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Dive into the multifaceted world of aesthetics with a podcast that encompasses it all. From cutting-edge plastic surgery procedures and dermatological treatments to the nuances of practice management, we've got you covered. Each episode offers a blend of insights into the latest treatments, tools, and technologies, along with invaluable tips for managing and growing a thriving practice. Discover industry trends, gain insights from key decision-makers and influencers, and uncover the secrets behind the most successful practices. With a mix of clinical expertise and actionable business strategies, this podcast is a must-listen for both seasoned professionals and newcomers eager to navigate the aesthetics industry. Whether you're honing your techniques or refining your practice's operations, tap into a wealth of knowledge that propels you to the forefront of aesthetic excellence.
Alison Werner (00:10)
Hello and welcome to the Plastic Surgery Practice Podcast. I'm your host, Alison Werner. We're going to be doing a special multi-part series with medical aesthetics industry consultant, Terry Ross, to discuss the opportunities, challenges, and growth pathways in the medical aesthetics industry. Over the next several episodes, we'll explore practical insights and actionable strategies that can help practices thrive in today's dynamic and competitive market. In this first episode, we set the stage by examining the current state of the industry and discussing some of the key obstacles
practices face from market shifts to business training gaps.
Terri is a globally recognized practice management expert and CEO of Terri Ross Consulting. With nearly two decades of experience, she specializes in helping medical aesthetic practices achieve sustainable growth through strategic business development, team training, and data-driven solutions, empowering providers to maximize efficiency, profitability, and patient outcomes.
In this episode, we're going to talk about how practices can identify their growth opportunities, the importance of business fundamentals, and why training for both doctors and their teams is crucial for unlocking potential. Whether you're a provider, practice manager, or team member, this series is designed to give you the tools and knowledge to move your practice forward. So let's jump right in and see what insights Terry has to share.
Alison Werner (01:27)
Terri, thank you for joining me today. It's really great to see you again.
Terri Ross (01:28)
Yeah. You are so welcome. Lovely to be here, Allison. Thank you so much for having me.
Alison Werner (01:34)
Well, as I said in my introduction, we're going to set the scene and talk about the state of the medical aesthetics industry. So what are you seeing with your clients?
Terri Ross (01:44)
Yeah, such a great question. And obviously, with an election year, I think the industry is struggling. I think the industry as a whole, not I think, I know, the industry as a whole is down around 17%. But there is a lot of tremendous growth opportunities. I think that the biggest challenge practices face right now is there is a lot of private equity coming in and roll up in consolidation. I think there's also a lot of struggle with practices understanding
Alison Werner (02:01)
Mm
Terri Ross (02:14)
where their growth opportunities are. And that's simply because of a lack of training or a lack of understanding the knowledge of what the benchmarks need or should be.
Alison Werner (02:24)
Okay, so you mentioned there that, you know, those are some of the things contributing to this decline. What about, what are doctors doing that is preventing them from turning around and finding a way forward with growth?
Terri Ross (02:44)
It's such a loaded question. Yeah, I mean, I think it's very easy for, you know, physicians, medical providers as a whole in the aesthetic space to just, you know, show up for work, do surgery, treat patients. And a lot of what I teach all over the world and at every society is that this this still is a business, right? There's a business of plastic surgery, and we have to treat it as such and give it the same level of
credence that we do our clinical experience and giving patients this journey and results. That's only one piece of it. If we want a sustainable, profitable practice, we don't have a choice but to say, maybe perhaps the same way someone's been doing it isn't good enough anymore. And I will have to say that from all my experience in almost 20 years in the space and lecturing all over the world and
what I do for a living is really help practices identify those areas of opportunity. And a lot of it comes down to, again, not understanding gross profit of procedures, not understanding efficiencies of time, not understanding the right compensation models, not understanding how to build a treatment plan that can combine both surgical and non -surgical, which ultimately
That is the quickest way to get better patient outcomes and increase revenue. But all of that comes down to a fundamental problem and one problem only, and it's a training issue.
Alison Werner (04:21)
Okay, so talk to me some more about the training. What do you think is missing?
Terri Ross (04:31)
The industry, the industry lacks fundamental business training. And, and I think, you know, Dr. Renato Sulz is a key opinion leader, plastic surgeon in Park City, past president of many societies. Myself, Dr. Sulz and Isaac Musely, my co -CEO, my ex co -CEO and business partner with Apex, started our own business conference called the 4S Summit.
And we started it in 2023 to fill the gap. While people can go to all these ASAPs and ASAPs and everywhere, there is a practice management track, but it's 15, 20 minutes of talks and not enough for someone to actually go back with a blueprint of what to do and how to educate. So that's the problem. We're in these roles and no one's held to KPIs.
No one's holding anybody accountable. No one's inspecting what they expect. And then the ones that are, you know, how do we coach to change? Because at the end of the day, is just, it's change behavior. Change management is what we have to do if we want something different.
Alison Werner (05:38)
Okay, so this might be a lot, but what are some tips for just getting started with that? Like you mentioned, you have the summit, which is a great educational opportunity. But for a practice that's just sitting down, maybe what's the best way to assess? What do I need to do to change the culture within my practice?
Terri Ross (06:00)
Yeah, I love it. Thank you. Such a great question. I mean, look, this is maybe a little self -serving, but I think that if, I, you know, there are experts in businesses, right? For a reason, we would hire a coach, an athlete, a tutor. We hire experts in other areas of our life. And I very much pride myself on.
that when we work with practices and they retain us is that every practice needs to go through like a practice assessment, some sort of business valuation, not evaluation financially, like evaluation. Like what is the health of your business? That is the diagnostic tool, right? It's the history and physical. We have to start there in order to understand what's wrong, what's right, where are the areas of opportunity? More importantly, how do I course correct it to make money? That's where people have to start.
Alison Werner (06:34)
Mm
Mm -hmm.
Terri Ross (06:54)
whether they retain me, work with an expert or try to do it on their own, you know, is another thing. If they work with us, that's where we start. And then we are on that journey with them to execute change. If, you know, they wanted to just look at two metrics that I would advise people to look at right now. And you have to look at where is your gross profit of procedures and whether that's in surgery or non -surgical. And most plastic surgery practices have both.
Alison Werner (07:01)
Mm
Mm
Terri Ross (07:22)
and know what that baseline is because if you don't know what that is, you know, then we're paying time and labor and probably losing money. So I can affect that change by again, looking at efficiency of time and or increasing the cost and or perhaps not doing it at all because maybe it's not making money and it's bringing revenue down. And then looking at revenue per hour and surgeons have a baseline revenue per hour. Non -surgical rooms have a baseline revenue per hour. And that's looking at the revenue generated by divided by the hours.
Alison Werner (07:33)
Okay.
Mm -hmm. Right.
Terri Ross (07:52)
a provider worked, that's the baseline. Those two metrics in of itself, if no one did anything, can be changed immediately to have an exponential change to the bottom line.
Alison Werner (07:59)
Mm
Okay. So and I know part of what we're to be talking about in this series is pathways to growth. So opportunities. So if you take those metrics and you realize I'm struggling, how do I grow? Can you talk a little bit about kind of what you think about what what's on your radar in terms of growth? We're going to get into specifics with each episode, but just kind of talk about what pathways give an overview of the pathways you see at this point.
Terri Ross (08:35)
You know, it's quite simple, honestly, if somebody were actually to just take a moment to digest their business and what has to happen.
Practices, I mean, look, if we really are honest about the industry, it's becoming a commodity, right? I mean, there's, I'm in Los Angeles and one of the most competitive markets in the country. And it's competitive and it's a commodity. What's not is not anymore how, you know, are they board certified and how many years of experience and how many case studies? Yes, that's true. And yes, that is a value proposition.
But if some doctor is up against other people in a three mile radius where there's hundreds of people doing something similar, how is a consumer going to choose? And we have to be clear on that value proposition. And then that comes down to, again, I'm going to beat a dead horse. It comes down to training. If practices are spending money to acquire a patient, right? So one, what is your marketing spend? I'll give the number. It really should be around 8 to 10 % of total revenue.
And if it's, so then you're, so then look at your CAC. What does it costing you to get a patient? Then if they call the practice, this is, this, this is directly related to your question, the areas of opportunity, those patients better be converted. Those conversion metrics need to be at 70%. Most people don't track them. Most people don't even know. If you know that, then you're like, okay, now I can back into, am I getting the right patient in the door or is my team just not trained to convert them?
Alison Werner (10:04)
Okay.
Mm
Terri Ross (10:12)
Now they can fix the problem. So that's one area of opportunity. Are we getting the right person and then are they being converted? Second is looking at those two KPIs I just said. What services am I doing? Surgeries am I doing? What is my narrative to the world? Do they yield the highest return on investment? Two, because that's what we're going to be marketing for. Three is when patients come in for the consultation,
Alison Werner (10:16)
Okay.
Okay.
Mm
Terri Ross (10:39)
you know, is the philosophy of your business transactional or transformational? So if I just acquired a patient and, you know, Allison comes in for a consultation, am I going to talk to Allison about her facelift or Tommy Tucker boob job only, or am I going to give Allison a comprehensive treatment plan that encompasses a, you know, a whole host of modalities that will get you the best outcome and then in turn,
Alison Werner (10:55)
Mm
Terri Ross (11:09)
increase your revenue and help with lifetime value and retention. And if we can master those three simple things, they sound simple, but it's a lot of work to master those things and then hold people accountable to the metrics. But if we can, I mean, this is where magic happens. This is really where exponential growth happens and where practices will outperform someone else.
Alison Werner (11:20)
Mm
Well, and I, yeah.
Well, and I like that you said that, you know, it's the doctor, it's also training the staff and it's recognizing that it's the team has to be on the same page to make a change.
Terri Ross (11:38)
100%.
Yes, unfortunately not a lot of
I don't say a lot. mean, obviously, think there have been, you know, people are recognizing now that they they don't have a choice. And if they don't know how to do it, they should work with experts to help them learn how to do it. Because it is the team. The team can make or break the business. It's not just good enough anymore that I'm a great surgeon in the O .R. But what is the rest of my team doing?
Alison Werner (12:09)
Mm -hmm. Yeah. And I know some of the pathways we're going to discuss in the future episodes are very specific to services that can be offered and how to maximize the value of those services, the value per patient. But overall, this is about creating that larger connection between doctor and team to make something of these programs. So if you're going to offer a service, make the most of it.
Terri Ross (12:17)
Yeah.
100%. I mean, absolutely. And understand, you know, when we analyze financials for our practice, you know, sometimes just the total revenue is all clumped into one area. And so where's the breakdown of the revenue? What percent of the time are you doing ex -surgery, ex -non -surgical? Like, where is it really coming from? And is that the driving force? And then how many people come in for just one thing versus multiple things?
And if we just are able to recognize that data can be scary for a lot of people, but it's very sexy when you understand what to look at, because it's the power of intention of how to make the right changes. Otherwise, we're uninformed. We think we're busy all day. Busy doesn't mean being profitable. And then we're looking at our books and we see money in the bank. Well, that may not be your not profit. Like, let's really take a look at this and how to end.
Let's bring it back to the culture. It's going to improve culture and reduce turnover.
Alison Werner (13:37)
-huh.
Absolutely. Yeah, no, exactly. Exactly. So there is a people element to this as well. But I like what you said there of, you know, don't be afraid of the data because I know I, you know, I talked to so many doctors in this specialty and others and the business training isn't there. You go there to be you go to school, become an expert in your clinical field. And maybe now some of the medical schools are catching up and offering a business.
Terri Ross (13:44)
as a whole other series, right?
100%.
Alison Werner (14:09)
you know, course or two, because they recognize that you're also probably going to be a small business owner if you're not working in a hospital. And so you also have to accept that that you are a business owner and that is a completely different skill set. And it comes with some data and it's not scary.
Terri Ross (14:17)
right.
Yeah. Yes, it is. And let's talk about this because it is a retail medicine. It comes with saying, you know, I have to be a salesperson. You know, people don't like that word and I have an entire training program, but they have to really embrace that you're not selling anything, but you are educating these clients on what's possible for them to achieve an outcome that they want.
Alison Werner (14:37)
Yeah. Yeah.
Terri Ross (14:53)
And that does require a skill set that's very hard for many providers to do.
Alison Werner (14:58)
Yeah, yeah, absolutely. And then, and that makes it important to have staff members as well who can also excel at their sales skills, which might not be what you're looking for when you're hiring. So, yeah, yeah. Well, Terry, I'm looking forward to talking with you over the next couple of episodes as we explore some of these growth paths. So I ask our audience to please check back for the next episode. And I hope you enjoy it. Thanks, Terry.
Terri Ross (15:07)
Right. 100. Yeah, absolutely. Absolutely.
Thanks so much, Alison. Thanks, everyone. Talk soon.
Alison Werner (15:29)
Thank you for checking out this episode of the Plastic Surgery Practice podcast. Be sure to check out PlasticSurgeryPractice.com to keep up with the latest industry news. Until next time, take care.