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.
My guest today is Dr. Philip Miller, a double-board-certified facial plastic surgeon specializing in rhinoplasty and facelift in private practice on the upper east side of Manhattan for more than 2 decades and partner in Gotham Plastic Surgery.
Dr. Miller is a clinical Associate Professor in the Department of Otolaryngology at New York University School of Medicine, where he teaches facial plastic surgery to residents and students.
Dr. Miller has authored numerous manuscript chapters and peer reviewed journal articles for rhinoplasty and neck rejuvenation.
He is regularly invited to lecture on specific techniques with his peers at national facial plastic surgery meetings and has been voted Best Doctors in America and Top Doctor of NY since 2007.
In 2019, he won the Castle Connelly top doctors Award. And has gotten much PR on the Discovery Channel, NBC, several top magazines, as well as The Wall Street Journal and The NY Times.
Listen to the episode to learn:
- How he developed his practice structure for Gotham Plastic Surgery
- How he differentiates himself while successfully reaching his target markets
- How technology is an important aspect in his business model
- What drives him to be successful
Want to learn more about Dr. Philip Miller? Visit his website www.DrPhilipMiller.com
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Philip Miller MD
Catherine Maley: Hello everyone and welcome to Beauty and the Biz where we talk about the marketing and 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 I have a special guest today that I’m really excited to talk to. It’s Dr. Philip Miller, and he’s a double board-certified facial plastic surgeon in rhinoplasty and facelifts in private practice on the upper east side of Manhattan. He’s been there more than two decades, and he’s also a partner slash owner of Gotham Plastic Surgery and Surgery Center.
Now, Dr. Miller is a clinical associate professor in the Department of Otolaryngology, New York University School of Medicine, where he teaches facial plastic surgery to residents and students. Now, he has also authored numerous manuscript chapters and peer reviewed journal articles for rhinoplasty and neck rejuvenation.
Now he’s regularly invited to lecture on specific techniques with his peers at national facial plastic surgery meetings, which is how I know him. And he’s been voted best doctors in America and Top Doc of New York since 2007. And in 2019, he won the Castle Connolly Top Doctors Award and has gotten much PR from the discovery channel, NBC tons of magazines, as well as The Wall Street Journal and New York Times.
So, welcome to Beauty and the Biz Dr. Miller. It’s a pleasure to have you.
Philip Miller: It’s great to be here. Great to be here. Nice to finally see you it’s been some time. Unfortunately, we haven’t had a chance to see one another at our normal stomping grounds at all these meetings.
Catherine Maley: I can’t wait to get back by the way.
Philip Miller: Are you going to the Vegas? I’ll be there.
Catherine Maley: No, I’m going to wait until probably the Global Meeting in November in Miami.
Philip Miller: I’ll be there.
Catherine Maley: Oh, great. I’ll see you there. All right. So, one way I would like to start out is you currently have your own practice in Manhattan with your own surgery center, with another surgeon, but you didn’t start there.
What was your journey? Did you first, like when you are done with fellowship, did you join another practice? Did you go into hospital? Like how did you get to where you are right now?
Philip Miller: Yeah, you know I’ll probably answer, oh, I’m going to answer obviously on what I did, but often the mindset of those who might be listening in and how best to go about answering that question for them.
And I would say, think the important thing is to throw them, do an inventory of your resources and ask yourself, ultimately, what do you want to retain? What do you want to achieve? What do you have currently in order to get there? And, you know, I, I didn’t come from means, I didn’t have a lot of money. I didn’t build a new practice in New York City it was almost going to be impossible.
And so, I sort of always knew that I wanted to do a little bit of academics, but that I also wanted to have my own private practice. So, I did explore when I first ended fellowship going into other practices, but realized that I would probably end up following the footsteps of so many other facial plastic surgeons who join these group practices with the idea that they would be the group practices, facial plastic surgeon, or they end up doing a smattering of this or that, and ended up really not doing much of anything, facial plastic surgery wise.
And I didn’t want to fall into that trap. And so, I have the honor and the privilege of being invited back to New York University School of Medicine and within the department of be, and it’s need to be the second facial plastic surgeon there. And I jumped at it and so I, I broke up doing somewhat general otolaryngology at, at the start, but with the emphasis on building a facial plastic surgery practice.
And I think, you know, for those who are listening, it’s important for you to define success. And for me, in those early years, I define success, not making more money, but in the amount of facial plastic surgery for procedures that I was doing. And even if my revenue stayed the same or fell, if I was doing more facial plastic surgery, procedures year after year after year, I was feeding, I was achieving my goal. And that’s what I used as the criteria. And that’s more or less what I did as time went on. I slowly stopped doing a number of general otolaryngology procedures until such time as I was exclusively doing facial plastic surgery. And that took around, oh three years or so, maybe four.
But after being an academic for seven years, you get the chance and the edge is to be much more independent to have greater control over your life, to be able to Institute policies and procedures that the institution itself, a large medical center prohibits you from implementing to incorporate technology that you know, would be beneficial to your practice, that the medical center is not up to yet in terms of their state of art.
As you know, Catherine, I’m quite the techie and I’ve incorporated that into my practice. And so, in 2004, around 70 years after I was in my at NYU I left and built this place which is in Midtown Manhattan, a border on the upper east side right off park avenue. And it’s been just great ever since.
Catherine Maley: How did you structure it? Does, did your partner join you at, where did the class surgeon come in?
Philip Miller: Right. Yeah, so, so I came here by myself, but at the time I was having and still do have a lot of patients interests, interested in body plastic directly. So, I wanted to bring in a body plastic surgeon and interviewed a number of them.
And finally, was introduced to Dr. Douglas. Steinbrech also a graduate of the NYU plastic surgery program. And the two of us just sort of hit it off. And he was, he had a practice, he was renting space elsewhere in New York, two days a week for his private practice. And then he would come to my office two days a week and see the patients that I would refer to him.
And one year turned into two, turned into three, turned into more and. Before, you know, it, we were sort of becoming really good friends and business associates, if you will. And I was helping him decide sort of what his next step would be. One day when I finally scratched my head and said, you know, yes, you can do this and yes, you can do this, but you know what?
We really should talk about maybe being business partners. I know I’m going to want to partner in the future. You and I already had been together for five years. I know I can trust you. You know, you can trust me. Let’s work on this. And the truth is that we shook hands and we lived sort of in sin, if you will, as partners for a year without finalizing our contract or our agreement, it took almost a year for us to hash it out.
But we ultimately did. And we realized that it was like, like any type of long-term relationship. We would have our ups and downs, but that ultimately, we respected one another. We were, we trusted one another. And that we knew that we were better together than we were independently. And so, no matter how difficult issues have raised over the years or knock-on wood, things have been just terrific for years.
We always worked at, we worked it out. We always worked it up.
Catherine Maley: Is it a 50 50 partnership?
Philip Miller: You know, here’s, what’s fascinating about agreements, is a partnership can be broken down into a percentage wise on just about anything and everything. So, you can, I can be, let’s say 100% owner of our partnership and have an agreed to have zero profit.
I can agree to take 5% ownership, but also negotiate that I received 95% profit.
Catherine Maley: Right.
Philip Miller: So. I think it’s important for everyone to understand that everything in a partnership or in a business is negotiable and the percentages that people describe maybe in terms of ownership in the company, but that doesn’t necessarily mean the revenue share.
And our particular model we basically, as they say, you know, you get what you kill, so to speak, but we, we, we refer to one another all the time. So, we’d benefit from each other’s expertise.
Catherine Maley: It can get trickier though with the surgery center, because I’ve watched where maybe you’re doing more surgery than the other guy. And, and, and hopefully that all divvies up, like the overhead costs are congruent to the revenues brought in, you know, so and they’re all different ways to do this, but I’ve just noticed it, number one, I think it works beautifully when you have very strong boundaries, your neck up, he’s neck down.
I think that’s super helpful.
Philip Miller: Yeah, but we don’t. We actually, one of the conditions of him coming on board through his perspective was he did not want that limitation. We want it to be able to do above the neck.
And I quite frankly felt awkward, prohibiting him from doing. But being a specialist in the nose and understanding that that really was my area of expertise. In addition to facelift and necklift. That, that was something that he asked, we asked and agreed that that would be my belief of domain. And that worked just fine between the two of us.
In terms of competing in the operating room, I have my two days, he has his two days. But, you know, rising tides raise all ships. Right? And I don’t see him taking my to, I see him being successful and I’m thrilled for him. I genuinely am. And I would much rather see that time be used in case I don’t have a case that day.
And he, I know, feels the exact same way. So, we, we, we genuinely support one another, it’s unique. It really is. I don’t know how, how often a successful partnership can last. Ours has been going on now for probably over 12 years. And it, and it’s strong as ever. Where, we built out two offices in new Orleans and Chicago and LA we’re looking at to Miami as well.
So, we’re, we’re, we’re doing pretty well.
Catherine Maley: Whoa. I did not know that. All right. What’s that all about? And does that have something to do with your Natra trademark?
Philip Miller: No. It, it, it could, no. One of the things was that Doug, Doug had an interest that in LA, his spouse is a movie producer. And so, they were out in California quite frequently that’s that.
And so, he felt comfortable with being in LA and he wanted some warm weather. I looked into it and quite frankly, I didn’t like the five-hour flight and the three-hour time difference, to be honest with you, I wanted something a little quicker. So, I was going to go down to someplace like Miami or to that effect.
But then I, I had an interest myself in New Orleans. Let’s just say that. And so now I’m down there. Rather than opening up shop in in Miami and our former Dr. Steinbrech, former fellow who was here last year, we put up in Chicago and so he’s opening an office in Chicago and Dr. Feinberg, and I still want to open up a place in Miami or on the beach or something like that.
Catherine Maley: All right. What does that business model look like? Because I have just noticed in my 21 years of experience, when you’re not there to manage something that you’re, you’re away from can be hazardous to your revenues. So how are you working that out or are these just med spas and you have nurses in them or are you guys really…
Philip Miller: Protocols, protocols, protocols.
So, you know, it’s got to work in the home base and then you transport that elsewhere. And it’s, we, we have a, of a concept that we apply to our patients and that’s called one voice. And that means no one is allowed to dial anything to any of the patients, unless they know it’s the truth. It’s, it’s, it’s, it’s sort of doctrine, right?
If you do not know the answer, it is worse to make it up than it is to just say, you know what? I don’t know. Let me go check. Okay. We do not want the patients getting two different directions, two different, two different advice, assessment advice. Same thing when it comes to running a business, there’s only one way to do things.
Now that doesn’t mean that there’s the right way to do it. There’s just one way to do it. And it’s the way we all have to do it until we agree that we should change it and do it a different way. And that way we all know how we do it, and that’s how we do it wherever we are. And, and I think that that’s a way for this kind of oversight work to know that the protocols and the processes that have worked in our New York office will work and can be transported elsewhere.
Catherine Maley: And how are you holding people accountable to follow those protocols?
Philip Miller: Well, fortunately our entire practice runs on a practice management software system that we can offer.
And so, we can see what they’re doing and how they’re doing when they’re logging on. When they’re logging off, who they’re putting in, what they’re changing, what they’re adding, if they’re processing bills, payments, et cetera, et cetera. We can check that up against phone calls that are coming in. We can check that up against the video that we have.
So there, there’s absolute ways that we can confirm, you know, and I don’t, I didn’t come up with this. I, I attribute this to Dr. Vito Portillo who I adore. And you probably know Vito very well. Veto once told me it’s probably not his line either, but Vito wants told me it’s not what you expect, it’s what you inspect.
And so, we, we, we, we here are the protocols but, but we, we turn around and we check them to make sure that they’re being done properly.
Catherine Maley: So, the business model is you have a working business model in New York, and now you have pretty much franchised it out to the various locations. Is there another doctor surgeon plopped into that location or is it just staff and you guys are flying around doing the surgery?
There is one in Chicago, in LA, not yet in LA it’s Dr. Steinbrech. In new Orleans it’s me and in Miami, it’ll probably be the two of us. And then ultimately, yes, we would put someone else in there, but right now we could want to have the luxury and the, and the ability to go to those other locations.
That’s a lot. That’s a lot you took on, you know? Cause you also have to look at the opportunity costs of, I mean, New York, you, don’t just, it’s not a hobby to practice in New York. You’re in the middle of the jungle. Like you guys are pretty darn competitive there and most of you it’s just eat, sleep and drink this, you know?
So, when you’re away, gosh, that good for you. If you can pull this off, have you been doing it already? Traveling? Cause the travel also, I used to travel a lot and I loved it, but it’s exhausting.
Philip Miller: Yeah. I mean I only travel. I go away, I’m, they’re down at a one person I’m there for a week, so I’ll leave on Friday on and then I’ll come back on the following Sunday and then I’m seeing patients and operating down there for the week.
So, you’re right, I think going for away for a day or two and the coming back can be exhausting. Dr. Steinbrech’s schedule in LA, is similar to that. Right now, in Chicago it’s took maybe one or two days, but he has someone, well, we have someone out in Chicago with this at this point. Who is full-time, who is building their practice as Dr.?
Gonzalez is an amazing surgeon. Terrific, terrific guy. He will do afterwards anomaly well; we have no doubt about that. And again, we’ve taken our system, we’ve trained everybody here in New York and then we’ve transported them out to Chicago.
Catherine Maley: Gotcha. Do you have any hiring tips? I’m always hiring staff for, you know, practices all over the United States and I have to tell you, I think I’m pretty good at it.
And I would say my batting average is pretty darn good, but it’s still, oh, no. Some people just really interview well, some don’t some, it takes them 60 days before they show their true colors, you know, or just not a good fit. Any words of wisdom there.
Philip Miller: Yeah. You know, and I, I think you’re absolutely right. I, I think my only recommendation would be, you’re absolutely right people usually knock it out of the interview and then they may not perform very well. And that’s, what’s so crazy. Is that those who don’t interview well, probably never even really get a chance to, to, to show us what they can do occasionally, maybe, but most of the time you got to knock it out of the interview. But then after a while, I would say my advice would be get them in and as fast as possible, let them, so what they can do, and if they don’t perform, get them out fast. Get them out fast. You know, the good, the great has that line, get them on the bus. And if they’re in one seat, try them in another one and then you get them off. Well, we’re a small organization. We don’t have many seats, so they’re meant to come on for one seat and if they don’t work, get them off. But I for example, I recently hired a what was a recent, a couple of years ago.
I hired an executive assistant really nice individual. I liked him. Three days after he was working for me, I just called him in. And I said, you’re a great guy. You’re a nice guy. Clearly you don’t get me. You know, if I have to explain myself two or three times, then it means we’re not on the same page.
And I can, I don’t, I don’t have a problem personally, if you don’t, if you need to come back and ask me for more direct things, but if you’re asking for the same directions, that’s a problem. It is because if I, and I, and I actually had a whole list, I could, I’d love to pull it out and share with you, but I sort of the head of my Dr. Miller’s sort of pet peeves, I try to remember them. But and these are good things to convey to those who you’re going to hire so that they know who you’re working with. Some other good things to facilitate hiring is to make it clear how the person who you’re hiring wants to be communicated to and how, who they’re working for needs to, and wants to be communicated to.
Because a lot of times that can be in and of itself a problem. I email them, but in fact, they prefer to be spoken to in person, they are waiting around or talk to me when I would much rather prefer them to send me an email. I mean, something as simple as that can facilitate a communication and a job, a successful job.
But getting back to my pet peeves that I was referring to is one of them was the notion of completing a job. And the analogy I said is it says, if I tell you, I want you to change a light bulb in the room, I don’t really mean go in change the light bulb. I mean, the bulb in the room isn’t working. Hmm, I’m assuming the light bulb is out, but you just go in the room and change the light bulb. When you’re done turn on the light switch, you make sure that the light is still on. If the light doesn’t go on, fall on electrician, get the light to work.
So, the simple task, hey, change the light bulb in room three really means, make sure that there’s light in room three. And that’s a really important concept that those who work with me understand is when I say something, when I, when I mentioned a task, it’s really a task, it could be as simple as a task, but it’s also a project and get, take care of it and get it done.
And if you’re having problems, come back to me and we can discuss how it needs to be modified or changed, or you’re hitting the roadblocks. There’s nothing wrong with that, but understand what’s being asked of you. And complete it. Don’t just go in, pull out a fully functioning bowl, replace it with a fully functioning bowl and think the job is done when in fact the problem is there’s no preceded in the bowl..
Catherine Maley: I have seen that over and over, and I don’t know if it’s because as I get older and they get a lot younger and I find that I have to be so much more specific. When I was younger, when you gave me a job, I thought I was thinking all the time, thinking, how do I get this done? How do I finish up? You know, how do I do a good job?
And in today’s world, I just feel like I have to be so detailed. And I’m so like for me, a rockstar is somebody who gets it. Like they get me, they get it. They, they go the extra mile or they actually do the complete job without me completely detailing every step. But it’s also helped me learn how to manage people.
You know, you have SOPs, you have your metrics. It does force you to learn.
Philip Miller: Yeah, I always tell, what I tell them is every time you talk, every time you complete something, you should just instinctively say, what else? Like what else? Like, okay, I know I probably need to do one more thing here. And like what, what else?
What is, oh yeah, look the switch. Make sure that, you know what I mean? And then just by asking yourself, what should I do, one other thing, a lot of times you can think of. But if you don’t even go that step and ask yourself what else you’ll never, you’ll never get to that. I would say the second thing, one of my other second pet peeves, or this is really a good indication that things aren’t working out.
I want to work not only with vendors, but also with staff where, when I tell you or ask you to do something, I don’t need to set a reminder to myself that I asked you to do it.
I know who I can work with. I know which vendors I can work with. In fact, I eliminate vendors as well as staff, where I have to keep a list. It’s one of the criteria. If I start creating a list of things that I asked you to do to remember whether or not you got it done, you’re out. The vendors I work with are amazing because I can send that to him by an email or after conversation, they hear it, they get it, they know what they need to do.
And I never have to worry about setting reminder for itself.
Catherine Maley: That’s so true. The litmus test is if you can email somebody and then let it go, let it off your list because you’re confident that it’ll get done. That’s when I know there’s a staff issue when I realized I go, oh, I emailing, but I know darn well, I better check up on this.
That’s silly. You know, we, we have plenty to do, right?
Philip Miller: Absolutely kids. You have to sit there and ask yourself, oh, you know what? I wonder if it’s going to get done. Yeah. That that’s a big sign that maybe that staff needs.
Catherine Maley: Let’s get back to the surgery center for a minute because that’s been coming up a lot during COVID.
A lot of you had trouble getting hospital time, you know, at surgery centers and I’m getting that call a lot. Is it time for me to get my own surgery surgical center? Is it just a nice thing to have a necessity? Is it going to be a a revenue drain for me and I’m going to regret it? How, what did you, when you were building yours, number one, what was your decision-making process?
When did you decide it’s time for me to build out my own? Or did you rent, like, start up, like from scratch?
Philip Miller: You know, I mean, historically I started at the university, so I work whenever I needed it, I would actually have to use the universities facilities, which were incredibly, expensive. And then I, I, I converted one of my exam rooms into a JCAHO accredited office space, certain, and you can, it doesn’t take much.
It really doesn’t. And I’m not talking about being able to three surgeries. I’m talking about office-based surgery center or office-based surgery facilities, and you can convert a simple, large exam room into an accredited office-based surgery facility. And that’s how I started something as simple as that.
Now what gets accredited is not the location and not the person, but the organization. The organization at the time, it was called Beside Care and now it’s called Gotham surgical at the time. That organization was accredited. And so, when I moved out of NYU, I simply notified the joint commission that the office-based surgery facility, Called Beside Care was getting moved to a new location and then it’s it does require a, another visit from them, but not as extensive as the, every three-year renovation process that they put us through, which is wonderful. I might say, I think as residents, we all hate JCAHO because the hospital administrators couldn’t stand them and we have to do this with that.
I happen to love JCAHO because they keep us all honest. You would keep us with protocols and procedures that keep the patient safe and infection free. So, I don’t mind that at all. And I’m very proud when them, JCAHO representatives come by every three years, I want to show them what we do, but it doesn’t, doesn’t necessitate a huge commitment in terms of space.
It really doesn’t. Do not think that it’s going to be a revenue center. None of your, not for plastic, not for cosmetics, or it will break even. But you make your money, because you are no longer spending time going to another institution. And back you have the ability to sit at your desk. Now, look on the monitor, see when they’re ready for you and just get up and walk over.
When you’re done with your case, you’ve got three patients waiting for you in the examining room. But probably the most important thing is particularly in a cosmetic practice. Patients don’t want to go to facilities. Patients want the anonymity, patients want the exclusivity, and they want the experience of being in a more luxurious environment than a sterile, cold, and very public environment like a hospital or any, any large institution.
So, I would argue that if you really want to take your cosmetic surgery practice to the next level, it’s almost mandatory that you have your own, so.
Catherine Maley: I agree. I agree. I’ve found as a patient, I’ve done all of them, the hospital, the surgery center, the private suite, I’ll take the private suite any day.
I did, it’s so much more comfortable. It’s private. There’s always in and outdoor that I, you know, I slip in and out, no big deal. The people are so friendly because it’s the every day, it’s the staff, you know, it’s, it’s the surgeon staff, so you really get to know them. And they’re just I just, I can’t imagine not doing it.
You know what else I was thinking your conversion rate will be affected. If you don’t have a surgical suite, because if I had to give you a, like, I’m the coordinator, if I have to, you say I want a rhino on let’s check the schedule and the patient’s trying to tell you, I want it on Thursday and you say, oh wait, I don’t, we don’t have anything on Thursday, cause the hospital’s booked.
And you’d have to scramble trying to figure that out. There’s no way you’re going to convert that patient that day because now you’re going to go back and forth and back and forth. And the hospital’s more expensive than that surgery center. So now you’re thinking, well, maybe we can get you in on Friday and the surgery center and we’ll save you a couple of dollars and I just think it would hurt your conversion rate as well.
And it’s not, it’s not user-friendly, I’ll just put it that way.
Philip Miller: And, and I’ll, and I’ll, and I’ll put a pitch in for the purpose of the surgeon. And the result is that particularly to the younger surgeon, you know, you want to limit all of your variables, right? You want to have the only variable in your outcome being a patient and that’s it.
You want to have the same anesthesiologists. You want to have the same sterile surgical instruments, the same supplies, the same scrub, the same circulator, the same anesthesiology. You want to have everything be the same. And the only thing that’s different on that day is the patient.
And that’s how you can get consistent excellent results.
Catherine Maley: That is such a good point.
Philip Miller: Imagine going into, if I’m telling you right now, if I went into another operating room and someone gave him someone else’s rhinoplasty set, it would be as foreign as operating on the moon.
Catherine Maley: Right. I mean, it’s almost like cooking in someone else’s kitchen.
Philip Miller: It is exactly like someone else’s kitchen. You don’t how to, you don’t even know where, you’re spending work on, figuring out where. All of the pots and pans, or you’re not spending as much time chopping up the ingredients.
Catherine Maley: For sure. All right. So, thank you for that. I just needed to hear you know, cause I, I have my own opinion as a patient my own opinion is your own private OR suite is the only way to go. As a surgeon, I would think you’d want to save time and be more efficient and take that on and, but not take it on as a profit center. Take it on as a convenience for you, for everyone involved.
Philip Miller: Exactly. Yeah. You know, again, if you are, you’re trying to think of it as a profit center, you’re going to be disappointed.
But you don’t, you’re not looking at it like that. Even if you break even. And you’ll break even, right? You are still so far way ahead of the game. It’s ridiculous in terms of convenience. And you know, I don’t have to assign, wrote about that. You know, I’ve been doing this for over 25 years, but I have felt this way ever since I started, which was, it’s not just about the money.
People can’t think that way. Okay. It’s about your livelihood, about your lifestyle, about your happiness, your contentment, you enjoying what you do. If all you’re going to think about day in and day out is money, money, money. I’m telling you something. We can affirm that we are going to be on half. Okay. You need to find a motivating factor greater than just that.
Catherine Maley: Well said. So, let’s switch gears and talk about marketing. And one thing I really would like to hear from you is your marketing plan because you are working with two very different target markets. Typically, the rhinoplasty is the young kid and the facelift is the more mature woman. Now, if you could get some kind of combination deal going for the small kid, the rhino and his mom gets the facelift.
I think that would be brilliant. But how are you toggling that? Because it’s a very different kind of conversation, marketing message, marketing channels. Can you talk to that?
Philip Miller: Yeah. Well, first of all, is what works the best is when the mom wants the face lift comes in and gives me their children for the rhinoplasty to see whether or not the mom wants me to do the face. And I’m telling you, I’ve had a couple of very, very funny and what’s even funnier is the children arguing with one another? Who’s going to go first. So that definitely happens. You know, on one end, you can’t be, you cannot be everything to everybody, right.
But there’s no reason to just be one thing to a group of people. And I, I have a passion for rhinoplasty. I love it. I really enjoy doing it. I think I have a strong message there that has been sent out not only by my website, not only by my before and after’s, not only by my dedication to at the time, a separate website just on rhinoplasty the preponderance of the before and after’s of rhinoplasty on Instagram, which as you mentioned, is more of a younger generation of who are viewing them as opposed to Facebook, which might be seen by an older generation and more predominance of facelift type marketing materials on websites, which is where the older individuals are going to be looking at.
And the print media for more facelifts. So different media, which as you know, is going to be viewed by different populations are going to get different messages. And they don’t contradict with one another because often those two channels, aren’t looking at the other one, you know, the, the young child or the young child, but the young individual who’s interested in a rhinoplasty.
They’re looking at the Instagram. They may be looking at Cosmo, but they’re not reading The Wall Street Journal.
Catherine Maley: Right.
Philip Miller: And they’re not reading, you know any type of couture type of magazine. So, you have to know who your audience is for each one of these marketing initiatives and then our get the procedure that you want for those particular marketing materials.
Catherine Maley: Let’s talk about that. Natural, that trademark thing that you’ve done in the GI job, which I think is hysterical. That’s terrific. How is that differentiating or, helping you to differentiate from all the others?
Philip Miller: Yeah. You know, I, I I’ll tell you my, my business partner, Dr. Steinbrech, he is the world’s best coming up with names. I mean, he does these phenomenal male buttocks contouring, and he called it the Brady Butt. I mean, the guy’s brilliant. Okay. He has a great way for, or we’re designing the abdomen and he called it the six pack abs or something to that effect or, or, or a life of six pack liposuction or something. So, he’s much better than I am.
But but I wanted a term that reflected how I evaluated a patient out. How I, and, and, and more or less the results that I achieved in how, I go about achieving them. And so, I developed the natural look process, which I think is what your approved, registered trademark and the natural look process is the means by which I get the results that I do. And it starts with achieving what I call a unified vision.
And I explained to the patient, you’re going to come to me with your own perception, your own event, your own requests, your own concerns, your own desires. And I’m going to look at you and see in my own mind, what I think I want, what, see what I can achieve, what is possible? What isn’t possible at all?
And the first thing the two of us have to do is come up with a unified vision. We both have to realize this is what needs to, what, what, what, what can be achieved and what they want to be achieved. And if we can’t achieve that unified vision, then after the process doesn’t proceed, it just stops right there.
If it does proceed, then we move on to the next step, which is called the prep. And then the prep obviously is a time during which we will having already set the date for the procedure. We’ll sit down again and we’re going to go through the process all over, again, answer more questions, doing some administrative work, go over the photographs.
Have them complete the consent forms, et cetera. So that by the time that the procedure date occurs, the next step, the last thing, all they have to worry about is showing up. That’s it. They don’t have to worry about medications, they don’t have to worry about administrative details. They don’t have to work; they know everything that is going to happen to them that day. And they should and can feel relaxed.
Then they go through obviously the recovery phase and they get the final result. So, obviously to a certain degree, we all do this, but I’ve labeled the actual steps and I’ve given criteria for each one of the steps and I’ve conveyed that to my patients.
And I think it directly relates to the natural appearing results that I am able to achieve.
Catherine Maley: I would say it seems to me; rhinoplasty patients can be the toughest to make happy. Is that true? Or do you have a couple yellow flags that come up that, you know, for sure I’m out, you know, you’re not going there.
Philip Miller: Yeah. And you know, I think rhinoplasty patients can be, but I would say ear patients and, and lip patients are much more consistently finicky and picky. And patients who come in to have otoplasty done, or if I do any kind of lip revision what happened was, I think maybe 20 years ago, a woman who had some silicone injected into her lips.
Was going, I don’t know, everywhere, couldn’t get any help. And she came to me and I reconstructed her lips. Went online and she told the entire Silicon infected, infested lip world that Dr. Miller is the guy. So, I have this little side business as the guy to go for lip reconstructions, which isn’t necessarily what you want to build a practice on it.
But but I’ve got that rolled in there. And my point to you is that I find that those patients are much more, a much harder to please necessarily, because no matter how good you get it, they just can find something else. And I tell them that on the, from the very beginning, you know, I’ll make it look great, but I’m telling you right now, you’re not going to be happy.
You’re going to want something to work, you know, something done after this. And, and, and, and come back so I can tell you that no, you’re not getting anything else done. And, and it almost becomes a joke cause they, they, they love the result, but they’re like, you’re right to be just lifted up over here or over here.
So, but getting back to your original question about meeting expectations. Yeah. I, I think that that’s all that we do here, right? That’s the only thing really that we in the cosmetic surgery industry are responsible for is meeting their expectations. That’s it? You know. If you have pneumonia, you don’t discuss with your doctor, what the expectation is after visiting them.
You don’t say, well, doc, or after I take this, will, my cough goes away and stop creating phlegm and my fever be gone and my chills. It’s implicit that you’re, they’re sick. And you want to get better at the doc gives you the script and you get better. When patients come to me, I have to really understand what it is it, what is it that you want to achieve?
And after 25 years, it’s more than just what they’re telling me. I bring to that conversation based on the procedure, all of the expectations that all the other patients have ultimately revealed to me after the surgery that they never revealed before the surgery that I know that this patient in front of me.
Catherine Maley: Like what’s an example of that or example.
Philip Miller: So, you come in and you say, Dr. Miller, I can’t stand my neck. That’s what bothers me. All I want is my neck. Yes. Is that the only thing about, yes? And after the surgery is done, Well, you know, what about this line over here? You know, I thought that that was going to get done. And I thought that this was going to get done well, not, you didn’t tell me that that was gonna, that was your concern. Associated with any procedure I found are maybe three or four associated anticipated results that are almost never vocalized, but you would have to bring up in conversation just to find out if they are or not a hidden expectation and get that on the table right now.
I’ll give you an example. This is, this is a little bit of a side note. Actually, patient came in a couple of days ago and well, this is actually not an example of a hidden expectation. This is an example of something else. So, I’ll just table that for a moment. Cause it’s not really an example of this. It’s an example of setting proper expectations.
So, so. I mean, I can give you an example if you want. Oh, well this is, this has to do with just being careful about angry patients. So, patients can get very, they can be upset about their appearances, but for some reason, and I don’t know why they can also be angry about their appearances. And though it’s a particularly dangerous patient because that anger gets transferred to you.
And you have to have an honest conversation with the patient ahead of time, but you’re here because you don’t like that. I’m here to help you. I didn’t cause that, and I’m not going to be able to take it away completely. I’ll improve it a lot, but it’s, you’re not going to be happy with an improvement. I’m telling you right now, you’re going to be angry at me.
That anger that you have there, do you, are you angry? Yes. I’m angry, right? That anger is going to go towards me. Or an area that would be that I never ever take a patient back with her mother, patients’ mother. Never take a patient back to the operating room if the mother and the child are disputing the necessity or the indication or the result intended result of a procedure.
Never, ever cause guess who wins between mommy and surgeon.
Catherine Maley: Mom?
Philip Miller: Mom always wins. Right. And the surgeon will always be the bad guy. So, unless they’re in complete understanding with one another, I do not bring them back to the OR.
Catherine Maley: Are you using computer imaging?
Philip Miller: I’ve been using computer imaging for 25 years.
Catherine Maley: I don’t know why it’s not used more often. A long time ago. I had a client that, he had this down and when he started doing computer imaging and he and his coordinator had a really nice process going, they probably triple well, plus he also gave her a facelift, the coordinator. So, she had a facelift and then they were using computer imaging.
He tripled his facial or his facelifts. It just became a thing. And I love computer imaging. I, I, it’s a great communication tool. You know, your little is not the same as my little, you know?
Philip Miller: That’s exactly right. This isn’t, you know what that right there is a classic example of someone who I know is going to be a problem.
They, tell me what it is that they want. I go ahead and I make the changes on the computer, and then they sort of ignore it and start, keep using words. And I look at them and I’m like, no, no, this is not a words business. This is not, this is not a look that’s legal. You can go to the legal department, you know, and the other, this is a visual process.
And if you don’t look at that picture and say, you like it, then I’ve got to change it. Or maybe that’s not what you want. Or maybe you don’t know, you know, another potential problem patient is the individual who knows what they don’t like, but doesn’t know what they want.
Catherine Maley: Good point.
Philip Miller: Okay. So, they’ll look at it and go and they ignore it and then they just start describing it or they pick up their pick their phone and they start showing you other ones.
It’s like, no, no, no, no, no. Don’t show me pictures of Angelina Jolie. Okay. That’s you. That’s what I can do. Do you like it or not? And if you don’t let me know why, and I can see I’ll see whether or not I can make a change and if they can’t do that, don’t talk to them.
Catherine Maley: For sure. Also, back to marketing, I almost forgot, what marketing channels are working the best. And now that I learned that you have these other locations. How are you handling that? Is that, do you have to have different websites, different on Instagram accounts? How are you going to handle it?
Philip Miller: Yeah, so, so we, we try to, we track every guy. Can I mention other vendors?
Catherine Maley: Well, yeah, sure. What the heck.
Philip Miller:] But we have systems, we have systems I’m trying to keep it plain, but we have systems so that we’re able to track, at least with both telephone calls and emails, where they came from.
So, every single marketing endeavor we have, whether it’s an Instagram account, whether it’s a Facebook, whether it’s an ad with, we don’t really do, but let’s say a sponsored something here or there. Whether it’s again, Instagram or okay. Whatever it is, we have a unique telephone number and we can attribute that phone call separately, to that individual.
And it’s sophisticated enough. That if you came in, let’s say on my website and you lost my telephone number and you pick up and you call me on Instagram, the system will not buy by going on Instagram, and Instagram, and getting my Instagram, the number that’s listed on my Instagram account will know that you are actually the same person and that you originally came to us from the original referral source.
Catherine Maley: Oh, nice. Nice.
Philip Miller: But, but more, you know, I don’t know if you found this, but that being said, the truth is what really is the reason why pay, what marketing source can you really assign a patient.
Catherine Maley: Word of mouth referrals.
Philip Miller: And I go, oh, how’d you find? And they’re like, oh, you’ve got the world’s best Instagram.
Right? Well, thank you very much, but that’s great. You’re like my before and after’s. Oh yeah. Yeah. I think they’re absolutely great. I mean, I never would have known about it had, you know, my doctor not told me about it, but they told me about it. And they said that you were really the best guy to go to. So, I went to your Instagram.
I go, what, which doctor was that? Oh, well, Dr. So-and-so because, cause well, my other, my other friend who you operated on, they told me to go to that doctor and you know, I really liked my friends’ results, which is, I guess my friend is the one who really told me about you. Okay. So, is it a friend referral, the doctor referral, or the Instagram account?
Catherine Maley: It’s the friend referral and it’s getting all clogged up now because they’re six zagging all over the place and everyone forgets the true cosmetic patient came typically from a girlfriend or somebody told them about you, typically.
Philip Miller: Right. If you, and that’s, what’s really interesting is every once in a while, and I asked all my, you know, I asked the doctors to do this.
Every once in a while, just ask a patient. So, how’d you hear about, but don’t take their first answer. Push a little further, and you will find that typically they needed three, four, five points of contact before they actually committed to coming in and saying, they heard your name from a doctor, they saw your ad on TV.
They ran into your Instagram. They saw your Facebook. They, they were friends with three people who had surgery value. Trust me, it’s, it’s usually more than one, which is why you need to have a comprehensive marketing initiative and what I call a digital representation. You need to have a really strong digital representation of your work. In all aspects of digital media.
Catherine Maley: Yup and on all platforms. So, I see you’re doing a pretty good job on YouTube. I hope. And I’m assuming, you’re repurposing all of that. So that’s the way to go. Nowadays, you develop some type of content, repurpose it on every platform you can think of, and that builds your digital footprint and then people are bound to run into you or hopefully, you know, more than not.
So, are you spending much time on marketing or is that outsourced or how does it, well, it takes you, you’re doing your own YouTubes and you’re doing an Instagram, so?
Philip Miller: Yeah. Well, I, you know, what’s interesting is it was, it was a lot easier a years ago when all you had to do is worry about SEO and make them pay someone else to do it.
Now that it’s all about content, you can’t outsource. You got to produce it. Now I can outsource the production. I can outsource the uploading and I can outsource a lot of other things, but the truth is you’re right, I gotta be the one who actually puts it together. And what’s even more awkward in some respects is now we are putting our patients, before it used to be, we were just, we were just asking, Hey, can we use your before and after? Now we have to interview them, now they have to be part of our marketing. And it is awkward. I mean, I ask every one of my patients in your mind that you’d like to do, would you like to an Instagram, do you want to do a podcast, do you want to do this? And I find it a little embarrassing, to be honest with you, that, that we’re at this point, I get it.
But it, I, I, I tell them all the time, if, if you ask me if I was in your team, I would say no. So don’t worry about it. If you say no, it’s fine.
Catherine Maley: Actually, that’s a great way to say it because that almost forces them to say, oh no, no, of course I will. But I got to tell you the social proof, you know amongst the, the target market you want, you know the patients talk it’s as good as word-of-mouth referral, you know?
So, for you asking, and frankly, it’s you asking that gives you such a good result from that. Trying to give that to your staff and say, staff, you ask them if they’ll do it, that’s almost even more awkward, you know? So, I’m glad you’re, I’m glad you have, you see that. And a lot of that…
Philip Miller: It took a long time. I gotta be honest with you, Catherine, it took me a long time but now I finally realized the value of it and really appreciated it.
And there were a lot of patients who want to share their story. And so, I give them that opportunity.
Catherine Maley: You can see it on Instagram. You have some pretty happy patients who are dying to tell their story. They’re very happy doing that. So. Kudos for you for doing that. So, let’s go down to mindset. What’s driving you.
I’d love to figure that out. I should, if I didn’t get an MBA, I would have gone to school for psychiatry or psychology, but I didn’t, I didn’t want to go that crazy. But what, what makes you do what you’re doing and growing your empire? Cause I’m hearing that you’re not satisfied with one. You want more, more, more, we all want more, but you’re going for it.
What’s driving that.
Philip Miller: I wouldn’t say I want more, more and more. I would say that I don’t want the alternative.
Catherine Maley: Which is?
Philip Miller: Complacency. That, that’s not exciting. I remember I was hiking one day in the woods. And I was having a conversation with myself and asking myself, okay, so what’s our all about, you know, I mean, am I supposed to like make enough money so that I can retire? And what would I do if I retired? By retire. I mean, I guess people go play golf.
Well, if I had a choice. If someone said here’s what you can do, you can wake up in the morning and you can spend a day in the operating room, or you can spend a day on the golf course. I would choose a day in the operating room any day. Right? I mean, I really enjoy what I do. And so, for me, it’s about avoiding the mundane and appreciating on a daily basis, how fortunate and lucky we are to do what we do, to change people’s lives, to change, to use our skillset and use our hands.
Ever since I was a kid, I love to fix things and here I get to do it as an adult and change someone’s life. And that’s such an unbelievably rewarding and satisfying experience that I don’t understand why you would ever want to give that up.
Catherine Maley: What about when you’re in your mid-seventies and you’d like, do you have an exit strategy? Because eventually not that, I can’t imagine retiring. I’m not that I, not that type of personality. I wouldn’t mind not grinding all the time. Like I do feel like I’m trying to constantly, but I would like to have other interests, you know.
Philip Miller: As you know, I love technology. I am sort of building on the side, I’m building a technology company.
Catherine Maley: Okay. Tell us what that is. I forgot about that. Cause I was on your website and I saw it and I thought, oh, that’s interesting. Now, you know what I liked about yours? It was very authentic. The chatbot is always pretend that there’s somebody there like, oh, this is Betty.
How can I help you? And yours actually says, what is your say? It’s like, oh, I am the AI. You know, like.
Philip Miller: Hey, I’m Dr. Miller’s artificial intelligence chat bot.
Catherine Maley: I like that. And I can answer some of your questions or most of them, hopefully, you know, like it was really authentic. I like that.
Philip Miller: Right. And, and cause what that emanated from was I was at a technology conference one day and I sort of was looking at, it was a conversation it was a discussion about artificial intelligence and they had within the context of customer service and all of a sudden, it just, it was like bing like, you know what? Hey, frequently asked questions. Patients are always asking the same thing. These conversations are all so scripted. This is perfect for a chat bot and that’s it.
I basically, after that went out and built what, what I, what is the only aesthetic industry chat bot that is out there right now. And it works exceptionally well. We get over 80%, 80% of the people who interact with the bot, give us their name and their contact information, and often what procedure they’re interested in as well.
And we are, are met, we’re constantly metric based. So, we’re constantly evaluating whether or not the bot is giving what responses that are appropriate or not, and tweaking it constantly. We found out for example, and trying to get this information out to our customers, we have around 10 clients right now who are using the bot.
And you may find this as well. A lot of offices are reluctant to put on their website, the cost of their procedure.
Catherine Maley: Right. I say, at least say starting at or ranging from, because in today’s world, you cannot skirt around that question.
Philip Miller: Correct. Now, if you call an office, every single office has a script that they tell the person, this is how I want to get it near to the question about price, right?
So, it’s somehow okay to give that information when there’s a back-and-forth exchange, but not have it be printed on your website. And I get it. But what we did is we took that exchange that went on the telephone and we put it into the chat.
Catherine Maley: Nice.
Philip Miller: And when we saw that under procedures, where we allowed results in the same kind of sequence in the chat bot that we were doing on the telephone.
I had a much higher conversion than when we basically said the typical, every case is different. You’d have to come in and we’d have to give you an evaluation routinely. When patients got that result, they just stopped engaging with a bot. When they were given a range in the manner in which was no different than what people said on the telephone,
it was continued.
Catherine Maley: That’s what we want to transparency. And we want to frame, or we want a straight answer and it doesn’t have to be the perfect answer. But an okay answer is better than that, “I can’t tell you; you know, we don’t give out pricing”. People are just not gonna tolerate that in today’s world, so good for you.
Good for you. Okay. So back to mindset, is there any, how are you getting to be like this? Are you a, a reader you know, leaders are readers and what’s that other saying, readers are leaders and something else? But anyway, are there certain books that you like reading, or courses, or how are you staying up to date?
Philip Miller: I’m a, I’m a disciple of the strategic coach. I dunno. I think you may have heard that. Yep. I know all of you guys are in there. Yeah. Good for you. It started with Peter Adamson and Peter Adams and ultimately got Vito Portillo and me in it. And I got Russ Kridel involved. I’m not quite sure how many others now, but …
Catherine Maley: The funny part about that while you guys were doing that, I do like internet marketing conferences.
So, I knew Dan Sullivan from the internet marketing conferences. Of course. Yeah. So, I know all those guys and then it’s so funny because Dan Sullivan says in one of the talks, so I worked with some plastic surgeons and I walked up to him. I said, oh, I work with a plastic surgeon. And he names off all you guys.
And it’s like, oh my God, what a small world.
Philip Miller: You know, Joe Polish. Oh, who else? They have that podcast, I love marketing.
Catherine Maley: Genius Network. Yes, I, I did a mastermind with him big guy. Oh my God. I met.
Philip Miller: Dean Jackson. Yes. I love Dean. It’s so funny because we’ll be in the coach and, and we’ll be having this lively discussion, you know, thoughts here and there.
And then all of a sudden there’ll be this pause and Dan will go, okay, Dean, give us your insight. And like in 15 words, Dean just summarizes it perfectly and hands it to everyone on a silver platter. He’s just has that great insight mind you really do.
Catherine Maley: He doesn’t talk a lot, but when he talks its genius.
Philip Miller: Yup. Yeah. I really, I really like both of those guys. Yeah. Joe actually is on a I think, Joe’s on a digital hiatus for a while. He just dropped off the whole digital network for them.
Catherine Maley: Oh, I’m also you know being more stringent with my time because that’s a rabbit hole that never ends, you know, you’ll follow one guy and then they introduce you to the other guy and had the guy in the other guy.
And then I get all tweaked out going, oh my God, these guys never sleep. I can’t live up to that. I just can’t do it anymore. And I’m not the hustler that they all are. And they’re all making billions. And it’s like, oh, some days I think, why am I comparing myself to them? This is ridiculous.
Philip Miller: I fall into that, you know, I’ll give you a Dan Sullivan-ism , which I think is really great. And Dan, Dan Sullivan concept is called The Gap.
Catherine Maley: Yes!
Philip Miller: Have you heard of that expression?
Catherine Maley: I have the book. Yes. Gosh, darn it. That little, little book. He has The Gap and it’s so true. Yeah. If anyone’s an alcoholic or has an addiction, The Gap is the answer for why you have that and how to stop it.
Philip Miller: Yeah. Yeah. And for the listeners, The Gap, is The Gap is, is best described as the distance between your ex, your current situation, your current position, your current achievements, and what your goal were, as opposed to your current position, your current situation and where you were. So, a more, a better analogy would be someone who’s constantly comparing their progress, not by stopping and looking over their shoulder and seeing how far they’ve gone from shore and how they can’t even see the shore anymore.
Cause they’ve gone so far, but they just keep comparing it to the horizon in front of them, which is unattainable and just getting constantly upset and depressed because you’re just, you’re never there. So, you measure your success and your achievements by where you as an individual have come from, not necessarily from what you haven’t achieved, moving forward as motivation.
Catherine Maley: Yep.
Philip Miller: But don’t judge yourself.
Catherine Maley: And don’t discount how far you’ve come. We never go. We never focus on how far we’ve come. We always keep going out there, out there. When do I get there? Like way over there. And that helped me a lot, wow.
Philip Miller: And I’ll tell you something and to be, and I’ll share this with you and, you know, you know, I I’m, I’m very, I’m very proud of my success.
I’m very proud of my achievements. But I can look at a lot of other guys and go, wow, they killed it, they nailed it. You know? And it’s sort of like a professional quarterback player. Can the NFL, not everybody is Tom Brady. Not everybody is going to be a Dan Marino. Not everybody is going to be, you know, but they’re still playing in the NFL.
They’re still, and that’s sort of how I think you have to look at it. Don’t judge yourself. There’s always going to be someone who you can find who’s better than you, and that’s fine. Respect it. That’s great. But acknowledge how well you’ve achieved and the success that you’ve learned.
Catherine Maley: Wow. And with that, I think we’re going to wrap it up because those were giant pearls there. I hope everyone was catching them. You got a little psychology today, also with your business and your marketing.
So, Dr. Miller, how can anybody reach out to you if they so choose to.
Philip Miller: Oh sure. If I’d be delighted to speak with anybody? My… probably the best way is through my assistant, and, but you can still reach me.
It’s Dr. Miller. That’s [email protected], D R P H I L I P M I L L E R.com. So, Dr Miller at Dr Philip Miller dot com.
Catherine Maley: Thank you so much for your time. I really appreciate it. And I, it looks like I’ll see you in Florida in November.
Philip Miller: I will see you in Florida. It was great speaking with you. It really was.
Catherine Maley: Thank you. All right, everybody. That’ll wrap it for us this time, this episode. And hopefully you enjoyed it. If you did, please head over to iTunes and subscribe to Beauty and the Biz feel free to leave a review if you feel so inclined. And then if you want to get ahold of me with your feedback or questions, just head over to my website, CatherineMaley.com or certainly DM me on Instagram at CatherineMaleyMBA.
Thanks so much. And we’ll talk again soon.
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