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BUSINESS of PLASTIC SURGERY Navigating a Successful Career Copyright © 2010 by World Scientific Publishing Co World Scientific 7339tp.indd 2 5/6/10 4:37:46 PM Published by World Scientific Publishing Co. Pte. Ltd. 5 Toh Tuck Link, Singapore 596224 USA office: 27 Warren Street, Suite 401-402, Hackensack, NJ 07601 UK office: 57 Shelton Street, Covent Garden, London WC2H 9HE British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library. THE BUSINESS OF PLASTIC SURGERY Navigating a Successful Career Copyright © 2010 by World Scientific Publishing Co. Pte. Ltd. All rights reserved. This book, or parts thereof, may not be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system now known or to be invented, without written permission from the Publisher. For photocopying of material in this volume, please pay a copying fee through the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, USA. In this case permission to photocopy is not required from the publisher. ISBN-13 978-981-4277-29-7 ISBN-10 981-4277-29-0 Illustrations by Heather Furnas Cover design by Max Jaime Korman and Jimmy Low Typeset by Stallion Press Email: [email protected] Printed in Singapore. Shelley - The Business of Plastic Surgery.pmd 1 8/2/2010, 6:17 PM May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm We dedicate this book to all plastic surgeons who are committed to doing the very best for their patients. In today’s world, success is often determined by more than skill and hard work. We hope these chapters will help the accom- plished surgeon develop the necessary business acumen to ensure a happy and healthy career. v May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm Preface The idea for this book came from a general feeling that we did not learn anything about the business side of plastic surgery while we were in training. In fact, after almost 20 years in practice, the information in this volume is what we would have liked to have known when we first started our professional careers, as well as through the years of practice. Plastic surgeons are as diverse as the procedures we perform, but most of us have two things in common: an MD degree and effectively a “Bad in Business” degree. Long gone are the days of the good insurance reimbursements and increasing your practice volume based on your fine reputation. Health maintenance organizations (HMOs) and provider panels did away with both. With the commoditization of the specialty, many patients are happy to settle for the cheapest price in town. Times have changed, and we have to change with them. There are many aspects of running a practice that were not even on the radar screen 10 or 20 years ago. This book collects the expertise of disparate professionals to help you practice smarter. We have divided the book into five parts. The first, Career Directions, is intended for both residents in training as well as plastic surgeons who are considering a change in their practice venue. It pays to choose your mode of practice with eyes wide open. It can be time-consuming, costly, and stressful to choose the wrong venue or to make a major change mid-career. The second part, Marketing and Monitoring, will be most useful for the private practitioner, either in solo or group practice, and the information pre- sented here can be utilized more broadly for other practice venues. Web-based and more traditional marketing can drive the patients in the door, but is your practice retaining them? Tracking those numbers is what monitoring is all about. Of course, you will never reach the numbers you would like without vii May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm viii The Business of Plastic Surgery a well-managed practice. Practice management is generally undervalued and underappreciated by physicians, and that is to our detriment. The third part, Enhancing Both Practice and Career, reaches beyond a basic practice to explore building an outpatient surgical suite, publishing, investing in ever-expanding technological toys, building a medical spa, or launching an invention. Many plastic surgeons are talented, creative people who can grow beyond being clinicians alone. Often adding these facets to one’s practice can be for fun, but they can be profitable if done well. The fourth part, Watching Your Back, is devoted to peace of mind. Physicians in general, and plastic surgeons in particular, lead stressful lives. We can be doctors with unhappy patients and partners with souring part- nerships. We may be indebted from education and business loans, and suffer difficult relationships with parents, spouses, and children. Bad contracts, mal- practice, and mental stress can take their toll if you take the wrong approach. These chapters aim at both prevention of problems as well as how to deal with them. The final section, Retirement and Protecting Your Assets, lays out what we all should know during our working years so that we are not painfully surprised when we retire. We should all know how to protect our hard-earned money, how our assets are vulnerable, and how we can save for the future. We owe immense thanks to our contributors. There are things we know, things we do not know, and most painfully, the things we do not even know that we don’t know. Our contributors have worked extremely hard to mini- mize our ignorance. We hope this book will serve as a compass to help you steer through the sometimes stormy waters encountered in the practice of plastic surgery. Josh Korman Heather Furnas May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm Contents Preface vii List of Contributors xiii Part I: Career Directions 1 1. The Job Search 3 Steven P. Davison and Mark W. Clemens 2. Choosing an Academic Career in Plastic Surgery 29 Geoffrey C. Gurtner and Michael T. Longaker 3. Solo Practice 39 Joshua M. Korman and Heather J. Furnas 4. The Combined Reconstructive and Cosmetic Surgery Practice 51 Joseph M. Mlakar 5. Making a Living in Reconstructive Surgery 71 Steven P. Davison and Mark W. Clemens 6. Pursuing a Career at Kaiser Permanente 89 Robert Pearl 7. Group Practice in Plastic Surgery 97 Debra J. Johnson ix May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm x The Business of Plastic Surgery Part II: Marketing and Monitoring 109 8. Internal and External Marketing and Public Relations 111 Anne Cohen 9. Online Marketing 149 Ryan Miller 10. Optimizing Your Practice 169 Marie B. V. Olesen 11. Preventative Maintenance of Your Practice 199 G. Marshall Franklin Part III: Enhancing Both Practice and Career 227 12. Developing, Establishing, and Operating Your Own Surgical Suite 229 Gordon Merrick 13. Publishing in Plastic Surgery 259 Deepak M. Gupta, Nicholas J. Panetta, Geoffrey C. Gurtner and Michael T. Longaker 14. Technology, Toys, and Traps 277 Francisco Canales 15. A Medspa: To Have or Not to Have 289 M. Dean Vistnes and Lynn Heublein 16. Medical Inventions: From Idea to Funding 303 Joshua M. Korman May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm Contents xi Part IV: Watching Your Back 321 17. Contracts 323 Carol K. Lucas, Esq. 18. The Wheel of Misfortune: Avoiding Medical Liability in Elective Surgery 345 Mark Gorney 19. Use of the Internet by Patients: How It Affects Your Practice and What to Do About It 363 Ronald P. Gruber 20. Recognizing and Dealing with Stress: A New Model of Resilience 377 Stephen Sideroff 21. The Challenges for Women in Plastic Surgery 399 Debra J. Johnson, Cissy Tan, Cristina F. Keusch, Sarah Troxel and Heather J. Furnas Part V: Retirement and Protecting Your Assets 415 22. Physician Asset Protection 417 Jay Adkisson 23. Personal Financial Planning for Plastic Surgeons 435 Lawrence B. Keller 24. Qualified Retirement Plans 473 Richard A. Pope Index 503 May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm List of Contributors Jay Adkisson, JD Riser Adkisson LLP Newport Beach, California USA [email protected] www.risad.com Francisco Canales, MD Plastic Surgery Associates of Santa Rosa Allegro MedSpa Santa Rosa, California USA [email protected] Mark W. Clemens, MD Department of Plastic Surgery Georgetown University Hospital Washington, D.C. USA Anne Cohen, MBA Principal, A. Cohen Marketing & PR, LLC Kingston, New York USA [email protected] www.acohenpr.com xiii May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm xiv The Business of Plastic Surgery Steven P. Davison, DDS, MD, FACS DA Vinci Plastic Surgery Washington, D.C. USA [email protected] G. Marshall Franklin, Jr., MBA, MHA Executive Consultant, Mentor Solutions Atlanta, Georgia USA [email protected] www.mentorsolutions.com Heather J. Furnas, MD Plastic Surgery Associates of Santa Rosa Allegro MedSpa Santa Rosa, California USA [email protected] Mark Gorney, MD, FACS Clinical Professor Emeritus, Stanford University Founding Member, The Doctors Company Napa, California USA [email protected] Ronald P. Gruber, MD Clinical Assistant Professor Division of Plastic and Reconstructive Surgery University of California, San Francisco Adjunct Clinical Faculty Division of Plastic and Reconstructive Surgery Stanford University East Bay Aesthetic Plastic Surgery Center Oakland, California USA May 6, 2010 13:42 SPI-B902 9in x 6in b902-fm List of Contributors xv Deepak M. Gupta, MD Division of Plastic and Reconstructive Surgery Department of Surgery Stanford University School of Medicine Stanford, California USA Geoffrey C. Gurtner, MD, FACS Professor of Surgery Division of Plastic and Reconstructive Surgery Department of Surgery Stanford University School of Medicine Stanford, California USA [email protected] Lynn Heublein, MBA Co-Founder, SkinSpirit Skincare Clinic and Spa Palo Alto, California USA [email protected] Debra J.
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