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Med Spa Success Strategies
From Injector to CEO: How to Build & Scale a Thriving Med Spa - Interview w/ Dr. Alex Roher
00:38:21
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- [00:03]
A
Hey there. I'm your host, Ricky Shockley with MedSpa Magic Marketing. And this is the MedSpa Success Strategies podcast where MedSpa and Aesthetics practice owners come to discover strategies and tactics that help them better market and manage their practices so they can grow, improve profitability and have greater impact for their teams, their patients, and themselves. Excited today to be joined by Dr. Alex Rohrer. Dr. Rohr remains a practicing board certified anesthesiologist, but his real passion remains helping people change their lives for the better. Back in 2012, Dr. Rohr opened a SD Botox with a desire to help people achieve enhancements with minimally invasive cosmetic procedures and micro treatments. Since then, SD Botox has been a groundbreaking endeavor. Dr. Rohrer has helped tens of thousands of patients achieve amazing results, and he's done so in a warm, relaxing environment. Dr. Rohrer, we're really excited to have you today. Can you start by just giving the audience a little bit of your backstory?
- [00:54]
B
Yeah. So My name is Dr. Alex Rohrer. I went, I went a very traditional route. I did undergrad in med school at the University of Arizona and then my residency in anesthesiology at Loma Linda and then came down, moved to San Diego maybe 12, 13 years ago, graduated after finishing residency and practiced full time anesthesia for about, maybe, I want to say like seven years. Pretty early on in my anesthesia career, I started a company called SD Botox. SD is San Diego. Botox doesn't need any explanation, obviously. And it's. I called it SD Botox just because it was my little side hustle, you know, and all I knew how to do was Botox. Didn't know how to do filler, didn't know anything about lasers and wellness. You know, learned all that as, as I went along. Didn't have any business background, but SD Botox, no one came in for a couple months and then slowly started trickling in and then got pretty busy. You know, it took me about a year or two to ramp up. And then there was a, there was another Med spa and they had racked up a huge bill with Allergan. And so they couldn't buy Botox from Allergan again anymore. So I started selling them Botox. Wasn't even making money on them, just kind of being neighborly and. And then one day they approached me and like, you know what, we're underwater. Will you buy us out? And I never really thought about second office acquisition, etc. But when I looked at it, met the staff, everything felt right. Got a great deal on it, so bought it. And that's the one that really exploded. So then I had a conversation maybe with. I had a conversation maybe six months later with my wife. And I always said, I don't want to do anesthesia anymore. You know, when my mind goes idle, I don't think about putting patients to sleep or an epidural. I think about aesthetics. I think about like the. The business behind it all. And she was super cool about. She's like, all right, go for it. I really thought that first year my income would go down, but it went up. And so I learned that, you know, that I loved, like the inner. I love this field because in traditional medicine, it's like you're sick and then are you healthy? Then you're sick and then we hope to get you healthy again. Like, you know, like if you need surgery, need pills, whatever. But here it's like we're just optimizing people, be it aesthetically or wellness. And so everyone's so happy to be there. It's fee for service, everyone, just as everyone knows on this podcast, you know, they just pay for your Botox on your way out, whatever. And so I really started to love this business at that point. And then Covid happened and kind of like, I think it's Warren Buffett, he said, when others panic, I buy. And so I actually acquired three or four new practices during that time for kind of really good deals. You know, it's harder to find those deals now because venture capitalists and private equity have come and kind of ruined my. All my fun in that respect. Now we're doing more de novos, but. But yeah, just picked up a bunch more. Now we're up to seven offices in San Diego, two in Texas, one in Austin, and one in Killeen, which is a kind of this little city around Austin. And then I've kind of like made some spin off businesses, um, that kind of similar industry, but not quite pure aesthetics. We get into that later if you want.
- [04:13]
A
Yeah. Dr. Roger, those spin off businesses. So that would be the. The hormone weight loss and hair transplant businesses we talked about and you mentioned they kind of operate as like sub brands of SD Botox, right?
- [04:23]
B
Yes.
- [04:24]
A
Do the. Do they work inside of the same offices? These expanded office like these other businesses?
- [04:29]
B
We tried that. We did. We had some offices that were like a hybrid. Um, but honestly, businesses do better when they're freestanding. So they're. They're not in the same building, they're just freestanding. So the main business is SD Botox, which is aesthetics. And then I didn't want to put all the wellness in there. I don't even want IVs in there, really. I just. We do allow GLP1s there because obviously weight management is both wellness, you know, like to prevent metabolic disease, et cetera. But it's also aesthetic. Every, you know, everyone wants to look at it and typically that for a lot of people that involves weight loss. So that's really the only service that is offered both at Scbotox and my Hormones and Wellness by SD Botox brand. They then take it further and they offer hormone replacement primarily. So we specialize largely and we have a lot of men. But I love taking care of perimenopausal women oftentimes because I'm still a provider myself. I still work Tuesday and Wednesday. So a patient will come in to see me and she's, you know, let's say 45 year old woman, she came in for Botox. I'm taking care of that. I'm asking her questions about her, how she's sleeping, her body composition changes, her mood, her energy, sex drive, etc. And at the end she ends up going to one of my other offices, getting her labs drawn and starting on, you know, the appropriate hormones. And then she, I see her again maybe three, four months later and she's like, my life is so much better. I appreciate that so much. It was like she was there for Botox. And I say it's like polishing the brass on the Titanic. It's like the ship is going down. Like, let's definitely do the Botox. That's important, but let's see if we can help you further. And I love this industry as I love that people come for one thing and it just becomes like, it just, it changes their life. And this is like the conduit, like how they enter this and this, this part of the medical system.
- [06:25]
A
Yeah, I love that. Like you said, it's like in, it's getting them beyond baseline. Like in, in the medical side, you're getting people sick and trying to get them back to baseline. The aesthetic side, you get to have a little bit more fun and enjoyment at times because you're getting people beyond their baseline even better than they were before.
- [06:38]
B
Exactly. I mean, Botox is literally needles in your face. And they're so excited to be, they're just like leaning into it, you know?
- [06:44]
A
Yeah, for sure. So obviously that's interesting. I feel like a lot of people that are listening to this probably really struggle with the idea that somebody's coming in For Botox, I'm going to convince them to do hormones, I guess. Two questions on that. Do you find that you have unique success communicating that? Do your other providers have that same success in terms of being able to convert like a Botox client into a hormone client?
- [07:06]
B
Some do. You know, I, we have 21 providers. I'd say there's like three superstars that send patients that direction. You know, oftentimes with our compensation model, there is no, they don't get anything for doing that. And so, yeah, you know, but they do it because they have a good relationship with their patient. They want what's best for their patient. Oftentimes if they're trying to sell something, it's more like a new service for themselves, you know, which is fine. Which I love too. I'm not knocking that. But it's more like aesthetic to aesthetic as opposed to aesthetic to wellness.
- [07:36]
A
So.
- [07:37]
B
But I do have like, they, the employees get great pricing at, you know, of each company, they got great pricing. So they do know each other. When we do company events, I invite both companies, the aesthetic side and the hormones and wellness side. So there is a lot of, like, there's a relationship there. And then we have really good employee pricing where a lot of my, my esthetic providers end up, you know, getting on hormones or peptides, whatever, using the facility for, you know, we also have like infrared saunas, cold plunges, cryotherapy, hyperbaric oxygen, red light, et cetera. So a lot of them go there and then they just know the brand and they just want to do what's best for the patient sitting in the chair. And that oftentimes involves some of the hormones and wellness side.
- [08:23]
A
That makes sense. Random aside, but based on that answer, I had another question. Those other services like cryo, red light, those types of things, we've talked about that in some recent episodes on those services. Do you find like in our, in our conversation just before this, we talked about sometimes you're trying to jam a square peg into a round hole when you're selling a service that, like, there are certain things that are your gateway drug that are going to generate the relationship, the initiation of the relationship, and then you're cross selling or referring them into some of these other services. Do you find that that bucket, like the red light type stuff, is that generally coming from existing clients that already know like and trust you moving into those services, or is there a healthy customer base of people that are just coming straight for those services as like the origin of the relationship?
- [09:05]
B
Yeah, I would say Both. But I think there's, there's more of the patients that are coming with the initial thought of doing the wellness and health side. You know, we do send a lot from aesthetic wellness, but a majority of people, it's a different patient base. It's. I would say it's closer to 50, 50 men and women over at Hormones and Wellness, as opposed to like 80, 20 women versus men in the aesthetic side. And it's also just a different type of patient. You know, like, they're very. There is a lot of crossover, but it's also. Some people don't care how they look so much like wrinkles don't bother them, but they are all about like, you know, like, we have Dexa scans and they're just like, how do I get my body fat down to 9%? You know, so it's like, yeah, so there's a crossover. But I would say overall, most patients enter for the hormones and well, as for the health side, and then they. Yeah, sorry, this.
- [10:05]
A
No, that's a good, good answer. And, and this is kind of a broad question too, but kind of just going back to thinking about, you started this as an anesthesiologist, I guess. Follow up question to that even. Were you working, working as an anesthesiologist full time while you were starting the med spa? Did you scale back your schedule as you made that transition gradually or was it.
- [10:24]
B
Yeah, that's a good question.
- [10:25]
A
So.
- [10:28]
B
My first job in San Diego was at a hospital that was smaller in communal hospital and it was pretty light. You know, I was probably working 30, 35 hours a week. So that's when I started it. I then switched to a bigger hospital system that was, you know, pushing 50 hours a week. And that's when I had to bring on a nurse, my first nurse to, to help kind of line my load. That. Yeah, initially, you know, like when I think people start med spas, they brand themselves, which I think is smart. You know, you got to brand because that's how you get the name, get the reputation. People, you know, want to come see you. But then as you get bring on ancillary staff, you know, everyone wants to see you and no one wants to see Patty. And so I'm like, oh my God. Like, so I had to purposely, consciously, and if there are marketing, like unbrand myself and then Mark, Dr. Rohr and I had a brand St. Botox. Then as we scale up, scaled, it's almost like it was, it's. We're at a point where I'm trying to Rebrand myself. Like doing podcasts like this and just like on the website, more prominent and just almost like it needs a face again. And it's like my schedule is full enough where. And I'm not going to work more clinical hours. So it's. It's really just to kind of build the halo effect from Dr. Rohr onto the rest of the brand.
- [11:47]
A
Yeah, we've talked about that quite a bit. It's like you. I think it does help to have a face with the business that is, you know, I think just this is a business that's based on personalities and no like that know, like and trust component. And it's a balance of trying to figure out how do you serve as the face of the business from a branding standpoint without creating the expectation that you're the one actually delivering service and sort of pass that credibility through to the providers. Is there anything that you think about that helps you do that? Like, like. Or is it. Is it just the halo effect, essentially? Is there anything else you do to try to make sure that those people like that they know that Dr. Rohr, he's the face of the business and whatever he does systematically process the, like, the way that he wants to treat is also going to be done by the providers and the people that you hire.
- [12:31]
B
Yeah. So what I'd like to do is I like to have patients, like, I can't see every new patient, but I try to see a lot of new patients kind of establish that cross trust like they know they're seeing the owner, etc. And then I try to recommend services that I don't do. So all I do is injectables, Botox and fillers. I specialize in liquid nose jobs, but I try to then have the new patient establish a relationship with one of the other providers and that they have two is they're going to have their ongoing relationship with. From a branding point of view, I am the face. But I mean, I'm booked a couple weeks out, so most patients know they can like, most patients that try to see me will or what. They almost like prioritize being seen soon over being seen by me, which is perfect. Which I'm fine with, you know?
- [13:18]
A
Yeah.
- [13:18]
B
Because I love our. You know, I've cherry character van Pick this whole. All these providers, and they're awesome. So feel good about wherever they end up.
- [13:25]
A
That's interesting in terms of like, the time allocation and the strategy, because what we've heard a lot of people try to do is the exact opposite of that, especially like if somebody started running ads or trying to do something to acquire new patients, they're like, okay, we'll just give them to the new person. We'll build their base. But the challenge sometimes with giving those to the new person person is that person's the least equipped to give someone the confidence that they've come to the right place. So you're kind of prioritizing still, like you want somebody that's like that you really, either yourself or somebody that's really high up in your organization that you really trust in terms of their experience, their expertise, their ability to demonstrate those things, to kind of have some of the first touch points with clients, ideally, because that establishes the relationship, and then you're able to kind of pass them off and hand the baton to the person that's providing service. That's kind of interesting. I think a lot of people try to do the opposite, and it feels like a mistake to me. So that was interesting that you mentioned that.
- [14:12]
B
Yeah. And we follow retention. We define it as the patient comes back within four months. So we have those metrics on all the providers. We have KPIs, like, we know how everyone's doing from everything from like average ticket spend, revenue per hour, alternative modalities, to non injectables, even botox waste. You know, we've really, we've really matured as a company in that respect. And we review those numbers on a weekly basis for specifically any outliers. But it's it. We do have a little bit of the model where, you know, we could see how people are doing and then we could preferentially pull that lever and have the call center book that provider. You know, there's also different types of providers. You know, we allow providers to kind of have their own style. And so the call center, once a month spends a day with a different provider and they see how they do things and then they get a feel for the patient on the phone and then they feel like they can, one, they could credential them better, but two, they can match that patient to the provider. That would be like a good personality or what they're looking for. Fit.
- [15:16]
A
Yeah. Awesome. This episode is brought to you by Med Spa Magic Marketing, my agency. We help Med spas and aesthetics practices grow with more effective marketing strategies. And I know that's a vague phrase, right? That's a vague claim. So I have an offer for you. I offer this to any new prospects. If you're interested in exploring a new. Of another marketing option, a new agency or just getting into Facebook Instagram, Google Ads for the first time. I'd love to show you why we're different, what we're doing for clients. And we can do that via a one and a half hour planning session where I'll outline a specific marketing plan and I'll give you all of the blueprints that we would implement if we were to do business together. Now you can take that, use that on your own, hire someone else to help you execute it or work with us. We really don't hold anything back on that strategy call. And I think you'll have a lot of people confidence in how you manage your marketing investment moving forward. Understanding some of the nuances that can help you implement more effective marketing strategies for your business. So if you want to do that, you can go to medspa magic marketing.com being really good with the metrics I think is insanely important. But just like your background, you have a lot of people in the space that come from the medical side and the business side is, is kind of like hard to learn. It's not the thing that comes naturally to them. And that's where a lot of businesses struggle. It's obvious that you've really gotten very good at the business side of what you're doing. I think that's evident in just the fact that as these other businesses around you were closing, you were the one buying them up and not vice versa. How did you go about managing that transition to like, hey, I'm coming from medical school and anesthesiologist, I'm starting to do injections now. I've got to figure out how to be a business person, especially with the scale in multiple locations. Is there anything that you've done to be intentional about that growth?
- [16:53]
B
Yeah, I think, I think one thing initially is that a lot of people want to do this and they're just scared. So be willing to take that leap. I think is, you know, obviously, you know, the type of personality that I think like a lot of people go into medicine because the only real barrier for, for physicians is getting into medical school. But once you're in medical school, which is difficult, like 99% of the students graduate and everyone gets a residency may not be in the subspecialty you want or the, you know, the institution you want, but everyone gets something and then everyone graduates. Everyone makes, you know, let's make up a number, like $350,000 a year. And so, but it's not, it's like this. 350. 350. 350 etc. Maybe a little up, a little down, but it's not the wild fluctuations of, of like a business. And so I think a lot of the personality in medicine, probably on the nursing side as well, are risk adverse and just want kind of that, you know, that good steady paycheck that, like security of knowing that. And so I think just willingness to take that leap is one thing that has served me well. I think as far as the business side, I, I did get up, I wanted to take business golf. I wanted to take golf in college and you only. Was only open to if you're a business minor or a physical education major. And so I did end up getting a minor in business, but I didn't, I don't think I got that much out of it. I mean the golf class was awesome obviously, but like, I don't know the accounting and like, you know, they get an MBA certainly since finishing, you know, it's kind of like learn as you go trial by fire. Like someone said like running a business is like flying up flame while trying to paint it. And it's true. It's just like, you know, you're, there's so much you're not, you're not going to anticipate and you're gonna have to figure out on the way you're gonna make mistakes. You have to reframe them in your mind as opportunities, you know. And like you really have to, you just have to like kind of have that mindset and you have to be willing to fail. I failed many times. I mean I could go into that if you want. And then I, I've never, I read business books, you know. One great one is Traction by Gina Wickman. I'm sure it's flown around my office here somewhere.
- [18:59]
A
Do you all implement EOS in the organization?
- [19:02]
B
We never fully implemented it, to be honest. We did get like a. But we structured the company, we structured the business meetings. We never got like an EOS implementer and like you know, come in and professionally do that.
- [19:13]
A
I, I'm still here. I don't know why my camera cut off. Sorry.
- [19:16]
B
Oh yeah, no worries. And then I, I've, I've kind of gone through like the business group. There's. I started out in something called EO Entrepreneur organization and there's minimums of I have to make and, etc and then you know, to join these groups. They have chapters every city and then they have like, you know, you're within the chapter which is like, let's say 100 people. You have a forum which is a group of like, let's say eight to 10 people, where you go deep. You talk about your, you know, top 5% and bottom 5% of your personal life, your family life and your business life. And obviously there's. It's, you know, weighted more towards the business in most cases, unless someone's going through something. And so that's always been helpful. I went from EO to Vistage to ypo, and that's the one I'm in right now.
- [20:00]
A
And so it's been very intentional about it, though, essentially very intentional about, like, keeping, like. I understand now I'm running a business. This is part of my job is to be a business person, not just a medical provider.
- [20:12]
B
Yes. Oh, yeah, yeah. And it's tough to wear those hats. You know, it's like the Mondays are my admin days. You know, we're doing this podcast on a Monday, and I just stock it with meetings. We have our big company meeting with all my, you know, like marketing and ops and, you know, finance etc, and then Tuesdays and Wednesdays I'm clinical. Thursdays I'm. It's kind of like my outside interest on the other side of the businesses days. I try to keep all that then. And then I have two kids, five and, I'm sorry, six and seven. So my weekends kind of belong to them. So Friday is like my day where I golf or boat or, you know, I do something more adult, more, you know, something for me.
- [20:58]
A
Yeah, I love that. Speaking of wearing the multiple hats, that can be a major challenge and trying to figure out when to take some of those hats off of your plate. Like you mentioned early on, when you were transitioning, still the job in anesthesiology, you had to hire a nurse. You had to have somebody else kind of helping with just some of the fulfillment. Right. Like actually serving the clients. How have you thought about, first of all, managing the schedule of wearing multiple hats? Because most people in their businesses, I mean, we all like to think we're just going to be the CEO and we're going to work on CEO problems, but there are 97 other things that we're probably doing or that are falling under that CEO bucket. At the very least. How do you think about managing your time and how do you think about when it's time to delegate and put those responsibilities on somebody else on your team?
- [21:41]
B
Yeah, I think we're a certain size now where it's almost. It's like 95 delegation, to be honest. I have a super strong COO, Rochelle, and she's Yeah, I mean, I put a fair amount on her, to be honest. She does a great job. She really does the day to day. The kind of stuff that bogs me down. So I could focus on big picture and clinical. Clinical care, both as the provider as well as the chief medical officer, knowing what to bring on, how to deal with complications, etc. Brain protocol. And so. But it's tough when you're transitioning from small to big to know when to bring what on because we've definitely been too fat at times at the admin level. And that is one metric I look at is how much, how much of our labor, hr, how much of our payroll goes towards like revenue generating positions, being front desk, provider manager even. And how much is admin being, you know, like all these other things I was talking about like marketing ops, you know, accounting, call center, etc. And so I look at that. It was close to 50, 50 at one point and that was troubling. But we're there right now, so I.
- [22:57]
A
Feel, I feel that pain. Exactly.
- [22:59]
B
Are you scaling as well? You're. Yeah.
- [23:01]
A
Do you think that's just part, do you think that's just a point where you're trying to build that infrastructure because you need those roles but now it does throw those ratios off and then you, and you do settle into a place that's a little bit healthier.
- [23:13]
B
Yeah. You kind of, it's kind of like taking that leap. It's almost like you have to hire for a position that you don't fully need at times. Sometimes you're too late and you're like, you hire for that position, you realize you needed it two years ago.
- [23:24]
A
Yeah.
- [23:25]
B
So it's very much a feel. And then there's. You gotta. Once you get bigger, you make your org chart, you know, and like, so everyone from the top to the bottom knows who to call for what. And I'll be honest, like, Rochelle really helps with a lot of that. She came from the corporate side. And so, you know, and then because the company matures too, it's like, you know, I still go out and have fun with all my providers and front desk, etc. And now we're a certain size where it's like, you know, it's just like, I don't like it. I don't want to say we're corporate, but. And we do company events together, but I'm not regularly going out with the staff. It's just not a good thing. Yeah, good idea anymore. So it does lose a little bit of that, like fun mom and pop, like we're all in this together, let's party feel. But you know, it's a life cycle of a business. It's the maturation of it and you know it's, it's every phase of it has had. It's like a. I joke that it's like my baby, like I have a, like I said a 6 and a 7 year old like all SD, Botox, my like 13 year old when things aren't going well, like a 13 year old, like you know, like all those hormones etc, you know it's going through some stuff but yeah, you just have to be able to kind of compartmentalize all the things that are going on, the good and the bad and just you know, like there's a good book, it's called Atomic Habits. Most people have probably read it but it wasn't even about the habits part. It was just kind of about like the first couple chapters or when you think back at about a business, it isn't necessarily like the three big decisions you made that have made it what it is. It's those little incremental day to day 1% gains, you know, or like that really like raw you from like a small little, you know, renting a room in an esthetician's office to having 7, 9, 13 locations. So yeah, I mean again I go back to attraction. Gina Wickman he calls it letting go of the. I forgot what it was. He's like hanging on to like a little plant like on a cliff. And from some point you just have to like kind of relinquish control and allow the people you hire to, to do what you hired them for.
- [25:22]
A
You mentioned this like COO role being really important to your current operations. What level do you think that position makes sense to hire for when, when, when is the right time? Ish.
- [25:34]
B
Again I would say when you're multi location I would say, you know, 3ish probably makes sense. And I've gone through also like the type of person that would accept the pay and, and have the skill set to take you from like 1 to 2 isn't the same person that could take you from like you know, 7 to 13, you know, so it's like you can't have the perfect person right away. And so oftentimes there's some tough conversations where you have to replace people with kind of level up people. And that's been difficult, you know, like. But someone once said your success is directly proportionate to the amount of uncomfortable conversations you're willing to have. And I'm pretty.
- [26:14]
A
Yeah.
- [26:15]
B
I don't consider myself very. I don't like confrontation, but I'm willing to for the betterment of this company and everyone in it.
- [26:23]
A
Yeah, that is. That's definitely, I think, a major challenge for growing businesses. Hey there. Wanted to briefly interrupt the episode to make a quick ask. If you're a podcast listener, it would mean the world to us if you'd leave a review for the podcast, whether that's on itunes or Spotify. It's something I hadn't really remembered or thought of asking for, but it does help us show up more frequently so that we can reach more people with the information that we're providing. So it mean the world to us if you'd leave a review on itunes or Spotify. If you're listening on audio. If you're watching on YouTube, make sure to hit the subscribe button so you're in the loop for future videos, and you don't miss any of the content that we're putting out. What, from a high. Just overall standpoint here, you've been very successful in your ability to grow this business. From even the early days, it seems all right. Like, it established. It built some momentum. You were able to acquire that first location, then you're building additional locations. I think a lot of med spas, a lot of businesses in general, they feel like they're kind of hitting a wall constantly where it feels like, I don't know, they get a step ahead, they fall a step behind, and they sort of fall into a place where it's just stagnant. What's allowed you to be very, like, growth focused, growth oriented? Is it just serving patients well? Reputation? What do you attribute that to?
- [27:34]
B
Yeah, you definitely need a good reputation, but you also have to have a growth mindset. You also have to be willing to take risk. You have to be willing to fail. You have to be willing to forgive yourself. You have to. I mean, that's like the ultimate. That's stronger than any mba. It's just like life experience, especially specific to the industry that you're in.
- [27:54]
A
And.
- [27:55]
B
And so, you know, I've closed offices, I've closed businesses, like side hustles. I've definitely, you know, I've definitely experienced all that. But, you know, it's just like, at the end of the day, do you make more good decisions than bad decisions? And like I was saying, are you doing that, like, 1% growth a week or not? Not necessarily even financial growth, just like, betterment of the company, the culture, the feel like some future Opportunity. Just always be striving. Always, always have your business in the back of your mind and apply whatever you're going through in life to it. Like, opportunities come up in the craziest places. You know, I had a. I had a exterminator come to my house and. And they left a review on or like a note on my door, a little hanger. And they were like, if it was great, let us know and we'll bonus this guy. So we started doing that, you know, like, leave us a review on Google, Yelp, whatever, and we'll bonus our, you know, we'll tip that provider.
- [28:51]
A
Cool idea on your behalf.
- [28:52]
B
Yeah, I don't want to give you give away all the company secrets here, but that was a good one.
- [28:56]
A
So that is a really good one.
- [28:57]
B
Can have that one. I love that one right there.
- [28:59]
A
Yeah, that's a good pearl.
- [29:01]
B
But yeah, I mean, that's just one example. Like, like I took something that was from literally the exterminator to us, and it's been, you know, like just so. It's kind of like just. Oh, like it. You want a clear mind so that you can really focus on growth and like, obviously personal things happen and, you know, you don't have it for a while. Also, I think I swing between kind of like growth and lifestyle. Business, meaning lifestyle, being like. Like, I'm gonna travel, you know, 16 weeks this year or something. And then there's. There's years where I travel, like two weeks because I'm just like, head down, like, go, go, go. And you know, so it's like, I think that's healthy, you know, I think like, I think vacation. Yeah. So healthy. Like just like. And then I always come back inspired with something, you know, like, it's like, it's not even my intention, but just kind of like my mind goes to a. Kind of a clear place where I'm able to look at the business from a different point of view.
- [29:57]
A
Are those typically family vacations, you and your wife? Like, what are those?
- [30:01]
B
Yeah, it's a mix. Sometimes it's just me and my wife. Sometimes it's. It's probably primarily me and my wife and my kids. Like, we went to Africa for. And we actually traveled for 35 days this summer. It was crazy if like my. Somehow my daughter, my 6 year old decided that we packed for 35 days and like halfway through the trip, she decided her favorite color was blue and not pink anymore. So every day it was like a battle to get her to take and then like, like to wear clothes and then, and then like, and then she didn't want to take her malaria pill because it's like, you know, she's six years old. So my day would be like book ended with like arguments with my six year old.
- [30:37]
A
Oh my gosh.
- [30:37]
B
But, but it is something that I want to continue. I do think like, you know, family's so important. That's why we do all this, everyone. So it's like, yeah, the business has.
- [30:46]
A
To be here to serve you in a sense. Like if, if we're just like if the business owns us and all we're doing is sitting here pulling out our hair trying to make business things happen, that's, that's not really what we want to do long term, I don't think.
- [31:00]
B
And don't be discouraged. There are time periods where that is the case, you know, like just know that there will be time periods where it's not, you know, like especially businesses tend to be very front loaded, you know, like, not like there's no such thing as passive income like ever. Like, I mean, and sometimes I could be on a vacation if something's not going well in the business. Like I could literally be on like a yacht in, I'm not saying yacht, but a boat, let's say like in like the Mediterranean. And I'm. My mind is on, is literally thinking about so am I really physically I'm there. But if I'm, you know, if I'm, if I'm thinking about work all day, then it. That's on vacation.
- [31:35]
A
Yeah. So do it at a time that feels right. Make sure you have your ducks in a row because yeah, it does.
- [31:39]
B
It ruins it.
- [31:40]
A
If you feel like there's major fires you're trying to put out or big problems you're trying to solve, maybe that's not the time, that's not the period to take that vacation because I've experienced that. You're not going to enjoy it anyways. Right?
- [31:51]
B
Exactly. Yeah. I try to be like very present and we all do, you know, gratitude, etc. Work. The ongoing battle for everyone. I'm sure for sure.
- [32:00]
A
The expansion, expansion strategy of like kind of buying like the failed med spas, what do you see commonly that's going wrong in the med spas that are failing that you end up acquiring.
- [32:13]
B
It's changed a little bit. I think. Initially I was getting a lot of just like solo provider, like a nurse that just overhead his or her head and just kind of, you know, doesn't understand the business. Like, you know, like all the aspects of it. And so stays shut down and. Or we buy their assets or you know, like we'll take over. Right now I'm seeing a lot of the private equity that first round those guys are failing. They didn't really understand the business. I'm sure they're master at spreadsheets and I think they're beginning to understand the business. But I think that in that initial like pop of PE coming into this world in like maybe 2021ish, I think those ones, they, they I would say underestimated but didn't understand what they were getting into, let's say. And. And so we're getting. Picking up a lot of those.
- [33:04]
A
Yeah, there's a really interesting video on kind of that topic from a guy named Michael Gurdley on YouTube. I stumbled across it on accident, but it was a really good little analysis of like the private equity and all the people that thought they were going to come in and use the med spa space as just kind of like a cash cow and why it didn't quite work out for many of them and why he thought that just concept of like using this as a private equity play was a lot more complicated than people thought it was. I know we've got a wrap. I would love to do another episode. We've got so many other things we could talk about. Barely scratch the surface, I feel like. But I did want to end on one question that I was. I jotted down which is you mentioned your providers. You're tracking all of these metrics related to like initial visit revenue retention rates per providers. Two quick questions to wrap on that. One is do you see a big disparity between your top performers and the bottom?
- [33:49]
B
Yeah, yeah. But it just depends on the metric because sometimes someone has awesome retention but they're, you know, revenue per hour Botox wastage, What, you know, 50 other things they struggle with. So they're all, it's all their personalities and they're all kind of all over and we have, we rarely have to do discipline based on that stuff. So we, we. I like that there isn't truly like an SD Botox way to do a consult. Like there is, but there's like they have a lot of freedom to do things the way they want to do and we can tweak it. We. I can have them shadow other people that do something better. But I do like that they have the, I know like skin spirit, for example, has the skin spirit way and you have to do it that way. Like one hour console. You got to sell micro. You Know, it's just like, that's not our. That's not for me. You know, like, I like places where people feel free to do it how they want, and then they could try something new. And then like, oh, that's a great growth opportunity right there. Maybe let's start doing it that way. Pick up that technique I like, you know, pick up that talk track, that pearl, whatever. So, yeah, so, yeah, there is a lot of discrepancy. Depends on which metric you're talking about. But yeah, there is. There's a fair. There's a big deviation for sure.
- [34:54]
A
Do you use. Do you use lessons learned from the top performers? Like, hey, like this. This person, Sarah, she's actually killing it. Her rebooking rate's 16 higher than our average. Do you try to figure out, like, what they're doing and coach the rest of the team on some of those things to improve?
- [35:07]
B
We do. We do. We study it ourselves. And then we also do peer to peer where, like, quarterly, we'll do our provider meeting and we'll highlight someone that's killing it on, let's say, retention, your example, and they'll give a little talk on. On what they're specifically doing to get patients to rebook. You know, like last. Last meeting we had one outlier that she saw. I think, like, 13 of her total sales was skin care, I think as their company average or I don't even want to say her number because it's embarrassing. So it's like we had her give a talk on, like, her talk tracks and how she's doing it, how she's, like, when she walks the patient to the front, she's putting the product on the top, et cetera.
- [35:46]
A
So it was like, yeah, that's so interesting. We have talked a lot about, like, the. Trying to figure out a way to make it consistent, trying to make sure that one provider to the next is more. But what you're doing is an interesting flip on that because you're. The advantage that you have here is you're basically mass testing different ideas and different options, different ways of doing things, and then you're able to highlight the things that have worked. If you've got 10 people kind of doing things a little bit differently, you find the thing that's working best. You coach the team on that thing, and then you have another provider that's maybe doing a, like you said, selling product better than everybody else, and now she can share her secrets. So by giving the people the flexibility to do things their own way, you're getting an extra layer of testing to improve the overall performance of the business. That's really interesting. I never really thought of it that way before, but a cool tidbit. Dr. Rohrer, I know we're out of time. Can you tell people where they can learn more about you and some of your businesses, what you're all up to? So we can put those things in the show notes?
- [36:35]
B
Yes. So you could. The company is called SD Botox. It's in San Diego and Texas and just SD Botox.com and then you could find me. I'm. I specialize in liquid nose job. So my Instagram and TikTok are. Dr. Alex knows best. So Dr. Alex and then knows no se best. And then we also have aesthetic training academy. So that is the problem. The issue with this world is that every nurse I want, I know wants to be in esthetics. And once they know what they're doing, they're so invaluable. So it's like we created a Training Academy that's four weeks online, one week in person. You inject I think 22 patients with six, 600 of Botox and filler. And it's like. And then we have help job match through. I believe it's called job style. And so. And we hire some too. Obviously they will cherry pick the best providers. And so yeah, that's just aesthetic training academy dot com.
- [37:39]
A
Yeah, we'll make sure too all those are in the show notes. That sounds like an awesome resource. I'm excited to go check it out and do some digging too.
- [37:45]
B
Yeah.
- [37:45]
A
Dr. Rohr, I'd love to have you back sometimes. Like I said, I've got. I had like four categories of questions and I love the conversation. I think we got to one chunk, but that was super invaluable. Appreciate your time. Thank you so much for being on the show.
- [37:55]
B
Yeah, thank you.
- [37:57]
A
Thanks everyone for tuning in. This podcast is a production of Med Spa Magic Marketing. If your Med Spa or aesthetic practice is in need of digital marketing services, help with advertising on Facebook, Instagram, Google lead generation and booking more appointments, please visit Medspamagicmarketing.com.