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📅 Schedule your free 30-min strategy call with Catherine ⚙️ Restart your practice in 7 days ⬇️⬇️⬇️ Hello, I'm sure you are [painfully] aware that it's no longer enough to be an excellent surgeon in order to be successful. That's a given. It's just as important to gain other new skills as the world changes around you. That's why we talk about the business and marketing of plastic surgery on the Beauty and the Biz Podcast. And why I interviewed P. Daniel Ward, MD. Dr. Ward is a facial cosmetic and reconstructive surgeon in private practice with three offices throughout Utah. Listen in as Dr. Ward talks about how he has grown his own successful cosmetic practice by: Bringing on key team players to free him up to do what he does best Managing both the surgical and non-surgical demands of his patients Where social media fits into his marketing plan and a whole lot more Dr. Ward also mentioned that in 2013, Forbes reported that Salt Lake City was the vainest city in the United States! Who would have thought?!? Visit Dr. Cole's website at https://www.wardmd.com Enjoy! Catherine Maley, MBA ⬇️ FREE BOOK: 📕 Get my 5-Star Rated Book, "Your Aesthetic Practice — What Your Patients Are Saying," FREE! Just pay S/H ✅ STAY UPDATED: 🌐 Catherine's Website 📝 Catherine's Blog 🎤 "Beauty and the Biz" Podcast 📺 "Beauty and the Biz" Videocast 🔊 "Beauty and the Biz" on Apple Podcasts 🤝 LET'S CONNECT: ➡️ Instagram ➡️ Facebook ➡️ Twitter ➡️ LinkedIn P.S. If you need help differentiating yourself, schedule a complimentary 30-minute strategy call with me. Review Beauty and the Biz on Apple Podcasts and get my 5-star rated book. FREE! Catherine Maley, MBA: Everybody that's going to wrap it up for us today on Beauty and the Biz. If you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA. If you've enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don't miss any episodes. And of course, please share this with your staff and colleagues. And we will talk to you again soon. Take care. "The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there. So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It's guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I've gleaned over the years into one playbook of the most successful practices and what they do to win. Go to www.CosmeticPracticeVault.com and let's grow your cosmetic revenue." Transcript: Surgery, Staff and Snow with P. Daniel Ward, MD (Ep.137) Catherine Maley, MBA: Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, staff and snow with P. Daniel Ward, MD. Now I'm your host, Catherine Maley, author of Your Aesthetic Practice - What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. And I'm excited about today's guest. It's Dr. Preston Ward. Now he's double board certified in facial plastic surgery, as well as head neck surgery. Dr. Ward lectures worldwide on his innovative techniques and serves on multiple committees for the American academy of facial plastic and reconstructive surgery. Now, Dr. Ward's in private practice with three offices in Salt Lake City, as well as Riverton, Utah, and specializes in rhinoplasties. Revision rhinos, facelifts blephs, and cosmetic injectables as well as hair restoration. Now he has his own private surgical facilities onsite as well as medical spas to cater to his non-surgical patients. Now, prior to his career in plastic surgery, Dr. Ward studied chemistry and that prompted him to work with the leading cosmetic labs to develop his own skincare line. That is commercially available. Through his office as well as other medical spas in the region. Dr. Ward has a lovely wife, four grown children, two adorable dogs. And from the looks of it, he loves snow skiing. So, Dr. Ward, welcome to Beauty and the Biz. It's a pleasure to have you. Daniel Ward, MD: Well, it's great to be here and great to talk to you. I've loved listening to you over the years on the podium, and it's nice to talk to you about over zoom. Catherine Maley, MBA: Thanks so much. So lately first of all let's talk about snow skiing just for a second. I used to snow ski a lot because I'm in Sausalito, California, and I'm only three and a half hours from lake Tahoe, which is breathtakingly gorgeous. And I just haven't had the time, like I used to. How far are you from the slope? Daniel Ward, MD: So, I am my house is seven miles from Snowbird, so it's really close and that we have, we have we, we frequently go up north to another place in garden city, Utah, or lake Utah, which there's another place it's about 15 minutes from there. So yeah, skiing is part of what you do. If you live in salt lake. Catherine Maley, MBA: For sure. So, Dr. Ward, everybody would love to know how did you get from wherever you did after graduating after medical school and fellowship and all of that? How did you get to private practice? So, what was your… Daniel Ward, MD: I finished my fellowship at the university of Michigan and was fortunate enough to get a position at the university of Utah, which I loved. I ended up leaving the university of Utah though. Due to some changes I, I would have at the time when I left, I would have said, oh, it's because I'm concerned about the potential pay cuts there that they're making to our pay structure. But actually, it was a little bit more than that. It's like, I realized that for me, I really like building things. It's not about finances, it's about building things and creating something that is kind of, I guess, bigger than, than what I am. And so that's what, why I decided to leave the university. I'm still a faculty member they're just not employed there. And I mean, there are some times when I kind of do miss the safety and security of employment, but it's so rewarding and it's so fun to be able to build something of your own, take care of your patients, the way that you want to develop the practice that you would. To do. It's very rewarding and I could never, I'd have a really hard time going back to full employee just because it's so fun to be able to do what we want to do. And part of that is really kind of is that vision, being able to have a vision and carry that vision out for us, our niche is kind of really higher end services. And it's about the experience. And that is something that I'm passionate about. And that kind of gets me up in the morning. Catherine Maley, MBA: And did you start out with, I mean, you have a gorgeous place with an awful lot of staff, you know, you have quite a little empire there right now, but how did you start out? Was it the wife at the phones kind of thing? Daniel Ward, MD: Kind of, I think we start with nine employees. We, we did to take a business loan just to help with the funding for that. We don't have any other equity partners. Which something that this as a little aside, I think that a lot of physicians, especially don't understand that that certainly, you know, borrowing money from a bank can be conceived very expensive, but borrowing money from equity partners is even more expensive. That kind of confused me at first. So, there is nothing wrong with getting a loan from the bank, especially with interest rates, being what they are now. So, we started out pretty small. We actually had a little bit of a personal tragedy, right? As we were opening, our daughter was involved in an accident and. The plan was for the, for my wife to help a little bit more. And we kind of had to shift gears and change that. Cause she was living at the hospital for a few months with, with our daughter. So that kind of shifted things, but we were just kind of full steam ahead, oldest. We'll just try to get this done. And then we just kind of grew from there and I have to confess, we have made. Every mistake that I can conceive of making. And some of those have been more painful than others. But it's all about the learning and the older I get, the grayer I get, the more I understand and appreciate those learning opportunities. And that's actually part of the fun is making those, I mean, nobody thinks making a mistake is fun, but learning from it and learning how to do it better is really is part of the fun. Catherine Maley, MBA: Well, we can't leave it there. I was going to ask you later, but give us one big mistake that could help everybody else avoid. `If they're listening. Daniel Ward, MD: I mean, I, I, I've got so many where, you know, which one to choose from this big menu. For me, I think it's, it's kind of a lack of an appreciation of culture of an organization, which if you read almost any business book, they're going to mention like, you know, culture is everything. And I guess, I guess maybe the biggest mistake is maybe not realizing the culture starts with me. I, you know, I don't mean this to be like a big, big may a Copa spouting out, but, but I think, you know, if you're a business owner, most of the problems, they are all your problems, then oftentimes those problems do start with you. And for me, it was kind of realizing that, you know, a lot of our cultural problems were problems with me. And it's not necessarily that I was a bad person or am a bad person or Purposely made mistakes, but part of us, you know, the, the surgical training, the path that we go through leads a lot of us to being, you know, kind of injured in a way. And until you can kind of heal yourself and get yourself into a healthier state, it's hard for you to kind of be that sort of leader that you need to be, where you can kind of set that culture. At least it was for me, I think a lot of people are naturally gifted at that. That's not one of the things that I was, and, and that has been a huge change is. Kay is realizing that that the business is going to run more efficiently. It's going to be more profitable. It's going to be more enjoyable for everybody. If I, you know, in a way kind of step back and take a little time to be selfish and take care of myself so that I'm in a better place and I can make better decisions and be a better leader for our organization. So, I guess to summarize all that, it would be the biggest mistake is, is kind of not realizing that the problem starts with me and I need to fix me before I can expect to fix the other things that are going on in our business. Catherine Maley, MBA: I'll tell you, after hanging around with you surgeons for 22 years now what I have learned is there's been such a mind shift that you have to make, because for whatever 14 years, you had to become a surgeon. Now you have to become a leader and a manager, not even a manager, if you're a good leader, you find somebody to manage for you, but it all arrows point to you. And that's the good news. And yeah. You know. Yeah. If you can, if you can step up to that everyone's looking to you and you're the role model and there's no more hiding in the surgery surgical suite, you know, you've got to show up and tell the staff, what, what do you want? You know, what is your vision? What is your mission? Where are we going with this? I've just found that the clearer you get about all of that and tell your staff that's how the culture is developed. You know? Okay. Team here's where we're going. Just like in sports. Daniel Ward, MD: It relates to. So, when I was, I did my residency and fellowship at the university of Michigan, and I had several friends there who were getting graduate degrees and they have a really big organizational behavior program. And I have to confess, I've told this to them that I used to kind of be a little judgmental about their career choice. That is like the softest easiest field. Like, what are you talking like? That is the, I, this is all going on in my head. You know? Like, why are, why are these guys doing this that, you know, do something real like chemistry or, you know, I mean, that's kind of the judgmental side of me, I guess. And now what I realize, you know, whatever 15, 20 years later is that those guys are actually the smart people. Cause they realized early on that. How important it is to kind of make an organizational, you know, that it's really difficult to get an organization to behave the way that is going to make it profitable and healthy. And so, I've had to kind of, you know, go back and eat Crow a little bit about my, my judgmental state about that kiss that is so important. And it's those softer that, you know, quote unquote software things are actually the really difficult things to get. Right. And the older I get, the more I realize how important. Catherine Maley, MBA: And that's why I have this podcast because it's the business side of surgery. If you don't get that, then you probably shouldn't be in, in retail medicine because this is the fun side of medicine. Nobody needs to see you. They're going to hand you a credit card, not insurance card, unless you get the business side of this down. Well, I guess you stay in reconstructive or you work in a hospital and let them handle the business side. But I'm talking about that are still doing reconstructive or where's your percentages. Daniel Ward, MD: Yeah. So, I love to do reconstructive stuff still. And so, we, yes, we, we still take insurance which from a financial standpoint, you know, from a professional fee standpoint is, is not as good as cosmetic from a facility fee side. It's actually very good. So financially it makes sense for us, but also from a satisfaction standard. Is this such a big part of my training and my background of my initial interest in, in rhinos in plastic surgery was reconstruction. So, I definitely enjoy doing that and don't anticipate ever kind of stopping that. Catherine Maley, MBA: Okay. And then you have just an athlete, gorgeous office and a few of your own surgical facilities. Give us a few of the pros and cons of that because that's no easy feat, number one, getting approved. If, you know, especially if you're doing a reconstructive, I guess you, you need a, you know, quite a or whatever on a bit about doing that because so many surgeons say to me, when is it time for me to get my own surgical suite? Like what's, what's. And what's the downside. Daniel Ward, MD: Sure. So, I did it initially for, cause I wanted it to be convenient for me. Like I wanted a place, this to operate where I was seeing patients. I could see patients there. But it's, it, it, it really is from a business standpoint, it is a clear no-brainer. If you are doing any sort of insurance cases, To try to, to bring those to your surgical center. So, the pros are, it can be very financially beneficial. The downside is that it's a heck of a lot of work to, to follow all the rules. We actually just had our Medicare accreditation survey this week. So, you know, surprise visit. And thankfully we were, we passed with flying colors. We felt really good about that. I ended up to, to, to help with that process. Actually, I took the course to become a surveyor. So, I feel like I understand the rules better and can, can make sure that we're living them as well as following them. So, yeah, I would say that the pros are financial benefit. The downsides are, it's a pain in the neck. And you know, part of it is the accreditation, but I would say the accreditation is the easy part. The hard part is actually just having the extra staff to look after, you know, because you're not, we're not big enough that we can hire like five scrub techs and 12 nurses and you know, all these different people to help. So, if one person's out. You know, somebody who's got COVID or somebody's sick or whatever. What do we do? You know, how do we cancel two weeks to surgeries or, you know, how do we manage that? So, it's really been an effort to try to, to get people cross trained. I think we're finally at a point that we are just getting to where we feel a little bit more comfortable with that. Next week. There are probably some, be some other wrench thrown into our plans, but, but it's actually just the staffing thing, the logistics of getting staffing there and making sure that things run it's, it's a lot more complicated than I think most of us as surgeons think. Catherine Maley, MBA: I, I saw a talk once at one of the meetings and it was so interesting that the guy did a survey on working with a surgical staff that you don't know versus the one that you know, really well. And you're like the well-oiled machine versus the flunky machine and that it actually hit your bottom line pretty like 5% or so of revenues was due to just being more efficient about it. And another thought somebody had mentioned an app and I haven't checked it out, but there's this app for the exact reason you're talking about with someone's out, we're kind of screwed and you go on and say, I needed a scrub tech boom. And it's like an Uber for a hospital staff or surgical staff. I think that's amazing because it happens all the time. And what do you do? Daniel Ward, MD: Yeah, what do you do? But no, you're right. And I think, you know, there's, there's certainly some quantifiable financial things that can happen by, you know, by having your own staff and stuff like that. You know, like you said, the 5% number. But the other thing is it's your own peace of mind? I mean, I remember actually one of the straws that broke my camel's back at the university was I was used to operating. A certain operating room and due to staffing she's. Now that I understand them a lot better, now that I have my own, but due to staffing issues, the Orr administration moved me from this out nice little outpatient surgical center. That's pretty small that they're kind of already knew my preferences to the big cancer center, which I, which I operate at. But, but now with like, like they're not used to doing, I think it was like a face lift and a blepharoplasty that they moved me to. It was really stressful for me. Cause I, you know, I, I was working with an assistant who wasn't used to working with me. They didn't have all the instruments that I was used to having. And although I don't think that it affected that patient's results. It's certainly affected me. And I probably have a few more gray hairs here because of that and those little things that. The again, the older I get, the more I realize you needed. We need to take steps to make our life easier, happier, less stressful. And as for me, anyway, maybe I'm just a little picky, but moving from a little tiny out-patient or to the big or where they weren't used to using, it was really stressful to me. And I just didn't want to have that anymore. Catherine Maley, MBA: I hear you and not, and no more commuting. I Do the older I get the easier on getting, I'm going to simplify my life. Period. You know, I'm going to get rid of the hassles as every day. I'm just not going to help because you get older and you just, you want life easier. Daniel Ward, MD: It can't be this difficult while you can. Right. Catherine Maley, MBA: So, I regarding the surgical suite though, a lot of doctors say to me, so do I like, how big do I go with this? Do I just. Or sweet, a small sweet just for myself. Do I grow a two or three or sweet where I have other surgeons come in? You have any tips on how you handle that? Or? Daniel Ward, MD: Yeah, I mean, I think if you've got a group of people that are, that are there that, that can, that are committed to operating the. Then, you know, two or three rooms at the max is probably what I would do, but there is nothing wrong with one or two rooms. And if you look at the utilization of most operating rooms, you know, I remember at the university the utilization of the operating rooms, which seemed super busy was still only about 80%. Like one room. You can be very creative with scheduling know, so you can do block time with like half day blocks. So, you can even do like four- or five-hour blocks where you start at say maybe even as early as 5:00 AM go, you know, go to like five to 10. 10 to three, three to eight. And sometimes that's easier to, to get staffing that was so being a little creative, like you don't have to do things the way that the big hospitals have done them forever. And that's one of the real advantages about being small. As you can be nimble to make changes the way that are going to fit your schedule. The best. I will say this though. It is. I hate to pick on my own profession, but we, as physicians are really difficult in terms of understanding business principles. I bet you, you know, better than I do. It is really tough. Like there are physicians will shoot themselves. It's what's the saying? Cut off your nose to spite your face or something. Like, I can't really exactly say, but they will do it. And if they, there, there's almost like this, like profit is kind of like a dirty word in medicine. And if, if, if other surgeons feel that you, as, as someone who has a financial stake in an operating room stands to benefit from. From there using the operating room that is almost a stronger motivator than them, but they may not be really happy that the big healthcare system in your area is making money off of them going there. But there are a lot happier to give that money to the healthcare system, that to you as an individual physician. And so, it can be really difficult to, to do that. So, I, I guess I. The word of warning, there is nice to say that is I would set up some sort of system in place where they really are tied to the, or before you invest $300,000 into building out a three room or, and you're, you know, you've got these verbal promises from these other surgeons that they're going to come and operate there. I would Get something to make sure that they're going to go there, whether you're financially tying them in or, or, or they're actually partners somehow in it, because otherwise you could be out a whole bunch of money and they're still taking their cases together hospital, which is tough to swallow. Catherine Maley, MBA: I've seen that so often I; they say one thing they do in. The surgeon is 10 million in and trying to figure out how is he going to get this thing to operate. And I'm, you're absolutely right. You've got to get some commitment ahead of time. But also, don't just don't count. Surgeons do not work well together, period. I've even seen offices where you know, they're all ophthalmologists and there's one cosmetic facial plastic surgeon, and they don't even help him, you know, and they all can profit from it. So, I, I, I would say Golightly, you know, I would. You could always grow down the road. Speaking of growing and scaling, because I think you have a nice little entrepreneurial mindset going there. You're very good at taking what you have and making the most of it. I'm watching you as you've grown the med spas. You've added another facial plastic surgeon. You've added a PA. How are you? What's your game plan? Daniel Ward, MD: Well, you know, that changes, you know, there's, you know, in the business world we talk, the term is pivoting, but it's kind of, you know, going down different trails or different forks. We started off initially and had a ton of success. You know, I left the university started off and. Our growth of the med spa, the aesthetic side of things was just phenomenal. So, I I'd read this, this great book. You've probably read it before. It's called blitz scaling. It's about, it's about like, Hey, you know what you like when you scale, like the normal way to scale is to nail it and then scale it written actually by my good friend, a neighbor, Paul Holmstrom. It's a wonderful book. Read that book first, nail it, then scale it. But before I read Paul's book, Blitz scaling and blitz scaling simply states like, Hey, listen, forget all about this traditional stuff, grow your business, grow a big, and then, you know, if you build it, they will come. And that's, that's certainly been true, but that carries with it some stress. In the sense of your you're you've, you've got these commitments that you've now made. You're in leases for buildings, you bought equipment that you're now paying for. And You're like, geez, I don't know if I really want to support that. And we, as we grew into that, we had some success and then we had some COVID issues. We had another issue with a wish we, we hired a plastic surgeon who just, it was not a good fit and that kind of really hurt us. And that kind of comes back to the culture. And some of that is my fault. Some of that is just, it was just a bad fit, but With this kind of blitz scaling thing. We had this, this thing with the surgeon and then we COVID came. And so, we've decided to use this opportunity to kind of change things up a little bit and really focus on what we think our core mission is. And for us, our, our core mission we've decided is more along the, the stronger medical aesthetics realm, not. And what I mean by that is more along the. Surgical side of the spectrum and less along the day spa side of the spectrum. So, for example, our is used to offer massage. We don't offer massage anymore. We've cleaned out most of our makeup. We used to have a huge inventory of makeup items. We still have some, but we've cleaned that out for the most part. We do offer facials, but they're kind of a little bit more aggressive facials and what you'd see otherwise, it's like, if you're going to get a facial hair, it's going to be like a hydrophobic. It's not going to be, you know, kind of like the touchy feely, sort of one. And we've got partners that we are working with to, to try to cause we think those services are, are obviously still valuable, but that is not our niche. You know, like we can't be everything to everybody. So, if part of this is our, our pivot has been a little bit on focus and what we're currently doing is something I'm really excited about is we are trying to create some mechanisms where we can partner with entrepreneurial aesthetic. Providers. So, whether those are estheticians, whether they are injectors, where we will offer the space, we will offer the medical directorship, we'll offer the supplies for a fee that's a lot more affordable for these aesthetics providers, where they can partner with us to provide these services that we don't think that we are necessarily wanting to focus on primarily. And then we're going. Allow them to do that. And that we that's really satisfying to us because it allows us to focus on our real passion within aesthetics, which has that kind of like more surgical, heavier duty aesthetics thing. It also allows us to focus on sharing our passion for entrepreneurship and helping other people grow the businesses that they want to grow. And so, we're very excited about that. We're going to offer that in at least one of our locations. We've started it in one location and probably in another one, but we'll see how that. Catherine Maley, MBA: I love that idea. See, I knew you were entrepreneurial. I would just a heads up on the person that you choose. I have watched other practices try to control that person. And one of the issues is here's the good part. Typically, they've been humbled. They tried to run this on their own and they're like, I give up, I don't want to manage anybody. I want to reject, you know, that's all they want to do. So, it's a perfect solution for them. However, when it comes time to marketing or branding, now, all of a sudden, it's. And you're not in the picture or like, who are they to you? You know? And it just, it confusing to the patients. But I would also say the goal is all arrows still lead to surgery. So, if somebody is in their office and they're getting injectables, I would have in-house signage around. I would have your work going off, you know, like on digital photo frames because everything goes to surgical after a while. So anyway, I think it's a fabulous idea though. But now do you manage and give me some staff tips on managing, because I would say. Surgeons tell me, I would say that's their probably number one complaint is to start staff business. You know, how to manage people, how to motivate them how to stop being blindsided by them. You know, how to stop the embezzlement all of that. Do you have, I'm sure you have some of your own horror stories or some really good tips on what have you done to get a really good team surrounding you. Daniel Ward, MD: Yes. I, when I talked to surgeons, you know, there's a couple of little chat groups that I'm part of that we, you know, complain to each other and then this or that. And that is that's, that's the majority of what, of what it is, unfortunately, because what we're really passionate about is going to kind of our craft and learning that. It's going to sad. We've spent so much time talking about, about this. The first thing I would say is what I already said is start with you realize, you know, it takes quite a bit of humility and you know, spending time really thinking about ways that, that you're actually the cause of the problem. And that's that, like I said, it's, it's very humbling to go through that, but it's really inspiring to, to learn that you can overcome that and become better. And so, I really liked that. The other thing that I think is that so many of the tasks that we do in business as physicians, if, if they're, if they're like me, we think like, oh, I can just do that. I can, I can put that into QuickBooks. I can, I can just do the HR paperwork. I don't want to say. Whatever $2,000 a month on this or that just spend the money. It is so worth it because those tasks build up and you don't have, you really just don't have time to do it. And it takes you away from the things that you love the most, whether that's surgery, whether that's your family, friends, skiing, you know, whatever it might be. So didn't spend the money to do that. And so that, that would be, you know, kind of the simple solution as we've, we've hired an HR. That handles all of our you know, like the employment issue. Like they verify that they're eligible to work. They verify that we do like random drug testing. They, they make sure that that's handled, you know, all those sorts of things. They handle that if there is ever an employee issue, which there always will be because people are people, you know and that's not necessarily anything wrong. And whether there issues, it's not like that person is a bad person. That's just a misunderstanding. So, I'm having them to help with that. And having them act as a mediator really helps where they can kind of help us better understand. And I remove a lot of the emotions cause so many things with employees comes with emotion, both on, on your side as a business owner and on their side. And so, it's only fair to kind of have somebody to help. The other thing that is really key for me is getting the right support staff in terms of leadership in position, I think is physical. And I'll speak for myself, but I think I'm probably like a lot of people we think that we can do it at all. And I know that I can't do it all. You know, we have got a couple of, well, we've got four or five really amazing leaders. I'm going to mention a couple of them, Matt Walker, who is like our operations administrator. And he, he is just incredible in terms of how he can interpret data and then apply that to the clinical setting to make it work better. He he's good. Understanding the vision and how to integrate that into the practice. He works very closely with the CJ Terremoto. Who's a nursing director and operations And he, doesn't the same thing, you know, really good at this, the simple things like how do we get the exam room? Why can't I, you know, I'd be really frustrated with this. And here's an example of bad behavior on my part at the end of the day or, or three-fourths through the day I look and I see like, oh my gosh, like this, the drawer in the exam room, I need to examine this patient is empty. I know for sure that we've got like a hundred of these instruments, where are they all? Why don't we stock them last night? I like my way of dealing with that is like to complain to everybody. Right? And then they, then they feel, but I make them feel bad unintentionally, but I make them feel bad. They're not very effective at their job. They're not motivated to do it. Whereas if I just tell CJ about it, he deals with it in a much more constructive way that doesn't make people feel like, like they're, you know, down or not doing a good job. Whether it's time or personality. I just don't seem to have that skillset as naturally as what others do. Another really great leader that we have is Jared long Hearst, who is a phenomenal leader. He's actually got a marketing background, but the thing that Jared. Thrives on is, is culture and helping people understand what we're part of and what we're working towards. And he's good at helping people feel good about that and helping them feel fulfilled at their job. That's what we say. We tell people, our staff, we want you to wake up in the morning, excited to go to. Realizing it is called work. It's not called play pick. You're going to go to work and you're going to feel inspired. You're going to feel like you're productive at work. And then you're going to leave, go home to your family and feel fulfilled at the end of the day. And Jared, really, you know, by working with Matt, he really does a good job with that. And then we've got an amazing sales manager. Who's M J. Chase road. She does a wonderful job. And then our marketing director is Bree, who just really helps. And they all understand our vision and they all integrate it. They understand the complaints go up, not, not, not down, definitely, but definitely not even sideways. They always go up and that we work on, on fixing them. And that's been a really big change for us. So that's getting those people in place that can do the job better because here's what used to happen is that I'd be walking from my office to the, or, and they'd say, Hey, Dr. Ward. So, is it okay if we? Do this or do that. And I, you know, I spat off some answer off the top of my head without really thinking it through. Just wanted to cross it off my to-do list. And it's ends up not being the right decision. So having those questions go to Matt who have those questions go to Jared has really changed things because I just need to focus on what I do. And my job really is to do the surgery and to provide that vision. And that's what, that's what we try to do. Catherine Maley, MBA: I hope everybody's hearing you. That's exactly how you run a business. You do what you're good at. You set the vision and the tone and the, you know, how we're going to act here, but we're going to roll and then you hire your C-suite. So, you hired the right people. You have your COO and your CML and all of those people. And. Are the mediator between you and the staff and the public, because everyone's got a love, you, you can't be that tiring anymore in today's world. They, they have to like, everybody's got to like you, you know, and so for you to be the bad guy, that's not the way to go. You have a whole team that's around you that handles all that for you. And then you focus. I've seen so many times where the. It is I'm attacked in the hallway and he's making these decisions on the fly and sure enough, it either goes very sideways, but then the staff says, well, you told me I couldn't, or you're like, what are you talking about? I mean, I don't even remember this discussion. And so, you know, you just can't win with all of that. So Daniel Ward, MD: before that, cause that's exactly what they would say about me. Catherine Maley, MBA: So, I was going to ask you about the services you are offering, because I was surprised that you were offering massage and a makeup counter. I, that kind of threw me off because I thought, I don't think you can win this game, being everything to everybody anymore. And there's so much PNL each of your profit centers and I'm sure that's what you did. You looked at that. What's the, what's the hassle in this, the time involved, the staff involved, is it worth it? Daniel Ward, MD: And I'm assuming that's exactly right. And, and again, that takes somebody like Matt going through the numbers, looking through it and say like, Hey, listen, you know, We've got all this stuff and it's, you know, it's not necessarily losing money. It's certainly making money, but I'll tell you what it's, it's, it's actually start directly making money or losing money, but it's indirectly losing money because we're doing inventory on this every month or we're having to restock it or, you know, this to that, is it, is it really worth it? And, and you're right. You can't be everything to everybody. Catherine Maley, MBA: Well, I think it can be a distraction too, because people forget to look at the opportunity costs of not doing something or doing something. The more you're focused on this piddly stuff, the less you're focused on the bigger ticket items or the bigger profit centers. And so, you know, I'm so glad somebody looked at those numbers because I have not seen that work out well in pretty much anything. However, I would actually backtrack back to that plastic surgeon. I have seen that work remarkably well. When there's a very big boundary neck up is you neck down is a plastic surgeon, like, you know, very thick lines there. And when you get the right one. I think it's a no brainer because I'm, I'm that cosmetic patient who needs, who needs everything. So, I will keep coming back. I'm not dying to go shop around if I love a place and I go there for my injectables and my facelift. And then I go back to the light bulb. I'm an elbow up and down this thing for decades. So, I liked that, you know, I would take a look at that because I think you, maybe you just had the wrong fit. But it's it that works better than anything I've ever seen where you had to have the same two facial plastics, two plastic surgeons. I just think they're, you know, one plastic or one facial, one body seems anyway, that would be my two sentences. Daniel Ward, MD: That's excellent advice. Catherine Maley, MBA: So, let's talk about marketing. It's pretty darn competitive everywhere, but I'm assuming Utah's no different than anywhere else. How, how is how competitive is. Daniel Ward, MD: Well, in 2013, I think it was Forbes named Utah, the vainest state in the union, or maybe a salt lake city, the Bain city in the union, which, I mean, Utah's a pretty conservative place overall. So, they're a little surprised they, they base that based on Per capita plastic surgeons. There are more surgeons, plastic surgeons per capita than anywhere else in the country. It's a really interesting place. It's almost like a combination between Texas and California. In the sense of, you know, like each of those has maybe like a more familiar sort of stereotype associated with it, but it's kind of like so it is pretty competitive. Utah is growing pretty rapidly, which I think has been nice for us. I think with the last census numbers percentage twice, it was the biggest percentage growth of any state. So, it, it is rapidly expanding in terms of marketing. I mean, it's. No. I think marketing is just a part of what we all do and trying to figure out how to, how to use that spend wisely is what a lot of us as surgeons try to do. Our marketing, go ahead. Catherine Maley, MBA: What marketing channels are working best? Daniel Ward, MD: So social media works the best for us. I have a love, hate relationship with social media. Sometimes I'm really into it. And I think it's fun. Sometimes it just seems like a terrible burden. For me, it's been I have, I tried to make our marketing about education. And so, we try to do marketing based on education and, and sometimes that's, it that's, that can be a little bit difficult in the sense. You look at your numbers. I spend, you know, 30 minutes putting together some posts where I explain like what I did to the cartilage of the nose and how we would take the rib graft or did this or that. And I think it's just beautiful and really educational and it gets like no interaction. Whereas I put a picture of my dog. And the interaction is like through the room. Catherine Maley, MBA: So, I think out the window of the car, adorable, I will never forget that. So that catches my attention. Daniel Ward, MD: Beetle, I, I give a talk every few years, I'm at meetings and I'm asked to give about marketing. And one of the points that I try to make is we're all familiar with Julius Caesar. Julius Caesar, you know, became famous as the. As the general who kind of conquered Gaul or continental Europe and France. Interestingly, there weren't any, there wasn't anybody that told his story except for him. And that's the one thing I think is really interesting is that he essentially made his name, who knows what really happened. But the only thing that the Roman people knew about was what Julius Caesar was writing back and telling them that happened. And of course, you know, as surgeons, we want to be ethical and honest. We're not here to lie or till, till fibs, but on the other hand, there's not going to be anybody. Who's going to tell your story besides. And social media has offered such an incredible opportunity for us to be able to do that where we can tell our story. And we can tell about the things that we like, you know, so for example, for me, my, my aesthetic, if you will, is for very natural results. I think a lot of surgeons feel that way, but I'd rather have a nose that's maybe a little bit bigger than, than others. Cause I think that looks better or You know, what, whatever it may be. And so, who's going to tell that story except for me and social media really allows us to do that. And so that's, that's maybe the word of advice that I would give to surgeons is, is I know, I realize, I understand you hate social media. It's a pain in the neck. I was actually just part of this chat group the other day. And somebody said, I'm so sick of Instagram. I'm done, you know, and, but that's really the only opportunity that we have to, to tell our story and tell about the, explain our vision. To, to our client base, which is kind of what we need to do. So, I think that's a huge part of marketing for me. Catherine Maley, MBA: Well, you're doing a good job. You've got like 46,000 followers, so good for you. You know why, you know why you can't dismiss social media because the patients love it. And you've got to be where the patients are. So, if you want to play the game, you've got to be on the field. And Instagram is here to stay. I'll take Instagram any day over Tik TOK. I'm, I'm writing a blog right now. Do I need to be on Tik TOK as a surgeon? And so far, I'm going to say what it doesn't matter. I'll tell you later on, but. The it's worth the time, but the smart part is how do you figure out how to put the time in, because I know you want to do education and that, and people love that, but they love the personality side. We women, especially, we want to know who's the man behind the mask, you know, who is, who is this surgeon? Is he, who is he? Does he like maybe not dance, but you know, he likes to snow ski. He's got these dogs and hanging out the window that are adorable. He's got a lovely wife and all the kids. That's what we want. And that's what the patients are doing there. They're literally going to Instagram, they're seeing you and going, oh, who's that? And then they're watching, watching, watching. Oh, okay. That's interesting. And then eventually get to your website or a girlfriend has mentioned you and typically they literally will almost go to social media before they're going to go to your website because for social there's still. Looking around for, I think when they get you to their website, your website, they're a lot more serious about getting to that. You know, so I think you have to, you have to work, work it out. Do you have a support team? Do you have somebody following you around with the iPad? Do you have who's editing the videos? How much time are you spending on this versus your team? Daniel Ward, MD: Yeah, so I, I think you're right. I think that that personality is actually one of the most important things to just before I really answer your question. W something you said kind of piqued my interest. I just did just this week, I did a little poll on an Instagram story and I said, Hey, what do you want to see more of in 2022? And I did like educational content before and after. W personal stories or something else, I think. And by far the winner was personal stories. It's so, I mean, it's just so interesting to me, but so I think there does need to be some personality that comes through in terms of you know, who does it. We, we do, we do have somebody that helps with marketing. Especially for example, if I'm in the bed in the middle of clinic and I, and I see a patient who, who is happy to talk about their experience, I can say. Just have her go in and she just talks to the patient and, you know, finds out what kind of, what we can do. We do a pretty good job of trying to ask patients if we can use their before and afters, because you know where I do face. It's not like it's a, you know, an abdomen or whatever. That's not recognized. It's you? Your face is you. So, we try to be very thoughtful about that. You can always worry about their identity being out there, not, not using it. So, we are usually pretty open to just about asking them. Ideally, I mean, we're, we're in the middle of kind of a change right now. We had a really great social media manager who ended up leaving But we're trying to get, get one for each of our accounts, one for the skincare account, one for the, for the Durham spas. And then one for me itself where we have someone who's, who's taking the video, who's getting the content, but it really does have to be with the search. I'm sorry to say what we're trying to answer for, you know, all your listeners and said. Hey, you guys can just hire somebody and pay them. They'll take care of it. They just can't cause it, cause they're not you. And so even though I don't necessarily answer all the comments or the, you know, do the likes or whatever that really does need to, we, we try to do it in my voice so that it is captured as my personality. Catherine Maley, MBA: Do you have a way of collecting the data? Do you have any idea how much money comes out of the social media? Because one of the biggest issues is how do you track this? How do you know that you're spending this time wisely? Is it really, is it really creating new surgeries or new patients? Do you know? Daniel Ward, MD: Yeah. I mean, without question, it is probably about, I don't have the numbers in front of me, but it probably about 50% of our patients are from social media. And I do think there is something, you know, I used to would have maybe thought this was I don't know, it's kind of nonsense, but there really is like the older I get, the more I realize that there definitely is a different aesthetic between surgeons, especially with the. You know, so for example, the nose that I do has a particular look to it. And I, and I see some other general surgeons around that. I see their, their noses and they have a particular look to it. And people see that on, on social media and they share it and they talk about it. And so, we, about 40% of our patients are in state the restaurant. And it's because they, they see it on social media. So that really is that that megaphone of social media allows you to now reach across the state lines. Whereas before, you know, it was just like, you can put up a billboard and there's 5 million people who drive by it every day, but who knows how many people are actually interested in, in getting a rhinoplasty? Catherine Maley, MBA: Have you also noticed the patient demographics changing? I'm it seems like they're getting younger. What do you think? Daniel Ward, MD: For noses? No, that, that hasn't been my experience. I I've actually seen an interesting trend. I don't know if it's coincidence or, or what, but, but there seems to be people who, you know, like in their like fifties, sixties who met, you kind of think like, well, if their nose bothered them, they would come in and get it done before then, like, oh yeah. This bumps always bothered me. I'm retired. Decided to get it done, but the actual reverse has happened with facial rejuvenation, where I am seeing more and more younger patients coming in, you know, people in their thirties or forties who I would have just turned away before. Who are wanting something done for facial rejuvenation? I think it's just because they now recognize that there is some power to, you know, filler, jawline, reshaping, that sort of thing. And with and they, but they do realize that eventually there's only so much that they can. And, you know, before, if you keep adding filler to your cheeks, you've got this big wide face that nobody likes. And so, they maybe want like some facial contouring, which for me, my, my, my facial competent technique is buckle fat removal, facial liposuction, really to start to make the cheekbones stand out more the jaw line, stand out more. And with that, the As a result there's patients who are, who are seeking that. And, but then there's also patients who are just very excited about, they just actually just want like a mini lift or a face lift, even though there, you know, 36 or whatever, they realize that if I just reposition this tissue up here, It's going to look better and there, they don't want to wait until they're 72 years old and they're all wrinkly to do it where there's a big change. They want to maintain that look so knows. I've actually seen a little bit of an increase in the age, but facial rejuvenation and the opposite, the younger Catherine Maley, MBA: I'm actually one of those nose patients. I didn't even, my nose never bothered me ever. And I think it's because of the mope was on the side. And I don't look at my side on my early fifties and actually a plastic surgeon, friend of mine. You don't need a facelift; you need a noise job. And I thought, how dare you? And sure enough, I had a no shop done, like, you know, the next month. And I love it. It softened my whole look, but who knew, you know, I completely agree the nose, the rhinoplasties or, you know, the aging nose. Maybe we should call it the aging nose and. All right. So, let's talk about how you're collecting reviews. You're doing a very good job with reviews. I'll tell you what you're doing, all the right things. You're whatever you're doing with the reviews and you have a photo room. So, you, you know, before and after photos are essential, we women, we, people, we patients love to see the results of other people on photo room. How are you doing? Daniel Ward, MD: Yeah. So yeah. So first of all, it's the photo room. I am a big pet peeve of mine is we, you know, we've spent a lot of time talking about social media is social media. I think patients don't realize how manipulating, how manipulative the photos can be. You know, changing the angle, changing the head. It's just a little bit changing the lighting. I mean, I can, I can, I can give somebody a facelift just with lighting and head position. And that's a pet peeve of mine. That is, I think it's just not ethical and not honest, if you don't do it. Proper. So, we have a photographer who, I mean, he is a real photographer. He's, you know, he's not here, he's out in like the mountains capturing these amazing photos. He's, he's really incredible. But in terms of the reviews, we do a couple of things. Number one is it's really cheap to invest in. And a lot of our EMR is already have this as part of it. A review collection thing, we can send out a text or an email to request it. The thing that's been best for us though, is that we just get kind of staff excited, right? S and so it might be we used to, we haven't done this for a while, but we used to do something for about a year or so. We did it where they got extra. The way that we kind of provide some incentives for staff is, you know, the name of our spots form Durham spot. So, they would get formed by. For certain things. And every month, part of their bonus to get extra form bucks was if they got, if we got a certain number of reviews, so was like a team reward, you know, and it wasn't really high. I was like, oh, if we get two reviews this month or five reviews this month, whatever the number was, then everybody gets these four bucks, which essentially a form buck allows you to buy roughly like 20 or 30 units of Botox. So, they can just get that on that, on the business. So that, that really helped, but even more than that I just love this concept. You know, a lot of us are familiar with the research and BF Skinner who did like a lot of the psychological testing with intermittent rewards and intermittent stuff with, with rats and humans. If we go to this, if we do this, this if I go on the beginning of a clinic day and I say, Hey, Hey team, let's in our huddle. Let's see if we can get. Let's ask a hundred percent of our patients for reviews and let's see if of those a hundred percent. And if we can get five, there's no reward. There's no incentive. It's just like that inner, I don't know what it is, but as humans, we like that, but we need to be reminded of it. So, if we do little things like that, that has actually been the most successful thing through dynamo that reminds we haven't done that. For a few months, so we better get back on the train and start doing it again. Catherine Maley, MBA: You know what I would suggest that has also worked well, rather than have it at that open thing or the entitlement thing, I would have a dry, you know, like, let's say you have this annual new patient drive and for one month or one week or whatever you focus on word-of-mouth referrals. Another time there's a drive. Like let's say during the summer, when it's slow, you focus on. I don't know, social proof, you know, getting more before and after photos, testimonials, video testimonials then it becomes this event in your office where people are focused on it. Daniel Ward, MD: But there also has to be a good carrot involved in that. I love that idea because I think that it's so hard for us to maintain our focus as human beings. Catherine Maley, MBA: Well, I honestly, I'm not even married. I don't have children. I have no excuses. I have a dog that I keep alive and well and happy, but I don't know how everyone's doing it with all the information coming at us in today's world. I'm trying to keep up because I love learning and growing and I am struggling to it's. It's just a fire hose, 24 7. And., I don't know how everyone's doing it. I just think it's really difficult to get somebody's attention in today's world for more than a nanosecond. And then you need it long enough for them to not only notice you, but you've got to get them to that point where they literally trust you with their face and body. And now they're, they trust you so much. They're actually willing to call or text or email. Then they're actually willing to come in and give you money and have it done. That's there. That is a monumental task and I, I commend you for doing a good job. Well, thank you. So how did you learn the business and marketing side of plastic surgery? Because you seem to have it down? Daniel Ward, MD: Well, I don't know if I have, if I eat ever learned this. Right. So, it's a constant process. I read a lot. I mean, I'm, I'm a huge audible fan when I'm out with the dogs when I'm working out or. That's kind of probably what I'm listening to is some book. And I, I listened to it at like three X speed. So, I'd get through a lot fast. I think a lot of us do that. But that's probably the biggest, biggest thing for me is just like learning from the people who, like, I'm not going to reinvent the wheel. I'm just learning from what other people have already learned for Catherine Maley, MBA: sure. Do you have a. A few tips that you would like to share. Daniel Ward, MD: That's up level for marketing specifically, you… Catherine Maley, MBA: Mean growing a practice, growing a cosmetic practice in the world today? What's it? What's something that works well. Daniel Ward, MD: I think for, for, for me, it is these sounds so soft that it's, it's hard for me to even say it out loud or put into words, but try to be, just be yourself and enjoy it. Because you know, so many of us get into, into medicine because we like talking to people. We enjoy being around them. We liked talking to them. But over the years, it gets beat out of us. You know, we're, we're stressed out, we're running from patient to patient. We don't have time to talk to this one or that one, or these five patients are waiting, hurry up. We're just learning to enjoy even the patients that maybe aren't the, that you dread talking to the most, in the sense of, because maybe they're not thrilled with their result or maybe there's some, I don't, you know, whatever it might be that that's, you're kind of dreading going to that room. But for me, if I can kind of get myself into a point where I'm excited to go in there and just talk to them as a human. And try to be at random for me, that a big part of that has been not trying to be anybody different than myself. I just go in and I'm not going to try to mislead them if they've got a result that, that I'm not thrilled about. I'll I tell them which I think sometimes backfires because then they're like, well, is there something. My deformed, my ugly, and, you know, so you have to kind of figure out the right way to do it, but then, you know, the conference is true too. If I think they look great, I'll tell them that I think they look great. And that's just made things so much more enjoyable to me. And it's kind of one of those things that I find that the more I enjoy doing it, the more successful and profitable it is. The other thing I will say just really quickly is One of the, one of my favorite books, which I know he's a little controversial Dave Ramsey, you know, this is like the extreme saving budgeting guy, which I don't think necessarily works for a lot of us, but by the way, but he's got this really interesting book called entree leadership is combining like entrepreneurship with leadership and. That in that book, there's a whole bunch of great tips on how to run a business that I think is really easily digestible for lots of us as surgeons. But one of the things that he said in that book that has that I cannot get out of my head, it's that running a business is about two things. And they both start with P it's about people and profit. If you're not profitable, you're not going to be in business for very long. And you're not going to able to take care of your people, which is the next part. The people of course, are your customers, but even more importantly, it's the people that are. Where you, where you work. So, your team members, and that's really the. That shift for me is like, I had to learn like, okay, I'm a person too. I need to take care of myself. And then I can take care of my team members, those people. And then as a group, me and our team members, we can take care of our people who are our patients and our clients. And that's been a really huge part for me. So those are the really quick succinct tips that I would say to grow practice. And it was people and profits are the only two things you need to worry about. Catherine Maley, MBA: My tip is when I'm consulting, if you would please shift. Your interpretation of state. Staff are an asset to you, not a liability, not an overhead expense. And you don't know that until you lose a really good one. And then you realize, oh crap, I should have, I should have paid more attention. I should never have let her go. If you could shift that part because I think surgeons have a tendency to think, whatever who cares. I mean, it's front desk. Well, who can I'll get another one? I right now, it's not easy to get another one. Daniel Ward, MD: Just like you can't just throw money at them. I think a lot of times it's mistakes that we started spending like, oh, I'll just bump up their pay and he keep bumping their pay up every time that that little thing makes them unhappy. And that helps for a while. But it's really not about that. You know this appose guy, Tony was, was really good about talking about that. You know, there's a great book pink called drive. Like, Hey is not what drives us. It's important. Like you got to pay your people appropriately, but that is not the thing it's fulfillment at work and feeling like they're doing a good job. And that's what I think a lot of the times we as physicians, we just like, oh, let me just write a check for this, or I'll bump up your money. And then before, you know, you're paying a hundred dollars an hour to, to every nurse that you have, and you're not going to be profitable at that. Catherine Maley, MBA: Well, and that's old school thinking, and frankly, I'm from that world, like I'm, I'm paying you, I'm paying you to do your job, just do your job. That's not going to fly anymore. And that's where the culture thing comes in. And, you know, honestly people want to be appreciated and acknowledged and. And I don't know what it is. I think it makes some of us feel whole honorable. Like if I acknowledge them, they're going to ask me for more money. Or if I pat them on the head every day, it's like, really do I really have to do that? Because I came from a different work ethic. But that's, you know, you have to go with the times and adapt and it's a staff today really different than before. So. It's just another complexity to add to our list of things to do to just to wrap it up. Can you give us one thing? That's pretty interesting about you that we don't know? Daniel Ward, MD: Oh gosh, I'm pretty boring. One interesting thing. Gosh, Gavin, you put me on the spot here. Okay. Here's something I am, I am currently I'm wrapping up a tour of presidential biographies. So, I'm a little bit of an amateur historian with most of my reading. That's not business being spent on presidential history, which has been a really cool way to actually learn about the present. Like it's crazy how. Last week was, or yesterday was January 6th. And You know, that was kind of a big day. There's been other days just like that, that are equally crazy when you read about it and we just don't know about it. So, it's been a kind of a cool way for me to kind of, I guess, better calm down about the present situation I'm in, in the world. That by better understanding the past. Catherine Maley, MBA: Very nice. That's interesting. I never would have guessed that. Alright, thank you so much, Dr. Work for being on beauty and the biz. I really, really appreciate it. And how could somebody, if they wanted to get ahold of you? What, look, I know your website is ward md.com. Is there any other way to get ahold of you? Daniel Ward, MD: Well, on Instagram @WardMD and be if you want to email me [email protected]. Catherine Maley, MBA: Gotcha. Thank you so much. I really appreciate it. I'll be watching your growth and hopefully I'll see you at another conference someday. Daniel Ward, MD: Yeah. Right. And someday we got to get back on it. Thank you very much. This concludes this episode of Beauty and the Biz Surgery: Staff and Snow with P. 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