Today, things are very different, but the correct type of marketing is essential, especially for young surgeons who are just starting their practice. Before throwing a bunch of money at advertising it’s important to know who you are, where you are, and where you want to be. To be most successful, your efforts need to be specific and goal driven.
As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Dr. Larry Nichter and Dr. Jed Horowitz.
Dr. Larry Nichter and Dr. Jed Horowitz, board-certified plastic surgeons in Newport Beach, California, have been operating together for more than 25 years. Partners in practice, they founded Pacific Center Plastic Surgery and BioSpa, one of the most successful cosmetic surgery practices and medical spas in Southern California. They aren’t only a dynamic duo there, but also at Mission Plasticos, a charitable organization they founded to train surgeons while treating underprivileged children and adults around the world that are in need of reconstructive surgery.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?
Dr. Nichter: It’s hard to believe, but Dr. Horowitz and I have known each other for nearly four decades. We met as Plastic Surgery co-residents at the University of Virginia. After graduation, we initially pursued different paths. He joined a private practice, while I helped start the new Plastic Surgical program at the University of Southern California (USC) by assuming a full-time faculty position. We grew the program from three faculty members to 27, one of the largest in the United States at the time. It was during my tenure at USC that I became increasingly active with non-profit organizations traveling overseas to help people in need of reconstructive surgery, which Dr. Horowitz helped with as well. A film about one of the missions I led to Vietnam won an Academy Award Oscar for Best Short Documentary, “The Story of Healing.”
During this same time, Dr. Horowitz was instrumental in building one of the largest private plastic surgery groups in California. This group was called Plasticos Institute for Plastic Surgery. In 1993, I was invited to join Plasticos which continued to grow to six plastic surgeons with four offices and an outpatient surgery center. It expanded quickly! Plasticos surgeons provided services including emergency and reconstructive care to patients at several hospitals in Los Angeles and Orange County (regardless of a patient’s ability to pay).
As California’s healthcare system evolved, it became impossible to continue to deliver care under the same structure. As a result, the Plasticos surgery partnership dissolved. But, Dr. Horowitz and I remained together and formed Pacific Center Plastic Surgery and BioSpa, which we run today. We now have four plastic surgeons at our center, as well as a dermatologist, medical spa specialists, and a staff of about 20. It was an interesting but fulfilling journey getting here, and we are proud to have grown to be one of the most well-known and sought-out practices in Southern California.
I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
Dr. Horowitz: I was lucky. I met some great mentors when I was in Atlanta at Emory University. They had an incredible plastic surgery division, and I had the opportunity to learn from the people that were writing textbooks on plastic surgery and developing new techniques. I was surrounded by an invigorating group of surgeons, and they really inspired me to continue developing my own techniques and to never stop learning. Staying at the forefront of new technology and treatment options is something that’s very important to me and it’s something that I can certainly attribute success to as well.
What made you want to start your own practice? Can you tell us the story of how you started it?
Dr. Horowitz: Our gusto for academia and the faculty position experience at USC inspired Dr. Nichter and I. Our goal was to have a “university quality” practice in a private setting. With our training and skills, we are able to perform every type of cosmetic and reconstructive surgery. Managed health care changed the economic profile of medical business, so most of the reconstructive surgery we perform these days is through our non-profit, while our cash-based practice primarily provides cosmetic surgery. This approach has been both professionally rewarding and financially lucrative.
Can you share the most interesting story that happened to you since you began your career?
Dr Horowitz: This is a difficult question as there have been so many interesting patients and cases that I have experienced over the years. Many have been during overseas trips with Mission Plasticos, our non-profit foundation. Taking my oldest daughter to India when she was just 19 years old, for example, allowed her to see first-hand the need for the life changing surgeries we perform. She actually interviewed a number of Indian women her age who were the victims of Dowry Homicide attempts, which resulted in severe burn scars on their face, neck, chest and arms. Although we were initially there to treat children with cleft lips, we ended up operating on a large number of these unfortunate young women.
Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?
Dr. Horowitz: It’s true, we are in the helping profession and providing the best patient care is always the greatest priority. We strive for excellence in outcomes, as well as the overall patient experience from the first phone call onward. I never really “discharge” my patients from my care. I want to see their results one year, 10 years, even 20 years after their surgery. As a result, my patients continue to return and send their friends and family for treatment.
The business side is more difficult. We rely on our team members from front office staff to our practice administrator to our business consultants. We’ve learned to hire the right people to help grow the business. We also rely on our industry partners and their insights when it comes to market strategies and business trends.
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
Dr. Nichter: It’s quite the balancing act and it truly takes a village to run our practice. Our patient care team includes receptionists, patient consultants, physician assistants/nurse practitioners, doctors, aestheticians, and a practice administrator, plus we have our business advisors including human resources, accounting, and marketing, just to name a few. Having a strong team and the right resources in place is key.
Effective time management is also very important. While I see patients during the day, I also have to set aside time to focus on the business. Personally, I’ve created a habit of dedicating a few hours each night to educational endeavors such as keeping up with surgical journals, plastic surgical writing, preparing presentations to advance our field, and of course to answering emails and “inspiring our work family.” While this is a small detail, it helps me compartmentalize. Whatever you do, remember that communication is critical and when you need help, be sure to ask for it. Perhaps one of the biggest challenges is finding time to smell the roses, exercise, and keep up with hobbies and friendships. This will always be a forever goal.
From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?
Dr. Horowitz: While there are many advantages to having partners and a robust staff, it is also challenging. Partners may have different visions for the business. With staff, there are many personalities to blend. When medicine in this country moved to a managed care model, we were unable to sustain six surgeons, 35 employees, and five offices. We ended up dividing the practice and Dr. Nichter and I pursued a different practice approach. We found other ways to continue practicing reconstructive surgery, which was an important part of our training and subsequent career satisfaction.
Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)
- Don’t spread yourself too thin.
Dr. Nichter: For many years, in addition to working in private practice and being Chairman of the Board and Medical Director of Mission Plasticos, I continued my role as a voluntary clinical professor of plastic surgery at USC and the University of California, Irvine (UCI). I was traveling to developing countries up to six weeks a year to train surgeons, while still doing plastic surgical clinical research, writing and presenting here and abroad. While I absolutely loved each of these aspects, I found that I was scattered in so many different directions. I really needed to hone in on the one-to-one relationships with my patients. While you may want to do it all, it’s important to recognize what’s most important and focus your time and energy there.
- Take the time to understand the full patient experience.
Dr. Horowitz: It’s really important to me that my patients have an amazing experience when they come to the office. I can perform great in the operating room and provide fantastic results, but if patients don’t feel welcome or taken care of from the start, it doesn’t matter. Spending time with our staff members to make sure they are properly trained and staying tuned into what’s happening in the office is crucial.
- Find your niche.
Dr. Horowitz: We perform several operations that are not offered at other practices and not commonly done by other board-certified plastic surgeons. Our innovative operations and techniques set us apart. In fact, many thriving practices have been built this way. If you find a niche and fine-tune your craft, you become the go-to for patients looking for exactly what you offer (something that other practices do not).
- Utilize your talents to give back.
Dr. Nichter: While this may seem contradictory to creating a thriving practice, giving back is incredibly important. At the end of the day, you will have a longer career if you are doing something that you love. My involvement in non-profit work has helped fuel my passion for patient care. I appreciate my patients, family, friends, and especially my craft that much more because of my volunteer work. After all these years, I look forward to coming to the office and I feel very grateful to be able to do what I do. In my opinion, I have the best profession in the world, and I am glad to continue practicing my skillsets to improve the lives of others.
- Be true to your brand.
Dr. Horowitz: To build a thriving practice is one thing, and to maintain that practice is another. In the early days of my career, advertising was actually “illegal” for our industry in some states and considered unethical by many of our national societies. Today, things are very different, but the correct type of marketing is essential, especially for young surgeons who are just starting their practice. Before throwing a bunch of money at advertising it’s important to know who you are, where you are, and where you want to be. To be most successful, your efforts need to be specific and goal driven.
As business owners, you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?
Dr. Horowitz: I naturally have an enthusiasm for innovation. I view the growth and the expansion of our practice as exciting. Every day we are problem solving but I truly enjoy it. I think it’s all about perspective. Working around the clock is a given and when we were first building Pacific Center Plastic Surgery, we took on a lot more of the working ON the practice role out of necessity. Now that we are an established practice, we spend less time ON the practice and have hired business professionals to help with that. It allows us more time IN the practice seeing patients, which is what we love most. If I had to estimate, I’d say that I spend about 20–30% of my time on administrative tasks these days (staff meetings, marketing efforts, reviewing finances, etc.)
I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?
Dr. Nichter: Find hobbies or stress relievers outside of the office. Whenever possible, I personally seek out ocean and mountain sports. In the winter, it’s snowboarding and skiing and, in the summer, my favorite activities include ocean related, hiking and mountain biking. I am fortunate to live close to the ocean for surfing and bike rides on the weekends, ocean walks, tennis and pickleball. Whatever your passion is, make time for it and get out in nature. It’s not easy to find “work-life” balance in this profession but even just a few minutes a day to decompress and unwind can make a big difference.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
Dr. Horowitz: “You will never look back on your life and think, I spent too much time with my family.” I love what I do, but I love my family the most. Balance is difficult. Medicine is a very different career and I must always be available for my patients. It is the commitment we make when we chose to become doctors. Unfortunately, I do feel that I have missed many special days with family and friends over the years. Some of this was unavoidable. It’s critical to have a life partner who is understanding and supportive of your career choice. Our youngest daughter will be going to medical school this year and I think she has and will have a better perspective on the necessity of work-life balance. I believe she will make great contributions to medicine and that she will also be able to have a great life and rewarding career going forward. As they say, we all “stand on the shoulders” of those who came before us.
How can our readers further follow your work online?
Dr. Nichter: You can check out our plastic surgery practice by visiting our website: www.ThePacificCenter.com and you can check out our medical spa by visiting: www.MyBioSpa.com online. We are active on social media as well including Instagram, Facebook and YouTube. Follow and connect with us! We always enjoy meeting fellow medical professionals, business professionals, and the like.
Thank you for these great insights! We wish you continued success and good health!