Specialize or Offer Everything? — with Gregory Chernoff, MD

Specialize or Offer Everything — with Gregory Chernoff, MD

Catherine Maley, MD: Hello everyone and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery. I’m your host, Catherine Maley, author of “Your aesthetic practice — What your patients are saying”, as well as consultant to plastic surgeons to get them more patients and more profits.

Now, I’m really excited about today’s guest because I’ve known him forever. It’s Dr. Greg Chernoff who will be sharing some great tips on if you should specialize or offer everything. Now, he’s a cosmetic surgeon in private practice in Santa Rosa, California, which is maybe an hour up from where I’m at now, and knows whether you should specialize or offer everything. He’s been in practice for over 30 years. He’s authored several papers and studies from his extensive research, and he’s given over 700 lectures and teaches his innovative techniques to surgeons all over the world.

Now, he sits on several medical and scientific advisory as well as editorial boards, and he’s a member of several medical societies. He also gives back to Survivors of Violence Foundation that helps men, women, and children who have injuries and scars as a result of violent acts, abuse, illness, or birth defects.

Dr. Chernoff, welcome to Beauty and the Biz. It’s a pleasure to have you.

Gregory Chernoff, MD: It’s a pleasure to be here. Catherine, as you mentioned, I’ve known you for a long time and your quality as well has been unwavering, so…

Catherine Maley, MD: Thanks for that. I really appreciate it. Now, a lot of people don’t know you. You came from Canada and I’m always fascinated with Canadian medicine because it’s very different from our medicine down here. How does this impact your experience on whether to specialize or offer everything?

But you’re more innovative. I think you’re more bureaucratic, but almost more innovative as well. So, what brought you, how did you get here from Canada? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: So, I did my medical school in Canada. I did my residency in Canada, and then after residency you can do one-on-one training years called Fellowship. So, I, I initially came to Indianapolis and did a microvascular breast body fellowship.

And then after that came to U C S F and did a facial plastic fellowship. I returned Indianapolis opened my practice there. And two years after that my, my fellowship director of Larry Schrock died too young at 58. Oh no. So, he had operated the day before he died, I was asked to come back to, to take care of his post-op patients.

So, I came back with the intention of keeping his practice open so, that they’d have something to sell. I, I knew the patients, and so, most of them said, well, why don’t you buy it? So, that was over 30 years ago. So, it’s really, it’s given me the, the privilege of doing what I love the most, and that’s operating every day.

Between Indianapolis and Santa Rosa, we do upwards of 750 to a thousand cases a year. So, it just gives us a great volume of, of nice people to take care of. In addition, 2020 5% of. My practice has stayed dedicated to research. We continue to be alpha, beta test sites for majority of the, of the laser energy companies in many of the cosmetic and drug companies.

So, when we do studies, it gives us a great bell curve distribution of, of all the different skin types. Probably 40% of my practice in, in Indiana is African American, 30 to 40% in, in the North Bay would be Asian, Mediterranean, Hispanic. So, Just a nice bell curve of people to take care. So, how

Catherine Maley, MD: do you, how do you manage a practice when you’re there half the time and do you have like extenders who are keeping it going and keeping the money in with the non-surgical while you’re somewhere else doing surgery and, and how, how are you managing that? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: So, you, you really couldn’t do multiple locations first and foremost without a, without a business plan. And without financial advisors, the key being for whom you listen to. Because I think the, the, the biggest problem with most doctors is that most doctors think they’re good business people, but they’re not.

And the, the more frightening part is they don’t know what they don’t know, right? So, we have a, we have a great business plan, second and second, and tied to that are, are great people around me. Julie has been my, my office manager and office nurse for 30 years in Indianapolis. Annette’s been my operating room nurse for 30 years in Indie and, and in Santa Rosa.

We have a, we have a, a tremendous lineup of people who, who really take good care of me. I take very good care of them as well as just like family. But I think that’s the key is surrounding yourself with people who always have your back and, and in return you always have their back as.

We’re having that kind of longevity.

Catherine Maley, MD: Honestly, most of the top practices I work with or know of, there’s usually that, that continuity person there, that one who has been there from the, from the beginning through thick and thin, they know it inside and out, and the trust level is over the top. How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: Yeah, definitely Julie. I always tease people at, when I give OC, I tell them from a business standpoint, the first thing that they need to do if they’re starting is to find their Julie in their office. Julie for me has been the sister I never had, and I’m the brother she never wanted.

Catherine Maley, MD: So, how much are your, I mean, I know you’re doing crazy amounts of surgery is like, is that a good revenue stream for you to have both the surgical profit center for you, but then the non-surgical with you extend is that. How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: No question because as, as part of your business plan, it has to be what, what will happen when you decide that you are, are ready for your exit strategy. And in, in this day and age patients you know, one step back, as you know, through the years that there’s such a difference between taking good care of patients and just doing things to people.

But patients these days in the aesthetic realm, they, they appreciate one stop shopping. So, our patients know that they can come to us if it’s for a little mole that they want biopsied. If they have unwanted pigment, if they have if they want to improve the tone, quality, clarity of their skin, a above the, the, the shoulders if they have unwanted fat, cellulite, skin laxity, poor muscle tone below the below the neck as well.

They like to know that that we offer. And it, it’s really nice. Remember with, with all of these machines, there’s always a gm Ford Chrysler. Nice. And so, having, having your story because again, it’s all, it’s all about what you portray in, in your book to patients. And so, having good reasons why you are using whatever you’re using.

But in the exit strategy, if you looked at our p and l’s monthly, you know, surgery, you know, my patient coordinators keeping me in the operating room eight hours a day is definitely what, what secures paying the bills. But we haven’t downed such since the non-surgical volume is really just in the, in the pure profitability.

Standpoint. But, but both if, if run properly or are very strong profit centers to a practice.

Catherine Maley, MD: You know, I’m very curious though, how do you handle the consultations because you’re very streamlined and process oriented. You always were. And it still takes you to do these consults somehow, unless you don’t have to do them. How does this impact your experience on whether to specialize or offer everything?

Is somebody else doing them for you? Are you doing virtual? Are you just doing them quickly? Consults and surgery? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: So, having, having stars that are patient coordinators both in, in both of our practices. So, our, our system is really time tested. A patient contacts our office for information and it’s our patient coordinators that give them the initial information.

They, they bring the patient in first to meet with them. So, that we can find out definitively what a patient’s goals are if they are a non-surgical candidate versus a surgical candidate. We do the computer imaging for them. They get educated not only in what they’re seeking. My coordinators highlight my accolades, and then if we have if we know that a patient, because there’s a lot of tire kick.

Pardon the expression also that come in thinking that surgery might be neat, but they think a facelift should be $500. So, I, I, I don’t need to, to spend my time with those patients. But if a patient is pre-qualified, no different these days than if you’re. Buying a house many times, you can’t even go and see a home unless you are pre-qualified.

Mm-hmm. So, if you know that a patient is, is, is pre-qualified financially, emotionally, then they, then they meet me. So, I, I meet most patients now after they already have their deposit in for surgery. Patients who want to meet me before that we’re fine with that. I think Covid was an excellent eyeopener to show us that many patients are happy doing, doing Zoom consultations.

Mm-hmm. It saves them time as well, and in their process of deciding whom they want to take care of them. So, we really have the streamline now such that I meet our patients once, once we know they’re, if not already on the schedule, if they’re ready to commit.

Catherine Maley, MD: I will add a caveat though. How does this impact your experience on whether to specialize or offer everything?

The reason you’re able to do that is because you’ve got such a well-rounded and balanced website, you have positioned yourself as the expert. And I tell doctors this all the time. When you’re at the meetings, make sure your person’s there taking photos of you at the podium, in the hallway meeting. How does this impact your experience on whether to specialize or offer everything?

Really well-known surgeons, you know that’s pr, whatever you want to call it, pr, marketing, whatever. It, when I was on your website, all I could think of was he bothered to take the time to show how greedy is, but you’re bragging in such a sophisticated, professional way, and that’s how you do it. That’s why I can, I’m sold on you before I’ve met you, and I can live off of a Zoom 15-minute console call. How does this impact your experience on whether to specialize or offer everything?

To, to just put icing on the cake. That’s how you do it. How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: You know, our best, our best source of referral is always another happy patient. Mm-hmm. And so, we, mm-hmm. We enlist happy patients to talk to perspective patients. That vote of confidence goes a long way. And really, you know, when I. When you and I first started at this, many of the things that we do now, we wouldn’t have dreamt that we would’ve had to do.

I employ a, a full-time social media graduate and you know, I, I employ the full-time photographers, full-time web people whose, whose jobs are, are, are never ending given the, the changes in Google formulas and whatnot. So, times are always changing and if you’re not willing to change with them and spend the money to do that, then, then you’ll get you’ll get.

Catherine Maley, MD: So, going back and forth between Indianapolis and Santa Rosa. Not an easy feat because Santa Rosa is a lovely town, but it’s outside of SFO. I mean, I, I, it’s probably about an hour. Are you flying private by any chance? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: No, I’d I’m just I’m just a few hundred million short of affording 40. No, we’ve, we’ve stayed, we’ve stayed commercial.

Okay. But it’s all, it’s all in the planning. I’m, I’m also blessed, you know, I think another key. To success. My, my wife Jill was with Roche for 15 years before we got married, but she really oversees the running of both practices. She, she is responsible for my schedule. All of our, you know, our, our schedule is mapped out during the, the end of the third quarter for the following year.

Our flights. We’re all booked. So, we typically fly into, I used to keep a car there, but it’s actually cheaper now just to rent a car for the week. It’s nice you get to drive vehicles. You might be interested in buying at later date. So, it’s really, and we, and we know the timing as, as you and I know, if you if, if we land at non traffic times at SFO. I’m to my front door with, you know, within an hour.

If you land at bad times, it’s three hours. So, we, so, we know when to fly, when not to fly, and that’s just, that’s just, I’ve done it for 30 years. It’s just part of life now and my, my way of preserving my health as well as I promised myself, I don’t do any work on the plane. That’s my time to read enjoyable or watch a movie.

And that’s some downtime where, where people can’t get ahold.

Catherine Maley, MD: Oh, that’s so funny. The plane for me is my quiet time and that’s where I do my best riding. Yes, exactly. Because I’m sitting still with nobody bugging me. Exactly. On that. Yeah. So, because you’ve been around a long time, just give me one big mistake that you really learned a lot from that others could avoid making. How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: Not having a, and that, that’s an easy, you know, fine, because you can break your practice down into it. It’s a given, it’s a given that we’re here to take good care of patients, but we’re also a business. Yeah. And, and if you don’t run your practice as a, as a business, then you can, you can waste a lot of money and lose a lot of money.

And so, my, my biggest mistake as, as I alluded to at the start, was thinking that I knew everything that I needed to know about the business of running a practice. And now, and now I, I have a business advisory board, if you will, comprised of, of CPAs, accountants, business people. And I have to write a pledge that I will listen to them.

And many of the things that they advise me to do aren’t what I want to do, but I, I listen to them and it turns out to be right. So, so, younger docs starting out really need to first define for themselves who are they? What do they want to practice? Do they want to be in an academic setting? Do they want to be in private practice?

Do they want to be a solo practitioner? Do they want to be in. In a group do they want to stay exposed to research? Do they want to be just surgical or have a, a non-surgical limb, which then also involves expenditure in buying, you know, most of the machines that you look at buying or, or are all upwards about, you know, they’re all like buying a nice car.

They’re all upwards of a hundred thousand dollars to. And you would, you have to also look at your return on, on, on investment with, with those. So, that was probably the biggest mistakes that I made in my first decade because when we finished, so, I was, you know, between fellowships and whatnot, I was, I was upwards of 300,000 in debt with student loans.

And because there’s such a delayed gratification, you, you really come out gung-ho thinking, I have to do everything. I have to do everything tomorrow. The first thing you need to do for tomorrow is start saving. Mm-hmm. And so, a, a, a proper business plan that keeps your, your expenditures as low as you can, while you can still you know, operate your practice how you want to, is really important.

But, taking the time and, and, and young docs should do that through their residency as, as you become exposed to more. Things. And I think it’s really important to go to all of the different academy meetings, that there’s a, as you know, our, sadly our, our meeting industries in such dire need of consolidation.

La last year I did a hundred hours of C M E talks. And, and, but there’s, so, that means for, for people looking, there’s, there’s such tremendous information that’s being offered at these meetings, both in the scientific limbs and the business limbs. So, that those things, companies like yours that, that are, that are so, valuable in, in guiding the way you’ve, you’ve watched so, many people do well, but you’ve watched so, many people not do.

And so, you, you’re a, you’re really a, an encyclopedia of knowledge for someone who’s looking to become successful as they start. So, but, but starting with a plan, starting with a budget and, and adhering to those I think are, are very important. Plans change as times change, but, but the essence of who of who, who a person is also shines through in their practice as.

Catherine Maley, MD: Well, you have such a good vast perspective on this industry because you’ve been a surgeon in solo practice. Then you’ve had two locations, then you had, I think you even had a third location. Then you work with the vendors, you work with the medical societies. You’re very involved in the industry. What would you say to surgeons who maybe are just stuck, like stuck in a rut or they’re so, confused that they’re like ready to give up, or that it is just not fun anymore? How does this impact your experience on whether to specialize or offer everything?

Like any suggestions for how do you, how do you gain footing in this industry being the uber competitiveness and just all the advances in technology and so, how does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: As, as you alluded to, the you know, all of the things I, I I’m humbled by, by what I’ve been able to accomplish in 30 years. But there are days that I say that even though that I still after 30 years love what I do, I realize that all I do is what I do.

So, it’s, it’s an enormous time investment to be in solo practice, to also be involved in, in research. But if some, if someone’s stuck you know, there, there are many docs. Just like me, who are always willing to talk to people you know, I, I was blessed and, and always being trained by people who, who believed in sharing their knowledge both medical and non-medical.

So, anyone is always welcome to, to reach out to me with specific problems and, and we’re always happy to help. People, and I think that’s, talk to people who’ve been at it for a while. And be open. Be honest. Hang, hang your ego on the door, and be willing to, to admit what your shortcomings are and really go with what your strengths are.

Most docs haven’t reached the point of, of finishing a residency start. Go into, you know, looking into how they want to practice. If, if they haven’t been in the higher percentages of, of IQs and, and, and willingness to work hard. But towards the end of education, I think that’s when a lot of people hit a wall and they get very discouraged because they do have, they do have choices you know about which, which road.

And you may choose a road to go down and I that, I did that a few times too. You may choose a road to go down and, and realize that that’s not. Right avenue for you. It’s okay to change t and to change course midstream. I think some of the most miserable pe people that I’ve met in my life are people that are doing things every day that they don’t like to do.

Sure. Life’s too short to live that way. If, if, if you realize that you’re not doing something that you have a passion for, that you, because patients will pick up on that as well. It’s still my, my nicest compliment every day is when patients say, gosh, by talking to you, we can tell that you still really love what you do.

Mm-hmm. And I, I think that makes the consultation very genuine as well.

Catherine Maley, MD: Would you have any advice for somebody who’s like, let’s say they, they like research in academia, but now they’re ready to make some money, so, now they want to go out into the regular world. Do they go solo? Do they try to buy in with, you know, with somebody else’s practice? How does this impact your experience on whether to specialize or offer everything?

Or, you know, that new trend now is all this private equity going on? Do any thoughts on any thoughts on where we’re heading here as a solo surgeon? Where are you going to go with this? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: Yeah. Th those are all, all excellent questions. And I think you know, most, most physician multi-doctor practices that have been successful are usually doctors that started together.

I think most, I think most doctors, if they’re not in an academic setting, most doctors would like to be out on their own. Mm-hmm. And so, if a person has the inkling that they want to be out on their own, then they should do what I did. And that’s Go to a bank, take out a loan. Mm-hmm. And start, you know, and, and start on your own.

And, you know, there are, there are always you know, older guys like me who are looking for new associates. Mm-hmm. I think the, the formulas, the formulas have changed for doctors looking for associates. I think most, most docs who bring on an associate now would require a young doc to take out a loan, do a buy-in right away, away, because we’ve, there’s been many stories of, of young docs coming into practices only to, to abscond with patient lists and.

You know, and, and open up, down, down the block. I think that’s one thing that’s, that’s a across the country, non-competition clauses are weakening. In, in many states, you’ll see more, more doctors protecting their established practices by having younger docs buy into them and then, and then earn, you know, earn their, their buy-ins.

Al also then over, over time.

Catherine Maley, MD: But then should there be a honeymoon period before you have a buy-in to make sure you have shared values and vision? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: I think a lot of that is built, a lot of that is built into, you know, the, the, the early, the early contracts. I think, I think younger docs need to also appreciate, though it’s, it’s not easy to start your own practice.

Patients these days with the internet, they have many choices about where they, about where they can, they can go. So, there’s benefits. To younger docs in joining established practices. I think they, they can be mentored into excellence that, that way there’s benefit also, and by, by older docs bringing in younger docs to carry, to pick up the baton.

The, the, there’s a lot of private equity firms. I think, you know, this really started in the dermatology professional. Where dermatology practice started getting bought up. The doctor was offered a certain percentage in cash, but then the ability of putting some, keeping some equity in the company and for the larger equity company to buy up again, so, to see some profit off of that.

As well. So, those, there’s a lot of those formulas around, but I mean, those, those equity companies are looking for more established practices that would, you know, it, it wouldn’t be, you know, looking for a, for a, a multiple of, of, of, of earnings. So, you have to have a track record before a private equity company would, would really consider you in that regard.

And as part of that, you have to have clean. You can’t have, you can’t be running your practice as your own private bank account. As well. You have to show profitability for equity companies to be interested. But I think young and that, that’s, that’s also a, a positive for young people coming out of training is that they have many options that they can know, that they can look at.

Think you also have to if you’re going to. Be in the field of aesthetics. Look at what your primary specialty is, and you have to decide, am I going to be an aesthetic doctor, non-insurance base, or am I going to keep a certain, you know, a, a certain percentage of my practice in the insurance area? Which, which, which can always act as a, a backup if, if times, if, if the economy worsens.

Although I think this is interesting. You know, before Covid I would’ve been booked on average, you know, eight weeks in advance. I’m, I’m booked here. We, here we are in coming up in April and I’m booked through September, October for many things. So, I think with, even when times get bad, people will always spend money on themselves, and that’s what we’re seeing with Covid.

Maybe people aren’t traveling as much, so, they’re spending more on themselves or their house.

Catherine Maley, MD: Oh, I think, I think cosmetic rejuvenation has become a way of life now. The stigma is almost gone. Social media helped that a lot. Social media also hurts it, like everything. There’s a 50 50 to it, but I just think no problem with the demand here. How does this impact your experience on whether to specialize or offer everything?

My problem with insurance is it’s hard to dabble in it when everybody else. Eating, sleeping and drinking cosmetic, and then you’re doing some insurance. And the, and the cosmetic is kind of a hobby. It can’t be in today’s world, it’s just too competitive. And I think you need pretty extreme focus on something. How does this impact your experience on whether to specialize or offer everything?

But I want to talk about that because, Normally in today’s world, I say, you know what? Get really good at a few things. Don’t try to be everything to everybody but somebody like you who’s so, into research and you love the new technologies you offer. Talk about an umbrella, like you talk about a one-stop shop. How does this impact your experience on whether to specialize or offer everything?

Like you offer everything and all the lasers and the injectables. And you’re from Canada and you have all the latest like, you know, everything that’s happening, like coming up with fillers and non-surgical. How do. Do you think it’s a good strategy to provide everything for everyone, or is that difficult to manage? How does this impact your experience on whether to specialize or offer everything?

What’s your feeling on that? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: If you’re, that’s an excellent question. If you, if you have the desire to, and you can break down surgically and non-surgically, if you have the desire to be head to toe surgically, you have to have the appropriate training. Certainly. And you have to, I think most surgeons know what they do best.

Mm-hmm. And I that, that’s a better you know, Operate and do the operations that you know you’re good at because it only takes, it only takes one unhappy patient. Mm-hmm. I always, I always tease young docs and, and tell them, since most people still don’t want folks to know that they’ve had anything done.

Right. If you make one person happy, they may tell two or three of their friends, but if you make one person unhappy, they have the potential with one bad review of telling millions of. So, you really, you know, stick to, stick to surgically what you do best. Stick to, you know, offer non-surgically, you know what because you can go to all the, the academy and, and, and, and you have lists as well of what you know are the most popular nonsurgical therapies that are people are looking for.

I think first and foremost, and this was advice that was given to me as well in starting, is first pick where you want to live. Mm-hmm. Cause if you go, if you go someplace that you know you want to live, that you’re happy living, number one. And then number two, if you do good work and you’re nice to people, you’ll be busy no matter where you go.

And you’ll be happy because you’re living where you want to live, you’re doing what you enjoy doing. And, and still to this day, the most gratifying part for me every day is watching how the smallest changes for a patient have such a dramatic effect on self-esteem. Mm-hmm. That’s really the, the, the gratitude that our patients display to us every day by just the, the smallest of changes that is so, so, gratifying.

You know, once you can make a list for yourself of what you want to offer. You can really map that out in a way that can also become profitable.

Catherine Maley, MD: You mentioned patients and what’s your take on how, how different is the patient demand now than it used to be? And how have you molded your consultations to that? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: I think we, we as aesthetic providers have to really show a tremendous amount of tolerance these days because the internet has become such a double-edged sword. Every day I meet patients who’ve read an article and they know more than I do after 30 years now. And so, it’s always, you always have to listen.

The other, the other thing that that more docs need to practice at getting better at is listen. And not talking it it’s still our job to listen to a patient as it relates to what has brought them through your door. Then it’s our job to give them information relating to what it is that brought them through the door in a manner such that they don’t think that you’re trying to sell them right.

Any, sell them anything. And, and that that’s the, the artistry that’s involved in, in the consultation process as well is if, if a patient really senses that you’re engaged with them. Once you walk in that room or if you’re on the zoom that, that they have your, your, your total attention and that you’re really engaged in, in the problem for which they’re seeking your, your help.

They’ll get the sense that you really want to help them and not just do things to them, but it is very, you know, I walked into one of, one of my consults to a, a 60’ish year young lady, and she was holding two papers and, and she said to me, just like this, I want to make sure that you’re going to do my facelift just like this.

Great. And so, it would’ve been, it would’ve been easy for me to, to tell her what I was really thinking. Yeah. But again, I, I, I helped her see how that, that really probably wasn’t the best tack for her to, to take upon first meeting her surgeon.

Catherine Maley, MD: They have gotten very demanding. They’re very educated, they’re very demanding. How does this impact your experience on whether to specialize or offer everything?

And you know what I’ve learned as a, as a consultant, I say to the doctor, you’ve got to decide who you are and get grounded in your values and your own vision. Because when the public’s coming at you from every which way you can try to acquiesce to that or you can say, no, no, no. Here’s how we do it. How does this impact your experience on whether to specialize or offer everything?

Here, here, here’s what I’m comfortable with. And then let the rest go. Because dealing with the public is exhausting, isn’t it? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: So, to that lady, I took my current textbook on facelifts is four is four three that you wrote the book on page volumes. And I, I said, wait, right here, I’ll be right back.

So, I went and I got the textbook and I brought it in and I put it on her lap and I said, we’re going to do this differently now. We’re going to do your facelift with you awake. I’m going to talk you through it and you’re going to do your own surgery. And so, her mouth o opened and he thought about it and she said, “I get your point”.

Right people. It’s so, I, I, I think if you, you know, pa patients have to know that they’re coming to see you because you, you are the expert. You are the person who will take good care of them. You’ll listen to them. But there comes a point where you, where you have to draw the line in the center. You wouldn’t say to your cardiac surgeon who’s just said you needed quadruple bypass, just do three minor arteries or two minorities and I’ll be fine.

Catherine Maley, MD: So, how are you in today’s world with marketing? Like you were always a really good marketer before, but you did it usually through patient education then I really, I mean, this was many decades. You were doing the patient education events before everyone else was, and I thought that’s how to do it. How does this impact your experience on whether to specialize or offer everything?

Like you don’t have to sell anything to anybody. People want to look good, help them understand what it takes for them to look their best. It’s, it’s a no-brainer, but how much of your practice nowadays is marketing versus just good old patients coming back for more and referring their friends? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: I think both, both are, both are still equally important, you know?

Mm-hmm. You, you and I could sit down and, and, and show a beautiful equation on the value of one happy patient. Mm-hmm. Cause one happy patient. One patient may start coming in, doing fillers, doing Botox. That will transcend then to maybe some laser work for pigment fine lines. Then as time goes on, they, they see that the gravitational diss.

That they are, that they are now seeing, as well as their volume loss, their loss of elasticity is, is now warranting surgery. So, they may start with doing their eyes, their brows, their liposuction, whatever, they’re happy, then they tell a friend or two, then they’re ready for something else. So, so, one happy patient when you meet them is worth hundreds of thousands of dollars in, in in the end.

So, protecting that. Is, is very important. So, there’s that aspect of, of marketing through meticulous results. Mm-hmm. And then there’s, then there’s the dollars that you never like spending. We still do public. I think public seminars have been very, Valuable over the years because you can, you can extend information in a, in a very non-intrusive, non-threatening way to, to people.

And, and you can waste a lot of money on, on ads you know, on print ads. The internet is still a very valuable resource that if you, if you know how to play the, you know, the different equation game It all adds up, but, but you really, I think to be successful, you really have to do it all.

You, you can’t just, you can’t just focus on, on one avenue of, of, of marketing. And, but, but again, my, my greatest recommendation to anyone is to hire someone like you because that’s what you, you know, that’s what you are there for is to, is to educate and, and to help people be a.

Catherine Maley, MD: Well, and not to waste so, much money. How does this impact your experience on whether to specialize or offer everything?

Yeah, I, it’s shocking that they won’t pay for my services yet. They’ll give it to some PR company that works, what, five grand a month for eight months and you got what from it? You got something in Toledo, Ohio, like some kind of like that, a magazine nobody reads. And I think, what the heck? You know, that’s. How does this impact your experience on whether to specialize or offer everything?

I just, I’m on, I’m into marketing in today’s world. Smart marketing, you know? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: Okay. Because I’ve, I’ve wasted a lot of money on companies that grossly overpromised and even worse, under delivered. And so, you, you, you really have to, there’s so, many, as, you know, shysters out there who. You know who, who talk, talk a good story, but, but you know, provide very little inner turn.

Catherine Maley, MD: Yeah. Well, you’re really up on the technology because you’re on all those advisory boards and you’re out there in the world like what’s happening. Because half of us, remember when I, when we first started, you surgeons wouldn’t even dream of injecting Botox. Like you were like, are you kidding me? I am a surgeon. How does this impact your experience on whether to specialize or offer everything?

And then you really came around full circle and said, no, no, I need to grab that patient. You know, so, now I do injectables as well as surgery, but like I know you’re very involved in regenerative medicine. Yes. So, what’s coming down the pike? Like, what else do we need to look good and feel great? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: I think we’re seeing more; you know, we’re seeing more people.

I’m really seeing two, two distinct new peaks. In, in my practice. We’re seeing younger people. A lot of the, you know, the, the generation Z patients, the generation X patients coming in c as well. With healthcare being what it is, I’m seeing many more 70, 80, 90-year-old patients coming in. With sometimes letters from their family doctor saying, don’t discriminate against this patient because of their chronological age.

They’re the biological age of someone much younger. And these elderly folks come in saying, you know, I don’t feel my chronological age, but yet the person that I’ve seen in the mirror doesn’t match how good I feel in my heart. So, if you have a safe way of helping me, I’m really interested. So, both of these subsets come.

Seeking what I refer to as preventative aesthetics. Mm-hmm. As compared to corrective aesthetics. Remember the, the three signs of aging. The only reason that anyone comes to someone like me is, is three reasons. Number one is the gravitational dissent of their muscles, both above the. Above the shoulders and below the shoulders.

And for gravitational dissent, there’re really no surgical options at a point for which the patient, you’ll do the things for them and they’ll go, wow. The second reason they come to us, it’s all these non-surgical reasons, volume loss. So, all of us lose fat in our faces in the mid-face. Lower, lower third, and this is where the injectable fillers are.

Fat transfer. There’s, there’s nothing. And then the third sign of aging is the loss of tone, quality, clarity of skin. And this too is where, where many of the non-surgical treatments, the fractionated CO2 systems, the needle rf treatments that they’ve never been better, but the whole field for, for 30 years, we’ve been involved in, in the fields of cellular medicine, regenerative and stem cell therapies, medicines is going to change so, much in the next decade.

The whole field we, we’ve been involved very highly in, in the field. Called exosomes. Exosomes are the tiny little articles that all of our cells communicate with. And they’re packed with growth factors just as your own p r P is, but your own p r p is your age, whereas a memal stem cell exosome is, is very robust with growth factors.

And so, there’s the therapeutic side of exosomes. They can improve the tone, quality, clarity of skin. They have such a tremendous, because they’re loaded with, with regenerative and healing factors. They can help us in wound care and scar therapy. But the whole field of biogenetics and epigenetics we, we know what genes now are responsible for what features in in the body.

Exosome Diagnostics. There’ll come a day where you and I can spit in a cup or pee a cup, and based upon the exosomes that our own body is secreting, we’ll be able to detect disease states before the first cells even hit an organ. And then exosome therapeutics will be able to load at your own exosomes with disease fighting, fighting drugs will, you know, disease states like melasma like hypopigmented disorders will have very specific treatments coming up from these that are personalized based upon your own.

Your own gene. So, the whole field of gene therapy isn’t that far away. There’re some great companies we work a lot with some companies at Purdue at Stanford, that, that are involved in, in innovative genetic therapy so, that the field is so, exciting and I really envy people that will be around for.

20 to 50 more years because they’ll be doing very different things. Not even today. I, I do very little how I did things 30 years ago, right? And, and, and very little of what I did even 15 years ago, both surgically and non-surgically. Mm-hmm. All geared to give better results, to have healing times. Quicker for patients as well.

So, the technological advancements that we’ve seen since I started, and it’ll continue to see will really be jaw dropping for, for providers and for patients alike.

Catherine Maley, MD: Well, I’ve been using every technology that they had introduced because I’m going to say, I’m going to fight this aging process forever for as long as I live. How does this impact your experience on whether to specialize or offer everything?

It’s why I’m in this industry, although I should probably be more, more interested in the genetic stuff, you know, because I, I don’t think, I don’t know if I have great genes, but it’d be nice to, you know, I. I already feel really good like everyone else; I feel great. I can’t believe I’m the age I am and I don’t want to, How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: You and I are both 90 and look how good people.

Catherine Maley, MD: That’s right. And so, if you could hurry up and research a little faster, we can get to one 20 looking good. So, what is driving you, where do you get this motivation? Because I’m pretty sure you’re not sleeping a lot. When you’re doing 700 sur, like a thousand surgeries a year, what the heck? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: What, what’s, and I, I really say this from the bottom of my heart. A any my mother was a high school teacher who, who really believed her, her favorite saying to my brother and I was, don’t, don’t, don’t settle for mediocre because there’s, there’s mediocre all around us. And so, I’ve always, I’ve always been driven to, to be my best.

And that that really hasn’t changed. And it really, but like I said, I, to this day, I genuinely, without hesitation or reservation love what I do every day.

Catherine Maley, MD: Ah, that’s so, nice. Now tell us something we don’t know about you? How does this impact your experience on whether to specialize or offer everything?

Gregory Chernoff, MD: Cooking is still my hobby. And so, that’s the, what’s your specialty? You know, I, with our, with our foundation for survivors of violence, my wife and I put on two charity barbecues.

Last year we cooked for 250 people in our backyard. So, that’s still, holy cow. Still, still a hobby. I still play. I used to play hockey. My arthritis doesn’t let me. I still love golfing and, and other sports as well. So, there, there’s, there’s no end to doing things like that in spare.

Catherine Maley, MD: Well, you’re probably still cleaning up after that barbecue. Dear Lord, that’s a lot of people in your backyard, so, alright. If some, if somebody wanted to reach out to you, what would be the best way? I know your website is called www.ChernoffCosmeticSurgery.com. Is there any way they can or, or, or just www.DrChernoff.com?

Gregory Chernoff, MD: They can also reach me on my email. Just [email protected], [email protected]. And I’m happy to communicate and share, share anything that I’ve learned over the years.

Catherine Maley, MD: Oh, thank you so, much Dr. Chernoff. I really appreciate it. I’m glad we could catch up. Hopefully I’ll see you at a meeting coming up soon and that’ll do it for us today.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on if you should specialize or offer everything.

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

A big thanks to Dr. Chernoff for sharing his experience and advice on if you should specialize or offer everything.

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.

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And we will talk to you again soon. Take care.

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-End transcript for “Specialize or Offer Everything — with Gregory Chernoff, MD”.