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Ep.86: Robert Singer, MD – Former President of The Aesthetic Society


Beauty and the Biz Podcast with Robert Singer, MD FACS:

World-renowned former president of The Aesthetic Society.

Member of several international, national and state medical societies.

One of only 8 plastic surgeons who’ve been awarded the coveted ASERF Career Achievement Award

Has received awards and honors too numerous to mention.

https://www.RSingerMD.com/

FREE! The choices your patients make…Explained!

FREE! 30-Minute Strategy Session with Catherine!

Welcome to Beauty and the Biz.

Where we talk about the business and marketing side of plastic surgery.

I’m your host Catherine Maley, author of Your Aesthetic Practice – What Your Patients Are Saying, and consultant to plastic surgeons to get them more patients and profits.

Today’s distinguished guest is Dr. ROBERT SINGER

He’s a world-renowned board-certified plastic surgeon in private practice at his La Jolla, CA Surgical Center in San Diego County. He’s been in practice for more than 40 years.

Dr. Singer is the former president and chair of the board of trustees of The Aesthetic Society and is a member of several international, national and state medical societies.

Dr. Singer is just one of 8 plastic surgeons who have been awarded the ASERF Career Achievement Award – One of the most prestigious awards in the field of plastic surgery.

He’s also received many awards and honors too numerous to mention.

He appears regularly on radio and television programs such as Larry King Live, and is seen often in national and international magazines.

Dr. Singer is a sought-after speaker who lectures around the world and has also authored many scientific publications on reconstructive and aesthetic plastic surgery.

Dr. Singer it is an honor to have you as a guest on Beauty and the Biz. Welcome!

Transcript:

Beauty and the Biz

Episode 86: Robert Singer MD – Former President The Aesthetic Society

Catherine Maley, MBA:

Hello, and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery. I’m your host, Catherine Maley, author of Your Aesthetic Practice: What Are Your Patients Are Saying, and a consultant to plastic surgeons to get them more patients and more profits. Today’s distinguished guest is Dr. Robert Singer. I’m thrilled to have him. He’s a world-renowned board-certified plastic surgeon in private practice with his surgical center in La Jolla, California. And if you don’t know where that is, it’s in San Diego and it is gorgeous there. So that’s where he is practiced for over 40 years.

Dr. Singer is the former president and chair of the Board Of Trustees For The Aesthetic Society, he’s a member of several international, national, and state medical societies. Dr. Singer is one of eight plastic surgeons who had been awarded the Asers Career Achievement Award, which’s the most prestigious award we have in plastic surgery. He’s also received many awards and honors, too many to mention. He appears regularly on radio and television programs, such as Larry King Live, and he’s seen often in national and international magazines. Dr. Singer is also a sought-after speaker of lectures around the world and authored many scientific publications on reconstructive and Aesthetic Plastic Surgery. Dr. Singer, it is an honor to have you as a guest here on Beauty and the Biz, welcome.

Robert Singer, MD:

Thank you. Thank you for having me. I hope I live up to that introduction.

Catherine Maley, MBA:

So I have to ask right away. How did you end up as a plastic surgeon in the most gorgeous part of our country?

Robert Singer, MD:

Well, there are two parts to that. How did I end up as a plastic surgeon? I grew up well, I never grew up, but I got older in Buffalo, New York. Then I went from there to do my surgical training in Palo Alto at Stanford. I originally wanted to become a cardiologist. My dad had a massive heart attack when I was younger. His cardiologist befriended me as a mentor, and as I went to medical school, I realized I had more of a surgical personality. So I went to Stanford to become a neurosurgeon. I had no exposure to plastic surgery until I was there. After having exposure, I realized that was a better fit for me. I like the idea that you need to know basic information about anatomy, tissue, wound healing, but it was also a little more creative, not as much dogma as neurosurgery or cardiac surgery. For me, it was the right fit. I got drafted out of my residency.

They had a special physician draft during Vietnam and I spent some time running the emergency room at Balboa Naval Hospital here in San Diego and spent some time in Vietnam. When I finished, I wanted to finish my general surgery training, and I did that in Santa Barbara. Then I looked at options and I was fortunate enough to do my plastic surgery training and Vanderbilt Nashville, whichever help Station Program, tremendous clinical material. I looked at academia and I had some offers. But the best advice I got was from someone who was running a program at UCLA said, Give me an academic position here, but don’t follow what your mentors want you to do or your chief, follow what you want to do in your heart. That was a combination of reconstructive and cosmetic. In private practice, it was the best information given to me because it turned out to be the right fit for me. I had spent some time in San Diego La Jolla as a kid when I came out, visited my relatives who lived in LA, and I used to come down with my cousins and serve here, it’s a spectacular community.

It looks like a sleepy retirement community used to be said, Jolla was a place where retired couples went to visit their parents. But it’s a dynamic place. It’s a biotech center, one of the biotech centers of the world. And it’s a great place to travel from and always come back to. For me, it worked out well. I’ve been involved in plastic surgical organizations and education in educating the public since then. And although I was in private practice for many years, and not joined an MSO group, its number of practices, physicians will number spas. We’ll be looking at additional practices with the idea that aggregation of practices in today’s world of business climate and everything else is the teacher.

Catherine Maley, MBA:

How interesting? Let’s talk about that. One question I always ask the doctors is, how do you get into this industry? 40 years ago, you came in through the hospitals or your reconstructive work, but when you’re cosmetic, hit the ground running? Do you open a solo practice? Do you join somebody else’s practice? Where do you think basketball going?

Robert Singer, MD:  

Those are interesting questions everybody has to look at. I was fortunate because I had a great background in reconstruction. When I came to San Diego, I ran to 13 different emergency rooms. He couldn’t do that today because of the traffic. That helped me build up a clientele of patients by offering good service, not cutting corners, and primarily emphasizing safety. That eventually built up an elective practice, where a lot of the patients I had operated out as trauma, or the hospital either came in for a static procedure, so-referred friends, but there was no shortcut. It was a lot of hard work. It is still one of the best referral surfaces where patients who have had good results previously.

Catherine Maley, MBA:

So sorry, my dog wants to hear every word you’re saying.

Robert Singer, MD:

I love seeing your dog, he can interrupt us anytime. Oh, you will?

 

Catherine Maley, MBA:

I’d love to hear about this management corporation you’re developing or LLC. What is the intent of it? What does the structure look like?

Robert Singer, MD:  

It’s an aggregation of different practices. So individuals can practice their way. But it has an economy of scale, concerning purchasing supplies, about marketing, and concerning a concept and an ethic, branding of producing the highest level of care from the best-trained individuals. That’s the concept. It’s been proven to be successful, it’s good. It’s different from the models of derm and orthopedic have had to buy up practices, fitting them into a corporate model where it’s like a franchise, and you must have a square peg fit into a square hole. This is different. But it gives guidance for those good positions. We’ve been growing was purchasing a couple of practices North, but I still practice the way I practice before with my staff. I have a quad A approved ambulatory surgical facility that’s right on the grounds of Scripps memorial in the hospital, but patients rarely want to go to the hospital because of COVID today’s situation. We’re an accredited facility with anesthesiologist and several physicians in the community who don’t have that, who can’t operate in the hospital today because the hospital will do elective surgery, or the ASC six shutdown had called and said, Can we use your operating rooms? That’s a model for success for the future. One thing I’ve always felt if you want to see the future help create it. Make your own decisions, to assure yourself what are the fewest problems that arise in the future and how do you avoid them? It’s planning It’s a lot of work.

Catherine Maley, MBA:

Okay? So if you can’t go through the hospitals anymore, like you’re used to running er, er, and running a solo practice, what would you recommend somebody do if they were entering the marketplace? Do they go solo? Do they join a partner or become a partner? Do they become an employee? Do you have any? What words of wisdom do you tell those coming out? Or even those who are running ragged and burned out from all of this and want to do something different? Do you have the advice you give them?

 

Robert Singer, MD:

Well, if I was coming out of a residency or fellowship, I would look at many things. Where do I want to live? What’s ultimately going to make me happy, what’s going to make if you have a significant other, and you’re lucky enough to have one, that’s a good partner, what’s going to make that person happy as well. You’re going to make a living wherever you go. Be realistic. If you come into certain marketplaces, it may be more difficult. It may take you longer, be sensible; you don’t want to get in the hole financially, because you’ve already probably come out with loans. The idea of coming out and thinking you’re going to be the most important sought after aesthetic surgeon in the community when you’ve come out of residency is pure fantasy, it’s going to take time, it’s going to take work, in today’s marketplace, I would not go into solo practice, I wouldn’t try to build that, you are not known and if you have aggressive marketing, you may have a meteoric rise and a fast collapse.

There’s no shortcut. I would see if I could join someone, nothing about business coming out of a residency and fellowship. It’s better to lean on somebody else’s dime and learn the basics of training, of running a practice of what it takes as far as personnel. So I would join somebody if I could. In the past, most people in the aesthetic society were solo practitioners, except most people in HSPS are in academia or have joined groups. They’re no longer. One reason for selling my practice, after many years of looking at an exit strategy, was at one stay involved, I wanted to continue to teach; I wanted to save the interaction with my staff and patients. But I didn’t want necessarily all the pressures. So for me, this MSO group was reasonable. But that’s different from somebody coming in, it may be an option for someone coming in into an entity like that. But I would look at opportunities to join, realizing it’s difficult. If you join someone, you think you’re worth more than they do; have a niche you’re bringing, what is it you’re bringing to the practice that is going to be adding value. The individual who’s running the practice has built it up for a long time they built up the image, they’ve done all the things. So you will not come in as an equal partner. No matter what they’re offering you, it’s more than they want to and it’s not enough for what you want.

You have to be realistic. Talk to consultants, talk to someone like you to get information before you go in. If you’re going to start a practice, if it’s practiced, or join someone, get good consultants, realize that a lot of consultants are more interested in their pocket than yours. But there are good consultants, practice management consultants, you need a good attorney, good CPA, advice as far as marketing, and you can’t do it by yourself. There’s are many things you need to think about before you enter practice. Look at ultimately how long will it take me to make a living. You don’t want to incur debt that you’re going to then make bad decisions to satisfy that debt. You don’t want to get behind the eight balls of debt.

Catherine Maley, MBA:

Well, I’ve seen some practices. There’s either those that grow and they listen to the marketplace and they get this huge team going. They have their surgery center. They have a hairdresser Plants division; they have skincare full Med Spas. Their overhead is unbelievable. They’ve got a staff of 30 to 50. Then there’s the other way, No, no, I’m going back to my wife, my surgical assistant, and my receptionist, do you? How do you feel about that?

Robert Singer, MD:

Different practices have to run in different ways. I have had estheticians, in my practice, we have within this MSO, a couple of spas are outside of the practice,  the model has to be what you’re comfortable with, and what’s realistic in your community, what works in the way won’t work in North Dakota, won’t work in New York, or Miami. So there are different models. I know a lot of individuals make grandiose ideas, built monuments to themselves with lots of space, and they’re paying a lot of rent. And in a downturn, they don’t survive a lot who had large spas, the success of spas is like the success of new restaurants fatality rate is huge. There’s a role for it, but you have to be realistic and you have to be a business person. Unfortunately, coming out of the training programs, you know little about business, successful practices, or running successful businesses, and you need help to do.

Catherine Maley, MBA:

All right, I know a few surgeons who have gone back and got an MBA. I have an MBA and I can tell you everything you need to know in two days; you don’t need for your evening program to do that. But business is business, what’s funny is we all think our business is different. But business is business. You have revenues; you have liabilities; you have assets, it’s all the same.

Robert Singer, MD:

Teaching practice management courses for years with original with gus colonial, unfortunately, passed away by repressive aesthetic study with Mark jewel, Mike Edwards. We talk about basics, and business practices run across every arena. They’re not unique to plastic surgery, and sensible business practices are successful. Fads come and go but you have to look at expenditures, look at the bottom line; look at new expenditures, what makes sense. Look at personnel; you need to have a good HR consultant. All of those things are not natural, take a lot of time, effort and work. Running an individual practice is difficult. And it’s certainly difficult with regulations of labor in California.

Catherine Maley, MBA:

Let’s talk about personnel, hiring staff, and not just hiring them but finding the right players, motivating them, and training them. How you must have been through a few staffs in your 40 years? What tidbits of information or pieces of pearls you could give us for hiring, motivating, keeping them happy, and keep keeping them put staff turnover will hurt your bottom line.

Robert Singer, MD:

Lose institutional memory. Most of my staff, I’ve had through the years have stayed with me a long time. I had a patient coordinator who was with me 25 years before she retired, went back to a family in Texas. I’ve had scrub nurses who were with me for over 20 years. So if you can ideally have long-term staff, that has some issues because they’ve become yet prima donnas you want to avoid that. You’re as good as your staff. You’re as good as your staff. So I would say you need to be careful in hiring. I never hire someone for the first time, I have multiple interviews, and I have my other staff interview them also because they have to be compatible and fit in with the group. You need to know what, what are their motivations? What do they plan to do when a couple of years from now? Which gives you insight are they going to be staying with you? You need to hire, you can teach a lot of basics of the information about surgery. But you can’t teach personality.

Looking at somebody who’s a great nurse in the hospital may fit in and a Omar but are they going to fit in with taking care of the patients are they going to fit in the coordination with the front staff. I would rather have somebody in my front office rather than come from a medical background. I would rather have them having been trained by four seasons or Neiman Marcus as a premier shopper. That’s the type of mentality. It’s to me, it’s all about how would I want a member of my family and myself treated. If it’s not good enough for them, it’s not good enough for the patient. So that mentality of service is key. That’s whether I’m doing a favor for somebody referred in from the barrio, or it’s somebody from royalty I’ve operated. Kings, queens, and royalty, everybody should be treated like royalty, that’s the most important thing you can do is take care of the person. I told my staff, I’m not the most important person, and it’s not the next call, it’s the person you’re talking to.

At that moment, that’s the most important person, I learned this from the CEO of one of the famous hotel chains in India. He said, it’s not about you. It’s not about the company, it’s about the client first. That’s the mentality we want here. So interviewing, then doing background checks on everyone who comes in, and realize everybody looks good on a resume. You don’t know what you’re getting until they’re there. Sometimes it’s a Crapshoot, and you don’t know what you’re getting. And then reality comes into play. It’s tougher today because the same motivation existed as far as work ethic, I’m sorry, doesn’t exist for many people out there. People think nothing about going from company to company today. That’s a result of what we see in the biotech world and the dot com (.com) world. It’s a different world out there, but you want to screen carefully, and then you want to reward your staff, you want to keep them long-term.

I’ve learned a long time ago that you criticize in private, but you praise in public, you make sure they feel special, feel part of the team, you’re working with them, they’re not working for you, I have open communication. And many times they have an issue, they can come in, we can talk about it, and he wants to solve the problem you don’t want to let fester. We have frequent office meetings, and anybody could say there’s an issue, let’s meet, and we’ll do. That requires also a good office manager, and good HR policy all written out. You follow that, don’t cut corners, if there are you’re growing, there are profits, you need to share some so they feel a vested interest in the practice.

Catherine Maley, MBA:

Let’s talk about that for a second because that’s coming up a lot. I do a lot of HR for practices. I’m good at finding people. But like you said, some people are professional interviewers, and they get on board, they need about a month before they show their true colors. And then you’ve got a bad hire, but said, you have a good hire. I’m hearing over and over and over. What’s the incentive here? Like, what’s your commission plan? How do you feel about those commissioning people, and I know there are some bleeding issues in our industry? But if that new group feels they’re going up, they’re going to do more when they’re paid more. You probably don’t have the right person, anyway. How can you make them feel special, but also reward them because they know you’re bringing in the money here?

Robert Singer, MD:

Okay, first, you need to look, hat’s the going rates for good people in your community that’s different. It can’t be cheaper to expect to find the best piece. The other aspect is, there are different philosophies about commissions. I don’t work in my office for anyone, because it’s a team approach. If somebody is given a station, they’re selling a product, what happens if the person on the front is selling the product? What happens if the coordination doing that? There are different models, I’m telling you, that’s not a model I like the idea that if there’s a success, there’s a shared pool. At the end of the year, or when you decide, quarterly or wherever, whatever you decide, you can share among everyone. They don’t all have the same percentage depending on what they do and their job. But there’s an incentive for them if they do a good job. It’s a team approach. I know the other model works for some. We talked before we came on, different chefs cook different ways, and they still have good meals. So the model that works for me won’t work for Dr. X and Dr. Y, they have to find a model that works for them to keep their staff.

As far as what you alluded to about bad hires, you have a honeymoon period, you’re going to have some idea. I would never hire somebody on a full-time basis until they’ve had a three-month trial period. At that point, you can make a better determination, you’re going to have an idea well before that, but you don’t know what you get until they’re there. If they’re a bad fit, don’t change it and uniquely educated, nobody’s going to come in knowing everything, they will not get it by osmosis. You want to hire people with the idea; you want them to succeed, not fail. So that requires a lot of ongoing education, within the staff, from other staff, and you. You can’t expect staff to behave in a certain manner. If you don’t, you set the example and they’re going to follow. But if you have somebody who’s doesn’t fit, get rid of them, because they become toxic to everyone. You don’t want factions in the office. You don’t want gossip in the backroom; you need to function. As a team.

Catherine Maley, MBA:

I wholeheartedly agree with everything except for an end-of-the-year reward system. In today’s world, that’s too long. I don’t think people will stay motivated with that. I came from a strong sales background, I was paid if I sold something. So I have that mindset. But I would recommend doing quarterly or monthly or have fun little contests throughout the month. But because you’re trying to keep people engaged, I would put that in there.

Robert Singer, MD:

I agree with that. That’s why I said someone will do it every quarter. Years aren’t good and you need something ongoing to continue to motivate and keep people happy.

Catherine Maley, MBA:

Well, they say…

Robert Singer, MD:

There’s also, I’m sorry, there are other value-added benefits. You can give, skincare, you can provide fillers and Botox. My staff has gotten surgery after a certain period. Whatever the arrangement is, you need to set out of policy. So it’s no different from one person to the other. They have to understand that going to be in lieu of a bonus or merit raise. Is that going to be? Are you are they paying for the ordered supplies? There’s no right or wrong? It’s you have to decide and then follow that for everyone?

Catherine Maley, MBA:  

Absolutely. Their fairness is a big deal in a practice. Yeah, yeah, I am. Regarding business mistakes, can you give us one or two business mistakes you made, either with staff or business equipment or overhead or whatever, that could help the audience, not make those same mistakes?

Robert Singer, MD:

Every office has probably looked at some technology and lasers that are at racks or something else in the back room. Applying new equipment, you need to look carefully at I would say, lease rather than buy if you can look at the maintenance, look at what the cost is. Look at what’s realistic of how many cases you need to do to justify buying that. What is going to be the cost structure of that and realize you can’t buy everything, nobody can afford everything? You need to be selective, does it fill a niche, if you’re the first in the area, and it’s something productive, that’s great. If you’re the fifth, it becomes a commodity it’s different in your pricing is different. So I’m looking back at some of those I would do things differently.

As I’ve learned more about the business, I’ve surrounded myself with most of my friends who are not in medicine, most of my friends, one fortune 500 companies or biotech company. I’ve learned and realize that businesses are similar to the principles of learning about business. You need to educate yourself with one of the other things in looking back is I suffered from success. I’ve been busy. I’ve been fortunate. I’ve made some good decisions. What made the reputation the way it is today is because I didn’t cut corners. I always emphasize what’s the best approach to safety for the patient. Also, FAMAS, less than deliver more don’t over-promise. So those are the things that would be a good thing. The thing was that I suffered from success is I didn’t understand and get into social media as much as I should have, or if I was starting, or if I was in a middle of a practice.

In today’s rural world, although I have many issues with social media, that there’s no filter, and there’s much misinformation. A patient came in for console, you educated, they started at zero, and you brought them up to here. They’re starting at minus 30. It takes a lot of effort, because of the misinformation on social media, to bring them up to zero. But I don’t think you can survive in today’s world economically, without having a social media presence. You need people to handle that. I’m not sure everybody has the time, or the ability to handle their own. You need to handle the message and make sure what goes out is what you want to say. But I find PR people, practice management people, website management is key, I would have done a lot earlier than I did.

Catherine Maley, MBA:

Well, talking about marketing in our general industry. 40 years ago, you weren’t even allowed to market and the best you could do is a yellow page ad that was and then when I came on board 21 years ago, definitely the reggae or the rebels were advertising but looked down. How did you handle marketing as the decades went on? What did you jump into? Because I know you’ve done a ton of PR and I know that doesn’t happen, you usually are doing something like paying a PR agency. But how did you handle all the aspects you can do, magazines, TV, radio? How did you handle the marketing early on?

Robert Singer, MD:

I looked at what existed in the community? How could I make my community better? What were the things that interested me I could become involved in? So it was a matter of speaking to groups. It was a matter of being on board. It was a matter of being philanthropic. That wasn’t for marketing, I did that because it improved my life. It improved my community,, and that has its rewards. Being involved in things like the symphony, being involved in things like the museums, being involved in animal welfare in the zoo. You interacting with individuals who were in the demographics that wanted Aesthetic Surgery wanted to look better; it gave me an entrée to that; it wasn’t paid to advertise. It had its benefits; it took time, effort, and money. But it wasn’t because I was doing it for marketing. Today, if I came into a certain practice, I am not sure you could do all of those things and be successful. You need to have professional marketing for them.

Catherine Maley, MBA:

I know up here in San Francisco; we had Bruno Risto and Jack Owsley. They were famous plastic surgeons here in San Francisco, and they hung around with the high society crew. They had wives who were involved in philanthropic efforts. That’s how they built everything, but then I realized…

Robert Singer, MD:

I haven’t heard from Bruno for about a week. Oh, and you’re right. They were involved in the higher society of the city. They were involved in the fine arts. They were involved in a lot of things on board and they gave back a lot. I’m fortunate to have a spectacular better two-thirds my wife and he helped oversaw and got the downtown Public Library in San Diego built after 30 years of them mucking around with it. She was here President of the San Diego Zoo foundation. He’s president of the giant flossy international gorilla foundation. So she’s been involved in a lot of named entities, but also a lot of small charities you never hear of need the money and need to support. So you can’t expect to get clientele if you don’t interact with clientele, right? But I would also say you never want to be out there talking surgery and marketing. At those events, you want to create an audience of trust, of being a respectable individual, providing information. That’s what made my practice. It may be different for somebody else mine wasn’t glitz. That’s still when I believe it was a lot of hard work and we’re still well involved in a lot of things in the community. But if you look at not San Francisco, you look at New York; you look at Dan Baker, Sharon lasted, they were involved in the community, they’re involved in society. But not everybody has to play at that level, right? Decide what is the image you want of your practice, you can’t be everything to everyone, you can either be, Harry Winston, Neiman, Marcus, or you could be Costco, you can’t be both decide and then fasten it that way. But if you’re going to be a higher-end, you need to provide a better service; you need to provide something that distinguishes you from everybody else who wants to play in that arena.

Catherine Maley, MBA:

So regarding marketing, how much has it? Well, it’s changed completely. But what marketing would you do in today’s world, you wouldn’t have done before? But if you had mentioned social media, if you think about it, it’s still going to be time. You guys used to spend all of your evenings at symphonies parties and doing all the cultural events. So it’s all it’s done is shifted. You’re spending your evenings in front of a camera trying to make videos, but how do you feel about what’s going on with marketing? In today’s world, how do you think it should be done? Or what do you think makes the most sense?

Robert Singer, MD:

I’m at a different point in my career. If it depends, if you’ve started practicing, or middle of practice, or you’re at the tail end, practice, how you approach things. It’s not the same for each one of those. But I would look to a good consultant. I’m not a PR expert. I’m not a media star…

Catherine Maley, MBA:

Yes, you are. You used to be.

Robert Singer, MD:

Well, when I lecture to plastic surgeons finishing a residency, I explained to them or the middle of their practice, you’re not and I’ve been on a lot of red carpets, but you’re not a rock idol. Don’t start believing your PR, you are a professional, you’re offering a service. You’re a glorified tailor, you do piecework, don’t get carried away with who and what you are, then get good input from professionals. Get somebody to give you guidance, and PR, what’s the niche you can fit into in your community, you need a good; you need a good website; you need some social media presence. You need to keep learning; you need to go to meetings; you need to take teaching courses; you need to take symposia on marketing, on business management. Once you stop learning, you might smoke quickly, you need to continue to adapt because it’s an evolving marketplace. What worked for you five years ago will not work for you today. So you need to continue to look at what’s current. How do you fit in what’s comfortable for you? What fits in with your image in your personality? Because what might be right for somebody in San Francisco, the next person in San Francisco to say repugnant, I wouldn’t do that. One of the hard things for us as members of the Aesthetic Society, Board Of Certified Plastic Surgeons, is you have to maintain ethics, and not everybody out there has to do that. But once he compromised that there’s no coming back.

Catherine Maley, MBA:

Have you looked at your numbers though, because here’s where I run into trouble with social media? When I consult with practice, I get factual, and I’m data-driven. When we look at those numbers, and we pull revenues by referral source, do those numbers equate to the time and effort you’re putting into that referral source? So I’m your practice, like, it’s a mature practice, I would think most of it is word of mouth. Any practice that’s been around for at least 15 years, I would hope the majority is word of mouth. But social media should be more like a fun thing you do, just because you’re bored, but I haven’t seen the numbers prove that that’s where all your age to go?

Robert Singer, MD:

I haven’t. But you’re right. The better patients of mine are coming from our patients and operated before our referrals. They’re not through marketing or social media, most of my marketing, I’ve dealt with a lot of marketing, but not always, or most of its internal marketing. You need to look at data, I’ve always believed data was king or queen. You can get that data with K wise, other things through things like ANN eustatic, the neural network of the aesthetic side to Anzu. But if you don’t have data, and you don’t look at the data, having the data, I mean, that dead is bad data out? What if you don’t analyze your data, why bother accumulating or getting it? So there are good programs, like the Ann program?

Those things will give you key information to make valid decisions going forward on what’s worthwhile, what’s not? What if a patient comes in for Botox? What’s the value of that patient down the road? Are they going to be converting to surgery? What’s the long-term benefit? What procedures aren’t valuable, but I don’t think you can look at a onetime ad if you’re doing that, and look at the ROI on and think that’s going to be long-term going to give you valuable data, it may be the accumulation of all the things you do that brings your name out there. But you need to look at, if I’m doing a program on social media, if I’m doing an interview, if I’m doing a lecture, you need to then evaluate and see the return then make further decisions that Where should I put my effort? And it’s not a slam dunk, it takes a lot of evaluation and if you can’t evaluate, get an expert, who can.

Catherine Maley, MBA:  

Whenever the new people come out, they have unusual expectations about how long it takes to grow a practice. When I got into this, we used to always say it takes about 10 years and in today’s world; you have about 10 months. How are you handling setting expectations? With new guys coming out? Why isn’t this happening for me yet? I’ve been at this for a year now?

Robert Singer, MD:

It’s a different world.

Catherine Maley, MBA:

It is.

Robert Singer, MD:

It was when I came to San Diego La Jolla. I was, 13th or 15th plastic surgeon here. I have more plastic surgeons in my building and the building next to mine that most states have. I mean, San Francisco’s like that, New York’s like that. Be realistic, and you’re coming into a sought-after area with one plus six, or it’s going to take you longer than in a place that doesn’t have as many. You can’t expect, you may come up as a chief resident and you were running the show there at your residency or you came out of a fellowship, you come out, you’re done editing when you’re coming to practice. That’s why I say coming into solo practice today, I would find it difficult and it’s not something I would do at this point. You need to look at and around and see Dr. X, Y, and Z are successful and they have this, they have that, you will not get that in six months. You will not get that year. They worked a long time to do that. But you also have to look at the people who came in with a lot of flashes who didn’t survive who weren’t there. Right.

Catherine Maley, MBA:  

I want to switch gears and go to mindset because I hope people are hearing your growth line that you never stop learning. You stayed involved in everything like in your community, the cultural side of your community, but also the Medical Society. How much have you put into that medical? Are these medical societies speaking and writing? Can you talk to that? How much of your life has been spent growing?

Robert Singer, MD:

My ongoing learning, whether it’s medicine or anything, or key, as my wife says, Robert, what do you still do this? Right? I mean, it’s, it’s, it’s the essence is part of my DNA, I believe in giving back some people were none of us got here, well, people mentored me, and I feel a commitment to doing that. Plus, it keeps you fresh; it keeps you learning, ah, when I stopped learning, I’m going to, I’m going to practice that I don’t do a procedure today, the same way I did it five years ago, I there may not be dramatically different, but there are nuances. That comes from attending meetings, symposium, talking to peers. I’ve done a lot of that: I am constantly involved in running panels around the world, or on zooms or writing papers, or I’m not on the editorial board of the Office of aesthetic surgery journal.

Looking at those things, I started the emerging trends, hot topics for Task Force, for the aesthetic Society of HSPS. That keeps me fresh, it’s looking at all the new things that are out there. Many of the new things that are out there, prove not to be better, not to be as safe, and not to be as good. So because it’s new doesn’t mean it’s going to be worthwhile. But that’s the assessment of that and then fitting into what fits in my practice, what makes sense to my patients, what makes sense for my staff. I’m currently helping oversee the aesthetic society COVID task force came up with all the guidelines for safe practice, and re-entering practice. Those are things we implement, patients want to know you’re safe. They also want to trust you, if they don’t trust you, they will not do business with you. They wanted safety today, especially with COVID is critical. You can’t cut corners, and you can’t become complacent about that. I’m still involved in the hot topic.

I still give input to quadruple ASF. I was president of their trustees for years, but I believe in safety. We’re extending that to the international society. Hopefully, at some point, they’re going to need an as criteria of membership, the same thing I implemented, and I push you stakes it and SPS do the same. If you’re going to be a member of these organizations, you’re going to have to either operate an accredited or licensed facility, where you will not be a member and that raises the bar safety. That’s one thing I’m proudest of. We’re doing that with the internationals. So it’s continued education, of not educating others in the public, but educating yourself.

Catherine Maley, MBA:

Excellent. Any last words of wisdom for anybody, any 111 pieces of advice.

Robert Singer, MD:

Don’t take yourself too seriously, realize it’s ongoing, you need to enjoy what you’re doing. If you’re not enjoying it. Don’t do it. As I say most of my friends, either are CEOs of major companies, fortune 500 companies. Yes, I’ve made a nice life for myself and I didn’t go into this for the money. I went into this because something I believed I was fortunate to make a good living, nowhere near what my friends have made. But the quality of my life when look back is much more rewarding than many of them have looked back at a patient who comes in 30 years later and said, Oh, you did my nose. We’ve made such a difference in my life by giving me confidence. It was the best decision I made or I feel better about myself.

I see patients who came in with their mother, and their mother was going to have surgery and they said no way in the world would I ever do this, 20 years later, I said well that’s time I want to do something about myself. Seeing the response, you look back, and you get difficult patients. Those are the ones who remember, and it’s difficult day-to-day to satisfy all the needs and the increasing needs of patients. But when you get somebody satisfied, they come in and thank you, for that makes it all worthwhile. The greatest problem is not your competition is the unsatisfied patient. Don’t over-promise. There are patients I say no to, I know I can’t make happy. They’re not your problem until you accept them as a patient. Once you accept them, they become yours. You need to screen and it’s not about getting a patient in and doing surgery.

Catherine Maley, MBA:

So true. So tell us something we don’t know about you.

Robert Singer, MD:

Well, even though some would say I am an altitude Lee challenge. I played a lot of team sports; I played a lot of basketball; I played competitive tennis. My passion is my family, travel, and learning. We spend a lot of time in Africa. I’m proud of my wife said he was president of the Fossey Foundation. The mountain gorillas are an endangered species, one of the few that are increasing, exist because survive because of diet phosphate and the Fossey Foundation continued that. So we’re involved with that. I’ve adopted elephants, orphans, I’ve adapted Cheetah orphans, I’ve adopted a gorilla orphan. We love our animals, we’re involved in the Humane Society here, which is a no-kill policy and that’s improved our life. That’s a bit about me.

Catherine Maley, MBA:

That’s pretty darn interesting. Thanks for sharing. All right. So if anybody wanted to learn more about you, I’m sure your website I believe is our www.rsingermd.com.

Robert Singer, MD:

Yes, and they can also go to prime plastic surgery, which is the entity I’m involved with, with another plastic surgeon, and we’ll have several others. As I say, I don’t see there will always be a future for the private practitioner like Harley Street in London, but there are going to be fewer and fewer those who can survive with the demands from regulations of the government, the decreasing reimbursement. I think concise, I won’t say koala consolidation, aggregation of practices will allow you to still practice the way you want, but will give you a little more freedom, a little more guidance, and a little more help. You don’t have to do all the things by yourself. Because none of us are experts in everything. That’s going to be more of what we’re going to see. The thing that separates plastic surgery why I think it will still survive, and there’ll be a future is the concept of innovation, quality, and taking care of patients and not hyping script.

Catherine Maley, MBA:

Well, we shall see, won’t we? But Dr. Singer, thank you for being on duty in advance. It is an honor to spend time with you.

Robert Singer, MD:

It’s been a pleasure. You’re a real professional. I appreciate the opportunity. If you can help practices as you do they’re way ahead.

Catherine Maley, MBA:

Thank you and thanks to everybody for joining us on Beauty and the Biz, then if you would please subscribe and if you feel inclined to rate review would be super helpful. If you’ve got any feedback or questions for leaving them at my website www.CatherineMaley.com or you can always DM me on Instagram at CatherineMaleyMBA.

Catherine Maley

Catherine Maley

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

BEAUTY AND THE BIZ

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

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