Stay true to who you are and what your brand is. Oftentimes that is not the easy or quickest way to make money and everyone always has an opinion. Personally, I wanted a boutique aesthetic practice that offered high-end, high-quality, services. My goal was to create natural results and improve my patient’s confidence and quality of life. That means I’ve often had to turn patients away. I’ve also not offered frequent sales and discounts. I’ve been told by many that you never say no, all money is good, and if discounts will get people in the door, go for it. While it takes more time to do it my way, the end results will be a practice that you are proud to have your name behind.
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. Smita R. Ramanadham.
Dr. Smita R. Ramanadham is a double board-certified plastic surgeon offering aesthetic care to her patients throughout the New Jersey, New York City, and Tri-state areas. As a female plastic surgeon, Dr. Ramanadham works to understand their specific needs and goals before formulating a personalized procedure plan. She understands the delicate mix of beauty, art, and science that is required to refine and rejuvenate the aesthetic appearances of her patients so that they experience optimized results.
As a New Jersey native, Dr. Ramanadham understands the unique goals of women and men in the Tri-state area. After a successful academic career in Boston, MA, she is excited to be back in her home state.
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?
Thank you so much! I’m a Board-certified Plastic Surgeon in NJ, but my path definitely took a few twists and turns along the way. Born to immigrant parents who were both in the medical field, it was only natural that I also wanted to pursue a career in medicine. Similar to most medical students, I changed course several times with respect to my specialty but ultimately decided to pursue further training in General Surgery, which brought me to Dallas, TX. Using to my hands to heal and treat disease was especially appealing. As the years went by, I further realized that my passion was indeed Plastic & Reconstructive Surgery. It blended my experience in the visual arts with science perfectly. The ability to mold, shape, reconstruct, the attention to detail, knowledge of anatomy and to truly have a transformative effect on patients and their quality of life was beyond rewarding. I began my career in academic medicine as a clinical assistant professor at Boston University, and over the years decided to pursue a new dream of owning my own practice.
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?
I cannot stress this enough and, in fact, have published papers in peer-reviewed medical journals on this very topic. I truly cannot say that there has been one mentor that has been the most influential. They have all played a tremendous role in where I am today. First and foremost, my parents. My father, a pharmacist and business owner, showed me the importance of hard work, kindness, and following your dreams and passions no matter how difficult that road might be. My mother, a pediatrician, introduced me to medicine at a young age and truly led by example in how she treated each and every patient with compassion and as a member of her own family. Professionally, countless teachers, colleagues, and friends that have lent a friendly ear, and provided wisdom and advice as I navigated my career path.
What made you want to start your own practice? Can you tell us the story of how you started it?
I did not always know that I would end up owning my own practice. In fact, this was the last thing I wanted to do as I was going through my training. I wanted to stay in academic medicine, work in a group of plastic surgeons, and teach residents and medical students as a part of my clinical practice. I did, in fact, find that job in my previous position in Boston. As with most new graduates from residency, I think many of us learn a lot about ourselves in those early years. Prior to that, we are so focused on learning our field with the aim of being the best surgeons we can be and to provide the best care to our patients. For many of us, it’s only after that time that we learn about the business of medicine and the different practice models. For me, I learned that I really craved autonomy. I had a vision of what I wanted my career, my practice, and my brand to be and I did not feel that I could adequately accomplish that unless I was on my own. After much thought, I took the leap to start my own practice. The benefit of plastic surgery, which I think is very unique to this field, is that I can transition into private practice but also maintain teaching and research opportunities with residents on my own terms. All in all, this was the best decision for me, despite it being rather daunting at first.
Can you share the most interesting story that happened to you since you began your career?
The most interesting I would say is the shutdown. As most business owners can attest to, starting a business takes more time than any of us are willing to acknowledge. After many delays, I finally opened my office doors in November 2019. We had our grand opening in mid-January 2020, and just as we were gaining momentum, we were shut down due to COVID-19. The anxiety of the unknown and whether my brand-new practice could survive this was real. Surprisingly, when we re-opened, we were shocked by the increasing demand for plastic surgery, wellness, and self-care. It was a very pleasant and welcomed surprise.
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?
There are truly two aspects to this. The reconstructive aspect, such as reconstruction after traumatic injuries or cancer surgeries, and then the aesthetic aspect. In the aesthetic portion of the practice, it’s a bit more straightforward. We provide their cosmetic procedure or treatment for a fee as is customary for any services provided in other professions. These are not medically-necessary treatments, whereas reconstructive procedures generally are. In these cases, many of us work directly with insurance companies for payment for services rendered. While our number one goal is to always ensure that the patient has the best care possible, medicine is still a business and we have to keep our lights on and our employees paid.
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
It is a balancing act and I don’t believe we are ever completely balanced. The day to day varies. Some days you are the clinician, other days you may have to focus on the administrative aspect, and other times, you have to wear both hats at once and pivot based on where your attention is required at that moment. The key to all of this is that you need the passion and desire to be on this journey. It’s certainly not for everyone.
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?
My biggest struggle definitely came during my previous employment. I found myself burnt out and unclear as to why I felt unfulfilled and unhappy with my career when I finally achieved my goal of being a board-certified plastic surgeon after a long 8 years of training. For me personally, it took a lot of soul-searching, and speaking with mentors, friends, family, and colleagues before I realized that it wasn’t necessarily my specialty but the job itself. I began a journey of exploring other pathways and practice models including jobs at other academic institutions, group private practice and hospital-employed positions, and finally landed on solo practice. It was a huge step that I could not have predicted for myself but after doing my due diligence, I realized that this was the only step I could take at that time. I took that step and have never looked back.
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.)
- Stay true to who you are and what your brand is. Oftentimes that is not the easy or quickest way to make money and everyone always has an opinion. Personally, I wanted a boutique aesthetic practice that offered high-end, high-quality, services. My goal was to create natural results and improve my patient’s confidence and quality of life. That means I’ve often had to turn patients away. I’ve also not offered frequent sales and discounts. I’ve been told by many that you never say no, all money is good, and if discounts will get people in the door, go for it. While it takes more time to do it my way, the end results will be a practice that you are proud to have your name behind.
- Treat every patient as if they were a family member or friend. It’s easy in today’s age to get lost behind a screen, to rush through visits, and to treat everyone like they are just a number. We get to know our patients well during their treatments and recovery and conversely, they get to know us. They know we are always available and we can always be reached night or day. It makes the relationship a very unique one and inevitably is what drives patients to refer us to their friends and family.
- Stand behind every service, product, and treatment you offer. In our field, it’s easy for patients to feel like you are pushing services or products. I’ve often found that patients come in with an interest, they are curious, they know what bothers them but they are not quite sure they want to take the leap to treatment. My office staff and I use the products we sell, in fact, I don’t sell anything that I don’t have first-hand experience with. We’ve had the treatments that I offer. What better way to endorse, believe in, and recommend a treatment than to do it on yourself?
- Be honest. Sometimes that means saying no. While that does not help your bottom line in the short run, it does amazing things in the long run. Patients quickly learn that you won’t just offer a procedure because they ask for it. You offer it only if it will achieve their goals in a natural and, more importantly, safe way. They learn to trust you. You also gain a reputation in the community and that is something you cannot put a dollar amount on.
- Create a team that shares the same mission. It’s important that everyone shares a common goal and that goal should and always be to create a great and safe experience for the patient. Every encounter from that first phone call can make or break your practice, so it’s very important to make sure that each staff member is on board, works well together, and works well with you. It’s amazing how easily patients can pick up on the vibe or tension in the office, so these dynamics cannot be overlooked. At the end of the day, I cannot do my job well without the support and work of my team, so surround yourself with the best, treat them well, and, in turn, your practice will only grow and flourish.
As a business owner 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?
Inevitably, it’s impossible to only focus on one aspect at a time. While you are working IN the practice, you are also always working ON the practice simultaneously. It’s important to be fluid and pay attention to decisions you have made administratively and how those changes directly affect the work flow or experience for you, your staff, and your patients. It’s not uncommon that I’ll see patients and either through that experience or based on a discussion, I’ll come up with new marketing or educational materials. You also soon realize that decisions you made a few months ago may not be relevant or beneficial at the moment, and need to be addressed as your practice and staff grow. Generally, the work ON your practice traditionally happens off hours. Weekends, weeknights, in-between patients, or administrative time you set aside during the week. While this may seem like a lot, it’s fun, it grows your practice, and gets you closer to your dream. It doesn’t seem like work because you want to do it, and you enjoy it because you can see the direct effects of each and every action. Having said that, it is important to put away that laptop and have personal self-care time, whatever that is for you.
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?
Unfortunately, burn out is a real and growing problem in medicine. We have been trained since medical school that our patients always come first at the detriment of our own needs, both mentally and physically. This mindset has to change. We cannot provide the best care to our patients if our fuel tank is empty or, worse yet, in the negative. It’s important to set aside that time for yourself so you can refuel. This is something that is completely personal to you. It can be working out for an hour a day, meditating, turning off your cell phone when you are home, traveling. What works for me won’t work for someone else and vise-versa. For me personally, I cherish my one-hour a day where I can escape and sweat. Whether it be a run or an OrangeTheory class, I get to release some stress and have nothing to think about other than my workout.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
“Success is not final; failure is not fatal: it is the courage to continue that counts.” — Winston Churchill
This quote always spoke to me because nothing in life, personally or professionally is guaranteed. It is constantly changing and there are always ups and downs. For me, the biggest hurdle of leaving the stability of an employed position to open my own business was this idea of failure. Failure isn’t a term that many of us have in our vocabulary so this was difficult step. Add in the fact that I didn’t know anything about business, let alone how to run my own. I was learning along the way with the help of others that I had to rely on for their knowledge and expertise. The turning point for me was when I realized that the worst-case scenario, failure or shutting down my business was and is better than the alternative of not pursuing that dream at all, and all failures are actually opportunities to learn from and grow. This quote states that so perfectly. The most important thing in business is to be consistent and to continue to move forward.
How can our readers further follow your work online?
They can follow me on Instagram @thedrsmita I do all of my own social media and this is great way to get a glimpse into my work, my practice, and me as a person! Additionally, my website is www.drsmita.com
Thank you for these great insights! We wish you continued success and good health!