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Ep.103: Interview with Kristi Hustak, MD


Beauty and the Biz with guest, Kristi Hustak, MD.

Dr. Hustak is amongst the 7 plastic surgeons at the prestigious Aesthetic Center for Plastic Surgery in Houston, TX, where she’s also the Assistant Program Director.

They have a state-of-the-art private surgical center as well as med spas in 2 locations.

Visit Kristi Hustak’s Website

📖 Get a Copy of Catherine’s FREE Book

📲 Schedule a FREE 30-Minute Strategy Call with Catherine

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” and consultant to plastic surgeons to get them more patients and profits.

⬇️ Interview with Kristi Hustak, MD ⬇️

Interview with Kristi Hustak, MD
Board Certified Plastic Surgeon
Assistant Program Director, Aesthetic Center for Plastic Surgery Aesthetic Fellowship
➡️ www.KristiHustakMD.com

Dr. Kristi Hustak is the only female plastic surgeon of the 7 plastic surgeons who make up the prestigious Aesthetic Center for Plastic Surgery in Houston, TX. They have a state-of-the-art private surgical center as well as med spas in 2 locations.

But what’s super interesting is that Dr. Hustak was born on an Apache Reservation in Whiteriver, AZ. ​

She started her training in Ohio, completed a medical mission in Peru, graduated Magna Cum Laude from the Ohio state University College of Medicine, married her best friend and classmate, and settled in Texas; where they are raising their 3 children.

​Dr. Hustak, it’s a pleasure to have you on Beauty and the Biz. Welcome!

​First, I have to ask about your experience on a reservation.


Q&A with Dr. Hustak:

BUSINESS:

  • Associate or partner?
  • Democracy or dictator?
  • Managing Surgeon?
  • Meet often?
  • Pros and Cons?
  • Sales Leads?
  • Staff issues?


MARKETING:

  • Did you have to market?
  • Referral Source?
  • As a practice or separately?

https://kristihustakmd.com – her own website and blog since 2014

Transcript:

Catherine Maley, MBA

Welcome to beauty in the biz where we talk about the marketing business side of plastic surgery.

I’m your host, Catherine Maley author of “Your aesthetic practice, what your patients are saying” as well as consultant to plastic surgeons, to get them more patients and more profits. And today I have a really special treat for you. I’d like to introduce. Dr. Kristi Hustak and she’s the only board-certified plastic surgeon of a practice of seven plastic surgeons there in Houston.

It’s a very prestigious group called Aesthetic Center for Plastic Surgery in Houston. Now they have private state-of-the-art, uh, cosmic or, um, surgical center as well as two locations. Now what’s super interesting is. Hustak was born on an Apache Indian reservation in White River, Arizona. And to look at her, you never guessed that.

So, she started for training in Ohio and I’m going to abbreviate this. So, she starts in Ohio. She completed a medical mission in Peru. She graduated Magna cum laude up from the Ohio State University College of Medicine. She married her best friend and her classmates, and then settled in Texas where they’re raising three children.

You believe that Dr. Hustak it is a pleasure to have you on Beauty and the Biz. Welcome. Absolutely. So, we have to start with the Indian reservation. How in the world did you end up on an Indian reservation in Arizona?

Kristi Hustak, MD

Yeah, I and I have genetically tested myself, so it is true. Cause I could have guessed I was the milkman’s baby as well, but um, yeah, so my mom’s an Apache.

Um, now my bloodline’s been diluted out, so I’m only an eighth now. Um, but my dad is a Mexican American, but some Spanish blood. So, my mom has a little bit of Irish. My dad has a little bit of Spanish and somehow that combination, uh, became me. Uh, but yeah, so they met, uh, my mom grew up on the Rez and married, um, my dad who was in the small town next to the reservation.

And so that’s how they met. Um, and so I only, I was born on the Rez, but I only lived there for about five years, uh, before my parents separated. And then I moved up to the big city of Phoenix. Um, but yeah, so that’s where the story began. My grandparents still live there. I have some aunts and uncles. Uh, and so we go back, you know, once every couple of years or so to visit, not that often, but, uh, yeah, absolutely.

It’s kind of a funky thing in Arizona. It’s not super weird cause there’s a lot of native blood there. Um, but certainly once I’ve gotten out of, uh, Arizona, people are like, oh my gosh, wait a minute. And I was like, oh, I guess that is unique. Yeah,

Catherine Maley, MBA

It really is. I’ve never heard of that before. I’ve never met anybody.

Who’s been an Indian reservation. So, what a nice background, you know,

Kristi Hustak, MD

Yeah, I think it’s, you know, so much of your background colors, who you become. And I think part of that probably gave me a hunger to try something different. Um, because college really isn’t on the radar of most people graduating from the Rez.

You never leave. It’s a very small knit community and that’s part of why they recruit from the reservation. Um, to give these kiddos a chance. Um, and so, although I didn’t go to high school there, my mom did, um, and I was recruited actually for art. She’s an artist by trade and then she got knocked up at 17 and did not go, but that’s not uncommon for the reservation.

It’s, there’s a big fear to leave your, your little happy nest. And so, um, it is neat when you get a chance to get out and try new things.

Catherine Maley, MBA

And how did plastic surgery get on your radar? Was it from the Indian reservation?

Kristi Hustak, MD

Yes. No, it was not. Um, so my mom, when my, when they separated, she had to put herself through school to learn a trade.

And so, she, uh, went into surgical technology school. So, her and my aunt actually lived together and were single moms and raised. Uh, one went to day school, one went to night school, um, and they cross trained, um, to be able to raise the kiddos. And so that’s how I got interested in medicine. And then her first job was with a plastic surgeon.

So, I got to kind of get immersed in that early on. I saw my first surgery at 14, uh, which was an employee who allowed me to come into the operating room because I said I was interested in medicine and blood and guts didn’t scare me. And I loved it. I mean, I got a little bit. nauseous With lipo. I don’t know if you’ve ever seen it, but it’s like not natural.

And so, as a 14-year-old, that creeped me out and I got a little nauseous, but, uh, but certainly fell in love with the trade and your ability to kind of mold the body in different ways. And, and I think, um, coming from a family of four, Um, I am not very good on canvas. My mom used to make us paint our own pictures as kids and mine were awful.

Like my flower is like not good. Um, but the big joke is that obviously my, my medium was not canvas. It was the human body. And so, I think I, my creative outlet.

Catherine Maley, MBA

So, you always knew even going to medical school, you always knew it was going to be plastic surgery. Even when you were doing rounds on other specialties, you were all set.

Kristi Hustak, MD

You know, hindsight’s always 2020, but I think there is something about natural inclination and mentorship. My kindergarten yearbook says doctor, there was no doctors in my family, which is really funny. It’s a doctor slash sports journalist. So, I don’t know. There you go. Um, but my, my high school yearbook and all through high school.

Desire to be a plastic surgeon and when I graduated high school. So, I think that was always, uh, always in the back of my mind. I mean, I rebelled in training, medical training, um, because I didn’t want to pigeon hole myself and then it was funny how I, oh, I love this. I love this. And actually, I loved everything.

Um, it just, in the end, once I hit plastics, I was like, okay, you’re right. This is, this is definitely.

Catherine Maley, MBA

So, once you, I don’t even know how you got through school and fellowship and residency and pregnancy all at the same time, but w we can talk about it if you like. Cause that’s insane to me. I have a dog that I barely can keep alive.

I don’t know how you’re doing it with three children. That’s admirable. Um, any, any secrets by the way, of how to, how you’re doing.

Kristi Hustak, MD

Uh, outsource. I think that’s the only way you can survive. As I give myself grace, I am never going to be a super doc, a supermom, you know, a super, you know, Pinterest, I’m never going to, sew their uniforms for sports, you know, and I just, I have to triage what I enjoy.

I enjoy cooking. So, I do that. I don’t enjoy the grocery shopping, so I don’t do that. Um, I don’t enjoy laundry. I don’t enjoy trash. I don’t enjoy gardening. Those things just have to go. So, I, you know, I have to just triage my time cause there’s just so many hours in a day. And so, I do what I enjoy and I outsource the rest.

My husband laughs at me all the time. Cause he’s like, God, you hired one more person to do this. And I said, yes, he’s like, but I asked you to do that. I said, yes, there is no time. So, I decided not to do it. So, he’s like, you just hire people. And I said, yes, I do, but

Catherine Maley, MBA

I hear you. Yep. Instagram or Instacart was the greatest thing that ever happened.

Amazon. Another good one. Um, I love, love, love so good for you so you’re in, Ohio. And you’re, I don’t know if you started the family yet, but how, how did you end up here?

Kristi Hustak, MD

Yeah. So, um, so from, I’ll start from the Rez. So, um, born on the Rez went to school in Phoenix and then, um, Ohio State is a big minority recruiter actually.

And so, they recruited me because my background of the Rez and I’m half Mexican as well. Again, you would wouldn’t believe it. Um, and so I was in student council at the time I was, um, a vice president and so I was helping everybody set up their colleges. Um, and I was at one of the largest high schools in Arizona.

And so, we had one of the largest college fairs. And so, I just happened to help Ohio State set up their booth and they were chatting with me and, um, and one thing led to another and they said, Hey, come check out Ohio State, I said, it’s far away. Where is Ohio get on the map that this was not on my radar.

I’m in Arizona. Why would I go to cold? That’s reverse. Um, but I flew out for a recruitment trip and I loved it. It was exactly what I thought college would be. Everybody had Ohio State t-shirts on the campus was all inclusive. Um, everybody was singing, you know, go Buckeyes the whole state rallies around college.

And I think in my mind, that’s what I expected. I expected a small community within a bigger university and, and I think that’s what. So, I flew out there. My mom cried. Um, she shipped a box and flew out with me and flew back and dropped me off in the middle of Ohio. I’m on a whim, but they both raised me to be independent.

And they said, go spread your wings. And there I went. So it was, uh, I was the first person to go to college in my family. So, you can imagine going to college and far away. It was pretty crazy, but I think it was, it was awesome. Cause I, I grew, I had to depend on myself and figure it out. And I think that there’s some benefit to that as well.

Cause you learn that independence. Um, and so I did that at Ohio and then went to undergrad there and stayed for medical school. Met my hubby. Um, first, uh, first day of medical school, actually, um, I had met him briefly and undergrad. We want rerun a similar scholarship. So, I had kind of like met him casually, but none, anything.

And then the first day of school, he was like, Hey, I remember you. I remember you. And we sat next to each other. And that was that. So, marry him at the end of the four years of high school or the medical school.

Catherine Maley, MBA

Oh, that’s

so cute. How did Texas get

Kristi Hustak, MD

so, um, so he’s an anesthesiologist. And so, the way that medical training works is you, um, apply for residencies, you interview places, and then it goes into a computer it’s called the match.

And so, they changed it where you can couple match. So, you can go. Spouse or a best friend even, or a life partner. Uh, you don’t have to be married. Um, but that was to prevent you from being coastal, um, because that’s hard on relationships. So back in the days, it didn’t matter. You could be New York city and you could be LA and then you, that’s just where you go for six years.

Like there is no choice um, and so now they link those applications. So, they take you or leave you as a pair. And so, we, um, highly ranked a lot of places where we both could live, which makes sense. And Texas has a fantastic medical community, tons of hospitals and training programs here. And so that’s why it was so high on our list.

Um, and it was warmer weather, which was important to me. I was sick of Ohio winters. And I said, even if we live in Ohio, the rest of our lives, let’s go take a sabbatical for a couple of years and try some new training. Um, and so we landed in Texas, um, and then have stayed because we just love it. So, we’ve been here about 14 years.

Catherine Maley, MBA

Oh, wow. And then you met at this practice for seven years. So, when you first got there, did you, how did you have that?

Kristi Hustak, MD

Yeah, so my, um, so at the end of training, when you’re looking to decide whether or not to do additional training, like fellowships or to go in practice. So, my husband finished a couple of years ahead of me.

So, he joined on as academic faculty at the university where we trained. So, he was there very comfortable, very happy, but also mobile, so we could kind of go anywhere. Um, and so we started looking locally and remotely. Um, but most people do end up practicing cause you make connections where you train. Um, and so we made a lot of great connections here and one of my partners.

That, um, now trained with me. And so, he said, Hey, I know you’re looking to go somewhere. I know you’re thinking academics. Um, what if I told you, we could make this academic II, um, but you would still have the benefit of private practice. What would you say? And I said, oh, you know, I was trying to figure everything out.

Well, let’s meet for dinner. Let’s chat a little bit. And in the end, we all met for a dinner, uh, with the other six surgeons who I hadn’t met superficially, but never really worked with, um, turns out that was my interview. It was great that I didn’t know about it because I was very casual and they offered me a job.

Position, uh, the next week. And I was like, oh, and so I sat down with my husband and I was like, you know, I feel like I’m selling out, you know, um, cosmetics. I feel like I can, you know, take a piece of tissue from your back and make a breast out of it. Like, why am I, you know, going to do this? And then he was like, oh my gosh, there were so many ways that you can train the next generation with private practice.

You have flexibility. As a mom, I had two kids in residency. So as a mom, you can make your own schedule. If you want to have muffins with mom, go have muffins with mom. Uh, and you can do that. And I was like, God, from a quality-of-life standpoint, because I’m blessed. I don’t have to work because I married a doctor.

Ha isn’t that what your parents tell you to do? But but I love what I do. And so, there’s lots of flexibility in that as well. So that’s kind of how I, I joined this practice as they were looking for a female, something to differentiate themselves. Um, and I was looking for something with flexibility and where I could still teach.

And so, we actually have our own fellowship and we train the residents where I train. So, I get the best of both worlds. I am not tenured. I’m not required to present and do research, but I can train people and I can do research if I want to. So, it’s like the perfect hybrid.

Catherine Maley, MBA

Gotcha. Now, um, I’ve worked with quite a few practices throughout the world, actually.

And the, the more the cert, the more surgeons you add, the more complexity you have, um, how in the world do all of those personalities? Come to a decision. Is this a democracy or a,

Kristi Hustak, MD

yeah. Gosh, so this is such a great conversation because, um, it is incredibly rare as you know, to have out. I was surprised we added, we’re adding the eighth come July.

We’re keeping one of our fellows, uh, Abigail Rodriguez, who is a, uh, another female. So, I’m very excited to have some more estrogen. Um, but it’s very rare with cosmetic in general, we take no insurance. So, we’re all fighting over the same pot of money and the same, uh, region. That’s incredibly rare. Um, but my three senior partners have been together, gosh, going on 30 years now.

And so, I think, and they were together from the get-go. So, there was never any one captain of the ship. So, I think from the beginning they learned how to compromise. And I think that sets the tone. Because this is a marriage of sorts. Um, and that’s the only way this works is to be able to sit down once or twice a month to be very transparent and to be on the same playing field.

Um, you know, I joke with my partners, that the reason I chose to join them is because they’re all married to their first wives. And that told me that they could compromise and they’d been together. I mean, there’s something to that, right? That they could survive that in the midst of a crazy medical career.

And so that’s how I knew that there was, um, some real opportunities there, uh, for partnership. Um, and from day one, they have been transparent with everything. Business-wise I know how much they make; they know how much I make in every ounce in between. Um, and I think that there’s no secrets there, even if we disagree, at least we disagree.

Um, and, and the reasons why to openly. Yep. so, we meet twice a month. Now we have partner meetings at 6:00 AM, twice a month, um, to really iron out business. Um, and then we’ve all set it up, uh, kind of in a corporate structure with MD oversights. So, we all take turns every two to three years on some oversight. So, I’m our medical directory of our surgical center right now.

Somebody else is overseeing marketing, somebody else’s overseeing clinic, somebody else’s overseeing research. Somebody else’s overseeing the fellowship so by each one of us MDs being on top of one of those things and taking turns, we rotate through, we get to learn every ounce, more intricately of that business structure.

Um, and I think, and then being able to recognize like, wow, that really sucks. Thanks for doing that for two to three years. And then we can shift gears and things like that. So that’s how we make it work is by just staying open and having these meetings with agendas, with our managers to kind of keep it all transparent.

Catherine Maley, MBA

So, the way you’re set up. Is it a partnership, a partnership plus associates who could become partners? How are you set up with that?

Kristi Hustak, MD

Yeah, so we’re set up with, uh, with a partnership plus associates. Um, so once you hit a certain threshold of income, then you’re considered for, um, true partnership. Um, and then we have our medical spa and our surgical center, uh, which are income producing.

Right? So then there there’s opportunities to kind of shift and buy into those as we progress. Um, and so that’s kind of how we’ve set up the…

Catherine Maley, MBA

you’re buying into the various profit centers equity. Right?

Kristi Hustak, MD

You got it. Yep. So, we’re, I’m a partner of our surgical center, our medical spas as well.

Gotchya. Can you be a partner of the medical spa and not a surgery center?

Could you get to pick and choose? Or…

when we shifted where the three seniors in the three associates at the time, now we have one now, two juniors coming in, even below that, um, we set it up as a separate entity. Uh, that means that we’re getting ready to spread it out this year where they’re all three going to be separate variables.

So, I do think that that option is going to come. And, but when we set it up, initially we bundled the surgical center in spa because it was right at the time, we could build those out. And so, for the build-out loans and whatnot, it just made more sense to combine those at the time under a separate S-corp.

Um, and so, but now we’re actually getting ready to spin those out. So, each one will be separate. Yes.

Catherine Maley, MBA

I would highly recommend that. That’s good.

Kristi Hustak, MD

Perfect. Yeah. And that’s kind of, as it’s progressed, we’re like, okay, this doesn’t make sense from this perspective. Yeah.

Catherine Maley, MBA

Well, so now the other three gentlemen who started 30 years ago, they’ve got to be getting up there in their sixties.

Seventies. Is there a plan of success? How are you going to do that?

Kristi Hustak, MD

Yeah. So, it’s so funny because this has been a big discussion over the last three to four years because their plan originally was three seniors and they’d shift to the three juniors and they’d almost be a flop, um, because as we’re discovering and a lot of surgeons are discovering, um, your, your business is you

so, as you phase out, like, you know, but now we have an extender. So, we have some nurse practitioners some RNs and our med spas. that help run that. Um, again with there’s only so many hours in a day, I can’t be operating and injecting 24 7. They’re just not enough time um, and so we do have some fantastic extenders. Um, but the idea was they have a book of business as well.

That’s under each one of us. And so, you know, as they rotate out, would they go and just continue that book of business and some oversight of their patients in the medical spa, that can be their tail, um, as they kind of transitioned out of surgical practice and then later in five years later, then they retire completely, um, and, and sell out there shares

of the practice to the younger generation. So that’s kind of how we’ve got it set up right now. Um, as, as they phase out, there’s a tail in the med spa and then that will phase out completely, uh, at some certain time point.

Catherine Maley, MBA

Well, you know, where I find there are some hiccups where it can go sideways is when you’re sharing expenses, but you’re also, you’ve got that high producer.

Who’s, you know, the guy who’s gonna like crush it. And then you have somebody like you who actually wants a life, you know, work like that. How do you figure all that out? Are these expenses even or? Due to via production of…

Kristi Hustak, MD

it’s via production. And that’s the only way it could make all practice makes sense, because otherwise your high producers, my senior partners who have been in practice for, you know, 30 years, it doesn’t make sense for me coming in at seven years, even though I’m on an upswing, I’m just not as busy as that.

And that’s just the reality of it. Um, so, but I’m also not utilizing as many resources. And so, there is, you know, kind of, we’ve worked out by production. So, there’s a lion’s share of my high producers is paying more of the overhead. There’s some shared of capital expenses and things like that. Um, but, but globally, we share profits on the back end by your productivity as well.

So, I don’t work. I don’t make as much, but it’s not necessarily inhibiting the growth of my, my senior partners.

Catherine Maley, MBA

and everyone feels paid…, well well-paid they don’t feel like, cause we here’s where it runs into trouble. When there starts to be some resentment over, I work more than you. I bring in more than you. I should be, you know, whatever treated better.

Um, there’s some problem starts or even with the sales leads, you know? Um, how do you divvy up that?

Kristi Hustak, MD

Yeah, I haven’t seen rebuilt. Yeah. I think we feel very REL well reimbursed for what we’re. Producing that I think has been really ironed out. Well, I think we’re all globally, very happy that I think that’s very transparent and equitable.

Um, I do think that one of the difficulties comes in with how do we share those sales calls? So, the way that we’ve done it is a doc of the day. So, we have a call center we’re big enough. Now within many partners, we have, we have 89 full-time employees. So, it’s gotten to be a big production between the two offices and med spa surgical center.

Um, and so we’ve had a call center where we have four gals. Um, and so the way that works is by a doc of the day, there was no other good way to do it. So, if somebody called in and doesn’t have a definitive doctor, Whoever that doc of the day is, is where our team is going to funnel those patients. Um, there’s a couple, like I do female genital rejuvenation.

That’s my niche in the practice. So, a lot of labiaplasties and vaginoplasties nobody else in my practice does internal vaginal work. So that’s a natural class. If somebody calls for that, it goes to me. Um, I have one partner who does, um, butt implants, nobody else in the practice does butt implants you know, I have another one of my partners that does complicated secondary rhinoplasties.

Nobody else does that. So those get funneled to him. So, there’s a couple small niches that go to that direct doc, but globally, we do it by doc of the day and that rotates now on a seven-day basis based on the docs.

Catherine Maley, MBA

Okay. Good for you. Do you all get along?

Kristi Hustak, MD

Fantastically, I think globally, I mean, it’s a marriage. I mean, there are certain moments were like, you know, you know, crap so-and-sos at it again or simple things like that are like, oh God, so can’t, so-and-so take responsibility.

Oh my gosh. You know, just like any marriage, there’s that cattiness that small, but relatively incredibly small. I think these are some of the most fantastic people let alone fantastic surgeons, but people. And I think that makes a difference there’s nobody there that drives me bonkers. I would go have a beer with every single one of them and their spouses any day.

And that’s helpful. Yeah.

Catherine Maley, MBA

I mean, honestly, this is a miracle, you know, it’s so unusual that I, you know, I, I can just tell you from a different perspective. Good for you. If you can all pull that off all these years, too, um I also bet it’s also about your values, you all value, marriage commitment, um, communication, you know, uh, getting along.

Kristi Hustak, MD

I think there’s something to that. And we’ve had, um, in the group there’s been maybe two people that left over the last 30 days. Um, and I know at least one of them that was part of it. Like I want to be captain of the ship and they’re just like, you have to have that personality that you’re not going to be the lead boss, but you’re going to get these other benefits and you’re right.

I think we triage people that value those things.

Catherine Maley, MBA

Oh, that’s fantastic. So, when it comes to staff, what I have noticed is that staff are, they’re like little kids and parents they’ll go to the parent who says yes to them. And they can often create a lot of havoc. If the, if the doctors let them come direct, is there some type of a buffer between all of you and all the staff?

Or how is that handled? Is there,

Kristi Hustak, MD

There is. I would say that sometimes that still naturally happens. Right. And then we have to have as part of our partner discussions, like we have two different offices, um, a couple of us go to both, so that’s easy, but there’s a couple that only go to one. So, then they feel like the parents of that clinic and that staff

it’s a little like, oh, we had a team bonding party, but then only that staff was invited and that breeds animosity. Right. And we’ve had to kind of have conversations over the years that like, we got to be really fair when it comes to staff, you cannot buy Christmas presents, even if it’s just a Starbucks gift card on your own to this staff, because that breeds resentment.

So, we try to do staff parties twice a year. Our staff all get bonuses on productivity for the practice that gets separated equally. There are things like that. We try to be really good. We have a manager, each office oversight manager at the office, and then manager over like med spa surgical center, et cetera.

And so, they keep us in line because they are the buffer. So, when they try to come to us docs directly, we say, nuh-uh that’s not how it goes. You go to your first line of defense who will liaison with us because we’re pushovers. No question about it. I mean, I, I will be a pushover. My patients, you know, can I have a discount?

Sure. you know, but it’s a business so that I don’t talk finances, same thing with my staff. Hey, can I do this? Can I take off early thing? That’s not how it goes though. Right? We really rely on our managers to be that buffer for us. Um, and then, you know, they’ll usually run stuff by us and be like, Hey, what about X, Y, and Z.

But we try to be really good about separating ourselves from that and this kind of corporate structure. I think that works a little bit better. It’s not perfect all the time. You know, they’re like, Hey, but so-and-so said I could do this and blah, blah, blah. And we’ve really good. That’s, but that’s not how that works.

So sorry we go and have a conversation with them. You can’t do that. Okay, fine. Fine. Okay. You know, and they say, sorry, and that’s, it is what it is, but yeah,

you know when

Catherine Maley, MBA

you’re in medical school. I maybe, because you’re still, you’re newer. Maybe they now taught business in medical school. Um, were you shocked at the business side of plastic surgery when you entered like a real practice that works as a business?

Kristi Hustak, MD

Yes. I’m still shocked. I mean, it is, I think one of the best benefits of going with these partners is that they had 20 plus years of tried and true. Right. So, they made those mistakes. They still do not teach business in medicine, they don’t. And for lots of years, this was supposed to be so part of it is we set up medicine to not be in business.

We were always supposed to be healers and we were never supposed to be involved in businesses. But as we know, as we’re Medicare, Medicaid, and politics, that’s not the case anymore. So, and especially with private practice and stuff, medicine is unfortunately, If you talk to the doctors a business, so we have to learn how to adapt.

So, so many of these principles are against every grain of our being as a doctor who is supposed to do anything selflessly. So, I think it’s, it is, it’s hard for most of us to figure that out. And that’s why we surround ourselves with people that understand business, but you have to learn. So, you don’t get taken advantage of, I mean, if fraud is rampant, you know, in practices because we’re not.

We’re not business people, you know, we’re just not. And so, I think you have to surround yourself with good people because as you know, I mean, that’s the, you know, we’re, we’re not built for medicine and we’re still not. Um, but I learned a lot by sitting with managers again, on these meetings, we talk about.

Um, our areas of marketing and ROI and why we’re using different certifications for certain things, HR details. When we shifted from doing internal HR, to having a national organization take over the HR and the paychecks, you know, and not having to do our Excel spreadsheets and crap like that. Um, and so, you know, trying to enlist a more corporate structure has been beneficial, but there’s learning curve for sure.

Catherine Maley, MBA

Let me ask it. Let me back up and talk about that concert or the call center. I just think that’s brilliant. I think it just like you do in your personal life business should be that too. Why not outsource what? You’re not good at? You can, you could stop and try to get good at that. Or you can outsource it to somebody who’s really, really good at it, but watch what they’re doing.

You don’t just advocate you give somebody responsibility, but you watch over it. You know, you trust, you know,

Kristi Hustak, MD

we cold call these gals often. Yep. We do cold call them just to see where they’re at, how they’re presenting it to make sure they’re doing doc of the day as they’re supposed to, if nobody had that voice in.

Um, and, and do that. Cause we ha, like you said, you have to verify trust, but verify. And so that’s been, you know, once a month we do cold call them and we have absolutely fired people because of it.

Catherine Maley, MBA

Yep. And are they in-house or are they external.

Kristi Hustak, MD

in-house. Well, COVID has been a funky year. So, they have been a lot, um, at home because that’s one of those that can easily be, um, done at home.

Um, but, but yes, but otherwise we have a whole call center with cubicles that are kind of separated for sound buffers, and they actually liked that because they can bounce things off of each other. We have all of our brochures and information. So, if they’re looking for something, they can actually be like, oh, let me send you to Dr. Hustak. And actually, they’ll grab it off the shelf. They’ll put it in a package and they’ll send it that day to that patient, letting them know, you know, they’ve made this appointment with me and sending me off all my information to them. So, part of our practice is we’re an umbrella, but we each have an individual identity.

I think that’s probably something different too. We each have our own website. We each have our own patient coordinator and we each have our own marketing staff. That’s ours under a big umbrella. So, I think that keeps us, I think, a little bit more fair too. So, if you’re putting more marketing dollars, you have more staff you’d expect that you’d probably have a little more productivity and vice versa.

So that’s one way that we kind of keep it more fair from that perspective as well.

Catherine Maley, MBA

So, regarding marketing, we’ll talk about that next. If you want to spend more on marketing than somebody else you can, but then that comes out of your expense.

Kristi Hustak, MD

Yes, absolutely. So, we have a 5% budget for ACPS. The rest is all under our individual.

Um, so a certain the way that we have it set up as a certain percent of my productivity, obviously goes to my ANP, my after my implants and everything goes to the practice. And that’s what helps pay for the overhead, including this budget for global marketing. So that’s our billboards and our, um, our magazines of our branding our branding all comes out of that massive budget.

And then we can spend more, um, and as us younger docs, you know, one cool thing that they did with my contract that I think was, was brilliant is they required me to, as part of my, to keep 10% aside of my own dollars For marketing. So, it forced me to market in the beginning, in those years that you wouldn’t want to, as you’re building a practice.

And I think that was instrumental in growing me as quick as I did. Um, and I use some of that money for like my national associations and travel and things. So, it didn’t have to be all marketing, but I would have never spent, you know, $20,000 on some branding ads. And things like that had I not had that money that was automatically set aside.

And so, I think that was brilliant because they kept it. It was my money, but they kept it in a little nest egg with the practice for me. So, I could pull from that.

Catherine Maley, MBA

That’s a great idea, by the way. So, when you first joined the practice, they didn’t just hand you a bunch of patients. You had to go work for it.

Kristi Hustak, MD

I had to go work for it, In the beginning, where we had to, you know, take call and sign up with hospitals and all that stuff. Um, you had to do some of the leg work. Now that being said I’m busier than I probably deserve to be by association. So, by being the only female that was there by being the young one whose schedule was wide open, you could wait two months with this doc and pay a hundred bucks console fee, or you could go tomorrow.

With this doc who’s new, but obviously great because they picked her and she’s available next week for free. So, by that association, I got patients that were calling the main center and we’re like, oh, huh, let me read about her a little bit. Cool. Yeah. Put her with me. She’s free. And she’s available next week.

That’s fantastic.

Catherine Maley, MBA

That’s Terrific. Um, so is there, give me the, give me a big pro and then a big con of working for this huge operation.

Kristi Hustak, MD

I mean, I think the pro is that I have partners to bounce ideas off of, so I can say, Hey, listen, I have this problem patient. It’s kind of like a, we used to call them tumor boards or, you know, morbidity and mortality conferences.

When you have your problem, patients difficult patients, I have. Six people that I can run that by. Hey, this is what I’m thinking. What stitch, how do you think I should approach this? So, from a technical standpoint, having that access is fantastic. Most private guys go to their meetings to get that. I get that every single day by association with these docs.

So, I think having that extra security net of problem patients and difficult cases is really fantastic because it gives you the confidence. Um, to, to really take really good care of people, um, which is great. I think one of the cons is kind of what you alluded to earlier. Um, it takes a little bit more to get things done sometimes from the business standpoint, because we’ve kind of shifted the rules where we didn’t have to have unanimous decisions because that just was six different minds.

It was really difficult sometimes, you know, Hey, I want to buy this machine. That’s new and cutting edge, but it’s $250,000. I don’t need that machine. I will never use it. I don’t do face case. So, how do you then, you know, do that? Well, the face guys, like I’ll use this a bunch. And so, we’ve kind of worked out algorithms for that.

Um, we’re majority wins. So as long as you afford, or the six volt that was there and then any kind of capital expenses over a certain amount, we decided we all need a different kind of vote structures for, but that was the only way we could get it done and then separating out the profit from it. So, making sure the high users were paying the lion’s share of the expenses for it, but then some of that profit was going to everybody, um, to pay for those machines and bring in patients and things like that.

Catherine Maley, MBA

You know what I find interesting with the way you guys. It looks like there’s a, the big umbrella, the big practice, all of you have your own individual Instagram’s websites for all of you are no more really into social media and some are not, is that,

Kristi Hustak, MD

yeah, I think it depends on your social media or your personality.

Um, I think we’re all trying to have a better, um, footprint On social media. Um, but I think some people are just naturally better at it. Like I have, um, our, one of our younger surgeons, Dr. El-Zokm that I was talking about earlier. He’s fantastic. He’s just natural. You know what I mean? Um, I don’t think I’m necessarily as natural at it, even though that I’m a younger generation, um, I mean, I have girls that are fantastic at it and I’ll post up, but I don’t think I’m very interesting.

And, but I, I think that I had to get over. It’s not about thinking that you’re interesting. Like I’m like, I don’t need to tell everybody every moment that I’ve tried new lip gloss, like that’s ridiculous. Um, but I think it’s not about that. And my gals have gotten really good about teaching me that this is for them to learn you.

So, my conversion rates are much better because they feel like they already know me. And so, I think that’s what social media has been good for me is just to let them know who I am. So, by the time that they get to me, they already feel like they know me. So, it’s, it’s what I can deliver. And do they like me in person, but they already feel like they know me.

And I think that’s what makes the process of conversion much easier for my practices is I don’t have to convince them of anything. You know? Um, my work that they’ve already seen speaks for itself and they’re like, okay, cool. I feel like I already know you and know the person that you are. So, this makes that transition easier.

So that’s how I’ve used. Social media for me is just so they can get a glimpse of who I am as a person that way, if they think I saw it, don’t like me, then they, I, they don’t even need to come see me. Great.

Catherine Maley, MBA

Right. But isn’t that great though, that there’s so many filters now to find those who love you come those who don’t, detract and that’s fine.

I think it’s so efficient, you know,

Kristi Hustak, MD

I think it’s way more efficient. That’s a really good point to it. And I do think that you’ll start to differentiate certain patients coming to you. Right? So, I tend to get a lot of mommies for mommy makeovers naturally because I’m a mom and this is what I talk about. And that makes sense for me, I’m not going to get a lot of gals for stripper boobs. That’s just not my demographic. You know, I’m not going to necessarily get the snatched waist the huge butts, like some other Miami doctors, like I think you’ll start. To get some differentiation of your patients, because they’re going to gravitate towards you for your type of results, um, and kind of your clientele.

And I think social media is beautiful for that as well.

Catherine Maley, MBA

Hmm. So, um, let’s talk about where your head is at because you are very much an overachiever. I’m sure you’ve heard of that. What possessed you to have three kids while you’re going to school to become a plastic surgeon that is no small feat when you are going to have to, I mean, it’s the jungle.

You have to compete with those who eat, drink, and sleep plastic surgery. You know, that’s gonna be their lion in the jungle. And there, I mean, it’s so competitive and you’re innately very competitive. So, what, what were you thinking?

Kristi Hustak, MD

Yeah, well, you know, I think medicine in general is becoming 50 50, right? So, 50% of a new medical school entrance are going to be female.

Like that’s shifted now. Um, but most of them are not doing surgical. Subspecialties that is still very male dominated. Um, and a lot of it is because of the length of training. So, I think naturally you’re self-selecting for alpha females that go into that field anyways. So, I think there’s something innately, um, about us that gravitate towards that.

Anyway. Um, that were just like you said, overachiever is, um, we, we are naturally going to advocate for ourselves. I think that personality does go that way. I mean, I remember, um, a female surgeon telling me day one, you know, uh, I was with another female and she got upset about something and started crying and she like pulled her aside.

And I remember this distinctly and was like, there is no crying in surgery. You put your face on, you go cry in your car later, but you, you have a job to do. And there is no crying in surgery. And I just remember thinking like, Oh, God, what did I get myself into? You know, because it just, it is, it’s just, that’s a tough thing.

And you had to develop a tough exterior. Um, that being said, I think, you know, I’m all about balance and I think you have to be, I have to recognize that again. I’m not going to be okay. I’m not going to be a massive innovator. There are just not enough hours. Um, in my brain, I read this really interesting article about some of these really high scientific minds and innovative minds, and they would talk about how they would sit in their office and think, and dream and draw and create.

For hours on end. Um, you don’t get that luxury as a female classic surgeon there. You just, you know, and as a mom, like you, your net, nobody’s ever going to bring me lunch and let me just sit and think and drink my coffee all day long. Like that’s not going to happen. You know, I have a running list in my mind, 24 7 of, oh my gosh, she’s got soccer practice that starts at six. Where’s her uniform. I got to wash that. I got to get this together. Ooh, teachers’ gifts. What teachers get do I like this? I gotta make sure I put that on my list for my nanny to pick up, you know? And so, there is a running list, 24 7 in this brain multitasking. And so, I’m just not going to be able to do it all.

And I’ve given myself grace to know that I’m not, again, triaged what’s important to me create that balance. There is no such thing as balance. It’s whatever you create it to be. So, I create my balance of happiness and I let the rest go.

Catherine Maley, MBA

Do you meditate?

Kristi Hustak, MD

Um, in ways? Um, yeah, no. Yeah. I do like quiet time. So, my quiet time is usually like before the kids wake up in the morning, I have my glass of coffee.

Um, my husband’s really good about going for runs in the morning. I cannot motivate myself to get up at 4:00 AM to run it ain’t happening, but I’ll have my coffee. Um, there’s moments when I won’t pick the kids up right away after school, I’ll give myself 30, 40 minutes. To take the dog for a walk or something, um, or get massages.

My downtime is massages. So, I’ve, I have gotten in the habit now of scheduling a day. Like I’ve scheduled. I put it on my schedule. I blocked my day and I go get a massage. I turned my phone off, nobody can find me. Um, and that’s my happy zone. So, I just read a dirt magazine. I re I listen to podcasts and audibles and I just relax. I go sit in a sauna, you know, and just have a moment to do nothing. That’s going to stimulate my brain.

Catherine Maley, MBA

Wow, you’re singing my song I can’t believe I haven’t seen you

tell us one thing about you that we don’t already know.

Kristi Hustak, MD

Uh, let’s see. Um, I play on a competitive kickball Friday night. Yeah. So, I turned that we’re not as competitive as I thought we thought we were better than we were. Um, but I think it’s my moment to get some aggression out. Um, I liked sports as a kid.

I played soccer and volleyball and ran track. Um, and so I think it’s a moment where, and my husband. 40. So it’s great because we get to, to kind of do a sport together. And we did in medical school, we played softball together and whatnot. And so, um, on Friday nights we get together with other parents of our kids.

Um, sometimes we bring the kids. Sometimes we get a nanny and we go drink beer and play kickball for a couple hours on Friday night. So, it’s our thing to get together. I mean, the amount of hamstrings that I’ve pulled and knees that I busted. I I’m embarrassed. Like there are days, it takes me two days to recover from the stupid kickball game because I’m not 20 anymore.

Um, it’s fantastic just to get out there and feel like I’m doing something active. Um, you know, be able to socialize with some, some friends of mine, um, and be able to spend some spills some spouse time to you know I think that’s important to really continue to connect with your partner in crime uh on something other than raising children Because we share those things innately

Catherine Maley, MBA

Yeah, All right And the last question what would give me one Pearl that you would share with other surgeons kind of your age are coming up What would you tell them to do to get into this field now at this crazy competitive

Kristi Hustak, MD

Um cool Um from getting into medical school or getting into residency

Catherine Maley, MBA

getting new practice

Kristi Hustak, MD

just getting into practice Yeah So the majority of plastic surgeons um do not stick with the first practice as you know so like that’s you know you almost always joined somebody and then you go out on your own I think choose a place that you want to live and build around it Yeah I do think that that’s important um because the rest of it will come And so I think in know that you’re not going to make money especially in private practice for years And that’s okay You know set yourself in a position where it’s okay to not make a lot of money work ER call or things like that to keep the ship afloat Um but build it now don’t wait because you’re going to look back 20 years from now and say dang it I should have done it And you really have so many years to practice I mean it’s amazing because we start so late you know I started practicing at 30 years old I mean I distinctly remember my dad who’s not a medicine saying will you get a job already Like I don’t understand what you’re doing You’re a doctor now And he didn’t understand residency cause he wasn’t in medicine And so you know it was funny when I got my first job at 30 He’s like yeah So you get a paycheck yet You know you’ve just been paying all these years And I was like I know but it’s a really good job dad I remember him being like dude go get a job go work And so you know you only have so many years left right I don’t like 30 years if I do it right Maybe less if I retire well um to really practice And so you know your body shuts down at some point and your mind starts to shut down at some point And so start it now don’t wait 10 or 15 years Wishing for something you could have built from the beginning recognizing you know you’re going to pay the price for five or six years and that’s okay

Catherine Maley, MBA

Well thank you so much That was really it’s great talking to you I really appreciate it

Kristi Hustak, MD

Thanks for having me This was super fun I wasn’t nervous at all I was worried I’d be but yeah

Catherine Maley, MBA

All right Well thank you so much And everybody I hope you enjoyed our beauty and the biz episode If you did, please go head over to iTunes and subscribe or go to apple I guess and subscribe and then give us a good review if you feel so inclined And then if you want to get ahold of Dr Houston how can they get ahold of you Yeah So

Kristi Hustak, MD

um they could probably send me an email Uh it’s super easy Christy has at uh gmail.com That’s my business account So you can send it there Um or you can always go Yeah So, it’s Kristy has tech md.com So keeping it simple as well And then ACPS aesthetic center for plastic surgery has a [email protected] as well And you can always reach me through there There’s a dropdown list at the docs

Catherine Maley, MBA

Right, That’s the best part You guys have such a huge footprint on the internet because all arrows lead back to you guys

Kristi Hustak, MD

Yeah, And that’s a great benefit as well So we have there and then ridges from there So yeah

Catherine Maley, MBA

Okay And if you want to talk to me or give me any feedback, I’m at CatherineMaley.com or you can certainly DM me on Instagram at CatherineMaleyMBA Thanks so much And we’ll talk again soon.

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Catherine Maley

Catherine Maley

Catherine is a business/marketing consultant to plastic surgeons. She speaks at medical conferences all over the world on practice building, marketing and the business side of plastic surgery. Get a Free Copy of her popular book, Your Aesthetic Practice: What Your Patients Are Saying View Author Profile.

BEAUTY AND THE BIZ

Beauty and the Biz is for Plastic Surgeons who know they don’t know everything and are open to discovering the pearls to grow and scale a sellable asset when they’re ready to exit.

Listen in as Catherine interviews surgeons who talk about the business and marketing side of plastic surgery and listen to Catherine’s pearls from consulting with plastic surgeons since Year 2000.

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