Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and Dr. Pozner’s 75% referral practice.
I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called “75% Referral Practice — with Jason Pozner, MD”.
If you have been practicing for a minute, you quickly realize the difference between consulting with an admiring patient who has been referred to you vs. the resistant Internet stranger patient who doesn’t know you from Adam.
It’s just plain easier and more fun to convert consultations who are pre-framed to say yes to you. And it feels great when your surgery schedule is full 😉
This week’s video is an interview I did with Jason Pozner, MD, a board-certified plastic surgeon who is the founder of Sanctuary Plastic Surgery and co-owner of Sanctuary Medical Aesthetic Center in Boca Raton, FL.
Dr. Pozner enjoys a 75% referral-based practice, but that didn’t happen by accident. He explains all the hard work that goes into it.
I’ve known Dr. Pozner for decades and he’s a pleasure to know and watch since he thinks differently than the norm.
👁 DON’T MISS THESE INTERVIEWS 👁
Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and how Dr. Pozner has a 75% referral practice. I’m your host, Catherine Maley, author of “Your Aesthetic Practice, what your patients are saying”, as well as consultant to plastic surgeons to get them more patients and more profits. Now, I have a very special guest today because I’ve known him forever and he’s really tough to track down, and who has a 75% referral practice.
It’s Dr. Jason Pozner. He’s a board-certified plastic surgeon with over 30 years’ experience learning the world’s most advanced plastic surgery procedures, laser procedures, as well as skin rejuvenation treatments. Now, Dr. Pozner is the founder of Sanctuary Plastic Surgery and co-owner of Sanctuary Medical Aesthetic Center in Boca Raton, Florida, and runs a 75% referral practice. And we’ll learn more about that.
Dr. Pozner, who now has a 75% referral practice, graduated from Icahn School of Medicine at Mount Sinai where he trained for five years doing an intensive general surgery residency. He then completed his plastic surgery residency at State University of New York Downstate Medical Center, as well as two fellowships in microsurgery and aesthetic surgery at Maryland’s esteemed Johns Hopkins Hospital.
Now, Dr. Pozner is a member of numerous professional medical societies and has received several awards and honors as a top-rated surgeon by patients and peers alike, not to mention having a 75% referral practice. Dr. Pozner, welcome to Beauty and the Biz. It is a pleasure.
Jason Pozner, MD: Thank you so much. I hate it when people read my bio. I hate it.,
Catherine Maley, MBA: I had to condense it and congratulations on having a 75% referral practice.
Jason Pozner, MD: You have, I know. I, I just listen, it’s just a, I was just like board certified plastic surgeon in Boca Raton, Florida, and that’s easy for me.
Catherine Maley, MBA: Oh, so how did you become a plastic surgeon and get a 75% referral practice? Because I do know your father was in the medical.
Jason Pozner, MD: Yeah, it’s my, my dad who’s deceased a couple years was an internist who did a lot of weight loss and, you know, I, I was kind of interested, it was interested in some of the stuff he did and, you know, if I wasn’t plastic surgeon, I might have been an endocrinologist, but I hated all the medical stuff, so I kind of fell into plastic surgery.
You know, the people ask me this question a lot, like, why you do plastic surgery? Why do you like it? And, you know I, I kind of like MacGyver, you know, it’s sort of like my idol and stuff and I’m sort of, kind of. Good to figure out different things. So plastic jewelry is like very MacGyver. There’s no right or wrong way to do stuff.
It’s how you get it done and there’s lots of ways to do it. That’s what’s fun for me.
Catherine Maley, MBA: That’s fantastic. So, did you end up like, gimme a quick story on running a 75% referral practice because I know you didn’t start in Boca Raton, how did you?
Jason Pozner, MD: No, no, no. End up in Florida and private practice. So, what happened was I did my you know, after I finished my residency, I wanted to learn more aesthetic surgery and I grew up in general surgery in the endoscopic days, laparoscopic days.
You know, in the beginning we were, everything was open. And then midway through my general surgery training, we were doing lap, lap gallbladders, lap lab APIs, all that kind of stuff. And I had done a lot of laparoscopies, so I kind of liked that. So, I did a fellowship in Baltimore with Oscar Ramirez, and I was on staff at Hopkins at the, at the time math faculty appointment there.
And we had done all of the endoscopic classic surgery things. We taught a lot of courses. So, it was really fun. And then I joined this practice for a year, and then I got an offer to come to Florida. So, I kind of worked in, in a, some chop shop for a year and a bit to get my boards and just get a bunch of cases.
And then I had enough of everybody and I just opened up by myself. I had like no money. It was like, oh, almost went broke a couple of times and then kind of built it up from there. You know, it wasn’t easy. I opened up this practice. We had an operating room in the practice. It was basically taking over another plastic surgeon’s practice that moved to a different location, so spruce it up and then like a month and two into practice there.
Florida banned office surgery for a while, so it was like, oh, what am I going to do? So that was, that was early on. And then we lived through a lot of stuff. We lived through 2008 and a lot of ups and downs. So, you know, pretty good right now, but you know, you never know what, what time we’ll bring.
Catherine Maley, MBA: I didn’t know that about Florida, I mean am I correct in an assuming Miami. That’s the wild, wild west there with Search Street. So how long did they shut down doing surgery in your 75% referral practice?
Jason Pozner, MD: You know, it was a couple of months. It was a good couple of months. It was in, I think 2000 when I first got started in, in, in my private practice location. But what happened was, you know, they had a bunch of deaths in the office operating room and so they really tightened up the regulations, you know, and I got to tell you, it, it’s probably for the better.
The regulations are good and they do have problems in Miami with a lot of cases. And they tightened up the regulations again recently. With all the BBLs going on and all the deaths from BBL L but over the last few years, they’ve kind of left us alone because they’ve had such a bad opioid epidemic so that they’ve really been concentrating on all the pill mills and things.
I mean, just north of us in Delray and just a little north of where I’m in Boca is one of the rehab capitals of the world. So, they, they do have a lot of problems with pills and rehab and drugs. It’s pretty bad. But you know that, that’s, that, that’s the story with that.
Catherine Maley, MBA: Yeah. Any tips on the surgical center though, building it out, or did you take over a practice that was already just to go to get you a 75% referral practice?
Jason Pozner, MD: Well, they had a rehab. Yeah, they had a, I mean, they had a small, they had a, they had an OR and basically, I just got quad A accreditation. Learned a lot through that. You know, I think the best advice with this nowadays, if you’re asking me what to do is hire a consult. You know I think that there’s too many rules.
It’s very hard to do it yourself. And you know, we’ve had a consultant and we’ve been under contract since I started for the last 20 years, with, with the same group that basically helps us every year they do peer review for us. They check out, or they check our crash cards. It’s hard to do it yourself and not worth the time and effort higher.
There are very people who know this like the back of your hand and you really should go to them. And there’s many good ones across the country. So, I that, that’s my recommendation. Don’t do it yourself.
Catherine Maley, MBA: It’s a pain in the neck for sure. Yeah. Did you know, you do general anesthesia, but you also do IV sedation in your 75% referral practice?
Jason Pozner, MD: Right.
Catherine Maley, MBA: Are you offering that in your 75% referral practice? Why offer both?
Jason Pozner, MD: Because I, I like… Well, you know, it’s, it’s, it’s, it’s actually really, really simple. I have an anesthesiologist; I like an MD in the practice. I mean, early on in my career, I had a problem working in a sur when I first got to Florida, working in a surgery center.
And there was a case where had a C R N A and they caused a problem. And I was responsible for the CRNA’s behavior and problem because if you, if you have a C R N A, you’re responsible as a. So, in practice I’ve only worked with MD anesthesiologists because, you know, it’s their responsibility as well as my responsibility, and I like that.
I like having that MD in the practice. So that’s just off the, that’s right off the top. So, I have an anesthesiologist and when we book a case with the anesthesiologist, he discusses with the patient what type of anesthesia to do. And if it’s an older facelift patient, oftentimes it’s IV sedation. If it’s a younger one, often it’s general, but we go back and forth between the me and the anesthesiologist and the patient as to what’s best for the patient.
But we also have a minor room and I also do a lot of local anesthesia cases when I run my numbers. Now, a third of gross revenues are local anesthesia cases in our, in our operating, in our, in our surgical center. So, this is a separate business from our med spa. So, we discuss numbers. I won’t discuss any non-surgical numbers as a separate portion.
I’ll, I’ll put group then in my med spa. So, we actually just, we have two separate practices. I have a surgical practice and I separated out the med spa business around 15 years ago. And we’ll talk about that later cause we’ve had some ups and downs and it with that. And we’re in a good place now, but definitely have some lessons to be learned from that.
So, my surgical practice so I have an OR and I have a minor room. And the minor room will do pro and we’ll do some mild oral sedation, which I’ll also do in the operating room. So, for example, Today I did Minit mini tummy Tucker, and some lipo was my first case. Okay. Came out of the first case, general anesthetic case.
Case. Went into the recovery room. I went right into our minor room and I did a minor laser procedure. Patient had pro on board. We monitored the patient, but they didn’t have any oral sedation. They just had products for that particular case. I think I did some chest bbl or, or moxie or something else on the face.
I don’t remember. Then I went back in the, OR did another general anesthesia case. That was a, a revision breast case, which I, I do a ton of revision breast, the revision breast case. Then went out of that, went back into the minor room and did a little la, another laser case, and then went back into the operating room.
And I did something weird. I took a vein out of someone’s hip forehead, immuno know surgically, and then I did a, my elevate neck procedure. So, so I went back and forth all day. So, two general anesthesia cases and four little, little short cases. And that’s my typical day. Tomorrow, I have three general anesthesia cases, and I think two couple locals too.
Catherine Maley, MBA: Are you finding the patients are asking for less anesthesia in your 75% referral practice?
Jason Pozner, MD: Yeah, and it’s, it’s different. I think we do a lot of lo we do a lot of smaller things now. I think the key to a successful surgical practice is we can’t think like we did 20 years ago where everything was big in asleep, in multi parts. Many times, people just want lower eyelid laser.
I mean, Monday, one of the cases I did actually Tuesday before I even started clinic, I have clinic on Tuesdays. I did two little cases and one was a removal of breast implants under local. And the other one was a lower eyelid laser. And it was considerable revenue just for two cases. And I, I started at seven, I was done by eight 15 with two cases.
I bounced between two rooms. I mean the, the, you know, sometimes people just want their implants out. They want to see what’s going on. So, this lady had saline implants. I made a small infa incision. I punctured the implant and pulled the bag out. And I mean, I was literally done in 15 minutes, but it was a couple thousand dollars and it was, you know, cost of goods were one two sutures.
Catherine Maley, MBA: So, I know that you also brought another surgeon on board in your 75% referral practice. Yes. So, it’s called Sanctuary Plastic Surgery, Right? So that is you, the surgeon team, the anesthesiologist in your 75% referral practice?
Jason Pozner, MD: Gotcha. And a little bit and the other surgeon. Yes, yes. And we actually have a couple surgeons. So, you know, I, I, I learned early on in that if you wanted survivability should not be in your name.
No. If you want to sell a practice or somehow divest a practice or grow a practice down the road. Jason Pozner, MD I is not probably the best name to have. The building is called Sanctuary. The area behind us is a, is a housing development called Sanctuary. So, I think I spent $10,000 on a marketing company to name the place based on a book I read in like one of these airport books.
The guy wrote a lot of marketing books and I hired him to come up with the name and he was terrible. He was just terrible. And the name of the place was Sanctuary. So, he said, oh, sanctuary sounds good. So, we called it that and I hired a junior guy. He did a fellowship with, he did, he spent a year with us right out of his plastic surgery training, did great.
And then he was programmed to do a hand fellowship and then he came back and he’s been with me for almost a year and a half now. Excellent. Doing really well. I’ve had other people join me in the past that did not work out. It’s not so easy. You have to really get along with someone. I’ve learned a little bit what to look for a little more now.
Catherine Maley, MBA: Like what, cause that’s the big challenge in a 75% referral practice is trying to bring somebody on board that you clearly tolerate. And not only that, right? Like actually have some really good synergy with, I find that you’ve got to, it’s hard.
Jason Pozner, MD: It’s hard. I mean, it, it’s hard. I mean, it’s better if they spend some time with you. So, I’m associated with both Cleveland Clinic, Florida, and University of Miami, so I do get the residents from both.
So, it has to be someone that one has the same mindset towards patient care. I think that’s the main thing. I mean, if someone’s a cowboy and doesn’t care about the patients and you do, probably not the best person to have in your practice. The other thing is good skillset. I mean, I, I won’t take anyone with bad hands.
And then the other thing is, you know, I write a lot of papers and do a lot of academic things. So, I’ve had people who are less academically minded and they didn’t fit well with our practice. Dr. Cook, Jonathan Cook was with me. He’s, he’s more academically minded than the people I’ve had in the past.
We’ve co-written, like, he’s spent a year with me. We wrote like 12 papers that year. And we, we do a lot of writing, we do a lot of clinical trials. We do a lot of involved with a lot of companies. I brought him into every deal with every company now, and he sits on our conference calls. We had a standing call every Tuesday night with Cyan, and he’s part of our group.
So, he works really well with me and, you know, look, always some learning curve with, from both sides, but he’s doing really well with us. I decided that I, I turned 61 a month or two ago. Congratulations. Getting old. Getting old, thank you. 61 was nothing. 60 was hard. 60 was hard, but you know, it’s like, I’m, I, like I said, like what do I want to be when I grow up?
You know? And like, I’m kind of getting to that age. I’m like, I, I really don’t enjoy doing lipo, you know, we do well with it. But I’m like, so Jonathan, you do all the lipo, unless it’s combined with something else. I enjoy doing faces and breasts and I like doing those, and especially revision breast. So, if I can kind of do that for the next 10 years or so, I’ll be happy.
Catherine Maley, MBA: And then so did you bring him on as a fellow or as a, what did you bring him on in your 75% referral practice?
Jason Pozner, MD: So, so the first year that he was out of his resi, out of his plastic jury residency, I brought him on as a junior attending rather than a fellow. So, I, I could have had a… I could have applied to ASAPS for an aesthetic fellowship.
I did not. I just brought him on as a junior faculty. And the reason I did that was if I brought him on as a fellow, he wasn’t, that didn’t count towards his board eligibility. So, I brought him on as a junior faculty. He was able to accumulate enough cases to take his boards and pass his boards. So then when he came back after his hand fellowship, he came back as a board-certified plastic surgeon, not as a board eligible doctor.
C collecting cases got, so he hit, he hit the ground running and it really worked out. That was a good move for us to do that.
Catherine Maley, MBA: All right. That’s a really good pearl. But now what is he in your 75% referral practice?
Jason Pozner, MD: He’s a board-certified plastic surgeon in the practice. He’s doing a little hand you know, not too much, but you know, he’s doing a lot of the, I’m trying to send him all the lipos, all the BBLs and all the stuff that I don’t want to do.
Catherine Maley, MBA: And did you bring him on as an associate in your 75% referral practice?
Jason Pozner, MD: So, so, so, so he is a, he’s an employee of the practice. And his, his deal is two years employee of the practice. And then we’re going to talk about partnership this, this coming August. W when he’ll be there for two years.
Catherine Maley, MBA: I have found the two- and three-year mark is where things start either gelling or going sideways in a 75% referral practice.
Jason Pozner, MD: Right, right. You know, that makes sense. So that’s why I waited two years and then, you know, and then the deal will be, we’ll, we’ll work out some deal, we’ll get an independent evaluation of the practice for numbers and things like that. And then he’ll probably vest over a few years.
So, time for him to pull out. I don’t want to make it onerous on him. You know, gurah and Bill and, and Joe hen Said’s practice had a successful buy-in to his practice and that we’re, and Barry’s working on that as well. So do Bernardo. So, we’re kind of looking at looking to them as models, but we’ll want to be happy.
I wanted to be good for everybody. I’d like him to continue the practice. And I’d like to be able to work there till I feel like, till I feel like I don’t want to work there anymore.
Catherine Maley, MBA: Right. There’s a balance though in a 75% referral practice. What happens is a lot of the surgeons who want to bring somebody on, they’re so kindhearted, they actually give them their patience, put them in their marketing.
Right. Really invest in them. And then, you know, later they, they can do it on their own and they don’t realize what they, it’s hard in a 75% referral practice.
Jason Pozner, MD: And, and I think, I think that the people nowadays oftentimes don’t have the same work ethic as someone who’s a little older.
Catherine Maley, MBA: Honestly, I think that’s true in a 75% referral practice.
Jason Pozner, MD: And, and I’m not saying it’s a bad thing, you know, maybe a little bit better work-life balance is better.
I mean, I’m certainly, this is my third night of conference calls and then I have one again tomorrow. So, it’s four out of four out of nights with, with calls and maybe, maybe that’s not so good. Maybe a little bit more leisure time. You know, getting to the gym is a good thing. But I am going to hit the gym after I talk to you tonight.
Catherine Maley, MBA: I did I did a podcast with somebody and he literally said, I’m not going to kill myself. I’m going, I’m going home for dinner every night. I have little kids at home. And I thought, I’d never heard that before, especially in a 75% referral practice. You know?
Jason Pozner, MD: Yeah. I’m, I’m still, I’m still killing myself. I mean, it’s, it’s, it’s, and you know, and part of the deal is, is, you know, maybe I don’t quite have depression mentality, but I’ve lived through some ups and downs in the practice.
I, I’ve been through prep times. Things weren’t so good financially, and, and I’m ho I’ll be honest about it. I kind of know what to do and what not to do, but things are good right now. And the question is, are they good? Because I’ve hit my stride. I’m a certain age, people move to Florida, our results are good, you know, or certainly not the economy because friends in other markets are telling me that the economy is taking a hit a little bit.
And we haven’t seen it yet in Florida. I’m not sure it’s because of our governor and our business in the state of Florida, or because people moved here or because, you know, we’re doing a good job in our practice. I don’t know. And frankly, I don’t care. It’s going to, I’m going to take it, I’m going to keep at it while the going’s good.
Catherine Maley, MBA: It’s a good time to be in Florida in a 75% referral practice. My God.
Jason Pozner, MD: Weather’s good. Look, I’m sitting on the beach even though it’s night right now. No, my background. But it’s, it’s nice. It’s warm here. People are here. There’s good business right now. You know, it, it’s interesting, you know, it’s, it’s a slow down a little bit from the mid pandemic in terms of.
No, we, when people came in for a consultation last year, they took a spot right away. They’re like, listen, my coordinator said, you know, we got a spot in five weeks from now, or six weeks from now. The next one’s a month out from there. You know, I, and I’m not booked six months out. I’m booked out about right now.
We’re booked out around six to seven or eight, eight weeks, something like that. But there’s a couple of holes the end of January. But I do a lot of surgery a week. I mean, I’m not the guy who does those surgery and goes home, you know, we did 6, 6, 7 cases yesterday. I got like five, six cases tomorrow. So, we’re, we’re pretty busy.
Catherine Maley, MBA: Yeah. Do you the, the surgical side, then there’s the non-surgical side, but medical center as part of your 75% referral practice?
Jason Pozner, MD: Yes. Yeah, we, we kind of changed the name. We almost won bankrupt a couple times there. Okay. So, so in 2008 I split off this. What happened was, I, I have a space, my space is five 6,000 square feet. That’s my surgical center, and we were doing injectables and everything there from 2000 to 2008.
There was a space next to us. So, the building I’m in is an office building, and our particular building has two suites in it. It’s a one-story building. There’s a couple of towers next to us with an underground parking lot. That’s our, that’s where we are. And the place next to us was a, first was a travel agent or something, and then it was a yoga studio that didn’t last.
And then the place became available. And then I don’t, I think it was, I don’t know if you remember, we bought it right away or rented it. And then bought it. But we ended up buying it and I started this medical center with David Goldberg, dermatologist from New York. And we split off the non-circle and he was coming down and we started, we were doing pretty well.
We actually opened an anti-aging center in the next building over. So, we were doing really well from that. And we were, we were, we were, well, cash was coming in, we were. But we, we kind of decided to expand and that’s where we really had some problems. We hired a guy who was a former Navy captain, who, who was running our practices, both my surgical practice and the med spa practice.
And he didn’t watch the bottom line. And I think this was a big learning lesson. I mean, you really need to watch the bottom, bottom line with this. So, we expanded too fast, we almost went bankrupt. We had some problems and a business guy bought him out and then he was terrible, pro terrible. He got us out of the financial issues, but he was probably one of the evilest human beings I’ve ever met.
Oh my God. Terrible. Just evil. But eventually what happened was I got introduced to these two young Harvard MBAs and they were doing their senior thesis at Harvard and they came to visit me one day through a, through actually Barry de Bernardo, and they said, we just want to pick your brain. And I sat with them for an hour or two.
They were nice. I told them around or took around and they, they had picked the brains of a number of people, including Grant and Renado and, and Jay Austin at Harvard. And they picked my brains and they wanted to be in Florida. And then basically like six, eight months later, they bought out my business partner.
And so, they’re my partners in our med spa. And since then, we’ve, we’ve bought a couple of other practices. They’re well-funded. We have practices now in North Carolina, Virginia, and San Diego. We have 11 med spas. And by the end of this year, or beginning of early next year, we’ll have 14. How interesting.
Catherine Maley, MBA: Yeah, it’s really good. You didn’t grow the surgical side, you just, you just veered off the med side. So, you probably have LLCs or separate topics for your 75% referral practice, right?
Jason Pozner, MD: Absolutely. Everything’s different businesses, everything’s different corporations. So, the surgical side is one corporation. So, when don’t we do surgery there?
We do some lasers there. Any kind of more of the lasers that require a little bit of anesthesia. Pro Knox, whatever else. And in the med spa, we, we have two dermatologists that work there. We have a lot of extenders. It’s about 6,000 square feet. Fairly bi, fairly busy, really busy. We have a lot of devices there.
We pretty much have everything known to man. And so, the other practices have some different technology, but normally in Florida we test all the technology and something works well, we’ll roll it out to other places. Like we, we had the first Soft waves device a couple of years ago, right after, during Covid we got it.
I bought it and we did well with it and then we rolled it out to North Carolina and they’re doing really well with it there. And I think we’re going to roll it out to San Diego next.
Catherine Maley, MBA: So, so you’re doing your franchise besides your 75% referral practice?
Jason Pozner, MD: It’s a franchise. It is, it, it is. And eventually we’ll flip it or something, but it’s kind of nice because I don’t have to worry about the administration or worry about the front desk or worry about the marketing or worry about who’s who, which ma is working in there.
I worry about my surgical side and I let them worry about the other side and, and I’m the medical director, so I, I deal with the patient aspects of things and doctors are having problems or problems with patients. I deal with them, but I don’t have to deal with the administration. I think it’s a very nice balance because if I was trying to expand the med spa and run my practice and do research and be on podcasts and do other things, I mean, it’s kind of difficult.
I, I don’t have any time as it is, so I think it’s a nice way to kind of accomplish my goals, which is, you know, grow that and still be involved and still do teaching and still do new te. It worked for me.
Catherine Maley, MBA: Did you bring private equity in apart from your 75% referral practice?
Jason Pozner, MD: And now they, they’re funded from, they went to Harvard for their MBAs and they’re funded through some Harvard alumni.
So private funding, not a big PE group yet, but that would be the next round. Once we get to a, once we get to a higher number. That’s very interesting. It’s, it’s, it’s working well. So, if you know any med spas with, with a plastic surgeon who are looking to do something, please have them contact me.
We’ll, we’ll, we’ll take a look at you. They’re very easy to deal with and, and that’s what I like compared to my previous business partner, not Goldberg. Goldberg was great to deal with, but compared to the previous business partner I had who was very micro, he was micromanaging everything. I mean, he was terrible.
These people that kind of leave us alone to do the medicine. But you know what happens is we talk about what technology to buy for the other practices because I get a lot of stuff for free to test and you know that’s part of the deal. I’ve been in this business a long time and you know, if you like something we’ll buy another 10 devices for the other practices.
They don’t get free stuff there. I do test it so it works well. Feeds me in inhabit of new tech.
Catherine Maley, MBA: Is the point of going with you to they would get a better, they would get group pricing discounts in your 75% referral practice.
Jason Pozner, MD: Yeah, we absolutely we’re, we’re, I think we’re number 13 in Allergan for the country right now, so, so we, we buy a lot.
We do get some group things, but, and also, you know, some of the people just don’t want to manage stuff anymore. I don’t blame them. It’s, I, I like to be in the operating room and I don’t like to have to deal with pt o time and this one wants a raise and this one’s sick and this one’s car broke down and this one doesn’t one that come in today.
You don’t have to pain in the neck. No, it’s none, none of us want to deal with that. It’s, you need a good office manager for that and, and frankly, you know, still, even with the good office manager, it comes back to you. So, this allows me to just manage the 12 or so people on my surgical side and not have to worry about another 20 or 30 people on the med spa side.
Catherine Maley, MBA: So, you have peace of mind knowing that they are watching the numbers in your 75% referral practice.
Jason Pozner, MD: Believe me, they’re really watching the numbers. I mean, they, they know it. That everything down to every penny. No. And I watched surgical numbers. It’s a little easier to watch the surgical numbers. Right. You know, it’s a lot different on the cost of good side of things on surgery.
And matter of fact, I sat with my office manager today and we went over November numbers. Mm-hmm., you know, and you know, it takes a couple days after the end of the month to come in and we looked at our profits, we looked at, you know, things like that. And we’ve been pretty consistent every month this year, which is very interesting.
July was, one month was a little slower cause I was out of town a little bit, but that was, that was it July And it wasn’t that much off.
Catherine Maley, MBA: So, you have two surgeons working in your surgery center, but what about those other in your 75% referral practice?
Jason Pozner, MD: There’s more, there’s more. Just wait. So, there’s me and Dr. Cook, you know, and Florida is, I like older surgeons and I like older surgeons.
They’re oftentimes in Florida. You know, this is a great retirement place. I know so many plastic surgeons now who have houses in Florida who want to play golf, and I don’t play golf. I’m trying to put them together for a golf meeting. But I like older surgeons who still want to work a little bit and don’t want to open up a new practice or run a practice.
So, Alan Gold from New York worked with me for a number of years. He came down here, he came down a week, a month because he had a place in Florida and he wanted to retire here. And he had a retirement plan. So, he came down a week, a month. He did noses and faces and we had him on our quad, and it was, it worked really well.
And, and then he became full-time when he, he sold his practice to Larry Bass in New York, and he moved here full-time and he still went back and took care of a few patients and then finally cut ties to New York and was here full-time. And he worked with us for a number of years and he, he retired. He just retired this summer.
He said, all right, I’ve had enough.
Catherine Maley, MBA: Were you, were you getting him, the patients, like when he was coming down monthly to your 75% referral practice, were you setting him up and he was just doing the surgery and some were…?
Jason Pozner, MD: Some were his patients from New York who, you know a lot. There’s a big New York Florida connection. So, a lot of his patients from New York found out he was here.
And then also I decided that, you know, look, I wanted to concentrate on face and Bre face and breast. And he’s such a, he is such a, an experienced nasal surgeon. I sent him all the noses. Okay. So, you know, anyone who wanted a nose got to him and he did a lot of faces. And finally, he said, all right, I’m not doing faces and eyelids anymore.
He did mine five years ago, but he said, I want to do that anymore. I just want to do noses. And for the last couple of years, he just did noses. He did a couple of months; he did a great job. And then finally over the summer, he said he was going to retire. And I have another doctor, Rhonda, Rhonda Walker from Rondy Walker from DC who’s coming down part-time now, and she’s doing some of the noses with us and.
No, I kind of l look, look at life like FARs Gump. You have to look at opportunities. Uhhuh, and, I don’t know, about eight months ago or so Elliot Jacobs from New York came down and he brought his wife to me for, for a, a light, a little laser procedure. So, a little HIPAA violation here, but whatever. And, and she was nice.
We did a very light laser. She’s a beautiful woman, didn’t need much. We just did a little, a little, you know, a little aesthetic laser stuff. And I got the talking with him and he was in the process of selling his practice, closing it down and renting his location. And, you know, he came down, he and he sent me an email, says, look, I’d really like to talk to you.
I’d like to keep working. So, he came down here and he only does male gynecomastia and female to male top surgery women, transsexual women who want to become men. That’s it. Nothing else. Little lipo here and there, but that’s it. And he has these patients that are coming from all over the world because he is a true master at these things.
I mean, I’ve never seen better gynecomastia than, than he’s, than he’s done. So, he came down and I made it easy for him. I made him an offer he couldn’t refuse. We got him hospital privileges and got him on our quad, and he’s doing eight, 10 cases a month.
Catherine Maley, MBA: Out of your 75% referral practice facility or at a hospital?
Jason Pozner, MD: My facility, my quad, a facility.
So, you know, what I’m trying to do is maximize my or time. So, I operate three full days a week, Monday, Wednesday, Thursday, and Tuesday and Friday were dead days. We had this space, no one was using it. My anesthesiologist wanted to do some work. And so, Elliot plugged in mostly on Tuesdays.
We did two cases yesterday. I mean yes, he did two cases yesterday. So, I mean, he’s, he’s busy and it, it’s great. And it gives him a sense of purpose. It, it takes, it covers my overhead a little bit. The one thing is if you’re looking to add another surgeon to your practice, you can’t, you’re not going to get rich on another surgeon.
You, you can’t think of it that, Which you got to think of it as whoever comes and works with you is offsetting your overhead a little bit. Right? Maybe I could take a week of vacation and the payroll’s paid by him that that week because he’s doing some cases, or maybe the light bill’s being paid or some of the, some of the rent.
But it, it offsets, it, it, it eventually puts profits in your pocket, but you’re utilizing your facility a little bit more. Your variable costs go up, but your fixed costs don’t change.
Catherine Maley, MBA: Right. Then what about your other, the, the surgeon you brought in, the younger guy where, when does he do surgery in your 75% referral practice?
Jason Pozner, MD: He, he also works on Tuesdays and Fridays and some of the other days, and he’s doing a lot of local cases in our, in our minor room.
And he also does some hospital cases. Like today, he he’s working on Friday. He’s got a big ca he’s got a big case on Friday. He actually had another case on, so I think Elliot did a week, a case or two on, on Tuesday. And then Jonathan did a case after that. I think actually Elliot only did one case on Tuesday, and Jonathan did a big case afterwards.
Catherine Maley, MBA: Okay. But I’ve also seen other surgeons on your 75% referral practice website, like Devar Barry.
Jason Pozner, MD: Yeah, Barry comes down once in a while and, and so does Dan delve once in a while, but we haven’t seen Dan since Covid, but they were just in Florida doing some, doing a case here and there. Okay. Just to kind of play, play around.
And Barry and I do some research stuff, so he is on my door and on my website and things. Cause he’ll come down once in a while for some research things. But it’s mainly, right now it’s me and Jonathan and Elliott Jacobs and Rondy Walker is kind of ramping up a little bit.
Catherine Maley, MBA: And then is there a plan 75% referral practice? Like what’s your, what is your plan?
Do you have an exit strategy or is that right now, you know…?
Jason Pozner, MD: You know, I don’t know. I’m 61 and I’m, you know, thank God I’m right now in good health. But, you know, that could change if health, if health changes a little bit. But, you know, I think the key is work, you know, surgeon work out a lot. Make sure you’re in good shape.
Keep your diet, keep your weight under control. So, I, I try to really stay in good shape, but I don’t know, I’d like to cut back a little bit, but I think what I’d like to do is just again, focus on, on breast and face. And if I don’t, don’t do another lipo in my life, I think I’ve done enough in my life.
That’s fine. Thinking of all the lipos. Yeah. Yeah. Shoulder hurts and Yeah. Whatever. You have to figure out what you like to do.
Catherine Maley, MBA: You, I like revision point to pick and choose what you want, you know in a 75% referral practice?
Jason Pozner, MD: Yeah. I mean, I like, I like revision face and breast revision. Breast and face. That’s what I like to do.
Perfect. I mean, I’ve done f so by the end of this week we’ll have done six revision breast cases and I think two, two or three face cases, it’s a lot.
Catherine Maley, MBA: Be nice. Yeah. Okay. Alright. Do you, and by the way, everyone says they’re going to retire and then when it gets closer, they say, oh, another five years. Yeah.
Jason Pozner, MD: Yeah. I don’t know. We’ll see. We’ll see. I mean, look, I, I’d love to take off Friday afternoons, but it’s not happening right now.
Catherine Maley, MBA: Yeah. That’s a goal, just work four days a week in a 75% referral practice.
Jason Pozner, MD: But I, but I don’t want to, what to do with myself. Right. I just, I just, I just like to get home early enough on a Friday to work out. That’s all.
Yeah. I worked a couple; the last two days were 11-hour days. I mean, that’s still a lot. I’d rather work an eight-hour day and go to the gym. I hear you.
Catherine Maley, MBA: Yeah. How about Cheryl, your practice manager, how instrumental has she been? I’ll tell you what, you’ve gotten very good at letting go in your 75% referral practice. Like, you know how most surgeons want to control the heck out of everything, right?
And it sounds to me like you have let go.
Jason Pozner, MD: Yeah. Can you Well, I’ve had good and bad, I’ve had good and bad over the years and, you know, when I needed a new a new administrator, I went to a head hunter and, you know, I, I interview people from head hunting and Cheryl by trade is an accountant. She’ll still do, she’ll do a little counting on the side.
And I was looking for a good business manager to manage all the books and, you know, it, it, you know, it took a while, but, you know, she’s a, does an awesome job. One, I trust her. And that is, that is the key to that. And then the other thing is, you know, there is a little bit of division of responsibilities and things like, like just what, any practice, you can’t have one person holding all the money cards, you know, the, you know, the money comes in with the coordinator and Cheryl goes to the bank and leaves me the cash deposits and other things.
So, you know, everybody watches everybody and, you know, and I, I trust her a million percent, but still, you know, it, it’s still a business. And I have been stolen from in the past as pretty much every other plastic surgeon. So, you got to watch the, watch the numbers, watch the monio, it comes in most of the time nowadays it’s all credit cards.
Anyway. And, and, and the other thing is, you know, back in the day, many surgeons used to cheat the IRS out of dollars and things like that. And I think that’s a bad idea. Everything’s computerized, everything goes in the bank. Just, you know, if you’re cheating the IRS and you have a disgruntled employee, you’re going to get screwed.
You’re going to jail get it.
Catherine Maley, MBA: Discount disgruntled employee.
Jason Pozner, MD: Yeah, just, just, I’m, I’m going to tell you, just keep it honest. Put everything in the bank and, and you know, just get a good accountant and sleep well at night. Sleep well, yeah. No, I, I mean, if anyone turns us in for anything, the worst thing they’re going to find is I might have put my public’s bill the supermarket on my office account that day instead of my private account.
Catherine Maley, MBA: But everything has lunch, it comes, right in your 75% referral practice.
Jason Pozner, MD: What we do, we, we buy staff lunch. Yeah. So, I buy my, our staff lunch every single day. Cause our, our, our, our hours are irregular. We don’t know when they get to take breaks, things like that. I buy the whole office lunch once a week. Every Thursday we pretty much get sushi.
I pretty much buy pizza on Fridays anyway, so, and they get, they get lunch at least two, three, I mean, pretty much they get lunch a lot, a lot. So that’s a ni that’s a nice thing. We give good bonuses. No, I, I think you need to be nice to your employees and I’ve had, I think three, three people be there over 20 years and one 15 years.
Oh. So, you know, we keep, we keep employees for a long.
Catherine Maley, MBA: Did you have to learn how to build a culture in your 75% referral practice? Did you just know how to do it?
Jason Pozner, MD: No, I, I, I think it’s, it’s, I, I, I think it’s, some things were inherent probably from my dad who treated his people pretty well and he, and you know, I, I always say you can tell people by how to treat the wait staff at a restaurant.
And, you know, I’m the kind of person who’s nice to the wait staff. I tip well. I, I’m, I don’t make a big deal and I like to have staff around me that are nice people. I think you have to be nice. I, I don’t think you can grow a successful business without being nice to people.
Catherine Maley, MBA: I have been very surprised after Covid or whatever happened with this resignation thing, I’ve been really surprised that people are not innately.
Nice or friendly. I, and I can’t treat hassle like even during the interview process. They’re not friendly and I think, wow. Where mean, where did that come from? How did you, how did you miss that in your 75% referral practice?
Jason Pozner, MD: Terrible. I mean, we paid everybody during covid. A lot of people fired everybody during Covid. I mean, what we did was we were closed down.
Florida was pretty good. We were closed down for six weeks. I think that was, it couldn’t do anything. So, I, you know what I did what I said there was, I, I’m not sure what’s going on. I’m not sure whether we’re going to get our P p P money or anything else. So, I had them work halftime, they came in halftime. I said, you know, we’ll pay you take the rest on p t o time for the six weeks.
And then after six weeks we’ll figure out what happened. Well, we got our P P P money and we went back into business. So, I gave them back all their p t o, so they, so they basically got halftime half vacation paid. I didn’t care. We had a good year that year. But, you know, I thought it was the right thing to do.
I heard practices fired people and rehired them as a starting employee. They’re there 15 years and now they’re rehired as a year one employee with minimal benefits. I mean, come on, come on. You know, that’s not how you engender loyalty in your practice.
Catherine Maley, MBA: Yeah. Well, that’s why people have been there 20 years in your past in your 75% referral practice.
Jason Pozner, MD: Yeah. Yeah. We, we have, we have a 4 0 1. We, you know, we try to be nice to people and you know, we’ve, we’ve had some people in and out and I, I have a hard time firing people. I probably keep some people too long. But, you know, I think right now, you know, at the level that I’m playing at now, I consider our team to be a major league team.
We’re a major league baseball team. Okay. And that’s how I see it. And, and if you, you can’t have a bad player in a major league team. You can’t have a minor league player in a major league team at this stage, at this stage when you’re starting out. Different story. But when, you know, every time I go into the or, I expect a hundred percent I need a, I need a home run case.
I can’t expect to have a, oh, that’s just came out. Okay. Everything has to come out perfect at my stage right now.
Catherine Maley, MBA: Mm. And I think it’s priceless when you have a cohesive team that knows what they’re doing and knows how to work together in your 75% referral practice. The efficiency of that is amazing. Yeah.
Jason Pozner, MD: And we see a lot of patients in a day.
I mean, we, we run, but you know, I don’t really sit down, but, you know, the team is great. Team is really good. I mean, we do a case on a Friday, there’s someone in there on Saturday seeing the patients, you know, it’s a lot easier with your phones now. We, we have a lot of patients that fly in and drive in remotely.
So, a lot of times, you know, take the dressing off, we’ll do a, I did a, I did a, a scar revision on a lip. It is my last case on Monday. You know, friend of the family and she had had an accident. It was terrible. It was the last case. I still do some little things like that. It’s kind of fun. But, you know, I said She doesn’t have to come in tomorrow, just FaceTime.
So, we FaceTimed her and she said, oh, you look great. Okay. Bye. That was it. You put some ice on it, No. So I think with our phones now, we, we can stay in touch with the patients a little bit easier.
Catherine Maley, MBA: Sure. Are you using a lot of technology now that you didn’t used to use in your 75% referral practice?
Jason Pozner, MD: You know, I, I, I mean, we use Nex Tech.
We already we’re, we use Nex Tech. We’re e emr. Everyone always keeps trying to get me to switch, but it works for us. We use Mirror. We’re cloud-based. We’re cloud based on next tech. We have Mira, we have a good photo system. Anything that Barry Diardo tells me to do photo wise, I do, you know, so I, I, I do that.
And then we use our phones a lot. We, you know, we do some virtuals, but we use a lot of, you know, email and photos and, and HIPAA compliant things to look at. Look at patients before and after. I, I think it, they don’t need to drive here anymore. That’s, we, we learned during Covid that not everything has to be in person to see if they’re doing okay.
Catherine Maley, MBA: I love it. I, I’d rather meet you on the phone for two minutes than Yeah. Drive over you to your 75% referral practice.
Jason Pozner, MD: How many you got? No. How many times? You know, I, I get a call on the weekend, you know, it’s like, oh, I, I did a breast lift and there’s a little scab or something looks funky. I said, send me a picture. You know, they text me a picture and then they, they text me a picture.
Probably not HIPAA compliant, but you know, they text me a picture. I said, no face. Just send me the area. And then I call them back and they’re happy. I’m happy. I don’t have to go to the office. They don’t have to drive to the office. And the whole encounter took five minutes. Love it. Yeah. Yeah. I, I think we got to play smart like that.
Catherine Maley, MBA: Yeah. Especially in today’s world. The efficiency is what is going to win. Now, I, you, there’s no, there’s no big home runs anymore, it seems like. No, your 75% referral practice has to just get so well run and that’s how you win. Well, team is how to do that.
Jason Pozner, MD: But just what you said is, is what’s critical. I mean, you know, there’s an old adage in baseball, you don’t win baseball games with home runs.
You’re win with singles and doubles and it’s just continued cases fill your schedule. I mean, how many dermatology practices do you know, that are not accepting new patients or OB GYNs? Yeah, right. They’re full, they see the same patients and you know, that’s great for a derm or OB G Y N, but you know, if I do a successful surgery, I got to fill that spot again until they come back for something else.
Yep, yep, yep, yep. That’s the nature of our business. You do a good breast job, you know, hopefully it’s 15, 20 years before they come back to you or facelift 10 years or whatever.
Catherine Maley, MBA: As long as they’re referring their friends to your 75% referral practice. As long as they go, you know, every year if they’re referring more people, that’s how you, you do the flywheel, get that thing going right?
Gimme one big business mistake that we’ve made a big one. But that you learn from because it’s all about learning, right?
Jason Pozner, MD: I think the, the big one for us is expanding too fast. You know, if you want to expand, you know, you have to expand. And I think, you know, it’s a different world nowadays. You know, you, you know, look at partners in this.
You can’t do everything yourself. And I thought we could do everything ourselves, and we ran it too loose and, and, and we, it, it almost took us down. So, I think you have to play smarter and hire good people like yourself. Hire good consultants, hire people who are smarter. You can’t know everything. You know, I know this much.
I have blinders on. So, from our quad a to our marketing, to our branding, you know, I, I work with a lot of good people like yourself to help us grow. You cannot do it yourself.
Catherine Maley, MBA: So, when you expanded too quickly, are you talking about you brought on surgeons too fast into your 75% referral practice?
Jason Pozner, MD: No, too, too many in Boca, extra locations. And we couldn’t, and we had extra locations in building and things like that, and we couldn’t, we, we, we couldn’t afford to keep those places going.
Okay. The doctors that we brought into those places didn’t perform like we thought they would perform. Well, the over funding, we’re funding it ourselves too. That was the problem. We should, we shouldn’t have funded it ourselves.
Catherine Maley, MBA: And doesn’t it take a lot longer to get it off the ground than it used to in a 75% referral practice?
Jason Pozner, MD: Yeah. Takes a long time. Took a long a lot. But less lesson learned. Hence, I have partners now, hence I have partners with other people’s money. I won’t make as much I’ll make as much, but my liability as much less.
Catherine Maley, MBA: Yeah. And not so much risk. I mean, you doctors are signing your name away a lot in your house.
Jason Pozner, MD: Well, that was a problem. That was the problem. We were personally guaranteed on everything, and I learned not to, not to do that, but at least, you know, that’s why my, we have good corporations, we have good, we have good accountants, we have, you know, good protection. We have our money in good places. So, I think you have to run a business like that.
This is a business and it becomes a big business for a lot of dollars. So, you need good people around you. You need, you can’t have a rinky-dink accountant, you know, you have to have a good accountant that you can speak to. You know, I’m buying another card. Do I pay for it? Do I write it off the business?
I have a, I, what I learned also is I have a consulting company, so I get paid to give lectures and, and do things that they pay. My consulting company, another car is off the consulting company. We don’t u that money is in a different account. So, you know, these things that Barry and I learned, and Barry and I kind of follow each other for.
Catherine Maley, MBA: I’m assuming they’re all under different LLCs in your 75% referral practice.
Jason Pozner, MD: Yeah, they’re under, they’re probably, it is probably under, under a whole C-Corp anyway, but, or a whole S-Corp anyway. But you know, they’re, they’re different companies. So, you know, talk to you, I’m not saying giving anyone tax advice, but hire a good account and let them do it.
That’s their job. Just like I said, you need a consultant, hire you, you’ll do a great job. But hi, hire people who are smart, have done this before and not reinventing the wheel.
Catherine Maley, MBA: That’s so true. So how are you differentiating yourself in your 75% referral practice? Because Boca Raton, the whole world wants to live there, and so I assume a lot of service providers also want to follow all those people.
Jason Pozner, MD: So how I have no life, you know what? I honestly have no idea at this time. We don’t have a huge marketing spend. We spent the money on branding. But I, I don’t have a big marketing spend at all. It’s mostly I have a referral business. You know, I, I’ve been in practice at this location now for 22 years.
Most of the patients come from somebody else. I have a little bit of marketing spend on the, on our websites and with RealSelf on breast implant revisions. Cause I like to do those. I do get them from other, other places. But if you look at my schedule every day, it’s all word of mouth. I did their friend, I did their sister, I’ve done them before.
And that’s a mature practice. That’s what you do in your sixties. If you’re in practice for 20 years. If I didn’t have a referral practice, I’d have a problem, but a lot don’t.
Catherine Maley, MBA: Because they have not concentrated or focused on the staff, the customer service. Right, right. The consistency in the patient experience.
Right. That just kudos to you with your 75% referral practice because that doesn’t happen by accident. You can be in practice for 30 years running a crappy business and not getting the word amount. So, you’re spending on advertising cause you’re constant churning.
Jason Pozner, MD: So, so that’s your job. That’s your job to go into a practice and figure out what the problem is.
You know, is their office manager horrible? Is the doctor have a bad personality? Are their outcomes bad? Well, you need good outcomes, but you know, people are well trained nowadays. There’s a lot of good outcomes. Good outcomes, especially on the chip shot stuff. If you can’t do a good light bulb or tummy talk or, you know, basic blepharoplasty, you, you should go to some courses and learn how to do those things.
You know, the complex revisions, I mean, 70% of what I do is secondary now. So, I mean, that’s a different story. That takes a little time to learn those things. But you know, just like secondary noses for secondary noses, you want to go to someone who does that every single day.
Catherine Maley, MBA: I agree. So, what’s your demographic in your 75% referral practice, because, are you doing any insurance?
Jason Pozner, MD: No, I don’t do it. Oh, doc, doc, Dr. Cook does a little insurance, but what happened was when I first got to Florida, I couldn’t get any on, on any plans. They were all full. So, I struggled and, and after that I’m like, okay, I don’t need to be on any plans.
Catherine Maley, MBA: Yeah, good for you. I you don’t need that in today’s world.
Jason Pozner, MD: I don’t, again, for, for face and secondary breasts, it’s, it’s, it’s all cash pay anyway. And my prices are not crazy. We keep it, we keep it relatively reasonable. We have gone up a bunch. I think I raised prices four times, you know, since covid. But, you know, little, small increments, you know, we kept testing it.
You know, I hear stories. People are booked out for a year. If you’re booked out for a year, your prices aren’t high enough. That’s stupid prices. stupid. Raise your prices until you’re booked out two months or so. And then worst scenario, you’ll lower them a little bit if you, if there’s a problem.
Catherine Maley, MBA: It’s really funny because I do a lot of consulting and they’ll say, I’m so booked out, what do I do?
And I say, isn’t it obvious? Like you would just raise your prices? And they’re like, I couldn’t do that. I would lose a lot of business. And I think you’re losing it anyway. Cause no one’s going to wait a year. They’re going to figure something else out eventually.
Jason Pozner, MD: That makes, makes no sense. You know, raise your, but that’s what people do.
They raise the prices until you get to a point where it’s a, you’re starting to see a little bit of, of resistance and listen, what’s the worst-case scenario? You see someone who can’t afford you and you want to do the case; you discount them a little bit. You know, say, I like you. Okay, we’ll do a teaching case.
We’ll use it for some marketing purposes. We’ll take 20% off if that’s what you can afford.
Catherine Maley, MBA: And that’s, I hope everyone heard that that’s how you do discounting. It starts out as a very good price, and if they want something, they have to give something in return. Right. So, you meet them in the middle and you got what you wanted, which is training for your other people to watch.
We, we, they got what they wanted and everyone’s happy.
Jason Pozner, MD: Like we do a lot of my elevates, which was, you know, a, a face procedure from Greg Mueller. So, we do train. I’m going to hear him on next week. Oh, Greg’s great. We, I love Greg. He, he’s, he’s phenomenal procedures. Phenomenal. I’ve done 2 55, I think, cases to date in three years.
Yeah. So, Greg taught me well, but one of the things with that is no, it’s not that cheap a procedure. So, we do training for them once a month in our, in our office for surgeons who want to come watch on a Saturday. So those days are half price for the patients. So, I, you know, the first question is do you do the work?
I was like, of course. I do all the work and I do all the work and they watch and I also do training for Cun Quarterly where we do a deep re servicing seminar. So, we do, you know, normally it’s five to $6,000 for a deep re servicing, so it’s half price that day. Some people watch, I still do the procedure, but they watch and those are ways to get around that, that discounting especially, or, or the other way is, you know, be on call for a fill-in if, if, you know, during covid we had a lot of patients getting covid and, and other medical problems and sometimes we’ll say, listen, if you’re willing to go last minute or something, we’ll discount you to fill a day.
Catherine Maley, MBA: Yep. Have you noticed the patients have gotten more price sensitive in your 75% referral practice? No. Now than they used to be.
Jason Pozner, MD: The opposite. During Covid, they were less price sensitive and my coordinator said they’re starting to see a little bit resistance now again. But during Covid, they were not price sensitive at all. That’s how we were able to raise our prices.
She’s starting to see, I actually, we had this conversation today, and this is one of the other things, you need to talk to your coordinator. You know, you have to see what, what’s going on. We looked through the schedule, you know, how far are we booked out? Are there any holes? Do I need to do anything differently or am I not spending enough time with the patients?
Are there too many consults that day? Should we tone it down? You need to have this constant communication because things do change. So, one of the things we, we, she said was, see, starting take, yesterday we had a consult day. I had 17 consults was a lot. That’s, yeah, that’s a, that’s a, that’s a consult day.
Plus, I saw a bunch of follow ups and yesterday she said, well, only two books out of 17. And normally we’ll book a little bit more than she said today. Well, five, five more called and booked today. So, but, but during covid. When we had some limited spots, we probably would’ve booked 10 on the spot.
Catherine Maley, MBA: Well, there was a lot of money flowing through the economy also.
Yeah. You know, that’s not going to happen for long, ever, you know. Right. But I, I, you know what, you’ll know if you’re not seeing the patients enough, like if you at the 17th a lot and then, then you’ll start getting those reviews. Oh, you spent two minutes with me, you know, didn’t see.
Jason Pozner, MD: Right, right. That’s a problem.
I do get those reviews sometimes, and, and, and sometimes they’ll come back for a second consult and, you know, I, I don’t mind the second consult if I see them on the schedule. I know second consults, 90% chance going to book. Nice. But, but some of the times, you know, I had 17 consults on the books, but I sent three to Dr.
Cook and some were, you know, some of them are not good, good cases, you know, although 17, how many are actually good cases for you? 12. Maybe, you know, five. Were like too fat for, too fat for surgery. Too many medical problems for surgery. You better off in our med spa for a non-surgical procedure. You know, we do, I do turf them.
Catherine Maley, MBA: I do a lot of training with consultants and one of the things we do a lot is triage a lot more carefully at the beginning. So, we’re not waiting for so much time at the end. You don’t need the practice. You, you know how to as you don’t need 17, you need seven qualified. Actually, we’re not going to end up saying your VMI is ridiculous.
You’re on meds, you have heart trouble, you just had a transplant for god’s sake. Right, right, right. Why, why are we seeing this patient?
Jason Pozner, MD: But I do on Tuesdays, I do like. I do like those 15 to 17 consults on a Tuesday for me. That, that, that works for me. But remember, some of these might not be big cases. Some of them might be lower eyelid laser, you know, that’s a 2000, $2,500 case.
Not a huge case, but that consult takes me five minutes to 10 minutes. It’s not a long consult. You know, a revision breast might take me probably a primary Ag takes me longer than anything else. Revision breast is, revision Breast is pretty easy. No, you got a capsule, you got to take the capsule out and, and we’ll do a lift.
But a primary Ag is probably my longest consult. Faces don’t take me that long for consults. I don’t know why. But in general, the patients are relatively savvy and there’s a lot of secondaries who have had it before.
Catherine Maley, MBA: I have literally had surgeons say, I’d rather do facelifts all day than fiddle around with these 20 year old breast augs.
Yeah. They’re like, breast augs used to be the EP money. And now it’s like, no, they’re, they’re costing me a fortune. They’re wobbly, they’re flaking, you know.
Jason Pozner, MD: Yep. And I don’t do that many, I don’t do that many primary ags. I, I just don’t, I mean of, of, I haven’t done a primary AG in probably a month. You know, it’s a lot of revision cases, but again, that’s what I like to do and that’s what comes in and seeks me out.
If they, they’ll go to Miami for cheap prices. If they want a primary Ag.
Catherine Maley, MBA: And there are plenty of those places. My goodness, I’ve never seen anything like it. That’s another story. But very interesting watching how else you can do this and whatever. Okay. What about social media in your 75% referral practice? Are you jumping on that bandwagon?
What, what are you doing in your 75% referral practice?
Jason Pozner, MD: No, I, you know, it’s funny because I, I, I had a whole meeting with my associate today, Dr. Cook about that. You know, we’re just not that good at it. Yeah. And, you know, I hate to say it, we’re just not that good at it. We’re looking at things to make it better, but I’m not the kind, you know, me for a long time.
I’m not the kind of guy to be dancing around. Right. You know, we, our time is spent doing research and other things, so we’re trying to work on that to get our message out there, which is, we’re a new technology place. We like our new stuff. This is my bread and butter, but this is my research interest.
We’re going to start changing things around a little bit. I work with Plastic Surgery Channel with Bill Adams, whose content is amazing. So, I’m actually going to be talking to Bill this weekend about how we can kind of work on some new projects together with this getting our message out about, you know, you know, what is elior, what is, what is this, what is, what is the difference between these RF devices?
So, we’re going to try that for a while. I’ll let you know next year whether it works or not for sure.
Catherine Maley, MBA: Speaking of all the devices in your 75% referral practice, you probably work more with other vendors or pharma companies in the industry than anybody else I’ve ever seen. Probably. Why, why is what? What’s the advantage to you to do that in a 75% referral practice?
Jason Pozner, MD: So, it’s, it’s inte for practice. It, it’s intellectually stimulating to me. Yes. That’s, it just is, I mean, I just like new toys. I basically want to put myself out of business. You know, what, what do people want? I mean, look at, historically, when I was a surgical resident, the kings of the hospital were the cardiac surgeons who cracked chest and did bypasses.
Right? Yeah. Now they’re peons because the, the minimally invasive cardiologists are doing stents and other things, and the cardiac surgeons are only doing the worst of the worst patients. So, I think that’s the nature of medicine. We’re getting more minimally invasive and I think there will be a time that I’ll be able to take a patient and offer them procedures as they’re getting older.
So, they may not need a face. And I, I think that’s the way we’re going. I mean, you know, the weight loss meds are amazing now, you know, these G L P agonists, the, you know, Wago and, and Manjaro are doing a great job for weight loss. Our light bulb numbers may go down on these bigger patients. We do may do more body contouring as they start to lose weight.
So, things change. You need to be aware of what’s out in the market and you need to adapt to how things are changing, right? So, I mean, when I was a general surgery resident, we were cutting out stomachs for ulcer disease and now, you know, 30 something years later, bacteria cause ulcers and you need to treat it medically.
So, there’s different ways to treat these, and that’s my research interest, making non-surgical things better and, and surgical things. But I love the non-surgical research.
Catherine Maley, MBA: And the consumers love the non-surgical too. So just follow the consumers. If, if they will go non-surgical, as long as humanly possible, if their technology’s available if they can get by with no scarring, less money, less downtime, you, you can’t beat it.
So, I right there, there’s room for all of that right now, especially in a 75% referral practice.
Jason Pozner, MD: And, and the difference between me 20 years ago and then me now is I invested these companies. As I hear about them, I put my money where my mouth is and some win. And some don’t win as much. But I’ve done pretty well an along the years I learned, because back in the day, Barry de Bernardo, Larry Bass and myself, spent a lot of time with all therapy people.
We worked with them; we worked all their protocols out. We did a lot of their early data and you know how much we got from them when they sold for $600 million. Zippo. Okay. We don’t do that anymore. So, we put our money where our mouth is and we work with the companies and we get paid for our time and effort.
And it, it’s, it’s mutually beneficial. We put our time in, but we get paid for stuff. Sometimes it’s on the back end, but we get paid for, we, we do get paid for things. And I do put my money in these, in these investments. I think that’s the way to really invest in what, you know, when I stay in my lane, I make money.
When I go out of my lane, I lose money.
Catherine Maley, MBA: Well, and the wealthy get wealthy from investing, not from making the money they investing anyway. So, tell, so we’re going to wrap this up. Tell us something we don’t know about you apart from you having a 75% referral practice.
Jason Pozner, MD: Can you hold on for one second? Of course. Hold on for one second and I’ll show you something.
You No, no. You don’t know about me. Okay. Hopefully he comes back shortly. I’ll become very shortly while the length is off here. Frosty. Come here. Frosty. Come here.
Catherine Maley, MBA: Okay. Frosty. Okay. I’m assuming there’s an animal involved.
Jason Pozner, MD: You hear some noise here?
Catherine Maley, MBA: Okay. I don’t know what it is yet for those don’t know what it is.
You’re just listening to audio. We don’t know yet what he’s talking about
Jason Pozner, MD: You don’t know. You don’t know? Okay. Where’s Frosty? This is Frosty.
Catherine Maley, MBA: Oh my God. It’s a parrot.
Jason Pozner, MD: It’s a parrot. So, I have, so I’ve been working with birds for 30 years now. Oh my God. And this is, I just, the lights were just off, so. So, this is Frosty.
Frosty is literally with him. Frosty is a 20-something year old Malkin Cockatoo. She’s a female. She’s a, she’s a sweetheart. She’s, she’s one of my birds. Yeah, she talks a lot. You want to say hi? Say hi. Say hello. Hi. Say bye-bye. Bye-bye. Say bye. She talks to nonstop. I think I woke her up. But I have seven parrots.
I’ve read a few of them. I’ve had a bunch of babies over the years. So, I have one cock of two. I have former cause and two African grays. They all move in the house. They live in an aviary, which is Oh, so the, the house I’m in now, which eventually I’ll move, but the people that own the house before me had an office in their garage, so it’s air conditioned and special lighting and stuff.
So, I have a whole aviary in there with huge cages. Like, are they fun pets? They’re fun. I love birds. They’re sweethearts. Say hi, frosty. Hi. Say hello,
She talks, usually talks like crazy. Say bye bye-bye. Does There she goes. Bye-bye. Bye-bye.
Catherine Maley, MBA: Hi, frosty. That is, oh, okay. Now she’s not going to show.
Do you have to watch TV before? Okay. That’s really funny. The bird is beautiful. Yeah. Just out of curiosity. Do you have to give bath or something? How does it say?
Jason Pozner, MD: You know, it’s funny, she had this one. I, I usually spray them down a bit. I actually gave her a bath about a week or two ago because every time I was petting her, my eyes were irritated.
So, there was something on her that got me. But I, I gave her a bath the other day. But normally, normally I just spray them down. I do, they like water not really. One of my Macau loves to be sprayed, but you know, some like, and some don’t. But remember, it’s Florida, it’s warm outside. So, you know, on the weekends I have purchase outside.
I’ll take them out on the, I’ll take them out in the backyard. I’ll sit with them and read a book and spray them. It’s nice.
Catherine Maley, MBA: Well, this was the first for Beauty and the Biz and our talk on Dr. Pozner’s 75% referral practice. We’ve never had Parrot. Thank you so much, Dr. Pozner. We’ve had dogs.
Jason Pozner, MD: The dog’s not here today. Bye Bye bye. Alright, Catherine. Alright.
Catherine Maley, MBA: Alright. So, everybody, thank you so much for joining us on the topic of running a 75% referral practice. Please if you would, would subscribe to Beauty and the Biz and share this information with your colleagues as well as your staff. And then if you’ve got any questions for Dr. Pozner… Dr. Pozner, how would they get ahold of you? Your website?
Jason Pozner, MD: Yeah, just email me. Best way to get me is email me is J p o z n e r MD at Gmail. That’s my private email. Just, just, just, just best way is email me that you just told a whole bunch of people. Okay, that’s fine. I’m, I get, I get a million emails a day, so, and I do, if I, if I don’t respond email. Sometimes it gets, it goes to trash or I get lost.
Catherine Maley, MBA: Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on Dr. Pozner’s 75% Referral Practice.
If you’ve got any questions or feedback for Dr. Pozner, you can reach out to his website at, www.SanctuaryMedical.com.
A big thanks to Dr. Pozner for sharing his philosophy on running a 75% referral practice.
And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.
If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.
And we will talk to you again soon. Take care.
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-End transcript for the “75% Referral Practice — with Jason Pozner, MD”.
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