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Selling but Staying in Your Practice — with Andrew Kaufman, MD (Ep. 210)

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Content provided by Catherine Maley, MBA, Catherine Maley, and MBA. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Catherine Maley, MBA, Catherine Maley, and MBA or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and selling but staying in your practice.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "Selling but Staying in Your Practice — with Andrew Kaufman, MD".

This week’s Beauty and the Biz Podcast is an interview with Dr. Andrew Kaufman, a board-certified dermatologist specializing in Mohs, dermatologic and cosmetic surgery in Thousand Oaks, CA for over 28 years.

He built a nice size practice with several doctors under him plus 40 staff and a lot of accounts receivable.

And, like others who have put decades into building their practices, he was searching for an exit plan that made financial and emotional sense to him.

Dr. Kaufman recently sold his practice to a big private equity derm group known as Forefront Dermatology so we talked about the specifics of that transaction.

We discussed:

  • Why he was ready to sell
  • What made his practice attractive to buy
  • How his associates and staff reacted
  • What it’s like to sell yet stay in the practice as an employee

He offered great advice on how to set yourself up to sell, how much time it takes to prepare and who to get help from to negotiate the best scenario for you.

Visit Dr. Kaufman’s website

P.S. Please review!

📲 If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

✔️ STAY UPDATED!

🤝 LET'S CONNECT! 🤝

Transcript:

Selling but Staying in Your Practice

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and selling but staying in your practice. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits. Now, today's episode is a little different.

It's Dr. Andrew Kaufman. Now, he's a board- certified dermatologist specializing in Mohs dermatologic and cosmetic surgery in Thousand Oaks, California, and he has been practicing for over 28 years. He’s also very knowledgeable on the topic of selling but staying in your practice.

Now, dr. Kaufman is a recognized expert in Mohs and reconstructive surgery and author of numerous publications on facial reconstruction following skincare surgery, skin cancer surgery, as well as a frequently invited speaker at national and international meetings.

Now, I wanted to talk to him because he recently sold his practice, and we've been talking about that a lot lately. Like, how do you walk away from a practice? So, I wanted to get his take on it because his practice is now known as Forefront Dermatology.

So, we're going to talk about the specifics of that transaction. Dr. Kaufman, welcome to Beauty and the Biz.

Andrew Kaufman, MD: Thanks, Catherine. It's good to be with you.

Catherine Maley, MBA: Thanks so, much. So, let, why don't you just start by describing your practice before you sold it or partnered, or whatever you want to call it. What was your practice consisting of? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, my practice is primarily in Thousand Oaks in Santa Barbara and I had moved to that area about 28, 29 years ago. After I'd completed a moose Fellowship at UC San Francisco and joined a general medical dermatologist, I knew pretty well that I, I would do well in the area because there weren't many, there weren't any moose surgeons at the time in the area and, I had done residencies in dermatology down there and residency in internal medicine.

So, I knew primary care physicians and dermatologists, and I knew there was a need for a Mohs surgeon. So, I was able to build up over time. I bought his practice and then we added additional dermatologists over time to the point where there's approximately five or six general medical dermatologists and a facial plastic surgeon who also does.

You know, facelifts, Mohs and rhinoplasties blepharoplasties, whatever's necessary that the other doctors aren't doing. So, that's pretty much what my practice had been before I started considering you know, an exit strategy. And did you have a pathology lab? We didn't have a laboratory. We do have a board-certified dermatopathologist who's read all of our slides since she's been there for the last.

Eight to 10 years probably.

Catherine Maley, MBA: Gotcha. Now, how many staff did you have? So, you had five D, five dermatologists, plus you plus, yeah. Facial plastics. How many staff? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: It's somewhere between 30 and 40, somewhere around there. Probably, maybe a little more.

Catherine Maley, MBA: Yeah. Who is managing all of this? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, you know, over time there's a number of different administrators or managers that I'd worked with and So, me very good and some not quite as good.

I was fortunate in the latter part of my career as a, as a practice owner that I had a very good one administrator who kind of helped me through the processes that I was going through.

Catherine Maley, MBA: And what was your biggest challenge, would you say? Running solo practice. How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, you know, in California it isn’t easy to make a living and stuff.

Things are expensive. HR, you know, human resources. Employees are expensive. Doctors are expensive. Health insurance is expensive, but at the same time, reimbursement from commercial carrier insurances continues to go downward. So, I think the biggest challenge is, is running a business when expenses keep going up, but reimbursement keeps going down.

Catherine Maley, MBA: Right? So, now it's somehow what got on your radar? Like what did the, this what's it called? Forward dermatology. How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Forefront Dermatology.

Catherine Maley, MBA: Forefront Dermatology. How did they get on your radar, and were you even thinking about. Your exit strategy? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, I mean, the whole point was, you know, I've been doing this close to 30 years and I'm the sole, you know practice owner.

So, I kind of had to come up with a, an exit strategy that made sense. I didn't want to develop. You know, an illness or die or get injured or something that was going to seriously impair the practice. And so, I started considering exit strategies and first, the first option would've been, could have been, you know, selling to my associates.

They weren't interested really, you know, part of its kind of a generational thing. Nowadays a lot of people. Aren't really looking, they're not particularly entrepreneurial, and they would rather come in work and go home which is fine. I respect that. But they weren't really interested. And then second option is I looked at also was academic centers like UCLA and USC Cedar Sinai and Stanford to see if they had any interest in having a satellite you know, dermatology office and ambulatory surgery center.

In Thousand Oaks in Santa Barbara. And there really wasn't, you know, although in the past they, there had been some interest with some dermatology and other practices. Right now, they're not really interested in buying private practices. And after that, then I started looking at private equity-based groups primarily.

And you know, there's a, a few that are in California and then there's a few more that are, that want to come to California. So, you know, we went through a, a number of different groups and kind of vetted them to see what was going to be the best fit.

Catherine Maley, MBA: But how would you know, like, do you, this is so, new for you. How did this affect your decision on selling but staying in your practice?

How did you know what you were looking for? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, there's certain things, you know, that I wanted in the deal that, you know, were important to me, and there was, and it varies between the different groups as to who's willing to do what. And there's also, you know, there's a difference between the groups.

You know, you, you know, when you meet people there's a difference between people who are running the group and whether you, you feel that that's going to be a good fit for you. To me it was important that things were ran as smoothly as possible after the close of the deal, as it had before the deal.

So, spent a lot of time trying to get to know the people and. And kind of like what their thought process was and how things would've worked out. I wanted things to be similar for not just myself, but the other doctors and my staff and my patients. So, that was kind of important to me. And, you know, other, other factors were also important to me.

And, you know, for example, things like you know, whether or not stock was available, they felt if I was going to help their company grow, I wanted. To benefit from that to some degree. I wanted to have my cash up, you know, at the time of close. I didn't want to have 20% of it or whatever dangled out there for several years for somebody else to decide whether or not I get it.

And things like that.

Catherine Maley, MBA: That's a really interesting point because we've been talking a lot about private equity. You didn't go with private equity; you went with a physician based led. What is it? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, no, it is. It is a private equity group. Generally, all of the private equity groups have a physician board and physician president.

Because in order to practice of medicine, they have to have a physician as their leader. But it's a business. And when I talk to people about it, I try to make it clear that This, this is, these people are, it's a company, it's a, and they want to, they want to get a return on their investment.

Mm-hmm. They want to get the best deal that they can. And so, you know, I think that best thing a person can do is make sure that you have a good accountant and a good attorney, both of which are well versed and well experienced in mergers and acquisitions, especially in healthcare. Because you want people on your team that have done this a lot before and know what's right and what isn't right, what all the tricks are, and what's the proper thing, so, that you're well represented.

Catherine Maley, MBA: That's a really good pearl. Not just legal, but somebody who really specializes in m and a for healthcare, right? Like that's pretty specific. And is there a reason you went with such a big group? Do you, does that feel more, I don't know certain, when you, I mean, that's a really big group that you went with. How did this affect your decision on selling but staying in your practice?

Did, did that make you feel more secure that they had more money? That they, because you're saying that you got a pretty good, it sounds like you got a pretty good cash outlay, right? It's from the get go. Because usually there's a lot of dangling on the back end, you know? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, I mean, pretty good is all relative.

So, so, you know, it's, like I said, it wasn't the, the main, my main interest was to set something up for an exit strategy. Mm-hmm. So, that my, my, I would be safe, my patients would be safe, my staff would have jobs and stuff like that. We wouldn't have to worry about stuff. So, the number one thing was I wanted to be certain that things were going to be stable.

So, yeah, I guess having a. A larger group associated with it. You don't have to worry quite so, much about financial issues. We were really the second group that they had they had purchased in California, so, mm-hmm. They were brand new to the West coast and you know, they're still...they're looking and meeting with other groups now and doing deals with other groups right now.

But the main thing was that, you know, I wanted what I considered to be a fair price for my practice. And I wanted some of those other things I talked about, and I wanted to feel like things were going to be as close to where it was after the deal. As it was before the deal.

Catherine Maley, MBA: Exactly. By the way, what were they looking for? How did this affect your decision on selling but staying in your practice?

But did, did you, do you own your building or was it just a long lease that they liked? Or what were they, why did you look attracted to them? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, you know, the Dermatology's been kind of a target for private equity groups for a number of years now. And they, they like dermatology because they have skin cancer, they have dermatopathology and dermatopathology labs, and then they also have cosmetic.

And they feel that, you know, that's, you know, they can do well, that they can, they can do well in their business model with those things. So, So, I mean they're, you know, we have a pretty, you know, robust, good sized dermatology practice with three different offices. So, that was probably attracted to them.

You know, we, I do a fair amount of MO surgery. We have dermpath, we have people doing cosmetics, so, those are the things probably we're attracted to them.

Catherine Maley, MBA: For sure. And then were several groups kind of courting you or can you play them off of each other? Was that a strategy? I'm just so, many surgeons or surgeons are looking at this saying, I don't even know who to talk to. How did this affect your decision on selling but staying in your practice?

Like, where do you even begin? Any advice on that? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: I don't want to say you can play off of them, but you can get a, an idea about what each is going to be offering and. Maybe you can get an idea from a couple at the same time. But once you sign an LOI, a letter of intent, you're really just, you're, you're planning to get married to one, so, you can't keep playing that.

So, I'd say you can get an idea from the different groups and then go with one over the other, or two. You can talk to two or three at one time. But I, you know, it gets kind of, Confusing and complicated when you start doing more than that because you know, you're sharing part of your, you know, you have to share your me your business records and everything.

And you want to kind of keep everybody straight so, you can get a pretty good idea. But you can also get an idea early on about whether you want to work with this particular group or whether you feel comfortable, you know, you're going to be communicating with these people afterwards and whether that's going to be a good fit or not.

That'll screen some people out.

Catherine Maley, MBA: I check them out online and they say it looks like they take over HR, legal, marketing, scheduling. Do they do all of that or just if you're comfortable doing that, what did they take over for you that you no longer have to settle with? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, ultimately, they take over all of that stuff.

You know, it's their practice. So, and for the most part, you know, again, different groups are different. So, me are going to want to brand your o office. So, me of them don't really care, although they may have like a tagline, bra a branding of it. Right. So, it just kind of depends on the individual, but most of them are going to want things to kind of fit like their other groups.

So, we had not, we did not have electronic health records before we sold. Oh. But within about five months after we did. They're, they're planning, you know, I think they're doing some centralized billing, centralized scheduling, things like that. But we still have some scheduling and little bit of billing and stuff too.

But the, the whole idea is that they, by converting to what they have, is that's they're going to make, do a better on their return on investment.

Catherine Maley, MBA: So, how long has it been by the way that they've been on board? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Like a year and. Four or five months, something like that.

Catherine Maley, MBA: Okay. How difficult was the transition Or how easy was it? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: It wasn't bad at all. I mean, honestly, I mean, because again, for me it was kind of an exit strategy. I mean, when you're the sole owner, you know, I make all the decisions and if something needs to get done, then we get it done. So, now decisions have to kind of go through a different type of hierarchy or.

You know, decision tree or something. And that's fine by me because I've given up some, a lot of the headache stuff that I've had to deal with as the, as the owner in the past. So, what, what has what I've given up on is made up for by the things that make my life a little easier.

Catherine Maley, MBA: So, no regrets of losing control? Because I don't know many surgeons who, who I mean, there's a reason you're in solo practice usually.

You like control, you like to do things your way. Was that a transition for you? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, I mean, I'm not solo practice. I'm so, I was a solo loner, but so, not, not particularly difficult. I mean, you know, yeah, it's, it's different but I enjoy kind of being where, in the same seat where my associates have been for all these years, you know, where I come in and take good care of my patients and go home and I don't have to worry about the little things and stuff.

Catherine Maley, MBA: So, how does the agreement work? You, you still need to stay a, a while, correct? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah. You know, basically these companies are buying. A business they don't want, you know, if, if you're a big part of that business, they don't want you disappearing like six months after the deal is done. So, it really varies, you know, group to group and you know, private equity group to private equity group, and it differs from practice to practice.

If I was a solo practitioner by myself and somebody bought me, I would think that they would want me to stick around for a longer period of time because I'm the practice. Mm-hmm. And it'd be harder to replace me and harder for them to get a return on investment. So, it just makes sense for them to, you know, keep people long enough so, that they get their return on investment and it doesn't disrupt things.

So, It really varies, you know, how long the groups will want you to be on. If you're a very large group, then you're maybe not quite as important, but they still want you to be around for a period of time.

Catherine Maley, MBA: Can you say how long? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, it really varies. I mean practice to practice and everything. I mean, some of them are three years, some of them are five years, some may be somewhere in between or more or less, I'm not sure, but somewhere around there probably.

Catherine Maley, MBA: Let me ask it this way. Is it more financially good for you to stay put? The longer you stay, the more money you make? Is it like that? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Not necessarily. I mean, you know again, the company wants to get, make their profit, so, I don't have control over overhead like I did before. Quite so, much. You know, they have decisions that they make about doing this or doing that, so, I'd say, you know, as an exit strategy, I think it makes sense.

If you were like brand new and, you know, started working five years ago, when you're thinking that, okay I'm going to sell and then I'm going to work for these people for 20 years, that might be a little bit more of a challenge. But you know and there are sometimes young people that do that, or maybe they sell and then they.

Work, their commitment and then they move outside of the restrictive covenant. But for me it was a good fit as an exit strategy.

Catherine Maley, MBA: If you did want to walk away sooner than planned, can you, like legally, does everything blow up or is there a way out if you wanted it? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: I haven't really evaluated that.

I'm trying to avoid any reason why I would stop, stop working. So, for me it's about, you know, I'll continue working, you know, I have a contract with them, and if after that period of time they want me to stay on and I'm enjoying what I'm doing, then I may stick, stay around, or I may negotiate it another contract and stay around.

But I'm just kind of playing it by ear and seeing how things go. But I mean, if you leave, then. The company has is, is going to make, it'll be more difficult for them to get their return on investment. They've already put money up front, so, they're going to want to get some of that, that money back, I would imagine.

But I'm trying not to find out about that. I guess so.

Catherine Maley, MBA: Okay. I'm really curious about when you transitioned, how, how did it affect the staff and your other physicians? Was there a change in attitude? Was there a turnover? What happened with everyone? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: All the, all the doctors that were there before are still there, with the exception of one doctor who.

Left, not so, much related to the company, but left a little while after he was kind of a part-time person. Other than that, everybody stayed. My staff, the ones that work around me anyway, are all still there. For the most part. I mean, maybe one person's left. So, it hasn't really changed much.

And when I sold, I wanted to make sure that I was communicating with my referral doctors. About what was going on and that I wasn't leaving and that I was still going to be here, and that things weren't going to change, and if there's any problem to gimme a call or text me or something. So, I wanted to make sure that everything still went as well as possible.

Catherine Maley, MBA: So, would you say like what percentage of your business is referral based? Because now I see what you're saying because I was thinking if you're such a big practice, why would it matter if you left or not? But it's your referral base that they're interested in, is that right? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, well, they're, they're interested in having somebody who brings money, you know, a decent amount of money into the practice to stick around.

So, there's another most surgeon in the practice. Who's been there for about a few years now, and we try to feed him as many of the in-house referrals as possible. I mean, there's still a fair number of patients that want to see me. Mm-hmm. And the vast majority of my practice is referral from outside of the walls of the building and stuff.

So, it's, it's not related as the company's concern wasn't necessarily the referrals from outside, they just want. People that are generating a good income to stick around, whether it's me or whether it's the other most surgeon.

Catherine Maley, MBA: So, they really like the most part, right? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well yeah, because it's skin cancer and it's you know, it's one of those things that in good economies and not so, good economies, there's still going to be skin cancer.

You know, the downside is you're dependent on insurance commercial carriers, you know, are not paying like what they did 10 or 20 years ago and they have to deal with that. And but yeah, you know, business of skin cancer is, is attractive. Just like the other things like cosmetic and the derm path.

Yeah.

Catherine Maley, MBA: And, Did the facial plastic surgeon stay put or was he just a plastic surgeon? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, no, he's, he, he's facial plastics and yeah, he's still working there at as before and I'm hoping that he'll get busier with you know, the addition of other groups, you know, that this company is going to try to bring on board as well.

So, hopefully he'll get busier with that as well.

Catherine Maley, MBA: Well, you were also offering a lot of cosmetic nonsurgical treatments. Was that, did that play a part in this? Was that valuable to them? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: I think, yeah. I think all of it comes into play and is in interesting to them. You know, they have, like, as you point out, it's fairly good size company, new to California.

So, they have other groups that do that. Other dermatology groups, I think they do have some other facial plastics people in, in the, in the company too. But more consistently it's a lot of dermatology stuff and the kind of cosmetic things that dermatologists do.

Catherine Maley, MBA: So, what's the best part about this transaction? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: For me, like I said, it's that I get to go home and not worry about the, the crazy little things or worry about payroll or worry about you know, dealing with HR issues, you know, employee issues and, you know, in a state like California, that's, that's not a bad thing to have to give up and stuff.

So, like I said, for me, it's the best part, I guess, is the security, knowing that, you know, I don't have to worry about that stuff or that my family wouldn't have to worry about it

Catherine Maley, MBA: And then what's the worst part about this transaction? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, you know, I don't control everything anymore, so, you know, it's, That's, that's the worst part.

So, it's kind of like, it's, it's, they're both related. Yeah. So, but I'm okay with that. You know, like I said, I've, I've, I've been the person that was in charge of everything for almost 30 years and sound like a good time to you know, hand over the reins to somebody else.

Catherine Maley, MBA: And no regrets? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: No.

Catherine Maley, MBA: Nice. Any advice for somebody else thinking about this? How did this affect your decision on selling but staying in your practice?

Even if they're you know, usually I work with plastic surgeons, but any advice with that, with, for that?

Andrew Kaufman, MD: You know, kind of is you know, number one would be you know, bet your potential buyers. You know, you want to make sure you understand these people. These are the people that after the deal you're going to be asking for things or talking to them about things.

So, make sure that you can see yourself working with these people. Number two is you know, I guess number two, I think a really important thing is to understand that when you get to the point where you're signing an LOI, a letter of intent, if it's not in the LOI, it's really hard to get it afterwards.

So, let's say you want to have. Your consultation room still all yours for when, when you're there five days a week or whatever, let's say you want to have two, two nurses of similar quality working with you all the time. Let's say that you want whatever the same number of days of vacation or whatever it is, or, you know, make sure it's in the LOI.

And again, you know, a good attorney who's experienced in mergers and acquisitions. Should, should know that and should tell you that. I mean, I learned that from listening to a lecture once in, in a, in a dermatology or dermatologic surgery lecture. And I just think it's a really good advice. So, I think that's important.

You know, think about what you're going to want your practice to be like and make sure that make sure that it's, it's good for you, it's good for your associate positions if you have associates. And it's good for your staff and your patients too. You know, you don't want to sell and then be miserable or have your staff miserable or your patients miserable.

So, make sure that they're going to pay, you know, your staff and your, and, and not going to try to make things more challenging for your patients. Make sure that your doctors can get ahold of you and everything afterwards.

Catherine Maley, MBA: Has your golf game improved since you've transitioned? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: You would've thought you would've thought so.

Maybe when I ultimately retire, re retire, maybe when I ultimately retire, I'll be able to fix that. But right now, I'm basically better at Mohs reconstruction than I am at golf and, okay.

Catherine Maley, MBA: Good to know. And the last question, just out of sheer curiosity, tell us something we don't already know about you.

Andrew Kaufman, MD: Well, I mean, I collect medical, surgical and apothecary.

Antiques.

Catherine Maley, MBA: Is that what's behind you? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, that's part of it.

Catherine Maley, MBA: Wow, okay. That's unusual. I haven't heard that before

Andrew Kaufman, MD: There you go. So, yeah, so, anything from surgical sets to antique stethoscopes to massages, which are wax models, do books, textbooks related, you know, things like that. Like how far back. I have a pretty good collection, so, you know, I have.

You know, I, I probably don't buy much anymore unless it's like 18th century or something or something really special. Yeah. So, from the 17 hundreds, which is a long time ago, and those things are fewer and far between. But yeah, it's kind of fun and you know, as a physician it's kind of fun to you know, appreciate that, that stuff and appreciate how things have changed in just the last a hundred years or so.

Catherine Maley, MBA: Right. So, fascinating. Well, thank you so, much. If anybody wanted to talk with you, how would they get ahold of you?

Andrew Kaufman, MD: My best option is probably to, to reach out by telephone, you know, at my office (805) 497-1694. And like I said, best option is "find yourself". Don't necessarily go with your accountant or your attorney.

Find somebody that's going to represent you well and Come up with a good game plan and make sure that you're protected and they're taking good care of you.

Catherine Maley, MBA: Excellent advice. Thank you so, much, Dr. Kaufman,

Catherine Maley, MBA: All right, thank you so, much.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on selling but staying in your practice.

If you’ve got any questions or feedback for Dr. Kaufman, you can reach out to his website at, www.forefrontdermatology.com.

A big thanks to Dr. Kaufman for sharing his experience on the topic of, “selling but staying in your practice”.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

The fastest way to success is to model other successful surgeons who have what you want, but you can only see their results, not the path they took to get there.

So, you continue to jump from one thing to another, hoping to find something that will work for you too, but it rarely does. So, try this shortcut instead. It’s guaranteed to move you forward. I compiled my intellectual property to grow cosmetic revenues, everything I’ve gleaned over the years into one playbook of the most successful practices and what they do to win.

Go to www.CosmeticPracticeVault.com and let’s grow your cosmetic revenue.

-End transcript for “Selling but Staying in Your Practice — with Andrew Kaufman, MD”.

#plasticsurgeonmarketing #cosmeticsurgeonmarketing #podcast #aestheticpracticemarketing #stafftraining #cosmeticsurgeonbusinesscoaching #plasticsurgeonbusinesscoaching #strategiesforsurgeons #morepatientsmoreprofits #aestheticsurgeonbusinesscoaching #medspabusinesscoaching #medspamarketinghelp #cosmeticsurgeonmarketinghelp #howtogetmorepatients #plasticsurgeonmarketinghelp #aestheticpracticemarketinghelp #beautyandthebiz #podcastforplasticsurgeons #podcastforcosmeticsurgeons #catherinemaley #catherinemaleymba

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and selling but staying in your practice.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "Selling but Staying in Your Practice — with Andrew Kaufman, MD".

This week’s Beauty and the Biz Podcast is an interview with Dr. Andrew Kaufman, a board-certified dermatologist specializing in Mohs, dermatologic and cosmetic surgery in Thousand Oaks, CA for over 28 years.

He built a nice size practice with several doctors under him plus 40 staff and a lot of accounts receivable.

And, like others who have put decades into building their practices, he was searching for an exit plan that made financial and emotional sense to him.

Dr. Kaufman recently sold his practice to a big private equity derm group known as Forefront Dermatology so we talked about the specifics of that transaction.

We discussed:

  • Why he was ready to sell
  • What made his practice attractive to buy
  • How his associates and staff reacted
  • What it’s like to sell yet stay in the practice as an employee

He offered great advice on how to set yourself up to sell, how much time it takes to prepare and who to get help from to negotiate the best scenario for you.

Visit Dr. Kaufman’s website

P.S. Please review!

📲 If you’re thinking about making a change and could use a different perspective, let’s talk. Schedule a Free 30-Minute strategy call with me at: https://www.catherinemaley.com/apply/

✔️ STAY UPDATED!

🤝 LET'S CONNECT! 🤝

Transcript:

Selling but Staying in Your Practice

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and selling but staying in your practice. I'm your host, Catherine Maley, author of "Your Aesthetic Practice, what your patients are saying", as well as consultant to plastic surgeons to get them more patients and more profits. Now, today's episode is a little different.

It's Dr. Andrew Kaufman. Now, he's a board- certified dermatologist specializing in Mohs dermatologic and cosmetic surgery in Thousand Oaks, California, and he has been practicing for over 28 years. He’s also very knowledgeable on the topic of selling but staying in your practice.

Now, dr. Kaufman is a recognized expert in Mohs and reconstructive surgery and author of numerous publications on facial reconstruction following skincare surgery, skin cancer surgery, as well as a frequently invited speaker at national and international meetings.

Now, I wanted to talk to him because he recently sold his practice, and we've been talking about that a lot lately. Like, how do you walk away from a practice? So, I wanted to get his take on it because his practice is now known as Forefront Dermatology.

So, we're going to talk about the specifics of that transaction. Dr. Kaufman, welcome to Beauty and the Biz.

Andrew Kaufman, MD: Thanks, Catherine. It's good to be with you.

Catherine Maley, MBA: Thanks so, much. So, let, why don't you just start by describing your practice before you sold it or partnered, or whatever you want to call it. What was your practice consisting of? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, my practice is primarily in Thousand Oaks in Santa Barbara and I had moved to that area about 28, 29 years ago. After I'd completed a moose Fellowship at UC San Francisco and joined a general medical dermatologist, I knew pretty well that I, I would do well in the area because there weren't many, there weren't any moose surgeons at the time in the area and, I had done residencies in dermatology down there and residency in internal medicine.

So, I knew primary care physicians and dermatologists, and I knew there was a need for a Mohs surgeon. So, I was able to build up over time. I bought his practice and then we added additional dermatologists over time to the point where there's approximately five or six general medical dermatologists and a facial plastic surgeon who also does.

You know, facelifts, Mohs and rhinoplasties blepharoplasties, whatever's necessary that the other doctors aren't doing. So, that's pretty much what my practice had been before I started considering you know, an exit strategy. And did you have a pathology lab? We didn't have a laboratory. We do have a board-certified dermatopathologist who's read all of our slides since she's been there for the last.

Eight to 10 years probably.

Catherine Maley, MBA: Gotcha. Now, how many staff did you have? So, you had five D, five dermatologists, plus you plus, yeah. Facial plastics. How many staff? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: It's somewhere between 30 and 40, somewhere around there. Probably, maybe a little more.

Catherine Maley, MBA: Yeah. Who is managing all of this? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, you know, over time there's a number of different administrators or managers that I'd worked with and So, me very good and some not quite as good.

I was fortunate in the latter part of my career as a, as a practice owner that I had a very good one administrator who kind of helped me through the processes that I was going through.

Catherine Maley, MBA: And what was your biggest challenge, would you say? Running solo practice. How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, you know, in California it isn’t easy to make a living and stuff.

Things are expensive. HR, you know, human resources. Employees are expensive. Doctors are expensive. Health insurance is expensive, but at the same time, reimbursement from commercial carrier insurances continues to go downward. So, I think the biggest challenge is, is running a business when expenses keep going up, but reimbursement keeps going down.

Catherine Maley, MBA: Right? So, now it's somehow what got on your radar? Like what did the, this what's it called? Forward dermatology. How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Forefront Dermatology.

Catherine Maley, MBA: Forefront Dermatology. How did they get on your radar, and were you even thinking about. Your exit strategy? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, I mean, the whole point was, you know, I've been doing this close to 30 years and I'm the sole, you know practice owner.

So, I kind of had to come up with a, an exit strategy that made sense. I didn't want to develop. You know, an illness or die or get injured or something that was going to seriously impair the practice. And so, I started considering exit strategies and first, the first option would've been, could have been, you know, selling to my associates.

They weren't interested really, you know, part of its kind of a generational thing. Nowadays a lot of people. Aren't really looking, they're not particularly entrepreneurial, and they would rather come in work and go home which is fine. I respect that. But they weren't really interested. And then second option is I looked at also was academic centers like UCLA and USC Cedar Sinai and Stanford to see if they had any interest in having a satellite you know, dermatology office and ambulatory surgery center.

In Thousand Oaks in Santa Barbara. And there really wasn't, you know, although in the past they, there had been some interest with some dermatology and other practices. Right now, they're not really interested in buying private practices. And after that, then I started looking at private equity-based groups primarily.

And you know, there's a, a few that are in California and then there's a few more that are, that want to come to California. So, you know, we went through a, a number of different groups and kind of vetted them to see what was going to be the best fit.

Catherine Maley, MBA: But how would you know, like, do you, this is so, new for you. How did this affect your decision on selling but staying in your practice?

How did you know what you were looking for? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, there's certain things, you know, that I wanted in the deal that, you know, were important to me, and there was, and it varies between the different groups as to who's willing to do what. And there's also, you know, there's a difference between the groups.

You know, you, you know, when you meet people there's a difference between people who are running the group and whether you, you feel that that's going to be a good fit for you. To me it was important that things were ran as smoothly as possible after the close of the deal, as it had before the deal.

So, spent a lot of time trying to get to know the people and. And kind of like what their thought process was and how things would've worked out. I wanted things to be similar for not just myself, but the other doctors and my staff and my patients. So, that was kind of important to me. And, you know, other, other factors were also important to me.

And, you know, for example, things like you know, whether or not stock was available, they felt if I was going to help their company grow, I wanted. To benefit from that to some degree. I wanted to have my cash up, you know, at the time of close. I didn't want to have 20% of it or whatever dangled out there for several years for somebody else to decide whether or not I get it.

And things like that.

Catherine Maley, MBA: That's a really interesting point because we've been talking a lot about private equity. You didn't go with private equity; you went with a physician based led. What is it? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, no, it is. It is a private equity group. Generally, all of the private equity groups have a physician board and physician president.

Because in order to practice of medicine, they have to have a physician as their leader. But it's a business. And when I talk to people about it, I try to make it clear that This, this is, these people are, it's a company, it's a, and they want to, they want to get a return on their investment.

Mm-hmm. They want to get the best deal that they can. And so, you know, I think that best thing a person can do is make sure that you have a good accountant and a good attorney, both of which are well versed and well experienced in mergers and acquisitions, especially in healthcare. Because you want people on your team that have done this a lot before and know what's right and what isn't right, what all the tricks are, and what's the proper thing, so, that you're well represented.

Catherine Maley, MBA: That's a really good pearl. Not just legal, but somebody who really specializes in m and a for healthcare, right? Like that's pretty specific. And is there a reason you went with such a big group? Do you, does that feel more, I don't know certain, when you, I mean, that's a really big group that you went with. How did this affect your decision on selling but staying in your practice?

Did, did that make you feel more secure that they had more money? That they, because you're saying that you got a pretty good, it sounds like you got a pretty good cash outlay, right? It's from the get go. Because usually there's a lot of dangling on the back end, you know? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, I mean, pretty good is all relative.

So, so, you know, it's, like I said, it wasn't the, the main, my main interest was to set something up for an exit strategy. Mm-hmm. So, that my, my, I would be safe, my patients would be safe, my staff would have jobs and stuff like that. We wouldn't have to worry about stuff. So, the number one thing was I wanted to be certain that things were going to be stable.

So, yeah, I guess having a. A larger group associated with it. You don't have to worry quite so, much about financial issues. We were really the second group that they had they had purchased in California, so, mm-hmm. They were brand new to the West coast and you know, they're still...they're looking and meeting with other groups now and doing deals with other groups right now.

But the main thing was that, you know, I wanted what I considered to be a fair price for my practice. And I wanted some of those other things I talked about, and I wanted to feel like things were going to be as close to where it was after the deal. As it was before the deal.

Catherine Maley, MBA: Exactly. By the way, what were they looking for? How did this affect your decision on selling but staying in your practice?

But did, did you, do you own your building or was it just a long lease that they liked? Or what were they, why did you look attracted to them? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, you know, the Dermatology's been kind of a target for private equity groups for a number of years now. And they, they like dermatology because they have skin cancer, they have dermatopathology and dermatopathology labs, and then they also have cosmetic.

And they feel that, you know, that's, you know, they can do well, that they can, they can do well in their business model with those things. So, So, I mean they're, you know, we have a pretty, you know, robust, good sized dermatology practice with three different offices. So, that was probably attracted to them.

You know, we, I do a fair amount of MO surgery. We have dermpath, we have people doing cosmetics, so, those are the things probably we're attracted to them.

Catherine Maley, MBA: For sure. And then were several groups kind of courting you or can you play them off of each other? Was that a strategy? I'm just so, many surgeons or surgeons are looking at this saying, I don't even know who to talk to. How did this affect your decision on selling but staying in your practice?

Like, where do you even begin? Any advice on that? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: I don't want to say you can play off of them, but you can get a, an idea about what each is going to be offering and. Maybe you can get an idea from a couple at the same time. But once you sign an LOI, a letter of intent, you're really just, you're, you're planning to get married to one, so, you can't keep playing that.

So, I'd say you can get an idea from the different groups and then go with one over the other, or two. You can talk to two or three at one time. But I, you know, it gets kind of, Confusing and complicated when you start doing more than that because you know, you're sharing part of your, you know, you have to share your me your business records and everything.

And you want to kind of keep everybody straight so, you can get a pretty good idea. But you can also get an idea early on about whether you want to work with this particular group or whether you feel comfortable, you know, you're going to be communicating with these people afterwards and whether that's going to be a good fit or not.

That'll screen some people out.

Catherine Maley, MBA: I check them out online and they say it looks like they take over HR, legal, marketing, scheduling. Do they do all of that or just if you're comfortable doing that, what did they take over for you that you no longer have to settle with? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, ultimately, they take over all of that stuff.

You know, it's their practice. So, and for the most part, you know, again, different groups are different. So, me are going to want to brand your o office. So, me of them don't really care, although they may have like a tagline, bra a branding of it. Right. So, it just kind of depends on the individual, but most of them are going to want things to kind of fit like their other groups.

So, we had not, we did not have electronic health records before we sold. Oh. But within about five months after we did. They're, they're planning, you know, I think they're doing some centralized billing, centralized scheduling, things like that. But we still have some scheduling and little bit of billing and stuff too.

But the, the whole idea is that they, by converting to what they have, is that's they're going to make, do a better on their return on investment.

Catherine Maley, MBA: So, how long has it been by the way that they've been on board? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Like a year and. Four or five months, something like that.

Catherine Maley, MBA: Okay. How difficult was the transition Or how easy was it? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: It wasn't bad at all. I mean, honestly, I mean, because again, for me it was kind of an exit strategy. I mean, when you're the sole owner, you know, I make all the decisions and if something needs to get done, then we get it done. So, now decisions have to kind of go through a different type of hierarchy or.

You know, decision tree or something. And that's fine by me because I've given up some, a lot of the headache stuff that I've had to deal with as the, as the owner in the past. So, what, what has what I've given up on is made up for by the things that make my life a little easier.

Catherine Maley, MBA: So, no regrets of losing control? Because I don't know many surgeons who, who I mean, there's a reason you're in solo practice usually.

You like control, you like to do things your way. Was that a transition for you? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: So, I mean, I'm not solo practice. I'm so, I was a solo loner, but so, not, not particularly difficult. I mean, you know, yeah, it's, it's different but I enjoy kind of being where, in the same seat where my associates have been for all these years, you know, where I come in and take good care of my patients and go home and I don't have to worry about the little things and stuff.

Catherine Maley, MBA: So, how does the agreement work? You, you still need to stay a, a while, correct? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah. You know, basically these companies are buying. A business they don't want, you know, if, if you're a big part of that business, they don't want you disappearing like six months after the deal is done. So, it really varies, you know, group to group and you know, private equity group to private equity group, and it differs from practice to practice.

If I was a solo practitioner by myself and somebody bought me, I would think that they would want me to stick around for a longer period of time because I'm the practice. Mm-hmm. And it'd be harder to replace me and harder for them to get a return on investment. So, it just makes sense for them to, you know, keep people long enough so, that they get their return on investment and it doesn't disrupt things.

So, It really varies, you know, how long the groups will want you to be on. If you're a very large group, then you're maybe not quite as important, but they still want you to be around for a period of time.

Catherine Maley, MBA: Can you say how long? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, it really varies. I mean practice to practice and everything. I mean, some of them are three years, some of them are five years, some may be somewhere in between or more or less, I'm not sure, but somewhere around there probably.

Catherine Maley, MBA: Let me ask it this way. Is it more financially good for you to stay put? The longer you stay, the more money you make? Is it like that? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Not necessarily. I mean, you know again, the company wants to get, make their profit, so, I don't have control over overhead like I did before. Quite so, much. You know, they have decisions that they make about doing this or doing that, so, I'd say, you know, as an exit strategy, I think it makes sense.

If you were like brand new and, you know, started working five years ago, when you're thinking that, okay I'm going to sell and then I'm going to work for these people for 20 years, that might be a little bit more of a challenge. But you know and there are sometimes young people that do that, or maybe they sell and then they.

Work, their commitment and then they move outside of the restrictive covenant. But for me it was a good fit as an exit strategy.

Catherine Maley, MBA: If you did want to walk away sooner than planned, can you, like legally, does everything blow up or is there a way out if you wanted it? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: I haven't really evaluated that.

I'm trying to avoid any reason why I would stop, stop working. So, for me it's about, you know, I'll continue working, you know, I have a contract with them, and if after that period of time they want me to stay on and I'm enjoying what I'm doing, then I may stick, stay around, or I may negotiate it another contract and stay around.

But I'm just kind of playing it by ear and seeing how things go. But I mean, if you leave, then. The company has is, is going to make, it'll be more difficult for them to get their return on investment. They've already put money up front, so, they're going to want to get some of that, that money back, I would imagine.

But I'm trying not to find out about that. I guess so.

Catherine Maley, MBA: Okay. I'm really curious about when you transitioned, how, how did it affect the staff and your other physicians? Was there a change in attitude? Was there a turnover? What happened with everyone? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: All the, all the doctors that were there before are still there, with the exception of one doctor who.

Left, not so, much related to the company, but left a little while after he was kind of a part-time person. Other than that, everybody stayed. My staff, the ones that work around me anyway, are all still there. For the most part. I mean, maybe one person's left. So, it hasn't really changed much.

And when I sold, I wanted to make sure that I was communicating with my referral doctors. About what was going on and that I wasn't leaving and that I was still going to be here, and that things weren't going to change, and if there's any problem to gimme a call or text me or something. So, I wanted to make sure that everything still went as well as possible.

Catherine Maley, MBA: So, would you say like what percentage of your business is referral based? Because now I see what you're saying because I was thinking if you're such a big practice, why would it matter if you left or not? But it's your referral base that they're interested in, is that right? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, well, they're, they're interested in having somebody who brings money, you know, a decent amount of money into the practice to stick around.

So, there's another most surgeon in the practice. Who's been there for about a few years now, and we try to feed him as many of the in-house referrals as possible. I mean, there's still a fair number of patients that want to see me. Mm-hmm. And the vast majority of my practice is referral from outside of the walls of the building and stuff.

So, it's, it's not related as the company's concern wasn't necessarily the referrals from outside, they just want. People that are generating a good income to stick around, whether it's me or whether it's the other most surgeon.

Catherine Maley, MBA: So, they really like the most part, right? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well yeah, because it's skin cancer and it's you know, it's one of those things that in good economies and not so, good economies, there's still going to be skin cancer.

You know, the downside is you're dependent on insurance commercial carriers, you know, are not paying like what they did 10 or 20 years ago and they have to deal with that. And but yeah, you know, business of skin cancer is, is attractive. Just like the other things like cosmetic and the derm path.

Yeah.

Catherine Maley, MBA: And, Did the facial plastic surgeon stay put or was he just a plastic surgeon? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, no, he's, he, he's facial plastics and yeah, he's still working there at as before and I'm hoping that he'll get busier with you know, the addition of other groups, you know, that this company is going to try to bring on board as well.

So, hopefully he'll get busier with that as well.

Catherine Maley, MBA: Well, you were also offering a lot of cosmetic nonsurgical treatments. Was that, did that play a part in this? Was that valuable to them? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: I think, yeah. I think all of it comes into play and is in interesting to them. You know, they have, like, as you point out, it's fairly good size company, new to California.

So, they have other groups that do that. Other dermatology groups, I think they do have some other facial plastics people in, in the, in the company too. But more consistently it's a lot of dermatology stuff and the kind of cosmetic things that dermatologists do.

Catherine Maley, MBA: So, what's the best part about this transaction? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: For me, like I said, it's that I get to go home and not worry about the, the crazy little things or worry about payroll or worry about you know, dealing with HR issues, you know, employee issues and, you know, in a state like California, that's, that's not a bad thing to have to give up and stuff.

So, like I said, for me, it's the best part, I guess, is the security, knowing that, you know, I don't have to worry about that stuff or that my family wouldn't have to worry about it

Catherine Maley, MBA: And then what's the worst part about this transaction? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Well, you know, I don't control everything anymore, so, you know, it's, That's, that's the worst part.

So, it's kind of like, it's, it's, they're both related. Yeah. So, but I'm okay with that. You know, like I said, I've, I've, I've been the person that was in charge of everything for almost 30 years and sound like a good time to you know, hand over the reins to somebody else.

Catherine Maley, MBA: And no regrets? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: No.

Catherine Maley, MBA: Nice. Any advice for somebody else thinking about this? How did this affect your decision on selling but staying in your practice?

Even if they're you know, usually I work with plastic surgeons, but any advice with that, with, for that?

Andrew Kaufman, MD: You know, kind of is you know, number one would be you know, bet your potential buyers. You know, you want to make sure you understand these people. These are the people that after the deal you're going to be asking for things or talking to them about things.

So, make sure that you can see yourself working with these people. Number two is you know, I guess number two, I think a really important thing is to understand that when you get to the point where you're signing an LOI, a letter of intent, if it's not in the LOI, it's really hard to get it afterwards.

So, let's say you want to have. Your consultation room still all yours for when, when you're there five days a week or whatever, let's say you want to have two, two nurses of similar quality working with you all the time. Let's say that you want whatever the same number of days of vacation or whatever it is, or, you know, make sure it's in the LOI.

And again, you know, a good attorney who's experienced in mergers and acquisitions. Should, should know that and should tell you that. I mean, I learned that from listening to a lecture once in, in a, in a dermatology or dermatologic surgery lecture. And I just think it's a really good advice. So, I think that's important.

You know, think about what you're going to want your practice to be like and make sure that make sure that it's, it's good for you, it's good for your associate positions if you have associates. And it's good for your staff and your patients too. You know, you don't want to sell and then be miserable or have your staff miserable or your patients miserable.

So, make sure that they're going to pay, you know, your staff and your, and, and not going to try to make things more challenging for your patients. Make sure that your doctors can get ahold of you and everything afterwards.

Catherine Maley, MBA: Has your golf game improved since you've transitioned? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: You would've thought you would've thought so.

Maybe when I ultimately retire, re retire, maybe when I ultimately retire, I'll be able to fix that. But right now, I'm basically better at Mohs reconstruction than I am at golf and, okay.

Catherine Maley, MBA: Good to know. And the last question, just out of sheer curiosity, tell us something we don't already know about you.

Andrew Kaufman, MD: Well, I mean, I collect medical, surgical and apothecary.

Antiques.

Catherine Maley, MBA: Is that what's behind you? How did this affect your decision on selling but staying in your practice?

Andrew Kaufman, MD: Yeah, that's part of it.

Catherine Maley, MBA: Wow, okay. That's unusual. I haven't heard that before

Andrew Kaufman, MD: There you go. So, yeah, so, anything from surgical sets to antique stethoscopes to massages, which are wax models, do books, textbooks related, you know, things like that. Like how far back. I have a pretty good collection, so, you know, I have.

You know, I, I probably don't buy much anymore unless it's like 18th century or something or something really special. Yeah. So, from the 17 hundreds, which is a long time ago, and those things are fewer and far between. But yeah, it's kind of fun and you know, as a physician it's kind of fun to you know, appreciate that, that stuff and appreciate how things have changed in just the last a hundred years or so.

Catherine Maley, MBA: Right. So, fascinating. Well, thank you so, much. If anybody wanted to talk with you, how would they get ahold of you?

Andrew Kaufman, MD: My best option is probably to, to reach out by telephone, you know, at my office (805) 497-1694. And like I said, best option is "find yourself". Don't necessarily go with your accountant or your attorney.

Find somebody that's going to represent you well and Come up with a good game plan and make sure that you're protected and they're taking good care of you.

Catherine Maley, MBA: Excellent advice. Thank you so, much, Dr. Kaufman,

Catherine Maley, MBA: All right, thank you so, much.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on selling but staying in your practice.

If you’ve got any questions or feedback for Dr. Kaufman, you can reach out to his website at, www.forefrontdermatology.com.

A big thanks to Dr. Kaufman for sharing his experience on the topic of, “selling but staying in your practice”.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at www.CatherineMaley.com, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so, you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

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-End transcript for “Selling but Staying in Your Practice — with Andrew Kaufman, MD”.

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