receptionist

To ting der ærgrer mig - og som koster dig dyrt...

I denne specialepisode, som foregår direkte fra landevejen efter at jeg er checket ud ad mit hotel, kan du høre om to situationer som er dyre for hoteller.

Den første situation handler om de dyre, dumme og uundværlige OTA'er - i dette tilfælde booking-dot-com som jeg blev nødt til at benytte på grund af en uheldig kombination af tidspres og dårligt hjemmesidedesign fra hotellets side.

Den anden drejer sig om aftensmaden - du ved den vare som mange hoteller har på hylden og som bliver forøgt hemmeligholdt af gud ved hvilken årsag.

Begge temaer har du måske arbejdet med og begge temaer er noget som denne podcast har haft på programmet før. Men jeg syntes alligevel, at der var grund til at starte optageren, da jeg sad i bilen, for det ærgrer mig oprigtigt, at de hoteller jeg besøger, går glip af penge - mange penge.

Derfor kan du i denne episode få inspiration til:

At sælge mere aftensmad - via et enkelt spørgsmål.

At øge omsætningen i en restaurant - uden at det koster dig en krone.

At kombinere excellent service, god kommunikation og mersalg.

At sikre dig, at travle bookere ikke bare hopper over på en dyr OTA - fordi det er svært at navigere på hotellets webside.

At få de gæster der har booket via en OTA til at ændre adfærd i fremtiden - uden at skælde ud.

Tak fordi du lytter - og god arbejdslyst :-)

Receptionists. They see and hear the good, the bad and the ugly. It’s typically a role that we can forget about in the ecosystem of a workplace because they tend to field so much feedback and are empowered to solve issues before they hit your inbox. It is a crucial element of what we talk about every time we see a 1-star review, primarily because they may have already interacted with the person fielding complaints for your office or business.

Lane Hahn joins us on the Lone Star Podcast this season to chat through their experience as Campus Advantage’s (AWARD-WINNING) Front Desk Coordinator, and what they bring to situations every day through phone calls, emails, and the like. The review in question details a LOT of communication fatigue, so speaking with Lane brings forth multiple takeaways and ideas for how we can bridge the gap of a miscommunication, or a lack of communication altogether. We also bond pretty heavily over some almost-traumatic experiences in our yesteryears!

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We answer and schedule your new patient phone calls either as your primary or backup - Stop using outdated answering services as nobody leaves voicemails anymore ... We speak just like your own employees, remote in and schedule new patients and they never know a "third party" answered!

www.NewPatientGroup.com/FreeCourses
At New Patient Group, we are more than just orthodontic practice consultants. We are a transformational coaching and marketing company bringing outside of healthcare expertise to orthodontic practices wanting to thrive in the new economy. We come from outside your orthodontic practice “bubble” with real expertise in all the non-clinical skill sets you and your team must have to succeed in today’s commoditized orthodontic industry. We are described by others as having an “underground cult following” with a client retention rate of over 98% and the biggest orthodontist names as clients while spending virtually nothing on advertising. 

We are founded by Brian Wright, a world-renowned expert in business growth, sales, customer service, and consumer psychology. He is also a trusted speaker for the finest companies in the world, including Invisalign, Henry Schein, Dental Monitoring, OrthoFi, and others. He has been described as a combination of the team from Shark Tank and Marcus Lemonis from The Profit. 

The best orthodontists in the world utilize our innovative coaching and marketing services to become better versions of themselves, streamline their practices, advance their careers, break through plateaus, improve conversion, increase new patients, and more!  

Schedule a Free Consultation today and let us learn more about you, your orthodontic practice, and how we can customize something specific to your wants/needs.

t your orthodontic or dental practice, your receptionist is often the first point of contact for most patients. Traditionally, the main purpose of their job was to greet patients in the office, answer the phones, and schedule appointments. But with the growth in this industry, their job has become so much more. Your receptionist plays a crucial role in propelling new patient growth as they take on more of a treatment coordinator role, selling your practice to your clients and potential clients. 

Did you know that on average, those looking for a dentist or orthodontist are calling up to five offices before they decide to visit? That means your potential patients are talking to your receptionist and four other receptionists before they bring their business to the one who impressed them the most. This means your receptionist has to really wow every individual they speak to over the phone. They have to act as a salesman to really leave a lasting impression on the individual in order to compete with the other four receptionists they’ll talk with. 

With so much competition in the dental and orthodontic field, every practice needs to find a unique way to stand out against the competition. Your receptionist is your secret weapon here. In this new economy, your receptionist will need to play five different roles in order to capture the attention and commitment of new patients. 

One: Get Patients to Schedule

Because most patients are calling multiple offices, every phone call inquiry is not equivalent to the number of new patients you will see entering your practice. Your receptionist may answer 20 phone calls one day, even if every question is answered right on script, this does not guarantee that the caller will schedule an appointment at your office. Your receptionist has to be trained to go off script and to create a compelling argument that separates you from every other doctor they have called. Most receptionists follow the same script and provide callers with the same answers as their competitors. 

Most

The Pirates talk about careers and how they got where they are today. Three very different occupations with some of the struggles in each one are discussed, as well as a few mentors who were inspiring and pushed for greatness! 

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 take-a-ways.

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.

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

✔️ STAY UPDATED!

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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”.

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#increasesurgeryprofits #givebacktopatients #ryanneinsteinmd

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. This Week Only! If you want better results from your advertising efforts, the solution is to fix your lead gen process. I’ll do it for you at a fraction of my usual fees.
Watch this video…..

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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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”.

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#offsettingcosmeticsurgeonoverhead #offsettingyouroverhead #jasonpoznermd

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

P.S. Get my hard copy book for free when you leave a review at Beauty and the Biz Podcast. Just follow the instructions below:

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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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”.

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#surgeonlifeinsurance #cosmeticsurgeonfinancialplanning #plasticsurgeonfinancialplanning

One of the stylists, Courtney Gandy comes on the show to chat about what she's learned in her seemingly vast career search. From being a flight attendant, to working at a podiatrist's office, Courtney shares what led her to become a hair stylist and how that decision has changed her life for the better. 

Further reading at WhileYoureInMyChair.com

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

P.S. Get my hard copy book for free when you leave a review at Beauty and the Biz Podcast. Just follow the instructions below:

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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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.”

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#burkerobinsonmd #alpharettaplasticsurgeon #solopracticesurgeon

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and the easy 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 “The Easy Way to Success...”

I made this quick video for you so you’d know the easy way to success.

By the way, The Cosmetic Practice Vault Intro Offer includes….

• Lifetime Membership
• (2) Strategy Calls with me personally
• Cosmetic Patient Attraction & Conversion Blueprint
• Patient Coordinator Scorecard
• Marketing Trends Guide
• My popular book

But it ends Saturday!

The Easy Way to Success…

Now, here’s the easy way to success because the fastest way to success is to model other successful surgeons who have what you want, but you most likely don’t know how they did it because 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 help with the easy way to success. So try this way instead. It’s guaranteed to move you forward, so you’ll learn the easy way to success.

My intellectual property to grow cosmetic revenues comes from the following: 23 years, working exclusively with plastic surgeons to increase their cosmetic revenues, 21 million in revenues generated from my practice building strategies, 441 blog posts 182 podcast, 1000 social media posts, 237 talks given around the world, 5,800 doctors following my work, and 2100 doctors have invested in my consulting and projects and services to get, be, have, and do better than they knew was possible to learn the easy way to success.

I compiled everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win and how you too can learn the easy way to success.

You get LIFETIME membership during this introductory period so act now by going to www.CatherineMaley.com/Vault/ and I’ll see you there.

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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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 enjoy a steady stream of cosmetic patients.

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 "Enjoy a Steady Stream of Cosmetic Patients".

When I consult with cosmetic practices and ask them their top priority, it’s usually they want more leads.

They are most satisfied when the phone is ringing, they have lots of internet leads for their staff to follow up on and their schedule is booked with consults.

They feel good when they are extremely busy moving from room to room with patients eager to talk about their cosmetic services.

But do they really want more “patients” or do they REALLY mean  more procedures?

Here’s the reality, just because you’re busy doesn’t mean your profitable.

If you’re doing 10 consults per day but only booking 2 of them, something is off.

In regards to doing 10 consults per day but only booking 2 of them and something being off, that's not how you enjoy a steady stream of cosmetic patients. Here’s what I mean…

Getting more cosmetic procedures is a 3-step approach:

1. You need to get more CALLS
2. Your receptionist needs to be able to convert these CALLS into APPOINTMENTS
3. Your coordinator needs to be able to convert these appointments into paid PROCEDURES

And although this seems to be pretty straight forward on how not to enjoy a steady stream of cosmetic patients, it's not that easy to get more calls, appointments and procedures. Here’s what I mean:

1) Get more CALLS:

You probably receive a lot of emails from people claiming that they can get your phone to ring!

• Some might try to sell you "pay-per-click (PPC) advertising.

• Or, they tell you 53 things that are wrong with your website so you’ll hire them to re-design it.

• Or, they tell you the "penguin / panda / zebra-safe way" to catapult your website to the top of Google through some Voodoo SEO.

Have you ever tried any of these tactics?

How did it work out?

For many surgeons these "magic bullets" to enjoy a steady stream of cosmetic patients don't seem to work, yet they are told to "give it more time" and just pour some more dollars into pay-per-click while they’re waiting for organic leads.

Then there’s 2) Get more booked APPOINTMENTS

Let’s say you pulled the trigger and sunk a small fortune into a gorgeous new Website and you paid big bucks to get prospective patients to it. They check you out. They like what they see. They call your office to learn more. And?

What kind of experience do they have on the other end to help you enjoy a steady stream of cosmetic patients? Is it consistent with your new “look and feel” or is there a major disconnect between the high-end look of your branding and the low-end quality of their phone experience with your office?

It’s not enough your receptionist have a nice phone voice; although that certainly helps. Your receptionist also needs the skill to take a “look-e-loo” caller who is going down the search results list and calling you and everyone else to figure out who can help them.

A majority of the callers will be lost here if your receptionist is not a trained ambassador who skillfully welcomes the caller to your practice and invites them in to get to know you better, so you can enjoy a steady stream of cosmetic patients.

And lastly, #3) Get more PROCEDURES

Ok, now you’re making progress so you can enjoy a steady stream of cosmetic patients. The new patient found your new Website. They called and booked an appointment. And, they actually showed up for their appointment so things are looking good.

Now what? Do they have a great first impression of your office? Are they made to feel welcomed and relaxed? During their consultation with you and your staff, did they discover overwhelming evidence of why you are the BEST CHOICE?

Because here’s the reality that helps you enjoy a steady stream of cosmetic patients…the cosmetic patient with a credit card, as well as a lot of choice in providers, is looking for who can best give them what they want. What they want is a great result in the easiest, most comfortable way possible – financially, emotionally, physically and psychologically.

That’s why so many different variables go into their decision-making process when choosing the right plastic surgery practice for them. Yes, your reputation, credentials and before/after photos are essential in helping them “see” your skill and expertise.

But there are other factors that are more subtle, yet equally important to help you enjoy a steady stream of cosmetic patients:  your demeanor, your eye contact, your listening skills and it goes on and on.

And here’s the biggie….Is your patient coordinator able to convert them to a paid procedure? If not, then you can't enjoy a steady stream of cosmetic patients.

This is where the rubber meets the road. All that you have spent on advertising, marketing, staff, office and web design is wasted when the prospective cosmetic patient chooses your competitor over you.

Because nothing else matters until the patient actually chooses you and PAYS for your services.

This step in converting a prospective would-be patient to a paying customer is no easy feat as you know and have experienced.  

It takes skillful planning of each step in the patient experience to prepare that prospective patient for a YES rather than, “I’ll need to think about it.”

Here is a helpful suggestion to help you enjoy a steady stream of cosmetic patients, and for you to gauge the experience a prospective patient has when interacting with your practice….

You and your staff do a “walk-through” of each step the prospective patient goes through when visiting with you.

Be sure to involve your receptionist, your coordinator and anyone else who interacts with the patient. You are looking for ways to improve your processes that leads to improved conversion rates.

That is how you enjoy a steady stream of cosmetic patients who keep you profitable rather than just busy.

If you could use more patient leads to help you enjoy a steady stream of cosmetic patients, and if your staff could use help converting more callers and consults, please check out my

Cosmetic Practice Vault loaded with proven working knowledge such as

• 10 + Hours of Mind-Expanding Insider Knowledge
• 44 Business Strategies to enjoy a smooth-running practice
• 86 Marketing Strategies to attract a lot more cosmetic patients
• 77 “Swipe & Deploy” creative Graphics you can use
• 44 Proven Scripts to Convert, Follow Up on leads, write Ads that get a result, Interview questions to identify a-players and a whole lot more.

You get LIFETIME membership during this introductory period so act now by going to www.catherinemaley.com/vault and I’ll see you there.

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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#cosmeticpracticevault #catherinemaleyvault #aestheticvault #plasticsurgeonvault #plasticsurgeonbusinessprogram

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and teaching your practice to market itself.

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 "Teaching Your Practice to Market Itself."

Some surgeons have a “one and done” mentality so they spend a fortune advertising for new patients and their staff spends a crazy amount of time working those “leads” to find the diamond in the haystack who is ready to move forward with surgery.

Other surgeons realize its smarter, easier, cheaper and faster to create a great experience and connect with their patients so those patients, in turn, refer them to others who also become surgical patients.

Neither is the right way; however, creating a referral-based system teaches your practice to market itself. That way, you energize your staff, attract more of your ideal patients, deepen your patients’ engagement with you and solidify your own commitment to build a practice worth talking about.

AND Referred Patients = a Healthy Practice

In teaching your practice to to market itself, the health and success of your practice can be gauged by this simple factor – how many patients refer you to others they know. If you don’t know the answer, pull a report called “revenues by referral source”. 

I have surveyed top cosmetic practices all over the US and the average mature practice gets 45% - 70% of their revenues from referrals. That’s good to know and tells you where to spend your time, money and efforts proportionate to external advertising efforts.

And, if your percentage is less than 45%, that indicates you spend a lot more time, money and effort attracting new patients to replace these “one and done” patients who are NOT bragging about you, which is the key take away with teaching your practice to to market itself.

But here’s what we know… referred prospective patients are more likely to convert to paid procedures, and more likely be willing pay a premium for the added social proof of a referral.

That leads to lower advertising costs as well as labor costs since these are highly qualified leads that convert, and that leads to increased staff satisfaction and morale.

Here are strategies to grow your own referral-based practice so that you can begin teaching your practice to to market itself…

Develop a Referral Mindset

This starts at the top. Your staff probably treats your patients about the same way you treat your staff. And, if you have a customer service mentality, then your team will likely adopt one as well.

Think about ways your everyday behavior might be affecting your practice’s ability to generate referrals while adopting this mindset, “The surgeon takes care of the staff, the staff takes care of the patients, the patients take care of the practice”.

Give your patients ”Braggable” Service

This starts with the right team and everyone in your practice is part of customer service. This idea must be drilled into everything you and your staff do, think and say. This is a core aspect of teaching your practice to to market itself.

Hire for Attitude, Train for Skill

You can train someone to do the tasks required; however, you can’t train them to be naturally friendly, kind, and compassionate. Hire those innate characteristics and people skills.

Never-Ending Improvement

Regularly meet with your staff to remind them of your vision and standards of behavior you expect and how important customer service is to your practice’s survival. Have them read your reviews, both good and bad, have them review before/after photos of great results and make a big deal out of thank you gifts and cards you get from your happy patients.

Give to Get Mentality

Focus on the question, “How can we serve our cosmetic patients better than we are?”  This question makes your mind think of how you can add value to your patients’ lives and that changes everything. Find ways to empower your team to create, deliver, mend, and extend the total patient experience.

Exceed Expectations

Identify every potential touch point of a patient’s journey with your practice. Do a patient walk through with one staff person focused on visual, another on smell, another on auditory and another on kinesthetics. Now brainstorm how do we make this experience with us even better to help in teaching your practice to to market itself?

Surprise & Delight

Everyone loves surprises, so how could you incorporate them into your practice?  For example, when a patient puts down their deposit for surgery, thank them with a goody bag with pre-surgery products to help with scarring and/or faster recovery.

Be Different to Stand Out.

Look at what your competitors are doing and do the opposite. Examples include: No wait or Starbucks is on us, “We want you happy guarantee”, give patients the morphed computer print outs and anything else you can think of that would differentiate you.

Get Social to Get Referrals

All of your efforts above should be highlighted on social media since this is engaging and authentic content worth sharing and can grow your reach exponentially to help in teaching your practice to to market itself.

Interact with your audience on social media and encourage them to participate by asking them questions, getting their feedback and inviting them to share their thoughts and their selfies!

Use these strategies to set up a systematic approach to generate word-of-mouth referrals so your cosmetic patients voluntarily participate in your marketing and attract new patients to you so that you're now teaching your practice to to market itself.

That’s how you teach your practice to market itself.

So if you like this content, I have something new for you.

It’s called the Cosmetic Practice Vault and it’s chock full of my business and marketing strategies in easy-to-follow training videos, swipe and deploy graphics and proven scripts for your staff. Think of this as your practice playbook moving forward.

During the introductory period, you get lifetime access and strategy calls with me.

You can check out the details at www.cosmeticpracticevault.com

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

✔️ STAY UPDATED!

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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 pose the question of, "should you rent or buy your office space?"

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 "Should You Rent or Buy Your Office Space? — with Jeremy Warner, MD."

What’s smarter? To tread lightly and slowly grow your practice with a short term rented space, or jump in, double-down, and build the practice of your dreams that you own? 

As always, there’s no right answer. Just the right answer for you. 

We talk about renting vs. owning your office space on this week’s Beauty and the Biz; while interviewing Dr. Jeremy Warner, a board-certified plastic surgeon and facial plastic surgeon in private practice in a high-end suburb of Chicago. 

P.S. Watch for a big announcement next week. It’s something that I’ve been working on behind the scenes for months, so stay tuned!

Visit Dr Warner's Website

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

✔️ STAY UPDATED!

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#rentorbuyoffice #buyyourownoffice #buyorrentoffice #cosmeticsurgeonoffice #aestheticpracticeoffice

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and pose the question of, "do you know your numbers?"

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 "Do You Know Your Numbers?"

Bad things happen when you don’t know your numbers.

• Maybe you’re making decisions based on bad information or incomplete information that skews your thinking.
• Or, maybe you have a leak in your processes that is costing you a fortune, but you don’t see it because it’s hidden in the numbers.
• Or worse, maybe someone is fiddling with the numbers and skimming your profits without your knowledge.

That’s why it’s essential you “know your numbers,” so you can pinpoint issues before they blow up into big problems.

On this week’s Beauty and the Biz Podcast, I talk about important numbers for you to know so you have peace of mind knowing you’re running a healthy business.

Because as they say, “What’s measured improves” and that says it all.

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

✔️ STAY UPDATED!

• Website: https://bit.ly/31O4DHp
• Blog: https://bit.ly/31HmEHx
• Podcast: https://bit.ly/3DMIHJN
• Videocast: https://bit.ly/3DNLjXL
• Apple Podcasts: https://apple.co/3pGyY2o

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Transcript:

Do You Know Your Numbers?

So, the big question is, when you first go into solo practice, is “do you know your numbers?” You have one simple goal, and that is to bring in revenues. But a lot of surgeons are surprised to learn that you can bring in a lot of revenues without actually turning a profit. And how is that even possible? Well, it happens when you don't know your numbers.

Now maybe you're making decisions based on bad information. Maybe there was a problem that you didn't catch in time, or maybe you were so focused on running your practice that. Fell by the wayside. Now it's essential that you grasp the question of, do you know your numbers. So, you can pinpoint problems before they get out of hand, and you can more easily plan for the future.

But you may find financial information intimidating. So maybe you are trusting it to your accountant and bookkeeper, but think about how much peace of mind you would. If you knew your numbers were in good shape and your practice was strong and healthy, because numbers help identify where your practice is leaking money.

Now, when you run regular financial reports, you see how much you're spending on certain expenses and you know to question the expenses when they appear higher than what you planned. For example, you may notice how high your advertising expenses are, and once you've identified that, you can question if that's money well spent or money down the drain.

You would also know which services are making you the most money. Now, you can measure the profit margins of each procedure to know which is more profitable and where the weaknesses are in the ones with the lower margins that. You can make adjustments with the expenses and fees for that procedure to decide if it's worth focusing on, and you would have a clear understanding of how much your practice needs to earn to meet your annual goals, which is pivotal to the question of, do you know your numbers.

Now, when you understand how much revenue you need to bring in to make a profit, it helps. Establish goals. You will understand what revenue level your practice needs to achieve to break even. Now, here's the best part. When you keep your numbers in check, it reduces your expenses, thereby adding more profit and more profit means more money in your pocket.

Business is all about the numbers (do you know your numbers?) and your numbers are telling you a story. So, these four numbers should be measured and reviewed regularly since they are the foundation of a cosmetic practice. Now, here's number one, lead generation. Where do the best? Leads come from how many do you need to generate and what actually generates them?

If you don't know this, it's likely you're going to waste lots of money on things that are generating the wrong kinds of leads. Or potentially worse, you'll abandon a lead generation tactic that actually is working, so you want to leave it alone. Now of course this means that you must be tracking which leads convert to procedures and which patients are most profitable.

By the way, it's much harder to increase the number of leads significantly and much easier to double or triple your lead conversion number. Once you start paying attention to it just saying, here's number two, percentage of leads convert, converted. Do you know what percentage of your leads actually turn into cash paying patients? This is why the question of, do you know your numbers, is so important.

Now the biggest resource killer of all practices is the chasing of leads that are not qualified, not educated about you, and they're not ready to appreciate the unique value you have to offer. So, when you start to measure this and discover how low your conversion rates actually might be from initial phone call to a patient saying yes.

You want to fix it, it's too painful. Otherwise, when you see how much money you are losing, when callers don't book appointments and consults, don't book paid procedures. Now, here's number three, cost per patient acquisition. Every new cosmetic patient comes with a cost. By measuring that cost with some sort of value to your practice, over time, you have a metric that can determine what you can actually afford to spend to acquire. A key aspect to the question of, “do you know your numbers?”

And then go to work on lowering that cost while creating more accurate budget forecasts. So, look at all of your marketing and advertising expenses and compare it to your new patient revenues for that year. Do those numbers make sense? Through careful lead analysis, you can cut the cost per lead greatly by making better.

Spending decisions. And then lastly, number four, average value of a patient. It's generally much easier to increase your revenues through additional sales to existing patients than to go out and find new ones. Now you can do this one of two ways. You can increase the perceived value of your offerings and raise your fees.

Or add on other complimentary services and or products your existing patients also might want. So, as you can see, there's no rocket science with this list (do you know your numbers?), but are you really measuring these four significant numbers when it comes to growing your practice? Because the bottom line here is that you deserve better and so does your practice.

When you grasp the question of “do you know your numbers?”, you make better decisions, avoid unnecessary surprises, and have peace of mind knowing you're on track to reach your goals.

Everybody that's going to wrap it up for us today, a Beauty and the Biz and this episode on the do you know your numbers.

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 “Do You Know Your Numbers?"

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#knowyournumbers #doyouknowyournumbers #knowyournumbersforsurgeons #numberssurgeonsneedtoknow

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how to convert 25-50% more consultations with the right coordinator.

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 "Convert 25-50% More Consultations with the Right Coordinator."

A patient coordinator with the right character, mindset and skills is truly a game changer for cosmetic practices..

They can take your practice revenues from “just enough to pay the bills” to a windfall every month because they know how to book cosmetic procedures!

This position cannot be taken lightly. You may think anyone can step in to do the job of a coordinator, but you would be sorely mistaken.

Converting consultations is an art and trained skill. It takes the right strategies, knowledge and then lots of practice to get good at confidently taking a “stranger prospect” to a cash-paying cosmetic patient.

So here are three main attributes that make the biggest difference when you have a great patient coordinator representing you and generating revenues:

The Right Mindset and Attitude

The best coordinators are here to serve – not sell. They have confidence knowing they are providing a valuable service to prospective patients who have a pain point and you are their best solution. They believe in the surgeon(s) they are representing, and they also believe in cosmetic rejuvenation as a gateway to personal self-fulfillment and happiness.

That means they do all they can to help the prospective patient get to a yes and they persevere in the face of resistance. They don’t see resistance as rejection. They see it as an opportunity to offer different perspectives and clear up the confusion on the patient’s side, so the patient actually makes a decision to better themselves.

Excellent People Skills

The right coordinator  has the people skills to make a prospective cosmetic patient comfortable and trusting enough to open up to them and make a decision to have their cosmetic procedure with you.

They stay focused on the patient’s wants, fears, objections so they can artfully address the issues in the patient’s mind that are stopping them from moving forward. They do that by bonding with, listening to and asking questions so the patient feels heard. The patient now opens up more because they trust the patient coordinator has their best interests at heart.

Skilled at Converting

Converting prospective patients to paid cosmetic patients is the #1 skill needed to be a top patient coordinator. This is where the rubber meets the road. This is the difference between an okay coordinator and a converting rock star.

This takes confidence, courage and proven strategies that are practiced and engrained.

The patient is looking to you for guidance and isn’t going to hand it to you–

You have to ask for it in a professional and comfortable way, so the patient says yes.

For example, when the coordinator has presented the options to the prospective patient, they must transition to a strategic question rather than a yes/no question that can trigger resistance.

So instead of asking, “Sarah, did you want to do this?”, you ask, “Sarah, did you want to go with the full Mommy Makeover or start with just the Tummy Tuck?”

When they pick one of the choices given them, the patient is moving forward and you now have a booked surgery!

Now, the inverse of a fantastic coordinator is also important to be able to spot because it can be subtle so watch for these clues telling you  you DON’T have the right coordinator:

• Here’s the big one…
• the wrong coordinator takes zero responsibility for their poor results. They blame everyone and everything EXCEPT themselves.        
• For example, if you’re hearing complaints such as:
  • I’m not getting enough leads
  • These leads are awful
  • They are just price-shopping
  • They don’t have any money

That tells you you have a coordinator who is negative, pessimistic and thinking lack. So, you want to address that before it gets any worse. Either free her to work elsewhere or have her join The Converting Club and let me turn her around and train her to be a converting rock star.

Simply go to www.ConvertConsultations.com, sign her up and she’ll get 24 training videos, along with quizzes that must be passed before moving on to the next module.

She’ll also be required to complete metrics each week about her consults and then we’ll be bi-weekly coaching calls to go over the details of each consult to determine what went right and what else could have been done or said to get to a yes.

It’s the accountability that makes the difference and turns around their mindset and results so please check it out.

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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Transcript:

Convert 25-50% More Consultations with the Right Coordinator

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 convert 25-50% more consultations with the right coordinator. 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 episode is called Convert 25-50% More Consultations with the Right Coordinator. Now a patient coordinator with the right character mindset and skills is truly a game changer for cosmetic practices because they can take your practice revenues from just enough to pay the bills to a windfall every month because they know how to book cosmetic procedures and keep your schedule filled.

Now, this position cannot be taken lightly, especially if you want to convert 25-50% more consultations with the right coordinator. You may. Anyone can step in to do the job of a coordinator, but you would be sorely mistaken. I see that so often that the coordinator leaves and they just put the receptionist in there and that's just really a disservice to you and the receptionist. So, converting consultations is an art, and it's a trained skill just like anything else.

It takes the right strategies, knowledge, and then lots of practice to get good. Confidently taking a stranger prospect to a cash paying cosmetic patient. So here are three main attributes that make the biggest difference when you have a great patient coordinator representing you and generating your revenues.

So, here's the first one, the right mindset and attitude. The right coordinators that convert 25-50% more consultations are here to serve. Not to sell. They have confidence knowing they're providing a valuable service to your prospective patients who do have a pain point, and you are their best solution. Now these coordinators know that they didn't pull anybody in off the street.

These people literally called you. They have a pain. You have a solution, and that just makes logical sense. So, they believe in you, the surgeon that they're representing, and they also believe in cosmetic rejuvenation as a gateway to personal self-fulfillment and happiness. I mean, quite frankly, a cosmetic coordinator who hasn't had any cosmetic.

I also think that hurts them. You should really be drinking the Kool-Aid and well, if nothing else, maybe they're young or they don't have any big issues, so they haven't had surgery, although it'd be nice if they did, and especially from you. But if they haven't, if they could at least have the empathy of what.

It's like to go through this journey of a cosmetic patient just by watching and listening to your current patients, tell them it's a tough journey for a lot of people. It's full of uncertainty and doubt and fear. So, they need to have that empathy. To help that patient get through this. Now that means they've got to do all they can to help the prospective patient get to a yes, and they persevere in the face of resistance and they will always get a lot of resistance.

We always resist when we have to make big decisions or spend money or have downtime, or there might be pain involved, but they don't see the resistance as reject. They just see it as an opportunity to offer different perspectives and then clear up the confusion on the patient side. So, the patient actually makes a decision to better themselves rather than continue to procrastinate like they have for the last five years with the, they've been thinking about it.

So, here's number two. The right coordinator that can convert 25-50% more consultations has excellent people skills, so they have the people skills to make a prospective cosmetic patient comfortable. In my book, I asked them over and over, why did you choose this practice versus another practice? The overwhelming answer was, I felt more comfortable with this practice, this staff, this surgeon.

That was a really big one and I felt a connection with them as well. Because that's how they trust you enough to open up and especially they need to bond with the coordinator because especially women, we need to tell you our story and how we feel about everything. And you need somebody in the practice like your coordinator to be able to get them to open up and then help them make a decision to have their cosmetic procedure.

So, the right coordinator that can convert 25-50% more consultations stays focused on the patient's needs, fears, objections, and wants, so they can artfully address the issues in the patient's mind that are stopping them from moving forward. Now they do that by bonding with listening to, and then asking very strategic questions so the patient feels heard, and not just that, so the coordinator can hear what's going on in the prospective patient's mind, so they're going to be able to address it.

But that can only happen when the patient opens up because now, they trust the patient coordinator has their best interests. And then here's number three. They've got to be skilled at converting. Converting prospective patients to paid cosmetic patients is the number one skill needed to be a top patient coordinator.

Now, this is really where the rubber meets the road. This is the difference between an okay coordinator and a converting rockstar that can convert 25-50% more consultations. Now this takes confide. Courage and proven strategies that are practiced and ingrained. And I have to tell you, most coordinators do not have this. I shouldn't say most. The ones that I'm training definitely don't have it, and most actually let everybody off the hook.

They don't want to push; they don't want to feel me or aggressive. So, what do they do? They, they present the numbers and then they chicken out. They say, okay, then do you have any other question? Alrighty, then will you just think about that and you gimme a call when you're ready, That is not how a professional handles it, because if you think about it, the patient is looking to your coordinator for guidance and they're not gonna just hand it to them.

They've got to, you've got to ask for it in a professional, in a comfortable way. So, the patient says, Now, here's an example. When the coordinator has presented the options to the prospective patient, they have got to transition to a strategic question rather than a yes, no question that can trigger resistance.

So instead of saying something like so Sarah did you have any other questions? Okay. Or, Sarah, did you want to do this instead? A pro. Ask this, Sarah, did you want to go with the full mommy makeover? Or start with just the tummy talk. Now when the patient picks one of the choices, given them the patient's moving forward and you now have a book surgery.

Now the inverse of a fantastic coordinator is also important to be able to spot because it can be subtle. So, you want to watch for these clues telling you do not have the right coo. Now, here's the big one. The wrong coordinator (who can’t convert 25-50% more consultations) takes zero responsibility for their poor results. They blame everyone and everything else.

Everyone else except for themselves. Now, here's an example. If you are hearing complaints from your coordinator, Where she or he is saying such things like, I'm not getting enough leads. These leads are awful. They're just price shopping. They don't have any money. That tells you have a coordinator who is negative, pessimistic, and thinking lack, so you want to address that before it gets any worse.

Free them to work somewhere else, or please have them join the converting club (so your right coordinator that can convert 25-50% more consultations) and let me turn them around and train them into being a converting rockstar. Now, you simply go to convert consultations.com, sign them up, and they'll get 24 training videos along with quizzes that must be passed before moving on to the next module, because I want them to catch the main thought that I have in that training.

And they'll also be required to complete metrics each week about their consultations, and then we'll be doing biweekly coaching calls to go over the details of each consultation to determine what went right. What else could have been done or said to get to a yes. And that's where I'm listening to their mindset.

They're telling me why people didn't book, and I'm telling them back, here's a different perspective to look at it. Here's some strategies that make a lot more sense. Please try these and that can. Typically turn them around quite easily. And it's also the accountability that makes the biggest difference.

And it turns them around from this meek victim like mindset to an abundant mindset, optimistic. And they really do get a lot more results once they think differently, do differently, and then they be different. That's how we turn them into a converting rockstar.

Everybody that's going to wrap it up for us today, a Beauty and the Biz and this episode on the how to convert 25-50% more consultations with the right coordinator.

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 “Convert 25-50% More Consultations with the Right Coordinator."

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#convertmoreconsultations #therightcoordinator #convertmore

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and secrets to long-term staff.

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 "Secrets to Long-Term Staff — with Giancarlo Zuliani, MD."

Some surgeons look at staff as an overhead expense that must be “dealt with” to run their practice.

They wish they could forgo staff altogether and skip the hassle of hiring, training and managing people.

They have had enough of bad hires who: come in late, leave early and do mediocre work in between.

They can’t understand why staff can’t just do the job they are getting paid to do. What’s the big deal? It can’t be that hard and so on….

Other surgeons think much differently about staff.

They know they can’t do it alone and good staff can make them look good and make their life easier.

They like working with staff who have their back, who support them and who move the practice forward.

They see staff as their practice secret weapon who is an asset to their success.

Dr. Giancarlo Zuliani is of this later mindset.

In this week’s Beauty and the Biz Podcast, I interviewed Dr. Giancarlo Zuliani.

He is a facial plastic surgeon in private practice in Bloomfield Hills, MI and focuses on rejuvenating, restoring and reconstructing the face through surgical and non-surgical procedures.

We talked about how he finds good staff (even with today’s staffing challenges) and keeps them engaged for the long run. Also, how they help him grow the practice using their own unique talents.

His attitude about staff being as asset has paid off, to the point where he is busy and now looking for more space.

His approach is refreshing (and he has run with the bulls!)

Visit Dr Zuliani's Website

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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Transcript:

Secrets to Long-Term Staff — with Giancarlo Zuliani, 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 secrets to long-term staff. 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 Giancarlo Zuliani, MD on the secrets to long-term staff. He's a facial plastic surgeon in private practice in Bloomfield Hills, Michigan. Now, he focuses on rejuvenating, restoring, and reconstructing the face through surgical as well as nonsurgical procedures. Now, Dr. Zuliani completed his general surgery, residency and chief residency at Wayne State University in Detroit, Michigan, and he completed a fellowship through the AAFPRS

Now, he's a speaker at other medical conferences as well as a member of several medical societies, not to mention having a lot to say on the secrets to long-term staff.

So, Dr. Zuliani, welcome to Beauty and the Biz. It's a pleasure to have you.

Giancarlo Zuliani, MD: Thank you for having me.

Catherine Maley, MBA: Absolutely. So, you have a pretty fancy name. Um, did you get that name in Detroit, Michigan? Are you?

Giancarlo Zuliani, MD: Yeah, so my dad's an actual immigrant from Italy. Right. And so, he came over at the age of eight and my mom's not Italian. And so, you know, they're trying to decide on names and, you know, Steve didn't work really well with Zuliani, so, you know, they, they made it a little bit more Italian singsong.

Catherine Maley, MBA: Now, do you speak Italian?

Giancarlo Zuliani, MD: I do, I do.

Catherine Maley, MBA: Is that, is that helpful to have in Detroit, Michigan while figuring out the secrets to long-term staff?

Giancarlo Zuliani, MD: Not really.

Catherine Maley, MBA: Ok. All right. So, I know you were in the hospital setting for a long time, and one thing the audience loves to hear is the journey from hospital insurance, et cetera, versus private practice cosmetic and how that relates to the secrets to long-term staff. So, could you just quickly go through how, what was that like for you to jump from one to the other?

Giancarlo Zuliani, MD: Sure. What coming out of fellowship, you know, everybody's. Unsure of what's going to happen and lot, a lot of people don't want to take on that big financial burden right off the bat, so you'll enter in some sort of agreement with the hospital. Myself, I went in with an academic practice, which was a multi-specialty group based out of multiple hospitals, not just one hospital.

Initially I was given a lot of leeway in terms of doing what I wanted to do so I can. Aesthetic work with insurance cases. The majority early in my career obviously were insurance cases. And it came to a point of probably about four to five years in where my cosmetic practice was picking up.

However, the mindset behind the academic group. Was not one of a private practice mindset. It was not business oriented. It wasn't patient oriented per se. And so, at that point, along with other hiccups that happened along the road, which are many and don't need to be explained here, but. Ed me that I needed to do this on my own.

And really, you know, once you get that mindset of doing it on your own, you just have to make that decision to get off the couch and do it. And so that happened about six to seven years in and took about two years of planning probably To get to a place where I wanted to be, you know, starting with where I wanted to open up shop who, how I wanted to construct a practice, you know, how to build it the way I envisioned to build it.

And so, it took a lot of planning. It took a lot of investment with my wife and I in terms of seeking out people around the country as well as around in my backyard to see how their experience went. Opening up their own practice, you know, securing financial backing for it. And working with established relationships in the community as well as with my vendors to support the practice.

And since that time, it's been you know, it's, it's the most work you ever put in, but we've come to a point where it's booming and obviously aided. The covid surge and things like that, but it's, it's been very humbling to know that it's been so success.

Catherine Maley, MBA: So back to the multi-specialty practice, what I find is when everyone else is in insurance, you become like this, not even a prima donna, you become like, I'm not helping him (which is counter-intuitive to learning the the secrets to long-term staff). You know?

So, a lot of times you join thinking, oh well this is my legion. You know, this is where the leads are going to come from. And, and then you're sorely mistaken because a lot of your colleagues who don't appreciate the aesthetic side for whatever reason they turn out not to be your legion source. After all, you have to grow it on your own.

But what, like, psychologically and how it relates to the secrets to long-term staff, how much courage? Cause I think it takes a ton of courage, but the keyword there was decide, right? Once you decide, you can now make. Decisions with a plan until you decide you're still waffling. How long did you waffle before learning the secrets to long-term staff?

Giancarlo Zuliani, MD: Well, at, at the, there there's a couple incidents that happened that made me convince or convinced me to, to do this.

They have to, It takes that. Yeah. So, and you know, one was an incident of A patient's information being stolen by a front desk member. You know, you know, things like that actually happen. So that, that was, you know, around the age of, think I was 40 or so, and then made my decision like at 40 I'm up my own doors.

I, I'm, I made a promise myself. And so that happened and you know, you are right in terms. You know, initially they, you know, the, the, the practice and the plastics practice within our division was, was going well. However, it takes a certain amount of money to sustain it, and you have to pay people and, you know, purchase a laser or any sort of other medical equipment as well as the on costs or recurring costs of injectables and neurotoxins.

And the other members didn't understand like why the overhead had to increase. So, But they had no problem taking, you know, 60% of what I brought in plus a Dean's tax of what I brought in. And what I brought in was more than most any other person, and I couldn't, and they judge people by VUS and I, you know, my VUS are, it's dollars.

You know, it's not, it's not a, it's not an indication of work. It's an indication of what people think I'm worth. And so, it became sort of, You know, a headbutting, you know, like should we support them or should we not support them? And you know, a lot of people try to convince me, even the head of the practice said, Oh, you, you know, you can't do this on your own.

You'll never succeed. And so that's all I know when people, and they said that to me and I kept that in the back of me. That's all the motivation you need.

Catherine Maley, MBA: That's exactly When there's none left, you fall back on that and learning the secrets to long-term staff.

Giancarlo Zuliani, MD: Exactly. Exactly. So, it's but you, you, you have to, you have to get up off the couch. You have to just decide and do it.

Catherine Maley, MBA: When you did learn the secrets to long-term staff, and thankfully you have a wife that supported you doing this, because that can also be a very big challenge, right? If the wife is not behind your decision to do this, it just, you know, it, it triples the, the, the stress of it. Exactly. So how, how in the world do you go about finding a location and then do you decide, I'm just going to rent, I'm just going to rent from the hospital.

No, I'm going to get away from the hospital. I'm going to go into a, like a consumer setting. Right. How do you decide? Cause lo is location as important as it is in real estate in the realm of the secrets to long-term staff?

Giancarlo Zuliani, MD: To a degree, but it was more important in terms of my lifestyle, to tell you the truth. So, I wanted to pick a place where, you know, I have young kids and I could be close to my home and close to the school that they attend.

And you know, I, my office is literally a quarter a mile away from my house. So, it, that was a, a big plus the area. It just happens that this area also has a lot of plastic surgeons around. I wasn't scared by, you know, having six, you know, competitors quote unquote around the, around the around the street or around the block from me.

So, it was more convenience to tell you the truth. But now we're in a, in a spot where I'm growing out of this facility and I'm looking to purchase my own building, which is really a struggle because things are just overpriced. These.

Catherine Maley, MBA: But I would think there's a lot more commercial space now. Didn't that, when the demand of that decreased, did that help you on your journey in figuring out the secrets to long-term staff?

Giancarlo Zuliani, MD: Yeah, to a degree, except for things that are zoned medicals, things that are zoned medical are still at a premium. People who are, you know, you know, corporations, you know, which may not be using them, we're big into auto around here, which may be pulling out, The only thing that's really hot still is medical because people need to go see their doctor.

So, it is it's been a challenge and so, you know, we're tackling that one. So, I've got my goal on that one for two years. And we're, we're cranking ahead.

Catherine Maley, MBA: But in the meantime, you have to work with these hospitals. Are you having trouble booking? I know you did during covid. Has that settled down is all in relation to the secrets to long-term staff?

Giancarlo Zuliani, MD: Thankfully my, my relationship with my, you know, outpatient surgical center and hospitals has been very, very good and I've been loyal to them since the beginning.

And so, I've had built in block time and they've really, Around helping me get all my cases in. You know, there was, you know, staff shortages everywhere and nursing shortages everywhere, and they had to pull back on rooms and amounts of cases you can board. But thankfully they, you know, worked with me where I didn't really have to pull back a lot.

So that's been, thankfully I've heard horror stories otherwise, but thankfully that's been the case for.

Catherine Maley, MBA: I literally have had calls from surgeons who had to cancel surgery the next day because the, they didn't have staff (or the secrets to long-term staff). They just, Yeah. It was like, what happened to our industry? When did all of this go sideways?

Giancarlo Zuliani, MD: I mean, that along with the shortages of lidocaine and saline in the, in the country, it's sort of like, what else can go on? The supply chain issues are just, Plentiful and so complex, it's hard to, it's hard to run your own surgery center. It's hard to go to the hospital. It's just, there's just not enough supplies nor there enough, you know, manpower to, to meet the demand.

Catherine Maley, MBA: Right. You touched on the car, the auto industry. I know Detroit, I'm actually originally from Chicago. Ok. I still have the accent. So, I'm hearing yours as well, but so how big of a deal is it? How big a deal are the secrets to long-term staff in the auto industry? Does that ruin you if they walk away? If they leave or, or what, What's your situation about that?

Giancarlo Zuliani, MD: Not necessarily. They're still the biggest provider of jobs I believe in, in the city with all the other ancillaries like the, the different tier. You know, suppliers and, and supply chains like that. But I think Detroit's be, become a little bit more of, a little bit of a renaissance.

Recently, the, the restaurant scene has been booming, the real estate market, and well as two huge real estate corporations, mortgage companies, Quicken and United Wholesale Mortgage have been really fueling. Sort of a, a comeback in this area, so it's not just strictly related to auto anymore. And now that the big three are getting involved in more electric cars and more technology I think they're diversified enough where they, they're not going to hit another 2008 where they need a an out.

Let's hope. Back then it was bad back then it was, it was pretty.

Catherine Maley, MBA: You also have an incredible mall called the Summerset Mall.

Giancarlo Zuliani, MD: That is, that is a half mile away from my office.

Catherine Maley, MBA: They literally, like Google will call it a, an attraction, you know? Right. towards attraction. So, is that where you all hang out or not really? How does that relate to the secrets to long-term staff?

Giancarlo Zuliani, MD: I mean, so Michigan is more of a, you know, it's a four-season state. You know, spending time outside and doing boating and, you know, golfing and tennis and or going up skiing to up north northern Michigan. But it's really more of an all-seasons type stage, you know? So, I don't, I don't really hang out at the mall, but hanging out outside for sure.

Yeah. I mean, it's, but it's a beautiful, it's a beautiful mall. I, Oh, I mean, it's, it's, you know, it rivals, you know, the, the country, right?

Catherine Maley, MBA: And it's under a, that's just spectacular. I must, Your mom was very impressed. So, are you completely cosmetic in learning the secrets to long-term staff?

Giancarlo Zuliani, MD: Yeah, so when I opened up my practice, I still would see some MOS reconstruction, things like that, but one year in, we stopped.

It was just too busy cosmetic wise, and so we gave up all insurance carriers at that point, and my cases are purely cosmetic now.

Catherine Maley, MBA: All right, so now this is what happens when you are a facial plastic surgeon. Typically, you can live off of, you know, from the neck up. There's plenty of business there normally, but a lot of you also want to keep that patient for a lifetime.

And you, you bring on the nonsurgical as well, and I believe you have done that as well. So how important has it been? To do surgical as well as nonsurgical, and do they complement each other and build a practice of people who return and refer. How does that relate to the secrets to long-term staff?

Giancarlo Zuliani, MD: Right. It's, I think it's essential. So, we have, you know multiple providers in the office doing, you know, energy-based treatments and injectables.

Full body injectables, full, full body treat. And so, you know, I can't scale me, but I can scale that, type, that business, and we brought on more aestheticians and more injectors to, to help with that. So, it's a, it's essential. And the, and the play between the two is, is seamless. So, you know, I'll say hello to their patients, even if I've not met them before when they're in the med spa.

And I'll, I'll peek my head in and, you know, it'll be, you know, I think it's time for surgery, so they'll schedule a consult with me, or I think you need to go see the aestheticians for X, Y, and Z, or go see the nurse injector. Perhaps you're not of the best. Facelift can, but if you want something to tide you over, maybe have a consult for sculpture or threads or, or things like that.

And, you know, it's, I think it's important to have a varied menu of services to offer people, which, which have each of their own separate downtime in each of their own separate price point. And it's our, it's not our business to tell people where to spend their money, but it is our business to tell them and educate them what each procedure, non-surgical or surgical, Can do and what their expectations should be.

And so, we want to build a, a treatment sort of pathway for them and allow them to sort of choose where they go. And it's sort of like a, a branch on a tree. If I do this, then I'll do this and I'll do, then I'll do, I'm lucky. I mean, I still have patients who found me from my original practice who still come and see me all the time.

So, building those lifelong relationships and then, you know, their friends and their friends, it's been more of a word of. Type of thing for me than anything.

Catherine Maley, MBA: Well, I know just coming from that, the patient perspective, most patients, I will say, generally speaking, don't jump into a facelift, regardless if that helps one learn the secrets to long-term staff.

Giancarlo Zuliani, MD: Correct.

Catherine Maley, MBA: They tick little bit steps, little steps to get to that facelift, but it starts easy. And typically, that's where your aesthetic comes in. Then your nurse injector, then the laser tech and all arrows point to surgery. It's just let them have surgery when they're emotionally ready for it. And in the mean, Develop that relationship that helps them learn the secrets to long-term staff.

I just think that's really smart business in today's world. Starting over every single surgery would be exhausting. Oh, for, you know, some say, You know what, I'm just a surgical practice, and I think, Okay. Then you'll find a bunch of surgery surgical patients, you know?

Giancarlo Zuliani, MD: You know, everybody who comes in, there's something to offer them later.

Now, once somebody has surgery, doesn't necessarily they, they're done, right? It's, you know, you want to keep them in your practice and keep their results up. And that requires further techniques and further procedures. You know, you know, you want to keep things tight and you want to keep looking good and you don't want to just go run out and bake on your boat and, you know, burn.

Catherine Maley, MBA: Right. That's not the way, but that's the American way, but not exactly in reference to the secrets to long-term staff. We destroy, then we destroy ourselves for decades and we say, Could you fix this thing?

Giancarlo Zuliani, MD: You’ve heard it all. Yeah. And, and the flex.

Catherine Maley, MBA: So, hurry up. So, I know you have lot of lasers. Do you have any words of wisdom or pearls about how to go about buying a laser and how that can help one discover the secrets to long-term staff?

I'm just hearing so many stories about them. What, what do you think?

Giancarlo Zuliani, MD: Well, it's. You know, I, I'm, I'm won't be the, I won't be the first to jump into anything that's really new and they're saying that it's hot and it comes with, you know, a lot of flashing lights are there. I mean, the flashing lights are there to draw you like a moth to a flame.

You know, it's, so you have to do your own research and talk to your colleagues around the country to see what is really the most bang for the buck. That doesn't necessarily mean you have to go out and spend. $350,000 on a huge platform. But perhaps you start with something smaller. And the other thing is everything is negotiable.

Don't feel like that is the price that they give you, is the price that it's going to be. The, these companies, for the most part, want to keep you as a lifelong. Purchaser as well. So, they realize that you know, we'll make calls to certain people suggesting certain things here and there. But you really got to b stand behind the technology and the company as well.

You know, it's, it's, it's a huge investment to begin with, but it reaps its benefits for sure. Mostly because the patients are recurring, the, the price ticket on them is not super expensive, and depending on the type of laser, the downtime isn't the worst. But working with a good company, which is, which puts their sort of.

Heart behind your practice and really wants to support your practice is valuable. I've, I've seen other companies where, you know, the last you see of the, you know, the salesman is the second they deliver it, and then they're gone. But you, you know, I've worked with some companies where that's not the case.

Catherine Maley, MBA: Well, I think the better companies they, well, they should be helping you market the darn thing for sure. Because a solo practitioner does not have the time, money, or wherewithal to do patient education. That's not your job. Correct. Isn't their job to drum up the consumer demand? And it's your job to be the supplier of that demand while learning the secrets to long-term staff.

So, I want a company that backs you up like that. Like we kind of practice building tools and strategies and budget. Do they give you, to make sure this thing hits the ground running? Because a lot of times I have to say the practice when it doesn't go well, they do blame it on the laser company a lot of times.

It's not magic. I mean, somebody's got to market the thing. Either you do or they do, but somebody's got to have a plan in place to make that work. Have you, have you noticed that when you bring a new laser on board, do they? How does that help you learn the secrets to long-term staff?

Giancarlo Zuliani, MD: Oh, yeah. Well, so we have, luckily, I have my own in-house social media people, so I think that's exceptionally important for.

Transitioning because it's a way that you can market on sort of a, a low budget without having to put up major ads on radio, print, or television. And you just have to, you have to grow it organically. It's a, it's a slow thing, but once you get the appropriate patient base and then using sort of, you know, click bait for Facebook or things like that, or on Google, Google ads, you can attract new people in for your, for your new.

Your new platform that you're going to be bringing on, and then you have to do a lot of education about it too. You have to get on the, you got to get on the camera, you got to talk about it. So how excited you are. Treat the staff, have the staff tell them, you know, what it feels like, what expected results are.

But it's, it's a lot about just marketing and internal marketing obviously is the best, right? So, you. Keep talking to your existing client base who already trusts you for, you know, trusting their face in you and you want to keep telling them what's coming up, what's, what's new, what's coming up, And, and, and it, and it'll be successful, but you can't just buy and expect it to sell itself.

It's not the way, that's not the way it works. You have to invest time and you need the company to help you too. Whether it's they're doing direct to consumer ads or they're giving you a certain allowance to. Pay for putting these ads out. It needs to be sold.

Catherine Maley, MBA: For sure. Here's my pearl on that. If they're paying for it, then sure they can use their name.

Otherwise, if you're paying for it, I would get away from the name of the treatment or the laser and I would only talk about pain solution. You have sun damage. We wipe it out. You know, you, you give me, you, there was this ad before. You give me five days; I'll give you five. Right. So brilliant. Nobody needs to know how, right now they're in advertising.

They just need to know the what. You know, they have a problem. You're, you have a solution. The details come in later. So that's what I would do, especially while discovering the secrets to long-term staff.

Giancarlo Zuliani, MD: You know, just, Right. That's the, that's good. Websites are built like that. You know what, what's your problem? And this is the treatment, you know, like. Brown spots Mala, you know, then, then you can go into what you can do for it.

Rather than say I have XYZ laser or XYZ radiofrequency micro kneeler, you know?

Catherine Maley, MBA: Yeah. They can pay for that. The vendor can pay for that problem. So, let's just talk about staff is always the biggest challenge. I'm assuming you look like you have a lovely staff. You took them water skiing. I mean, everyone should have been happy with that

So, what pearls do you have, in reference to the secrets to long-term staff? Just bring in the right staff on board, surrounding yourself with a good team.

Giancarlo Zuliani, MD: Right? Obviously, that, that is, that is the, the hardest thing for sure to get people to buy in. And from early on, we have, we had a really good core group that is still with me today, so a lot of it is, Giving them the reins to be creative and to have a certain amount of graduated responsibility, having their see a path of growth.

Meeting with them regularly, meeting with the team regularly, going over individuals well as corporate goals and then having fun together as well. It's, I think it's important to, to go out as a team and try and connect with people on a, a personal level. You know, and getting to know about their families and about their background and, you know, their inspirations, rather than just having it be a pure check in, check out where, you know, everybody's sort of living in their own silo and nobody really cares about the sort of common goal.

And that's what we're all, you know, we want a team, right? It's not. Necessarily a family, but it's definitely a team that you want to build and have some people rely on each other and it takes work. It's not easy. It's actually the finding people and retaining people is hard. And it, but it's a lot cheaper than recruiting, I'll tell you that.

So, you know, it's, it's important and, you know, with inflation, you know, people need to be paid too. And so, if you. If you have an employee that is just so stellar, make them feel that way because it, you know, without them, if you're going to be hurting, pay them accordingly and treat them according.

Catherine Maley, MBA: But how did you get it right from the beginning as you learned the secrets to long-term staff?

Like you hired some really killer people.

Giancarlo Zuliani, MD: Well, I had a, I had a consultant and I, my wife's background is in HR, so she knows hello. So, she an HR, she's an HR director at one of the big three, and so she knew sort of the ins and outs of how to do this. She wrote my employee handbook, I mean, without her. You know, it would've been too much work for myself.

Catherine Maley, MBA: Well, I hope she got a, a stipend out of that while she helped you to learn the secrets to long-term staff.

Giancarlo Zuliani, MD: Yeah., she got a couple nice bags., she but you know, with that, it, it was. Continuous work, but we found the right people and it's work now that have there been hiccups with other employees for sure, and Covid did not help that. So, you know, it's a constant process.

Trying to find people, but I think right now we've, we've, we're, we're hit a groove where we we're really getting along as a, as a team, and attitudes are great. So, but you'll go through ups and downs and ins and outs and you just have to weather the storm and be able to be positive about it and take your time to, to hire the right.

Catherine Maley, MBA: Well, I know I'm prejudice, but I'm from the Midwest and I think the best working minds come from the Midwest, the work ethic, the blue collar, whatever you want to call that. Mm-hmm. I moved from; I couldn't get out of Chicago fast enough, quite frankly. I, I couldn't do the weather, I just couldn't. So, I wanted to go to San Francisco and also learn the secrets to long-term staff.

And that, Wow. Talk about culture shock. another story. But out here, nobody did anything like, compared to Chicago. I mean, I was so disciplined and I didn't even know it. I worked so hard and I didn't even know it, but I thought, Oh my God, I'm going to be a big hit out here because I'm actually willing to get to, to the office by eight when nobody else was showing up till nine 30.

And I, I was just so surprised. Frankly, I think, well, the wife being an HR killer, killer strategy, And the next one is youre definitely in the middle of the Midwest where they have, they think differently or they used to anyway. How do you think that relates to the secrets to long-term staff?

Giancarlo Zuliani, MD: So, well, I mean, I, there's some, there's some grit, you know, there's some grit involved in Detroit's, you know, sort of a roll up your sleeves and let's get it done.

You know, even the, the, the basketball team is', Going to work was their motto. You know, the, it's, it's a blue-collar town, but people definitely put the work in and if you, the work in you'll reaps to get started and get the inertia going when it. You know, you don't have to push as hard. You can just sort of nudge the rock along.

You got, you constantly have to do it, but you're not going to be bearing, you know, the huge, you know, 3000-pound weight trying to roll the stone up the, up the mountain. Eventually it becomes a little bit easier, but you, but you gain people with you to help push it, right? So, you're getting a team to help push it everything along and, and, and help progress the.

Corporate goals and the practice goals, but you already said it.

Catherine Maley, MBA: You meet with them regularly, everyone chipping in. You work together as a team (which is one of the goals of the secrets to long-term staff). You're not best friends. I don't, I'm that can go sideways sometimes. Right. But but definitely just knowing that you care about your staff makes them work harder for you.

That I know. For a fact. For sure. And then for sure. And then, but sometimes they'll some of, some of the surgeons, like they'll have a Christmas party at their house and their house. Unbelievable. And sometimes I think that can backfire on you if you haven’t learned the secrets to long-term staff.

Giancarlo Zuliani, MD: Yeah. I mean, we've always done it elsewhere. Parties and like that, you know, we were, I mean, my and I just to London, we got everybody a.

You know, Union Jack, like little card carrier thing, you know, it's just, it's not nothing crazy expensive, but it's the thought. And, you know, you would've thought, you know, we'd have bought people Berger eggs, you know, everybody was like, so excited, But it's just, it's the thought and, you know, recognizing that you're on, you know, they're on your mind and that makes people feel.

Catherine Maley, MBA: Oh, that's fantastic to help master the secrets to long-term staff. Most surgeons would not even think to bring their staff back something, It just doesn't occur to them. And that's because they treat their staff like overhead and not an asset. And I think you watch them on my videos cause you and I are thinking the same way about you have to hang on them and when you have a great staff, there's nothing better.

Been a well-oiled machine, right? There's nothing better when everyone's doing their thing and you're all working together for the good of the practice, not for yourselves, nothing. It's just, you know, that's how to do it if you can. And then of course, as soon as it all works out, then somebody has sudden I have to move to Alaska.

Cause if their husband was transferred and it all falls apart, which doesn’t help with the secrets to long-term staff.

Giancarlo Zuliani, MD: But that's happened. I mean, we've had people like that. They've had to be transferred and so, You go through periods of like, Am I ever going to get out of this rut? Am I going to find somebody? And then it happens and you know, you know, the sun shines another day. It'll be okay.

Catherine Maley, MBA: It all works out in the realm of the secrets to long-term staff. I my motto, especially when you get older, you're like, You know what? This can't. Drama all the time, you know? Right. Like, all right, it, But it does seem to happen in in clunk clusters. It does. You know, like it all falls apart at the same time. It's like really? Like really?

Giancarlo Zuliani, MD: What? And my staff will say no. Mercury's in retrograde watch out. So, they'll you have three or four problems happening, like is going on. Like, know.

Catherine Maley, MBA: That's funny. So, let's talk about marketing  and how it relates to the secrets to long-term staff, because you're doing something that I have been talking about for two decades now. Make a signature treatment with your initial on it, so Sure.

You have the Z lightning lift. That's right. Can you talk about that?

Giancarlo Zuliani, MD: Oh yeah. It's a, it's a minimal access Facelift procedure, sort of hybrid using radiofrequency as well as sort of deeper plain tissue techniques that is done under local anesthesia only. We call it lightning lift because it's done quicker.

The recovery is quicker. We're using radiofrequency plasma, which is what lightning is. And so, We use the specific modality. I didn't call it by its name. I just created my own little thing. It's an own little niche surgery. Is it for everybody? No, but there are certain people who are, you know, in between.

Fillers and a formal facelift that just want something that's minimal but gives them the refresher that they want. And we came up with that like year one and it's been a boom. People will search it up and say, Am I a candidate for this? I'm a candidate. Unfortunately, a lot of people aren't there.

They're a little, a little bit older, and a lot of people can't handle just plain locally anesthesia, but in the right person. It, it works really well, and they appreciate not, not having to go to the surgical center, not having to go under, not having to pay those additional costs and having, you know, great results without all that downtime.

Catherine Maley, MBA: I think that's just genius. A lot of women cannot admit they need a facelift, but they need a little something, something. Right. That's why they're attracted to that, if I'm not mistaken. Did the lifestyle lift come from Michigan? How does that tie in with the secrets to long-term staff?

Giancarlo Zuliani, MD: It did. It did. It came right through three miles down the road in Troy, Michigan.

Catherine Maley, MBA: Okay. Because I'll tell you, I don't care what you say about them. They were talking right at the consumer. Right. No stars. It's a band aid, not a band. You know, like round your head? No. Down. Minimal downtime, minimal scarring, minimal everything local. I mean, it, they were, that was music to women's ears. You know, I can, an awful lot of result for a lot less, less money, less time, less hassle, less pain, less scarring.

And so, I'm assuming there's some of that came from that. That's also great to help with the secrets to long-term staff.

Giancarlo Zuliani, MD: Yeah. Yes. A lot of it was trying to find that sort of, that niche and that where people, you know, were in between. And so that's what we, we aimed to, to capture there.

Catherine Maley, MBA: So how do you use that in your, because frankly you could use it in all sorts of different ways.

There are women. Have you noticed the women are getting younger and younger who watch faceless? How has that affected your understanding of the secrets to long-term staff?

Giancarlo Zuliani, MD: Oh, I mean, it's, it's extraordinary. I mean, we're getting into late thirties, mid-thirties. A lot of people are like, I don't want. To be burned out on filler, I'm just going to, or, you know, threads or whatever it may be.

I'm just going to invest in it now. And so, we did one on a 36-year-old a few weeks ago. And that's where the lightning lift comes out. Like, Okay, let's offer you this. That doesn't mean you're not going to have a secondary lift 15 years from now, but this will tide you over. Right. So yeah. But younger, young, I just, you know, I was just, Saying hi to a patient who was receiving an energy-based treatment, and she was like, Is it right for my facelift yet?

She's, you know, she's, and I'm like, she's like, I just want to get it over with. I'm like, I understand. It's, it's, it's happening younger and younger and younger, and I think a lot of it's due to, you know, people are seeing, they're not scared of surgery anymore. They're seeing it more on social media and seeing sort of the results that surgical intervention can provide, and they're drawn.

Catherine Maley, MBA: Well, especially when they're watching the celebrities doing it at a younger age as well. Right. I just think though, psychologically, if they're already struggling now at 33, wait until they're in their forties and fifties and sixties, that's me. It's going to be way, I mean, I don’t know. They're shoot themselves; You know that. I wonder how that goes with the secrets to long-term staff?

It's not like you're going to have a facelift at 35 and you're good to go, you know? Right. There's a lot more that happens after that called, you know?

Giancarlo Zuliani, MD: Exactly. Exactly. No.

Catherine Maley, MBA: So is there, I know you, you have a lot of competitors around there. Is there any other way or strategies you're using to differentiate yourself from the others, and master the secrets to long-term staff?

Giancarlo Zuliani, MD: The, the sort of the patented surgical procedure was a great one that, that did it. The I'm in an area where it's a very highly sort of ethnic area where there's a lot of rhinoplasties going on and not too many people doing rhinoplasty in my area. Good point. So, you know that I never even needed to.

Advertise for, and we're doing, you know, 220 rhinoplasties a year, and I'm not, I'm not doing. Any sort of advertising for it. Where I am spending a little bit of advertising dollars is my aging face population, because it seems that everybody fights over that. You know, the full body plastic surgeons, the facial plastic surgeon, even dermatologists are fighting over, you know, lifts and, and things of that nature.

So, we, we do spend a little bit of money there, but nothing to even write home about. And it's worked, It's been consistent advertising towards that patient, consistent, putting information out there, consistently, having Facebook lives or Instagram lives doing q and as you know, from my own office, whether it's, you know, whether people are here or not, and.

Putting out, you know, the "before and after’s" and it's, it's working or, or it's up to, you know, 40% over last year just being consistent with it. And it's great. And that, along with the, the zoom boom, people not wanting to look at their necks, it's sort of just coincided that, you know, you can, and that that practice has.

Catherine Maley, MBA: I was watching one of your Facebook Lives and I was thinking, okay, for social media, you have somebody on board, which I think you have to have in today's world. Not just like the roving reporter in the office, but you also need somebody who knows how to video edit because they can make you look great, which also helps with understanding the secrets to long-term staff.

You know, especially if you're not into it and you're not like, You know, you've never wanted to be an actor. They can, they can really add some music, some highlights. You can get by almost without talking because they can put in the quotes, you know, or just things. So, I think that's going to be imperative for everybody in today's world.

Google's take, Google's not letting anyone get to your website anymore. I'm just watching how brutal that's gotten. They, I, I guess they just want to own the homepage for themselves and you don't even have to leave the homepage cause all the answers are right there and. What the heck are you guys going to do to find new patients if they keep like, closing all those doors? That must affect mastering the secrets to long-term staff.

Giancarlo Zuliani, MD: Yeah, it's all, it's all those algorithms. And I have, you know, you know, I keep asking my, my college roommates back in the day, they, you know, most of them went to work, go work for Meta or Facebook or Google. They don't really have an answer for it. I don't, I, I, they're just trying to keep things proprietary, I guess.

I don't, I have no clue, but. Going back to having somebody in your office, it's, it's very important that you invest in them and allow them to take classes on how to market on the internet. And so, we're constantly doing that with our, my, my patient care coordinators doubles as my social media manager and then, you know, farms the work out to every, you know, other people in the office.

She's constantly taking classes and constantly knowing how to, you know, beat the algorithms and things like that. So, it's important to invest in, definitely important to some, Invest in somebody like that.

Catherine Maley, MBA: Oh, in today's world I, I mean, I have an MBA, I have a BS and an MBA, and quite frankly, I've learned more on buying courses at night that I watch online than I ever did in school.

That took years and years to learn, right? Marketing nowadays, You're not learning a full-on foundation of things. You're learning one thing. How do you do a Facebook ad boom. How do you do a LinkedIn ad, boom? Like, that's so easy. Just go to YouTube. I mean, don't tell everything you wanted know. You have to want to put the effort in, you know, is that's the, the secret to it.

You know, you have to do that. If you've got staff who like to do that, they want to grow. It's more fun for them. And I've noticed, have you noticed social media is, Look, it's coming. Like it's becoming a team player event. Like it, it builds. Have you? How does that help with understanding the secrets to long-term staff?

Giancarlo Zuliani, MD: Well, everybody wants to get involved because it's, it's fun and it's, you know, you can do, you know, I'm not, I'm never going to be the dancing guy or anything like that, but I'll sure if the you know, if the other staff want to do that and have fun with it, I've got no problem.

You know, let your, let your personality show through. People want to know that you're a real person, not a robot, you know, So you have to incorporate, you know, not just your treatments, but you know, things that are going on in the office. You. We, you know, post about our outings and, you know, whatever it may be.

You know, you have to let people know that there's real humans here who are, who are doing the work. But it is, it's, it's, it's fun. You know, Most people, most everybody wants, I don't have a single. Not one that doesn't, one, one that doesn't like being one in front of the, you know, camera. You know, I'm, I'm not crazy about it, but I do it because I know it served a purpose.

But most people do want to, you know, help out in that regard.

Catherine Maley, MBA: Would you say social media is like one of those marketing channels that you're focused on, or is something else working better than that? How does that tie-in with the secrets to long-term staff?

Giancarlo Zuliani, MD: Well, you know, social media for one. But what really works for me is that I've, I've done surgeries on people who are in, in this area who are in a very tight knit community.

There's, there's a few. And it's both mostly word of mouth between them. They have like these; these communities have Facebook groups on their own asking about who's the best rhinoplasty surgeon. Who do you see for this? I had no clue that this was happening until mom showed me. And I was like, Oh my God, I, I have no clue.

It's like an underground network of, of questions and answers for plastic surgery, but that hap if this is happening here, it's happening everywhere. And so, you break into one of those communities and become the go-to guy. I mean, it sort of just spreads like wildfire.

Catherine Maley, MBA: It's like your own little real self, you know? Certainly helps with understanding the secrets to long-term staff!

Giancarlo Zuliani, MD: Exactly, Exactly. And I don't have to pay!

Catherine Maley, MBA: If you can get one, you can get that ho darn group, you know? Right. They all are connected; They hang around together. If you could give them that one procedure that they want like, like get known for that one. Like the rhino boy, you.

Giancarlo Zuliani, MD: Exactly. Yeah. Yeah.

Catherine Maley, MBA: All right, good for you.

Is there is there anything that you used to do for marketing that now just does not work and hinders mastering the secrets to long-term staff?

Giancarlo Zuliani, MD: Well, I never put anything into print per se. And you know, we, we, we used to do more stuff on like sponsored links or sponsored stuff on RealSelf, and I've quit all that. I quit all that maybe four years ago.

I wasn't seeing any real from that platform. Any real leads coming through that were really good. So, the, the advertisement on RealSelf, I've. Shied away from, I still have a, I keep a real self-link and things like that. But we've been doing our own, sort of reaching out to our patients through our social media and encouraging reviews, encouraging testimonials, encouraging video testimonials, encouraging patients to, you know, post about their journey with me and things like, And they'll do it on TikTok and then they'll share it with us.

So, they're going Reddit. I don't even know there is a plastic Reddit plastic surgery. That was amazed. You know, you know your patients and your perspective patients are, are reaching out on every platform known to man, looking for some looking for answers, looking for a real-life sort of experiences with you.

And so, you know, you want to encourage your patients to. Post on those so you can organically grow and it costs you no money other than asking them to do so. And a lot of people are scared to, to say that. But I encourage you say, please tell us about your experience, because I know we're striving to provide, you know, a world class experience here.

Catherine Maley, MBA: For sure. For the Facebook Lives. Has that been helpful to you? Profitable? Has it helped in the realm of the secrets to long-term staff?

Giancarlo Zuliani, MD: Yes, very much so. You know, so we'll, we'll, we'll go back and we'll analyze to see, you know, how many consults, you know, if 200 people books, you know, sign up, how many are actually showing up and watching it, How many are booking a consult from there.

But it's been a good, it's been a. You know, sort of pass through and thoroughfare of reaching more people. You know, some people are just sort of scared to come in the office. Some people are very hesitant to even make a consult. You know, you're just trying to maybe tip somebody in the right direction and let your personality come through and let them see who you are as a person and what, what maybe your surgical beliefs are and that, you know, that's, is its weight and gold.

I mean, that will get people in the.

Catherine Maley, MBA: Well, you know how I can tell when I look at your Instagram and you know, you can see the likes, they like dramatically increase. The more interactive you are being with that audience and those aren't easy to do those Facebook lives. If you're not used to sitting in front of a camera.

That can be very unnerving. You guys are doing a great job of that. But often I say to the surgeons, practice at home, get in front of your cell phone and just get used to talking to a screen. Right. You know, just so to lighten up, you know. The whole point is they need to see you as a caring, funny, nice, kind, compassionate person, human being. Also traits needed to master the secrets to long-term staff.

And however, you can get that to come across because you can't when you're so stiff.

Giancarlo Zuliani, MD: Yeah, right, right. I mean, long gone are the days of the sort of the patriarch doctor who sits there and is like, I'm going to do this and I'm going to do that. And that's what we're doing. And that's gone. I mean, it's, it's. The way of the dodo bird, you have, you have to be engaged and you have to be, you have to come out of your comfort zone.

You have, you have to do things that you have to get in front of the camera or else it's everybody else is going to be doing. You're going to be left on the side of the road if you don't.

Catherine Maley, MBA: That's, you know what, That's frankly your words of wisdom. If you don't adapt to this new way of nurturing, educating, attracting patients, you are going to be left on the wayside because they're, they're not going to tolerate less than that, right?

Boy, the more uncomfortable you are, the happier. The patient is so just you off. So, what would be, do any like last of wisdom for anybody who let's say is trying to make that jump that you made years ago to get into cosmetic? Anything you could tell them and how that can impact them learning the secrets to long-term staff?

Giancarlo Zuliani, MD: You know, it, it takes, it takes belief in yourself, but you know the best person to bet on.

The best thing to bet on is yourself because you can control that. You can put the work in so bet on yourself. And if you do and you put the work in and you surround yourself with great people around you, you will succeed. Yeah.

Catherine Maley, MBA: And my last fun question is, tell us something we don’t know about you, and unrelated to the secrets to long-term staff.

Giancarlo Zuliani, MD: When about let's see, how long ago was?

This was 20 years ago, so I ran with the bulls in Pamplona.

Catherine Maley, MBA: Oh, congratulations.. That's a…

Giancarlo Zuliani, MD: Yeah, I was scared.

Catherine Maley, MBA: Was of the, But did, were you a runner?

Giancarlo Zuliani, MD: Yeah.

Catherine Maley, MBA: I mean, like are you good at running?

Giancarlo Zuliani, MD: Oh Well not so much anymore. My knees aren't that great, but I've have run a couple half marathons and triathlons.

Catherine Maley, MBA: Right. Because you know, few beers and you're going to go along with it.

Giancarlo Zuliani, MD: I, I did have a few. And that's why I was at the front of the line.

Catherine Maley, MBA: Okay. Forget that. Yeah. Well, I'm glad you survived that. That is very interesting. I've never heard that one before. All right. Well, thank you so much, Dr. Zuliani for coming to Beauty and the Biz and discussing the secrets to long-term staff. I really appreciate it.

I hope to see you soon at one of our conferences coming up and everybody if you want to talk to Dr. Zuliani for whatever reason, his website is

Giancarlo Zuliani, MD: www.ZulianiMD.com.

Catherine Maley, MBA: Everybody that's going to wrap it up for us today, a Beauty and the Biz and this episode on the secrets to long-term staff with Dr. Zuliani.

If you've got any questions or feedback for Dr. Zuliani, you can reach out to his website at, www.ZulianiMD.com.

A big thanks to Dr. Zuliani for sharing his experiences on the secrets to long-term staff.

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 “Secrets to Long-Term Staff — with Giancarlo Zuliani, MD."

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#staffingsecrets #longtermstaff #secretstolongtermstaff #drzuliani #giancarlozulianimd

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and Park Avenue prestige.

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 "Park Avenue Prestige — with Thomas P. Sterry, MD."

We all heard its location, location, location, but is that enough to grow a successful practice? 

That’s what Dr. Thomas Sterry, a board-certified plastic surgeon with 20+ years of experience in private practice in Manhattan, NY asked himself when he had to decide if he would rather have a large, 2-floor office near Mt. Sinai or ½ that space on Park Avenue in Manhattan?

My guess was there is so much prestige with being on Park Avenue that can attract patients from all over the world, since the address alone gives him status.

That’s what Dr. Sterry thought that as well, so he set up shop on Park Avenue years ago, at his wife’s request to live and work in the City. 

While he enjoyed some out-of-town patients, he found most of his patients were locals coming in from Brooklyn, Queens, CT, New Jersey, Long Island and Staten Island.

This week’s Beauty and the Biz Podcast is an interview I did with Dr. Sterry where we talked about the moment he quit insurance and went to cosmetic medicine, his advice for residents soon graduating, as well as his love for vintage cars.

There is no right answer to where you should set up shop, but there is the right answer for YOU so choose carefully.

Visit Dr Sterry's Website

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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Transcript:

Park Avenue Prestige — with Thomas P. Sterry, MD

Catherine Maley, MBA: Hello 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. Thomas Sterry and he's a board-certified plastic surgeon with 20 plus years in private practice in Manhattan, New York.

Now, Dr. Sterry also teaches residents as a clinical assistant professor of plastic surgery at Mount Sinai Medical Center in New York City and is involved in several plastic surgeon societies of which he is currently VP of the New York County Medical Society.

Now he's won many patient choice as well as Super Doctor awards throughout the years, and he's a RealSelf top contributor and Hall of Famer. So, I'll ask him more about that and on Park Avenue prestige. Dr. Sterry, thanks so much for joining me at Beauty and the Biz.

Thomas P. Sterry, MD: Thanks for having me, Catherine. It's a pleasure.

Catherine Maley, MBA: Sure. So, I, I know your background a little bit more before you went to Park Avenue prestige, but you didn't come from a family, a surgeon, so can you just talk on that a little?

Thomas P. Sterry, MD: Sure. My Well, I didn't expect that to be your first question. Yeah. My, my folks were civil servants. My dad's a fireman. My mom worked in the court system in New York. I was sort of expected to go to college, but not necessarily become, A doctor, the goal was college and that was the goal. So, once I graduated college, it was like, well, not a lot.

I'm not really sure what I want to do. And I always knew I wanted to be a physician, but I didn't think it was possible. I came from a, a very blue-collar neighborhood and You know, it didn't seem realistic because there were these proverbial stories about straight A students who couldn't get into medical school and whatnot.

And, you know, as time went by, I found out that that was truly, really not the truth. That's, that's not how it really goes. You work hard, you can make some progress in your life. We do live in a meritocracy. And so, I ended up going to medical school and I wanted to be a general surgeon and found out that I didn't like trauma as much as I thought I did and.

One thing led to another and I found myself in plastic surgery where I thought I'd be a reconstructive surgeon.

Catherine Maley, MBA: So, did you work in the hospital for years before you went out on your own and got Park Avenue prestige?

Thomas P. Sterry, MD: I worked for three years at Mount Sinai before employed by the hospital. And eventually it was, it was, it was, it was a long three years and it was time to move on.

Got super frustrated with insurance and management, et cetera, et cetera. And It's not a decision that I ever made. I just kept acclimating towards, well, I have to pay the bills now. Now I've got a couple of kids and I've got bills to pay and I don't have any choice and I can't get stiff by insurance companies anymore.

And next thing I know, I'm a cosmetic surgeon,

Catherine Maley, MBA: So, I mean, you literally went from the hospital to solo practice with Park Avenue prestige.

Thomas P. Sterry, MD: Yeah. Yeah. So, there's 2003, four, and yeah, I, I just decided I, I can't do this anymore. It became untenable and so I found his face on Park Avenue and we did and moved on.

Catherine Maley, MBA: Because when I met you, you were on Park Avenue and you have since moved, but what possessed you to, to set up shop in the middle of the jungle of New York, in the middle of Manhattan?

I could it be any more competitive in the US or in the world, especially with Park Avenue prestige?

Thomas P. Sterry, MD: I mean, honestly, I have a very simple answer. My wife, oh, my wife refused to leave the city. Wow. And, and I, and, and I don't think she. What she was asking of me, because you're right, it was very challenging. It was really hard, and it, you know, what it really comes down to is working more, spending more hours, not at home working evenings and weekends and stressing quite a bit, but you make it happen.

Catherine Maley, MBA: So, you went completely cosmetic and got Park Avenue prestige.

Thomas P. Sterry, MD: Now I am a hundred percent cosmetic. Yes.

Catherine Maley, MBA: Okay. Now Park Avenue, when you were there, I, I just was so surprised when I b I know quite a few surgeons on Park Avenue and there have to be what a of them, I mean there're a lot surgeons on Park Avenue and I was so surprised how much you get done in such a small space.

It's very interesting because then you go to Texas and you. Your 2000, is there 20,000 square feet? You know, it's just crazy, the, the amount of space. But, but because of that, does it make you decide, I'm just going to do surgery or just going to do nonsurgical, or I'm only going to bring on a couple people?

Like how does that affect you? Building a practice? With slight, you know, with tight tightness, especially with Park Avenue prestige.

Thomas P. Sterry, MD: Yes. It, it, you're absolutely right. It does, because there's physically no place to put too many employees, number one. The, the overhead is enormous. And so, I've been forced to think about, well, what, what can I act?

Like I mentioned before, at the end of the month, The rent has to be paid at the end of the month. Verizon, the phone bill has to be paid. There's no, there's no negotiation about it. So, you really are forced to, to look at everything really closely. And it, it's a big challenge. There's no, I don't really offer any spa services because I don't have the space for that kind of thing.

It, it has affected some business decisions when you talk about investing in technology, because if I want to buy a gadget that takes. A whole room. I can't give up a room for, you know, an hour at a time for some treatment because you know that that room cost me. We literally have, at one point I had it figured out what it cost me to breathing air for an hour in my office.

It's insane. And, you know, you, you, you just can't, you can't give, you can't give it up that easily. And I noticed. As the years went by, I started to figure out that industry really wants a piece of us. And you know, they love the idea of cosmetic work. But I think you have to be really careful, very picky, and choosy about who you get involved with, with a lot of the industry folks that are out there.

Catherine Maley, MBA: So, when you were on Park Avenue, did you have an OR suite in.

Thomas P. Sterry, MD: I had the world's smallest or, yes.

Catherine Maley, MBA: Yeah. Cause I don't remember seeing it when I visited your Park Avenue prestige location.

Thomas P. Sterry, MD: It was it was a big problem. I, I was able to get it quite certified. It was, it was a, it was a challenge though, because I, be it, Pardon? No, I'm sorry. In part. Yeah.

No, I could not get it. Quad A certified. Got it. I had to go with joint commission because Quad A actually demands a certain layout and they know that you need some space, God forbid there's an emergency, and you have to give CPR some such thing. Whereas the Joint Commission was much more concerned with process and, and frankly, what I thought it was p.

And it was a very different, I honestly think that the quad a is a, is more appropriate for a surgeon to be certified by than the Joint Commission, at least in private practice. For, for what? What people like me here for.

Catherine Maley, MBA: But now you're on 5th Avenue. Did that give you more space versus Park Avenue?

Thomas P. Sterry, MD: Yeah. Yeah. I have a better layout.

I have a little more space. I've already outgrown it, but here we are. I don't, I don't really want to move again because I don't think it makes practical sense. But yes, I, I have a, a real operating room. I am currently quality certified. We have everything we need to, to do real surgery here.

Catherine Maley, MBA: Gotcha.

And but quite a typically, don't you need that because of the recon? I mean, is there, do, do you have to have that because, well, let me ask you this. Are you watching or hearing more patients wanting local versus general? Less downtime, faster recovery. Are you hearing that? Because I am, the trend is, can I have this done under, as it relates to Park Avenue prestige.

Thomas P. Sterry, MD: Yes, for sure. No question about, I've been hearing that for about 10 years. Yeah. But I'm also, you know, I, one of my, one of the things that I've tried to do is cut out the middle man as much as possible, and I love my colleague’s anesthesia, but they're expensive. And if I can, you know, patients are willing to pay X for a procedure.

So, if you can do it under local, you're better off if you, but it's got to be safe. So, you know, that, that really depends on the, on the procedure that they're wanting. In New York State, one can't give I the anesthesia without being certified by one of the three big entities. So, it's either joint commission quota, or what is it?

Triple A. And so, I, I stuck with Quad a, it making most sense to me. Gotcha.

Catherine Maley, MBA: And then did you add any non-surgical staff or are you doing your own non-surgical? Is it like, how big of a part of that, of your revenues is non-surgical now versus surgical, and how does that tie in with Park Avenue prestige?

Thomas P. Sterry, MD: Revenue wise, it's still not a big part. I, ironically, I guess I made a small mistake last year.

I hired a nurse who I wanted eventually to take over all my injectables. She ended up not liking the injectables any more than I do, and patients and the patients still want me to do it. So, I don't have a huge injectable practice because frankly, it's, it, I don't find it to be profitable. It's I find it to be a little bit bothersome, to be honest with you.

I know a lot of folks make it work, but in my neck of the woods with the tier that I'm in with the, the, the companies that sell the products, It, it just, you know, hour for hour, I'm better off operating. I like things like Botox. Botox is profitable. It's pretty quick and easy. Some injectables, things like volu in the mid phase, bing bang, boom.

You ring you out, you move on, it's fine. But when folks come in and they want things like lip injections, I find that to be. A money loser. You know, that's a real loss leader. You can do it if you want to, but it's if you think it's going to draw patients for something else, but it's a solid half hour of my time.

Or I suppose if they had a nurse injector hurt time. And invariably you get a handful of people who are unhappy and they want it to solve. Once that is bigger than the other, and you know damn well you put the exact same amount of product on both. It's just, it's that to me, I, I don't want to deal with the headaches.

I don't want to have to spend the time to explain it. It's, it's bothersome. So, I, we service the patients that we have, but we don't look for more of those.

Catherine Maley, MBA: Literally in your situation, if you asked me, I would say the only reason to bring on a nurse injector is if she brought a really good following with her, especially with Park Avenue prestige.

And it's not just injectable but it's Botox and maybe just a really good nurse injector can bring in a good profit center for you but not you getting involved probably.

Thomas P. Sterry, MD: Yeah, I, I could understand that. I believe you, but that's not what I did. Yeah. Right. And I do love my nurse, the death I hired someone who is terrific at a lot of different things.

She's just not an injector. Right, right, right. She, she took so much off my plates. She runs the, or I don't have to worry about the paperwork in the OR anymore. She's on top of it. Like, like why not write, she's.

Catherine Maley, MBA: No, I completely agree. I'm just saying if you did bring in a nurse injector, it would be one who's a really good marketer.

She knows how to market herself. She knows how to bring in her own clientele, so she becomes her own profit center without you involved. But then again, there's always that fear that she'll walk away, you know, and she'll take them with and you’ll lose some Park Avenue prestige.

Thomas P. Sterry, MD: Yeah, it happened to many of my friends. Yes.

Catherine Maley, MBA: Right, right. So how many staff do you have with your Park Avenue prestige

Thomas P. Sterry, MD: Three I have. I have Alex, who's my practice manager. She's been with me since I worked for the hospital. She came with me when I left. Megan is the nurse and my medical assistant is sh.

Catherine Maley, MBA: Nice. You probably sleep well at night with that kind of overhead, now with Park Avenue prestige. You know, watching some of the others there are two ways to do this.

You either build a kingdom or you build a lifestyle typically. And some surgeons are just built to just build, build, build. And others are built to, no, I want to see my family periodically, so…

Thomas P. Sterry, MD: Yeah, Nothing wrong with that. Yeah. Well, it's a mixed bag. You know, I decided, you're right. The way I looked at it was different.

I, I, I know that there's a certain. When I was buying my space, I thought, well, if I could afford to get more space and then rent space out and you know, set up some of the spa services we talked about, that would be great. That's a good business plan. But as I mentioned, my father was a fireman and I did.

And in New York you need at least 50% down. So, if somebody wants a million dollars for an office, you need 500 K to put down in cash. And it was not so easy. You know, there was this little financial crisis we had in the middle of my career. There's been a few stumbling blocks we come across, so.

Catherine Maley, MBA: For sure and as it related to Park Avenue prestige.

Have you ever tried to work with another surgeon or, you know, share expenses or any of that, or any thought of doing that?

Thomas P. Sterry, MD: There's always a thought. I kick it around periodically. I'd rather stay friends with people. I, you know, we cover for each other. We look out for one. Somebody needs Botox. We, we, we blend it to each other and whatnot.

But I haven't really seen too many successful stories there. And, and even when the group stays together, at least in my neck of the woods, there’s a lot of strife that goes on in the back, back room. I, I just, I, I sort of like running things this way. As I said, when I worked at the hospital and I had associates, it wasn't as smooth as I thought it would be.

Catherine Maley, MBA: I hear you. I, I also don't know many who have made it work. The ones that have, they have very thick boundaries like you do neck. I do neck down or I'm the dictator. You're this, you know boy, too many cooks in the kitchen, especially in terms of Park Avenue prestige.

Thomas P. Sterry, MD: And then at the end of the current contract, there's never going to be a partnership.

And the junior guy gets kicked out and I don't, you know, now that I'm on the other end, right now, I would be the senior guy. I, I don't want to screw over one of my residents. I have no interest or, or a younger guy, woman, man. I, I just, I think it's better. Like I say, we cover for each other. I do my thing.

You do your thing.

Catherine Maley, MBA: Do you have any words of wisdom for, I know you hang around with the residents, you're training them. Are there any suggestions you're giving them or recommendations? How in the world with a, with a newbie entered this marketplace, especially in New York with Park Avenue prestige?

Thomas P. Sterry, MD: You know, I, I, I think right now so much has changed, right?

It's only been 20 years only, but so much has changed. I, I really think that when you first finish, your best move is to be employed somehow. And in order to do that, your best move to get a job is probably doing a fellowship that somebody wants to, you need some advanced skills, which is wholly unfair because you're in your mid-thirties by the time you finish plastic surgery training.

But I, I. I think that's probably what I would do. I might, I've gone back to telling them you might want to think about a microsurgery fellowship because then that gets your foot in the door, you'll get privileges. You know, when I finished, my biggest challenge was getting, I couldn't get my hands on an application to a hospital to apply for privileges.

It was a big game. It was, it was unbelievable. You know? Well, you have to meet the chairman first. Okay. One thing. Oh, you know, he's a surgeon. He's very busy. Maybe about six weeks from now. Okay, fine. I'll take that appointment day prior. Get a phone call. Dr. So-and-so can't meet you. He's sorry. He apologizes, but he has emergency surgery.

He can't, well, when can I see me at six weeks from now? And so, it goes. And I was never able to, well, it was very challenging. You had to pull some strings. I, I, I got awfully lucky in a couple of different ways to, to make things happen for myself.

Catherine Maley, MBA: I do know because I also have been around 22 years and I'm watching the, the older guys, you know, starting to think about exiting and that's when they have to start saying, Okay, I like to run my own show, but now I need to figure this out.

And they try to bring someone on and is so difficult bringing the right person on it matches your values and your vision. So, nothing easy about that. So, what would you say is the biggest challenge facing surgeons today? Just with all the changes happening, any suggestions there, especially in the areas of Park Avenue prestige?

Thomas P. Sterry, MD: Oh, wow. I have several thoughts about that.

I mean, what, the biggest one, like I mentioned, I, I bailed out of insurance work. I'm very lucky to be in that position. But I, I just found that there were too many times, you know, there was always this phenomenon where they pay you less than at a time prior when they deny services, et cetera. But then there was one case in particular that I did a few years ago, and I just said, That's it no more.

Because I took care of a patient who I cared about very much. I knew this guy for a long time. And when I would, when I would do some work for folks who were paraplegic and such, I really felt like a doctor. You know, I was doing it because I wanted to do the right thing. But then again, you do have to be paid.

Big operation weeks of care in the hospital. The insurance company paid me zero. They denied it. Totally. And I said, what do you mean? What, how refile that that must be wrong. I spoke to my biller, no, just do it again. And they said, no, They, they don't think that you did what you said you did. I did a flap.

What are you talking about? So, I compared my note for the same patient from 10 years prior and I haven't dictated all, you know, you get into habits. It was almost the same. No. Why didn't they paid for it before, but not now. I had to have a one to one with a representative, a physician from the insurance company.

And, and I said, what do you mean I didn't do a flap? And look, I, I said, I rotated and I advanced the muscle and filled in the gap and blah, blah, blah, and covered the bone. He says, Doctor, you, you didn't name the blood vessel that supplied the flap, and therefore we don't consider it to be a, a rotated flap.

So, what are you talking? And the end of the story was, I got $0 for that one, and I, I, that's it. I said, no more, never again. And I haven't I feel terrible, but what? Look, once in a while I can still operate on people. I, I do across sometimes. You know, I just, I, I, I'd rather not deal with the hassle. I found that we wasted more time and more of my brain power.

Trying to get the few dollars that they might be willing to pay for something that I should just spend that time marketing and getting other cases that pay me ahead of time and we take care of business.

Catherine Maley, MBA: That's why I only work on the fun side of medicine because as much as we all need the recon side, especially when something goes horribly wrong in our own lives, I don't know who's going to be there to help us

Cause it just, they're, they've made it almost impossible for these surgeons who have spent what years and decades trying to learn this craft and they're not paying them and there's no upside to the darn thing. And I, what a shame, you know. And it's not just the, like the zero reimbursement, it's the time and the negativity and the mind space you have to put into fighting for it.

Then you still don't even get it. So, ah, I stay away from it, for sure. So, let's talk about something more fun and that's marketing, but in your world, how in the world do you differentiate yourself? By the way, I, people used to say, you know what, New York it, it goes both ways. There are a lot of competitors, but there are still like 8 million people that live.

Did. Is that still true or did everyone move to Texas or Florida or something like, so what's your population like in New York, or on Park Avenue prestige?

Thomas P. Sterry, MD: Well, the catchment area is still the TR tri-state region, so it's still something like 24 million people. Oh, so it's million in the island, in and around the city, I should say. Okay. They come from long and con jersey.

They sometimes fly in from other states. I've had several people fly in from Australia. I remember talking to this one woman on the phone and saying, you realize it was still the telephone by the way. I said, you know, you're literally going to fly past every other plastic surgeon on the planet to get here.

I'm not that good. You can go to somebody, go to la, go to Singapore. It's got to be somebody. And she wanted me to do it, so, okay, fine. You know, I wasn't going to argue with her too much. There's, there's still this when you talk about marketing. Yes. I was looking at a space next to Mount Sinai Hospital.

Mount Sinai is on fifth Avenue, but it's a little north. It's, it's almost Spanish. It's big borders on Spanish Harlem. And there was an office that was becoming available back in 2007 or eight before eight. Right. Before the crash, and I loved it. It would've been a fantastic space, 2100 square feet. Wow.

Upper level, lower-level cetera, condominium, so only 10% down. None of this 50% down. Stuffed. Yeah. And I thought, wow, I could actually afford this one. And it's beautiful. I asked, one of my patients said, if my office wasn't on Park Avenue, if, if I, my, if I was up by the hospital on hundred first Street, would you have come to see me?

She didn't late, she said. I said, But I'm the same guy. Why wouldn't you see me? And Sure. Our answer was very simple. Everybody knows if you want a good plastic surgeon, you have to go to Park Avenue. And I thought to myself, Okay, I can't fight this kind of stupidity. This is what they believe this is. This is just how it is.

So I went, Whoa. So, you know, I've been on park, I've been on fifth. This has not hurt me. I mean, I'm not fit, but I'm a little, I'm looking at the Guggenheim right behind your screen, right. And it, it's worked out fine, but I don't have any special abilities that anybody else in the country doesn't have. We all did basically the same training.

So, I, I do think there's something to be said for location in, in terms of, you know, the rest of the marketing. I've taken my lumps, I've, I've made some mistakes right now. I think social is the way to go. I, I think that's the best bang. Bang for your buck, bang for your time. It's where everybody, its worldly eyes are.

So, we, we spend a little more time there now.

Catherine Maley, MBA: I also checked out your Instagram because quite frankly, the cosmetic patients want to know who you are as a person, human being father, wife, I mean, husband, whatever, dog lover. I like the dog part. But I, so I checked it out and I saw that you did a tour of your office.

I walking out the door of your office and it was like the most beautiful, gorgeous, stay in New York City. And I thought, well, I, we should always look like. That was great. Then it showed the Guggenheim and, and you did like a little tour and the coffee place that's outside on the other side and it was so that was, that was fantastic.

And it's so true. You have to be in the right neighborhood, you know, to, you need the cache. It's very helpful. So, I take it you didn't take that other building over when getting your Park Avenue prestige.

Thomas P. Sterry, MD: No, it didn't make that rule. But you know, it's, it's true. Perception is reality. You got to deal with it. You got to roll with.

Catherine Maley, MBA: Well, you know how many surgeons use Park Avenue? They're not there, but they go there like once a month and they put it on their website. You know, they have a Park Avenue address. And I mean, Real Park Avenue is, does say something to a lot of people, so use what you have to if you have it. So, regarding your demographics, because I did notice Alex, your practice manager, who's been with you forever, and how helpful is that to have somebody who's been there from the beginning?

It's invaluable. Don't ever lose her. The continuity of that.

Thomas P. Sterry, MD: Priceless. Yeah. It, it is. And she is, you're right, you're right.

Catherine Maley, MBA: And she brings Spanish with her. Has that been helpful to open up your target market with Park Avenue prestige or has that been helpful for you?

Thomas P. Sterry, MD: It's been, yes. It's, it's that helpful when you need it. We don't need it every day.

We have taught, she and I have spoken you know, do we want to have a Spanish version of the website? Should I, should I brush up on more of my Spanish? Cause I used to ablo a little bit, but. The truth is that for the last few years we've been busy enough without worrying about it. So, we, we haven't now with this coming recession, if he thinks to start drinking again, but I haven't needed to go down that road too much so far.

Catherine Maley, MBA: So social media, you have like 13,000 followers, so you're doing a good job. You have somebody that works with social media. In today's world, I really think you need a dedicated, at least part-time dedicated person That is their job to focus on the social media and turn you into a star. Like it's their, like, it would be their responsibility to tell you, Okay, today we're doing this.

While they're walking, while you're walking down the hall, let me ask you a question. You know I really think you need that and almost a videographer or somebody who's good at video editing. So, your person like can take the raw footage, you know, of your iPhone or the iPad and then somebody can do something fun with it.

There's so much you can do on social media now that's super entertaining and you don't have to be the entertainment. But they can edit you into being that entertaining part, as it relates to Park Avenue prestige.

Thomas P. Sterry, MD: Right. I couldn't agree with you more so a couple years ago I made that decision and I hired someone part-time was worth every nickel.

And then some, I mean, you know, you know, somebody told me a long time ago, if you're doing your marketing right, doesn't cost you anything. It makes you money. You got to remember that investment. For sure, for sure. So, I had somebody who was fantastic. I didn't know how good she was. And then she, she went on to graduate school.

And I, I had to hire someone else who I loved very much, and she was terrific. But she wasn't as dynamic. She's now left also, and this moment we're actually kind of looking for the next person. And to the point you're making, I would, I'm looking part-time, full-time, part-time. Fulltime. You could make that a full-time job.

I mean it, I think it would be worth. The budget, but it's got to be the right person. As you mentioned, they have to have some insight. They have to know you and understand your brand and what you want to bring to the table. I had somebody here for a very brief minute and she was, trying to get me to do some, some, some funky things.

She didn't want me to dance on camera or anything because I made that was LA that down immediately. Yeah. Some of the things she wanted to do were just not on brand and I said, I don't think I want to do that. That particular video, I don't like that concept or that music and, you know it didn't work out between us, so we had two different visions of what I, I was going to be willing to offer.

And I also think that you're right, you need, and we're currently now working on mixing in some of the fun video along with before and after. Because my perception, and you correct me if I'm wrong cause you're the marketing person, but I think people want, they want to know that you're relatable.

The proof is in the pudding man. They want to see that before and after, once in a while, and they want to know that you can deliver the goods that they're looking for. See, we're trying to find a better mix to, to offer both.

Catherine Maley, MBA: I think you need both for sure, especially at a location with Park Avenue prestige. They want the before and after photos. You, you want them more than they do, but they want those chi, well, they want the transformational results.

They want to see that tummy that was out of control and now it is tight. You know, they want to see really good results and the patient's stories. If you could get the new person you., if they could get good at finding out that patient's story, that's what we're looking for, because we're looking for somebody like us, like, oh, I had three children.

I used to be so hot, and now my body's shot, you know? And I chose doctor's theory because, and then this is what he did for me and how my life has changed since then. We love the stories, but then we love the pictures because we want to see ourselves in those pictures. Oh, I even tummy like that. And now I can have that, that fantastic.

And then the entertaining part that is becoming because of where we're all heading in the world, apparently everything has to be fun. Now, I didn't come from that world, I came from the world of work hard, hard labor, and That's how you succeed. But apparently, and you did too, the blue-collar kind of mentality.

And nowadays it's not like that and people want to be so entertained. So, you've got to figure out that balance of how much do you want to share with them. That's another thing, like you're a limited on the family part, but how do you feel about sharing the family with the kids, with the hobbies you know, your vacations where you know what you did this weekend.

Are you comfortable with. Yeah,

Thomas P. Sterry, MD: I'm still comfortable with most of that. I, I, I don't mind too much of that. And so far, my family hasn't objected either, cause some people are not comfortable being on camera. But I, I think that the big challenge now, as you mentioned before about the patient stories, you know, Tim Cook is killing me.

I'm a big, I'm a big Apple guy. I'm, I'm looking at you right now on a love his products, but he's got a point about privacy and he's made everybody much more aware. Three or four years ago, it was, it was so much easier to get folks to, to allow me to share their story or their, their before and after.

Look, I'll, I'll, I'll either cover your eyes, I'll crop out the top of your face or all this or that. And nowadays boy, it's tough. Folks are very private. They, they're very insecure about having their identity out.

Catherine Maley, MBA: Now I, I'm going to question some of that because there are also that, that whole other, it's a 50/50 thing.

There are others who can't wait to put themselves out there with Park Avenue prestige. They're such narcissists, and they just love sharing everything. So, you just need to find them, you know? And I would just keep asking everybody until the right, you know, some of them say yes.

Thomas P. Sterry, MD: Well, we do, of course. But I guess the point I'm trying to make is I'm finding a trend, at least in my neighborhood, where there's, there there's more interest in privacy than there used to be.

And they'll be at that, you know, it used to be a lot easier for me to, to convince patients to let us use their photos. Then it is right now. Right.

Catherine Maley, MBA: Actually, I attended a seminar on this and there's a big war between Google, Facebook, and Apple and Apple because Apple literally runs the whole show with the darn mobile phone.

Even though Google owns the world, Apple has a very big. Control button on top of things. And all of us got to pick that question. You know, they had to put in that question, do you iPhone, do you want us to share all your information with third party vendors? Like the, like the question was, of course we don't, you know, like 90% of people said no, but yes, the privacy thing, and you know what?

I heard the, the reason they're doing that, Apple is going to get into the advertising. That's what I heard. And so, they need to control that now so they can now have this audience that they're not sharing with others and then they can start, start advertising, charging for advertising.

Thomas P. Sterry, MD: I don’t know, that would be an interesting paradigm shift for Apple, but yeah, well look, we'll see.

But yeah, I, I believe that Tim Cook has a lot to do with meta stop dropping quite a bit the last year, cause of some of the constraints you've put on.

Catherine Maley, MBA: Well, that's why I, I hope everybody embraces social media because another thing that's happening out there, even if you paid to get on the first page of Google, nowadays with search rankings, they're not going to let you there.

There's so, there's only so much room left unless you do the pay per click or Google AdWords, which are there's, there's a lot of big challenge to that, but they don't even have to go to your website anymore. Google's going to great lengths to make sure they don't leave the homepage. Oh, you want to know how much a tummy tech.

Oh, you want to know what the downtime is? Oh, do you want like, oh, you want to know you know, all, everything you wanted to know about it. Tummy tuck. You don't even have to the first page, even if realized, wait a second, I went, I'm meant to go find Siri's trying to, and I, gosh, it's.

Thomas P. Sterry, MD: Yeah. Yeah, that's true.

Catherine Maley, MBA: That's true. Yeah. So how do you feel about patient retention at your Park Avenue prestige location? Because I'm focused more on that than ever. You've been around for 20 years, you have a patient list that knows, likes, and trusts you. Do you spend any time, effort, and money on them versus looking for new stranger patients?

Thomas P. Sterry, MD: You're, I'm embarrassed to tell you, we don't do very.

We don't, and, and I know it's in your book, and I actually have purchased some of your, your other tools to make sure that that happens with email campaigns and such. And we've not been very good about it, but, well, look, you know what, the faucet was wide open since the pandemic. I mean, we, it was so easy.

There were patients falling out of the sky. We didn't have to make any. To, to bring anyone in. Things are about to change. They're, they're changing already right now. And I can see that coming our way very quickly. Just to give you an idea, a flavor. In June, we had a four-month waiting list. It's now the end of September, and we don't.

Catherine Maley, MBA: I hear you. I've heard that all over the country and also at your Park Avenue prestige area. And it can, do you know how quickly it happened? That's how quickly it can dry up. And we've all been around for a while. It's like, first of all, did anybody see that surge coming? I didn't. I thought, here we go again. Here we go With the DM recession again, we're all in trouble.

And instead, it was like, people must have plastic surgery, they absolutely must have it and they must have it now. That was crazy.

Thomas P. Sterry, MD: Yeah. And some of my junior staff, you know, they, they, they didn't understand. So, as you mentioned, Alex and I are together for 20 years and the younger staff didn't understand why, like, why are you guys still working?

What you mean you want to stay late again? Why, why are you going to work on Saturday? Like, how much do you need to get by? And I kept saying, we got to make hay. Well, a sun is shining. Yeah. This would not last forever. Yep. And I kept feeling as though, you know, there's a tiger chasing me and I got to get ahead and.

Finally, the tiger's here. I think, you know, finally, it took a while, took a couple of years, but here we go now we're going to have to deal with it, but we're in a much better position and I trust that all of us are in a better position now than, you know, maybe in, in oh 8, 9, 10, when we all struggled so hard.

Catherine Maley, MBA: For sure. So, we're going to wrap it up now. I know I was going to ask you what drives you, but I know you have a lovely wife and three little kids. Actually, they're not so little anymore. How, how old are your.

Thomas P. Sterry, MD: My oldest is 18, 16 and 14 on Monday.

Catherine Maley, MBA: Oh my God, how cute is that? So, is there anything interesting you can tell us about yourself that we don't know that you're willing to share with the world during your transition to getting Park Avenue prestige?

Thomas P. Sterry, MD: Gosh, I, wow, that comes out of the blue. I'm a about myself. I still, I still like working with my hands, even at home. I am a car buff and I have an old MG that I'm forever tinkering with. Trying to teach my kids how to turn a wrench and some, sometimes they're interested, most times not. But I, I still enjoy working on the old rust bucket.

So, do you drive? Yeah. Yes, I'm a New Yorker. It's true. But I grew up on Long Island, so I drive.

Catherine Maley, MBA: OK. Ae any of the kids going to follow you into medicine?

Thomas P. Sterry, MD: No. No. They, none of them have an interest. They all say, and this is the sad part, they all say, you know, we never see, we never see you. We never say, you growing up, you work so hard.

I don't want to work like that. Why would I do that? And I kind of, and I've said to them sometimes when we're really being serious and I say, look, you know, it's true. I, but I, your mother and I worked our tails off to blaze this trail. All you have to do is go to school and your name is on the door. The place is here.

Just walk in and operate. But so far there's no takers. We'll see how things change if they change as they kids grow. But so far, no.

Catherine Maley, MBA: Okay. Well, it has been a pleasure talking to you again about getting some Park Avenue prestige I hope to see you at a meeting someday soon. It looks like the travel's coming back, although it has not been fun to travel.

No, you can't seem to get anywhere where I want to go on time, but whatever. Thank you so much. Thanks. Thanks for your time.

Thomas P. Sterry, MD: Thank you and thanks for all you've done to help me in my practice over the last 20 years. I, I tell all my residents, they've got to read your book. I've bought it for a few of them so they can look it over.

And I love your advice.

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. Sterry got Park Avenue prestige.

If you've got any questions or feedback for Dr. Sterry, you could actually reach out to his website at, www.DrSterry.com, www.DrSterry.com.

A big thanks to Dr. Sterry for sharing his journey on moving his practice and attaining Park Avenue prestige.

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 “Park Avenue Prestige — with Thomas P. Sterry, MD."

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#parkavenueplastisurgeon #parkaveplasticsurgeon #parkavenuenyplasticsurgeon #nyplasticsurgeon #manhattanplasticsurgeon

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and www.BlackNoseJob.com with Jason S. Hamilton, 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. Now, today’s episode is called "www.BlackNoseJob.com — with Jason S. Hamilton, MD."

I am a huge fan of specializing. Becoming an expert in something, rather than a generalist in lots of different things, has its advantages….

• You have more focus.
• You get really good at one thing.
• You stand above the competition.
• You’re able to charge more.

Frankly, that’s how I grew my own business. I picked a very specific market (cosmetic surgeons) to help grow their practices.

I’m pretty sure you wouldn’t be following me if I was the self-proclaimed marketing guru to dentists and realtors and lawyers….you get the picture.

So, in this week’s Beauty and the Biz Podcast, I interviewed someone who took this strategy to heart and really went for it.

It’s Jason Hamilton, MD, facial plastic surgeon in Beverly Hills.

Dr. Hamilton is the director of facial plastic surgery at the Osborne Head and Neck Institute based at Cedar-Sinai Medical Towers.

He specializes in primary and revision African American rhinoplasty, while pioneering new methods designed specifically for the black nose.

He even owns the URL www.BlackNoseJob.com.

We talked about where he got the courage to specialize and what happened when he did (hint: huge drop in business, then came back stronger).

Visit Dr Hamilton's Website

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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Transcript:

www.BlackNoseJob.com — with Jason S. Hamilton, 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 www.BlackNoseJob.com with Jason S. Hamilton, 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.

Now, today's guest is very special, it's Jason S. Hamilton, MD, who will discuss with us about www.BlackNoseJob.com.

He's a director of facial plastic surgery at the Osborne Head & Neck Institute based at Cedar-Sinai Medical Towers in Beverly Hills. Now, Dr. Hamilton attended Duke University and did a fellowship through the AAFPRS. He's also held several teaching appointments as an attending surgeon and clinical faculty member in the department of surgery at Cedar-Sinai, where he teaches facial plastic and reconstructive surgery.

Now, he's also lectured internationally and he is published over 54 peer reviewed scientific articles and book chapters, and Dr. Hamilton specializes in primary and revision African American rhinoplasty, while pioneering new methods designed specifically for the black nose. Now, his goal is to give his patients a beautiful nose that will always look natural throughout their entire life.

That's no easy feat for Jason S. Hamilton and his www.BlackNoseJob.com. Now, he's been honored with numerous awards and is considered one of the top African American rhinoplasty surgeons in the country and probably the world. Now, he's an academic mentor to high school students. He goes on missions he gives back by working with several humanitarian organizations such as Face to Face, the National Domestic Violence Program, and Faces of Honor.

Dr. Hamilton, welcome to Beauty and the Biz. It is a pleasure to have you.

Jason S. Hamilton, MD: Thank you, and thanks for that great introduction.

Catherine Maley, MBA: Well, there was a lot to go through with how you, Jason S. Hamilton, MD and your www.BlackNoseJob.com. I mean, I had been researching you and I thought, Dear Lord, this guy's been around. And you look a lot younger for all of your achievements, but congratulations for that.

Jason S. Hamilton, MD: Yeah. Well, you know, we're, we're definitely in the right business. Keep looking younger.

Catherine Maley, MBA: Right, Jason S. Hamilton, MD. So, you have to start me out with, how did you say, were you a little boy saying, I want to be a facial plastic surgeon and create www.BlackNoseJob.com, or how do you get.

Jason S. Hamilton, MD: Yeah, so initially I I'm originally from Jamaica. That's where I was born.

So, we immigrated to Florida. And I had an interest in science and I like kids, you know, that those were my interests. So, I thought I wanted to be a pediatrician. No one in my family's in medicine. And so, when I got to medical school, you know, you get introduced to the different specialties.

So, my passion very quickly was anatomy, and I loved the head and neck area. And I started spending time kind of playing hook in the days because our lectures were recorded. So, I, I would listen to them. And in the day, I would go hang out with the surgeons in the hospital and try to figure out what I want to do with my life.

And so, hanging out and spending time with some of the reconstructive head and neck surgeons where they were rebuilding jaw bones, rebuilding tongues pharynx cheeks doing trauma surgery. That's where I really got my passion and interest in becoming a facial plastic surgeon. I didn't know that.

You would go through e n T to, to get to that point. So that was a surprise. But e NT is where you learn about all the anatomy of the head and neck and obviously all of the cosmetic and plastic surgery procedures. So, I really got passionate about in my ENT training about sticking with plastics and I was really, really interested in the reconstructive side of things.

I had no cosmetic interests whatsoever. I. Thinking about being a quote unquote plastic surgeon. I only wanted to deal with reconstruction, and then that kind of morphed as time went by. Patients who I had done some reconstructive procedures would come back and ask for cosmetic procedures.

They in turn would bring family members who I would accept as patients because it was a direct referral. And then, you know, I became passionate about that. And then things just kind of took a natural course from.

Catherine Maley, MBA: So, Jason S. Hamilton, MD, were you ever in solo practice on your way to figuring out www.BlackNoseJob.com, or did you go straight from the hospital and then join Osborne Head and Neck?

Jason S. Hamilton, MD: How did that transition happen? Yeah. I was never in a solo practice. I think our practice is kind of a hybrid, mm-hmm. because we, we published a lot. We have a foundation that does mission work, you know, throughout the world. We are involved with training of residents and even mentoring college and high school students.

So, when I. Was training in my residency. That's where I actually met Dr. Osborne. He was a chief and then our attending. And I was a first-year general surgery resident coming into the program. That's where we met and we kind of gained a lot of respect for one another. We started writing papers and presenting at that time.

And then when I was going to graduate and start my fellow. He was starting out here at Cedar Sinai, and at that time he was the, the first director of Head and neck cancer at Cedar Sinai. And so, when I was going to graduate, he, he kind of pulled me to the side and he was like, I know, I know you're going to hear a lot of stuff, but I think we should work together.

Right? And, and I kind said, hey, you're an oncologist, how are we going to work together? It's never going to work. And, and we basically came to the conclusion that the most important thing, and I think it's important for, for all docs or anyone business, is that if you have someone who is dedicated, enthusiastic, hardworking, intelligent...

And, and your friends then you can find common grounds to build something up, you know? And that might not be worth letting go to work with someone who just happens to be in your specialty, but you don't have anything in common, you know? So, so we just made a decision that we're going to figure out how we're going to work together, right?

And I, we started doing that while I was a fellow. We started building websites figuring out how we were going to kind of take the world by storm, so to speak. And then as soon as I graduated, I came here and I've been here ever since.

Catherine Maley, MBA: No kidding, Jason S. Hamilton, MD. You know when I looked at your website, I was, whoever did your branding was kind of magnificent because it looks very hospital-accredited and benefits from www.BlackNoseJob.com.

Like I, I thought, Jason S. Hamilton, MD, it was a hospital because of the way you have done it. And it wasn't the, your usual, like there are no social media logos. It was, it's very educational, straightforward serious. You know, you guys are not clowning around on this thing. And I thought, how interesting, because was that the point to look and also calling yourself institute, which can help with www.BlackNoseJob.com.

But was that the point to not be the typical solo practice going after all the cosmetic? You don't, you wanted to be a teaching institute? Yes. Training

Jason S. Hamilton, MD: was that, yeah. You hit the nail right on the head. So just coming out and getting started we figured that if we just do what everybody else does, right,

Yes. They're going to be two problems. One, we're in a big market, so we're not in a smaller mid-size city. We're in Los Angeles, you know, which is equivalent to New York or Dallas or Miami. So, we're in a big. Everyone is already doing what you're thinking about doing very well, right? And that's why you have an interest in being there because that's where the consumers are.

So, we quickly identified just from our training again. That we had interest and talent in areas that our colleagues probably didn't have a big interest in, you know, or shied away from because the surgeries took a long time or at the time they didn't reimburse well or They couldn't figure out how to integrate it into their practice.

But we started in that place. We said, we're not going after anything, or we're not going to take any interest in things that everybody's doing. Right. And so that's a slow process, right? But it has a future, you know, in our minds it has a future. And that's, that's, that's why our branding and our logo we wear white coats, you know, preferentially, we wear white coats.

We don't wear suits. We, we have a, a kind of clinical looking office, like a hospital. We don't have marble on the floors. Because that's not what we're, we're conveying. And that's not what we're selling and that's not what we're giving patients. What we're trying to convey is that we're kind of super specialists.

We, we have a passion for what we do. If you are in need of our services, we're going to approach this at the highest level. And you can be assured that we have training, we have research background, and that you're going to be getting delivered the highest-level product. And that's our focus. So, I'm glad to see that's your, your impression of what our branding is and because that's exactly what we want it to be.

Catherine Maley, MBA: Well, Jason S. Hamilton, MD of www.BlackNoseJob.com,, I think it's working for you because if I'm not mistaken, you have eight surgeons now at this point. Yeah, yeah. Where, where are you going with this? And you're probably doing a lot of reconstructive as well as cosmetic or how is that to up in your practice?

Jason S. Hamilton, MD: So, one of the things is that everyone coming into the practice is pretty much doing something different, you know?

And so, for myself, just organically I probably work with my partner doing reconstruction on all his cases. Oh. And then in my, in my in my practice, I'm mostly focused on rhinoplasty and some reconstructive things with the nose, like fixing supple perforations. So that's one of my big things.

And then then the side, the side interest just because I love sports and we've actually treated a lot of athletes like Stephan Johnson. Yeah. We're going to talk about that next. Yeah. Yeah. And, and so that, that's kind of my passion. So, I, I, we have the professional sports athletes that take care of myself.

Then we do the reconstructive surgery, and then the rest has been kind of whittled down in focus to mostly rhinoplasty and reconstructive nasal surgery. And, and specifically for the, the African, you know, descent population or ethnic rhino.

Catherine Maley, MBA: So back to running a practice, Jason S. Hamilton, MD of www.BlackNoseJob.com,, it's difficult enough for two surgeons to make a decision and have the same vision.

So, kudos to, you know, Hamilton and Osborne. Good job there. But when you bring on a bunch of others, how difficult is it for you to keep that brand intact? Make sure everyone has the same values, to have the same vision? Is that, is it, does it get more difficult as you add more surgeons?

Jason S. Hamilton, MD: I think actually it's the opposite.

Oh, right. So, it actually has been easier as we've added more surgeons because we look more at the brand, you know, as, as we've become larger. Right. So, so what I mean by that is when it was just, when it's the two of us we have an. We have an idea. When there's six of us, we have a brand, you know, and this is kind of the way, these are the jerseys that, you know, the Rams wear, you know, yeah.

This is the locker room. These are the shoes we wear. We run this kind of offense and it's easy to recruit and you know bring people in when you're very organized. And so, we focus on being organized sticking to the brand, not deviating from that. And then, so when you're bringing in new people, it just seems like this is how the organization is.

So, I liken it to, if you join the university of, you know, XYZ you wouldn't think that you could change your badge to whatever you wanted. I'm going to park where I want to park. No, they're going to tell you where you're going to park. These are the coats you wear; these are the color scrubs. You're not allowed to wear, you know, jackets with hoodies.

There's all the rules. You're going to get a flu vaccine or have a good reason. And so actually the, the, the more people we've added, the more solid the branding has been and easier it has been to get conformity. And then when we were interviewing people, you're, you're saying this is what we're looking for this is what we're all doing.

Are you interested in that? You know, and, and, and some people are not because as we were, you know, speaking before which we'll, we'll talk about. Everyone doesn't want to super focus or pick something that, that they want to go after. Cause it's scary. It, it's scary to just say, I'm going to focus on like highlight surgery or osis surgery.

Because you, you really have to have an acumen for it to, to build that practice and, and kind of just let everything else go to the wayside. And that can be a scary.

Catherine Maley, MBA: So, how difficult has it been getting staff, Jason S. Hamilton, MD of www.BlackNoseJob.com,? I know all we're talking about in today, this year, this year we're, we're, we're still having major staff challenges.

Not just finding them, but finding the right people who have the right, I don't know, discipline, whatever. Jason S. Hamilton, MD of www.BlackNoseJob.com,, are you also finding that, or has your branding done so well that you're attracting really key patients?

Jason S. Hamilton, MD: I think we you know, knock wood we were extremely lucky because at the timing of Covid, which I think is where this great resignation and yeah.

I call it the great reconsideration as well. People are thinking about their lives and now they want to live it, right? Yeah. And, and work is a big part of that. I think that we had had some, I wouldn't call them lifers, but we had, we had a, a critical number of people who had been here for at least 10 years already, right?

So, 90% of the people that were here when Covid hit had been here for 10 years, you know? So, we didn't have a lot of turnover. And everyone is still here, so I don't, we, we didn't feel that, those effects of having to get new people and having staffing issues, et cetera because it pretty much held our core group.

Some people You know, decided to do different things you know, for various reasons. Like, well, I know you guys are still open. I don't want to come into contact with Covid patients. So that's legitimate, you know, But I think going forward, I think staffing as we continue to expand or grow, I think staffing will be an issue.

You know, I think that's something that's, that's hard to resolve for most practices. However, I think we've all embraced technology just like how we're talking right now. You know? Technology is really allowing you to have close communications with your patients that you, you, it wasn't accepted or as easy, you know, as before.

And I think with technology, you can kind of automate some things and then kind of focus on getting great staff, you know? So instead of two good staff members that you add, you can add a great or an exceptional one, and technology can help that member. Do their job and facilitate communicating with patients?

In my opinion, that's my for sure.

Catherine Maley, MBA: Well, Jason S. Hamilton, MD of www.BlackNoseJob.com, one thing I have noticed with surgeons as they find the riches in the niches, they do, if given the choice, would rather hide out in the OR and never deal with staff or processes or KPIs or SOPs, they don't know what that is. They don't want to know what that is. Yeah. But in your practice, just the feel I get after doing a lot of research on you it feels like you guys just have this under control.

It feels you're very mellow. I love that. Your website's very organized. You just, it just feels very organized as you said. Do you have a management team behind the scenes that's running all this and making this run like a, I'm always trying to help practices run a smooth, like a Swiss Army knife, you know, Jason S. Hamilton, MD of www.BlackNoseJob.com?

Yeah. Like who, who's, who's in the back end?

Jason S. Hamilton, MD: Well, most, most of it I would say to the credit is my partner, Dr. Osborne. He's very hands on and he's, I would say in a, in a business sense, he's slow to hire. Right. And, and quick to, to fire, you know?

Catherine Maley, MBA: Well, that's what they always say, but we don't do it that way, Jason S. Hamilton, MD of www.BlackNoseJob.com.

Jason S. Hamilton, MD: Yeah. Most people don't do it that way. And so, it's really hard for you to get in here if not impossible. Right. And. And so it, it attracts people who have similar mindsets and are trying to kind of build a career and, and not just, you know, jump from job to job and people grow while they're here.

So, I think that's very attractive. So, he does have a good handle on it. And then, Behind the scenes. We also have great office manager who's been with us since the beginning. And we have good business and, and patient coordinators really keep the three key positions. So, so office management, business, and patient coordination, those, those individuals have been with us for 15 years plus.

And so that has probably been the key to, to our success. I would love to hide in the or under blanket. Anytime I could. But Dr. Osborne and those key people have really made all of our lives, including their own lives better just by being so solid and present in the practice. So yeah, I think that's really important.

Turnover. Turnover can, can kill a great practice, you know? And so, if you can hold on to great staff and make people feel like they can grow in your organization, then, then it, it really takes stress.

Catherine Maley, MBA: And it really is the secret, Jason S. Hamilton, MD of www.BlackNoseJob.com. The consistency, and the continuity of having staff that like working together and know how you can just feel it in an office.

You can feel how it's all, it's all working like clockwork. A few hiccups here and there, but that overall, when you're, when you're on your game, you know, when everyone's on their game and they know their role, oh, there's nothing more beautiful than that. Yeah. So, I want to ask you technically some of these questions.

What percentage of your practice is rhino versus face and neck cosmetic surgery, Jason S. Hamilton, MD of www.BlackNoseJob.com?

Jason S. Hamilton, MD: I would say 99% is Rhino. 99%?

Catherine Maley, MBA: Yeah. Of those rhinos, how many are cosmetic versus reconstructive, Jason S. Hamilton, MD of www.BlackNoseJob.com?

Jason S. Hamilton, MD: I would say 75% cosmetic and 25% reconstructive.

Catherine Maley, MBA: Gotcha. And then how many rhinos per year are you doing that adds up, Jason S. Hamilton, MD of www.BlackNoseJob.com?

Jason S. Hamilton, MD: I would say if I edited up, so about five, about 250,

Catherine Maley, MBA: That's what I was going to say, right around two 50 or three.

Yeah. How many revision rhinos could you have picked a more difficult procedure? You, you know, you're, most surgeons are very risk averse. You apparently came from another pool. I mean, you, you can't do anything more risky doing rhinos, then doing rhinos that are great for a lifetime. Cause you know, they're going to come back to haunt you, what, five or 10 years later at the time.

So, I'm sorry, I had to go off on that. What you to pick rhinoplasty of all, Jason S. Hamilton, MD of www.BlackNoseJob.com?

Jason S. Hamilton, MD: But I agree with you about those elements that it, it is a tough population. It's a tough surgery. A lot of plastic surgeons consider it one of the toughest surgeries because it's a singular unit, right? So, you have two eyes, you can be distracted left and right but the nose is right in the center.

But it's just the challenge, you know? It's very interesting. It does not become mundane. Everyone's nose is different. It's a combination of mom and dad to, to a different percentages. And so, and you're creating a new, a unique product for each patient. It never gets boring. And so that's, that's the, the surgical challenge, right?

Then there's also the challenge of trying to actually help the patient, right? I learned very early that the results don't really matter, right? Because everyone's nose looks different, so the results don't matter as much. The results that the patient is looking for. Yeah. Right. So, we can all think it looks great.

Patient may have some small complaints about asymmetries that, that you may not even see that they really want to be addressed and, and they have a difficult time being happy with anything that you deliver to them or any surgeon delivers to them. And then you have patients who are looking for minor.

Where you as a surgeon are like, no, we can fix all of these things., right? Yeah. And they're like, no, I just want this little bump that I never had before. You know, I got hit with the baseball. I just want you to take that down and I'll be happy. And so, the, the outcome is, is in the eye of the patient for sure.

It's not in your eye. And that is actually what's brought more satisfaction to my practice is not worrying about the surgery as much, which I've worried about to, to, to no end. It's about worrying about can I make this patient happy and if I can't, it doesn't matter what it looks like, right? If it's the best nose on the base of the earth, if I can't make them happy with that nose, then they're not ready for surgery.

And that, that's been the biggest thing that's helped me. And if they can be happy with, with a nose that I can deliver or, or even any surgeon could deliver, then they may be at that time a good candidate to have a revision surgery or a primary surgery. And that's, that's really been the key is, is, is as you're learning, you're going to, you don't know how to take Donna Hump.

You don't know how to get the tip right. You don't, so you are concerned about that as you should be. Yeah. But I'm telling you equally or, or that what trumps that is figuring out should I operate on this patient? You know? And when you're getting started, you won't operate on everyone because you don't have any patience.

You know? So that's what gets you in trouble, I think. But if you can resist that urge to, to just operate and really focus on is this a good candidate? And it can be very reward and then, if you're, if you're picking good candidates, then it's the best surgery. So, most satisfying, you can, you can operate on patients from 16, 17 in, in female 17, 18, 19, and males until they're, you know, I have seven-year-old patients that break their nose.

So, you have a wider range of feasible patients that you can operate on. Right. Who are healthy. Facelifts are older. Population fillers are, I mean, some people are getting fillers very young now, but fillers fat transfer, a blepharoplasty, that's an older population. So, it's actually a wider market, you know, and, and that's also attractive from a business standpoint.

Catherine Maley, MBA: But getting back to the patient, Jason S. Hamilton, MD of www.BlackNoseJob.com, this, now, you had so much experience, you probably don't remember, but were you trying to like to, to get into the emotional mindset of a patient is difficult at best? Yeah, so oftentimes I've asked the surgeon, you know, somebody who's been sued, I said, what did you learn from that?

He said that I should have trusted my gut. I knew something was wrong. I knew I thought I could handle. And I couldn't, or it came from left field. Like I don't know what happened. I don't know why this went so sideways. So, are there any pearls there that you learned? Do you have them take a test? Do you have them to go to a psychiatrist?

Are there any telltale signs to watch out for, Jason S. Hamilton, MD of www.BlackNoseJob.com, that now you flag immediately and go, uh oh, this isn't going to work out?

Jason S. Hamilton, MD: Yeah, so I think, I think it's a little bit of each. So, one, your gut, if you don't feel good, if it's not a good you are not obligated to do the surgery because someone booked a consultation and you just have to be okay with that.

So, feelings will be hurt. You may have to part ways. You do it kindly professionally and give them back their consultation fee and give them back their feet. Yeah. And, and then just be clean. You give them back their feet and it's clean. Right? No harm to foul. So that's just the gut feeling. The second thing is the, that are, that are red flags are.

Speed. Right. Someone who wants a rhinoplasty they've had this nose their entire life, but they for some reason need to have surgery within three weeks or five days or a month, or it has to get done. Because my birthday's coming up and I've been waiting my whole life for that. That speed is going to put the patient in position where they're not processing all the steps that are coming with specifically rhinoplasty.

Rhinoplasty is getting a graduate or a master's degree. It's a two-year process. Right. You're not going to be healed in a week. Right. And so, the, the speed, the rushing, no, I have to get in now. I'm in town, it just flew in. Yeah. And then I want to have the surgery before I fly out on my... That those are red flags.

That's, that's where problems are going to come from. It's just, just speed, right? And then and then patients who aren't really willing to kind of go through the process and not following directions before you even do the surgery, you know? If you say, can you submit your operating reports from your, your other case, it's been four months.

They, they never get them in. They come in for surgery and say, oh, I just couldn't I don't know what's going on. They, they can't get pictures from before their surgery. That's a red flag. Like you don't have any pictures from before. You know? That can be a red flag for you. Just having difficulty getting information.

They, they don't get their h and p, they're, they're having problems getting labs. All of those things are potentially little. Points where you can overlook it as just, you know, something minor. But those things are going to happen after the surgery as well, and then it becomes a big problem, you know?

So, I think your gut inpatients, you know, and then the patients that are not following your protocol that you set, or they want to modify your protocol. No, I want my sutures out in, in five days, you know, and you always do it in seven. I want my cast off the third day because I need to travel and that's not going to be good for me.

They're trying to modify everything that you're doing. Then that's going to continue after the surgery. So, some, when, when you look back, like, like how you asked your other clients, when you look back, there are red flags the whole time, you know, it didn't, it didn't really come out of left field. There are red flags now.

Sometimes a red flag may pop up. Right the day before surgery or the morning of surgery, and, and you may not have the courage to, to, you know, call it quits at that point, but, but you, but you should, you know, I've, I've canceled someone on the gurney rolling into the OR because they've changed what they, they keep changing what they want.

Oh, I want to take, no, I don't want to take it down. No, I want to leave that. No, I don't want to do it. I'm like, you're not. You know, and I'm very polite. I just say it's probably not a good time right now, you know? And the most patient, every time I've done that, those patients specifically have turned out to be like the best patients.

Oh, nice. Right? Because, because they, they will go back and thank you and say, I, I wasn't happy about things, but then I processed what happened, and I think you were right. I wasn't actually ready. Now I have clarity about what I want to achieve. I appreciate you doing that. And then you turn out to, you have a great relationship.

So even someone who seems like there are, there are potentially you know, a difficult patient for themselves or for you can turn. A good patient, they may need to say psychiatrist, they might need a therapist. You know I had a aha moment walking my dog one day. Right. And you know, we, we are all trained.

And you've probably advised, and you just mentioned it or alluded to it, like, how do you avoid difficult patients? How do you avoid patients that maybe have body dysmorphia that you, you just not going to be able to help them with a knife? Right. That's not the problem. You're not going to be able to help them with a knife or a laser or a procedure.

There are other things that they need to work on before they consider doing that. And so, these are the things you need to do. What are the red flags asked Dr. Other doctors what the red flags and, and I, my aha moment was, no, that's actually not the right thing to do. When someone comes in and we do their labs and they, they look like they're a diabetic.

We all. Stop and we send them to the endocrinologist. We don't try to figure it out, right? We don't, that's not what we do. We're not the expert. There's a whole specialty for that, right? If someone comes in and I've had that and their HCG is positive, like they're pregnant the week up, we stop. We send them to the OB/Gyn.

We said, figure out what's going on. Congratulations. We'll see you when you, when you're, when you're ready to have surgery. We don't try to handle it, you know? If someone's thyroid is high, you know, preoperatively, we send them to the endocrinologist. Again, if someone has a blood dysplasia, their, their coags are off.

We don't try to figure it out. We send them to the hematologist, they get it worked up and, and then they come back. If, if they have tachycardia, send them to cardiologists, but if they're. Or they've had too many surgeries, or you're not sure that their goals can be met. We try to figure it out and that's not what we should do.

We should send them to a therapist or a psychiatrist. Right. That was kind of my aha moment. So, I don't try to figure it out. I'm, I'm not trying to manage anyone's Body dysmorphia of myself just because I'm a plastic surgeon. That's something that needs to be managed by a therapist or a psychiatrist.

And, and maybe they can have treatment just like people may have short times where they're depressed. But maybe 50% of patients with true body dysmorphia can have procedures with therapy and, and, and setting the standard about what we're going to do. We're going to do one surgery, you know, we're not going to go back and keep doing things and adjusting.

And, and I think that can be very helpful for practice. So, you shouldn't try to figure out how to manage you know, difficult patients. Before if you sense it, you can ask them, Hey I'm not sure that you're, you're. Confident about what procedure goals you want to reach. And, and I think that I would like you to see our therapist or our counselor, you know to kind of help you manage those and make sure that we're communicating effectively and that we, we.

At absolute minimum, we want to meet your goals. But we'd like to exceed them if the patient's response is right, I'm offended. Absolutely not. Then the, you probably avoided something, right? If their response is okay, then that's probably a good patient, even if they don't need it, right? Or, or they just need one session.

You're probably going to avoid some difficult patients like that. So, so you can use that to kind of you know, check, test the water, so to speak. If you, if you re, I've had patients who have cardiac issues and I'm like, I think I need you to see a cardiologist and, and they don't want to do it, and it's no problem.

We're not doing surgery like we don't even think anything of it. But if it's so. With mental disease or, or something where someone has body dysmorphia, we feel a little bad internally about sending them away. Right. But we shouldn't, you know, we actually should help them and, and get them the right services they, they need just like we would with a diabetic or, you know a thyroid patient or anyone else that's preoperatively having surgery work up.

Catherine Maley, MBA: I have I know words matter, Jason S. Hamilton, MD of www.BlackNoseJob.com. I don't know if you can do this, but maybe call them a cosmetic coach instead of a psychiatrist. Just not to offend people because especially women are really funny about being labeled certain things. Yeah. Especially everybody is probably but I have noticed just being in this industry as long as I have if you a, a woman, several women will not use the word facelift.

They can't say it. They'll say I just need a little something. You know, something, something down here. You're like... Yeah. They cannot say facelift. And I think how interesting. So anyway, so then you try to figure out other words to say that's more comfortable for them anyway. So, having said all of that, what do you do?

You have to have tips for the unhappy patient, the one that you have had, they've had surgery, you think they have a fantastic result, or maybe you don't, I mean, maybe it wasn't your best work, but any tips for how to make them happy because that can go down this long road of stuff. Jason S. Hamilton, MD, how does it relate to www.BlackNoseJob.com?

Jason S. Hamilton, MD: Well, I think one, you want to be responsive, you know, you want to respond to their complaints or their desires to follow up with you or show you what's going on.

If, if they're, if the patient's talking to you, then you still have the patient, right? So, you should avoid middle men, right, or middle person, right? Don't put someone in between you and the patient. You should be talking to the patient yourself. That, that decreases their angst. If someone has a problem, they don't want to feel like they can't get to their doctor, right?

If you can bring them in, in person or look at them face to face, the video is better than a phone call, right? And then have them point out in detail It's bothering them. If a, if the concern is really just a matter of time, you know, let's see how things pan out, then you just keep close.

Follow up with them. If it's something that you need to fix or you feel like, Yeah, I could've done that better, you just need to tell them, we need to fix that right away, you know, no hesitation. And then work. Now, you know, many surgeons may have a difficult situation as far as getting people back to the operating room or getting things taken care of.

I'm lucky that we can just take patients back to surgery pretty easily. But if you need to take someone back, Just, just take care of it. If you can do it without any costs, yeah. That's preferable, you know? And then because that doesn't become part of the, the, the problem, right. And then and then just continue close follow up and usually, usually you can resolve most issues that way.

Right. If. And, and when things actually need to be fixed, then you can fix them, right? Now if someone has slipped through the cracks, right? And it's, it's just a difficult patient and you can't find what to fix, or you're having communication breakdowns then you, you definitely want to just have a comp, let everything kind of cool off, and then you definitely want to have a face-to-face conversation with that patient that that's your best bet.

And, and then at the end of the day, there's going to be one patient every, you know, five to 10 years that it doesn't matter what you do you're, you're not going to be able to satisfy, you know satisfy their needs. And if you come to that conclusion, you may, you may have to have an honest conversation about that too, you know, but that, that shouldn't, if you, if you're, if you're being cautious, you're doing what's best for the patient.

You're looking for red flags. You're not rushing in to do surgery. It shouldn't be more than one every 10 years, you know? But it's impossible for you if you just look at the numbers. It's impossible for you to avoid, avoid that in, you know, a restaurant is going to have a customer who's upset, you know it's impossible for you not to.

So, it's impossible for you to deal with a specialty where it is medicine, but there's nothing functionally wrong with the majority of the patients, right? So, nothing is actually wrong, right? They're making a choice. They're basically shopping and to think no one is going to have buyer’s remorse ever, right?

No one's going to. You know, I did like that tv, but maybe I could've got it cheaper. You know, I want to take it back, you know, is there anything wrong with tv, sir? No. But with plastic surgery, you can't take it back, you know, but those feelings are still inside human beings, right? And so, it's impossible to avoid a hiccup with a patient.

But you should be doing everything you can to avoid, you know avoid having problems or conflicts with patients. You should be looking for red flags. You should take your time and slow down, right? Be more concerned with doing a good job. Trying to find out if you can make patients happy instead of just trying to do procedures and build your practice.

Cause you'll build it up and it will, you'll backslide, you know, if you have problems with, with too many patients. And so, it, it seems like it's exciting and, and you know, you're in the little fever. You have the fever, you know, the practice growth fever, but you don't want to go faster than you can actually still be a doctor and take care of you.

Catherine Maley, MBA: For sure. And, and in your case, Jason S. Hamilton, MD of www.BlackNoseJob.com, I would think quality is better than quantity. Just to, just to keep things good because you know, who, who I think the worst patients the ones who develop their own websites to slam you. Oh yeah. They seem to always be the rhino patients, you know? And they go to great lengths to do that.

And I that's just, that's a funny patient. So, kudos to, I had a, a rhinoplasty at a much later age, and I didn't even know I needed one until one of my plastic surgeon friends said, you should really get your nose fixed. You don't need a facelift; you need a nose job. And I thought, oh, thank you, sir.

But I loved it. Like I loved it. It softened my look, but I was the easiest patient on the planet. I was like, Can I just get rid of this bump? Thank you. And we were done. Speaking of which, are you using computer imaging? Cause patients really like that? Jason S. Hamilton, MD, how does it relate to www.BlackNoseJob.com?

Jason S. Hamilton, MD: Not, Yeah, they do. I use it but I'm not using it to sell surgery.

Okay. Use what I'm saying. I'm using it to communicate. Just like you take a patient's picture and you're both looking at it together at the same time. Yep. You're also looking. The changes and the goals that the patient has together at the same time, so to speak. But I'm not trying to perfect anything on the computer screen, you know, and that's also a red flag, you know, if you show someone, if someone has a big Roman nose and, and you make it pretty straight, And they're like, It's really good, but maybe a millimeter more, no, half a millimeter.

No. Okay, that's perfect. Now I want to have the surgery. No one has that much control, you know, in, in a case. And that means they're not going to be, they're telling you I'm not going to be happy with a 99% improvement. Right. I'm only going to be happy with perfect. And we know perfect is not possible. So that's a red flag.

So, I'm actually using it to actually interview the patient as well. Right? And, and I, and I like it in that, that some people take the, the photos that I've morphed and they reor them, you know, and make the nose tiny and pinched. And I'm like, I'm glad you did that because that shows me that I'm not going to be able to deliver what you want.

I'm not going to do that. And, and we're not a good match. You know, we're just not a good match. And so, I like to use it that way. Some, some colleagues are using it to sell the surgery. You know, they, they make a perfect nose. They print it out, the patient's walking around with it like this, and they think that's what they're going to get.

And you, you, you're not a 3D printing, you know, robot. So, I would be cautious about using it to cell surgery. I would do a little less than you think you can actually deliver. Right? And, and you're using it to kind of interview the patient. From an aesthetic standpoint, you know, if you do something that looks really nice natural, and that you think you can achieve, the patient's completely unsatisfied with it, or they're like more, more and more than that, that's telling you that you, you, you may be cautious, you should be cautious about moving forward with that patient.

Catherine Maley, MBA: All right, so let's go on to the more fun stuff and positive, Jason S. Hamilton, MD of www.BlackNoseJob.com, and that's marketing and you people have that big out. One of the reasons I wanted you on this podcast I talk about this, I blog about it, it all of it's called extreme targeting. And most surgeons are appalled at the thought of only having a certain target market or a certain procedure, right.

Or a certain thing that that catapults them to be different, you know? Yeah. And you just jumped right in completely with that. And as too, you even have black nose job.com URL. You have an email called Ethnic Plastic surgery@gmail.com. If you look at social. You are called African American rhinoplasty, ethnic rhinoplasty before, after septal perforation surgery, Dr. Jason Hamilton, but you have absolutely bought into extreme targeting in regards to www.BlackNoseJob.com. And just tell me what that was like and were you scared to death to do it, to be that targeted or you know, do you regret it or, or has it actually catapulted you to get out of the fray of everybody?

Jason S. Hamilton, MD: Yeah, I, I think I think what you alluded to I like the way you kind of categorized that like extreme, you know, focus, it's an extreme focus.

Yeah. I, I think it's catapulted me. It was always my interest anyway, but just kind of putting a stamp on it and saying, this is who I. And, and I'm okay with who I am and, and this is what I do anyway. Let me just put a stamp on it. I think that that's catapulted me in, in that submarket to heights that I probably wouldn't think were possible.

It's catapulted me over just a regular practice too. I'm not the, the numbers are busier than a busy surgeon, you know, in, in my mind. And I couldn't do most of, I don't think I can do much more and not pull my hair up, you know? But it's definitely been, been a positive force, but I'll tell you where it came from.

One in a very competitive market, right? Yes. And so, if you're just going to be another Botox injector, you know it's, it's just going to be a price war at that point, right? A lot of doctors love rhinoplasty, especially in Los Angeles, you know big seed. They love doing rhinoplasty. But I think the niche for me is that I've, I've always just as a student, a resident, and then, you know, practicing on my own I find I've found that specifically black patients weren't getting great results on rhinoplasty.

You know Michael Jackson, you know, being a beat the poster child. Yeah, yeah. Poster child for that. And so, and then, and this is something that I, I was passionate about and I feel I was doing a, a really good job at, and so I, I just said, I'm going to put my stamp on it. I, I have some marketing advantages and, and I'm going to use.

I am of African descent. I'm black, so that helps. I'm a facial plastic surgeon. I love rhinoplasty and I'm okay putting my stamp on it. If you look at the numbers there were, there were probably about let's just say 400,000 rhinoplasties last year in the us in 2020 in the us probably down from the normal numbers, but that it's still the number one cosmetic surgery right now.

Only about 5% of those are, are African American or Africans, or described as African. So that does not seem like a good marketing strategy, right? If 95% of the patients have rhinoplasties are going to be represented by, by a different ethnicity or race. And so however 5% of 400,000 is a lot of patience.

You know, that's more patience than I could do in my lifetime. And that's every year. You understand what I mean? So, so if you, if you can actually have the courage, focus on anything because there's more than enough patience for you, you, there's more patience than you could ever operate on in your entire life.

So, so, being kind of hyper, super extreme focused has worked very well for me because you get attention you get immediate recognition for that if you're doing a good job and taking care of your patients. And it's harder the entrance point for anyone else coming in. It's a little, it's a little more difficult.

You can't just jump in, you know, it doesn't come out of a box as I like to say to, to my staff and stuff. But wrestling, I can just open a box. Botox, they can just open a box. Cool sculpting. You just open the paddles, stick them on, turn on the sensor. But for you, if you're a surgeon, this is just my belief, if you're a surgeon, you have a unique set of skills.

If you have a particular area of interest, developed you know, repeatable, great results. You should jump out. You should jump out, you know especially in a big market, which sounds like the opposite of what you'd want to do. If I was in a small market, I probably would just stick with everything.

Cause there's not a lot of competition, you know? In, in a, in a middle size sound, there may only be a couple surgeons. They may be cordial to one another and they all do different things. You should probably keep the breath of your, your specialty. But if you, if you want to compete and you have a talent for something, I think it's okay to just focus on that now when you let everything else.

Catherine Maley, MBA: You're going to see a nose dive that nobody can survive, Jason S. Hamilton, MD of www.BlackNoseJob.com.

Jason S. Hamilton, MD: They can't handle that. Right. You have to, you have to survive the phone not ringing. Right. You know, you have to survive the phone not ringing and, and your schedule going to you know, turning white basically, you know, like nothing's on the schedule, nothing's there.

You have to be willing to survive that. But then when you are building back up, it's, it's actually real, you know? It, it's I like to say if you just have a, a Botox practice you know, someone can set up shop across the street and get a, have discounts and you may lose, you know, percentage of those patients overnight.

If you're, if you're super specialized, you're probably going to be okay. You're going to weather a lot of storms and we've weathered a lot of storms. You know, I, I trained when I was training, it was during Katrina. You know maybe two years after I was done practicing the market crashed. You know even doctors weren't referring patients because no one had insurance or so they were holding onto their patients as long as they could.

I'm in la plastic surgeons aren't going to refer patients to, you know. And then and then I've been through the pandemic. I, I've had a lot of, lot, I started out in the recession, so that kind of made me aware that things can change in your practice, you know, and, and you want to have good stability.

You want to build in something that can weather the storm. And I think extreme, you know, specialization is one of those things, you know, if people need those services. They, they will find you. And, and I'm diversified. I'm not just doing cosmetics. So, the reconstructive part of my practice you, you, if you, if you fracture your orbit, you know, you're not going to be able to just walk around with that until you conveniently ready to take care of it.

So, I think all of those things are like, people let trauma, they let they let the reconstruction kind of slide away from their practice, where I think it's a great a great part of, you know, plastic surgery. One of the most common. Perform procedures for all plastic surgeons, right? It almost trumps everything else.

Is, is reconstructive, like doing skin cancer work? You know there's, there's a lot of work there for, for surgeons and, and if you give it up, you're basically giving up your diversity. You know, hey, you're not diversifying your practice, but, but when things are going well, there's a temptation to do that.

I'm just really lucky that when I came out, things were going bad for everybody, you know? So, if you, if you grew up in the Great Depression, you keep cans of peas, you know, in basement you know, just in case.

Catherine Maley, MBA: But back to extreme targeting, Jason S. Hamilton, MD of www.BlackNoseJob.com, that allows you to charge an awful lot more, which I hope you are, because you have put all your eggs in this particular basket or a lot of your eggs, and the patient now is be, is being attracted to your expert status.

Yes, your celebrity status, like you're hanging with the big boys, Jason S. Hamilton, MD of www.BlackNoseJob.com. Now at that you're also in Beverly Hills, so that hasn't hurt, but you've gotten some really killer PR from this. Yeah. You were on the doctors. The way is the doctors, is it kind of like a pay to play thing or some you had pay somebody to do something to get on these shows, right?

Jason S. Hamilton, MD: No. Just from our branding and experience. Yeah. We were contacted by the show to see if we could help, you know, a particular patient. At least in our case. That's how it's always gone. We were on Dr. Pimple Popper, you know, recently, and again, you know, she contacted us just from my reputation to help her with, you know, a case.

So that's how it's gone for us. And, and what I'm saying is, that's, that's better than having to necessarily have a PR person if, if you're just known as Okay. A lot of, a lot of practices can do this, but when you have a real. This is where you go, we're those guys, you know?

Catherine Maley, MBA: And so, and that's what, what everyone wants.

Like when, when you have a patient who wants something like a facelift, who do you go to? You want your name to pop up. And that doesn't happen by accident. You have to focus on that and write about it and speak about it and do a lot of it and have a lot of people talking about it. How about the celebrity status you have though, because you are attracting can you just tell one story about the that football player?

I don't know anything about football, but Sta Johnson Yeah. Did that kind of put you on the map and change your career a bit to help you, Jason S. Hamilton, MD of www.BlackNoseJob.com?

Jason S. Hamilton, MD: Yeah, I think so because you know, everyone's aware of like orthopedic surgeons, right? Dealing with some shoulder injury on a football player, but there probably has never been an E N T or a facial plastics doctor that's going to be on ESPN, you know?

And so, the Stefan Johnson had dropped, you know, 275-pound weight on his neck basically crushing his, his larynx and his ability to breathe. And we got the call to come to, to come help out and basically ended up saving his life and his career because he was able to get back out on the football field.

And that story through ESPN running, you know, almost every hour during the Christmas holiday, you know? Oh my God. We got a lot of notoriety wherever I. It, we were traveling to New York once, and it was on the jumbotron, you know, big screen in New York, Times Square, you know, so, so the, the, that definitely catapulted us and made people aware that we do also take care of athletes, which, you know, no one thinks that e t doctor or facial plastic, so you're thinking orthopedics.

But these guys break their nose, boxers, break their jaws. And it just kind of put us on the map for that. And then we started getting contacted by athletes and sports teams and to take care of patients. And it really catapulted that part of my practice. And that, that also builds, builds credibility, you know?

Yep. And then that allows you to build other parts of your practice. So, we're going to stick with our plan. Seems to be working, and that's a great plan. It, it's a slower, more methodical, meticulous road, but it pays dividends for a longer period of time, I think.

Catherine Maley, MBA: Right. So, what's driving you, Jason S. Hamilton, MD of www.BlackNoseJob.com,? I like to talk about mindset, like how did you get to thinking like this?

It doesn't sound like you grew up with medicine, so that kind of came out of left field, but do you have a drive to help people? Ego gratification? Like what, what, like what's driving you?

Jason S. Hamilton, MD: Basically, my drive is initially I wanted to get into medicine. Because I wanted to be able to take care of myself and my family.

Like you know, coming from Jamaica we don't have access to this level of healthcare. When my grandmother, for example, had surgery, we had to buy the implant and take it, you know, to the doctor and hand it to them., you have to bring food to the hospital and you have to feed your family member, bathe them, and do all, you have to change the bedding.

You're basically nursing and, and that you know, children process things differently. That seems a little scary to me., you know? And, and my fear was being a position where I can help my family or myself, you know? So that was my initial interest in saying, hey, I think medicine would be a good choice because you, you can help your family, you know, you can help, you can help people, and, and, and you don't have to, you know, live in fear.

And so that, that was one of my drivers to get into medicine and just being. Individually passionate about being excellent at something. That's, that's really what I wanted to be excellent at something. And I think we all do we all have those dreams but we may not know how to do it. And I, I wanted to feel like I could grow in medicine, in an area where I could find an expertise and kind of really focus on that.

And that's, that's really my drive. Rhinoplasty gives you that you'll never perfect it. You'll never perfect it. You know, you're really practicing medicine in the sense that you, you can become as, as good as you are. And even when you get to the, the stage where maybe even patients don't know what you're talking about, where you're finding critiques on yourself but you're finding them, you're finding those critiques, right?

And you want to make them better. And, and the further you go in your career, and you follow your patients, you get to see those long-term results. You get to see 10-year results, 15-year results, and, and then you think back and you're like, I'm not going to do that again. I'm going to, I'm going to change what I do, and then I want to see how that turns out in 10 years.

So, it's, it's very motivating and it's inspiring and it's you're kind of like a tortured artist in that sense. Ok. Cause you're, you're, you're picking yourself apart and it keeps you humble. So, I, there's no ego involved in it. It actually keeps you humble because you'll never perfect it. And, and agreeing to sign up for that challenge right.

Is very humbling. And, and it keeps the passion going for myself, you know, for myself.

Catherine Maley, MBA: Well, the payoff's been fantastic, Jason S. Hamilton, MD of www.BlackNoseJob.com,. You have, you just have a lovely practice, lovely demeanor, lovely reputation great patients. I think you did Cardi B recently, or no? Or no. There's, oh my God, you just, you have a lot of good things going on there and you, when you mentioned your dog, was it the dog? The therapy dog.

Jason S. Hamilton, MD: Oh yeah. Yeah, we have a well I have my own dog, but we, we do have a therapy dog that's part of the practice, you know Laney and that, that kind of grew out of Covid and it's called Pause for Patients. It's part of our foundation. And Elany will go to different schools and help.

Children with maybe learning disabilities and the children will read to her. And just get to kind of have some comfort or the excitement. Who doesn't love a dog? You know, it was really big during Covid because people were isolated. So, Laney was even doing video, you know, talks with kid’s classrooms and so it's been really popular.

And it's, you know, therapy dogs are well known. Most people probably don't have one as part of their practice, but you know, it's just, it's, it's very unique and We're excited about her participation and she, she's been able to, you know, Laney has been able to raise funds for us to do medical missions in other countries and health children and, you know, adults that have you know, maybe cancer diagnoses or tumors or deformities that they could never have taken care of because of resources in their country.

And that's something I'm passionate about too, and that keeps me really humble because I have a good balance. I'm in Beverly Hills plastic surgery. And then and then I'm going to third world countries and seeing what real, you know, poverty or lack of hope looks like. And it really balances, balances things out for me.

My kids get to see me do that and I've brought my children with me on these trips, and so they get to see what the world looks like outside of our bubble. And, and I think that's important too, and I recommend that to anyone is to you definitely. You definitely want to give back and you definitely want to see what the world looks like and what your gift is as a physician and what you can do outside of just your practice.

Catherine Maley, MBA: Huh. Excellent words of wisdom, Jason S. Hamilton, MD of www.BlackNoseJob.com, I think. We'll, we'll leave it at that. Thank you so much for coming on. I really appreciate it. I'll be watching you grow, although you probably don't need any more growth. You're doing just fine. But everybody if you did want to get ahold of Dr. Hamilton, you could go to www.BlackNoseJob.com.

Yeah. And then it'll viral off onto different places. But he's doing a heck of a job, so I would take a look at that.

Catherine Maley, MBA: Everybody that's going to wrap it up for us today, a Beauty and the Biz and this episode on www.BlackNoseJob.com with Jason S. Hamilton, MD.

A big thanks to Dr. Jason S. Hamilton for sharing his successes related to www.BlackNoseJob.com.

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 “www.BlackNoseJob.com — with Jason S. Hamilton, MD."

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons

#www.blacknosejob.com #blacknosejob #blacknose #drjasonshamilton #drhamilton #jasonshamiltonmd

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery and how to exit your practice.

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 "How to Exit Your Practice — with Lamar Rutherford, MBA."

Most cosmetic practice owners think about, worry and plan for their financial future.

They wonder how they’ll get off this treadmill and get their hard-earned money out of their practice when they decide to slow down or sell.

They ponder how many years they have left to shoot the lights out and grow their net worth, so they don’t have to step down their lifestyle once they retire.

So, in this week’s Beauty and the Biz Podcast, I’m interviewing someone who helps surgeons exit profitably from their practices when they’re ready to do so.

It’s Lamar Rutherford, MBA and CEO of Excellens Solutions based out of San Diego, CA.

Lamar is a licensed business broker, as well as a Mergers & Acquisitions Advisor to smaller businesses, including cosmetic practices.

She came on my radar because she was involved in the sale and merger of a few surgeons I know so I wanted her to share her words of wisdom for those of you who are, or should be, thinking about how you can exit your own practice profitably.

Lamar talks about her “5 D” exit plan that you want to know about so you, too, know how to set yourself up for a successful exit.

Visit Lamar Rutherford's Website

📲 P.S. If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

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Transcript:

How to Exit Your Practice — with Lamar Rutherford, MBA

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 exit your practice.

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 "How to Exit Your Practice — with Lamar Rutherford, MBA."

Now, today I have a very different kind of guest, who’s an expert on how to exit your practice.

Usually I have surgeons, but today, I am interviewing someone who helps surgeons exit profitably from their practices when they're ready to do so. It's Lamar Rutherford, MBA. She has a very fancy name and she's CEO of Excellens Solutions, who help surgeons on how to exit their practice, based out of San Diego, although she can work throughout the US.

Lamar is a licensed business broker as well as a mergers and acquisitions advisor to smaller businesses, including cosmetic practices. Now she has personally brokered the sale of over 50 businesses and over 100 transactions in a variety of industries and has started, managed, and sold several of her own businesses, and can help you learn how to exit your practice.

Now she got on my radar because she was involved in the sale and merger of with, of several surgeons that I do know. So, I wanted her to share her words and wisdom on how to exit your practice that she helped with the other surgeons. But now help you who might be thinking about or should be thinking about exiting your practice profitably.

So Lamar, welcome to Beauty and the Biz.

Lamar Rutherford, MBA: Thank you, Catherine. Thanks for the nice introduction.

Catherine Maley, MBA: Sure.

Lamar Rutherford, MBA: Definitely not a surgeon!

Catherine Maley, MBA: You know, now that I'm getting older, I've been in this industry for 22 years working with plastic surgeons and now that we're all getting older, there's a lot more discussion about how to exit your practice.

What do I do with this business? Like what is, you know, I have my practice. I've been working in it for 30 years, , and I'd like to step away, but how do I do that? In the old days, it was easier to do. In today's world, it's a lot more complex. And so my first question would be, when do you want to start planning your exit? How does one learn on how to exit your practice?

Lamar Rutherford, MBA: Well, you could start planning your exit any. But and have that goal in mind. We always say planning for the exit is good business practices, but you know, at least a year in advance you can really make a difference on what happens. But some of the things that make a difference for getting more value for your business, you want to start?

Earlier. And I'll give you an example. A lot of plastic surgeons, it's all about the name and the name of the owner. And so if you can start to kind of transition away from it being just about that particular surgeon, you'll get a better value. And sometimes surgeons are very specific about the work they do.

But if they bring on other surgeons or other nurse practitioners, that sort of thing then the business is not all about them and it's easier to get a better value when you sell. So to kind of think about it more, A business versus their own private practice makes a difference. And so, you know, when do you start that?

Well, the earlier the better because we always say you want to look at your business through the lens of a buyer. Our company name is Excellence, but we, we play off that. So if you think about it from the lens of a buyer, if the business is all about you and you leave, then the customers are more likely to.

To have the opportunity to change or to go to a different doctor or that sort of thing. So the more you can make those relationships and those customers not solely dependent on you, then the better the sale for the buyer, the, the less risky, and so you get a higher value and it's less risky. Does that answer your question?

Catherine Maley, MBA: Yes. And the really big question is, in regards to how to exit your practice, because if you look at it from, like, I always say I'm a consultant to surgeons and I always say, build your practices if you were going to sell it. You know, think of the practice as what, what value at do I have right now in this practice that another surgeon would also value and pay top dollar four?

Lamar Rutherford, MBA: Right?

Catherine Maley, MBA: So, what kind of assets. Because we always do the usual, like do you have a long-term lease? Do you have a big patient list? But in today's world, what is a value to another per another surgeon who would want to take over a practice, in regards to how to exit your practice?

Lamar Rutherford, MBA: And every time you mention something, I'm like, Well, I could talk about that.

So exactly you want to look at your assets and what would be valuable to a buyer. But let me give you an example. The lease it's helpful to have a long-term lease because that's something that the buyer can count on. But if you have a lease, With options then the landlord is sort of tied in with the options.

But when you go to sell once that option or once that lease is up, you get off the lease. So, if you have a really long-term lease, you often stay on it as a backup. And so. A couple of things related to that. You want to make sure the buyer is qualified and able to continue to pay that lease or if you can, are there ways to negotiate to get off that lease?

Landlords don't really have any motivation to let you off. They, you know, they can keep you as a backup if you sign that lease. Sometimes leases aren't personally guaranteed, so you don't have that risk. It's only guaranteed by the business. But they're all things to think about when. Evaluate a buyer.

And that's one thing to remember too is when you are selling your business to think about who is a good buyer for your business. And some of that is size related. Larger businesses are more likely to have maybe private equity group come in and by or other medical groups smaller businesses.

It's more difficult for those groups to come in and take over. So, You know, size matters in terms of who the buyer might be. You might be more likely to be bought out by an individual doctor if you're smaller. And then other factors related to buyers. Sometimes another plastic surgeon might want to buy you.

And that we consider that sort of a strategic buyer. Another plastic surgeon buying you. You want to make sure that there is value and they'll get your customers, you'll be able to transition them. Sometimes there's a period where you can transition and the, and the customers are more likely to stay.

So, so you want to think about that in advance and try and set your practice up so that it is easier for whatever kind of buyer to take it over. And the more buyers.

Catherine Maley, MBA: That's so out of curiosity, in reference to how to exit your practice. Some of the surgeons have bought their building, mm-hmm. and now they realize, wait a second, I don't want to sell my building.

I want to keep it for security and for passive income after I learn about how to exit your practice. So, I'd rather become a landlord now. But then does that hurt or help when you're trying to sell your practice? Does it her or help to have a building involved in the transaction?

Lamar Rutherford, MBA: Most of the time when people are buying a practice, buying the building as well, stretches their economics.

So often they want to buy the building, but not till later. So often the seller can get that lease and that passive income for a. At least a while and sometimes ongoing. So it doesn't really hurt the sale to not sell the building. It can help in some cases. A doctor wants to buy both, but again, a lot of times they're stretched out financially on just the business purchase and can't afford the business right away.

SBA makes it very attractive for owner occupied and so they will want to buy it and they'll want an option and you can kind of evaluate whether that makes sense.

Catherine Maley, MBA: And then where does the staff fit into this, in regards on how to exit your practice? Do you, do you like to package up the transaction, including the staff or not? Or, how does that work?

Lamar Rutherford, MBA: So, the staff is part of the business. So, if you think about it, the what? Buyers pay for is the, really the return on the investment. So, when they invest in your business, they want to make sure they get that annual income that you're making. To make that income, they have to have the assets of the business.

And part of the assets of the business is the staff. It's your processes and procedures. It's, you know, whatever is your equipment. It's all part of the business purchase and. The more that staff is willing to stay, the better the value. If the staff all leave when you leave, you know, it's almost like what are they getting a customer list?

It's a lot less valuable.

Catherine Maley, MBA: So, do you have to write them into the agreements and are they signing, like is the staff signing things that say I'm going to stay for two years, or anything like that, after the surgeon learns on how to exit your practice?

Lamar Rutherford, MBA: So, the most common purchase is what's called a bulk asset sale. That's different than a straight asset sale. A straight asset sale is where they're just buying your equipment and maybe your customer list.

A bulk asset sale is essentially buying your whole business. And it's similar to a stock sale. It's just called a bulk asset sale. And the advantages of a bulk asset sale over a stock sale for both buyer and seller is that once you. The bulk asset sale, you can close the previous entity, and so previous liabilities, there's no risk of those.

Even if there weren't any, there might be something that comes up. If it's a stock sale, then everything goes with the sta. So, the difference between a bulk asset sale and a stock sale is that with a bulk asset sale, one entity closes and another one opens. And so all the employees end up getting laid off and then rehired with a new entity and that.

You know, just overnight kind of thing. So, you have to get them to resign with a stock sale because it's part of the entity already. Then they just continue with it, so it's slightly easier. So that's, Asset sale versus bulk asset sale versus stock sale. With employees, you generally want them to stay and a lot of times buyers will negotiate that.

They want those employees to stay. You can't ever make an employee sign a contract where they have to stay. Right. It's, it's employment. It will. State or most places, maybe some states that's not the case. But here in California it's definitely the case and, and generally most places. And so, you can do things like if they really want those employees to stay, you can give them bonuses after they stay a certain period of time.

So that gives them motivation to stay. So that's a good tool. Sometimes buyers want to meet and. Get the employees to sign unemployment contract before the deal closes. I'm always very careful about that because you never know until a deal closes that it's really going to close. We had one deal where two hours before the money was being transferred, the buyer got slapped with a lawsuit and so the bank froze everything.

You just never know. It can be, you know, the strangest circumstances. So, we always to keep the stress low for customers, for employees, for everyone. We always recommend not telling them until it closes, unless you really feel like you have a relationship where you need to or it's required as part of the purchase, but we'll do that as close to closing as possible.

Catherine Maley, MBA: So many variables when learning how to exit your practice. This and, and so many are, are uncertain. You don’t know what's going to happen. Cause there are so many people involved and personalities and how they react to things. So, do you wait and shock them? You know, you tell the staff the night before, by the way I sold the place. I'm not, I'm not sure that's a, I don't know about that either.

Lamar Rutherford, MBA: Generally, I, you know, I've sold my own businesses and it's difficult, but generally I think it's easier to tell them once you know the answer and. If you tell them that, yes, we've been working on this. I'm sorry I couldn't tell you earlier, but I wanted to wait until we were sure. And I also wanted to be able to introduce you to the new owner and make sure that they were great.

So, I think that makes it a, I don't know. You know, everyone has a personal relationship they have to evaluate, but that's generally what we recommend.

Catherine Maley, MBA: I will tell you, just in my consulting, I have noticed that the one that works fairly well is when you bring that one in, that that not a fellow, somebody a little older or who's willing to, the doctor's willing to, you know, groom that person before he learns on how to exit your practice.

But he is, you know, he's younger. He, they bring them in kind of as an associate. Everyone feels everyone out. Make sure they have a good match with good values that you know are congruent. And then the staff's comfortable. Everyone's comfortable, and now they have a meeting. You know what we are going to be selling?

I'm going to be selling to this another doctor, you know, in a year or two just to like cruise into it instead of like this huge shock and being too quick on how to exit your practice.

Lamar Rutherford, MBA: I highly recommend that I think. Find someone who's a good fit and you can kind of test them out as maybe an employee or a staff person. And then over time, maybe they earn ownership over time, or maybe they buy it out at a certain point or they buy a percentage and then buy more.

I do a lot of those deals. I help structure those. So, and I, and I. I think that that's one of the, the great ways to do it. Sometimes these private equity groups that are buying practices sometimes they have a system for doing that. So, if you don't have someone you can sell to them and they can find someone to bring on and, and help make that transition smoother, that works too.

Catherine Maley, MBA: So, I haven't had as good luck with that, in regards to how to exit your practice. Like the, these big guys coming in who know nothing about plastic surgery, they don't know the people. I just think that's a little rougher road to go down. It's not the worst, it's just, it's, it's more, it's just, it becomes more bureaucratic and more business-like, which makes sense.

But then I don't know. But let me ask you about not just the staff, but the other revenue generators in your practice. Hopefully you have other people in your practice making money. God help you. If you are 96% of the revenue generation in your practice and you want to walk away, you don't have, what do you, You don't have anything to sell after you’ve learned on how to exit your practice.

You know, nobody wants to buy your list. They want to buy predictable income. So, if, I hope that at that point you have like a nonsurgical revenue stream, then perhaps you. I don't know about aestheticians, but certainly the bigger ticket items you have some nurse injectors or PAs or NPs who really make a lot of the money.

You know, actually I used to run a surgeon's coaching club and the my, my mentor said to the other surgeons, If you are more than 27% of your practice revenues, you're not running your practice. And everyone looked at it, I'm like 27%. How do you do that? You know, becuase that was such a shocker, in terms of on how to exit your practice. But he also was able to have a major personal problem his.

$6,000 home burnt down in 45 minutes. And because he was set up so well, it was just a little ping. It was like a, a pain in the neck kind of thing that happened rather than an absolute disaster. Cause he had his practice running so well with plenty of other people in there making money that he was able to take a lot of time off to fix that personal tragedy that happened with him.

But what do you think about that, in regards to how to exit your practice?

Lamar Rutherford, MBA: Well, you, Yeah, you raise a good point. Revenues and revenue. One of the things we watch for is customer concentration. Well, most doctors have multiple patients, so customer concentration isn't a huge issue. Customer concentration is when one customer accounts for a large percentage of the revenues but they have the opposite problem where they're often the.

The concentration or the revenues are all dependent on them. So, the more you can come up with revenue streams that are not dependent totally on the owner, and that is often other nurse practitioners or others doing services and services where people have to come back on a regular basis are more valuable than one time services.

And then recurring revenue. So, it's great if you can get aestheticians and nurse practitioners and that sort of thing to bring in revenue, but also if you have point systems or other systems that keep people tied in the stickier the revenue, the better. And so those things are great even, and sometimes recurring revenue.

You know, I always say, you know, some businesses recurring revenue is difficult, you know, based on technology. But I'm like, Amazon turn delivery into recurring revenue. So there, you know, sometimes you just have to be creative on how you look at it. So, so try and, and look at your practice that way.

If you can say, Okay, you're coming in for services once a month. What if we just charge you monthly and it's this rate instead of just per. Sometimes that works. But in terms of recurring revenue, the stickier, the better, the more valuable. So whatever you can do to get people signed into contracts where maybe it's 30 day cancellation, but it's still stickier than them paying you each time.

Does that make sense?

Catherine Maley, MBA: Yes, in regards to how to exit your practice. And that's exactly why I came up with my, my own program called the KISS Club, the KISS Loyalty Club, because you're absolutely right. It's so much easier to keep that repetitive nonsurgical patient than it is to keep that one and done surgical patient. There's so much more uncertainty with the surgical than the nonsurgical.

And I mean, a cosmetic patient will be a cosmetic patient today and tomorrow and next year and five years from. And if you take good care of them and add that stickiness, like a really special program, like a KISS program where they don't want to go anywhere else because they can't get kisses from anyone else, they can only get them in your practice, in regards to how to exit your practice.

Right. That's super helpful. So that's one thing I'm trying to do to add value to the surgeons who want to exit. So they have something to sell. But speaking of that, the revenue generators, such as the RNs or the laser techs, or the NPs or PAs, would they have to be packaged in with the deal or, because again, you can't make them stay either, but.

But they're way more, well, I shouldn't say way more. Everybody's important, but it's easier to lose the front desk person than it is to lose that RN who brings in a million a year, regardless if learning how to exit your practice.

Lamar Rutherford, MBA: You know? Exactly. It's very important that the more you can get them to stay and be sticky, the better too. Because they are the rev revenue generator.

Now, if they're easy to replace, like, Oh, you know, tomorrow I could go find a half a dozen nurse practitioners that know how to do this, you know, generally they probably. The ones that are easier to replace, those services are easier for people to get elsewhere. . So, so the ones that are really valuable are the ones that are better to make sure that they're sticky and, and stay when the buyer comes in, right?

Catherine Maley, MBA: In today's world, in relation to how to exit your practice, I don't think it's easy to find really good revenue generators, you know, if you can find one, I would hang on to them. Things have changed a lot. And there's so many options nowadays for where they can go. And then a lot of people who, like a revenue generator, let's say an RN, she's an excellent nurse injector.

Notoriously she says, Oh, I, I'm making a million for this practice. I'll just go out on my own and do it myself. And they don't realize what goes into that, you know? Yeah, yeah, yeah, yeah. I mean, that can be a rude awakening. I'm just wondering how legal do you have to get. If I'm a surgeon buying someone's practice, and I'm looking at, okay the surgeon has a terrific list of happy patients, great revenues, but, but, you know great reviews great referrals and all that, but it, but does that constitute money for me and learning how to exit your practice?

So then maybe, well, maybe not, I'm not sure. So then I'll look at his other revenue generators. He has two nurse injectors who are just crushing it. But how do you buy that if you. No. If they're going to stay, I don't get that part, in reference to how to exit your practice, that is.

Lamar Rutherford, MBA: Well, that's where sometimes they tie them in with you know, sometimes they change the purchase price and say we'll pay you more if they stay longer.

So that there are sometimes terms that way if it's a real sticking point. Generally, I try and avoid that when I do deals, but there's also You know, that bonus. Whereas if they stay, they get that bonus, that can be part of the deal and that can help alleviate that challenge. You know, it's not a perfect world, but it certainly can help.

Catherine Maley, MBA: Now, money, Money certainly is the motivator, when dealing with how to exit your practice, isn't it?

So, just generally speaking, what would you like, give me like the, the five tips, something like that, in relation to how to exit your practice. Like five tips of what you do now, no matter how long you've been in practice, what you can do now to plan for your exit whenever you decide to.

Lamar Rutherford, MBA: So, my first tip is always have good books. Your books are clean.

It's really important. I always say your financials tell a story. Your books tell a story. Make it a best seller. And so, so you really want things to be clean and straightened out and not anything that's going to raise suspicions. So there might be some old transactions that, you know, Oh, it was reversed, it's all great.

It's, it's all cleaned up. But the reality is anything that creates kind of some of that suspicion you want to clean up beforehand and make sure that it's like on a. If you get into a house and there are cracks in the foundation and no one told you about it, you wonder what else is wrong? . So, so clean books is my number one thing.

Number two, try not to make it all about you, which we talked about because it's harder to transition. Three recurring-revenue. Whatever you can do to make your revenue sticky and strong and keep your staff there, those are all important. Fourth is look at your assets. If your assets are in good shape and good condition that's important.

And also, transferability with assets. So sometimes assets. And I'm talking equipment. Sometimes equipment has a loan against it. Is that transferable? Are you going to have to pay it? So, pay attention to that. I don't, plastic surgeons often don't have insurance contracts, but that's also something that you have to pay attention to.

If you do have insurance contracts. Are they transferable? What do you have to do to do that? That's important too with customer contracts sometimes. You want to make sure what I recommend is if they, you know, have to renew every 30 days on, on your recurring revenue, make sure that just rolls.

And you don't have to call them up and reengage them because if there's a change in ownership that could be a problem. And your lease or your building, make sure that, that you're not going to get kicked out of your location. Your location matters. And so, so those, those are big tips.

Catherine Maley, MBA: Yeah. Lease is a huge tip and the laser machines are huge.

I didn't even think of that. I remember a one surgeon told me he was going to sell, but the maintenance. The new surgeon would have to pay the maintenance because the minute there was a change of ownership, it all, you know, all bets were off kind of thing. So, everybody who's got some equipment that they want to sell and there's maintenance involved and sometimes it's very costly maintenance.

You want to check into that, you know, what's the change of ownership? Terms and, and conditions. You know, what, what, what's involved in that? Because you don't want any big surprises when you buy something, it turns out great and you still have to pay 5,000 a year for maintenance, regardless if you figure out how to exit your practice, or not.

Lamar Rutherford, MBA: And we can do an assessment and kind of, you know, highlight some of these things that might be potential problems.

One thing too is like if there's two partners or they're buy, sell agreements, because if something happens to one, what happens? Any of the doctors, you know, what happens if something happens to you? We talked a little bit beforehand about the five D's death, disability, divorce, disaster, disagreement, and I think the stats are 50% of business owners over 55 are impacted by those five Ds, and so you, they add five Ds again.

Death, disability, divorce, disaster and disagreement. Oh, wow. Okay. So, you want to make sure you're just, you've thought about that, like what happens if something happens to you and it can be a divorce. How do, what do you do if you have to, you know, share your practice? Proceeds with your ex, that kind of thing.

But more frequently I see that if there's any kind of partnership that you know, what happens, suddenly you might be partnered with your ex-partners wife or kids, you know, So you want to make sure that there's an opportunity to buy out in that case. So yeah, I always raise that, just to think about that.

The, the, be prepared for the five. And sometimes it's keyman insurance. Sometimes, you know, if you have a, a key. Producer, maybe it's another doctor. Do you have insurance if something happens to them? So, so just, you know, be mindful of some of those things that can impact your business.

Catherine Maley, MBA: Would you say most surgeons just try to sell it on their own, or do they use a broker person like you?

Or how, how do they normally, if someone's even thinking about in reference to how to exit your practice. Do they want to contact you now and, and do a consult with you and then later on when they're ready, ready, you come back? Like, how does that work, in regards to how to exit your practice? I don't even know how you get started on selling a practice. All I heard is, call you.

Lamar Rutherford, MBA: Yeah, exactly. That's what I recommend. Call me. And there's different scenarios, different situations. So, if you have a. Then we, you know, would help you work through that transaction. If you want to be prepared, we can do an assessment and evaluate kind of what you need to do to prepare If you are already ready, know you want to sell, then we talk about what's the best strategy to sell your business.

So, I think that answers your question, what to do.

Catherine Maley, MBA: So, one last question for me, on the topic of how to exit your practice, is how different is the price that the doctor thinks his practice is? Versus what, you know, you could maybe get for it, you know? So, is there a big discrepancy normally, and if so, do you know why?

Lamar Rutherford, MBA: Yes. Most doctors don't factor in the fact that it's all dependent on them, and that's the biggest factor, but it, it all depends on what's in their books.

I'll give you an example. One business owner we looked at his books and did evaluation and the valuations are often multiples of, what's it called? Adjusted ebitda or seller's discretionary earnings, which is kind of a proximity for cash flow. So, when we were looking at that, we thought the value would be, you know, a multiple of that.

But then when we looked closer, it turns out he was not paying rent to himself. And so, it was an expensive building. That rent was over 200 grand a year, and so that had a huge impact on his valuation. So, there are things like that that can make a difference. You want to make. You know, you're evaluating your business based on market value of rent if you're not paying yourself rent.

So there, there's, you know, some, the Devil's in the details with, with some of these valuations. But generally, we can do a valuation for any company. We do it for a couple grand. It doesn't cost much. If you ever want to know what your value is, I think it's valuable because, First of all, you understand what the value is, and then you also know how it's calculated so you can kind of structure your business around that, although I've given you a lot of the information you need.

But so values, Yeah. A lot of times owners think the value is higher than it is because they might hear from someone who sold a much bigger business. And larger businesses tend to sell for higher multiples or they may just not know the details that might cause the value to be lower. Things like the rent or the dependency on themselves or, or other factors.

So…

Catherine Maley, MBA: Well, I know I did have a surgeon that did a huge build out in a penthouse on the top floor of this gorgeous building in San Francisco, and it cost him 800 grand at the time, many, many years ago. And he thought he was going to recoup that from the sale, and nobody, nobody else was going to pay for it.

Like, they were like, No, I'm just paying my, And I think he got like 200 grand when it was all said and done. But I, so, I, So no one's going to pay for your renovations, you know, like they, they're going to stay, in regards to how to exit your practice.

Lamar Rutherford, MBA: If the renovations drop to the value on the bottom line, then they'll pay for it. But it has to show up in the profits.

Yeah. And this, like, I have a plastic surgeon that has some IP they invested in technique and. But they haven't seen the value of that yet, so they don't have it. So what's the value? Probably the legal expense that you went through. But once that's up and running and you're starting to get a revenue and profit stream from it, then you get the value.

Mm-hmm. . Or sometimes there's some kind of trademark or patent that has been in operating for years. Well, you're not going to get extra value for that because it's already showing up in your numbers. So, some of that matters sometimes.

Catherine Maley, MBA: Another really big one. This is my last one, is Goodwill. A lot of the surgeons, I mean, and I get it, they went through hell to become a surgeon.

They went through decades of staff issues you know, landlord issues, building issues. I mean, it's just issues. And they want to get paid for that, in terms of how to exit your practice.

Lamar Rutherford, MBA: What do you say to that? The goodwill shows up in the numbers. Mm-hmm. So, if you know your assets are worth, I don't know, let's say half a million, but when we look at the numbers and your profits say the business is worth 1.2 million, then 700 grand of that is the goodwill.

So that's how it shows up.

Catherine Maley, MBA: I completely agree, in terms of how to exit your practice. I really appreciate this. I think you offered a ton of value there, and I highly recommend my audience to hire you for that assessment. How important is it for you to know how much is the value your practice right now? That might be a, a huge awakening to you, or a surprise or something that, or maybe it's even worth more than you even thought.

So highly recommend that assessment. How would they get ahold of you, if they wanted?

Lamar Rutherford, MBA: You can always email me: Lamar@ExcellensSolutions.com. It's like “excellent” except an “S” instead of a “T”.

Catherine Maley, MBA: Google like "Excellens" with an "S", and then Lamar, you pop up.

Lamar Rutherford, MBA: Do you want me to give my phone number? I'm happy to give that too. Okay, it's (619) 333-6296.

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 exit your practice.

A big thanks to Lamar Rutherford, MBA for sharing her treasure trove of knowledge on how to exit your practice.

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 “How to Exit Your Practice — with Lamar Rutherford, MBA."

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