Balancing cosmetic with insurance — with Gregory A. Greco, DO

Balancing Cosmetic with Insurance — with Gregory A. Greco, DO

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and balancing cosmetic with insurance.

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 “Balancing Cosmetic with Insurance — with Gregory A. Greco, DO”.

Balancing cash-based cosmetic procedures with insurance-covered procedures is not easy.

Yes, when you offer both, you have diversified your services and that allows you to cater to a broader patient base. 

That diversity can give you peace of mind knowing you have less risk of relying solely on one revenue stream.

However, if you’re not careful, the insurance side will eat up you and your staff’s focus and energy due to the time and effort it takes to get reimbursed. 

And while you’re fiddling with time-intensive insurance regulations, you could have been creating content to drive more cosmetic patients to you. 

Frankly, if you ask me, since the cosmetic patient is more lucrative and it’s so competitive, I would spend more time helping the cosmetic patient find the money to pay for your services. Just sayin…

⬇️ Click below to watch “Balancing Cosmetic with Insurance — with Gregory A. Greco, DO”

This week’s video is an interview I did with the current American Society of Plastic Surgeons (ASPS) — President Gregory A. Greco, DO who is in private practice in NJ.

When Dr. Greco is not traveling the world representing board-certified plastic surgeons, he is running his own practice that caters to both cosmetic and insurance-based procedures.

We also talked about:

  • How patient demand has changed thanks to social media and ASPS’ views on their members keeping their social media channels professional and ethical
  • How AI is going to make it difficult to authenticate your before/after images, as well as your voice
  • How ASPS has resources to pare its members who are looking to join/buy/sell a practice
  • How their annual meeting has added “Project Well” to keep their members healthy and happy 😉

Dr. Greco also admitted to me his guilty pleasures and we even share one of them. 

P.S. Earlier this week, I talked about following up on leads and that starts with your receptionist. Get 87% OFF front desk training with this one-time offer….

👁 DON’T MISS THESE INTERVIEWS 👁

Balancing Cosmetic with Insurance — with Gregory A. Greco, DO

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery and balancing cosmetic with insurance. I’m your host, Catherine Maley, author of “Your Aesthetic Practice, what your patients are saying”, as well as consultant to plastic surgeons to get them more patients and more profits, and I’m very excited about today’s guest who knows a lot about balancing cosmetic with insurance.

It’s Dr. Greg Greco, and he’s a board- certified plastic surgeon in private practice in New Jersey, and he’s also the current president of ASPS, otherwise known as the American Society of Plastic Surgeons.

So, I want to jump right in and talk about both his practice, how he’s balancing cosmetic with insurance, and the society. So, Dr. Greco, welcome to Beauty and the Biz.

Gregory A. Greco, DO: Catherine, thank you so much for having me. I really appreciate the invitation and I’m looking forward to this.

Catherine Maley, MBA: Oh, absolutely. This all came about because we recently, during Memorial weekend, why that meeting was Memorial Weekend. I don’t know, but we were at that California Society of Plastic Surgeons and you were like one of the first speakers and I thought, oh my God. How does this relate to you balancing cosmetic with insurance?

 It was so nice of you to show up in California for that meeting and you had such good things to talk about, even like the business side, the marketing side, the physical side, you know, like, like treat. You really know it all. So, I really wanted to pick your brain about things going on in the world. So, let’s just start with your own practice, because it’s not like your practice can take a break. How does this relate to you balancing cosmetic with insurance?

You still have to practice. So, can you describe what your practice is made up of? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: So, thanks Catherine. Thanks for that question. So, my practice I have, I’m in a solo private practice my entire career, and I kind of have this, this kind of hybrid academic, private practice, but predominantly cosmetic surgery practice.

So, so I am a full body cosmetic plastic surgeon. I, I also do a small amount of implant-based breast reconstruction as well which I never wanted to give up because I, I just love. Our breast cancer patients. And I kind of have this bimodal distribution of my cosmetic surgery practice where the mommy makeover patient and then the facelift blepharoplasty facial patients.

So, so I kind of spread the, the practice between two generations, if you will. And my hybrid portion that I’m talking about is I run a general surgery residency program. I have a board certified. General surgeon and a board-certified plastic surgeon by the American Board of Surgery, as well as the American Board of Plastic Surgery.

So, I maintain both certifications throughout my entire career. I’ve been in practice for 22 years and I have practiced both in Red Bank, New Jersey, which is a, basically it’s a bedroom community of New York City. And I also have a maintainer practice in on Central Park South in New York City.

Catherine Maley, MBA: Nice. I have to ask, how difficult is it in today’s world to balance the insurance side of your practice with the cash side of your practice? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: You know, it’s, it’s always challenging to balance your practice. Period. And then the insurance aspect, you know, we were predominantly cosmetic surgery, but the insurance aspect, I think, you know, again, maintaining that portion of the practice, especially for my breast cancer patients, you know, for me is so important.

But, but it’s difficult, right? Insurance companies or insurance carriers, Between the regulatory issues and the all the legislative issues, and then just the complexity of insurance makes it complicated. You know, we pay a lot in salaries to, to navigate all of that and it’s frustrating sometimes.

Moreover, you know, forget about our end of it for the patient. It’s really complex.

Catherine Maley, MBA: I, as a consultant to plastic surgeons, it’s just so difficult to consult on that because I just want to talk about the cash side because I know it so well. Yeah, and it’s just, it’s an, it’s a cleaner kind of business, but I appreciate those who still do insurance. How does this relate to you balancing cosmetic with insurance?

Thank God you know when you need it. Thank God there are good people doing it.

Gregory A. Greco, DO: Yeah. I mean, I, I think the, you know, having alternative revenue streams and, you know, I think when you look at, you know, the, the for-profit aesthetic medicine, you know, it’s certainly, it does, it’s cleaner. It’s easier to kind of figure out because they’re, you know, it’s predictable.

Mm-hmm. Whereas, you know, when you have a hybrid, I mean, it’s, it’s definitely more complicated again. But you know, like anything, you, you, you figure out how to navigate it.

Catherine Maley, MBA: For sure. Now, are you basically a surgical practice or do you also believe on, in the non-surgical and building that patient’s relationship, so they come back for surgery? How does this relate to you balancing cosmetic with insurance?

What’s your feeling on that?

Gregory A. Greco, DO: Yeah. No. I’m all in. I think it’s an incredibly important, I think it, all the services are, you know, you see your patients and you don’t want to, you know, parse out the services, you know, to different practices. So, one of the things, especially. Being a solo private practitioner, you know, the injectables, you know, we started, you know, this was 22 years ago, so neurotoxins, there was one and injectables.

There was really nothing that was worthwhile as, you know, you’re a consultant in this industry, you know. So, we went from, you know, stuff that was just marginally okay to so many different products now, so and so I kind of grew with the injectable market. My practice kind of grew the same way. And, you know, those were always the, the best way for me to have FaceTime with my patients.

I was always my own injector. I have several like, you know, injectors now and, and you know, other services offered within my practice. But no, I think we are a full-service practice for lots of different reasons. Because, I think it’s important for your patients, including your surgical patients. And, you know patients want all their services under one roof, if they can. That’s perfect for the patient.

Catherine Maley, MBA: It’s tough to manage all of those profit centers. Mm-hmm. So, who’s running the show over there? Are you trying to manage all of this? Do you have somebody helping? How? How are you set up? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: You know, it’s, it’s a, it’s actually a great question.

I mean, when you look at, you know, the profit centers within the business so I, I can happily say that I, I’ve had the same accountant since I started. So, we’ve had a great relationship and, you know, once every quarter, you know, we’re, we’re, we’re together in person and. And, but you know, between both of us, we, we seem to manage it so which is great and, and I think that, you know, over the course of time having so many really bright colleagues and you know, we always discuss this stuff, we always try to figure out, you know, whether another way to kind of twist the biz and figure out, you know, what the room is generating and you know which profit margin actually is.

And you know, because there’s a lot of complex math when it comes to dealing with industry about. You know, the cost of products and, you know, today versus tomorrow versus, you know, whatever incentive program is out there. So, but I think we, we, we seem to manage, so, but it’s always complicated and it’s always it’s always, you are always learning to stay ahead of it.

Catherine Maley, MBA: For sure. And then what about the trends in patient demand patient procedures, what are they liking? What are they no longer liking? What has surprised you about the demand? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Well, you know, the, it’s interesting, the demand for procedures, the demand for injectables, depending on, you know, so the one thing I, I think that we’ve all been kind of it wasn’t a surprise attack, but social media has really become the, almost the, the bellwether for what the phone.

You know, calls may be about the whatever particular day. So, because you know, now versus just having to read a paper, read a magazine, you know, you just have to go sit in, in your waiting room and, and go through the magazines to see what people are going to be asking you about. I don’t have the time, maybe the patience to sit and get flip through, you know, all of Instagram and figure out what were TikTok, what the patients are going to be looking for, however, I think there are things, you know, we recently had kind of this kind of surge in buckle fat, right?

People wanted buckle fat pad removal. And then, you know, we had the, the autologous fat grafting to the buttock and now we’re seeing the reversal of that trend. So, you know, I, I think. Regardless, you know, there’s always something trending, there’s no doubt about it. You know, the lip flip is still kind of, people are coming in and asking for the lip flip.

So, regardless of whether or not people truly understand what it is, it is something that staying on top of it is helpful just to understand the terminology. So, you know, I think that the non-inject, I’m sorry, the non-surgical portion of, of, of this business is always, I think, kind of. Getting us or it’s probably the bigger ask on a daily basis.

Catherine Maley, MBA: Mm-hmm. Regarding the patients though themselves, have you found that they come in a lot more, I don’t know if it’s educated or misinformed or, you know all of it. How are patients different now than they used to be during that consultation? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: You know, I, I think that the patients, at the end of the day, they’re educated.

It’s all information. So, I think that the patients have information, which is very helpful. My job as a practitioner and as a plastic surgeon is to just really. Help them understand the nature of their request, whether or not, you know, through kind of some shared decision making, whether or not whatever they’re asking for is actually appropriate for them.

You know, so, so I think that at the end of the day, as much as we want to be cynical about some of the things it’s driving, you know, patients to our practice, you know, because patients trust you. So, they’re going to say, okay, tell me about this. Is this actually a procedure that. I can do, do you think this is realistic for me?

Can I have this result? You know, so, so I think the expectation management at the end of the day, especially, you know, who knows what we’re actually looking at on, I mean, I’m looking at results saying, really, that’s amazing if you really got that result. So, so again, it’s, it’s confusing. It’s confusing to us.

As providers. I think it’s really confusing to patients, especially when you’re not aware of all, whether it’s a product, whether it’s a surgery, regardless. But I think patients, at the end of the day, they’re educated, you know, and, and my job is to make sure that they’re educated correctly and that I give them the information they need to make a decision.

Catherine Maley, MBA: Along those lines, there’s always that big discussion about. Board certified plastic surgeon versus non-board-certified plastic surgeon. And I know your organization has spent time on this as well. How do you educate the patients on that? Do they get it? Do you bother anymore? How, what’s your take on that? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Well, I mean, I think we’re, we’re always going to bother. I think it’s always worth, you know, and I think that the clarity has to be, Board certified plastic surgeon versus cosmetic surgeon. And I think the confusion is the fact that the term cosmetic surgeon, I. It can mean anything. There’s no clarity around it because there’s a lot of boards that aren’t a B M S or American board of medical subspecialties that are the real recognized boards.

There are some pay-to-play boards out there where some minor qualifications will get you a board certification and it’s very confusing for the patients. So, and that’s the, you know, unfortunately the biggest problem. So, we as plastic surgeons, you know, I spent, I. Nine years in residency, in operating rooms, making sure that I was as qualified as I could be.

So, do you need nine years of residency to inject Botox? Of course not. However, the, there, there’s so much that you learn to appreciate and recognize, and I, I always think of it as, you know, do I have the full armamentarium to take care of my complications? And the answer is yes. So, I can recognize and take care of them as well.

So, I think that’s where we tend to fool ourselves a little bit, where, you know, people appear qualified. And I think that when people, especially with social media these days, you know, just because someone has. X number of followers. It does not equate to competency. It equates to having a good social media background and you know, whether you hire them or you’re just good at it, but it doesn’t equate to competency.

And, and ultimately, you know, especially as the president of society and you know, we. Puts patient safety, you know, as if it’s a pyramid. Patient safety is number one. It’s the, it’s the, it’s the top of the pyramid and we just want our patients to make sure that they’re going to qualified individuals. So, yes, I’m going to say board certification matters.

Yes. I’m going to say plastic surgery matters. Although I have nurse injectors within my practice, they’re trained by me, and we all kind of recognize, you know, our aesthetic. We recognize, you know, what we want out of our, you know, whatever we’re trying to accomplish. So, we’re all looking in the same direction, at least.

Catherine Maley, MBA: Long time ago I came up with a marketing tool called Position the physician, and it visually shows the kind of education that went into board certification and I, because everyone can look at your long cv, but the, the world today, I think they’re more picture driven. Yeah. So, I just show a one page visual of.

This is what went into that while the rest of us got, you know, went to work after grad school. You were, you stayed put for like another decade, you know? That’s right. So, there’s a lot that went into that and there, there’s got to be a balance there between not, it’s not bragging, it’s like factually explaining why Yeah.

You are different than somebody else who didn’t go through that. Because, but God, I got to tell you, social media there’ve been a lot of surgeons who are usurped. By really good marketers. That’s right. At least in the short run, you know? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Yeah. And, and I’m not saying, and I’m not disqualifying everyone out there because it’s, you know, it wouldn’t be fair to do that because there are people who are doing, you know, good jobs.

 The, the concern is about the ability to recognize complications and moreover, serious, sometimes fatal complications and the ability to have that education. You know, there are things that, you know, There as a cosmetic surgeon, you know, not that you had to, but you probably never did a liver transplant.

You never did cardiac surgery, you never did. You know, the, so the anatomy, just everything being all over a body and, and operating from head to toe for 10 years. I, I don’t know. You know, again, it’s not that. Board certified plastic surgeons can’t have and don’t have complications. It’s just, I think that, you know, we put so much emphasis on, on research and meaning that us as consumers, you know, I always say that everybody will research their next dish, dishwasher, that they’re going to purchase more than they research their doctor.

And it’s really true. You know, you’re getting reviews, consumer reports seen at this, that, whatever, wherever you’re going and just. You know, you just go where your friend went. So, so it’s, it’s one of those things that, you know, is it hard to quantify? It’s hard to quantify, but when you hear it, you know, either in a pictogram or just, you know, just spoken out, it, it makes sense.

Catherine Maley, MBA: Yeah. So, part of your membership, I remember I used to do a lot of work with ASPS years ago and they are very careful about how they market. They had a big list of marketing no-nos. And my issue was, while your… I felt it was almost restraint of trade because you weren’t allowed to do a lot of things that the others were doing because there was no regulation over them.

Yeah. So, how, how is that going now? What do you allow or what don’t you allow in marketing, you know, numbers. How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: We, we recognize the fact that, you know, at the end of the day, you know, we want to, you know, hold our members to the, to highest. You know, metrics, whether it’s quality, or it’s ethics and, you know, the highest moral standards.

So, but we recognize at the same time, we don’t want to prohibit or limit the ability for our, our membership to stay competitive. As you said, you know, it, it’s almost, you know, we’re quashing their ability to, so, so. Recognizing that, you know, years ago there was, you, you couldn’t even market, you know, say there was a charity and you wanted to, to have a, a basket and have 50 units of Botox that people can, you know, spend a thousand dollars on or $2,000 on.

And it all went to charity. But we couldn’t even do that. So, we’ve recognized that, and we do allow certain non-surgical procedures. You still can’t, you know, we don’t. Recognize the fact that people should be giving away anything that requires, you know, surgery or surgical consent. You know, that’s still, you know, we, we prohibit that however, but we’ve become a little more lenient in what our members are allowed to do.

And certainly, we have social media standards and I think overall, you know, it’s kind of a little litmus test. Just do the right thing if it makes sense. It makes sense.

Catherine Maley, MBA: Yeah. Talking again about social media, how do you feel about how crazy that’s gotten? You know, people are showing everything huge surgical procedures.

 It’s just gotten very interesting and plastic surgery and social media don’t often get along. How are, are you as a society handling that or keeping it upscale and ethical? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Again, I think that we, you know, you certainly can’t police every so social media account, nor should we have to. I mean, I think most people recognize, you know what?

Patients want “befores and afters” for the most part. Mm-hmm. I mean, there’s a little intraoperative, you know, stuff a lot of people like to show them peeling away all the skin from the tummy tuck they just did. Yeah. You know, if, if that’s what people want to watch, I guess it’s fine, you know, but you know, your immediate three-minute result and your six month and one year result have nothing to do with each other.

So, you know, again, it’s good for social media. And, you know, people are certainly, you know, getting a lot of likes and followers from this, but I think everybody is now understands your consumption of social media has to come through a filter. So, and we all recognize that it doesn’t matter. I mean, other than watching, you know, Like, I’m a sucker for kittens, puppies, baby horses and goats.

You know, we, the rest of it, you just kind of, you’re just amused by it, right? So, so I think that, you know, if you’re getting your news and you know all things relevant to your life from social media, you should probably take a break.

Catherine Maley, MBA: So, at the meeting that we were at there were two heavy hitters from Beverly Hills talking about social media and ai, which is artificial intelligence Yeah.

And how much that is going to change this. Yeah. Oh wow. It’s going to change a few things. And one thing that one of the doctors said that I thought was brilliant was, get all your before and after photos up there right now with your watermarks dated just in case somebody decides to start messing with your photos. How does this relate to you balancing cosmetic with insurance?

 Down the road or something. Did you hear that one? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Yeah. No, it was, you know, Dr. Nazarian and Dr. Gava, I mean, they were great. It was great advice because I think AI is, you know, the, one of the biggest threats, you know, the other day the radio, I was just listening to an interview and they were interviewing Sam Altman who developed ChatGPT.

It’s fascinating because, you know, he was almost saying that, you know, he really thinks that you need government intervention to contain, you know, and to regulate, you know, ai and it was just likened it to, you know, nuclear proliferation and how this has to be a global issue. So, that was fascinating to hear from.

Someone who was responsible for, you know, his company for, for developing chat G B T. So, I think it’s all a concern. I think it’s existential until it’s not. So, I mean, yeah.

Catherine Maley, MBA: I think that horse is out of the barn. I don’t know how in the world they’re going to regulate that. I know. I love Elon Musk. I think he’s amazing.

He’s a, he is genius. And he said, I warned him years ago, don’t let this, don’t let this get out. It’s going to, it’s going to hurt us a lot. How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Yeah, that’s great. Yeah, I don’t, I mean, it’s really hard to comment on who knows. I mean, yeah, I think that, you know, there’s, there’s, you can ask ChatGPT for post-op instructions, and it still gets, you know, a fair amount wrong.

But, you know, as, as you know, listening to Mr. Altman the other day, he said, look, just like you would, it would just say, okay, like you would say, I’m going to call one of my smart friends, or I’m going to read. Some books, and I’m going to continue to learn about this. That’s what’s probably going to keep happening. So, the question is, you know, are we making ourselves obsolete?

I don’t, I don’t know. You know, so it’s a scary question. It’s a, yeah. You know, this is the “how” of 30 years ago.

Catherine Maley, MBA: Well, I just saw an example, like I love Joe Rogan. He just, he’s doing a really killer job on his podcast and they showed how they put Joe Rogan together with this speaker that he had, but they AI it, I don’t know if that’s a verb or not. How does this relate to you balancing cosmetic with insurance?

And they had Joe Rogan promoting that. Supplement, which was nothing of what was happening there. And you couldn’t tell, like I, I couldn’t tell. I thought why would he, I literally was thinking to myself, why is he promoting this on his show like that? Anyway, that’s kind of, yeah. How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: No, I think, I think just proving the fact that, you know, we’re going to be as consumers.

Unable to recognize, you know, the computer generated or you know, versus the real, and that’s concerning. I mean, who knows? Maybe this is going to be the same thing, you know, where it will just be computer generated images. You know, most of us have our voices out there that. Could be copied and, you know, I don’t know.

It’s a done deal. So, we’ll see what happens.

Catherine Maley, MBA: Well, I’m very happy with my filter on Zoom, so I, I would like to keep that. But the rest I don’t know how you’re going to date in, on the online, you know, the, the filters are going to be in insane. So, anyway another, imagine going back to the good old days. How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: What’s that? Imagine going back to the good old days where you actually meet somebody in person and —

Catherine Maley, MBA: That’s right. Have a conversation, God forbid. How about destination surgery? I did speak at a meeting in Florida and there were almost 10,000 people there. About destination surgery. I had no idea what a big deal it was.

 Does ASPS think it’s a big deal? Or how are you handling that topic? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: So, so there’s a, there’s a couple of ways to kind of break this down. So, there’s medical tourism, which can be international, right? And there’s destination surgery, which can be, you know, within our own borders. So, you know, and there’s several ways to, just to kind of look at this.

Number one, I think international medical tourism, you know, has the potential for disaster. And we have statements and I’ve actually been interviewed and, and also been quoted in multiple sources about this. One of the biggest concerns is that, you know, we have standards within the United States, you know, if you’re going to legitimate board-certified surgeons, and you know, if they’re credible and operating in, in whether they’re nationally accredited or state licensed facilities. You know, when you’re international medical tourism, you don’t know what you’re getting. You may you not only have the process of travel, which can set you up for a blood clot alone, then you have language barriers and you have, you know, itinerant surgeons, you know people who may be flying in.

You may not be meeting your surgeon, you know, until the day of your surgery. So, What does the postoperative care look like if you have drains? Are you being sent home with a drain? And then there’s a whole host of, you know, my, my biggest kind of, Tagline with this is, where are you comfortable having your complications?

So, you know, most plastic surgery, fortunately, you know, usually goes well, but there’s surgery that does not go well, and where are you comfortable with that? So, if you’re going to be in a, in a foreign land that you don’t speak the language, you know, you, you’re going to wind up. Paying more and probably, you know, possibly risking your life.

 Then there’s tourism, medical tourism within our own country. And I think the biggest thing with that, you know, people can get on a plane to go have procedures and it’s not uncommon and, you know, especially with plastic surgery and we just want to make sure that. From a society standpoint that whomever is operating is, you know, if they’re going to then turn the care over to a local plastic surgeon, that there’s communication, that they’re not just sending someone home and saying, Hey, which is something that we’ve seen from Florida.

You know, again, some of these, you know, for lack of a better word, these unfortunate. You know, chop shops where people are going and they’re being misled and they’re then being sent home and say, Hey, when you, you need your drain out, go to the er and they’ll pull out your drain. Oh my god. You know, and these things are just immoral and un unethical and, you know, we, we are obviously do not, you know condone any of that.

Catherine Maley, MBA: Yeah. I do know several surgeons who do zip over to Dubai, do surgery, come back. It’s a very lucrative thing to do in the short run. How does this relate to you balancing cosmetic with insurance?Personally, I’m thinking, is it helping you grow your practice? I, I, I, I can. Or if you’re just trying to get away from your practice and it’s more like a vacation, but how does ASPS feel about that? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Well, again, it depends, you know, Dubai’s actually a great example because Dubai, I. In as much as I know about it, I’ve met with the Chamber of Commerce in Dubai, you know, in part of my role and being a part of the not only the recent meeting, the ILAT meeting, but also the Emirates meeting.

And they do it right in as much as. They make sure that their operating rooms are in fact credentialed either by, you know, some of our national credentialing agencies or by, you know, the by Dubai, the UAE. So, and then the surgeons that are going over are going over spending time. They’re operating, but they’re taken care of by plastic surgeons and, you know, and they’re not Americans necessarily.

You know, I’m not really sure where the patients come from, but again, I don’t think, I’m not going to say it can’t be done well, but Dubai’s a good example of where a lot of it is done well. Because they understand that if they want to become a center for whatever, they have to do it right. They have to promote patient safety.

They have to make sure that their physicians are credentialed and boarded. And that they’re in fact doing, you know, they’re not doing harm to patients because they don’t want the stain on their reputation that patients are coming and having complications from plastic surgery, whereas some other countries, you know, don’t, didn’t, aren’t, you know, maybe privy to the fact that this is happening within their borders.

So, so I think Dubai, for the most part, the, the country itself is involved in this process.

Catherine Maley, MBA: Well, from what I’ve seen, the facilities are gorgeous.

Gregory A. Greco, DO: Beautiful, and they’re committed to patient safety. Again, I don’t necessarily think a 14-hour trip to go have surgery is necessarily the right thing to do, depending on where you’re coming from.

But I don’t know enough about the patient population, where they come from, et cetera. But I do know surgeons, as you do that, operate there and it seems to be a above board. Okay. What’s that? The few that I know, so again, I can’t comment on the entire industry, but at least the, the, the, some of the surgeons and the processes that I’ve witnessed.

Catherine Maley, MBA: Well, I will say the surgeons that I do know, there’s, there’s no story behind it. Like nobody’s had a drama or trauma or Correct. It’s been fine. Yeah. I just think you have such bad jet lag, like yes. If you’re over there for three days, it takes three days to recuperate. You know? I just, I don’t know. I don’t know if it’s a good use of your time, frankly, but —

Gregory A. Greco, DO: Yeah, I mean, I think that, you know, we can be more useful personally. In my own practice, right?

Catherine Maley, MBA: Yeah. Yeah. Why grow somebody else’s? So, let’s talk about A S P S and your position now, you’ve been in, you’ve been the president since November of 2022, and it’s a one-year term. How’s it going? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: You know, it’s been just absolutely a, a, a wonderful experience. Tiring experience, but a wonderful experience.

You know, I’ve had the opportunity to not only travel the country, but travel a good chunk of the world. And we have first we’re the largest plastic surgery society in the country and also in the world. So, we have 50 countries that we have MOUs or memorandums of understanding with. So, so we have just.

So, many bright, talented surgeons located that are either national members or international members throughout the world. And, and having the ability to meet so many people and just, you know, they’re so bright, talented, innovative, and just the cultural exchange and the scientific exchange has just been fascinating.

So, moreover, one of the greatest things is, Having the opportunity to get in front of our residents and medical students mm-hmm. And kind of that pipeline of plastic surgery, you know, all the up-and-coming leaders and, you know, it’s, it’s really been wonderful and, and, and also having the ability to kind of move the needle forward with migrate board.

 Just for plastic surgery, you know, whether it’s an issue involving, you know, it’s a legislative issue or it’s a regulatory issue, or it’s just something that has nothing to do with that. But you know it’s been really fun and like I said, I, I’m surrounded by so many great people to help, you know, to help us kind of move the needle of plastic surgery forward a little bit, which has been just a, a huge honor for me.

Catherine Maley, MBA: Talking about the residents and fellows. How do they enter the marketplace in today’s world? I frankly can’t imagine trying. It’s, it’s a crowded marketplace and a lot of them, are they going to go academia? Do you know? Have they told you? Are they going to go solo, academia, join a hospital, join a group? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: You know, so we, we have the statistics on, you know, where people are landing when they, when they go out into practice. You know, we still know, at least we know with our membership that about 50% of our ma our membership is still in private practice, whether it’s solo practice or, or group practice. But there’s still solo practice, so we’re about 50/50.

 I think one of the things that has become very difficult is just opening a practice, especially as a young plastic surgeon, especially if you just want to go into cosmetic surgery. You know, you’re really in a fierce marketplace depending on where you are. And the, in the, in the day, you would just go and you do medical stuff and, and.

You know, it was just, I feel for them, I think that stuff like this, podcasts, social media, you know, they’re just bound to have to be a part of it and participate in it. And the other thing is that when you’re starting. You know, especially with medical training, it’s very myopic. So, you know, we’re kind of, you know, we’re just kind of led every step of the way.

So, we don’t really ever think, oh, I can just go and open a practice. So, we always think you have to join somebody, you have to go look for a job. And I, I just got out and, and just couldn’t wait to. Be by myself, you know? So, but it is more, there are constraints, there are many constraints, financial constraints.

I think that the industry in medicine in general, because normally in the natural progression of so many plastic surgeons were, you got out, you took call in e emergency departments and you gradually grew a practice into if you wanted to be a cosmetic surgeon, do you know, plus aesthetic surgery. You kind of grew into that versus just beginning and starting that way.

 And the marketplace has become very different now. So, you know, as you know, many people are cosmetic surgeons now, whether they’re credentialed or not. So, they’re competing with a, a, a large group of individuals that may or may not be qualified.

Catherine Maley, MBA: I know so many surgeons who are looking for associates to join them to Then hopefully, Buy, buy them out.

Do you offer a resource to help them with that? Because I get those calls saying, do you know anybody? And I think that’s a really big question, you know? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Yeah. We have, you know, we kind of pride ourselves on the fact that, you know, we are from residency to retirement, you know, we have multiple resources available to every stage of your career.

So, our young career surgeons, our mid-career and our, you know, retiring surgeons, we have resources and opportunities and message boards and, and, you know, ways to kind of. You know, Bring everyone together. So, yes, I mean the resources are there. Everybody has to take advantage of them. We have residents’ forum.

We have, you know, young Plastic Surgeons Forum, and then we have our Senior Residents Conference. And, you know, there’s so many different things and we try to make and the, and the great thing about it is that the medical students and the residents are. They’re really industrious people, you know, they really take advantage of all of this, you know?

 So, so it’s great. And our messaging to them has been easier than our o older career surgeons, you know, which includes me. You know, you, we have email fatigue and, you know, we don’t necessarily live on social media to get our, you know our information. So, but we have so many resources available and we really pride ourselves on that.

Catherine Maley, MBA: Do you find that the newer generation, they’re just different. They’re more into quality of life and not crushing it 24 7. Do you find that? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: You know, I guess it depends on who you’re looking at, you know? So, I think, you know, and I, and I keep asking myself again, I run a residency program, so I run a general surgery residency program and I’m the associate program director for another program.

So, all in all, probably about 70 residents. So, and, and I, I want to generalize and say stuff like that, but I can’t because I have some residents that, you know, remind you of kind of the good old fashioned surgery resident. You know, they just work. And that’s it. They don’t complain. They just work. But I don’t know.

I mean, is it, is work life balance such a bad thing? Sometimes I think, okay. Did we have it all wrong? You know, here it is, 7:00 PM and I’m still talking to my computer. So, it’s, it’s I, I don’t know. I mean, it, it’s something that as long as you recognize the balance. And the reward. I think it’s fine. You know, so, and, and I think that, you know, whatever I want to see, and, you know, I, I have to, I’m the one who has to adjust probably more than the young career surgeon.

Like I said, I think it’s one of those things that as long as you have expectations of your, you know, your input and your reward, then I think it’s fine. Right. That makes sense.

Catherine Maley, MBA: For ASPS for the presidency, did, did you go in with certain goals that you wanted to conquer while you’re the president? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Yes, of course. I mean, every, every president has goals. And there were several things that I really wanted to see. I know, one of the things, and with my national meeting coming up in August, I’m sorry, in October, is, you know, there are a few things. Number one, I, I really. Honored and, you know, really take my mentors all of the help.

 I took that very seriously. And so, we’re giving our member surgeons the opportunity to recognize their mentors at our national meeting. Also, just some wellness to kind of talk about, you know, some of the things we were just discussing. I think that wellness and launching our, our project well which was started.

Maybe about two years ago, but we’re really going to emphasize it at the national meeting. Everything from programming to food choices, to just kind of some relaxation ways and yoga, and, you know, just recognizing that, you know, every now and then it’s, it’s good to take a little break. And then thirdly, the program that I’m in the process of initiating is something called the Pair program, which is the, it’s a, it’s basically The academic, private practice, academic educational resource to a way to, to have our private practice colleagues and our Academic colleagues kind of come together and not only for research opportunities, for resident opportunities because, you know, we look at our membership, our membership is 50% private practitioners and like myself, and, you know, there’s so many people doing so great work that we never hear from, you know, because they’re just busy taking care of patients.

They have great data; they have great results. And if they only had a resident that they can partner with, maybe to help mine some of their data, get some of their results out there, get them published, and then the resources to the academic programs would be, you know, all of a sudden, you know, there’s some scholarly activity for their residents.

There’s some maybe an aesthetic practice that, you know, the, sometimes the, the, especially with the academic programs, they may not have the strongest. Ac aesthetic programs depending on where you’re training. So, because they’re more reconstructive heavy, et cetera. So, it’s a way to have some synergy between our memberships and in the academic and the private world.

And it’s a good way to kind of farm both as well because it’s a job opportunity. You know, all of a sudden, you’re working with this resident who’s fantastic, you’re like, you’d be great in my practice. And then, you know, sometimes the academic center says, You’d be great. Come join us. You hate your practice; you hate running your practice.

You know, so it’s, again, it’s a resource management, you know, if you will, for, for both. And again, providing lots of opportunities. You know, we have so many clinical trials that occur that, you know, sometimes, you know, my patients being in private practice, I’m just not aware of. So, if I was partnered with, you know, X University up the road, I can say, okay, you know what?

I know there’s a great clinical trial and you’d be perfect for that. So, again, I think it’s a way to kind of optimize patient experience and physician experience.

Catherine Maley, MBA: So, when your presidency is over, do you think you’re just going to go back to doing things as you were or have you been enlightened and you have a new way of running your practice when you have more time? How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: I think my practice would love if I had more time to be in my practice. So, you know, I think it’s a, of course you, you know, you grow in every way. I think, you know, one of the great things is the opportunity to meet people through, again, through the country, throughout the country, throughout the world, and just really understand their practice models and you know, all the little takeaways.

You know, you’re at the California meeting and you’re just, You’re always getting some pearls, right. So, and practice management wise, fortunately, you know, I’m very proud of my team. And we’re, you know, I couldn’t do this without them, you know, so I’m very fortunate that, you know, we have a great team and my absence is, you know, it’s not, Overly detrimental to my practice.

It’s detrimental in the fact that when I’m on the ground, I’m running and operating and you know, but you know, they would love to see me here more than, you know, running around. So, but they appreciated. They’re, they’re, again, they’re very proud, which I, I love. And they have done everything to make this possible for me, which I really appreciate it.

But you absolutely, I will take away so much from this year and incorporate it into this practice.

Catherine Maley, MBA: Well, I know it’s a very big commitment that you made, so congratulations and Thank you then, and it, it’s, you’ll evolve so much just from what you just said. All of the perspectives you’re getting out there and all the people and ways of doing things. How does this relate to you balancing cosmetic with insurance?

No practice is the same and that’s what I find so interesting. Everyone’s got a different way to do it their way. Yeah, that’s right. Yeah. Good for you. Last question that I ask everybody, I hope you don’t mind. Tell us something very interesting about you that we don’t know. How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Oh God, maybe, maybe I didn’t get that far down on what don’t you know?

 I am a sucker for animals. And so, I will tell you that the majority of my screen time is watching, you know, little baby horses and, and goats and, you know, you name it. So, I don’t, I don’t care about the plastic surgery content as much. You know, it’s, you know, purest. I’m truly an escapist when it comes to downtime, I’m an escapist.

I will watch the worst movies on a plane. Things that I will never admit to. So, you know, I think when it comes to some downtime and recreational stuff I am, I would be embarrassed to say out loud some of the movies and books that I’ll read, so…

Catherine Maley, MBA: That’s very funny. I am such a dog lover. I love the funny videos.

Yeah. And then I love the real ones, like the super aggressive dogs and the dog daddy.com. He, you know, takes care of them in a minute. Somehow, he does some magic and maybe becomes docile. And I am just such a sucker for the dog ones. Nothing beats it. How does this relate to you balancing cosmetic with insurance?

Gregory A. Greco, DO: Nothing beats it. The animal videos by far, you know, I can watch people, pet monkeys, you know, all of them.

Even the things I hate the most, which, like, I hate snakes and I’ll watch every snake video because it’s just fascinating to me. So, the, the animal videos get me every time, so…

Catherine Maley, MBA: Well, I was with you until you said snakes.

Gregory A. Greco, DO: Yeah, exactly. I don’t like the snakes, but I, I, I’m fascinated by watching them. So…

Catherine Maley, MBA: So, we’re going to wrap up Beauty and the biz.

Dr. Greco, thank you so much for joining me. I really appreciate it. I know you’re pressed for time. If somebody wanted to get ahold of you, should they wait until after your presidency in November? Or how would they get ahold of you?

Gregory A. Greco, DO: No, absolutely not. They can, they can visit us on our website at www.DrGregoryGreco.com. They can instant message us through Instagram on DrGregoryGreco, or @DrGregoryGreco, and then they can always call 732) 842-3737. Are just a couple of the ways to reach us. Again, everything has links to everywhere, so, you know, we are very reachable.

Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on balancing cosmetic with insurance.

If you’ve got any questions or feedback for Dr. Greco, you can reach out to his website at, www.DrGregoryGrecocom.

A big thanks to Dr. Greco for sharing his wisdom on balancing cosmetic with insurance.

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 “Balancing Cosmetic with Insurance — with Gregory A. Greco, DO”.

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