it's, honestly, it's better to take a bigger swing. And, and that was my biggest mistake. It set me back financially, set me back chronologically as well. So, I would've just taken the elevator instead of the escalator. only. Only if you have, only if you have it in, you know, if you have it.

Catherine Maley, MBA: Right. You, you seem to have the stomach for that in regards to how to charge a lot / give a lot, because not many would take out 6,000 square feet near Central Park in Manhattan and hope to God it all works out.

Ryan Neinstein, MD: Did you listen? I have, I have fear, but I'm not afraid. Okay. Like, you know, I'm not, I'm not afraid and of anything doesn't mean I don't feel fear, but I'm not afraid.

Catherine Maley, MBA: So, when you were doubting yourself about how to charge a lot / give a lot, as you're paying that rent, every month was on, did you have that period of, God, I can hope I, I can pull this off, or you just knew it?

Ryan Neinstein, MD: Of course. Well, listen, when you sign that lease and you put a personal guarantee on, you know, eight figures, it's a big deal. But you know what?

That pressure either. Drives you or crushes you. So, it's a driving for me, it's a driving force for me. Pressure. It's pr, you know, I forget which person, which, which philosophers say, but pressure is a privilege. Oh, that's good. That's a good way. Yeah. You should be so lucky. Yeah.

Catherine Maley, MBA: Good for you though, for having the courage to play full out to help with how to charge a lot / give a lot.

Cause that was a big deal. And that was what, nine or Well, how long have you been in the new space? The new space?

Ryan Neinstein, MD: Two years in and we, four years ago signed.

Catherine Maley, MBA: So, you signed it four years ago and you did a build out. Is that what happened to help with how to charge a lot / give a lot?

Ryan Neinstein, MD: It did a big build out. Obviously, we were held back with Covid. But we persevered, we waited it out.

We made it.

Catherine Maley, MBA: Yeah. That's one of the issues with surgeons is it seems like your name has to go on the bottom line and you have to take all the risk. And a lot of other businesses don't have that. And you just really have to know yourself, you know, if you're up for that challenge for how to charge a lot / give a lot. And that's what it is.

It's either a challenge or it breaks you, one or the other, I guess.

Ryan Neinstein, MD: Yeah. I ex I accept all the risk and responsibility for everything, and, and I, I, I like that. I like being responsible.

Catherine Maley, MBA: Good for you. So surgical versus non-surgical, is it a big deal in your practice, in terms of how to charge a lot / give a lot?

Ryan Neinstein, MD: We're a hundred percent surgery. We just operate.

I saw it on your website, but it does So you don't have injectors. You're not trying, I have it. One of our nurse practitioners does a little bit of injectables, but we're like, you know, we're surgical practice and a lot of our PA we. The injectables are really just our surgical patients or a couple of younger patients, but a lot of it is like our surgical patients, just like when they're coming back for their follow-ups, they love the office and they just like want someone to do their toxin, you know?

Right. But I do zero. I do zero. We have no devices, nothing.

Catherine Maley, MBA: So, do you have any fear about the upcoming. What's going on in the world, in relation to how to charge a lot / give a lot?

Ryan Neinstein, MD: I don't want, I don't know what you want to call it, you know, the economy, whatever.

Catherine Maley, MBA: Do you have any fear about that, in regards to how to charge a lot / give a lot? And just being surgical? Do you feel like you could also grab them on the way down, grab?

Ryan Neinstein, MD: Well, I think, I think it would be naive for anyone not to have any financial concerns when there's macro-economic turmoil. That being said, I really believe in all businesses when things get rough economically. Industries tend not to shut down. So, the stronger, more predictable players within those industries tend to rise up.

You know, I do think patients will still continue to get plastic surgery even as the economic scenario deteriorates, but they're going to be much chewier. It's like, Hey, maybe I just won't go to this guy or that guy. Like, I'm going to, if I'm going to do it, I want to go to somewhere a little more predict. So, a practice that has, you know, a real structural d n a, like ours should be, should be well suited.

Catherine Maley, MBA: So, regarding your demographics, is there a typical demographic that you are trying to attract to your practice and is it working to help with how to charge a lot / give a lot?

Ryan Neinstein, MD: Yeah. Listen, our average patient is 35- to 45-year-old. It's, it's a mother of, you know, one to three kids who lives in, in New York City. Long Island, New Jersey, or South Florida, and, you know, they have, you know, similar socio sociodemographic, you know, things that they're into.

But we know who they are and we know how to get to them. And how's your word of mouth?

Catherine Maley, MBA: Because it's all working, in terms of how to charge a lot / give a lot. If you can get those people, especially, I love the tummy tuck group because they're usually older, more mature, right. They have the financial wherewithal more than the 20-year-old breast aug patient and mommy’s that they hang around with who also need your services, which can help with how to charge a lot / give a lot.

Ryan Neinstein, MD: So, so I'm almost a hundred percent mommy makeover is my operation. That's almost a hundred percent because of the tight-knit c. And I just find it provides such a deep, meaningful impact to people because they have real physical, structural changes that cannot be changed with diet or exercise. So, there's a low psychological burden to surgery.

It's not like, Hey, I just want to look better. It's like, you know, my core doesn't work. The skin is, is stretched and torn. Mm-hmm. So yeah, we have our key demographics that, you know, we choose in terms of your question based on word of mouth. So, we have the date on this. We're about 75% word of mouth, but I think the word of mouth has changed or matured a little bit.

Typically, what happens is someone will get my name from either their doctor or another patient, and then they'll follow us on social media for like three months. Then they're probably following. Lots of doctors and they are almost like interviewing you. They want to get to know you, see what your practice is like, see what your home life is like, see what kind of things you do.

They so that's, that's the typical story. Hey, my friend gave me your name and then I followed you for three months and now I've decided to make a consultation.

Catherine Maley, MBA: Right. And do you think they still got to your website or do you think they stopped at social media. How does this relate for you, in terms of how to charge a lot / give a lot?

Ryan Neinstein, MD: So, I think, I know we get a lot of traffic on the site and I actually think on, on certain pages, like the blogs that are deep dives into specific questions they have, I can, I know, I can see they spend a lot of time on those, on the generic pages.

I'm not saying they're generic. I mean it's all custom content, but like we're not going to write anything that's groundbreaking on breast augmentation versus every other plastic. But our custom deep dive blogs really give you more insight into what's happening in here and how it relates to the patient.

So, people do go to the website, they just do it in a different way.

Catherine Maley, MBA: Yeah, I, I honestly think nowadays, in regards to how to charge a lot / give a lot,, a lot of times a girlfriend mentions you, they go to your Instagram, then they go to your website, then they call or fill out the form. Yeah. It's gotten very zaggy and it's very difficult to tell. And a lot of times they tell you one thing on the phone, they tell you something else when they get there, then they tell you the real story when they get to know you better.

Ryan Neinstein, MD: So, well, it's important for the message to be cohesive, clear, and constant across all your mediums. So, it doesn't really matter if they get you on Facebook, Instagram, TikTok, or your. Everything looks and sounds and smells the same.

Catherine Maley, MBA: Well, you've done a good job with educational marketing to help with how to charge a lot / give a lot. I like that a lot.

Ryan Neinstein, MD: Cause that's, I've built my whole business on education. I all, all we want to do is be educational, informative and show a little bit of our personality so people get to know us. Yeah, pretty straight. That's pretty much it.

Catherine Maley, MBA: Do the patients ask if your wife had a tummy?

Ryan Neinstein, MD: Everyone asks everything. And you know, that's just human nature.

Catherine Maley, MBA: Yeah. Well, she's really a good walking, talking testimonial, and I wouldn't say if she did anything or not.

Ryan Neinstein, MD: You know, it's just, I mean, she's really a good she, she's the love of my life and I'm grateful to have her as the mother of my children and my life partner. Yeah. And you have a little boy and a girl.

I have a little boy and a girl, and there's nothing, you know, best thing I've ever done is a surgeons become a father. Not, it just, it, it helps provide such clarity in life.

Catherine Maley, MBA: Right. You probably get your priorities in order after that, which ultimately help with how to charge a lot / give a lot.

Ryan Neinstein, MD: Yeah. Life's straightforward with kids, you know.

Catherine Maley, MBA: Yeah. Well, and I, it's, it's chaotic, but straightforward I know you're showing them off on social. Some people don't. You do? Yeah. What's your philosophy on that and how it relates to how to charge a lot / give a lot?

Ryan Neinstein, MD: It's part of my life. It's who we are. We love our kids, you know, and I respect and everyone's opinions and choices on, on all.

Catherine Maley, MBA: They, you might change your mind as the kids get older and say, I don't want to do this, you know, then —

Ryan Neinstein, MD: A hundred percent correct. Exactly.

Catherine Maley, MBA: So, what is, what else is working for how to charge a lot / give a lot? So right now, the content is working, the social media's working. You're doing a good job. You've got 46,000 followers, so you're doing something right there.

Ryan Neinstein, MD: At the end of the day, there's only one thing that works is being an excellent surgeon and an excellent physician, just taking excellent care, being available.

To communicate, to be there for patients when they need you. That's, that's what, you know, everything else is great, but that's the real quintessential thing that matters. You being a person of, of, you know, real trust and compassion to the patients.

Catherine Maley, MBA: That's it. You need both. You can't just be a good surgeon in today's world to get how to charge a lot / give a lot. Who's going to know that?

Ryan Neinstein, MD: Someone's going to know you. You've got to, no, you got to get the word out, but great surgeon, you've got to do some good marketing

Catherine Maley, MBA: Take really good care of that patient so they don't say anything bad about you. And they might even, you know, ring your bell, you know, and tell everyone else about you.

I just think you have to have it all in today's world for the long run to help with how to charge a lot / give a lot.

Ryan Neinstein, MD: If you're in this for the long run, every patient should be treated as the, the one patient that you a hundred percent, a hundred.

Catherine Maley, MBA: It's too difficult to screw this up, you know, or not. No, it's too easy to mess this up, in terms of how to charge a lot / give a lot. That one patient, have you ever had that patient from hell and —

Ryan Neinstein, MD: No. I don't want to characterize again, you know, people, it's hard to see the world through someone else's lens. Mm-hmm. So, we don't allow any type of terminology around here, like difficult patient, tough person. We just, you know, they're. How do you meet ones that aren't, aren't feeling good to you? Well, I think everyone gets a little bit of a fighting sense, similar to, you know, dating and, but not everyone's a good match for each other, and that's okay.

Catherine Maley, MBA: So, I think you get a set to that, you know, one of the nice, or do you just increase your price or how do you handle that and how does that impact how to charge a lot / give a lot?

Ryan Neinstein, MD: No, I don't, I don't believe anything deceptive. Just, you know, Honesty, life's too short. You know, sometimes you're with a patient and you're just like, you know, I really don't think I'm the right surgeon for you.

I just don't think I can do what you want.

Catherine Maley, MBA: Do you know how many times they have given a bad review because of that? They'll literally say that, and it's like, I'm trying to be honest here, and I just don't think we're a good fit. And they'll say, Anne, he wouldn't even see me and he wouldn't help me. Anyway.

Ryan Neinstein, MD: Well, there, you know, Hemingway said there's a big difference between being defeated and being destroyed. So, everyone takes some hits and everyone takes some losses. You can't win everything, but you can be just, and, you know, honorable and ethical in every scenario. And then you, you know, you let the cards fall sometimes, you know?

But when you do that, you're going to win more than you lose. And if anyone tells you they don't have any losses in life, they're lying.

Catherine Maley, MBA: Yeah, for sure. Oh no. Everyone does the problem with social media and all of us where everyone's got their game face on, you know, and that's why I want to be more authentic and say, these are the issues that happened in this industry, which directly affect how to charge a lot / give a lot.

Like what would say your biggest challenge has been growing a practice. What has been your biggest.

Ryan Neinstein, MD: This is not enough time in the day. There's, I just, I want more time for patient care. That's it. You know, when you're running the practice and you're in an operating room, you're being pulled, you know, to do things to help with the business and surgery, and you want to spend more time with the patient. So that's a difficult balance.

That's the hardest time. Just need more time. That's why I get up to four in the morning, try to give myself an extra.

Catherine Maley, MBA: I hear you. I, I get up at five and I, it's, it's the only peace and quiet I get and I love it. I'd rather do that and, but then I have to go to bed at nine, you know, I definitely need eight hours. I'm not the four hours.

Ryan Neinstein, MD: Those are choices we make, but for a good reason. Yeah. Yeah. I just think better at five in the morning than I do at 11 at night, as we're Sure. Yeah. Things are clear in the morning. Make your difficult decisions in the morning.

Catherine Maley, MBA: Have you found it hard to balance business (how to charge a lot / give a lot) and family now that you have two kids?

Ryan Neinstein, MD: Well, I think balance is relative different stages in your life as long as you and your life partner understand, you know, if you're in a growth phase like we are, that I'm just not going to be around for a while. But, you know, the idea is that I'm going to invest more time now so I have more time later as the kids get older.

Right. So, it's important to recognize that balance, I think is a shifting structure and that, you know, I, you. Build a surgical practice working nine to five, Monday to Friday. That's just not possible. And it's not for everybody. It's not for everybody.

Catherine Maley, MBA: Well, a lot of those practices I work with, I think especially the older, some of the older people just, they're tired, which affects  how to charge a lot / give a lot.

They're like, I, I don't want to, you know, play this game as much anymore. But one of the issues is, or they still want to dabble in recon and do a little cosmetic, and I just say, You can do that, but that is a choice you're making because others around you eat, sleep and drink this, you know? Yeah. And how are you going to compete when someone's putting a lot more money into it?

A lot more effort.

Ryan Neinstein, MD: Yeah, listen, we're 20, we have 30 people, 24 7 pumping at one message. 365 days a year. We're relentless. And you know, we're not going to stop. Good. Okay. Tell us, tell us something we don’t know about. I'm an excellent water skier. I was a water ski instructor in high school. It was my, it was my, yeah, it was my first job I ever had, and hopefully one day it'll be my last job.

I'll go all the way. I'll circle all the way back.

Catherine Maley, MBA: Isn't the water super cold in Canada?

Ryan Neinstein, MD: Toughens you up.

Catherine Maley, MBA: I learned to water ski in Chicago in Lake Michigan, and it was brutal, but you certainly learned how to ski quickly. But the water was always like so cold, it never did warm up. It's a big leap.

Ryan Neinstein, MD: I always liked cold water.

Catherine Maley, MBA: Yeah. Yeah. And you don't do much water ski in New York, do you?

Ryan Neinstein, MD: Not much these days, unfortunately, but I hope I get to break, get my kids into it as they get older.

Catherine Maley, MBA: Yeah. How's your commute to assist in how to charge a lot / give a lot? Hopefully you live nearby, like you have a... I think everyone should have a short commute in today's world. It's so stressful to do all this work.

I think commuting is a shame. What do you —

Ryan Neinstein, MD: Three minutes.

Catherine Maley, MBA: Three minutes?

Ryan Neinstein, MD: Yep. That's fine. Three-minute, three-minute walk. Yeah.

Catherine Maley, MBA: Good for you. Well, thank you so much for being on Beauty and the Biz and sharing your expertise on how to charge a lot / give a lot. I really appreciate it. And if somebody wanted to get ahold of you and like pick your brain, how would they do that?

Ryan Neinstein, MD: So, we are located at Four West 58th on the 12th floor overlooking Central Park in New York City. You can follow me or message me at Dr. Neinstein on Instagram. And our website is www.NeinsteinPlasticSurgery.com. And you can find me at any of those places.

Catherine Maley, MBA: Do you happen to have a surgical suite that has windows?

Ryan Neinstein, MD: No.

Catherine Maley, MBA: That would be the ultimate, right? To help with how to charge a lot / give a lot?

Ryan Neinstein, MD: No, I wouldn't want it.

Catherine Maley, MBA: You wouldn't want it?

Ryan Neinstein, MD: No, because you should be so focusing on the patient, not the not central park During.

Catherine Maley, MBA: Oh, the ambiance. I think that sounds so good. I see. I watch a lot of the guys in Texas do that and it's just That's lovely.

Ryan Neinstein, MD: No, we take it, we don't, it's a hundred percent serious and our waiting room overlooks the Central Park and the Plaza Hotel, so I think that's a more appropriate place.

Catherine Maley, MBA: Yeah. By the way, we call it a reception area in Yeah. Nobody wants to wait (which facilitates better to charge a lot / give a lot). Yeah, just saying.

Ryan Neinstein, MD: Okay. Thank That's so true. That's excellent. Never heard of that. Thank you.

Catherine Maley, MBA: Catherine Maley, MBA: Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how to charge a lot / give a lot.

If you’ve got any questions or feedback for Dr. Neinstein, you can reach out to his website at, NeinsteinPlasticSurgery.com.

A big thanks to Dr. Neinstein for sharing his wisdom on how to charge a lot / give a lot.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It's guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I've gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let's grow your cosmetic revenue.

-End transcript for “Charge a Lot, Give a Lot — with Ryan Neinstein, MD”.

 

 

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#increasesurgeryprofits #givebacktopatients #ryanneinsteinmd

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and offsetting your overhead.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "Offsetting Your Overhead — with Jason Pozner, MD".

It’s common for surgeons to take out a huge loan and do a build out of their dream practice but then the bills to pay for all of it start coming in.

They quickly notice when the OR is idle and the exam rooms are empty, that’s costing them money.

It’s an uncomfortable feeling.
Should they bring on another surgeon to help cover the costs?
Should they hire a nurse injector to bring in more revenues?
Should they get more creative?

In this Beauty and the Biz Podcast episode, I interviewed Dr. Jason Pozner, a board certified plastic surgery with 30 years experience of learning and training on the world’s most advanced plastic surgery procedures, laser treatments and skin rejuvenation treatments.

Dr. Pozner is the founder of Sanctuary Plastic Surgery and co-owner of Sanctuary Medical Aesthetic Center in Boca Raton, FL.

He has experienced all the above scenarios. From expanding to almost going bankrupt to bringing in others to help (some good, some horrendous) and he finally found a balance that works.

Dr. Pozner dropped so many pearls, you want to hear this.

Visit Dr. Pozner's Website

P.S. If you want better results from your advertising efforts, the solution is to fix your lead gen process. Watch this video…..

Enjoy!

Catherine Maley, MBA

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

OFFSETTING YOUR OVERHEAD — WITH JASON POZNER, MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and offsetting your overhead. I’m your host, Catherine Maley, author of “Your Aesthetic Practice, what your patients are saying”, as well as consultant to plastic surgeons to get them more patients and more profits. Now, I have a very special guest today because I’ve known him forever and he’s really tough to track down, and who will discuss on offsetting your overhead..

It’s Dr. Jason Pozner. He’s a board-certified plastic surgeon with over 30 years’ experience learning the world’s most advanced plastic surgery procedures, laser procedures, as well as skin rejuvenation treatments. Now, Dr. Pozner is the founder of Sanctuary Plastic Surgery and co-owner of Sanctuary Medical Aesthetic Center in Boca Raton, Florida, and who knows about offsetting your overhead.. And we’ll learn more about that.

Dr. Pozner, who is an expert at offsetting your overhead., graduated from Icahn School of Medicine at Mount Sinai where he trained for five years doing an intensive general surgery residency. He then completed his plastic surgery residency at State University of New York Downstate Medical Center, as well as two fellowships in microsurgery and aesthetic surgery at Maryland’s esteemed Johns Hopkins Hospital.

Now, Dr. Pozner is a member of numerous professional medical societies and has received several awards and honors as a top-rated surgeon by patients and peers alike, not to mention knowing about offsetting your overhead. Dr. Pozner, welcome to Beauty and the Biz. It is a pleasure.

Jason Pozner, MD: Thank you so much. I hate it when people read my bio. I hate it.,

Catherine Maley, MBA: I had to condense it and congratulations on knowing about offsetting your overhead.

Jason Pozner, MD: You have, I know. I, I just listen, it’s just a, I was just like board certified plastic surgeon in Boca Raton, Florida, and that’s easy for me.

Catherine Maley, MBA: Oh, so how did you become a plastic surgeon and get to knowing about offsetting your overhead.? Because I do know your father was in the medical.

Jason Pozner, MD: Yeah, it’s my, my dad who’s deceased a couple years was an internist who did a lot of weight loss and, you know, I, I was kind of interested, it was interested in some of the stuff he did and, you know, if I wasn’t plastic surgeon, I might have been an endocrinologist, but I hated all the medical stuff, so I kind of fell into plastic surgery.

You know, the people ask me this question a lot, like, why you do plastic surgery? Why do you like it? And, you know I, I kind of like MacGyver, you know, it’s sort of like my idol and stuff and I’m sort of, kind of. Good to figure out different things. So plastic jewelry is like very MacGyver. There’s no right or wrong way to do stuff.

It’s how you get it done and there’s lots of ways to do it. That’s what’s fun for me.

Catherine Maley, MBA: That’s fantastic. So, did you end up like, gimme a quick story on knowing about offsetting your overhead because I know you didn’t start in Boca Raton, how did you?

Jason Pozner, MD: No, no, no. End up in Florida and private practice. So, what happened was I did my you know, after I finished my residency, I wanted to learn more aesthetic surgery and I grew up in general surgery in the endoscopic days, laparoscopic days.

You know, in the beginning we were, everything was open. And then midway through my general surgery training, we were doing lap, lap gallbladders, lap lab APIs, all that kind of stuff. And I had done a lot of laparoscopies, so I kind of liked that. So, I did a fellowship in Baltimore with Oscar Ramirez, and I was on staff at Hopkins at the, at the time math faculty appointment there.

And we had done all of the endoscopic classic surgery things. We taught a lot of courses. So, it was really fun. And then I joined this practice for a year, and then I got an offer to come to Florida. So, I kind of worked in, in a, some chop shop for a year and a bit to get my boards and just get a bunch of cases.

And then I had enough of everybody and I just opened up by myself. I had like no money. It was like, oh, almost went broke a couple of times and then kind of built it up from there. You know, it wasn’t easy. I opened up this practice. We had an operating room in the practice. It was basically taking over another plastic surgeon’s practice that moved to a different location, so spruce it up and then like a month and two into practice there.

Florida banned office surgery for a while, so it was like, oh, what am I going to do? So that was, that was early on. And then we lived through a lot of stuff. We lived through 2008 and a lot of ups and downs. So, you know, pretty good right now, but you know, you never know what, what time we’ll bring.

Catherine Maley, MBA: I didn’t know that about Florida, I mean am I correct in an assuming Miami. That’s the wild, wild west there with Search Street. So how long did they shut down doing surgery to knowing about offsetting your overhead?

Jason Pozner, MD: You know, it was a couple of months. It was a good couple of months. It was in, I think 2000 when I first got started in, in, in my private practice location. But what happened was, you know, they had a bunch of deaths in the office operating room and so they really tightened up the regulations, you know, and I got to tell you, it, it’s probably for the better.

The regulations are good and they do have problems in Miami with a lot of cases. And they tightened up the regulations again recently. With all the BBLs going on and all the deaths from BBL L but over the last few years, they’ve kind of left us alone because they’ve had such a bad opioid epidemic so that they’ve really been concentrating on all the pill mills and things.

I mean, just north of us in Delray and just a little north of where I’m in Boca is one of the rehab capitals of the world. So, they, they do have a lot of problems with pills and rehab and drugs. It’s pretty bad. But you know that, that’s, that, that’s the story with that.

Catherine Maley, MBA: Yeah. Any tips on the surgical center though, building it out, or did you take over a practice that was already just to go and start knowing about offsetting your overhead?

Jason Pozner, MD: Well, they had a rehab. Yeah, they had a, I mean, they had a small, they had a, they had an OR and basically, I just got quad A accreditation. Learned a lot through that. You know, I think the best advice with this nowadays, if you’re asking me what to do is hire a consult. You know I think that there’s too many rules.

It’s very hard to do it yourself. And you know, we’ve had a consultant and we’ve been under contract since I started for the last 20 years, with, with the same group that basically helps us every year they do peer review for us. They check out, or they check our crash cards. It’s hard to do it yourself and not worth the time and effort higher.

There are very people who know this like the back of your hand and you really should go to them. And there’s many good ones across the country. So, I that, that’s my recommendation. Don’t do it yourself.

Catherine Maley, MBA: It’s a pain in the neck for sure. Yeah. Did you know, you do general anesthesia, but you also do IV sedation and learning about about offsetting your overhead?

Jason Pozner, MD: Right.

Catherine Maley, MBA: Are you offering while knowing about offsetting your overhead? Why offer both?

Jason Pozner, MD: Because I, I like… Well, you know, it’s, it’s, it’s, it’s actually really, really simple. I have an anesthesiologist; I like an MD in the practice. I mean, early on in my career, I had a problem working in a sur when I first got to Florida, working in a surgery center.

And there was a case where had a C R N A and they caused a problem. And I was responsible for the CRNA’s behavior and problem because if you, if you have a C R N A, you’re responsible as a. So, in practice I’ve only worked with MD anesthesiologists because, you know, it’s their responsibility as well as my responsibility, and I like that.

I like having that MD in the practice. So that’s just off the, that’s right off the top. So, I have an anesthesiologist and when we book a case with the anesthesiologist, he discusses with the patient what type of anesthesia to do. And if it’s an older facelift patient, oftentimes it’s IV sedation. If it’s a younger one, often it’s general, but we go back and forth between the me and the anesthesiologist and the patient as to what’s best for the patient.

But we also have a minor room and I also do a lot of local anesthesia cases when I run my numbers. Now, a third of gross revenues are local anesthesia cases in our, in our operating, in our, in our surgical center. So, this is a separate business from our med spa. So, we discuss numbers. I won’t discuss any non-surgical numbers as a separate portion.

I’ll, I’ll put group then in my med spa. So, we actually just, we have two separate practices. I have a surgical practice and I separated out the med spa business around 15 years ago. And we’ll talk about that later cause we’ve had some ups and downs and it with that. And we’re in a good place now, but definitely have some lessons to be learned from that.

So, my surgical practice so I have an OR and I have a minor room. And the minor room will do pro and we’ll do some mild oral sedation, which I’ll also do in the operating room. So, for example, Today I did Minit mini tummy Tucker, and some lipo was my first case. Okay. Came out of the first case, general anesthetic case.

Case. Went into the recovery room. I went right into our minor room and I did a minor laser procedure. Patient had pro on board. We monitored the patient, but they didn’t have any oral sedation. They just had products for that particular case. I think I did some chest bbl or, or moxie or something else on the face.

I don’t remember. Then I went back in the, OR did another general anesthesia case. That was a, a revision breast case, which I, I do a ton of revision breast, the revision breast case. Then went out of that, went back into the minor room and did a little la, another laser case, and then went back into the operating room.

And I did something weird. I took a vein out of someone’s hip forehead, immuno know surgically, and then I did a, my elevate neck procedure. So, so I went back and forth all day. So, two general anesthesia cases and four little, little short cases. And that’s my typical day. Tomorrow, I have three general anesthesia cases, and I think two couple locals too.

Catherine Maley, MBA: Are you finding the patients are asking for less anesthesia while knowing about offsetting your overhead?

Jason Pozner, MD: Yeah, and it’s, it’s different. I think we do a lot of lo we do a lot of smaller things now. I think the key to a successful surgical practice is we can’t think like we did 20 years ago where everything was big in asleep, in multi parts. Many times, people just want lower eyelid laser.

I mean, Monday, one of the cases I did actually Tuesday before I even started clinic, I have clinic on Tuesdays. I did two little cases and one was a removal of breast implants under local. And the other one was a lower eyelid laser. And it was considerable revenue just for two cases. And I, I started at seven, I was done by eight 15 with two cases.

I bounced between two rooms. I mean the, the, you know, sometimes people just want their implants out. They want to see what’s going on. So, this lady had saline implants. I made a small infa incision. I punctured the implant and pulled the bag out. And I mean, I was literally done in 15 minutes, but it was a couple thousand dollars and it was, you know, cost of goods were one two sutures.

Catherine Maley, MBA: So, I know that you also brought another surgeon on board in knowing about offsetting your overhead. Yes. So, it’s called Sanctuary Plastic Surgery, Right? So that is you, the surgeon team, the anesthesiologist in knowing about offsetting your overhead?

Jason Pozner, MD: Gotcha. And a little bit and the other surgeon. Yes, yes. And we actually have a couple surgeons. So, you know, I, I, I learned early on in that if you wanted survivability should not be in your name.

No. If you want to sell a practice or somehow divest a practice or grow a practice down the road. Jason Pozner, MD I is not probably the best name to have. The building is called Sanctuary. The area behind us is a, is a housing development called Sanctuary. So, I think I spent $10,000 on a marketing company to name the place based on a book I read in like one of these airport books.

The guy wrote a lot of marketing books and I hired him to come up with the name and he was terrible. He was just terrible. And the name of the place was Sanctuary. So, he said, oh, sanctuary sounds good. So, we called it that and I hired a junior guy. He did a fellowship with, he did, he spent a year with us right out of his plastic surgery training, did great.

And then he was programmed to do a hand fellowship and then he came back and he’s been with me for almost a year and a half now. Excellent. Doing really well. I’ve had other people join me in the past that did not work out. It’s not so easy. You have to really get along with someone. I’ve learned a little bit what to look for a little more now.

Catherine Maley, MBA: Like what, cause that’s the big challenge in knowing about offsetting your overhead is trying to bring somebody on board that you clearly tolerate. And not only that, right? Like actually have some really good synergy with, I find that you’ve got to, it’s hard.

Jason Pozner, MD: It’s hard. I mean, it, it’s hard. I mean, it’s better if they spend some time with you. So, I’m associated with both Cleveland Clinic, Florida, and University of Miami, so I do get the residents from both.

So, it has to be someone that one has the same mindset towards patient care. I think that’s the main thing. I mean, if someone’s a cowboy and doesn’t care about the patients and you do, probably not the best person to have in your practice. The other thing is good skillset. I mean, I, I won’t take anyone with bad hands.

And then the other thing is, you know, I write a lot of papers and do a lot of academic things. So, I’ve had people who are less academically minded and they didn’t fit well with our practice. Dr. Cook, Jonathan Cook was with me. He’s, he’s more academically minded than the people I’ve had in the past.

We’ve co-written, like, he’s spent a year with me. We wrote like 12 papers that year. And we, we do a lot of writing, we do a lot of clinical trials. We do a lot of involved with a lot of companies. I brought him into every deal with every company now, and he sits on our conference calls. We had a standing call every Tuesday night with Cyan, and he’s part of our group.

So, he works really well with me and, you know, look, always some learning curve with, from both sides, but he’s doing really well with us. I decided that I, I turned 61 a month or two ago. Congratulations. Getting old. Getting old, thank you. 61 was nothing. 60 was hard. 60 was hard, but you know, it’s like, I’m, I, like I said, like what do I want to be when I grow up?

You know? And like, I’m kind of getting to that age. I’m like, I, I really don’t enjoy doing lipo, you know, we do well with it. But I’m like, so Jonathan, you do all the lipo, unless it’s combined with something else. I enjoy doing faces and breasts and I like doing those, and especially revision breast. So, if I can kind of do that for the next 10 years or so, I’ll be happy.

Catherine Maley, MBA: And then so did you bring him on as a fellow or as a, what did you bring him on in knowing about offsetting your overhead?

Jason Pozner, MD: So, so the first year that he was out of his resi, out of his plastic jury residency, I brought him on as a junior attending rather than a fellow. So, I, I could have had a… I could have applied to ASAPS for an aesthetic fellowship.

I did not. I just brought him on as a junior faculty. And the reason I did that was if I brought him on as a fellow, he wasn’t, that didn’t count towards his board eligibility. So, I brought him on as a junior faculty. He was able to accumulate enough cases to take his boards and pass his boards. So then when he came back after his hand fellowship, he came back as a board-certified plastic surgeon, not as a board eligible doctor.

C collecting cases got, so he hit, he hit the ground running and it really worked out. That was a good move for us to do that.

Catherine Maley, MBA: All right. That’s a really good pearl. But now what is he in knowing about offsetting your overhead?

Jason Pozner, MD: He’s a board-certified plastic surgeon in the practice. He’s doing a little hand you know, not too much, but you know, he’s doing a lot of the, I’m trying to send him all the lipos, all the BBLs and all the stuff that I don’t want to do.

Catherine Maley, MBA: And did you bring him on as an associate in knowing about offsetting your overhead?

Jason Pozner, MD: So, so, so, so he is a, he’s an employee of the practice. And his, his deal is two years employee of the practice. And then we’re going to talk about partnership this, this coming August. W when he’ll be there for two years.

Catherine Maley, MBA: I have found the two- and three-year mark is where things start either gelling or going sideways in knowing about offsetting your overhead.

Jason Pozner, MD: Right, right. You know, that makes sense. So that’s why I waited two years and then, you know, and then the deal will be, we’ll, we’ll work out some deal, we’ll get an independent evaluation of the practice for numbers and things like that. And then he’ll probably vest over a few years.

So, time for him to pull out. I don’t want to make it onerous on him. You know, gurah and Bill and, and Joe hen Said’s practice had a successful buy-in to his practice and that we’re, and Barry’s working on that as well. So do Bernardo. So, we’re kind of looking at looking to them as models, but we’ll want to be happy.

I wanted to be good for everybody. I’d like him to continue the practice. And I’d like to be able to work there till I feel like, till I feel like I don’t want to work there anymore.

Catherine Maley, MBA: Right. There’s a balance though in knowing about offsetting your overhead. What happens is a lot of the surgeons who want to bring somebody on, they’re so kindhearted, they actually give them their patience, put them in their marketing.

Right. Really invest in them. And then, you know, later they, they can do it on their own and they don’t realize what they, it’s hard in knowing about offsetting your overhead.

Jason Pozner, MD: And, and I think, I think that the people nowadays oftentimes don’t have the same work ethic as someone who’s a little older.

Catherine Maley, MBA: Honestly, I think that’s true in knowing about offsetting your overhead.

Jason Pozner, MD: And, and I’m not saying it’s a bad thing, you know, maybe a little bit better work-life balance is better.

I mean, I’m certainly, this is my third night of conference calls and then I have one again tomorrow. So, it’s four out of four out of nights with, with calls and maybe, maybe that’s not so good. Maybe a little bit more leisure time. You know, getting to the gym is a good thing. But I am going to hit the gym after I talk to you tonight.

Catherine Maley, MBA: I did I did a podcast with somebody and he literally said, I’m not going to kill myself. I’m going, I’m going home for dinner every night. I have little kids at home. And I thought, I’d never heard that before, especially in knowing about offsetting your overhead. You know?

Jason Pozner, MD: Yeah. I’m, I’m still, I’m still killing myself. I mean, it’s, it’s, it’s, and you know, and part of the deal is, is, you know, maybe I don’t quite have depression mentality, but I’ve lived through some ups and downs in the practice.

I, I’ve been through prep times. Things weren’t so good financially, and, and I’m ho I’ll be honest about it. I kind of know what to do and what not to do, but things are good right now. And the question is, are they good? Because I’ve hit my stride. I’m a certain age, people move to Florida, our results are good, you know, or certainly not the economy because friends in other markets are telling me that the economy is taking a hit a little bit.

And we haven’t seen it yet in Florida. I’m not sure it’s because of our governor and our business in the state of Florida, or because people moved here or because, you know, we’re doing a good job in our practice. I don’t know. And frankly, I don’t care. It’s going to, I’m going to take it, I’m going to keep at it while the going’s good.

Catherine Maley, MBA: It’s a good time to be in Florida and know about offsetting your overhead. My God.

Jason Pozner, MD: Weather’s good. Look, I’m sitting on the beach even though it’s night right now. No, my background. But it’s, it’s nice. It’s warm here. People are here. There’s good business right now. You know, it, it’s interesting, you know, it’s, it’s a slow down a little bit from the mid pandemic in terms of.

No, we, when people came in for a consultation last year, they took a spot right away. They’re like, listen, my coordinator said, you know, we got a spot in five weeks from now, or six weeks from now. The next one’s a month out from there. You know, I, and I’m not booked six months out. I’m booked out about right now.

We’re booked out around six to seven or eight, eight weeks, something like that. But there’s a couple of holes the end of January. But I do a lot of surgery a week. I mean, I’m not the guy who does those surgery and goes home, you know, we did 6, 6, 7 cases yesterday. I got like five, six cases tomorrow. So, we’re, we’re pretty busy.

Catherine Maley, MBA: Yeah. Do you the, the surgical side, then there’s the non-surgical side, but medical center and knowing about offsetting your overhead?

Jason Pozner, MD: Yes. Yeah, we, we kind of changed the name. We almost won bankrupt a couple times there. Okay. So, so in 2008 I split off this. What happened was, I, I have a space, my space is five 6,000 square feet. That’s my surgical center, and we were doing injectables and everything there from 2000 to 2008.

There was a space next to us. So, the building I’m in is an office building, and our particular building has two suites in it. It’s a one-story building. There’s a couple of towers next to us with an underground parking lot. That’s our, that’s where we are. And the place next to us was a, first was a travel agent or something, and then it was a yoga studio that didn’t last.

And then the place became available. And then I don’t, I think it was, I don’t know if you remember, we bought it right away or rented it. And then bought it. But we ended up buying it and I started this medical center with David Goldberg, dermatologist from New York. And we split off the non-circle and he was coming down and we started, we were doing pretty well.

We actually opened an anti-aging center in the next building over. So, we were doing really well from that. And we were, we were, we were, well, cash was coming in, we were. But we, we kind of decided to expand and that’s where we really had some problems. We hired a guy who was a former Navy captain, who, who was running our practices, both my surgical practice and the med spa practice.

And he didn’t watch the bottom line. And I think this was a big learning lesson. I mean, you really need to watch the bottom, bottom line with this. So, we expanded too fast, we almost went bankrupt. We had some problems and a business guy bought him out and then he was terrible, pro terrible. He got us out of the financial issues, but he was probably one of the evilest human beings I’ve ever met.

Oh my God. Terrible. Just evil. But eventually what happened was I got introduced to these two young Harvard MBAs and they were doing their senior thesis at Harvard and they came to visit me one day through a, through actually Barry de Bernardo, and they said, we just want to pick your brain. And I sat with them for an hour or two.

They were nice. I told them around or took around and they, they had picked the brains of a number of people, including Grant and Renado and, and Jay Austin at Harvard. And they picked my brains and they wanted to be in Florida. And then basically like six, eight months later, they bought out my business partner.

And so, they’re my partners in our med spa. And since then, we’ve, we’ve bought a couple of other practices. They’re well-funded. We have practices now in North Carolina, Virginia, and San Diego. We have 11 med spas. And by the end of this year, or beginning of early next year, we’ll have 14. How interesting.

Catherine Maley, MBA: Yeah, it’s really good. You didn’t grow the surgical side, you just, you just veered off the med side. So, you probably have LLCs or separate topics in knowing about offsetting your overhead, right?

Jason Pozner, MD: Absolutely. Everything’s different businesses, everything’s different corporations. So, the surgical side is one corporation. So, when don’t we do surgery there?

We do some lasers there. Any kind of more of the lasers that require a little bit of anesthesia. Pro Knox, whatever else. And in the med spa, we, we have two dermatologists that work there. We have a lot of extenders. It’s about 6,000 square feet. Fairly bi, fairly busy, really busy. We have a lot of devices there.

We pretty much have everything known to man. And so, the other practices have some different technology, but normally in Florida we test all the technology and something works well, we’ll roll it out to other places. Like we, we had the first Soft waves device a couple of years ago, right after, during Covid we got it.

I bought it and we did well with it and then we rolled it out to North Carolina and they’re doing really well with it there. And I think we’re going to roll it out to San Diego next.

Catherine Maley, MBA: So, so you’re doing your franchise, which helps with offsetting your overhead?

Jason Pozner, MD: It’s a franchise. It is, it, it is. And eventually we’ll flip it or something, but it’s kind of nice because I don’t have to worry about the administration or worry about the front desk or worry about the marketing or worry about who’s who, which ma is working in there.

I worry about my surgical side and I let them worry about the other side and, and I’m the medical director, so I, I deal with the patient aspects of things and doctors are having problems or problems with patients. I deal with them, but I don’t have to deal with the administration. I think it’s a very nice balance because if I was trying to expand the med spa and run my practice and do research and be on podcasts and do other things, I mean, it’s kind of difficult.

I, I don’t have any time as it is, so I think it’s a nice way to kind of accomplish my goals, which is, you know, grow that and still be involved and still do teaching and still do new te. It worked for me.

Catherine Maley, MBA: Did you bring private equity in while knowing about offsetting your overhead?

Jason Pozner, MD: And now they, they’re funded from, they went to Harvard for their MBAs and they’re funded through some Harvard alumni.

So private funding, not a big PE group yet, but that would be the next round. Once we get to a, once we get to a higher number. That’s very interesting. It’s, it’s, it’s working well. So, if you know any med spas with, with a plastic surgeon who are looking to do something, please have them contact me.

We’ll, we’ll, we’ll take a look at you. They’re very easy to deal with and, and that’s what I like compared to my previous business partner, not Goldberg. Goldberg was great to deal with, but compared to the previous business partner I had who was very micro, he was micromanaging everything. I mean, he was terrible.

These people that kind of leave us alone to do the medicine. But you know what happens is we talk about what technology to buy for the other practices because I get a lot of stuff for free to test and you know that’s part of the deal. I’ve been in this business a long time and you know, if you like something we’ll buy another 10 devices for the other practices.

They don’t get free stuff there. I do test it so it works well. Feeds me in inhabit of new tech.

Catherine Maley, MBA: Is the point of going with you to they would get a better, they would get group pricing discounts while knowing about offsetting your overhead?.

Jason Pozner, MD: Yeah, we absolutely we’re, we’re, I think we’re number 13 in Allergan for the country right now, so, so we, we buy a lot.

We do get some group things, but, and also, you know, some of the people just don’t want to manage stuff anymore. I don’t blame them. It’s, I, I like to be in the operating room and I don’t like to have to deal with pt o time and this one wants a raise and this one’s sick and this one’s car broke down and this one doesn’t one that come in today.

You don’t have to pain in the neck. No, it’s none, none of us want to deal with that. It’s, you need a good office manager for that and, and frankly, you know, still, even with the good office manager, it comes back to you. So, this allows me to just manage the 12 or so people on my surgical side and not have to worry about another 20 or 30 people on the med spa side.

Catherine Maley, MBA: So, you have peace of mind knowing that they are watching the numbers while knowing about offsetting your overhead?.

Jason Pozner, MD: Believe me, they’re really watching the numbers. I mean, they, they know it. That everything down to every penny. No. And I watched surgical numbers. It’s a little easier to watch the surgical numbers. Right. You know, it’s a lot different on the cost of good side of things on surgery.

And matter of fact, I sat with my office manager today and we went over November numbers. Mm-hmm., you know, and you know, it takes a couple days after the end of the month to come in and we looked at our profits, we looked at, you know, things like that. And we’ve been pretty consistent every month this year, which is very interesting.

July was, one month was a little slower cause I was out of town a little bit, but that was, that was it July And it wasn’t that much off.

Catherine Maley, MBA: So, you have two surgeons working in your surgery center, but what about those others while knowing about offsetting your overhead??

Jason Pozner, MD: There’s more, there’s more. Just wait. So, there’s me and Dr. Cook, you know, and Florida is, I like older surgeons and I like older surgeons.

They’re oftentimes in Florida. You know, this is a great retirement place. I know so many plastic surgeons now who have houses in Florida who want to play golf, and I don’t play golf. I’m trying to put them together for a golf meeting. But I like older surgeons who still want to work a little bit and don’t want to open up a new practice or run a practice.

So, Alan Gold from New York worked with me for a number of years. He came down here, he came down a week, a month because he had a place in Florida and he wanted to retire here. And he had a retirement plan. So, he came down a week, a month. He did noses and faces and we had him on our quad, and it was, it worked really well.

And, and then he became full-time when he, he sold his practice to Larry Bass in New York, and he moved here full-time and he still went back and took care of a few patients and then finally cut ties to New York and was here full-time. And he worked with us for a number of years and he, he retired. He just retired this summer.

He said, all right, I’ve had enough.

Catherine Maley, MBA: Were you, were you getting him, the patients, like when he was coming down monthly while knowing about offsetting your overhead?, were you setting him up and he was just doing the surgery and some were…?

Jason Pozner, MD: Some were his patients from New York who, you know a lot. There’s a big New York Florida connection. So, a lot of his patients from New York found out he was here.

And then also I decided that, you know, look, I wanted to concentrate on face and Bre face and breast. And he’s such a, he is such a, an experienced nasal surgeon. I sent him all the noses. Okay. So, you know, anyone who wanted a nose got to him and he did a lot of faces. And finally, he said, all right, I’m not doing faces and eyelids anymore.

He did mine five years ago, but he said, I want to do that anymore. I just want to do noses. And for the last couple of years, he just did noses. He did a couple of months; he did a great job. And then finally over the summer, he said he was going to retire. And I have another doctor, Rhonda, Rhonda Walker from Rondy Walker from DC who’s coming down part-time now, and she’s doing some of the noses with us and.

No, I kind of l look, look at life like FARs Gump. You have to look at opportunities. Uhhuh, and, I don’t know, about eight months ago or so Elliot Jacobs from New York came down and he brought his wife to me for, for a, a light, a little laser procedure. So, a little HIPAA violation here, but whatever. And, and she was nice.

We did a very light laser. She’s a beautiful woman, didn’t need much. We just did a little, a little, you know, a little aesthetic laser stuff. And I got the talking with him and he was in the process of selling his practice, closing it down and renting his location. And, you know, he came down, he and he sent me an email, says, look, I’d really like to talk to you.

I’d like to keep working. So, he came down here and he only does male gynecomastia and female to male top surgery women, transsexual women who want to become men. That’s it. Nothing else. Little lipo here and there, but that’s it. And he has these patients that are coming from all over the world because he is a true master at these things.

I mean, I’ve never seen better gynecomastia than, than he’s, than he’s done. So, he came down and I made it easy for him. I made him an offer he couldn’t refuse. We got him hospital privileges and got him on our quad, and he’s doing eight, 10 cases a month.

Catherine Maley, MBA: Out of your facility or at a hospital to help with offsetting your overhead??

Jason Pozner, MD: My facility, my quad, a facility.

So, you know, what I’m trying to do is maximize my or time. So, I operate three full days a week, Monday, Wednesday, Thursday, and Tuesday and Friday were dead days. We had this space, no one was using it. My anesthesiologist wanted to do some work. And so, Elliot plugged in mostly on Tuesdays.

We did two cases yesterday. I mean yes, he did two cases yesterday. So, I mean, he’s, he’s busy and it, it’s great. And it gives him a sense of purpose. It, it takes, it covers my overhead a little bit. The one thing is if you’re looking to add another surgeon to your practice, you can’t, you’re not going to get rich on another surgeon.

You, you can’t think of it that, Which you got to think of it as whoever comes and works with you is offsetting your overhead a little bit. Right? Maybe I could take a week of vacation and the payroll’s paid by him that that week because he’s doing some cases, or maybe the light bill’s being paid or some of the, some of the rent.

But it, it offsets, it, it, it eventually puts profits in your pocket, but you’re utilizing your facility a little bit more. Your variable costs go up, but your fixed costs don’t change.

Catherine Maley, MBA: Right. Then what about your other, the, the surgeon you brought in, the younger guy where, when does he do surgery while knowing about offsetting your overhead??

Jason Pozner, MD: He, he also works on Tuesdays and Fridays and some of the other days, and he’s doing a lot of local cases in our, in our minor room.

And he also does some hospital cases. Like today, he he’s working on Friday. He’s got a big ca he’s got a big case on Friday. He actually had another case on, so I think Elliot did a week, a case or two on, on Tuesday. And then Jonathan did a case after that. I think actually Elliot only did one case on Tuesday, and Jonathan did a big case afterwards.

Catherine Maley, MBA: Okay. But I’ve also seen other surgeons on your website, like Devar Barry, whom I assume knows about offsetting your overhead.

Jason Pozner, MD: Yeah, Barry comes down once in a while and, and so does Dan delve once in a while, but we haven’t seen Dan since Covid, but they were just in Florida doing some, doing a case here and there. Okay. Just to kind of play, play around.

And Barry and I do some research stuff, so he is on my door and on my website and things. Cause he’ll come down once in a while for some research things. But it’s mainly, right now it’s me and Jonathan and Elliott Jacobs and Rondy Walker is kind of ramping up a little bit.

Catherine Maley, MBA: And then is there a plan about offsetting your overhead?? Like what’s your, what is your plan?

Do you have an exit strategy or is that right now, you know…?

Jason Pozner, MD: You know, I don’t know. I’m 61 and I’m, you know, thank God I’m right now in good health. But, you know, that could change if health, if health changes a little bit. But, you know, I think the key is work, you know, surgeon work out a lot. Make sure you’re in good shape.

Keep your diet, keep your weight under control. So, I, I try to really stay in good shape, but I don’t know, I’d like to cut back a little bit, but I think what I’d like to do is just again, focus on, on breast and face. And if I don’t, don’t do another lipo in my life, I think I’ve done enough in my life.

That’s fine. Thinking of all the lipos. Yeah. Yeah. Shoulder hurts and Yeah. Whatever. You have to figure out what you like to do.

Catherine Maley, MBA: You, I like revision point to pick and choose what you want, while knowing about offsetting your overhead??

Jason Pozner, MD: Yeah. I mean, I like, I like revision face and breast revision. Breast and face. That’s what I like to do.

Perfect. I mean, I’ve done f so by the end of this week we’ll have done six revision breast cases and I think two, two or three face cases, it’s a lot.

Catherine Maley, MBA: Be nice. Yeah. Okay. Alright. Do you, and by the way, everyone says they’re going to retire and then when it gets closer, they say, oh, another five years. Yeah.

Jason Pozner, MD: Yeah. I don’t know. We’ll see. We’ll see. I mean, look, I, I’d love to take off Friday afternoons, but it’s not happening right now.

Catherine Maley, MBA: Yeah. That’s a goal, just work four days a week to help with offsetting your overhead?.

Jason Pozner, MD: But I, but I don’t want to, what to do with myself. Right. I just, I just, I just like to get home early enough on a Friday to work out. That’s all.

Yeah. I worked a couple; the last two days were 11-hour days. I mean, that’s still a lot. I’d rather work an eight-hour day and go to the gym. I hear you.

Catherine Maley, MBA: Yeah. How about Cheryl, your practice manager, how instrumental has she been? I’ll tell you what, you’ve gotten very good at letting go to help with offsetting your overhead?. Like, you know how most surgeons want to control the heck out of everything, right?

And it sounds to me like you have let go.

Jason Pozner, MD: Yeah. Can you Well, I’ve had good and bad, I’ve had good and bad over the years and, you know, when I needed a new a new administrator, I went to a head hunter and, you know, I, I interview people from head hunting and Cheryl by trade is an accountant. She’ll still do, she’ll do a little counting on the side.

And I was looking for a good business manager to manage all the books and, you know, it, it, you know, it took a while, but, you know, she’s a, does an awesome job. One, I trust her. And that is, that is the key to that. And then the other thing is, you know, there is a little bit of division of responsibilities and things like, like just what, any practice, you can’t have one person holding all the money cards, you know, the, you know, the money comes in with the coordinator and Cheryl goes to the bank and leaves me the cash deposits and other things.

So, you know, everybody watches everybody and, you know, and I, I trust her a million percent, but still, you know, it, it’s still a business. And I have been stolen from in the past as pretty much every other plastic surgeon. So, you got to watch the, watch the numbers, watch the monio, it comes in most of the time nowadays it’s all credit cards.

Anyway. And, and, and the other thing is, you know, back in the day, many surgeons used to cheat the IRS out of dollars and things like that. And I think that’s a bad idea. Everything’s computerized, everything goes in the bank. Just, you know, if you’re cheating the IRS and you have a disgruntled employee, you’re going to get screwed.

You’re going to jail get it.

Catherine Maley, MBA: Discount disgruntled employee.

Jason Pozner, MD: Yeah, just, just, I’m, I’m going to tell you, just keep it honest. Put everything in the bank and, and you know, just get a good accountant and sleep well at night. Sleep well, yeah. No, I, I mean, if anyone turns us in for anything, the worst thing they’re going to find is I might have put my public’s bill the supermarket on my office account that day instead of my private account.

Catherine Maley, MBA: But everything has lunch, it comes, right to help with offsetting your overhead.

Jason Pozner, MD: What we do, we, we buy staff lunch. Yeah. So, I buy my, our staff lunch every single day. Cause our, our, our, our hours are irregular. We don’t know when they get to take breaks, things like that. I buy the whole office lunch once a week. Every Thursday we pretty much get sushi.

I pretty much buy pizza on Fridays anyway, so, and they get, they get lunch at least two, three, I mean, pretty much they get lunch a lot, a lot. So that’s a ni that’s a nice thing. We give good bonuses. No, I, I think you need to be nice to your employees and I’ve had, I think three, three people be there over 20 years and one 15 years.

Oh. So, you know, we keep, we keep employees for a long.

Catherine Maley, MBA: Did you have to learn how to build a culture to help with offsetting your overhead? Did you just know how to do it?

Jason Pozner, MD: No, I, I, I think it’s, it’s, I, I, I think it’s, some things were inherent probably from my dad who treated his people pretty well and he, and you know, I, I always say you can tell people by how to treat the wait staff at a restaurant.

And, you know, I’m the kind of person who’s nice to the wait staff. I tip well. I, I’m, I don’t make a big deal and I like to have staff around me that are nice people. I think you have to be nice. I, I don’t think you can grow a successful business without being nice to people.

Catherine Maley, MBA: I have been very surprised after Covid or whatever happened with this resignation thing, I’ve been really surprised that people are not innately.

Nice or friendly. I, and I can’t treat hassle like even during the interview process. They’re not friendly and I think, wow. Where mean, where did that come from? How did you, how did you miss that to help with offsetting your overhead?

Jason Pozner, MD: Terrible. I mean, we paid everybody during covid. A lot of people fired everybody during Covid. I mean, what we did was we were closed down.

Florida was pretty good. We were closed down for six weeks. I think that was, it couldn’t do anything. So, I, you know what I did what I said there was, I, I’m not sure what’s going on. I’m not sure whether we’re going to get our P p P money or anything else. So, I had them work halftime, they came in halftime. I said, you know, we’ll pay you take the rest on p t o time for the six weeks.

And then after six weeks we’ll figure out what happened. Well, we got our P P P money and we went back into business. So, I gave them back all their p t o, so they, so they basically got halftime half vacation paid. I didn’t care. We had a good year that year. But, you know, I thought it was the right thing to do.

I heard practices fired people and rehired them as a starting employee. They’re there 15 years and now they’re rehired as a year one employee with minimal benefits. I mean, come on, come on. You know, that’s not how you engender loyalty in your practice.

Catherine Maley, MBA: Yeah. Well, that’s why people have been there 20 years in your past to help with offsetting your overhead.

Jason Pozner, MD: Yeah. Yeah. We, we have, we have a 4 0 1. We, you know, we try to be nice to people and you know, we’ve, we’ve had some people in and out and I, I have a hard time firing people. I probably keep some people too long. But, you know, I think right now, you know, at the level that I’m playing at now, I consider our team to be a major league team.

We’re a major league baseball team. Okay. And that’s how I see it. And, and if you, you can’t have a bad player in a major league team. You can’t have a minor league player in a major league team at this stage, at this stage when you’re starting out. Different story. But when, you know, every time I go into the or, I expect a hundred percent I need a, I need a home run case.

I can’t expect to have a, oh, that’s just came out. Okay. Everything has to come out perfect at my stage right now.

Catherine Maley, MBA: Mm. And I think it’s priceless when you have a cohesive team that knows what they’re doing and knows how to work together to help with offsetting your overhead. The efficiency of that is amazing. Yeah.

Jason Pozner, MD: And we see a lot of patients in a day.

I mean, we, we run, but you know, I don’t really sit down, but, you know, the team is great. Team is really good. I mean, we do a case on a Friday, there’s someone in there on Saturday seeing the patients, you know, it’s a lot easier with your phones now. We, we have a lot of patients that fly in and drive in remotely.

So, a lot of times, you know, take the dressing off, we’ll do a, I did a, I did a, a scar revision on a lip. It is my last case on Monday. You know, friend of the family and she had had an accident. It was terrible. It was the last case. I still do some little things like that. It’s kind of fun. But, you know, I said She doesn’t have to come in tomorrow, just FaceTime.

So, we FaceTimed her and she said, oh, you look great. Okay. Bye. That was it. You put some ice on it, No. So I think with our phones now, we, we can stay in touch with the patients a little bit easier.

Catherine Maley, MBA: Sure. Are you using a lot of technology now that you didn’t used to use to help with offsetting your overhead?

Jason Pozner, MD: You know, I, I, I mean, we use Nex Tech.

We already we’re, we use Nex Tech. We’re e emr. Everyone always keeps trying to get me to switch, but it works for us. We use Mirror. We’re cloud-based. We’re cloud based on next tech. We have Mira, we have a good photo system. Anything that Barry Diardo tells me to do photo wise, I do, you know, so I, I, I do that.

And then we use our phones a lot. We, you know, we do some virtuals, but we use a lot of, you know, email and photos and, and HIPAA compliant things to look at. Look at patients before and after. I, I think it, they don’t need to drive here anymore. That’s, we, we learned during Covid that not everything has to be in person to see if they’re doing okay.

Catherine Maley, MBA: I love it. I, I’d rather meet you on the phone for two minutes than Yeah. Drive over you to your practice.

Jason Pozner, MD: How many you got? No. How many times? You know, I, I get a call on the weekend, you know, it’s like, oh, I, I did a breast lift and there’s a little scab or something looks funky. I said, send me a picture. You know, they text me a picture and then they, they text me a picture.

Probably not HIPAA compliant, but you know, they text me a picture. I said, no face. Just send me the area. And then I call them back and they’re happy. I’m happy. I don’t have to go to the office. They don’t have to drive to the office. And the whole encounter took five minutes. Love it. Yeah. Yeah. I, I think we got to play smart like that.

Catherine Maley, MBA: Yeah. Especially in today’s world. The efficiency is what is going to win. Now, I, you, there’s no, there’s no big home runs anymore, it seems like. No, to help with offsetting your overhead, it has to just get so well run and that’s how you win. Well, team is how to do that.

Jason Pozner, MD: But just what you said is, is what’s critical. I mean, you know, there’s an old adage in baseball, you don’t win baseball games with home runs.

You’re win with singles and doubles and it’s just continued cases fill your schedule. I mean, how many dermatology practices do you know, that are not accepting new patients or OB GYNs? Yeah, right. They’re full, they see the same patients and you know, that’s great for a derm or OB G Y N, but you know, if I do a successful surgery, I got to fill that spot again until they come back for something else.

Yep, yep, yep, yep. That’s the nature of our business. You do a good breast job, you know, hopefully it’s 15, 20 years before they come back to you or facelift 10 years or whatever.

Catherine Maley, MBA: As long as they’re referring their friends to to help with offsetting your overhead. As long as they go, you know, every year if they’re referring more people, that’s how you, you do the flywheel, get that thing going right?

Gimme one big business mistake that we’ve made a big one. But that you learn from because it’s all about learning, right?

Jason Pozner, MD: I think the, the big one for us is expanding too fast. You know, if you want to expand, you know, you have to expand. And I think, you know, it’s a different world nowadays. You know, you, you know, look at partners in this.

You can’t do everything yourself. And I thought we could do everything ourselves, and we ran it too loose and, and, and we, it, it almost took us down. So, I think you have to play smarter and hire good people like yourself. Hire good consultants, hire people who are smarter. You can’t know everything. You know, I know this much.

I have blinders on. So, from our quad a to our marketing, to our branding, you know, I, I work with a lot of good people like yourself to help us grow. You cannot do it yourself.

Catherine Maley, MBA: So, when you expanded too quickly, are you talking about you brought on surgeons too fast that didn’t help with offsetting your overhead?

Jason Pozner, MD: No, too, too many in Boca, extra locations. And we couldn’t, and we had extra locations in building and things like that, and we couldn’t, we, we, we couldn’t afford to keep those places going.

Okay. The doctors that we brought into those places didn’t perform like we thought they would perform. Well, the over funding, we’re funding it ourselves too. That was the problem. We should, we shouldn’t have funded it ourselves.

Catherine Maley, MBA: And doesn’t it take a lot longer to get it off the ground than it used to in helping with offsetting your overhead?

Jason Pozner, MD: Yeah. Takes a long time. Took a long a lot. But less lesson learned. Hence, I have partners now, hence I have partners with other people’s money. I won’t make as much I’ll make as much, but my liability as much less.

Catherine Maley, MBA: Yeah. And not so much risk. I mean, you doctors are signing your name away a lot in your house.

Jason Pozner, MD: Well, that was a problem. That was the problem. We were personally guaranteed on everything, and I learned not to, not to do that, but at least, you know, that’s why my, we have good corporations, we have good, we have good accountants, we have, you know, good protection. We have our money in good places. So, I think you have to run a business like that.

This is a business and it becomes a big business for a lot of dollars. So, you need good people around you. You need, you can’t have a rinky-dink accountant, you know, you have to have a good accountant that you can speak to. You know, I’m buying another card. Do I pay for it? Do I write it off the business?

I have a, I, what I learned also is I have a consulting company, so I get paid to give lectures and, and do things that they pay. My consulting company, another car is off the consulting company. We don’t u that money is in a different account. So, you know, these things that Barry and I learned, and Barry and I kind of follow each other for.

Catherine Maley, MBA: I’m assuming they’re all under different LLCs to help with offsetting your overhead.

Jason Pozner, MD: Yeah, they’re under, they’re probably, it is probably under, under a whole C-Corp anyway, but, or a whole S-Corp anyway. But you know, they’re, they’re different companies. So, you know, talk to you, I’m not saying giving anyone tax advice, but hire a good account and let them do it.

That’s their job. Just like I said, you need a consultant, hire you, you’ll do a great job. But hi, hire people who are smart, have done this before and not reinventing the wheel.

Catherine Maley, MBA: That’s so true. So how are you differentiating yourself to help with offsetting your overhead? Because Boca Raton, the whole world wants to live there, and so I assume a lot of service providers also want to follow all those people.

Jason Pozner, MD: So how I have no life, you know what? I honestly have no idea at this time. We don’t have a huge marketing spend. We spent the money on branding. But I, I don’t have a big marketing spend at all. It’s mostly I have a referral business. You know, I, I’ve been in practice at this location now for 22 years.

Most of the patients come from somebody else. I have a little bit of marketing spend on the, on our websites and with RealSelf on breast implant revisions. Cause I like to do those. I do get them from other, other places. But if you look at my schedule every day, it’s all word of mouth. I did their friend, I did their sister, I’ve done them before.

And that’s a mature practice. That’s what you do in your sixties. If you’re in practice for 20 years. If I didn’t have a referral practice, I’d have a problem, but a lot don’t.

Catherine Maley, MBA: Because they have not concentrated or focused on the staff, the customer service. Right, right. The consistency in the patient experience.

Right. That just kudos to you in knowing about offsetting your overhead because that doesn’t happen by accident. You can be in practice for 30 years running a crappy business and not getting the word amount. So, you’re spending on advertising cause you’re constant churning.

Jason Pozner, MD: So, so that’s your job. That’s your job to go into a practice and figure out what the problem is.

You know, is their office manager horrible? Is the doctor have a bad personality? Are their outcomes bad? Well, you need good outcomes, but you know, people are well trained nowadays. There’s a lot of good outcomes. Good outcomes, especially on the chip shot stuff. If you can’t do a good light bulb or tummy talk or, you know, basic blepharoplasty, you, you should go to some courses and learn how to do those things.

You know, the complex revisions, I mean, 70% of what I do is secondary now. So, I mean, that’s a different story. That takes a little time to learn those things. But you know, just like secondary noses for secondary noses, you want to go to someone who does that every single day.

Catherine Maley, MBA: I agree. So, what’s your demographic to help with offsetting your overhead, because, are you doing any insurance?

Jason Pozner, MD: No, I don’t do it. Oh, doc, doc, Dr. Cook does a little insurance, but what happened was when I first got to Florida, I couldn’t get any on, on any plans. They were all full. So, I struggled and, and after that I’m like, okay, I don’t need to be on any plans.

Catherine Maley, MBA: Yeah, good for you. I you don’t need that in today’s world.

Jason Pozner, MD: I don’t, again, for, for face and secondary breasts, it’s, it’s, it’s all cash pay anyway. And my prices are not crazy. We keep it, we keep it relatively reasonable. We have gone up a bunch. I think I raised prices four times, you know, since covid. But, you know, little, small increments, you know, we kept testing it.

You know, I hear stories. People are booked out for a year. If you’re booked out for a year, your prices aren’t high enough. That’s stupid prices. stupid. Raise your prices until you’re booked out two months or so. And then worst scenario, you’ll lower them a little bit if you, if there’s a problem.

Catherine Maley, MBA: It’s really funny because I do a lot of consulting and they’ll say, I’m so booked out, what do I do?

And I say, isn’t it obvious? Like you would just raise your prices? And they’re like, I couldn’t do that. I would lose a lot of business. And I think you’re losing it anyway. Cause no one’s going to wait a year. They’re going to figure something else out eventually.

Jason Pozner, MD: That makes, makes no sense. You know, raise your, but that’s what people do.

They raise the prices until you get to a point where it’s a, you’re starting to see a little bit of, of resistance and listen, what’s the worst-case scenario? You see someone who can’t afford you and you want to do the case; you discount them a little bit. You know, say, I like you. Okay, we’ll do a teaching case.

We’ll use it for some marketing purposes. We’ll take 20% off if that’s what you can afford.

Catherine Maley, MBA: And that’s, I hope everyone heard that that’s how you do discounting. It starts out as a very good price, and if they want something, they have to give something in return. Right. So, you meet them in the middle and you got what you wanted, which is training for your other people to watch.

We, we, they got what they wanted and everyone’s happy.

Jason Pozner, MD: Like we do a lot of my elevates, which was, you know, a, a face procedure from Greg Mueller. So, we do train. I’m going to hear him on next week. Oh, Greg’s great. We, I love Greg. He, he’s, he’s phenomenal procedures. Phenomenal. I’ve done 2 55, I think, cases to date in three years.

Yeah. So, Greg taught me well, but one of the things with that is no, it’s not that cheap a procedure. So, we do training for them once a month in our, in our office for surgeons who want to come watch on a Saturday. So those days are half price for the patients. So, I, you know, the first question is do you do the work?

I was like, of course. I do all the work and I do all the work and they watch and I also do training for Cun Quarterly where we do a deep re servicing seminar. So, we do, you know, normally it’s five to $6,000 for a deep re servicing, so it’s half price that day. Some people watch, I still do the procedure, but they watch and those are ways to get around that, that discounting especially, or, or the other way is, you know, be on call for a fill-in if, if, you know, during covid we had a lot of patients getting covid and, and other medical problems and sometimes we’ll say, listen, if you’re willing to go last minute or something, we’ll discount you to fill a day.

Catherine Maley, MBA: Yep. Have you noticed the patients have gotten more price sensitive? No. Now than they used to be.

Jason Pozner, MD: The opposite. During Covid, they were less price sensitive and my coordinator said they’re starting to see a little bit resistance now again. But during Covid, they were not price sensitive at all. That’s how we were able to raise our prices.

She’s starting to see, I actually, we had this conversation today, and this is one of the other things, you need to talk to your coordinator. You know, you have to see what, what’s going on. We looked through the schedule, you know, how far are we booked out? Are there any holes? Do I need to do anything differently or am I not spending enough time with the patients?

Are there too many consults that day? Should we tone it down? You need to have this constant communication because things do change. So, one of the things we, we, she said was, see, starting take, yesterday we had a consult day. I had 17 consults was a lot. That’s, yeah, that’s a, that’s a, that’s a consult day.

Plus, I saw a bunch of follow ups and yesterday she said, well, only two books out of 17. And normally we’ll book a little bit more than she said today. Well, five, five more called and booked today. So, but, but during covid. When we had some limited spots, we probably would’ve booked 10 on the spot.

Catherine Maley, MBA: Well, there was a lot of money flowing through the economy also.

Yeah. You know, that’s not going to happen for long, ever, you know. Right. But I, I, you know what, you’ll know if you’re not seeing the patients enough, like if you at the 17th a lot and then, then you’ll start getting those reviews. Oh, you spent two minutes with me, you know, didn’t see.

Jason Pozner, MD: Right, right. That’s a problem.

I do get those reviews sometimes, and, and, and sometimes they’ll come back for a second consult and, you know, I, I don’t mind the second consult if I see them on the schedule. I know second consults, 90% chance going to book. Nice. But, but some of the times, you know, I had 17 consults on the books, but I sent three to Dr.

Cook and some were, you know, some of them are not good, good cases, you know, although 17, how many are actually good cases for you? 12. Maybe, you know, five. Were like too fat for, too fat for surgery. Too many medical problems for surgery. You better off in our med spa for a non-surgical procedure. You know, we do, I do turf them.

Catherine Maley, MBA: I do a lot of training with consultants and one of the things we do a lot is triage a lot more carefully at the beginning. So, we’re not waiting for so much time at the end. You don’t need the practice. You, you know how to as you don’t need 17, you need seven qualified. Actually, we’re not going to end up saying your VMI is ridiculous.

You’re on meds, you have heart trouble, you just had a transplant for god’s sake. Right, right, right. Why, why are we seeing this patient?

Jason Pozner, MD: But I do on Tuesdays, I do like. I do like those 15 to 17 consults on a Tuesday for me. That, that, that works for me. But remember, some of these might not be big cases. Some of them might be lower eyelid laser, you know, that’s a 2000, $2,500 case.

Not a huge case, but that consult takes me five minutes to 10 minutes. It’s not a long consult. You know, a revision breast might take me probably a primary Ag takes me longer than anything else. Revision breast is, revision Breast is pretty easy. No, you got a capsule, you got to take the capsule out and, and we’ll do a lift.

But a primary Ag is probably my longest consult. Faces don’t take me that long for consults. I don’t know why. But in general, the patients are relatively savvy and there’s a lot of secondaries who have had it before.

Catherine Maley, MBA: I have literally had surgeons say, I’d rather do facelifts all day than fiddle around with these 20 year old breast augs.

Yeah. They’re like, breast augs used to be the EP money. And now it’s like, no, they’re, they’re costing me a fortune. They’re wobbly, they’re flaking, you know.

Jason Pozner, MD: Yep. And I don’t do that many, I don’t do that many primary ags. I, I just don’t, I mean of, of, I haven’t done a primary AG in probably a month. You know, it’s a lot of revision cases, but again, that’s what I like to do and that’s what comes in and seeks me out.

If they, they’ll go to Miami for cheap prices. If they want a primary Ag.

Catherine Maley, MBA: And there are plenty of those places. My goodness, I’ve never seen anything like it. That’s another story. But very interesting watching how else you can do this and whatever. Okay. What about social media to help with offsetting your overhead? Are you jumping on that bandwagon?

What, what are you doing to help with offsetting your overhead?

Jason Pozner, MD: No, I, you know, it’s funny because I, I, I had a whole meeting with my associate today, Dr. Cook about that. You know, we’re just not that good at it. Yeah. And, you know, I hate to say it, we’re just not that good at it. We’re looking at things to make it better, but I’m not the kind, you know, me for a long time.

I’m not the kind of guy to be dancing around. Right. You know, we, our time is spent doing research and other things, so we’re trying to work on that to get our message out there, which is, we’re a new technology place. We like our new stuff. This is my bread and butter, but this is my research interest.

We’re going to start changing things around a little bit. I work with Plastic Surgery Channel with Bill Adams, whose content is amazing. So, I’m actually going to be talking to Bill this weekend about how we can kind of work on some new projects together with this getting our message out about, you know, you know, what is elior, what is, what is this, what is, what is the difference between these RF devices?

So, we’re going to try that for a while. I’ll let you know next year whether it works or not for sure.

Catherine Maley, MBA: Speaking of all the devices to help with offsetting your overhead, you probably work more with other vendors or pharma companies in the industry than anybody else I’ve ever seen. Probably. Why, why is what? What’s the advantage to you to do that to help with offsetting your overhead?

Jason Pozner, MD: So, it’s, it’s inte for practice. It, it’s intellectually stimulating to me. Yes. That’s, it just is, I mean, I just like new toys. I basically want to put myself out of business. You know, what, what do people want? I mean, look at, historically, when I was a surgical resident, the kings of the hospital were the cardiac surgeons who cracked chest and did bypasses.

Right? Yeah. Now they’re peons because the, the minimally invasive cardiologists are doing stents and other things, and the cardiac surgeons are only doing the worst of the worst patients. So, I think that’s the nature of medicine. We’re getting more minimally invasive and I think there will be a time that I’ll be able to take a patient and offer them procedures as they’re getting older.

So, they may not need a face. And I, I think that’s the way we’re going. I mean, you know, the weight loss meds are amazing now, you know, these G L P agonists, the, you know, Wago and, and Manjaro are doing a great job for weight loss. Our light bulb numbers may go down on these bigger patients. We do may do more body contouring as they start to lose weight.

So, things change. You need to be aware of what’s out in the market and you need to adapt to how things are changing, right? So, I mean, when I was a general surgery resident, we were cutting out stomachs for ulcer disease and now, you know, 30 something years later, bacteria cause ulcers and you need to treat it medically.

So, there’s different ways to treat these, and that’s my research interest, making non-surgical things better and, and surgical things. But I love the non-surgical research.

Catherine Maley, MBA: And the consumers love the non-surgical too. So just follow the consumers. If, if they will go non-surgical, as long as humanly possible, if their technology’s available if they can get by with no scarring, less money, less downtime, you, you can’t beat it.

So, I right there, there’s room for all of that right now, especially to help with offsetting your overhead.

Jason Pozner, MD: And, and the difference between me 20 years ago and then me now is I invested these companies. As I hear about them, I put my money where my mouth is and some win. And some don’t win as much. But I’ve done pretty well an along the years I learned, because back in the day, Barry de Bernardo, Larry Bass and myself, spent a lot of time with all therapy people.

We worked with them; we worked all their protocols out. We did a lot of their early data and you know how much we got from them when they sold for $600 million. Zippo. Okay. We don’t do that anymore. So, we put our money where our mouth is and we work with the companies and we get paid for our time and effort.

And it, it’s, it’s mutually beneficial. We put our time in, but we get paid for stuff. Sometimes it’s on the back end, but we get paid for, we, we do get paid for things. And I do put my money in these, in these investments. I think that’s the way to really invest in what, you know, when I stay in my lane, I make money.

When I go out of my lane, I lose money.

Catherine Maley, MBA: Well, and the wealthy get wealthy from investing, not from making the money they investing anyway. So, tell, so we’re going to wrap this up. Tell us something we don’t know about you apart from you knowing about offsetting your overhead.

Jason Pozner, MD: Can you hold on for one second? Of course. Hold on for one second and I’ll show you something.

You No, no. You don’t know about me. Okay. Hopefully he comes back shortly. I’ll become very shortly while the length is off here. Frosty. Come here. Frosty. Come here.

Catherine Maley, MBA: Okay. Frosty. Okay. I’m assuming there’s an animal involved.

Jason Pozner, MD: You hear some noise here?

Catherine Maley, MBA: Okay. I don’t know what it is yet for those don’t know what it is.

You’re just listening to audio. We don’t know yet what he’s talking about

Jason Pozner, MD: You don’t know. You don’t know? Okay. Where’s Frosty? This is Frosty.

Catherine Maley, MBA: Oh my God. It’s a parrot.

Jason Pozner, MD: It’s a parrot. So, I have, so I’ve been working with birds for 30 years now. Oh my God. And this is, I just, the lights were just off, so. So, this is Frosty.

Frosty is literally with him. Frosty is a 20-something year old Malkin Cockatoo. She’s a female. She’s a, she’s a sweetheart. She’s, she’s one of my birds. Yeah, she talks a lot. You want to say hi? Say hi. Say hello. Hi. Say bye-bye. Bye-bye. Say bye. She talks to nonstop. I think I woke her up. But I have seven parrots.

I’ve read a few of them. I’ve had a bunch of babies over the years. So, I have one cock of two. I have former cause and two African grays. They all move in the house. They live in an aviary, which is Oh, so the, the house I’m in now, which eventually I’ll move, but the people that own the house before me had an office in their garage, so it’s air conditioned and special lighting and stuff.

So, I have a whole aviary in there with huge cages. Like, are they fun pets? They’re fun. I love birds. They’re sweethearts. Say hi, frosty. Hi. Say hello,

She talks, usually talks like crazy. Say bye bye-bye. Does There she goes. Bye-bye. Bye-bye.

Catherine Maley, MBA: Hi, frosty. That is, oh, okay. Now she’s not going to show.

Do you have to watch TV before? Okay. That’s really funny. The bird is beautiful. Yeah. Just out of curiosity. Do you have to give bath or something? How does it say?

Jason Pozner, MD: You know, it’s funny, she had this one. I, I usually spray them down a bit. I actually gave her a bath about a week or two ago because every time I was petting her, my eyes were irritated.

So, there was something on her that got me. But I, I gave her a bath the other day. But normally, normally I just spray them down. I do, they like water not really. One of my Macau loves to be sprayed, but you know, some like, and some don’t. But remember, it’s Florida, it’s warm outside. So, you know, on the weekends I have purchase outside.

I’ll take them out on the, I’ll take them out in the backyard. I’ll sit with them and read a book and spray them. It’s nice.

Catherine Maley, MBA: Well, this was the first for Beauty and the Biz and our talk onoffsetting your overhead. We’ve never had Parrot. Thank you so much, Dr. Pozner. We’ve had dogs.

Jason Pozner, MD: The dog’s not here today. Bye Bye bye. Alright, Catherine. Alright.

Catherine Maley, MBA: Alright. So, everybody, thank you so much for joining us on the topic of offsetting your overhead. Please if you would, would subscribe to Beauty and the Biz and share this information with your colleagues as well as your staff. And then if you’ve got any questions for Dr. Pozner… Dr. Pozner, how would they get ahold of you? Your website?

Jason Pozner, MD: Yeah, just email me. Best way to get me is email me is J p o z n e r MD at Gmail. That’s my private email. Just, just, just, just best way is email me that you just told a whole bunch of people. Okay, that’s fine. I’m, I get, I get a million emails a day, so, and I do, if I, if I don’t respond email. Sometimes it gets, it goes to trash or I get lost.

Catherine Maley, MBA: Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on offsetting your overhead.

If you’ve got any questions or feedback for Dr. Pozner, you can reach out to his website at, www.SanctuaryMedical.com.

A big thanks to Dr. Pozner for sharing his knowledge on offsetting your overhead.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for the “Offsetting Your Overhead — with Jason Pozner, MD”.

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

 

#offsettingcosmeticsurgeonoverhead #offsettingyouroverhead #jasonpoznermd

📅 Schedule your free 30-min strategy call with Catherine

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and what happens if something happens to you.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "What Happens if Something Happens to You? — with Lawrence B. Keller, CFP".

Life happens. Your house can burn down. You can tear your ACS in a skiing accident. You can fall off a ladder and be off your feet for 6 weeks (those are just a few things that have happened to other surgeons I know).

So, to get you clearer answers for how to protect yourself when you’re not able to generate revenues like you used to, I interviewed an expert.

In this week’s Beauty and the Biz Podcast, Larry Keller, founder of
Physician Financial Services, offered straight forward advice for you to set yourself to win no matter what happens.

For the past 31 years, he has worked with surgeons and physicians on income protection, wealth accumulation and asset protection.
He offered great pearls for covering yourself if/when life goes sideways.

I think you'll find this helpful on what happens if something happens to you.

Visit Larry Keller's Website

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

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Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

What Happens if Something Happens to You? — with Lawrence B. Keller, CFP

Catherine Maley, MBA: Hello and welcome to Beauty the Biz, where we talk about the business and marketing side of plastic surgery and what happens if something happens to you. I'm your host, Catherine Maley, author of Your Aesthetic Practice — What your patients are saying, as well as consultant to plastic surgeons to get them more patients and more profits.

Now, today's guest is not a surgeon. However, he's someone who does help surgeons protect themselves against life's surprises and what happens if something happens to you.

Now it's Larry Keller. He's founder of Physician Financial Services. He's a certified financial planner from New York, and he, for the last 31 years, he's worked with surgeons on income protection, wealth accumulation, as well as asset protection by providing them with services such as disability, income, and life insurance to help with answering what happens if something happens to you.

Larry Keller, welcome to Beauty and the Biz.

Lawrence B. Keller, CFP: Oh, Catherine, thank you so much for having me. I am looking forward to it.

Catherine Maley, MBA: Sure. Now, “what happens if something happens to you” is a tough topic that a lot of surgeons don't want to talk about. And usually, they don't until something happens. Personally, I know after being around for a long time, I know surgeons who like one guy fell off a horse and he was out for six weeks.

Another one had a ski accident. He was out for eight weeks. I actually know a couple who during the pandemic, they were in the I C U for months. So, things happen in life, they just do. So, we're going to try to simplify it here and give them some really good tips about “what happens if something happens to you”, covering yourself when the stuff hits the fan.

Yes. So, let's start with one important question that I have on “what happens if something happens to you”. Surgeons spend a lot on their medical malpractice insurance. Is that different? Disability and life insurance on “what happens if something happens to you”.

Lawrence B. Keller, CFP: Yeah, it's completely different. And ironically, when you think about it, the surgeon goes out and they buy, you know, medical malpractice insurance and yes, it is to protect themselves and their assets, but it's really more about protecting their patients.

Because in the events something happens, their patients are going to be the ones that benefit that from that and not themselves. So, what we're talking about in its really basic context. Is at the end of the day, what happens if something happens to me? How do I take care of myself? How do I take care of my family?

And a lot of people, they just don't think about it. They say, I'm, I'm in medicine. I want to get into my practice. I want to do good work. I want to take care of everybody else. And unfortunately, very often, they neglect to take care of the most important person, you know, the.

Catherine Maley, MBA: For sure. So, you, so the medical map, so you're not involved in that part of it at all.

You're involved in more the disability and the life insurance part and “what happens if something happens to you”, right?

Lawrence B. Keller, CFP: Yeah. I'm much more on the, the personal insurance side and the, we will talk about this. There are some business overlaps and situations where insurance is used in the business side, and I'm familiar with medical malpractice and property and casualty agents and things like that.

Different specialty. Just like you have a face, say a facial plastic surgeon, and then you have a reconstructive plastic surgeon.

Catherine Maley, MBA: Yeah. On this show we only talk about cash medicine, which helps with “what happens if something happens to you”. That's my specialty. I only do cash.

Lawrence B. Keller, CFP: I like it. I like it. We, we'll focus in on the aesthetic and cash medicine, but the planning is going to be very similar.

Catherine Maley, MBA: Okay. So, what types of insurance should plastic surgeons consider when they're, when they want to cover “what happens if something happens to you”. What, what are you asking them? What are you looking for?

Lawrence B. Keller, CFP: Okay, so the first thing that they should do, and this is whether they're in a private practice, whether they're in a hospital-based practice, whether they're in their in a large group, is they really want to have their individual.

Ideally own occupation. Some people use the term own specialty, but that's not technically correct. And this is a policy that very simply put is if our surgeon is disabled and they can no longer perform their job duties, do it to an accident or sickness. Money is going to be paid to them so they can meet their expenses and maintain their lifestyle.

Now, ideally, what we want this policy to be is own occupation. And what it's going to say is, Catherine, if you're a plastic surgeon, and God forbid you are disabled, and you can no longer do your job duties as a plastic surgeon. We're going to pay you your full disability insurance benefit. You can do whatever you want.

You can make as much money as you want in another occupation or another medical specialty. Some policies, it's actually one company specifically has something that's called an enhanced medical specialty definition. And this could work potentially very well for your audience. And what this says is if more than 50% of your income is derived from invasive or surgical procedures, Even if you could still do some of your other job duties.

Maybe you had an array of jobs, you had your medical practice, but you also ran a men spa and you earned a significant amount of money from that. But more than 50% of your income was derived from performing your surgical duties. You're still deemed totally disabled. Full benefits are paid. You can remain in the same practice.

You can do a hundred. Overseeing of your medical spa and still get your full disability insurance benefit. That's the most liberal definition in the marketplace today.

Catherine Maley, MBA: And do a lot of surgeons have that kind of coverage, or do you find that they're lacking in that with “what happens if something happens to you”?

Lawrence B. Keller, CFP: I'd say if they're going to blow it somewhere, it's probably going to be in that area.

I mean, ideally, we're looking for own occupation, you know, plus or minus the enhanced medical specialty definition, because only one company offers that. It's relatively new, it's been around for about five years. But of the companies that have own occupation coverage, it's really going to be Berkshire, which is a guardian company, mass Mutual, standard Insurance Company emeritus.

Principal, Ohio National. Then you've got New York Life. They're not in every state. We've got Northwestern Mutual. They have now reentered the own occupation marketplace. So, if someone has their coverage for one of those companies, I would say they're probably okay. If they don't, the red flag should be going off and say, let me investigate.

That is what I think I have, what I actually do.

Catherine Maley, MBA: So, when a, like, let's say a surgeon right now is saying to himself, I, I don't know, I don't know what my coverage is with “what happens if something happens to you”. What would, if they're calling their insurance agent, what are they asking them? What is the question? Because I'm not sure what owned means.

Do you mean if the solo practitioner who, who has his name on the practice and needs to cover “what happens if something happens to you”, is that an owned occupancy? Occupancy?

Lawrence B. Keller, CFP: No. So own occupation is really just specific to the job duties that you are perform. And if you can't do those, your benefit is going to be paid even if you're working in another capacity. So, what I would say to my agent is, Hey, I know we've done disability insurance together.

I just want to confirm that my policy has an own occupation definition. Let me just clarify. This means if I'm a plastic and a reconstructive surgeon and an accident or sickness prevents me from doing that. I can work in another occupation or even medical specialty. I see. And still get my full benefit.

Catherine Maley, MBA: Gotcha. So that's a new trailer because oftentimes they just get it if they can't and it no longer re like generate revenues. Is that the point, in terms of “what happens if something happens to you”?

Lawrence B. Keller, CFP: Correct. So, you will find, we call this an own occupation and not engaged definition. Mm-hmm. So, it would read, don't want to bore you with the legalese, but it would say something.

Catherine, we will deem you totally disabled if you're unable to perform the material and substantial duties of your occupation, and you are not gainfully employed, right? So ideally, we don't want to see anything after unable to perform the material and substantial duties of your occupation, period.

Meaning if you are engaged in another occupation or specialty, there's no impact to you. Gotcha.

Catherine Maley, MBA: Okay. Very interesting in regards to “what happens if something happens to you”. That's a really good pearl, I think. So how do you talk to a surgeon who's like young? He's like, you know, he's single. He doesn't know yet exactly where he is going to be forever. He's, he's going to, he is going to set up shop in Austin, Texas and hope for the best.

Like, how would you prepare him to cover himself versus all the other scenarios of “what happens if something happens to you”?

Lawrence B. Keller, CFP: So, figure all the other scenarios, if it's a larger practice or a multi-specialty clinic, they're probably going to have some kind of long-term disability coverage provided to them. Here we have an individual where not only are they the business, They're also relying a hundred percent on themselves for their income.

So, if an accident or sickness prevents them from doing their job, like where is the money going to come from? Like at the very end of the day, I would say everybody we're just well-educated money machines, and if the machine breaks down, no more money is getting spit out. So, the first thing that they should do is exactly what we said.

They should have an individual. Ideally own occupation, disability insurance policy that pays them their full benefit if they can't do what they were doing, regardless of what else they can do or actually choose to do. Now, the second one is because they're in their own practice. If they're new, they're probably going to try to run their practice on the cheap.

I would imagine you would tell them that's what you should be doing. You know, maybe you'll get someone that answers the phone, but if you're going to spend money, you could be a great surgeon. But if no one knows that you. It doesn't matter. Let's do a feasibility study. Let's look what we're going to do to bring patients in the door to keep you busy.

But if they have staff, they have malpractice insurance, they have rent, they have fixed overhead. And this is stuff that patients are not going to reimburse for, like breast implants or Botox or Ru Juvéderm or Restylane. They're on the hook for those expenses. So, there's another policy that we buy that's called a disability overhead expense policy.

And this just like the personal money goes to the doctors so they can maintain their lifestyle and meet their expense. This one actually, the money goes to the practice. They use that to pay the expenses in the practice, and now they know they either have a practice to go back to, or if they're not going back, they're going to be able to sell it as a plastic surgery office, rather than, Hey, you know what, I'll take 10 cents on the dollar.

I'm just hemorrhaging money here and things are not going to end.

Catherine Maley, MBA: I would say no, the majority of the surgeons I work with are solo practitioners. They have to find their own insurance to cover them with “what happens if something happens to you”. There's no, you know, HR benefit waiting for them. But that, that just reminded me, where does workers comp fit into all of this?

Lawrence B. Keller, CFP: So, work as comp, if it's just you. Yeah, you don't have to have it on yourself because you are an owner, but it's mandatory. You have to have it for your employees. So, depending upon the state that you're in, you know the state might have a website that you could sign up for that. Or if you're talking to your property and casualty or p and c agent, this is going to be the person that's going to do your business interruption.

Like what happens if there's a flood and you're in an office building and now you can't use your practice? For months. What happens if there's an earthquake? You know, any type of thing. So that's the agent that you would go to and you'd say, can you set me up with my worker's compensation, my office pack?

That's going to ensure, you know, their equipment, that's going to ensure something happens where I can't go into my practice. But that's really going to be more like acts of God. This is going to be, you cannot work, you cannot perform your job duties as a surgeon because of an accident or sickness. It's not the office that's broken, it's you that's broken.

Catherine Maley, MBA: That's interesting. The surgeon that the surgeon I know really well, he had a 6,000 square foot home burned down in 45 minutes. And he wasn't there, but, and it didn't preclude him from still doing surgery, however, he needed to spend some time, you know, it was a huge loss and it, it, it interrupted him, but not, it wasn't catastrophic because he was, he's really set up, he's got a great team who was like covering for the “what happens if something happens to you” and he had other surgeons in there.

Mm-hmm. But is that kind of thing covered, or what do you call that, that, you know, the bumper sticker that says “Shit happens”, as in “what happens if something happens to you” like, yes, where does that fit into this?

Lawrence B. Keller, CFP: This would really be because it wasn't a business thing and it was his home. That's really going to be his homeowner's insurance, and unfortunately, he probably lost a lot of time from his practice.

I'll, I'll go one step further. This is probably not him. But let's say, because his home went up in flames, it was so devastating. Mm-hmm. that, you know, he now has mental and nervous issues like anxiety, depression, stress, and because of that, he can't work. Some policies are going to cover those types of claims for a limited period of time, like anxiety, depression, stress, chemical dependency, drug addiction.

Other policies are going to give you a choice. Like Catherine, our base policy has a limitation. If you don't want that, you can buy a policy that has unlimited coverage for those types of things. And there was a study that was done, believe it or not, it's in the Journal of Plastic and Reconstructive Surgery, and they said at some point, 40% of US trained aesthetic surgeons are going to deal with burnout in their career.

And if it gets to the point where the burnout is so bad and you are seeing a psychiatrist, or you're seeing a therapist and maybe you're on medication and you legitimately cannot work, a disability insurance policy can actually pay for that. Mm-hmm. So, a lot of people, when we think about mental and nervous conditions, they're thinking like doctors, right?

Dementia as a result of a stroke, a trauma, head injury, viral infection. Parkinson's, I've got this physical condition. I can no longer perform my job duties as a surgeon, even with a limitation. That stuff's going to be covered. I'm thinking more like the insurance guy stuff. Anxiety, depression, stress, chemical dependency, drug addiction.

Now, certain states like California, every policy in California has to have a limitation for those types of claims. But what if you're in a state like New York? And your plan is to move to California and start your practice. I would say you better buy your policy when you're in New York, so you could take it with you when you make it to California.

And if you don't want a limitation, you don't have to have one. Now, another fun fact, and you might be testament to this, is the state of California as far as disability insurance claims go is the highest of every. People in theory would rather be on the beach than in the operating room or clinic, and claims experience actually demonstrates this.

So, California happens to also be the most expensive state for disability insurance compared to all others. So, I don't know, maybe I practiced for a little bit. I decided I wanted to go back and do a facial plastic surgery fellowship, and I'm not in California doing my fellowship. Maybe I'm in. If I buy my policy in Illinois and I know I'm going to move back to California, I can get a better policy for less money.

So really, really important in terms of that. Now, ironically, And this kind of ties into surgery, you know, we know the difference. You and I and your listeners know the difference between a cosmetic surgeon and a board certified, let's say, plastic and reconstructive surgeon or a board-certified facial plastic surgeon.

Does the consumer know that? Absolutely not. They say if you're out, you're practicing, you've got a white coat on or a nice. You're a surgeon. You know, you might have done family medicine and now you're talking to people about breast implants, but very different. It's kind of the difference between getting a result and getting closer to the ideal result.

Insurance is no different, so I always say it's like that movie taxi driver, you're talking to me. You better know who you're talking to. Like how many surgeons do they work with? How long have they been in the industry? What companies do they recommend most often? And why? How familiar are they with what it is that you do?

And you are not spending any more money to work with, let's say, an experienced agent or financial advisor than you are with what I'll call a newly minted agent. Like, it's like Apple. The rates are the rates, and the only way one person can beat out another is to know of or have access to a discount, then another person doesn't.

Otherwise, if we set things up the same way with the same. It's going to be exactly the same. So, I always find that to be interesting.

Catherine Maley, MBA: So, you know, I was always taught like, get insurance when you're healthy to help with “what happens if something happens to you”. You know? Is that still like that? Like are you better off getting really great coverage? When you're young, and then hopefully it, it can't keep increasing on you as the years go on, or does that work still?

Or how, how does that work? Yeah, that's still, and as you add more kids to the mix and you just more liability to the mix with “what happens if something happens to you”.

Lawrence B. Keller, CFP: Yeah. That, that still works. Great. The premise behind it is this, You almost have to buy it before you know you need it, because once you know you need it, it's too late. So ideally, a lot of times I'll meet someone as early as residency or fellowship, and they'll tell me what their specialty is.

I'll ask them some medical questions. Ideally, they're in good shape. And I'll say, Hey Catherine, look, I can get you policy with any number of companies. It's ideally going to be own occupation like we discussed. It's going to have some other features to it, like a partial benefit. If you can work on a limited basis, it's going to increase in the event of your disability after a year.

We just call that the cost-of-living adjustment rider, but you hit it on the head. We want to have the ability to buy more coverage in the future regardless of your health, as long as your income is. And ideally you want to be able to do this every year or at least every few years without ever answering medical questions or doing an exam, blood test, urine test.

You literally want to just say to your agent or the insurance company, this is how much I'm earning, this is the other coverage I have, whether it's individual or let's say someone happened to be hospital based and they have a group insurance plan. And then we'll come back and we'll say, Katherine, you're eligible for an additional monthly benefit of.

Tell me how much of that you want. Do you want all of it, some of it, or none of it? And there's different rules depending upon the increase option on there. But you really want to set up your foundation before anything happens. Because once it happens, you might not be dead, you might not be disabled. But suddenly things that are very concerning to you are also to the insurance company.

So, a great example with surgeons would be, Bilateral carpal tunnel and you're like, Larry, I heard I got to get insurance. Maybe I'm a little late to the game. Can you get me something? I heard you're good. And I'm like, yeah, I tend to think that I'm pretty good also, let me ask you a couple questions. Oh, yeah.

You know, I got a little numbness and tingling in my hands and wrists and forearms. Okay. Have you seen anybody? Oh, well I had an MR and it's the beginning of bilateral carpal tunnel, or I had an EMG doc. Great news. I can get you a. It's not going to cover either or both of your hands, wrists, or forearms.

You deal with physicians all the time. What do you think the response to that is? Not good. Not good. Larry, are you kidding me? Do you know what I do for a living? I'm a plastic and reconstructive surgeon. I use my hands, wrists, or forearms all day. And let me get this straight. You are telling me you can get me a policy that's not going to cover my hands, wrists, or forearm.

So, if this gets to be so bad that I can't do surgery, you are not going to pay me. And the answer is, that's correct. I'm not going to pay you. You should have purchased it before you had this issue. If you had an increase option, we could have bought more and I wouldn't even be asking you about your medical history.

So yes, you hit that right on the head.

Catherine Maley, MBA: So, the “what happens if something happens to you” pearl is plan ahead. And it’s just regarding partnerships because a lot of surgeons start out, let's say they start out solo or they finally leave the hospital, they go solo. Now they're going to bring on some more people. Is everyone just getting their own individualized insurance or when does it make more sense to try to combine things?

Although that gets so complicated with surgeons. But are you better off doing a group policy for “what happens if something happens to you”, if you can get along?

Lawrence B. Keller, CFP: No, usually you want to do an individual policy first, because that's going to give you the better definitions. There's not going to be offsets to it. Once you maximize that and currently, no matter how much money you may have for them, the maximum that you can have for individual disability insurance is $30,000 a month.

To get that, you'd normally have to have an income about. 1,000,200 50,000. Now some companies will do a little less because we do something that's called a business owner upgrade. And we know you have some personal expenses. You might be pushing through your business and that's okay once you have the $30,000 maximum or you've reached your potential and you're like, it's just never going to get any better.

But you want. At that point, I would introduce a group insurance plan, and you could cover the other physicians. You can cover your office staff. No, plus or minus a short-term disability plan, maybe a group life insurance plan, but let's say you don't even have that. It's just you in your practice, you have staff, but you are the only surgeon.

You are killing it. You're earning, you know, $3 million. You've got your $30,000 a month, and you're figuring the percentage of my income that's being replaced is so small, it's really not going to do much for me. Then we go to Lloyd's of London. And when I say Lloyd of London, everyone starts to think like J Lo and I'm going to ensure my butt, or things like that.

No. Lloyds of London is great for certain occupations that the traditional carriers don't want, like singers or professional athletes or creative writers, but they're also very good for high income professionals where they're way beyond what the traditional carriers want. So, Lloyds of London would say something like, Catherine.

We'll do 65% of your income. We'll subtract out the other coverage that you already have. You can buy that difference. We only pay for a limited period of time. Let's say it's five years, but you can electively purchase a lump sum when you apply for the policy that says, Hey, if I'm a plastic surgeon and I'm still disabled at the end of five, And I'm not expected to ever be able to go back to plastic surgery.

Now, it'll pay a lump sum of a couple hundred thousand to a couple of million dollars to replicate as if the policy was going to pay benefits to the age of 65 or longer. Some other types of policies, which are interesting, so someone wouldn't do it on you, but let's say that you're in a plastic surgery office.

You know, it's you, you've got your injector, you've got your maybe pa. But you have a really good in-house marketing team that's doing your social media, and you are one of the few plastic surgeons that have really figured this out, and your patients are really coming in as a result of this person's efforts.

You can actually buy a disability insurance policy on that individual. We'll call this a key person insurance policy that if they're disabled, Money comes to your practice because you got to find somebody else. Same thing is true. If you and I were in practice, well, what happens if I become disabled? Now?

You have to run the whole practice. Maybe you have to hire someone else if I can't come back. So, there should be something in our agreement that's called a disability buyout agreement. And we have an agreement. We go to an attorney, we set the value in our practice. Usually there's a formula and if I become disabled, this triggering event is going to be funded because that's all it is with the insurance.

I find a lot of these buy sell agreements funded for. But not disability. And disability is much more likely than death among a young surgeon.

Catherine Maley, MBA: Yeah, that's a really good point in regards to “what happens if something happens to you”. By the way, what is you've been around a long time. Everyone used to retire at 65, and I just feel like that's so archaic at this point.

And that must be just causing chaos in the insurance business because a lot of surgeons, they're doing just fine at 72. They're not even thinking about retiring yet. Is that affecting your, like the decisions that you are or, or the suggestions you're giving to the surgeons to cover those “what happens if something happens to you” scenarios?

Lawrence B. Keller, CFP: Believe it or not, not really.

When you think about it for disability insurance, I really only want to get my surgeons from point A to point B, so point A, let's go all the way to the beginning. They're a PGY one. They're a newly minted resident. They have no money. They have no assets. They have a lot of debt, but they have a lot of academic and intellectual skills.

And then they've got the physical skills right here. Well, that's what their disability insurance is going to cover as their career progresses. They're going to pay down their debt, they're going to accumulate wealth. They're going to save for their retirement. They're going to pay for their kids' college education if that's what they're looking for.

And they're going to create a lot of assets. And at that point they're really working because they love what they do. They've honed their craft, they're good at it, but they can self-insure at that point. They don't need the insurance. Same thing is potentially true with life insurance. Now, if I'm in practice with you, and let's say you are a young physician, young plastic surgeon, and I'm the older guy, but my plan is to sell the practice to.

And I tell you, Catherine, I'll stick around for, I don't know, six months, a year, two years, three years. I'll make sure that the introductions are there and the patients know who you are. You'll buy the practice. For me, that's all well and good. If you have money, I'm okay. But what happens if you become disabled?

What happens if you die? I might never get that money. So that all ties into that buy sell agreement. And if I'm the older doctor looking to exit, I would want to make sure I had insurance on the younger guy that's funding my retirement. But at the end of the day, I would say the disability insurance and life insurance for an older surgeon, it's really just not there unless they want to leave money to charity.

unless they have, God forbid a disabled child because they're going to outlive you and financially, they're not going to be able to survive. And this could be some of your audience, but the limits are really high. So, let's say the two of us are married. There is something that's called estate taxes, whereas success tax and currently husband and wife together can leave in excess of 20 million with no taxes.

But what if those limits go? Or what if we're way above that? Let's say together we're 10 million over the limit, between insurance policies, between my practice, you know, maybe your practice, maybe you are working in my practice and of the 10 million overage, 6 million is going to go to the kids and 4 million is going to go to the government.

And you say, I, I don't want that to go to the go. Well now we could buy a policy that's called a survivorship life policy or a second to die policy. It ensures the two of us, if something happens to me, the guy always goes first. Nothing happens, but upon your death, that's when the estate taxes are due.

This policy pays out and we use that money to pay the estate taxes, and ideally, if we're doing it right, it's owned by what's called an irrevocable life insurance. And not only is the death benefit tax free, it's also estate tax free, but that's kind, so I would say advanced estate planning, but a lot of things that surgeons just don't think about.

Catherine Maley, MBA: Right. I know enough to know that that's super important to know about “what happens if something happens to you”. So, I would look into that. And just my last question out of more of a curiosity I, I, once I watched one of those 48 hour shows and there was literally a plastic surgeon on there that had, who had faked his death. Ha, Do you have any of those bizarre stories for real life that you.

Lawrence B. Keller, CFP: Yes, I, I've got one, not a client of mine. For those of you that like entertaining stories, you can just Google it. It's been on 48 hours. It's kind of well-known because it was local to me. So, you can Google Jeffrey Locker, l o c k e r, murder. Now, when I first came into the industry 32 years ago, I met Jeff Locker.

He was a motivational speaker. He was about five nine. He was into martial arts. He was a good-looking guy and his job was to take people like me. And try to bring it to the next level. So essentially, he was a Catherine Maley to surgeons. He was that to the insurance agent, and he knew the rules. He had a lot of clients that were insurance agent.

He helped a lot of them become very successful at marketing their practice and their services. Well, believe it or not, he invested in a Ponzi scheme and he lost a tremendous amount of. And as a result of that, he was in financial straits and he had a lot of insurance. He had 8 million of insurance. He was married, he had three kids, and he knew that if he bought more insurance and he committed suicide, his family could not collect If it was in the first two years of the policy ownership, this is what's known as the contestable period.

But if he was murder, His family could collect. So, he went out and he bought another 8 million of life insurance. He completely lied about his financial situation. In fact, he said he was going to replace the first 8 million, which he did not. He was approved for the policy. Now he's insured, so now he's struggling.

How am I going to leave my family in good straits if my plan is to commit suicide, because that's not going to be covered under the insurance. So, he drives to Harlem. For those of you that don't know, it's a relatively dangerous area in New York state. He finds a guy that's about six four, that's an ex-con, and he says, I'm going to give you my bank card.

I need you to kill me. And he's in his car. He gives the guy his bank card, the guy takes some money out of the, the, the bank account with the cash card and he murders Jeff Locker. And he will say, oh, well, Mr. Locker thrust himself on the knife when he was sitting in the car. And that maybe that's true, maybe that's not, but he also stamped him multiple times in the heart, chest aorta, and he got caught and it went to the courts.

And the whole thing was, what is this a. And we pay, or was this a homicide or a suicide and we don't pay. It was deemed to be a homicide and his family collected and they found all sorts of text messages and emails to his family. This is what you need to do to manage the money after I pass away. Tell your sister I love her very much.

I'm doing this for you guys. So sometimes the truth is crazier than anything we could ever make.

Catherine Maley, MBA: Who would kill themselves by stabbing. Why? I want something a lot faster. That's crazy.

Lawrence B. Keller, CFP: Yeah. Well, remember you couldn't take pills because that would be suicide. So, it had to be something that was deemed a homicide.

Well, would be better than stabbing would definitely, any of that stuff would work. In fact, that probably would've been cleaner. Yeah. Is he going to shoot himself? I, I don't know. So, this was really, the whole case was deemed like, Dr. Kavian of the insurance World, and this happened 2009, but it really was in every newspaper where I was in New York on Long Island every day for years.

And then after it ended, it was still in the paper for a significant amount of time. So, there you.

Catherine Maley, MBA: Okay. That's crazy. And with that, we are going to end it there. Larry, how can doctors get ahold of you if they now realize they might have some insurance questions about “what happens if something happens to you” scenerios?

Lawrence B. Keller, CFP: Yeah. So very easy. You can email me.

It's l keller, lkeller@physicianfinancialservices.com. You could certainly call me at (516) 677-6211. I'm happy to review coverage that you have now. I'm happy to discuss with the insurance you might be considering or should be considering. But view me as a resource. Thankfully in the beginning, everyone's a hand surgeon, right?

Anything you can get your hands on, and then after you've been around for a while, you realize, this is what I'm good at. This is what I'm not so good at. This is what I like to do. This is what I don't like to do. So, use me as a resource, have no fear. I am happy to help any way that I can.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on “what happens if something happens to you”with special guest, Lawrence B. Keller, CFP.

If you’ve got any questions or feedback for Larry Keller, you can reach out to his website at, www.PhysicianFinancialServices.com.

A big thanks to Larry for sharing his expertise on “what happens if something happens to you”.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

-End transcript for “What Happens if Something Happens to You? — with Lawrence B. Keller, CFP”.

 

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

 

#surgeonlifeinsurance #cosmeticsurgeonfinancialplanning #plasticsurgeonfinancialplanning

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to "Beauty and the Biz," where we’ll discuss mastering surgery and business growth. Additionally, we’ll discuss the general business and marketing side of plastic surgery.

As always, I’m your host, Catherine Maley, author of "Your Aesthetic Practice – What Your Patients Are Saying." Furthermore, I’m also a consultant to plastic surgeons, helping them get more patients and more profits.

Presenting today’s episode titled, “Mastering Surgery AND Business Growth — with John Vartanian, MD, FACS.”

Obviously, mastering the art of blending business acumen with surgical excellence is a complex challenge for plastic surgeons. Specifically, clinical skills demand years of training and precision. However, running a practice requires an entirely different set of expertise.

Therefore, surgeons must balance patient care with business operations. For example, this includes managing overhead, optimizing workflows, and building a high-performing team.

In summary, here’s what you’ll learn:

• First, overcoming common challenges: Indeed, Dr. Vartanian discusses the hurdles most surgeons face. Specifically, these include managing overhead, balancing patient care, and handling business operations. Additionally, he shares how he addressed them head-on.
• Second, streamlining operations: Next, learn how optimizing processes and improving team communication transformed his practice. As a result, these changes saved time and reduced stress.
• Third, making data-driven decisions: Finally, discover how tracking key metrics and analyzing performance helped him. Consequently, this allowed him to identify growth opportunities and make smarter business decisions.

Ultimately, this is real-world advice from a surgeon who has successfully blended his clinical expertise with sound business principles.

P.S. Time to level up? Whether you're looking to attract more cash-paying patients, streamline your processes or boost your profits, I’m here to help. With decades of experience helping plastic surgeons grow their practices, I’ve developed proven strategies tailored to your unique challenges.

Let’s uncover opportunities, tackle obstacles and map out a clear plan for your success—all in one powerful session. Click below to schedule your personalized Growth Session today!

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Visit Dr. Vartanian's website

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

#drjohnvartanian #johnvartanianmd

#cosmeticsurgeonpodcast #plasticsurgeonpodcast #aestheticpracticemarketing #cosmeticpracticestafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #plasticsurgeonideas #plasticsurgeonagency #plasticsurgeonconsultant #plasticsurgeonstrategies #plasticsurgeonservices #plasticsurgeontrends #plasticsurgerymarketing #marketingplasticsurgeons #marketingplasticsurgery #cosmeticsurgeondigitalmarketing #cosmeticsurgeonmarketing #howtopromotecosmeticsurgery #socialmediamarketingforplasticsurgeons #socialmediamarketingforcosmeticsurgeons #plasticsurgeonsocialmediaideas #howtofindcosmeticpatients #howtofindcosmeticpatients #howtoattractcosmeticpatients #howtoconvertcosmeticpatients #howtoretaincosmeticpatients #cosmeticpatientadvertisingideas #cosmeticpatientstrategies #cosmeticpatientconsultant #cosmeticpatientservices #cosmeticsurgeonads #digitalmarketingforplasticsurgeons #consultanttoplasticsurgeons #consultanttocosmeticsurgeons #seoforplasticsurgeonsusingai #onlinereputationmanagementforplasticsurgeons #leadgenerationforplasticsurgeons #cosmeticpatientreferralmarketing #brandingforplasticsurgeons 

📅 Schedule your free 30-min strategy call with Catherine

⚙️ Restart your practice in 7 days

⬇️⬇️⬇️

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how Burke Robinson, MD went from a 40-surgeon practice to solo.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called "40-Surgeon Practice to Solo — with Burke Robinson, MD".

I am fascinated by surgeons’ stories that relay their jagged paths from fellowship to where they are today.

Nobody’s path was a smooth one and nothing went scheduled as planned. 

That’s life. It’s full of surprises, twists and turns and the secret is to adapt to these challenges and grow (or give up and settle for less).

This week’s special guest Dr. Burke Robinson knows this well and decided to grow.

He is a board-certified facial plastic & reconstructive surgeon with 30 years of experience in private practice in Alpharetta GA.

Dr. Robinson had a tough childhood start but managed to become a surgeon in spite of it, and then he ended up in a 40-surgeon ENT practice for years. 

Like others who had the calling for “more”, he finally spread his wings and went out on his own. 

We talked about the challenges he faced, what it took for him to finally make the move to private practice and pearls learned along the way. 

He also gives a really good tip for buying a laser ;-)

Visit Dr Robinson's Website

Enjoy!

Catherine Maley, MBA

⬇️ FREE BOOK:

📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H

✅ STAY UPDATED:

🌐 Catherine's Website
📝 Catherine's Blog
🎤 "Beauty and the Biz" Podcast
📺 "Beauty and the Biz" Videocast
🔊 "Beauty and the Biz" on Apple Podcasts

🤝 LET'S CONNECT:

➡️ Instagram
➡️ Facebook
➡️ Twitter
➡️ LinkedIn

P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me.

Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE!

Catherine Maley, MBA:

Everybody that’s going to wrap it up for us today on Beauty and the Biz.

If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

"The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue."

 

Transcript:

40-Surgeon Practice to Solo — with Burke Robinson, MD

Catherine Maley, MBA: Hello everyone and welcome to Beauty in the Biz, where we talk about the business and marketing side of plastic surgery and going from a 40-surgeon practice to solo. I'm your host, Catherine Maley, author of Your Aesthetic Practice — What your patients are saying, as well as consultant to plastic surgeons to get them more patients and more profits.

Now today's episode is with Dr. Burke Robinson, who’s has experience going from a 40-surgeon practice to solo. Now he's a board-certified facial plastic surgeon with 30 years’ experience. He's in private practice with two offices in Alpharetta and Atlanta, Georgia. Now, Dr. Robinson has been nationally recognized as an expert facial plastic surgeon by peers and patients alike.

He's lectured at medical conferences around the world, which is how I know him, and he is regularly invited to speak on this subject of facial plastic surgery to. Now, Dr. Robinson enjoys numerous awards for his commitment to excellence in patient care, education, and safety that include "Castle Connolly's Top Doctors", as well as "Best of Georgia" and "Top Doctor" in Atlanta Magazine for eight years in a row.

It's a good accomplishment how he went from a 40-surgeon practice to solo. Now, Dr. Robinson is a huge proponent of giving back to his local community, and he supports many. Community events and nonprofit organizations. Dr. Robinson, thank you so much for joining me on Beauty and the Biz.

Burke Robinson, MD: Thank you for having me. It's a pleasure, Catherine.

Catherine Maley, MBA: Yeah, thanks so much.

So, tell me why facial plastic surgery, who grows up saying, I want to be a facial plastic surgeon and go from a 40-surgeon practice to solo?

Burke Robinson, MD: That's a great question. Well, really it goes back to what I did in college. I worked in an emergency room as an orderly or a tech. And my two responsibilities were a trauma room. This is before we really had level one trauma centers.

So, I'm dating myself and the suture rooms where all the lacerations were taken care of. And the thing I enjoyed the most was somebody who came in like Humpty Dumpty, a laceration that was like a Stella laceration. Very complicated. And the ER doctor would refer it on. To the plastic surgeon to come in and put them back together.

And I had the pleasure of first assisting the plastic surgeon in the ER as they put everything back together. And it just amazed me every time how I'd look at it in my novice way and go, I don't know what they're going to do for this one. And yet they would pull a miracle out of the hat and the patient would go home looking almost normal again.

So, I think it started there and then, Going into medicine and starting medical school. Of course, early on you want to be everything you're studying at the moment, cardiology, you know, whatever it is at your rotation. But it always came back to wanting to use my hands and being able to do something that could be seen by others.

And so, the beauty of facial plastic surgery is the combination of those two.

Catherine Maley, MBA: Gotcha. Now I had been, I read your bio and you started off in a huge ENT practice with 40 surgeons, before you went from a 40-surgeon practice to solo. Correct. What was that like? I can't imagine 40 surgeons making a decision about toilet paper, let alone running a business

So how, how did that go and when did you go from a 40-surgeon practice to solo?

Burke Robinson, MD: Yeah, it was, it was a good thing. It wasn't chefs, so there would've been knives flying everywhere. Right. It was it really was a good experience overall because I made a lot of real good friends who are still good friends and colleagues of mine to this day. And they were some of my referral sources.

I was the only facial plastic surgeon in a E N T group of over 40. E n t surgeons. But we were at one time, even from what I was told, bigger than Mayo Clinic, we had four pediatric ENTs. We had head and neck oncologist, et cetera. So, it was nice to be a subspecialist early on. Made a lot of good friendships.

I learned a lot from them. They learned from me. But you know, as you alluded to, at the end, after six years, it was just unyielding and, you know, everybody wanted to be in charge and nobody wanted to be the Indian. And so unfortunately the, the group dissolved. To this day I still have some very good friendships with many of those people in there, and we refer back and forth as we can.

But most importantly, it really jettisons me into where I am now because now, I've been in my solo practice for 21 years and it's the best thing I ever did for myself. And at that time, I was around 40 years old. I remember calling my dad and I always say my dad was the original motivational speaker.

He, he just knew what to say and when to. I was kind of confused, didn't know what to do. Do I try and hang in with the group that's dissolving, go on my own, do I move somewhere, whatever. And, and one of the options was to go out on my own in Atlanta, and it seemed daunting to me, and yet I thought that was the right move.

And his common sense was, well, son, if you don't do it now, when are you going to do it? And after that I was like, yep, it's time. And ever since then, I've never looked back. I thought I'd missed the camaraderie, but my camaraderie is really not people I see face to face, but people I talk to see at meetings or, you know, during a year's time.

And as a result, I was able to have a lot of independence. I rarely missed a child's event. Was able to take vacations when I wanted, how long I wanted. And in the end, all the ups and all the downs I've gotten to own and I'm very happy with my decision.

Catherine Maley, MBA: That's fantastic. What, what the audience doesn't know is we're both from Chicago.

Burke Robinson, MD That's right.

Catherine Maley, MBA: But how did you end up in Georgia and go from a 40-surgeon practice to solo?

Burke Robinson, MD: Well, yeah, it's kind of a long journey. We, I was born and raised in the suburbs of Chicago and we moved to Arizona when I was in high school because my dad, who was a businessman, he worked in the loop of Chicago, was injured the day before Thanksgiving, when I was in eighth grade.

and had a severe neck injury, and so we had to move out of the cold, damp environment to the desert for his rehabilitation. So that's how we ended up in Arizona. So, I finished high school in Phoenix and did college in med school in Tucson, and then from there did my residency in the University of Minnesota.

So, I went from the desert. Back to the Tundra. And then I did my fellowship with Davinder Mange after my residency and did some research along the way at Walter Reed as a n I H fellow, and then was recruited by the group that we just talked about here in Atlanta and ended up landing here. And it seemed like a great way to get started in a major city because I knew for what I wanted to do, which was elective cosmetic surgery, I really needed to be in a bigger environment and Atlanta suited it.

Catherine Maley, MBA: Perfect. Gotcha. What now did you stay with e n t or facial plastic surgery or reconstructive? How did, how did you, obviously you had to start with reconstructive probably to get the thing going, but where are you at now with that versus cosmetic surgery and going from a 40-surgeon practice to solo?

Burke Robinson, MD: Right now, I'm 100% cosmetic with no insurance, and that's a journey that takes a long time, and there's two schools of thought, as you know, consulting One is you jump off the deep end and you just do that from the beginning.

The other end is if you've been trained in an E N T residency, you start off doing that and build your cosmetic practice along the way. I did the ladder and I'm glad I did it that way. A lot of the referrals I had early on in building my career were from nurses, anesthesiologists, dermatologists, doing MO'S reconstruction.

They saw my demeanor; they saw how I handled situations. They could see that it was different from other people and built a lot of trust in the medical community that really started the groundswell. Once you then had those referrals from those type of referral sources, then your patients became your ambassadors and it builds, you know, and compounded from there.

So even though you know, it's not a, anyone who's done a fellowship in facial plastic surgery does not want to go back to general E N T or doing reconstruction, I don't think it's a bad necessary evil. I think there's a lot of prose to it, and it builds you. The respect in the medical community and amongst patients to this day, I will occasionally have a patient may have taken their kids' tonsils out 20 years ago, and they still remembered from the way I had my office decorated, which was strictly an aesthetic.

Practice. I didn't have Mr. Larynx on the wall. It was everything spoke about facial plastic surgery. They will come in and say, yeah, you took care of my kid 20 years ago and now I'm here. I want to do my eyelids, or I want to do my facelift. That's very complimentary because they saw me as being a good surgeon, not necessarily what I did, but also just being a good surgeon for how I treated their family.

Catherine Maley, MBA: In my experience in today's world, I, I'm not sure you can live off of the referrals anymore because of the way the insurance is set up. And I just think it's so difficult to dabble in cosmetics. There are too many competitors who just eat, drink, and sleep cosmetic, so it's really tough to compete when you are not in it 24 7 like your competitors are, or they're willing to spend more for to help them when going from a 40-surgeon practice to solo.

Cosmetic patient than you are, because it's just so difficult. I, I hear you. Like I used to say, just jump, you know, just jump. Right. But then we've all been through a recession for, in 2008. It's like, let's not jump yet, you know, So I, I, I hear you. I don't know what the real answer is, but I was staying on the fence, I don't think is the right answer for today's world, but I could be wrong.

Burke Robinson, MD: Well, I think if you took my route, you have to understand that if you walked into that office, you had no idea what I did other than plastic surgery. Okay. Everything was built around that way, and that's why it quickly transitioned. And I used to laugh because it used to be they come in and they wanted their septum fixed and they're like, oh, I see your plastic surgeon.

Could you do my nose? Now? They'll come in and they'll say, I want my nose done. And., I saw in your bio that you're also e n T trained. Can you fix my septum? Yeah. That's when you know you've arrived.

Catherine Maley, MBA: Yeah. that that's going to always be your biggest issue with the I need my septum. And while you're there, can you just take care of that bump, right?

Burke Robinson, MD: Yeah.

Catherine Maley, MBA: That's going to, that, that comes up. I, how often does that come up and how does that relate to going from a 40-surgeon practice to solo?

Burke Robinson, MD: All the time. Yeah, yeah. But at this point, my, I mean, I've been mature in cosmetics for a good 15 years. So, the first five years-ish was, you know, a transition. And then after that it, I haven't looked back.

Catherine Maley, MBA: Okay. Now, are you the only one that obviously you're the only one doing surgery, but I also saw you have a PA and an RN.

Where are they fitting into this and your goal of going from a 40-surgeon practice to solo? And are, and I noticed you're doing quite a bit, you have a full-on med spa with offering tons of nonsurgical. Treatments because that's another huge investment. Can we just talk about that? Because others are afraid to put that investment in, but how important is it to have a surgical slash nonsurgical practice in today's world?

Burke Robinson, MD: It's imperative, as you were talking about in today's world.

In, in today's world, you will not make it in this space without doing nonsurgical treatments, and we can break that down further to med spa and injectables. If you're not doing injectables and you say, I just have a surgical practice, you're not going to thrive. In my world, I, I always make the point that injectables don't replace surgery, and surgery doesn't replace what injectables can do.

They complement each other. Mm-hmm., and I think it's really important if you want to be a good business. That you have people working hard under you, that you're not doing everything and you know, pure profit is me in the operating., right? So, if I get injectors to do the injectables, I can be in the operating room more, which is a higher cell and a higher profit rate for the business overall.

Mm-hmm. So, I, I've done a lot of trainings. I'm a trainer for Galderma, so I've been around the country for 17 years teaching others how to do injectables. And the practices that are successful are the surgeons that are willing to let go of the injectable practice. And let the injectors get those patients not compete with them because they're going to be making more and more money for you while you're in the OR.

Okay. And you build them up, you keep the pricings the same if you have good mature injectors, which I do. Both of them been doing it for almost 15 years each. You'll do much better financially and you'll have less stress and you can focus more on what you're really meant to do, which is surgery. I still do some injectables, fill in some time, but I would never make it doing what I do just in injectables.

So, I would strongly encourage everyone to always be looking at getting some mid-level if the state laws require it and have them be working hard underneath you and get good people and then pay them. What they're deserving. Don't, don't hold back because they will work hard for you. And then separate from that, we have, we have our two injectors and we're already looking for our third, which is great because the two now are booked out a couple months and they're full-time.

But then we also have an esthetician and she's been with me for 24 years and she's amazing at what she does. And as you said, offering the lasers, the cyan, the b l, the halo. Peels, everything from as simple as doing the I'm blanking on it now. HydraFacials all the way up to doing broadband light and inhaler resurfacing, having that whole spectrum and everything in the middle again, allows the patient to find a space in your office so they're not ready for surgery or they've had surgery.

I always make sure. Then they go through the med spa and they do their assessment to tell them, here's what you do to maintain your investment long term, and those patients keep coming.

Catherine Maley, MBA: That's the secret to that and how that ties in with going from a 40-surgeon practice to solo. I'm telling you; I am that patient that goes up and down that ladder. I've had enough surgery at this point.

I don't want any more surgery right now. What else you have? You know, and Right, and I'll stay put. You give me, what else do you have? And now I'm loving. The lasers have come a really long way. The downtime's not half as bad as it used to be on certain treatments. I mean, you're getting, you're getting as much revenue out of me in between the surgical.

Because there's so many more things to do in regards to going from a 40-surgeon practice to solo. It's amazing if you have all the time and the money in the world, it's shocking. It's, it's shocking what you can do in today's world. You can go... I mean from the tip, you know, from top to bottom. You can tighten every body part you can. Fill in anything you want, you can undo.

It's just shocking what you can do nowadays. So, I couldn't agree more. Keep, get that patient, keep them with you, but then also have a good understanding or a bridge between the two of you, between surgical and nonsurgical. Mm-hmm., because I have noticed a tendency for the nonsurgical staff to like hoard that patient because they don't want to lose them and that's not the right.

They'll come back, let him, let him have surgery and they'll come back to you later to help you go from a 40-surgeon practice to solo.

Burke Robinson, MD: I agree. And I think on the flip side, for as the surgeon and the head of the business, you know, every patient at their six-week follow-up gets automatically sent. To, to either the injector or, you know, if I have time I'll inject, but usually I'll send them to the injector because I know they'll be able to do the return, return routine business because my schedule's too busy with surgery and they automatically are sent to go see my aesthetician as well.

 Because the patient at six weeks post-op is like a bird in the nest. And they'll do whatever you tell them to do because they're so happy. So, if you say, look, now this is what we're going to do to take you to the next step. They want to know what else they can do. They want to know what is my next step in this journey.

And I always tell them, you and I are done for a while walking down this path, but someone else is going to get on with you now and continue down the road. And they like to know that. And so, but it's so important that the, the surgeon says that they shouldn't have to go home and then go to your website and they, oh, they have an aesthetician.

Maybe I should call them, make an appointment. They get that appointment on their way out at that six-week visit.

Catherine Maley, MBA: Good job. Now it sounds, oh, do you have any tips on how to buy lasers and how that might relate to going from a 40-surgeon practice to solo?

Burke Robinson, MD: No, that's all good., you and I were just at the Global Aesthetic Conference and my good friend Ross CLEs gave a great lecture on that.

I, I think you have to go slow. So, here's an example. We have a great laser. I love it. The cyan, halo, all that stuff. But then we, I won't say the brand, but we bought a skin tightening machine three years ago, and it's the best-looking door jamb I've ever bought. So now they have a new flavor that's come out.

Here's my recommendation because this is really what, what? Wherever meets the road, there's a new version of something out there. Again, I won't say the name, but I told the salesman, I said, I will rent the machine from you one day a month, three months in a row, and I'm going to treat my own patients with my pictures.

And then we'll look at them and we'll decide. And if it does what you're telling me it does, I'll buy two of them. But if it doesn't, I'm not buying it. So, we're now on our third month on a trial. I think that's the best thing to do with any of these devices is you should test drive it first, not just goes by their pictures, because you can be misled.

Catherine Maley, MBA: So, how is it going? Because skin tightening, I'm still very underwhelmed by it.

Burke Robinson, MD: I'm not feeling like I'm going to opening my checkbook anytime soon,

Catherine Maley, MBA: I just, I, I wouldn't go there. I just wouldn't. There are too many things you can do to give somebody a really good result if you're going to make them wait.

Another thing is waiting three months. Patients. Nobody wants to wait anymore. Everything's become so instant. Right. I just, I wouldn't bank on anything that you can't see for real, like honestly honest photos, which helps in going from a 40-surgeon practice to solo. I just, good, that was a really good tip. Yeah. Don't jump in unless you know what the heck.

Like you see your own proof.

Burke Robinson, MD: Yeah. And, and another thing I've learned over the decades is being always honest. You know, you may have a car payment due, but that doesn't mean you should take advantage of the patient because you have a machine that doesn't really do anything. It's going to come back to bite you.

Right? And you'll get many more referrals with a patient who say, you know, we really don't have a great answer for what you want right now. They're going to tell five people that this guy is honest and they're going to send their friends. And as opposed to them blogging and about how you took their money and the thing didn't change how they look at all.

And so sometimes we have to bite the bullet and realize we bought something that doesn't work, instead of trying to push it on people and then pay a heavy price in social media.

Catherine Maley, MBA: For sure. That changed everything, didn't it? Oh, yes. So, let's talk about staff and specifically, going from a 40-surgeon practice to solo, because it sounds like you have a pretty good handle on staff.

You've had them for a long time. Mm-hmm., what's the secret? Have you also experienced that post covid staff resignation, or where are you at with that?

Burke Robinson, MD: Yes. I think everybody has staff re or they call it a slow resignation. Yeah, after Covid I had two employees who were excellent. Both leave to get out of.

Oh, they just burned out and they left not because of working here. They, they just, they, they went in and went into sales and her husband bought it. The other one, her husband had a business and she wanted to go work with him, and she was very good and loved medicine. Yeah, we've had a problem off and on with the, the co-post covid slow resignation that's going on, and it's really hard.

In fact, I would say that's the hardest thing in running your own business is the. Human resources are the thing that I've always found the most challenging. I think, again, treat people how you want to be treated. When I was in that big group, there were times I didn't think I was treated with respect, and I didn't want to ever do that to an employee that I had if I went out on my own.

I think people need to be able to make a good wage reasonable for what they're doing for the business. And I, I also. Provide all the extras. I provide health insurance. We, they have their p t O off. We have medical what is it, 1 25? I can't, I think that's what it is. And I pay for everyone's lunch every day.

We get groceries every week. Everyone puts in what they want to eat and so they don't have to leave the office. So, they make whatever they want to eat. Trying, trying and do everything I can, you know, retreats do everything possible to make them know that they're appreciated and you know, it's a fine line because you don't want to become so close like family, but close enough that they know that they are appreciated.

Anytime I ever get an award, I always send my email and verbally say, we won this. I didn't win this. And I think when staff are treated with respect overall, you won't have a big revolving door going on. That being said probably the biggest mistake I've made in my career in owning a business is sometimes I hired from within and I should not have.

The Peter principal has shown up more than once in my office, and I own that. That's my fault. But you. Close to staff and you think they can do the next level job, and that's not always the case. And so, I'd recommend to your listeners think twice before you hire for a higher position from hiring within, you may want to keep that for outside.

There are advantages of keeping people within and promoting them, but you may be promoting them to a position they're really not capable of performing. And perhaps your personal. Appreciation for them can get in the way of your business decision.

Catherine Maley, MBA: And then once you do that, it's difficult to demote them back to where they were, which can be contrary to being able to go from a 40-surgeon practice to solo.

It's getting all awkward. Yeah. But that's too bad that I don't find that happens as much. I'll tell you what I have learned that it's happened lately, which I've completely changed my stance on this. I used to have like a staff reward program and I mean, you give them like $250 a quarter as long as that new patient state that they referred, not patient, I'm sorry their friend.

You know, referred and then they stayed. So, they kept getting paid for it for that year. So, they got a thousand dollars, you know, to have this referral. The issue is if they leave, then the other person leaves. So now you lost two people at the same time, You know, so I thought, well, okay, that's not working out as well as it used to, so, no.

Yeah, I think it's always going to be a challenge because we, human beings are complex, you know, at the, at best, and circumstances change and life changes. I mean, it sounds like you've had a, a good run though, if you've had people that have been with you for more than five years. I think it's genius. You know, and you're feeding them quite well, which helps you in going from a 40-surgeon practice to solo.

I mean, I hope they appreciate that. That's a big deal and it does help with going from a 40-surgeon practice to solo.

Burke Robinson, MD: I think they do. They show up by staying and working really hard. I think. It's a good mutual respect and, and they do everything I ask of them with a smile. You know, we always say a servant attitude is what you have to have here. This is Disney World for adult women, basically.

Catherine Maley, MBA: Right. How do you, how do you get that culture? I am shocked when I'm the consultant who's going to do a practice assessment on site. Shocked at the, some of the attitudes that I'm, they don't look up (which doesn’t help them if they went from a 40-surgeon practice to solo). They don't acknowledge me as I walk in or walk by. They don't smile. And I think really, you're, this is a fun medicine business.

You know, like you're not having fun and you're not have it. Let me have fun. I just How do you teach that to help in going from a 40-surgeon practice to solo?

Burke Robinson, MD: That's a great question, Catherine, and I think. You teach it by demonstrating it, it's by your leadership of a servant attitude. There's nothing in this office that's below me that I wouldn't do.

Like if my medical assistant's busy, I'll grab a chart, I'll bring the patient back, I'll room, I'll take the pictures. I think everyone needs to see the leader being willing to do that. I think that's where it starts. And I also think Showing respect for everybody in the practice, no matter whether it's the administrator or the front desk person, they all have an important role and really one doesn't supersede the other one necessarily.

And I learned that because my first job in college was a clerk with the old IBM electric typewriter in the emergency room, typing out admission forms. and triaging patients. That was my first year in the er, and then the following years is when I became an orderly, but I realized what it was like to answer phones to deal with patients.

Through a window. And then it being you know, an orderly being on the nursing side, not the physician side, and seeing what made things easier for me and how I could be disrespected or respected. And I think learning that and then reproducing what I thought was appropriate when I would have my own business and people who were working for me, that I wouldn't make those faux PAs to.

Catherine Maley, MBA: Good for you. So then do you still have two locations that maybe helped you in going from a 40-surgeon practice to solo?

Burke Robinson, MD: We have our main location, as you mentioned, is in Alpharetta, the second location we are there off and on, it's down. It's with a cosmetic dermatology practice more inside Atlanta. You've heard of trading barriers? Mm-hmm., you know, so Atlanta's surrounded by an interstate and so you either live in the perimeter or outside the perimeter.

So sometimes you need to have a presence inside the perimeter because people in the perimeter just don't want to. Outside the perimeter to Alpharetta. Mm-hmm., but most of my time is spent in Alpharetta.

Catherine Maley, MBA: Okay. Because I know a lot of the practices, they have a satellite office and it's basically to attract just a, a bigger target audience, which in turn, would help them in in going from a 40-surgeon practice to solo.

But then I, now I look at that and I say, I think we should do a cost benefit analysis of that for you to be out of the office commuting worrying about what's happening there when you are not there. But in your case, that was different. You. You didn't have to run this whole practice and staff it and all of that.

But I think again, in today's world, I think the complexity of that can often outweigh the advantage of it in terms of going from a 40-surgeon practice to solo.

Burke Robinson, MD: I agree. We were down there a lot more, 50 50, and it became complex. And that was still subleasing. That wasn't a whole separate office that I was responsible for. I was, it was a turnkey with a cosmetic dermatology practice.

So, it was really just show up, pop open your laptops. But even then, it just became, and it became confusing for patients. Mm-hmm., because they would think they're going to that location to see me and I was in the other office. Ah. So, we've. Limited it quite a bit now from going there, just for the reasons you said the complexity and you know, even though I was only paying for when I was there, just no reason to pay for it.

And I think as you become more known in your community and your reputation, people are willing to drive. It's like your hairdresser, if she went across town in San Francisco, you're probably going to go across town, right? Yep. Yeah, I think it's the same for. Mm.

Catherine Maley, MBA: So, do you have any plans to expand to help you in going from a 40-surgeon practice to solo, or where you, I mean, you, you've been at this for 30 years, by the way.

You certainly don't look at, you're, you're holding up very nicely.

Burke Robinson, MD: I might. Thank you. What injectables can do for you.

Catherine Maley, MBA: Right? This, this industry is amazing. So, what, do you have any plans like to grow or, or, or not grow to help or not help in going from a 40-surgeon practice to solo?

Burke Robinson, MD: Yeah. We're going to be hiring a third injector here in the next year now, cause our two injectors.

Crazy busy. And that's the nice thing about the market, as long as the economy can kind of hang in there the injectable world is only going to explode. It's not going to shrink, and you got to be a part of it. So that's the next step. And then I'd like to get down to four days a week instead of five and then bring a junior partner in.

That's what I'm looking for, you know, down the road in the next, I don't know, three to five years, somewhere in there. But I really enjoy what I'm doing. I think I'm at my best right now. Mm-hmm., I don't know what I'd do if I was off the whole week, but I would like to have three-day weekends, so the short-term goals, the injector, and then go to four days a week and then bring in a junior and then start to transition out, you know slowing down even more and doing more things than I like to.

Catherine Maley, MBA: Do you have any hobbies (besides going from a 40-surgeon practice to solo)? I know a lot of surgeons don't have any hobbies, like doing surgery is what they like to do. So, what else would you do? You know?

Burke Robinson, MD: Well, that, that is, you know, that is a problem for surgeons because we have to recreate ourselves because we've been so dedicated. I, I like to play golf.

I'm not good at it, but it's something I really enjoy. Yeah. And I do want to focus that on, cause I think I can really take me. My focal abilities and really hone in on that skill, but it's something of repetition. So, I enjoy doing that. I enjoy skiing in the winter, go out to Colorado several times. I enjoy doing those two things.

And, and dinking around the, the house, some of the gardening, not a lot, but a little bit.

Catherine Maley, MBA: Yeah. Well, I'm out here in by Lake Tahoe. Have you? No. Skiing out at Lake Tahoe. Squaw Valley. It's beautiful out here.

Burke Robinson, MD: I know. I, that's one area I have not skied yet. And I've heard the snow is different. It's a heavier snow than the powdery.

Catherine Maley, MBA: But the weather's better. You know, it's like, it's a lot of spring skiing a lot of times. Yes. And that's now that I'm such a, I'm getting old. I don't, I don't want to fight the elements anymore, so I only go if I have to wear, you know, sunglasses. You know, it's got to be sunny. No, no wind.

Burke Robinson, MD: Yeah, I'm jealous. That's a beautiful part of the country and I love Lake Tahoe. I can go there any time of year and have a great time.

Catherine Maley, MBA: Thanks. It's lovely. I need to get up there more often. So, but that was the business side of going from a 40-surgeon practice to solo. Let's talk about the marketing to help in going from a 40-surgeon practice to solo because you're, you're in a very competitive area there.

Did you, how, how do you differentiate yourself from everybody else? And do you do it any differently now than you used?

Burke Robinson, MD: That's a great question. I, I don't know if I differentiate myself on purpose. I think what differentiates me is my honesty. Mm-hmm. and always giving my best and staying humble. I think that those the main things.

Staying true to what my roots are, which is sometimes facial plastic surgeons like to drift below the neck. Mm-hmm., and I think that dilutes you. That doesn't make you an expert anymore. I can't tell you how many times a week someone goes, I'm coming to you because you only work on the face. There are only pictures of the face.

All you talk about is the face. I want an expert like that. I don't want the brake guy working on my transmission. Right? And so that by itself is huge. So, you've already condensed down quite a bit. Who I am com because there's a lot of general plastic surgeons here and some of them are very good in the face too.

But PA I think patients are becoming very sophisticated in what they're looking for. And me staying true to that has been. I think what also differentiates a lot is reviews. Yep. You know, talking about marketing, I, I will say I was on the bandwagon really early with reviews, and if you Google and look, I, I have quite a few reviews and.

Anything I buy now; I go online and I do a review. Yep. I don't talk. I don't look at what the company says. I look to see what the buyer says and patients several a week like You have such great reviews, I just wanted to meet you in person and see if you're the right person. I think reviews differentiate you quite a bit and doing your best will be reflected in those reviews.

Everyone's going to get a bad review now and then just like the Four Seasons and the Ritz Carlton. But if, as Jeff Siegel says, the solution to pollution is dilution, as long as you're getting a lot of good positive reviews, those few negative reviews just really justify that. Those are all real. It's not, you know, your mom at home with an IP address cranking them out every day.

And so, I think, again, being who you truly are, and letting that be shown through patience and what they say about you differentiates you quite a bit.

Catherine Maley, MBA: You also did a really good job with video testimonials from patients. Mm-hmm., that's the next step that I think we all, we all have to embrace video of The audience today is just too lazy to read or I don't know what's going on, but it's all very visual now and very entertaining.

And how did you, and, and it looks like you've did a, done a good job with that. Was there any secret to getting the patients to do it, which helps you in going from a 40-surgeon practice to solo? Probably you asking was probably a good start.

Burke Robinson, MD: These are such great questions. So, let's go back to reviews for a second, then we'll go into that. I think the key of getting a review is I have to ask for it.

And a lot of surgeons can be timid, shy, or that's below them to ask for it. But like you said, you got to do it. If you want to get a review, you have to ask for it. Mm-hmm. and you need to get it in the moment. Don't send them a link because that's going to get lost in all their other social media. So, it's done in the exam room at that time.

That's critical. Now as far as getting patients to do video reviews, same. It's asking and it's me asking, not going. I don't want to ask them, send the marketing director in because she would turn around and say, no. The way it's going to work is you have to ask them and asking the patient directly. I just tell them; you have such an amazing result and I'd love to share it with other patients.

You have a great demonstration of. You know jowling that got resolved, or a tip that was under rotated and it's a beautiful rotation, blah, blah, blah, and they're already happy with the results. So that sweet spot again to me is at about six to eight weeks post-op. That's when you ask them, and rarely do they say no.

And I always preface it with, look, we have plenty of videos, which we do. There's no pressure. Mm-hmm., but I think you're well spoken. You look beautiful. Could we have you do a video testimonial? 90% of the time they say yes.

Catherine Maley, MBA: Who would say no to that? I mean, you're getting, you're good at the compliments that, that's helpful in going from a 40-surgeon practice to solo.

Burke Robinson, MD: Yeah. I mean, complimenting them because you really do believe it. We're not going to put up something that's not a great result. We want a great result and we want you to be the one. And they're very ha they're very happy to do it. And then getting a great videographer. We have an amazing videographer. Here in Atlanta and he shows up after five o'clock and our marketing director and I'm there and that's when we shoot it.

And they've really got it down to Grease Lightning now, and they, they streamline it quite a bit and do a great job. So, I'm glad you've got to see them.

Catherine Maley, MBA: Oh no, they're fantastic. I used to also, I have this strategy to help with going from a 40-surgeon practice to solo where if you're not going to focus on the. all the time. Then at least have a biannual or an annual photo shoot, and it's done on a Saturday.

Mimosas are helpful, or a little wine, and you have a videographer, a photographer, hairstylist, makeup artist wardrobe, like you, and it's all community service providers, so that helps with referrals and you make like a whole event out of it. And it's really fun. It's a fun thing to do. It's a pain in the neck.

It's like a, a, you know, planning a wedding almost. It's an, an event, but it, everyone's relaxed, it's fun, and it's all about, let me tell you, my story. The issue is the timing you catch. I need, you need to catch them when they're ecstatic, not just happy, frankly, they're not even going to remember six months from now.

Like, they're like, they're so used to it. They're like, no. Yeah, it was great. You know? No, we need them to say, changed my. You know, so anyway, there's no one easy way to do that. But boy, putting in the effort like you are and asking yourself, that's exactly how you do it and that ultimately helps in going from a 40-surgeon practice to solo.

Burke Robinson, MD: And I, and I think it's more important for the patients to say how they feel.

Yes, that's where the patient's bond than to me to be on a video. I mean, I'm, I'm in those videos, but I'm not really telling the story. The patients are telling their story and patients will find something that. That person on that video says that, you know, hooks them and they're like, that's how I feel, or that's how I want to say it, or that's what I want to look like.

And so, I think the focus should be the surgeon. Even though we all have the egos and we think it's all about us, it's really about the patient and they want to see how the patient turned out and what they say in their own words. It's been very powerful that.

Catherine Maley, MBA: That's great. Are, are there other marketing strategies, tactics that are working better than ever or working now that or some that don't work anymore, in terms of going from a 40-surgeon practice to solo?

Like, what's working for you and what's not?

Burke Robinson, MD: You know, that's a good question. One thing is, You know, back in the day, and I'm old enough to remember where print was a big deal, right? Print marketing and being on right side inside, cover all that placement. I think print, it's not dead, but it's, it's on C P R.

But we still do some very, very little print marketing just to keep a footprint in that space and looking at it, I would say we probably break even. That's about it. So, it's not somebody that's going to be a lead sales thing, but I still think it reinforces when someone hears my name and then they happen to see it in a magazine.

They probably aren't going to come in because of the magazine, but it was like, oh yeah, that's the guy. So, I think it, it's, it's kind of an indirect thing. I think has been helpful. The reviews we've talked about, I think is indirectly. I didn't think this would be as good as it is, but click pay to click.

Yeah. Pay-per-click. Yeah. Yeah, that has been really, really good. I've been very surprised at how well that has gone. We use reach local. Okay. And Tara Leifer is our account manager and she is a genius. Mm-hmm. And she had to twist my arm to convince me because it was at one of the meetings. Cause I was like, nobody clicks on Advertise.

you know, and I don't want to put my name there. Mm-hmm. Well, we did it and in preparation for this, we looked and our o ROI on that is five to one. Mm-hmm. It's really high. I'm surprised how many people they Google Facelift Atlanta. And if I come up first with click, you know, click advertising, they'll click on that and they will follow through and they'll come in and a lot of they're serious shoppers and they will end up having surgery.

Mm-hmm., here's the caveat for everybody. You want to make sure your competitor isn't paying on their click for your name. Because at one point I found that a couple competitors were bidding on my name. So, when I Googled my name, they came up and said of me, how did you find? So, we have to be careful in that space.

How do you know? You Google your name. When you Google your name and your competitor comes up first, instead of you, either whoever is doing your pay per click advertising is not doing a good job, or they're just outbidding you on your own name.

Catherine Maley, MBA: Right. You don't know. I, that's why t's so murky like this pay per click, it's murky.

You don't know what is going on behind the scenes. Unless you're really looking at these analytics carefully and, and knowing what's, I don't know. I, I think it's fantastic if it's working for you to help you in going from a 40-surgeon practice to solo. That is fantastic.

Burke Robinson, MD: Well, I think it's getting a good rep who knows their business very well. And the other thing is then your website has to match up well with that.

Your s e o and I had I was paying for a company out on the west coast to take care of my website and it was so messed up behind the scenes and I had no idea until I brought a marketing person internal and she started researching everything. We had broken links, the SEO didn't make sense, and once she took over and straightened that all out, then the paper click flows with the SEO O.

It has to all mesh. So, it's, it is a web, but if you have people that are dedicated to it and know what they're doing, it can be very, and you know what you're doing.

Catherine Maley, MBA: That's really smart, which helps you in going from a 40-surgeon practice to solo. You have that whole out of town page that gives you some cache, you know, it, mm-hmm., it, it helps your brand.

Mm-hmm., it just looks good. And the reach helps as well because Google wants you to be so local now. That's why that local's working so well for you. But you also want to be able to reach in case, I mean, do you have many out-of-towners?

Burke Robinson, MD: We've had people from the Bay Area, we had people around the country.

Isn't it interesting? It, it's very fascinating. Sometimes it's because they have family here. Sometimes it's because they used to live here and they trust this environment and sometimes it's just s e o and they end up finding me. And I think you bring up another good point is if you really want to be.

More known regionally or nationally, you have to accommodate your patient. So, we have partnered up with two hotels near our office that are almost a stone’s throw, and they give a discount for our out-of-town patients when they come in. So, it's been really good for them.

Catherine Maley, MBA: Nice. I also noticed you cater to men.

You have a men's section. Now just how, how big of a profit center is that for you? Catering to men and how does that help you in going from a 40-surgeon practice to solo?

Burke Robinson, MD: I think just like everyone else, it's not the majority. It's probably like 15%, maybe on a good month, 20, but probably about 15%. But you know they, they still keep coming in. They're not going to be really facelifted patients.

They're usually eyelids and, you know, Disport or Botox, that kind of a thing. I enjoy seeing them though. And, and they're what I would call the metrosexuals. They're going to look good too. Right. And they're not over the top.

Catherine Maley, MBA: Crazy. Did you build a man cave for them in your practice?

Burke Robinson, MD: No. If you saw it here in my office it's called the “Bat Cave”.

Catherine Maley, MBA: Oh, are you serious?

Burke Robinson, MD: Yes.

Catherine Maley, MBA: Oh. What, what does it look like?

Burke Robinson, MD: Well, we have a little shrine for Batman over there. It's got my face on a bobble head. The back of my chair here has a Batman cape, and each, each room in the o office is named, but mine's called the bat cave. It doesn't say Dr. Robinson's office.

It just says Bat cave with the wings. That is just having fun with the staff.

Catherine Maley, MBA: Do you, you don't have a cape?

Burke Robinson, MD: I wish I; I wish I could fly. Yeah. . .

Catherine Maley, MBA: So how, what, what about social media to assist in going from a 40-surgeon practice to solo? Are you playing it a little bit, like, are you jumping in or you're, it doesn't help or hurt or...?

Burke Robinson, MD: My approach again to social media.

I, I think that it can, it can be good or I think it can bite. And so, I think what happened during Covid, I, I, I, I mean I've still chuckled at some of the things I saw people doing on social media to stay in front of people cooking a steak. Playing the guitar and singing. I'm like, you're not Emerald. And you're not Bon Jovi.

Okay, so be who you are. Yeah. And I think there can be fatigue from social media when every day or every other day there's something coming out from your office that has nothing to do with what you do. And I think people can sometimes say delete, you know, disengage, don't want to be a part of it. So, my approach has been more, let's keep it educational celebratory, if we win an award or if it's a holiday, you know, veterans Day, whatever it is, and keep it more in that vein.

And we don't find many people falling off our social media. But for me to just do a video to be funny, to show my latest dance move, I don't think that enhances my image. And really, patients really want to see before and after pictures, and that's really where we stick to it. I think some people get a little too goofy, eh, maybe that works for them, but that's not my image.

That's not my style. And patients really want to know, what can you do now? What can you sing for me?

Catherine Maley, MBA: That's for sure. So, we're wrapping up, we're getting close to an hour here. Just I'd like to talk about your mindset and start with how did you learn the business and marketing side of plastic surgery to help you in going from a 40-surgeon practice to solo?

Because you guys did not grow up with this, nothing about it in medical school. How did you find, how did you figure it out?

Burke Robinson, MD: Gosh, you know, that's just on the job training. You know what works and what doesn't. You learn from your mentor. You know, I trained under Devvin Manget, who is a brilliant man, and for the marketing.

When I finished my fellowship in 91, he was cutting edge. It's really learning how to change as the times change and what works and what doesn't. Talking to your peers a lot. The ones who will really tell you the truth, not the ones that'll just make up stuff to make them look bigger and better than what they are.

I think you'll learn a lot from that. And I think also, Always looking at it from a consumer side, what would I be looking for if I was trying to find a good facial plastic surgeon? Again, to me, social media and seeing me, you know, make a filet on the grill doesn't tell me a thing about who I am as a surgeon.

Yeah, I'm a nice guy, but really show me your results. I think that that's, looking at it from the consumer side, the servant attitude. How would I want to be treated if I'm coming in with expendable cash? I'm not here because my h m O sent me here. I'm here because I decided to show up, tell them, proved it, why I should be dropping money in your pocket.

So, it's always looking at it from their perspective and, and then it's on the job training and trying what does work and what doesn't work. And you're, you're going to spend some money. and yet nothing as a result. Like as an example, having an open house we used to do that every year. It became an accounting nightmare for us, and it seemed like a year later I'd have this money sitting in the pot, and yet nobody had come to use it.

But I knew I had to hang onto it because when they showed up to use it, I had to buy the product., right? So, we over time realize doing specials every month, working closely with the vendors. They'll always work with you to promote their product and do a two for one or something. And it doesn't cost you anything.

They're going to, you know, resupply what you're saying, you're doing a two for saves you a lot, a lot of money and it's. It gives you something new and fresh to promote every month. And probably the last thing is bringing up marketing person internal. You know, there's not a lot of you walking around, unfortunately, but if you can find someone who really understands cottage industry marketing, not you know, park Avenue Marketing.

Mm-hmm., and it's a whole different breed as you. And that's why you're so busy with what you do, because there's not a lot of you around. And to find someone who's that good that you can bring inside, if you find them. Do it because otherwise, as I mentioned, you're third partying this out, you got somebody in another state and they really don't have their heart and soul into it because they're not seeing you every day.

So, if you can ever find someone who's truly trained in marketing and knows what they're doing and understand social media, s e o website graphics collateral material. That's the kind of person you need inside that'll take a huge weight off your shoulders and let them work with it.

Catherine Maley, MBA: You'll have peace of mind knowing it's getting done.

There are too many you're just too busy to hold vendors accountable. And that's the biggest battle is what are these people doing for me, and I'm, I, am I, why am I paying them and how does that help me in going from a 40-surgeon practice to solo? Or what am I getting out of this? And then they send you a 30-page report with numbers on it that you have no idea how to read.

And. That's just such a challenge. But speaking about challenges, because I hope you don't mind if we talk about this. We always talk about, like right now when we do this podcast, everyone's showing their best side. You know, I didn't wake up looking like this, you know, and you didn't just become a surgeon by accident.

You know, could you just tap into your childhood experience that helped groom you to who you are today and gave you the insight of going from a 40-surgeon practice to solo. All of them got all these characteristics that you have now. Can you just talk about that a bit because it hasn't been easy for you.

Burke Robinson, MD: Yeah. So, My childhood experience was my, my mom had multiple sclerosis at a, when I was very young.

So early on I was doing a lot more around the house than probably the average child. Loved doing it, mowing the lawn, shoveling the snow in Chicago doing all those things because my dad was more focused on earning a living and taking care of my mom as much as he could. So developed a res an attitude of responsibility early on and being responsible and doing my best because that's what we had to do at home.

And then when my father got injured, all of a sudden, I kind of became the man indirectly for a while there at age 15. And I used to joke around that I was the Uber of 1975 because I was driving them around with my learner's permit to their doctor's appointments. But it was a great inside. You know, how would I say it?

Just a, a way to peer behind the curtain from a patient side and see how my parents were being treated and what a compassionate doctor did, what a responsible doctor would do, and how my parents would feel when they left, good or bad. and then going from there on into college and then being on the provider side, but not as a physician.

But again, on the nursing side or as a clerk, always seeing and staying humble and understanding your roots of really what are you doing, what is your end game, of what you're trying to do? You're trying to help somebody. And I always say to people that even though we're in an elective, a. Environment.

We all went into medicine to help people. Okay. We get paid well for what we do, but we get paid well because we're helping people and we're doing the right thing. And I think during Covid, I, I came to the realization when we came out of Covid and we were so busy. Mm-hmm., I didn't realize how much.

Positive positivity and positive mental health we impart on patients through what we do. No, we're not curing cancer. We would never say that yet. We are filling a void. We're doing something for people that they can't get elsewhere. And if we always maintain that servant attitude and a humble attitude and just always doing the best at that time, and a lot of times that means turning something.

Because it's not going to benefit them or you can't give them what they need. You're going to always be thought of, well, and you'll always be kept busy, because people always think the best of you.

Catherine Maley, MBA: Well, good for you. I, you know, I, I have that Chicago Midwest work ethic, obviously you do too since you’re so good at going from a 40-surgeon practice to solo. We were all shoveling snow and mowing lawns and housekeeping and watching kids, and I thought, oh, dear Lord, this is, I'm supposed to be, go out having fun.

What's going on here? Right. So, I feel for you. And that was, that was tough, but you persevere and you're, you, you've really built such a beautiful practice. So, congratulations on your success in going from a 40-surgeon practice to solo.

Burke Robinson, MD: Well, thank you Catherine. I appreciate it. And you've been a part of it too, because I've leaned on you from time to time and we are actually using it right now with some of our surgery coordinators because I always think you can be better.

You can always take it to another level. I mean, that's what you're taught as a surgeon. You always look back and go, what would I have done differently? What could I have done to make that a little bit better? And I think that's the truth. That's the truth for all of your staff. And so, you've always been a, a beacon of light for me and my practice.

And it was so fun to have you introduce me at the last meeting, because I thought that was like a circle of life and I really got a tickle out of that. Yeah.

Catherine Maley, MBA: I just know that if you don't keep learning and growing to help in going from a 40-surgeon practice to solo. You know, you're, you're dying. You really are like, you've got to stay on your game if you want to play it, you know, it's, it changes.

Anyway. How can people get ahold of you if they'd like to?

Burke Robinson, MD: Okay, let's see. My email address is "drr", "drr@robinsonfps.com, which stands for facial plastic surgery robinsonfps.com. And the number here at the office is (770) 667-3090

Catherine Maley, MBA: But your website is Robinson FPS…

Burke Robinson, MD: .Com.

Catherine Maley, MBA: .Com. Yeah. All right.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on going from a 40-surgeon practice to solo, with Dr. Robinson.

If you’ve got any questions or feedback for Dr. Robinson, you can reach out to his website at, www.RobinsonFPS.com.

A big thanks to Dr. Robinson for sharing his experiences on going from a 40-surgeon practice to solo.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

-End transcript for the “40-Surgeon Practice to Solo — with Burke Robinson, MD.”

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