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.
⬇️ Click below to hear “40-Surgeon Practice to Solo — with Burke Robinson, MD”
He is a double 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 😉
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:
👁 DON’T MISS THESE INTERVIEWS 👁
Ep.62: The Word of Mouth Practice
A word of mouth referral is the absolute best advertisement...Read More
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 double 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”, “[email protected], which stands for facial plastic surgery robinsonfps.com. And the number here at the office is (770) 667-3090
Catherine Maley, MBA: But your website is Robinson FPS…
Burke Robinson, MD: .Com.
Catherine Maley, MBA: .Com. Yeah. All right.
Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on going from a 40-surgeon practice to solo, with Dr. Robinson.
If you’ve got any questions or feedback for Dr. Robinson, you can reach out to his website at, www.RobinsonFPS.com.
A big thanks to Dr. Robinson for sharing his experiences on going from a 40-surgeon practice to solo.
And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.
If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.
And we will talk to you again soon. Take care.
-End transcript for the “40-Surgeon Practice to Solo — with Burke Robinson, MD.”
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