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Ep.45: Surviving the Chaos of COVID-19 with Francisco Canales, MD

Surviving the Chaos of COVID-19 with Francisco Canales, MD

Co-founder of a Black Diamond Top-200 Med Spa, Dr. Francisco Canales, MD, lends insight on practice survival during crises through his unique perspective of weathering 3 practice closures in 3 years due to disasters, and now, COVID-19.

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Beauty and the Biz

Ep.45: Surviving the Chaos of COVID-19 with Francisco Canales, MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz where we talk about the marketing and business side of plastic surgery practices. I’m your host, Catherine Maley, author of Your Aesthetic Practice: What Your Patients Are Saying, as well as consultants for plastic surgeons to get them more patients and more profits. And today’s episode is timely, and it’s entitled Surviving the Chaos of Covid-19. And I have a special guest who I’ve known for several years, and I highly respect that. And when you hear his story, you’ll see why. So, it’s Dr. Francisco Canales. And he’s a board-certified plastic surgeon who was educated and trained at the top Harvard and Stanford schools. And he runs a beautiful practice called plastic surgery associates and Allegro mitzvoth. Now, he runs this practice with his wife, Dr. Heather Furnas, who’s also a board-certified plastic surgeon. And they’re both members of ASAPS as well as the California Society of Plastic Surgeons. Now, his practice is lovely. I’ve been there several times. It includes a state-of-the-art surgical facility that’s accredited and classy certified, and it’s got two operating rooms and a three-bed post anesthesia care unit and on-site recovery room for procedure rooms, a dedicated school CoolSculpting room as well as a med spa. Now they employ many staff that includes the surgical staff, of course, as well as the Med Spa, nurse injectors, nurse assistants, estheticians, laser texts, and so on. Now, this is the crazy part. Dr. Canales his practice is in Northern California, which is in the wine country, specifically in Santa Rosa, California. Now you may recall hearing about the Santa Rosa wildfires that destroyed 34,000 acres of land and destroyed more than 2800 homes, one of which was Dr. Canales. No, the fires happened in 2017. And then again, like in 20 1819. So needless to say, with the fires, and don’t forget, he also went through two recessions and now COVID-19 center. Canales has been through a lot, and he’s still standing. So, I wanted to talk to him now about how you survive and thrive in times of crisis. So welcome to beauty in a bid packet analysis.

Fransisco Canales, MD: Thank you, Catherine. Thank you for having me. And I guess I am a member of a very unique club of people who’ve had three practice closures in three years. So I guess I will be talking about my experience and COVID-19 is a very different pandemic and different closure than the wildfires were. And I’ll preface any comments today by saying that anything I say will likely be out of date by the time the podcast is over. The news is changing constantly. It changes hour by hour. In our area, which is just north of where you are in Marin County. We did have a Santa Rosa Police Department detective die from Coronavirus a few days ago, so really hit home for many people that one of our first responders not only contracted COVID-19, but went on to die. It also shed light on the shortage of protective gear for healthcare workers and other first responders. So, going back to mid-March, which now seems like 100 years ago, many of you may or may not know San Francisco and the surrounding six counties went into a shelter in place on March 17. And at the time, that seemed like a very bold move. And it seemed extreme to say that we would be sheltering in place until April 7. But as soon became the standard, in retrospect, why didn’t we do it earlier, we have decided as Dr. Furnas and I, my wife and I to close our own practice that very same data, San Francisco announced it and then the next day, Sonoma County where we live followed and shut down on March 18. The schools have been closed since then, and will remain close to the summer. So that shelter in place was the right thing to do. And it did save many lives. And we will never know how many lives it saved.

Catherine Maley, MBA: Well, I’ll tell you when this all first happened, because I’m in Sausalito and I actually don’t watch the news. I think it’s really bad for my mental health. And I haven’t watched it for Gosh, since I started my own business 20 years ago, I just knew I needed to stay in a positive state of mind to run a business. You know, you need everything you have. And I just thought the news was so sweet. And I didn’t trust it much. And I didn’t need all that negativity. But once again, though, I just thought they were crying with me it does. They pull it out of proportion. And I just thought, Oh, here we go again. This is so silly. And then when we had to go under shelter in place, I thought, are you kidding me? Like I just thought we were completely overreacting. And I’m sure a lot of people felt that way. And that’s why I think it was so slow to now get it Oh my god. I’ve been at home now for a month and I know I’m almost I’m not paranoid but I’m definitely understanding that we can’t stop this spread. We don’t get away from each other. So that is really make sense. I did not hear about that week. Officer What? If this is so insane? Isn’t it the craziest thing that ever happened? Holy cow. So, what’s your situation up there? Now? You guys are in shelter in place. Are they saying how long this is going to happen?

Fransisco Canales, MD: Well, as you know that initial shelter in place was supposed to end on April 7, that initial directive to stay until April 7 seemed ridiculous, like you said, and it seemed like so far in the future. But here we are. Clearly, that did not happen. And now we’ve been asked to stay close through May 3, hoping that may 4 is the date that we reopen. But that date itself is tentative, and we may need to push it out further, depending on the progress we make over the next couple of weeks. But we’ve been doing at least in Northern California, good job of social distancing. So, we managed to flatten the curve and save lives. But as you flatten the curve, the peak of the cases, and the peak of the use of your resources gets pushed out a little bit into the future. But regardless, our peak is going to be lower than it would have been otherwise. I think even a day or two or three is the case with New York, in adopting shelter in place makes a huge difference. And California seems to be doing extremely well.

Catherine Maley, MBA: 

Yeah, I saw your Instagram you gave some of your PCP supplies up or whatever that’s called on Congratulations, have is good. Have you manually California some of the surgeons were worried that the government was going to come over and take their surgical equipment? You know, did any of that happen?

Fransisco Canales, MD: No, it has not happened yet. And we obviously have an anesthesia machine which can be converted to a ventilator. We were proactive and just went to the local donation, places like the Salvation Army were collecting PPS and other surgical gowns and surgical masks for the hospitals when we dropped off a shipment early on in the campaign. Because there’s a shortage everywhere in the county, because we only have right now 20 people hospitalized in the county, we’re doing better than other places. But the Salvation Army can direct the supplies to where they’re needed the most. But the anesthesia machine is something that remains as a possibility. And clearly, we’re not using it right now. So, if somebody needs to, they could have it

Catherine Maley, MBA: I didn’t watch the little YouTube like the updates, because I do need to stay informed. And I did hear California sent something like 5000 URL ventilators over to New York. So maybe, maybe we’re on the upside now. You know, who knows? Maybe VR? So how different does this feel? And how different does COVID-19 feel to you versus the fires? The fires were very local, and this is very global. But what’s the difference for you?

Fransisco Canales, MD: Well, the wildfires were very personal and very devastating. But you’re right, they were local to California, mostly Northern California for us. And also, there was no wildfires in Southern California. But you know, we lost our home in the Tubbs, fire 2017. It doesn’t get more personal than that. And that was devastating. But what we knew is once a fire was over, it had a very clear, beginning at clear and in once the physical threat of the fire was over. And patients felt more comfortable and slowly started to return. The cost to our community for the 2017 wildfire was around $1.3 billion. The pandemic is totally different. There’s no clear end in sight. And even when we’re past the peak, we will have to live with it for many months into the future. And the economic impact is global, not just reasonable to California. And it’s not yet known, but I venture to guess it’ll be far greater than either of the wildfires for us locally, and I can’t even comprehend what it will do across the United States. The other thing is that the injury to the psyche of the American people is also not to be underestimated. There are many businesses which will not survive. Some people have estimated that 20 to 25% of med spas will go under during this time, and many Aesthetic Surgery practices may suffer for a long time, depending on unemployment and what the public decides to do with the money once they return.

Catherine Maley, MBA: Isn’t that the truth? That’s the part I’m not clear about. Even if we all go back, is there still going to be enough discretionary income to keep the plastic surgeons busy, let alone med spas, you know, so then I just think are the plastic surgeons going to go back to doing their own injectables or running their own lasers? Do you have any feel for that as–?

Fransisco Canales, MD: Well, we also– the lipstick effect happens. And if you remember the lipstick effect back in the world war two era, even when people have very little money, it turns out that women were going out and buying cosmetics and lipstick because it helped with their confidence and their self-esteem. And so, they were prioritizing some of those things even over household goods. We could hope that this happens, it may not happen. And certainly, our practice model has been one of physician extenders we have two nurse practitioners to pa as an RN injector to estheticians and it could be that we cannot hire the same level or the same number of mid-level practice extenders and we go back to doing injectables like we did 12 or 15 years ago when Botox was first around and fillers were first around, we were doing our own injections until the volume became such that we just couldn’t do it anymore. And Have a surgical practice. So, the way we run it up until the last month is to do our surgery, Dr Furnas and I do our surgery and then our mid-levels do all the injectables, and we do a ton of Botox and fillers. And our Med Spa is a black diamond top 200 med spa in the country. So, there is a volume there. The question is, will it return? Will it be half of what it was? Well, it will be three quarters, will it be one quarter? We don’t really have a way of predicting that.

Catherine Maley, MBA: For sure. One thing I know about cosmetic patients, if they had wanted surgery, and now they can’t or they don’t psychologically feel it anymore, they’ll downgrade to injectable. But will the injectables that they put? Or will they downgrade to facial or just buy the lipstick? You know, we just don’t know. And that will be interesting to watch. Because the longer this goes on the more uncertainty builds or recessions. I think one of the recessions, the latest one we had 2007 and eight, you know what I think happened? Everyone got sick and tired of being sick and tired. Like, I think they just weren’t done with, you know, being scared about it. I think everyone just kind of went back to life again, somehow. And do you think it could happen here? Or do you think this will linger for a while?

Fransisco Canales, MD: I think it may linger for a short period of time. But I think that you’re right, I think when patients decide to come back, they will probably just tiptoe their way back. Right now, a lot of people are unemployed. So, when they go back to work, the last thing they want to do is take time off from work to have surgery. But they can still have Botox, HydraFacial, mini peels, all the stuff that makes people feel better, but doesn’t cost as much as certainly does not require them to have any time off from work. Because work is going to be very important to everybody once we get back into the thick of things.

Catherine Maley, MBA: So, talking about work, what is your plan, with the government helping thank God all businesses that are you taking advantage of them payroll protection plan?

Fransisco Canales, MD: We sure are. And you know, one of the hardest decisions that we had to make was to lay off some of our employees and you know, we have 23 employees, and we laid off temporarily or furloughed 21 out of those 23. As we’re 100% aesthetic practice with a med spa, not the cosmetic surgery side. So, we immediately became a practice with zero income. And one thing that we learned from the previous closures due to the wildfires was that conserving our existing cash within the practice was vital for the long-term survival of the practice. So, we just kept to high level employees, one for the med spa and one for the surgery practice and they work remotely only one of the employees is here every day, to receive mail from deliveries and to ship out skincare products that patients are still renewing. But yes, we are taking advantage of that a PPP plan. We have three corporations, our Med Spa, our surgical suite, as well as our plastic surgery practice. And we are applying a separate corporation to the paycheck protection plan. And we’ve submitted the applications and we’re just on a waiting game right now to see when that will happen.

Catherine Maley, MBA: Right. I know a lot of surgeons are have been like on the phone with the banks all day trying to get it through. And I nobody I know has gotten money yet. But it’s in the process. And I hope it’s as fast as they say, you know, I don’t know.

Fransisco Canales, MD: Yeah, initially, the plan or the idea was to have a short application. And everybody talks about a one-page application, all you need is your payroll number and your employment or employer identification number you Ei n or ti n. And that turned out to be a one-page application with like 100 pages of documentation and you need every form of form 941 form 940 your payroll report your trailing 12 month p&l your driver’s license, you know it goes on and on and on. And before they open the PPP program. Last Friday, I spent a week with our accountant, just making sure that we had every report possible. And we’re lucky that we have the resources to be able to have all that reporting done and ready to go because I know a lot of small businesses don’t have those resources, and they don’t have payroll reports and trailing p&l and everything else. You know, I just think about my Korean speaking dry cleaner. He barely speaks English. So, I worry about somebody like that it’s gonna fall through the cracks and not even know about the program form. When they apply. They will face so many obstacles that they either give up or don’t qualify.

Catherine Maley, MBA: Right. That is for sure. So, are you planning– so you furlough people? And then I’m assuming you call the banks, or you’re like Amex was giving 60 day defer. I assume you call all your vendors and did that go well?

Fransisco Canales, MD: That went very well. And I called– initially not knowing what to expect. I called American Express and they said, Oh yeah, no problem. We’ll give you 60 days and I thought wow, that was pretty easy. So, then I call our MasterCard and we do pretty much everything through credit cards. In our practice. We put all of our Botox on there we go. That’s over a million dollars a year we put all of our breast implants on our credit cards. So, by getting the credit cards to immediately agree to a 60-to-90-day deferral, it took a lot of pressure off of us. We then went on to ask vendors, whether it was our surgical supply vendors or our breast implant vendors. And frankly, most people have been very understanding and have been able to say, Sure, we will defer for 60 days or defer for 90 days, we also have a local bank that we’ve been with for 25 years. So, I call them and ask for a deferral on all the laser machines that we have with them. So, we have, I think, six different loans with them, and they were able to give us a 90-day deferral on all those loans. So that immediately took some pressure, you know, obviously, this is not forgiven money, but it’s at least deferred money until we can get back on our feet.

Catherine Maley, MBA: Right. I you know, I think that is the secret to have a relationship with your local bank who can help you with this and have good relationships with your vendors. You’re doing all the right things. What else can you do? Um, so are you have you decided to do virtual cosmetic surgery consultations? Or where are you at with that?

Fransisco Canales, MD: Yes, we are doing them. And actually, we’ve been doing virtual consults for about 12 years. The difference is that 10 years ago, when we started or 12 years ago, we just had a static virtual consultation, it was a link on our website, and patients could submit a set of three photos a front side and an oblique of whatever body part they were interested in. And when they submit the photos, we would review them and then we would give them a call and do a phone consultation. Having used those photos Now the difference now is that we’re doing live online consultations. And I think that for the long term online virtual consultations are going to be with us long after the pandemic ends. Because it really simplifies a lot of things. We have a lot of patients who travel to three hours to see us, we’re the last sort of big practice in Northern California all the way to the Oregon border. So that it has always been a concern for people traveling for hours to come to our office. And then we could tell them, no, you’re not a good candidate. Whereas an online consultation allows you to do some evaluation ahead of time and allow them not to travel if they’re not a candidate. And also, if you’re out there right now, they are a lot of people who believe it or not, and they still have a job, they might be a firefighter or a police officer, they might work in an essential business, and there’s planning their vacation for September of this year. So, they’re talking about having surgery in June or July. So online consults give us the ability to catch those patients, while they’re still interested, have something on the books for June or July. So that when we actually are allowed to come back, we don’t have an empty schedule. And then we start from scratch. And one of the great things is that online consultations are benefiting from the platforms like zoom, we are using zoom right now. And so, there’s zoom, and there’s Obviously, we can do FaceTime. synplant has a new platform for telemedicine, and we’ve just started using a platform called Cloud. That’s Clara with a K that syncs with our patient management software, which is next deck. And it allows us to integrate the virtual consultation right into our practice management software. So that’s been great.

Catherine Maley, MBA: I didn’t know about that one, just call Clara. Okay, that’s good to know, are you searching for your virtual consult?

Fransisco Canales, MD: We are not charging for the virtual consult. So, I think at this point, that might receive a significant pushback. So [inaudible 18:04] consultation is free, we do have a lot of time right now. So, I’m willing to put in the time for free for my online consultation so that we can actually have something on the books for when we return. Yesterday, I did three online consultations. And two of them already too, but they were breast augmentations. A third one was interested in a facelift, but she has a wedding to go to in the middle of the summer. So, she’s going to downgrade to either fillers or thread less. But all three were very interested. So, if we weren’t doing online consultations, we will just be losing those patients to other people who are doing online consultations.

Catherine Maley, MBA: For sure, this past month, all of my intellectual property has been obviously, surrounded by COVID-19. And the only thing I’m telling surgeons to do is build your list, build your brand, build your list and offer free consults, this is not the time to look like a greedy capitalistic pig, you know, it’s the time to improve your brand by saying we care about you, we still want to take care of you. But we want to do it safely. I think virtual consults are going to become mainstream. Now. As a matter of fact, it’ll probably go the other way. And now patients are going to want it to virtual versus come in. And we down the road, I think we’ll have to put some boundaries around that. What I used to say to surgeons was I have some rules about it. For example, if you had to live, let’s say, an hour away before we would do a virtual, but now I think you’re going to have to address it, especially with the different generations and just people are busy, it would be so much more convenient, especially if you have to drive for a while and in traffic is horrendous up there. Sometimes, if you can do a virtual and then just show up at the right time for your surgery. Boy, the convenience of that I think is terrific. So, I’m glad you’re on board with that because I do believe that’s going to be our future, like it or not. So, are you doing any marketing right now? Or are you just sitting still or What’s your plan?

Fransisco Canales, MD: My short answer to that is no. We’re not doing any marketing right now. And I think you hit on something when you said build your brand. Well, there are other ways to build your brand and the optics right now are definitely not good at You’re marketing cosmetic services during a pandemic, when people are dying police officers and hospital workers are dying. And nothing is more insensitive than seeing somebody talk their breast dog or bbl on Instagram right now. And I still see it today. Even today, I saw some Instagram posts, saying how wonderful somebody’s Tummy Tuck is, etc. And I just does not come off well, and I think people will turn off. So, you know, for us, we’re not we turned off all of our social media as we turned off, even our Google Ads AdWords. So, in my opinion, it there’s a time for everything. And today is not the time to be marketing, our cosmetic services. But we are using the time to build content for a website to go on and put on additional before and afters. I’m writing some blogs and our daughter happened to come home from New York. So, she’s going to help do some videos at home and we have it all set up. So, there is a way to build your brand is still somewhat market by building the content that you put out.

Catherine Maley, MBA: For sure. The only thing I would recommend is if you can’t help yourself, and you want to advertise, only advertise free Virtual consults, and nothing else. The whole point right now is while we’re living in such uncertainty, just follow what the patient has going on in their head already, which is uncertainty, I don’t know what to do, but I am sitting still. So, I am researching. So virtual consults, I love the idea of building your list of interesting cosmetic patients. And you’re just getting their name, cell phone, email, and you’re just educating and possibly entertaining. If your daughter’s home, I highly recommend you do some personality stuff. Like I don’t know if you’d like to cook, but you in the kitchen, there’s somebody on Instagram, this doctor in Florida, he’s doing a really good job of it, he apparently loves to cook, and he’s always in the kitchen. And he makes a really elaborate meals. But the point being, this is the perfect time for patients to get to know you on a different level. Because they’re not thinking about, you know, having surgery right the second but they are thinking about it, and who they’re thinking more about, who would I go to. And this is a perfect time to develop your virtual personality and your relationship with them. And then when we do start again, you’ve got a beautiful list of you know, prospective patients who you can follow up with, I should wouldn’t sit around right now and do nothing for one or two months, if that’s what it’s going to be, I’d be building that list a time because you won’t have the luxury of building it when we start again.

Fransisco Canales, MD: So I think along those lines, this is a very important time to communicate with patience and to communicate either through your social media, or through MailChimp or Constant Contact whatever newsletter or email service you have, because the patients want to hear from you, they you know, one they want to know when you open or reopen. And again, you don’t want to be marketing your services, but you want to be helpful. They want to open your email only if it’s helpful to them. So, what we tried to do is send an email to our list every three to five days with helpful information, you know, links that you can go to, for emergency information, links to free workouts that are online, links to free movies or free music, something that benefits them, keeps them engaged to your practice. But also, you’re providing a service as opposed to just basically saying, we will have a special when we return because people will just click buzz on that very quickly.

Catherine Maley, MBA: 

Oh, for sure. When you had the fires that had to have been devastating. Does this feel any better? One thing I’m thinking is that I am not devastated only and I think the only reason is because we’re all in the same boat. It’s not like tragedy just hit my little life. It hit the whole world. So, I do feel like there’s comfort in numbers. And I don’t want that skewed. It’s probably skewed. But it’s my survival mechanism right now. So, do you feel any differently about this one? Or do you still have the same fears that you had, you know, different fires?

Fransisco Canales, MD: I think that that this is a longer run. So, I think this is a little bit more like a marathon, the fire was more like a 400-meter sprint, if you will, there are certain things that we cannot control. And when we had the fires, even within two weeks or so, our gym reopened, the pool had survived. So, we were able to use those resources right now we can go to the gym, we can’t use a pool. And so, it’s really affecting us on a personal level in a different way than the wildfires did. And because the wildfires were regional, I could count on a patient from reading that’s three and a half hours away, or Fort Bragg that’s three hours away, or even from the East Bay that was not affected by the wildfires to come to my office and just act like nothing had happened even if they drove through the wildfire zone where homes were lost. However, today that patient from reading from Fort Bragg from the East Bay is also affected by the pandemic. So, they’re not going to be in any way shape or form ready to have surgery with us. So, I think the impact will be felt much more widely for every single practice in the wildfires did to us.

Catherine Maley, MBA: For sure. Just out of curiosity. I can’t imagine how devastating that would have been. I only know we know that one other surgeon at Williams. He also had a hospital. At one time, it was just a real random thing because a 6000 square foot home went down in 45 minutes. And it was shocking. And he survived it. He learned a lot from it, I actually learned that he had a very nice Practice set up that could live without him. And during that time, because he needed to reprove at home, and he would, and he did prefer to be his house versus his business. You know, all that’s a terrible choice. But do you feel that way as well? And did you rebuild?

Fransisco Canales, MD: Well, we haven’t rebuilt. And that’s a very complicated issue, we are living in a much smaller house that we found. And it’s a small house that fell out of escrow about three months after the fires. And there are many complicating issues with insurance and lawyers and whatnot. So, we haven’t rebuilt and I think only about 20 to 25% of people in Sonoma County have rebuilt their house, and they’ve been lots of obstacles. So, we were happy to just sit on the sidelines. And I always thought that our life was complicated, and I was happy not to be rebuilding, well now even got more complicated. So, I’m very happy that we’re not rebuilding. The opposite side of all this is that we have a ton of free time now. And it is very strange to have all this free time I tell you, it’s so easy to get caught up on the 24 seven TV news cycle and get negative, whether you watch CNN or Fox or and the clips keeps being repeated over and over. So I’m just trying to control the things that I can. On a personal note, I try to exercise I’m trying to walk six to eight miles a day, trying to be mindful of allowing a little time for relaxation, catching some movies, spending time with a family. And you know, many people know I swim four or five times per week. So that part’s been really hard because all the community pools in our local Athletic Club pool have been closed. So just trying to walk I can’t run my knees can’t take it. So that’s what I’m doing on the personal side. And obviously for the practice, this PPP loan has been taken up our time 24 seven for the last week or so. But I think they’ll hopefully be progress soon.

Catherine Maley, MBA: By the way it works you like a professional swimmer at one time?

Fransisco Canales, MD: Well, back in the day, yes, I was not a professional swimmer. Because that category did not exist today. You can be a professional swimmer. You can be sponsored by Speedo or any other brands that are out there. But yeah, I swim internationally for Puerto Rico and I swim at Harvard. So yeah, and I swim with masters. Swim clubs right now.

Catherine Maley, MBA: Congratulations. And then you said the kids are home to get up. I mean, they’re in college. One of them went to Stanford, is he following in your footsteps.

Fransisco Canales, MD: You don’t have any doctors in the family, our son did go to Stanford, he lives in San Francisco, and he and two Stanford friends, co-founded an artificial intelligence predictive logistics firm. The good news is that they have now grown from three founders to about 45 employees. But all of them can work remotely. And so, they’ve been impacted not as much as the physical presence that all doctors need. Our daughter graduated from Harvard a couple years ago. She’s in a graduate program at Columbia. So, she was able to get out of New York, right when this whole thing started. And she felt them having been in New York and having traveled through three different major airports, that when she landed in Sonoma County, she wanted to self-isolate. So, she self-isolated for two weeks at a local hotel. And she’s great, and she’s fine. And she finally came home about four or five days ago. So, we’re lucky that both kids are out here. And we check in with our son by FaceTime every couple of days.

Catherine Maley, MBA: Now that while he’s in the right business AI is wow, that’s, that’s hot. Oh, good for him. Um, okay. Well, I think that about does it for us on any other suggestions to help other surgeons survive and thrive and how to keep your sanity through this chaos?

Fransisco Canales, MD: I think again, trying to be positive is hard in these times. But like the wildfires, this will end and you hear Dr. Fauci say this will end. The question is how strong will we be when we come out on the other side, from a business standpoint, for other surgeons, this is a great time to completely reset your business. This is a great time to do a SWOT analysis. And most people know. SWOT stands for strengths, weaknesses, opportunities and threats. And this is a time you can evaluate where your leads coming from, where do you want to put some future marketing money into, it’s a great time for doing in house training, either via zoom or one of these telemedicine platforms. Because there’s a lot of free information out there that your staff can look at. And you know, take advantage of conserving cash, cash is king. And this is a great situation. I mean, this is a classic cash is king situation. So, you know, all we need to do is stay afloat until the rescue ship comes by, and then then we should be okay. And there’ll be a return to electrosurgery. But we will not know exactly how strong that demand will be. We know that the demand can be pent up and maybe we’ll be busier than we ever were. So that’s what I hope for the future and I hope everybody else comes out of this strong and successfully.

Catherine Maley, MBA: Well, I know Americans for sure we– A lot of us have that entrepreneurial spirit and right now is a crunchy time because of the uncertainty. But we’re not we’ll make it we’ll get through and it’ll make us stronger always does. I know where you I don’t know if you were here for the San Francisco earthquake, but I was in the middle of all that. And I remember at the time thinking that, it felt like the whole world had stopped and falling apart because I was right in the middle of it. But it was just it was on San Francisco. It wasn’t global. But then it passes. You know, we all we always there’s an opportunity and every challenge, and we just have to get through it. Like don’t, we can’t stop in the middle of it, we just have to get through it. So anyway, that is that. So, I really appreciate you being on beauty in the biz. And I’d love for everybody to subscribe so you don’t miss out on any more topics coming up. And then if you give me a review, that would be terrific on iTunes. I’d love that. If you want to share this with your colleagues and staff. I think it would be helpful to them if you’ve got any comments or feedback for Dr. Canales Oh, by the way, Dr. Canales, where can they learn more about you?

Fransisco Canales, MD: I’m happy to answer any questions via either email or tax. Our website has a contact us button and you just Google my name. And our website is called and I’m happy to answer any questions or provide any resources if anybody would like.

Catherine Maley, MBA: Okay, that’s a good idea. His website is and you can leave him a message there. And same thing with my website is You can always leave me a message there or you can DM me on Instagram at catherinemaleymba. Thank you so much everyone, hang in there and stay healthy.

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 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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