MSD Insider 0:00
Welcome to med shark insider with Bill Fukui, your expert host on all things medical marketing and SEO.

Bill Fukui 0:08
Hello, everyone and welcome to another episode of med shark insider, I am absolutely privileged today to have one of the cosmetic industry’s most recognized and really the one of the most credible consultants that actually works with practices that are both new as well as more established practices, Sandi Roos, and she is the president and owner of practice enhancement specialists, which has been around for almost about a decade now. And she’s worked with some of the most recognized practices, and in many cases, built practices up from the ground up. So I’m actually privileged to have her today. And we’re going to be talking about really kind of some of the pitfalls that these newer practices or practices that are surgeons that are wanting to start up a new practice, what are the common things that they can avoid? Mistakes, saving themselves, not only a lot of time, but quite frankly, a lot of money. So welcome today, Sandy.

Sandy Roos 1:17
Hey, welcome. I’m so happy to be here. It is. Yeah, I love everything that you’re doing. This is amazing.

Bill Fukui 1:22
You know, we’ve we go back a long time. And and I think we met at one of the practice administrator courses, I think we were presenting either before or after me or something. Yeah. And I think that’s where we kind of connected I think I listened to your talk. And I’m like, going every marketer in the world should hire her. Because man, they will make you look so good. Because generating leads sometimes are the is the easy part is what do you do to close them? So absolutely, I think you were doing a course on on, on closing techniques or thing or handling the phone calls or follow up something like that. And I thought you were man, everything you talked about was so spot on. So I, I had to look you up, but we connected and and, you know, it was, it’s been great. So one of the things we’ve recently started doing more of and even collaborating on are these newer practices, these surgeons that are just looking to start their own practice, or who’s been out for a very short period of time, and is really in the early early stages of, of building that, you know that dream practice. So I’m going to ask you, number one, give a little background on you. Okay, and then I’m going to start in with kind of, what What should these guys start doing. So give a little background on yourself. So our audience can learn a little bit more about you.

Sandy Roos 2:54
Absolutely. Thank you. Again, I’m so excited to be able to do this with you, like you said, I think both you and I have a a passion for first of all this plastic surgery industry. And as well as like really, we’ve, I think both identified here over the last few years is that there’s so many things that you and I can collaborate on to really help these younger guys, just like you said, avoiding those pitfalls. So definitely thank you for having me. So just a quick background. I’ve actually worked in medical since the mid 80s. When I was going to college, I didn’t I wasn’t introduced to the plastic surgery or their cosmetic side of the plastic surgery until the late 90s. And it kind of just fell into my lap. So I started working with a young doctor right out of this fellowship in a very busy Scottsdale, Arizona market. And we grew his practice just based off of relationships. And that was something that at the time, you know, websites were just becoming the thing. And so we really didn’t have all of the technology that we have available to us today. But we grew pretty quickly. And so there was a medical device company and one of the breast implant companies reached out to me and asked me to come and work for them. And they were beginning starting a business development arm of their company. And so I went ahead and took the position had to move to Florida, fell in love with everything that I was doing, was promoted. So I moved up to Connecticut, super excited about that. They were then acquired by a larger corporation. And eventually one of my well my business partner and I we ended up acquiring the division and went out on our own and started doing the consulting back in like 2012 I believe. And then fast forward a few years Santra reached out and asked me to come and do that for them as well. And so up until just recently I was actually the director of practice development with them where I was able to, with my team really work with plastic surgeons nationally again on just being great at the intake process and helping them Um, if it was a new practice, you know, hiring, firing, setting up incentive plans, employee manuals, and then helping you know, the more some practices that might have been out a little bit longer, you know, staff skills training, but our biggest thing is just really working with practices on really capturing the data that we know that’s really going to help them be better in their practice, I most recently decided to part ways with Santra. It was they weren’t happy about it, but it was this decision that had to be made. But they’re still a great company. But so I’m just now back doing the consulting on my own. And I’m going to be partnering with a local plastic surgeon, surgeon here in Texas, and we’re going to be doing some really great things and continuing to do in my workshops and doing more training and really, again, helping plastic surgeons, but our primary focus is going to be on these younger plastic surgeons, because I just really feel that there’s such an opportunity there for us to give my years of wisdom on what you can do wrong and what you can do, right. And, you know, the things that I did back in my practice back in the early 2000s, we made a lot of mistakes, but at the same time we learned from them. But the things that we did that are totally different from what we make, what we suggest to our practices now. So we keep up on the times.

Bill Fukui 6:20
You know, Sandy, you know, you mentioned kind of, and I love the fact that you kind of addressed the really, the younger surgeons with and that’s where the growth in this industry is the industry is is is filled with entrepreneurial types of, of surgeons wanting to go out on their own that kind of stuff. But as you kind of mentioned, there’s all these different things that you can be helping them with. What do you see different? I mean, you’ve been in this industry, we both been in this industry for 20 plus years. What do you see different in these young surgeons today that you’re consulting and, and helping them with their practice? What do you see different in these young surgeons today as compared to say, 15 years ago, when you know, when it was a much different environment? What do you see different?

Sandy Roos 7:12
Well, I feel there’s quite a few things, I really want to focus a little bit more on this, the physician wanting to go out on their own versus the physician that is wanting to join a practice. And I think, you know, really, you can probably separate the two of those types of young plastic surgeons, and I would have totally different recommendations. So I really think today, I hope we will just focus on the ones that are just really wanting to go out on their own, starting our business. And I think what’s changed is that they have they they really understand the need for doing it right the first time. Right. And that’s even from five years ago, I’m really seeing that they will invest the time and the resources, sometimes that’s not, you know, money into making sure that they are getting out and you know, within that first year to be able to be relevant in their market. And in the old days. And I’m an old timer, I always say that in the old days, there was this, you know, this idea that young plastic surgeon had to go serve their time in the ER, they had to go do call, they had to go do reconstruction. And that’s, you know, not the case anymore. You know, a lot of these younger guys that I have the opportunity to be able to talk with, it’s the ones that really have that entrepreneurial spirit about them. And they recognize very early on, I need to do it right the first time. And so I to me, that’s one of the biggest differences right now that I’ve seen, like I said, even over the last five years,

Bill Fukui 8:49
you know, the other thing too was this, this topic of, of addressing pitfalls, and, and building a practice, you know, from the ground up that type of stuff that covers a lot of ground. I mean, we chatted very briefly at the very beginning about all these, you know, things that you do for these practices. I’m going to limit our talk today pretty much on the operational side stuff, because we can get into social media and all this. And man, we will be here all day to be honest with you. So I really want to focus in on those handful of pitfalls, or the primary money time saving things that you can help practices avoid in terms of an operations personnel, that type of stuff. So what would you say from that perspective, would be to say the most important things, where do they start? Where do they where do they begin? Sandy? I’m a New surgeon. I want to start, where do I start?

Sandy Roos 9:54
Absolutely. That’s such a easy, difficult question.

Bill Fukui 10:00
Sir, he’s a difficult I like the easy, difficult question.

Sandy Roos 10:03
I’ll try to keep things as short as possible, you’ll know when to interrupt me. But obviously, you know, hiring, staffing, and compensation, okay. And I know we were going to avoid the marketing talk right now. But you know, that is something as well. But you know, there was those are really the top four things that I see were practices. When I say they make mistakes, it’s because sometimes I will start, you know, be introduced to a practice at year three, or year four. And even though they’ve been out, you know, three years or four years, we’re having to go back to the beginning, because that’s where they pretty much haven’t made the correct decisions, right. So, you know, that’s where, to me, it’s it, those are the things you really need to focus on initially. And again, we can talk about marketing, I think, like you said, maybe our second part of this series, because that’s a big one where people make mistakes, though. Yeah, but definitely hiring, um, who to hire, you know, what roles do you hire? Where do we find them? And then obviously, like the compensation and then the, the processes, I’m a big process oriented person, I believe in tracking, I believe that you track correctly at the beginning. And that way, it becomes a habit. So you’re not introducing it at three years, where people get really defensive, and like, why do they care? Yeah. So it’s something I like to start the whole processes at the beginning as well.

Bill Fukui 11:26
Right? Okay. Well, let’s start with hiring kind of that. I mean, if that’s kind of, I mean, like anything else, a practice is only going to be as productive as effective. And really develop the relationships with patients is as good a surgeon as you have, it starts with people. Where do you start with that with a surgeon?

Sandy Roos 11:46
Yeah. So initially, it depending, of course, on what your five year goal is, I always say, you know, if you, if you build your practice, at the start off of the first two or three years, that’s when at the four or five year mark, when people are looking like, hey, you know, I’m wanting to get to that next level, and I’m just not getting there. So I always want to say start at the five year start with your five year plan. And that’s where you need to hire. And one of the great biggest pitfalls that people have done in the past, and I feel like they’re not doing it as much right now. But I’m still seeing it is the first person they hire is a seasoned practice manager that knows how to do billing, meaning like insurance, billing, and that’s great. But they are not going to be the one that’s going to grow that cosmetic side of the practice. And so again, that’s the other thing we have to look at, I always say, you know, people have this misconception that I only work with people that do cosmetic, and that’s, you know, it might appear that way, because that’s really where we focus. And you know, for physicians that really are going to be 100% Insurance their entire career, I’m probably not the best person for them to talk to. But if it’s, you know, a practice that knows that, you know, again, a five year plan, at year five, I only want to be doing maybe 30% reconstruction, or maybe 20%. I

Bill Fukui 13:02
think that’s true with most practice, and most of the practices don’t want to get it, you know, completely gone. Correct. In fact, they can’t really do 100%. But, you know, I think that’s probably I think that that would be a relatively ambitious goal for a lot of surgeons.

Sandy Roos 13:20
Correct. I agree. And so typically, what I also see is that for the first five years, the physician truly is very involved in the day to day running of the practice. So do you really need that office manager? Do you need that practice administrator that’s been doing it 20 years, and let’s bring him in, and they’re just going to build my practice, like for that doctor they just worked with, and I honestly don’t feel that’s the best person to hire at first, okay. Again, it’s because to me, if you find a really great patient care coordinator that had worked in a different practice, or even a very strong front office coordinator, that you know, Her next role or up the ladder, as far as building her career would be a patient care coordinator. I feel that’s a really strong first hire, because you need to have somebody that knows the inner workings of a clinic day of talking to the patient signing consents, you know, the financing portion of it, all of that. And that is the person that you’re going to actually have more success with, and be able to grow more quickly. If you have that key person in your practice. Versus an office manager, a seasoned office manager, they have the experience, but they’re not going to office managers typically aren’t really great patient care coordinators. Yeah. And so since you as a physician typically will still be doing the bookkeeping and paying the bills and could you need to keep a close eye on that your first few years in practice? I don’t think you need that office manager person per se initially.

Bill Fukui 14:53
I you know, that’s surprising. I mean, I think most most practices would think that would be the first hire is Yeah, who’s gonna hire you know, who cannot hire to run this business? Right, you know, and and really, I think they got to get their feet a little wet themselves. Right, like you said in the first couple of years, they are the ones, you know, they they get acclimated, you know, acclamation under fire kind of thing about running a business, which they’ve never been trained to do, you know, academically. But, but, you know, most of these guys are, let’s face it, they were the smartest guys in class or gals in class, they pick it up, they pick it up pretty quickly.

Sandy Roos 15:35
Well, and I think for me, like when I started with my doctorate, and he was right out of his fellowship, and I always like to tease him that he, he got really lucky. Because I had manager experience, I knew how to do the billing component as well, because I was a billing manager back in the 90s, for 50, physician, multi specialty group, but then I also knew the cosmetic side of it. And so, you know, for us, you know, as we were trying to build out our own office, we were sharing space, you know, his office was a closet, you know, mine, I had the bigger space, because, you know, I was the one that was making money, and I wasn’t when talking in selling the surgery, even though he was doing the surgery, I needed more room. And so it really it helped us, you know, really grow knowing that I was able to do pretty much everything right at the beginning. So again, you can have a patient care coordinator that’s acting as an office manager. Because you know, but again, that person has to have experience initially, you know, as you grow your practice, that’s where I say, if you have an office manager, that’s been there a while. And as you’re growing, there’s nothing wrong with hiring a patient care coordinator that’s never had plastic surgery experience, actually, that’s my favorite person to hire. But initially, that you your patient care coordinator needs to be the most experienced person. Yeah. And the plastic surgeons, you

Bill Fukui 16:53
know, I think the other part of that, too, is the dynamics of building a practice. You have more of that rapport, that instant connection with that patient, you know, the PCC, or than, say, an office manager who’s coming off doing their own thing trying to, you know, but you are there on the firing line with the PCC, you’re in consults, you’re, you know, you’re actually developing more of that. I think a camaraderie, a chemistry kind of a culture, I think,

Sandy Roos 17:26
absolutely. And they actually, in most practices will make more than the office manager as well. Yeah. Okay. And so unless you’re big, big practice, that’s not the case. But you know, for starting out that you’ll probably pay them more than you would your patient care coordinator. I mean, then like your office manager,

Bill Fukui 17:43
right. You know, and that, you know, now you’re getting into a whole nother topic about compensation. And that’s always a big question for the surgeons that are trying to start their business on their own. How do I put together a plan and fill in the blanks when it comes to compensation? What, what should I be planning on spending for these different positions? How do you address you know, compensation with with the surgeons? Yeah, and

Sandy Roos 18:12
that’s something that, again, we get, I’ve had practices, they call me doctors all the time, what should I pay my patient coordinator? What should I pay my nurse injector? What should I pay? Everybody’s? What should I pay? And it truly, I always say, you know, it’s based off of one experience where you are in the country, and what is your budget? You know, one of the surgeons that I worked with very closely, and that’s we’ve done a great job and growing his business, you know, since I started working with him as a consultant in 20, late 2014, one of the things he said early on, and I love this about him is that he said, You got to pay your people, you need to pay them and pay them well. And but it doesn’t always have to be in base. And, you know, it’s a bonus structure, it’s an incentive plan. And I’m big on incentive plans. And so it’s one of the things that I know, doctors would love to have just like me to be able to send this, you know, standard email that with all of their answers on compensation, but that’s a discussion that, you know, it’s a different discussion with each position I work with. Okay, and so it’s, you know, it’s but again, it’s always a base based and then I can incentive plan. Now, again, incentive plans, you know, because you’ve been on tons of my webinars, is that I don’t believe it should be a percent of the business and I can tell you, on a different conversation are a different webinar. Why because that’s a whole discussion, but that doesn’t incentivize them to grow. It’s you know, it’s it truly is you’re going to set a number goal that this is what we want to get out this month. And once you hit that you get to x dollar amount. I can’t tell you again, I’ve had a physician that early on, before I started working with them, they couldn’t afford the coordinator and so they paid her a lesser salary, and then said, but we’re gonna give you X percent of everything that you bring in and all that, you know, sales So that sounded great at the beginning, that patient coordinator was making $195,000. You know, at one point, I’m like, Okay, that’s

Bill Fukui 20:07
a little going up from there.

Sandy Roos 20:10
Exactly. And I can tell ya, the doctor was growing. But he, it was just, it didn’t make sense. And so it’s very hard to take somebody that’s making that much money and then change their whole comp plan to make less. And so I often

Bill Fukui 20:23
tell you what, they don’t stay after that they feel you’ve just, you know, you change the rules on me. Correct. You know,

Sandy Roos 20:31
so it is something that, you know, again, if you set them up correctly, and don’t do the percent, and I’m telling you, I’m seeing that everywhere, right now. I have, you know, consultants out there and, you know, telling doctors just give them a percent. I don’t know who has given people that idea. But I have a lot of doctors right now reaching out to me saying, hey, my coordinators wanting they should and they’re showing us like what they’re seeing that’s out there. Wow. Okay, so that’s, you know, setting it up correctly at the beginning.

Bill Fukui 21:01
Makes sense? Okay, how do you address that with the surgeon then when when they’re saying, Oh, my, you know, this gal that I’m, I mean, she’s gonna be great. She’s gonna be a great PCC. But she’s wanting an incentive plan that’s, that’s based on a percentage, how do you address that with the surgeon to say, you know, that, that really doesn’t make sense.

Sandy Roos 21:24
It actually, it’s a pretty easy discussion, it’s years ago, you know, part of being a part of the ASP s or a sound, I forget, which one is, there is nothing, you can’t do fee splitting. Okay. And I can tell you back in, you know, the early 2000s, when I was working with a different company, and one of the gentlemen there, he had actually said that, if you give somebody a percent of like, if the quotes 10,000, and you give them 1%, I completely made that number up. Even if it’s off the surgeons fee. That’s you’re splitting their your fee with them fee with them. And so, you know, depending on who the president of the Society was, would always depend on if they would consider that fee splitting, splitting. But that’s, you know, I just consider that fee splitting, as well as it truly doesn’t incentivize growth. And, you know, we really do like to, you know, look at a number and say, this month, and we only bonus off the surgeons fee, we don’t bonus off of Oh, our anesthesia, it’s not the total quote, it’s just the surgeons fee. And it’s when the surgery is performed, not when the money is collected. So it’s a pretty good plan. And then we also like to have a proficiency, part of our compensation plan. And that’s where you know, you have a financial goal, then you have like, whatever behavior we’re trying to change, or make better in the practice, whether it’s a conversion rate and no show rate, a same day conversion rate, we’ll, we’ll make that as a second component of that compensation plan, okay, to really, so we can split it up a little bit.

Bill Fukui 22:50
Okay.

Sandy Roos 22:51
So

Bill Fukui 22:52
you know, now that we’re talking about even kind of maybe taking it to the next step, in terms of how we’re going to be compensating them. Now, now it boils down to data, you got to have the data, how are you going to be compensating them if you don’t have the data to show that, you know, both to both the PCC, your office administrator or whoever you’re incentivizing as well as the surgeon? How do you go about because I know for a fact, most of my practices when I first start working with them, they don’t even track phone calls, or they don’t track anything, they track very little, you know, so where do you work with? Or how do you work with a surgeon to that, that this isn’t part of their regimen, that they become more acclimated to, you know, basing decisions more on data and not just their gut feeling or their wife or their spouse or, you know, their their other significant other that they’re making decisions based on data not not emotion?

Sandy Roos 24:01
Well, you, you know, me, I’m a data person. And I can tell you, when I start working with practices that are more established, one of the most difficult parts of the process and really engaging with them is getting data from them. And it’s you know, a lot of the EMR systems they have reporting but none of them have the you know, really accurate reporting. When it comes to like you were saying everything from the initial lead whether it’s a contact me a direct message from Instagram, or a chat lead versus a phone call lead. Most people start tracking at console and it’s so it’s, you know, that’s why I like to start working with these younger physicians because I’m we have spreadsheets that if you know, just show them that let’s let’s start tracking different you know, patients at different steps of the decision making process. Really looking at the spreadsheet comparing it then to the software that they might have, if it’s, you know, if the manual works, and it equals or is the same as the EMR data, then I’m saying you don’t have to do things manually. But I have this amazing spreadsheet that I put together that practices that have, you know, next Tech, they have patient, now they have all these my other software applications, they love it, because it truly allows them to track, you know, different from the initial lead at console, as well as then really the surgeons fee, and like helping them know where they are towards their bonus. Okay. And so that’s one of the things I really liked to work with these younger surgeons about is because I want them to make decisions based off the data.

Bill Fukui 25:40
Right? You know, and that’s how I think you’re right on they, the biggest mistake is they don’t track data. They don’t. And

Sandy Roos 25:47
they really, and they make assumptions to your point that the joke is, is that and I just when I was at Santa, I was taught, you know, training my new team. And I said, every physician you go to is going to tell them you have there’s going to tell you they have an 80% conversion rate. And it was very interesting to see how they got as they started talking with physicians, they would come back and like, oh, my gosh, they said they had an 80% conversion rate. I know. And I said, everybody does it. And so I’m like, well, let’s just start tracking, let’s just do it for two months, or let’s pull your data, you know, from you know, the schedule, not from the EMR, but from the schedule, let’s look to see how many consults you had in May, or June and July, and how many of them are booked. And the majority of the time there are anywhere between a 25% to a 48% conversion rate. And I think they’re at every once in a while I’ll see, you know, a 50% conversion rate, but nowhere near a reality.

Absolutely. And so you know, that’s why I’m like, let’s make decisions based off of data, I always say, even when I start working with practices, you know, it’s one of the biggest obstacles and hurdles we have is really working with the office manager and the coordinator. Because once they start seeing the things that we’re trying to track, and they see where their conversion rates are, is when they get you know, kind of defensive. In and so you know, that’s where I always tell the physician, if you start tracking at the beginning, you’re never going to have that problem. As well as if you ever have an office manager or patient coordinator tell him that you don’t need to track, you really don’t want them working with you. At least not in that type of position. Because there’s no way when I was a patient care coordinator, i Everything I did was based off of data. And I tracked it. And I could tell you, I thought for sure I had a much higher conversion rate until I started tracking it. And then I was like, wow. But I always knew then if things were you know, if I saw my conversion rate going down, and like why what do I need to do different? The doctor wasn’t gonna get mad at me because of it. But it’s, it was like an opportunity for me to like, take a step back. What have I forgotten to do and the things that you might I normally do? Or do I need to do something different now? And so it truly, you know, I made? Again, you’ve seen my workshops are every decision that I made in the practice was based off of, we wanted to have, you know, 50 to 55% of our people schedule surgery the day of console. And when I saw that number decrease, I’m always like, Okay, why are they booking at console? And then so, you know, we came up with those reasons over the years and doing workshops, you know, financing is a big one, people aren’t ready to, you know, price. Another one is they weren’t ready because they didn’t know, preoperative postoperatively, what the you know, what their limitations would be? So where can we pre console take care of that. And so to me, that’s where really working with the practice and developing good habits at the beginning, is going to really save them a lot of harder heartache in like two or three years. So again, I always try to even though like you and I know I like to collect data, I have to approach it differently. Because as soon as you start asking people to collect data, they get defensive.

Bill Fukui 28:59
Yeah. It almost becomes you know, it’s got to be something that’s ingrained from the get go. Right, and they’ve embraced it. And they’re no longer feeling. I think salespeople in general, you know, I can say that because I’ve been in sales, my whole pretty much my whole professional career salespeople in general are Mavericks, they don’t want to be held accountable, you know, in many cases. And

Sandy Roos 29:23
when you’re right, that’s a good number.

Bill Fukui 29:24
Yeah, exactly. Only if they know it’s a good number. But in general, it is they want to, you know, they generally are somewhat secretive about that simply because they don’t want to be accountable. I think when you develop a culture of of transparency, and it’s not a personal attack on you, if even even if you’re not getting yield those numbers or even if you’re at the 25% you know on conversions. It’s about what can we do to get make it better and instilling that type of call culture as opposed to one that that’s more defensive. Yeah. But I think that happens. Like you said, you got to start building that culture from the beginning.

Sandy Roos 30:08
Absolutely. And one, you know, we started talking initially about, like, who to hire. And I think what you just, you know, you kind of mentioned it a few minutes ago, is like, Who do we compensate? And one of the things you said was like, is it the office manager? Or is it the front office coordinator. And so I want to kind of backpedal a little bit to when we talk about who they should hire first, because one thing you and I, we, that I didn’t, I forgot to mention is that after the patient care coordinator, really the second person they should hire should be a really great front office coordinator. Oh, and one of the one of the things that people will do is they’ll say, Well, I only need them there, when I’m in the office. So with the doctors and surgery, they just, okay, you know, the front office coordinator is not there. And that’s what again, one of the biggest mistakes people make, again, you have a patient care coordinator, front office coordinator, you still don’t have that office manager yet. But your front office coordinator is going to be able to answer the phone and do other tasks. So your patient care coordinator can make sure that she’s talking to your patients doing all the follow up, you know, doing all the busy work that she needs to do when you’re in surgery. And again, a lot of practices, doctors will say, Well, I’m in surgery, I don’t need that for an office coordinator. But now that patient care coordinator is having to answer all the phones and do all of that. So I just wanted to back up a little bit on that just to make sure because, again, that’s one of the biggest pitfalls that I see doctors do in the hiring process is hiring, not hiring a full time for an office coordinator as their second hire.

Bill Fukui 31:34
Interesting. I mean, I that would have never occurred to me. Yeah, I would have and I think it’s pretty common, where the doctor is not in the office. For them, it’s out of sight, out of mind, correct kind of thing. And things just happen all, you know, almost magically on its own. But we all know that it doesn’t. So where do you you know, a good question would be, where do you find these people? Where do you find, you know, a PCC or a front office coordinator? Where do you find people with those types of skill sets? Because I don’t think they’re, they’re really, you know, promote, I, I wouldn’t think that I would get a lot of that off of LinkedIn. You know, personally,

Sandy Roos 32:19
well, you’d be surprised, not the front office coordinator, but the patient care coordinator. If again, I feel you need to have an established patient care coordinator, or somebody that’s been a really good front office coordinator in a very busy practice that, you know, wants to move into a PCC role, but there’s not the opportunity in their current practice, okay. And so you know, that would be my if you can’t, but on LinkedIn, you can like do a search like Patient Care Coordinator, I’m seeing more and more people having that because it is a career, I mean, you can make really good money at it. But obviously, we still go back to indeed, because that seems to be the one to me, you get, you know, 1% of you can get have 200 applications, and two of them will be patient care coordinators, right. But it truly is, is just like putting the word out amongst your reps, like who do you feel would be a good person. But again, you have to have an experienced one for front office coordinator. If you have that experience patient care coordinator. I love finding my own I like going to a restaurant I like going to a high end store pre COVID really watching people because to me, I want somebody that’s nice, I can’t train nice, but I can train them on everything else they need to do. Okay, but you can’t train a person, you can’t teach somebody how to be nice, and how to, you know, have that great customer service. I was most recently on vacation, and I was in Fort Lauderdale. And the person when we checked into the hotel was absolutely amazing. And I was like, oh, I need to hire her. I need to get her practice here in Fort Lauderdale. Because she was that great. On day three, when I went down by the front desk, that person wasn’t as great. But you know, I’ve seen it, you know where I’ve, I was, again many years ago in Washington DC with the practice meeting with the doctor and we were having dinner and the back server, they have two servers for each table because it was a nicer restaurant. She was amazing. And I mean, I just kept watching her throughout the night, how she interacted with, you know, the different people how she was just nice. You just You just wanted to be around her. And so at the end of the night, I went up to her and I said, I know this sounds really strange, but hey, you know, what do you do during the day, you know, and she’s like, actually, I just moved here from Long Island. And this is, you know, this is what I do full time and I said, Well, I have a practice that might be looking for a front office coordinator. You know, it’s a plastic surgeon’s office. You have an amazing personality would you be interested in applying I’m not offering her the job. Right. And by the way, I didn’t have an opening anywhere in any of my practices in America. But I did go to the doctor that I was working with and I said you have to hire this girl. Yeah, she is absolutely amazing. Seeing and he ended up hiring her. And she She lasted a few years until she moved back to New York. But that’s what I like to do. I like to go and find people. And see, I get to see how they interact with people because in an interview, they’re putting on their best front. Yeah, they’re, they’re outgoing, they’re going to tell you everything you need to hear, right. So for me, a front office coordinator, I feel you need to be a little bit, you know, different and how you do that and be a little creative. The person that replaced me when I left my job, in Arizona, I went to the mall to in Scottsdale, and she was at I saw her at the NARS counter articles. And I just loved how she talked to everybody, she treated everybody the same. And I’m like, Oh, that’s it. And so she ended up taking my position. Because she just was so good with people.

Bill Fukui 35:51
You know, I think that I think they, again, I think you can you can you can teach aptitude, you can teach attitude sometimes. And, you know, we’re actually in the middle of doing some sales training, where it is about, do they have the technical skills? Do they have the, you know, product knowledge? Is it behavior, you know, what, what, what all precedes itself, and I still gravitate back towards, it’s still attitude, you can do behaviors that help change your attitude, but it’s still, I still believe it starts with attitude does, and because without attitude, even the behaviors, you can’t persevere, you can’t persevere with behavior that may not be getting the results. If they get results right away, like you said, they get results right away, then great changes my attitude. But it’s the attitude that helps you get through those tough times. Absolutely, you know, the downtimes, that doesn’t change your behavior, because their attitude, and determination, those types of things stick with you. And then your it’ll, it’ll maintain your behavior. So you can get through those tough times. And you’ll still do the activities needed to get the results. But but it sometimes it takes that personality sometimes?

Sandy Roos 37:19
Well, I, you know, I think you what you said there as well as earlier is that it’s hard when just bringing somebody on and you have to create habits. Yeah. And so to me, when you’re bringing on whatever position it is, you want to make sure because like I always say, bringing on a new front office person, you get to teach her she’s not bringing bad habits with her. And that’s the only downfall I can say to not to a patient care coordinator and established one. And that’s because when they come in there, they’re going to have experience that you need. But you really need to make sure that they have experienced, but they also are open to doing things different, right. And I think that’s key, you know, you and I laughed kind of about it. I’m always making fun of my age. But again, I told you this story. I was talking to one of my favorite surgeons ever, and he were looking for a new location for open up, you know, he’s opened up his floor. And he’s like, Well, I found this one and it’s right next to an Alta, it’s in a really nice area. And I’m thinking I’m like, Well, okay, but gosh, you know how you got to think of people? Are they going to feel comfortable walking into a plastic surgeon’s office where everybody can see going in? Yeah, and he and I have a great working relationship. He’s like, Yeah, but that’s your age. You guys worry about that. And I’m like, Hey, he said, his target market is not my age in that area. And so I hear that’s one of the things he always says he loves working with me, because I’m always open. I never, I never feel like, just because I did it a certain way doesn’t mean that it’s the way you need to do it. And so I think that when you’re hiring somebody, you have to find no matter what position, the person that is going to be open to new ideas, and not be like, it’s my way or no way. You know, I’ve been doing this for 10 years, how dare you question me, because these younger surgeons are marketing a lot different than the surgeons that have been around 20 years. So I think that’s really key as you’re looking for somebody, and that’s why it’s and again, I’m not gonna, I’m gonna I’m gonna toot my own horn here at heart here. I like working with these younger surgeons because if they have a lot of times I’m involved in the initial hiring and helping them hire and now that person has, you know, formed a relationship with me. So I’m able to right away, start putting in spreadsheets and start really putting in these things that I know is going to make a difference. And it kind of helps the doctor not have to deal with that. But again, we’re starting it out the correct way. Right. And it’s even something I talk about when I’m talking to the possible patient care coordinators. You have so much experience. I want you to kind of forget a lot of it when you Knock in the door, you know, we’re going to use a little bit differently, but your experience is going to help that. But you can’t you can’t, you have to be able to want to do things differently, or you’re not going to help this doctor grow.

Bill Fukui 40:12
Right? I think I think that’s, that’s number one, it’s transparent. It’s being clear about expectations about, you know, a mindset when you come into a job. And that, you know, No, nobody’s bigger than the practice, correct. Nobody is bigger than the practice, right? At the end of the day. We’re all doing things. And I’m, you know, I started working with Medtronic digital, fairly recently, we founded med sharp fairly recently. And a lot of the things that we do are very different than what I, you know, for the last 20 years it did, you know, in my previous agency, very, very different. Not that it’s, it’s better or worse, it’s just, it’s different. And I do think that there’s a reason why we’re doing that that way, once I understand it. Now, all of a sudden, the light turns on, I get it, I get why you’re doing this makes a lot of sense. Yeah. But I think if you go in with the baggage and that it’s my way or the highway kind of thing. You limit opportunity. Yeah. Growth. No question. Absolutely. Do you do? Do you do much in the weight? So if I’m, you talked about location? What do you what kind of advice? Or how do you go about helping a surgeon when when they’re talking about location? Because that is one of the first things that they look at. Everybody said Location, location, location? What do you you know, how do you apply that in today’s environment? In terms of location for a plastic surgery? Office? There’s

Sandy Roos 41:50
two different things. There’s location is there in school, like, I don’t know where I’m going to go practice, like, where to work? And like, what state Am I going into? I see that a little bit more. But what I am seeing, they always say, I’m open to go anywhere. But boy, I’d love to be in Texas, or Oh, I’d love to be in Florida. I always say and as I’m helping some practices and you know, bring on physicians, one of the things we look at is what what do you have here? Why would you want to be here? Because we know, if they don’t have family here, they don’t have some history here, that the chances of them leaving are pretty, pretty high after like, really? Yeah. And so I am seeing a lot of the these younger surgeons within the first five years moving around, and I hadn’t seen that in the past. Okay, so we, for us, when we’re hiring on a new physician, we always want to like what, what’s going to keep you here. But then the second one again, is really, once they get like, Hey, this is where I’m gonna go on my own. I’m gonna go you know, open in Las Vegas, which I don’t ever recommend. But open in Las Vegas. I used to live there. I used to live there. And that was the most difficult market for plastic surgeons. Yeah, hire really great people. But Las Vegas is you know, there’s different areas there. Summerlin, Henderson, you those areas in that. But it’s really like, again, where do you want to be in five years? Right to me, you know, one of the great things that I like is and again, I believe that doctors should own their own buildings. But that’s pretty lofty goal at the beginning, is to go lease a space, build your practice, make sure that’s where you want to be, and then go and build your own space, hopefully, with an O R. Right? I mean, I really bet I’ve seen doctors that have went out right away, spend all this money on a build out or whatever. And one, they outgrew it pretty quickly or two was a really bad location. Okay, so you know, I kind of liked the model of just finding somewhere to lease, okay, you know, and build your business. So you’re not you don’t have all this overhead. And then like I said, just after you build it, then go ahead and like, Okay, now I’m ready to buy, I do think doctors should have their own or, and again, it’s a pretty, it’s one of the most expensive things that you can do and building your practice. So to me, again, a five year goal. Okay.

Bill Fukui 44:11
You know, so it’s so you’re pretty much, you know, laying the groundwork fairly early in the planning process. You know, we have goals, the goal would be once we open our doors, you know, in five years, that would be the goal, because that was one of the questions is that I was going to ask is some of the most successful practices I’ve seen that have gone out on their own, did exactly what you just said, they have their own or they’re not reliant 100% on privileges and different hospitals or whatnot. And I think there’s a credibility when it comes to cosmetic patients. When a facility has its own, you know, ASC and and their own staff, and they’re, you know, and there are people Well, I think there is a cohesiveness that gets communicated to patients. You know, when the doctor is in control, the surgeon is in control of not only just what they’re doing but the environment around them.

Sandy Roos 45:16
Yeah, well, and again, it’s something that, you know, even through 2020 doctors that have their own surgical center, we’re able to go back and do surgery much more quickly. Oh, they’d already, they’ve already developed relationships with the anesthesiologist, when a lot of the state started reopening for you know, cash pay, or, you know, cosmetic procedures, the ASC isn’t that the first responsibility was doing all of the anything that wasn’t cosmetic, it wasn’t a breast dog, you know, it was hernia repair it, you know, the different procedures, and anesthesia was like doubling their cost at that time. Oh, really, in a lot of the areas. And so doctors that have their own hours, pretty much were able to seamlessly go back because they already have those relationships. Right. So and again, it’s just it’s a nice place to be, you can control your days you have. And then again, I think there’s a whole nother series on, you know, when you bring on a new physician, you know, what do you do you have that, you know, should be separate from the practice, but right attached to it. If you have another name, could you then you know, on the days you’re not operating, let somebody else use it, you know, but it’s also nice when you’re ready to bring on a new physician that you have that oh, are so then it would be full five days a week versus just maybe three days a week, right? There’s just a lot of, you know, things to consider. But again, I think it’d be very short side of a short sighted of a physician to right out the gate say no, I’ll never going to have my own Anwar. But I also think it’s a lot it’s to do right at the unless you have family money to go out and start your own practice and open your own room are the same time. That’s that’s pretty lofty goal. I’ve seen it done when they’ve had family money. But it’s it’s a tough one other than that,

Bill Fukui 47:06
okay. Well, as long as you plan for it, and yeah, and budget for it, etc, I think it you know, and, again, just stay the course you got to have somebody to kind of coach you just stick stick to those things. I think there’s no reason why you can’t, you know, have those things. Because I think the market is there, the market for what we do. It’s there, there’s no reason why I practice.

Sandy Roos 47:32
My surgeons are having their best year and some of my younger surgeons, you know, they’ve been out for years, five years, and I’m like, okay, when are you going to bring on your next associate? Yeah. You know, they’re like, what I’m like, you have patients calling in that are going somewhere else, because you can’t get them in for surgery until June. Yeah, no. And they’re like, Well, wait, wait a minute, and then I have to bring on a new associate. And I’m like, No, you’re not ready yet. Yeah, you don’t need you don’t have enough leads, ya know, and so, but I’m seeing more and more of these younger people. That, you know, in years past, we never would have thought of ever needing to bring on a new associate without, you know, under 10 years. Right. But I see I’m seeing a few more of them now, that that five and six year mark that probably could bring on an associate in really

Bill Fukui 48:21
well. You know what, and I think you’re right, the environments changed. The environment has changed where that can happen today. And I think with entrepreneurial and business minded, planning, making sure you avoid the pitfalls and don’t have to take steps backwards all the time. You can build enough momentum where that you know, that four or five year where they are having ASCs or bringing on an associate, it’s absolutely the market. You know, in the midst of a pandemic, I’m hearing practices have their best year ever.

Sandy Roos 48:58
They’ve everybody’s crazy, crazy. And 2020 One’s the same. Well, because doctors didn’t go on vacation, vacations didn’t go on vacation. So they had extra money to spend they didn’t have to worry about you know, picking up Johnny from soccer because there wasn’t a soccer well and

Bill Fukui 49:15
years ago we had to wait for those tax return dollars coming in. Now they’ve accumulated enough money that they don’t need the tax return money to pay for because they saved it they think that

Sandy Roos 49:28
one of the things I think I don’t know how much more time we have, but it kind of goes with this as if we’re talking and I think it would be I think we need to unite need to talk about just briefly is like you know, naming the practice. Because you know, that’s one of the things you and I both have said over the years doctors come out and they want to name their practice you know, Joe Smith, MD or Smith plastic surgery, and you know, they can’t do that you have to for two different reasons. You need to have a name that’s not affiliated with your name, your name why So you can bring on an associate, right and to when you’re ready to sell or retire, your URL is the most valuable thing. And Euro are that you have in years past doctors would sell their practices. And you get their patients and there was value in that there’s not value in that anymore. And that change, you know, early on, because patients now, if Dr. Smith is no longer there, they’re going to go to their friend and say, Well, who did you have your breast surgery done by went to Dr. Jones? Okay, well, I’m gonna go Dr. Jones. So, you know, that’s something that, you know, again, we’re on our first of our series have to making sure that when you’re naming your practice, that it’s not your name,

Bill Fukui 50:40
I think that’s a great point. And that will go into our seconds, where we can talk more about the marketing and branding of, because I think that’s where you’re where, really the value of a practice is, it’s, it’s the brain, it’s because it’s the brand and you know, once it’s tied to a particular individual or a face, or a name, and that face and name is no longer part of the business, you know, that you know, a large part of the brand goes away.

Sandy Roos 51:09
Absolutely. And then having the building if you own your own building is owned by you, then you have the your office is one LLC, the nonsurgical is another LLC, and then the O R is a different LLC. And that way when you are bringing on new associates, you know, you’re they’re just buying into the practice,

Bill Fukui 51:27
not into the facility. Yes, exactly. So that’s another great, great pitfall to make sure that you avoid. Well, super Sandy, let’s do plan on a second second of the series, where we are going to go into kind of practice growth mode. Yes. You know, even for these young practices, what can they do to start, you know, priming the pump? How can we start filling and getting, you know, schedules filled, as well as referral referrals, how to build those types of things. And then we can get into a lot more of what I would call the fun things for

Sandy Roos 52:05
exactly things that we get excited about.

Bill Fukui 52:10
I mean, that, to me, that’s the fun part. But, but there’s no no question that the foundation that you’re building, you know, marketing only works when you have a good product. And without those building blocks, you know, all the marketing in the world will just be an expense, not a revenue stream. So absolutely super. Hey, Sandy, thank you again, for all your time today. We will all be in touch, we’ll schedule another one. But as always great insights. You know, I listened to you talk all the time. I still walked away with with two pearls. And I’m gonna I’m gonna pocket today. And likewise,

Sandy Roos 52:49
I always love listening. Like I said, I think we equally learned so much from each other. Because it’s all about learning. It’s you know, that’s one of the things I feel makes me you know, a better consultant is that I don’t get stuck in my ways. I’m always you know, looking to see what we can do different depending on technology and the environment and you do the same and I think that’s why I always say we’re the a team

Bill Fukui 53:12
together. We’ll say percent you have a great day. Thank you, Tim. We’ll be on the next show together.

Sandy Roos 53:18
Perfect. Thank you. Take care. Bye.

MSD Insider 53:21
Thanks for joining us for the med shark insider with Bill Fukui join us next week for another dive into all things medical marketing. All episodes can be streamed at WWW dot med Shark digital.com/med Shark Dash insider

Transcribed by https://otter.ai