Fellow to Partner — with Dr. Erin Smith (Ep. 216)

Beauty and the Biz

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Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, going from fellow to partner.

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 "Fellow to Partner — with Dr. Erin Smith".

I love interviewing successful surgeons to learn what their journey was like for them to get where they are now, going from fellow to partner.

It was never a straight path and it’s always filled with pivotal moments of decision that chartered their course, when going from fellow to partner.

All of them had mentors and influencers along the way of going from fellow to partner that molded their beliefs, desires and actions they took to carve out their standing in the marketplace.

This week’s Beauty and the Biz Podcast was an interview I did with Erin Smith, MD, a facial plastic and reconstructive surgeon in private practice in Austin, TX; who went from fellow to partner.

We talked about Dr. Smith’s journey from growing up in Mississippi, then moving her husband and 3 small kids to Beverly hills to do a fellowship with Dr. Paul Nassif of the show “Botched” and Dr. Babak Azizzadeh of The Center of Advanced Facial Plastic Surgery.

Then, how she went from Beverly Hills to becoming a partner in a flourishing practice in Austin, TX, in only three years.

One big take-a-way is to immerse yourself in a thriving environment of other successful surgeons who can show you how it’s done and save you years of guessing and testing, when going from fellow to partner.

Visit Dr. Smith’s website

P.S. Please help me grow the reach of Beauty and the Biz Podcast by subscribing and or reviewing.

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Transcript:

Fellow to Partner — with Dr. Erin Smith

Catherine Maley, MBA: Hello, everyone, and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and going from fellow to partner. I'm your host, Catherine Maley, author of "Your aesthetic practice — What your patients are saying", as well as consultant to get them more patients and more profit.

Now, today's guest is partner Dr. Erin Smith, who made the journey from fellow to partner. She's a facial plastic and reconstructive surgeon partner who specializes in both cosmetic and reconstructive procedures from the neck up.

Now, Dr. Smith grew up in Mississippi, where she earned her medical degree from the University of Mississippi School of Medicine, and then completed a rigorous five-year head and neck residency program at the University of Mississippi Medical Center — all before starting her journey from fellow to partner.

She then completed a fellowship in Beverly Hills with Dr. Paul Nassif, the star of the show Botched, and Dr. Babak Azizzadeh, founder of the Facial Paralysis Institute and Center for Advanced Facial Plastic Surgery, before becoming a partner in another practice. Now, when she's not working, Dr. Smith enjoys spending time with her husband and three daughters and we'll talk more about that.

So, Dr. Smith, welcome to Beauty and the Biz. I'm excited to hear your journey of going from fellow to partner.

Dr. Erin Smith: Catherine, thank you so, much for having me on today.

Catherine Maley, MBA: Absolutely. First of all, how does a little girl grow up and say, I want to be a facial plastic surgeon and go from fellow to partner? How do you get there? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah. So, my mom is the one who exposed me to medicine. So, she, growing up was started off as a nurse.

She was a labor and delivery nurse for several years. And then she was one of the first people to go on to be a nurse practitioner. So, she through her, I got exposed to medicine and. Ultimately decided to go more of the MD route, but that she was really the one who kind of opened the doors for me. And then, you know, ultimately went to undergrad and was very interested in the brain.

So, my undergrad majors were biochemistry and psychology. And I really thought I would go more of like a neurosurgery route or something to do with the brain and then. As time went on, got into med school which I also did in Mississippi, like you mentioned, and, and we started our head and neck surgery blocks in our and you know, you're, you basically have different blocks where you're.

Dissecting different parts of the body. And I just loved, loved the face and adding, I thought it was super cool. Specifically, the facial nerve, learning about that, you know, the nerve, the facial nerve is kind of the mind body connection, how we express ourselves, show our show our emotions, speak, eat all, all of the above.

And so, I just. I like would hang out in the lab for hours and hours in that specific block. And so, I knew I had kind of a passion for that area. And then as time went on, I got, I did some rotations in the head and neck surgery some more clinical rotations. And I just loved it. I love the surgeries.

I love the people. It, this particular specialty definitely attracts a specific type of person, people that are. Want to do surgery, but we kind of are known as like the nice surgeons, you know, we're, everybody's pretty type a and hardcore, but also you know, down to earth overall. And so, I during, you know, med school kind of leaned more and more towards that.

And then ultimately decided to pursue my residency program and, and head and neck surgery residency. It's all over the map. You know, you're, you're, you're doing everything from taking out huge head and neck. tumors to trauma. And I loved it all. I really, I truly did. But I found myself really gravitating towards anything soft tissue related where I could really get, get in there and get my hands dirty.

And, you know and I loved sewing. I love just a little intricacies of that. And so, and then throughout that process was still remain interested in, in facial, the facial nerve. Learning about facial paralysis and how I could kind of integrate that into everything. And so, that's what really drew me into ultimately pursuing the fellowship.

So, I went, you know, I was living in Mississippi but did my interviews all over the country. I, you know, I wanted to really open my, and I can talk about kind of. Later, but I want to, I interviewed all over and then ultimately ended up in Beverly Hills with Dr. Aziz a day and his fellowship is just really incredible because it, it does a great job of mixing like very high-end cosmetic which you don't get that in your residency, you know, in academic setting, you're, you're doing a lot of great surgeries, but you're not really getting that, that cosmetic side as much.

And then he has such a unique. Yeah. Practice where he has a private practice where he's doing facial nerve work and reconstructive procedures of the face. So, his niche that he had out there was very intriguing to me. So, that ultimately made me pick up our whole family and I can go back and talk about kind of that process later.

But yeah, we picked up our whole family and ended up in LA and then ultimately ended up here. So, there was, it was a lot of series of small steps along the way that got me here, but. I'm super happy for where I am now. So…

Catherine Maley, MBA: All right, but let's not gloss over that. That's a big deal. How did or does this impact your journey on going from fellow to partner?

So, here you are in Mississippi, before going from fellow to partner. You've always probably lived there. How much of a sticker shock sticker shock culture shock was it to go from Mississippi to Beverly Hill? And how sure were you? You must have been so, sure to move the family there. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: I mean, I honestly never. I, you know, I knew I, I did undergrad in Mississippi because I, I love my university and I got a great, great scholarship.

I went to Ole Miss, which is a great s e c college, and I got into the honors college there. So, that was a calculated decision to stay there for undergrad. Med school came along, same thing in med school. I had, I liked to have my daughter, my third year of med school. And so, by the time it came around to apply to residency programs, she was almost one.

And I, you know, at that time I, even in residency, I, I really wanted to go away and kind of go broader, but we made it, we made a calculated decision to stay close to family during that time because we were, we just had a young baby and. I was planning to have more. I knew that at the time. So, by the time that fellowship came along, I was like, okay, I'm, I'm ready.

And so, I knew I wanted to go away and, and fellowship's just such a blink of an eye. It's a short time period. So, I knew I wanted to get a broader exposure. I probably would've gone away sooner and, and done. And, but one, I just made it a calculated decision to stay closer to where we had grandparents around.

For, for my kids and ultimately the, the university Mississippi head and neck surgery program is incredible. So, that was, it was, I interviewed all over the country, even for residency and, and wanted to end up really wanting to stay there, but just because of, I mean, Mississippi has really some of the sickest people in the country, and so, I knew I would see kind of the worst of the worst, like the pathology that I'm exposed to there, whether it be trauma related or just.

severe advanced cancer. I knew that I could really, you know, for lack of better term, get my hands dirty and be really exposed to the worst of the worst, which would ultimately make me prepared to deal with anything. And so, that I feel like staying in Mississippi for that really helped me really develop my surgical skills.

And then going out to L. A. Was how I feel like I fine tune things, you know, we're able to kind of Fine tune things. And I, and but yeah, moving, moving out there was definitely, I had lived in other cities in the South. I had lived in Atlanta. I lived in New Orleans. I, you know, wasn't always in a, in a small town, but definitely LA was, it was a sticker shock in a good way.

I absolutely loved it. Even considered staying there. Love the weather. So, I'm, I'm an outdoors person and, you know, even though my fellowship was grueling, meaning the hours were, Yeah. You know, crazy, crazy long hours, which was a good thing. Cause I learned a lot. I would come out and it would still be beautiful and sunny and perfect LA weather.

So, no matter how hard I was working, I was always in a good mood just because, you know, being, being around that, that LA sunshine and being close to the beach. So, I loved it. And, you know, again, yeah, we thought we would stay out there, but ultimately kind of landed in the middle of Austin.

Catherine Maley, MBA: Your partner husband was a-okay with it.

Because the fellowships only one year. Did you have a plan for what happens after that year? You were like, well, did you have a plan? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: So, yeah, so, my program that I was at my residency program another kind of kind of backtracking a little bit. 1 of the reasons that I. Really shows facial plastics.

My mentor, Randy Jordan he was my mentor in Mississippi and ultimately my fourth year of residency, I was really kind of leaning towards facial plastic fellowship. And he has a really cool practice where he's, you know, an academic professor at the university, but he also has a private clinic called faces where he does a lot of cosmetic procedures.

So, I was very intrigued by his case mix. Meaning that he could go do these really cool reconstructive cases and teach residents at the hospital, but then have his kind of more high-end cosmetic practice. And so, around my fourth year, I was talking to him and, and, and saying, you know, let him know, I was thinking about doing facial plastics.

Actually, I guess it was my third year. Cause you, you decide a little earlier. And that's when I started, he's, he said, he said, Aaron, there's not a lot of practices like mine. It's really hard to find where you get the best of both worlds. So, he recommended that I come and basically kind of shadow some different other doctors that, that have facial plastics practices.

So, before I made that decision to leap to do the fellowship. And so, that's when I actually came in shadow, Dr. Buckingham here, cause they, they knew each other through the academy. So, I was a third-year resident, and then I went and shouted at a doctor in Atlanta and ultimately decided that yes, this is what I wanted to do.

So, my husband and we're communicating at the time. He's a financial planner. So, he's in business. He has a CFP license. And so, starting it was a. He started working from home. Actually, maybe it was around that time period. He moved companies and he was working from home commuting once a week to into an office a few hours away, but he was working from home.

So, when it became time for me to decide where I wanted to go for fellowship. There were really no limitations, which was really nice. His company so, he was doing Zooms before, before the pandemic, before Zooms were a big thing. And so, yeah, he was, my husband was super supportive of, you know, it's, it's a short time period.

It's a, you know, one year of your life. So, we were, we were prepared to go anywhere that basically offered the best training. So, then that's really been beneficial for me throughout my career and even, you know, getting my, my, my job now that he was able to kind of transition. So, he's had this, his same job for the last 10 years, and it's been able to kind of transition where I transition.

Catherine Maley, MBA: And so, how many kids to California with you? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: So, my husband, you know, I always thought I would, I wait till, you know, after fellowship, after all of my training to have kids, that was my initial plan when I was younger. And then I met my husband and he is he's eight years older than me. And so, by the time, you know medical school came around, he's, you know, not, he's not old, but he's eight years older than me.

So, he was ready. And I, you know, entertain the idea. sooner because I was, you know, I didn't want to wait too long. And so, during medical school, I, every child, I made a very calculated decision. Okay. I'm on this research block or I'm on this rotation. And we were very lucky that we were able to, you know, conceive when we did, when we did And so, we, we started having babies, you know, my, my third year of medical school, I had a child, and then my intern year, and then my, my fourth year.

Each child, you know, it was, I think things have actually evolved. I mean, I'm not, my kids aren't that old, but I think that the way, you know, childbearing during residency, I think it's a little bit easier than it was then. I mean, for you know, For Amelia, my, my she's my, she's almost 10 now. I was luckily in med school.

I was on a research block, so, I got a good month off with her. My poor middle child, Stella, I had basically three weeks off. And the middle child always,

Catherine Maley, MBA: Yeah, yeah, I'm a middle child and I'm still recovering.

Dr. Erin Smith: We were lucky because I had, you know, again, I made the decision to stay closer to grandparents.

So, when it was time for me to go back to work, I was able to have. Grandparents and even siblings come step in for those few weeks. And then my kids were all daycare kids. And you know what, they're tough and they, they did great with it. And then my, my third child, I had my fourth year of residency.

I was on a research block. So, she's kind of my spoiled child because she got a full eight weeks. So, we have about two, two months of a research rotation where I could work from home. So, she's my, my, we call her my coddled child. Cause I actually got, you know, a real maternity leave with her. But yeah, we you know, I, I think that in life there's, there's never a good time to have kids, whether you're, whether you're in your twenties, thirties or forties, no matter what stage of your career that you're in, it's never a convenient thing to do at all.

So, I, you know, was able to, to, to work it out where I was able to do it during my training and really not hinder my, my co fellows or anything. I or co residents, I front loaded my call and, you know, there's just ways to do it that if you're. If you're smart about it, you can keep, you don't have to extend your residency or anything like that.

And my program was, was, was pretty supportive, you know, I, I still, and I think, you know, just being a woman in medicine, we're, we're, we're trained to work twice as and just to, you know, keep up. And so, if anything, you know, If anything, I worked harder the years I had kids just to make up for where people weren't, you know, thinking I was, you know, being a slacker or anything like that.

So, by the time I got to a fellowship to move to LA, my kids were my youngest. I think they were going into first grade. First grade, pre k four, and then my youngest was two. And we got very, very lucky that we found this amazing school that was a block from our house. So, it was this cute Catholic school that we went to church, the same place.

And so, I, you know, my husband would walk them to school in the morning, a block away and pick them up during the day or pick him up in the afternoon. And he was able to, you know, for the most part, you know, balance his work as well. So, we just got. Very lucky being able to get into that school.

And they had afterschool programs. So, you know, sometimes I could pick the kids up and they stayed there till, you know by four or five in the afternoon. And so, that's always been, it is just kind of Making sure we have really great childcare and, and, and people that love our kids like we do.

Catherine Maley, MBA: So, when you are, your fellowship is coming to an end, before you became a partner. How did you get, well, let's stay with California? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah.

Catherine Maley, MBA: Where did Dr. Paul Nassif fit into all of this? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah, so, the fellowship is basically, there're two main fellowship directors, Paul Nassif and Babak Azizzadeh. So, my year was the first year that we started having two fellows.

And so, when we had two fellows, we basically would rotate every two months, where I would spend two months with Dr. Nassif, two months with Dr. Azizzadeh. And so, ultimately, by the end of the year. year, you have about six months of one-on-one time with each of those two physicians. And then, you know, if they were, if Dr. Nassif was filming “Botched”, or if they were at a conference or a meeting that I wasn't going to, we would work with other doctors in Beverly Hills. So, I got to work with a lot of other great doctors, Rebecca Fitzgerald, she's a cosmetic dermatologist, who's amazing. Guy Masry, oculoplastic surgeon also.

So, I consider all of that whole group are like, they were just all amazing. The lifelong mentors. But yeah, so, with Dr. Nassif he does, you know, a lot of cosmetic aging face, but at really high-volume rhinoplasty. So, with him, I was able to get, you know, very cutting-edge rhinoplasty experience.

And then Dr. Azizzadeh leans a little bit more towards the aging phase. He does great rhinoplasty as well, but leans a little bit more towards aging face. So, it was a really great balance fellowship. And then also of course, getting that that facial nerve exposure that was just kind of a, I wanted to have a niche, you know there's a lot of facial plastic surgeons, but I wanted to have a niche that I could market myself and getting that facial nerve exposure was, was really, I think just a, one, it's a passion of mine, but to being able to have a niche of another way to.

Kind of market myself of, of something that not everyone offers. So, the fellowship was incredible. I mean, I worked my butt off. I was many, many long nights, weekends, long hours, but I wouldn't take a day of it back cause I you know, that they prepared me extremely well to be out in practice.

Catherine Maley, MBA: So, then the next big transition is getting from Beverly Hills to Buckingham facial plastics in Austin, Texas. How did or does this impact your journey on going from fellow to partner?

What's the thought process there and what was the plan? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah. So, again, you know, it doesn't, you think, oh, I stayed in, I got, had all my training in Mississippi. That's where I'm heading back. But that was never the plan that really all my decisions have been based on one, my career and also what's best for my family.

And so, when I was in LA, I did have a great opportunity to go back to my home program and you know, end up working side by side with Dr. Jordan and kind of being his, his partner. And it was an incredible opportunity. But we kind of felt like we served our time. Our plan was never to be in Jackson, Mississippi for 10 years, but it was great for what we needed.

I got incredible training. We literally had our babies and raised our babies there. And, and so, it, it served the perfect. Purpose for what we needed, but that wasn't necessarily where we wanted to be long term. So, even though it was an incredible opportunity to go back there. I just, I didn't feel like it was the right thing.

My mom was about 45 minutes in New Orleans. So, I had a great opportunity to join a, you know, a group there. I loved LA. I considered staying there. LA is very, you know, it's saturated in this I had a, I had a candid conversation with Dr. Aziz today, kind of you know, around Christmas time and let them know, like, you know, who doesn't love LA just because of the weather.

And he's like, of course you love it. Everybody loves it here. And he's like, you knew what you could be very successful here. But it's a, it's a slow a slow rising, you know, it, it, it takes a while to really be extremely successful there. Just because of the, of how saturated it is. And for our family, it just wasn't the right, even though, I mean, it was so, hard to leave that little cute school that I was mentioning and that where our kids were.

So, yeah, I started kind of looking all over and I was, we were really open to any, it was really, what was the best opportunity for my career to launch? And, and be able to launch the scope of practice that I wanted to have. And then where was the best place to raise our kids. And so, we looked all over and when I slightly backtracking, I mentioned that I had Spent some time with Dr.

Buckingham when I was thinking about doing a facial plastic fellowship and then once I it was time to interview for facial plastics fellowships, I interviewed here as well. And so, I had already met him twice and, and spent time with him twice. And really, I love the practice. I love the group of people.

He's just such a savvy businessman and has really done an amazing, incredible job of building a really great team. And this is when our team was much smaller. But so, that was always kind of in the back of my mind. And then Austin was a city that I always had enjoyed visiting. I'm, I'm, I'm very much into outdoors.

I love music and I had, I had visited here a few times just when I was in college and after college, and it was always a city that I felt gravitated towards, I always, you know, even, even when I'd only been here twice, I'm like, I could live there. And so, I, when I interviewed here for a fellowship I, I had like three interviews back-to-back.

It was here and then I immediately flew to San Francisco and then I flew down to LA and they all were back-to-back and they all three were my favorite places that I interviewed. So, it was a very hard decision. And so, I, I had a, I was almost, I almost came here for, for fellowship. But I did it. And then and at that time, Dr.

Buckingham, he was You know, he had a, he had a fellow, but he was not interested in expanding or adding to his practice. And so, when I was in fellowship that I was, it was around Christmas. He reached out to Dr. Azizzadeh to get my new email because my previous one had expired and Azizzadeh forwarded me an email from Dr.

Buckingham. And he basically was at the point where he was ready to eventually add a new, add a partner to his group. He had this great building that he was that was in fruition finally, and he was just ready to finally expand. And so, he reached out to me and I was in, I was at this point, I was, you know, again, it was pre pandemic.

I was loving LA and we were, I was, even though I was only six months in there, we made such a great group of friends. And I was, I was like, okay, I got this interview to go to Austin. Let me go check it out. And my husband was 100% on board. He's like, we're, we're not California people. Southern people. So, LA, you know, Austin's a great middle zone.

And so, he was, he was very excited about the opportunity to come back here. And so, I came here literally for like a red eye. It wasn't a red eye, but it was, I was here for 16 hours. It was a very a quick trip because my fellowship was, again, I was in the heat of it where it was really hard to. And so, I came here, got in town for dinner, had a great dinner with Dr.

Buckingham and his wife, Dawn, who's an incredible surgeon as well. And we had, and then, you know, the next day spent some time back with the practice and it just really solidified what I'd already felt, you know, years prior it was just... You kind of like knowing your heart, it's like when you find a.

A relationship, you know, when you fall in love with your spouse, you just kind of know you know, when it's the right thing. And so, I got back home and he was really, you know, the, the, the scope of the practice that I would be able to do in Austin was really exactly what I wanted that same scope that Dr. Jordan said was, was hard to find, you know, getting that. balance where you're teaching and doing reconstructive procedures, but also doing cosmetic and also me being able to do my facial nerve work.

There's, there's a paucity of that in not only Austin, but in Texas where there's not really any other doctors providing the particular techniques and surgeries that I was trained to do.

So, it just made, it made sense. It was the right decision to come here for my family, financially, all of the above. The city is just a very kid friendly, a very family friendly. So, being able to come somewhere where I knew that we could, you know raise our kids that's safe where we can, where I could really grow my, my practice and be able to work with, you know, a, a really nice established practice.

Catherine Maley, MBA: So, you never had a thought to like go solo or work for a hospital. You thought it would be best to just join a practice that would allow you to do. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah, so, I want to do class and reconstructive. I had, I wanted, I looked at all, all, all the options. So, joining a hospital that was, there was a, there was probably three or different interviews that I did for that in different cities.

In LA there was a couple opportunities to, to do, you know, join where I'm doing kind of a combination of more of like reconstructive stuff and then, But it's really hard. A lot of those hospital environments, it's really hard to get it into the cosmetic sector, you know, especially if you're on a salary RV model, a lot of the even my colleagues that are in my fellowship year are having a really hard time of, of balancing that out.

So, I knew that if I were to join a hospital, that that would have been, it would be hard for me to be able to eventually branch out. It's definitely doable, but private practice kept pulling me. And then, you know, at this point in my career, I was ready to the reason I ultimately just, I didn't want to start from the bottom up, you know, I was, I had at this point, three kids, a family, I wanted some kind of steady income, you know, and so, joining a practice that's, you know, established was just the right like thing to us to do financially.

My husband had been grinding and supporting us for a really long time, but I got to the point where I was, I was ready just to enjoy my family. I mean, of course, work hard at my, my, my work, but I was ready to be able to not. Okay, start from scratch with a business where I'm having to not only be learned to, to, you know, be out in the clinical world on my own, but also have to be there on the business side.

I wanted to take away that stressor so, that I could enjoy you know, being with my kids. Cause they, I mean, those early stages of their life some, there was a lot of time with them that was sacrificed. They would never know it. You know, they don't, they don't, they honestly don't remember a lot of those early stages.

So, that's one of the benefit of, you know, kind of having children when, when you're in training. But I was ready to make them a priority. And so, in my mind, starting a business from the ground up would have really stolen more of that time from them. So, that was, that was a big factor too, as being able to kind of get more of that work life balance for sure.

Catherine Maley, MBA: The, with Dr. Buckingham. Do you, how does the marketing work? Do you market yourself? Does he, is he such a marketing machine that he just ciphers off patients for you? Or how are you working that part out? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah. So, I mean, he was super generous starting to practice. So, when I came here, once I, you know, finally signed the contract, it was he, he started marketing, they started marketing, doing press releases and stuff and whatnot right away.

You know, with, with the practice money, I wasn't like having to, To do that on my own before I arrived you know, we had a few magazine articles and things like that and just sort of send emails to the, you know, our patients and whatnot. And basically, the reason that he finally decided to hire a partner was because he was booked out surgically months and months and months, you know, for consults over six to nine months.

And so, he was losing patients, patients were going elsewhere cause they didn't want to wait. And so, you know, if, if a patient called in and they wanted to see him and they, they would go to him, but if they're. Just want to come in and see any doctor and it's more of they just want to have something done, then they, then they would get transitioned to me.

And so, that was really great. I mean, I, my practice took off immediately of getting here. I think we just, there was a void of because he has built this practice. We're going on 20 years now in the fall. He's been here for now 20 years. So, he has such an incredible reputation and the. His patients knew that if he was going to bring on a provider that it was going to be a very calculated decision on who he brings on.

So, the reputation that he was able to build, you know, people trusted me you know, early on, which I'm very grateful for that. And so, he did some front-end marketing and then, yeah, once we got me in here, we've continued to just, you know, market us both, but basically if a patient. Calls and they didn't have a doctor preference, then they would, they would be, they would be filtered to me unless they really, really wanted to see him.

And so, that allowed my schedule to get busy pretty quickly. And so, now in terms of, you know, marketing, we were we, we have several different outlets, obviously, you know, Google, the Google engine that I'm learning that I'm learning that. Side of the business. But you know, there's a, we, we have several magazines that will be featured in and the, and the big beast that we're learning is social media.

You, Dr. Buckingham, before I came on that he was, if anything, a little bit anti-social media. Yeah. Just because you know, our, our aging face population who are in there. 60s and whatnot. They're there. Most of them aren't, or at least in the past, we're not going to the social media, they were going more to the website, but that's changing.

I, one of my like top patients at this, you know, by the spry 82-year-old woman. And she said, you know, she checks, checks our Instagram every day. So, I feel like I, you know, that's something that I. Started starting my own Instagram account that is it's linked to the practice, but that's a way where patients can get to know me outside of the, the, the, the Buckingham umbrella because they, they want to know who I am you know, personally, and, you know, they want to see my results and whatnot.

And so, that's been something that. Has been important to me. It's having my own Instagram account where people can go to that and get a little, a little bit of a notion of who I am and get a vibe for my personality and my, my, my style and whatnot. So, you know, it's hard to maintain. I, the busier you get in practice, it's really hard to.

To keep that going. But luckily now we have some good marketing people. I still mean I still manage my own Instagram account. I'm not posting on it probably enough as I should, but I'm keeping it alive just because I want people to be able to look at me specifically. But so, that's been kind of a way that I've marketed myself outside of the practice.

And, you women physicians. That's been a big, a big thing and, and participating in any kind of you know, any kind of women's meeting, Austin Women, the things like that, that helps. But really, I mean, it's just word, pretty much after a few years, it becomes word of mouth with it. The best, the best patients I have are word of mouth patients from, My previous patients that I've operated on. So…

Catherine Maley, MBA: Always, always. I don't know why doctors don't spend more time on the patients they have who will bring them everybody else they need. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah, yeah, new patients.

Catherine Maley, MBA: They want to spend a bucket of money on AdWords. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah, I think there's an easier way to do this. Yeah, so, yeah, and I'm, and this is definitely an area where I'm just now learning because again, I'm, I'm, I'm in my third year here and the first two, three years I was focused on operating, getting good surgical results and make and making good relationships with my patient, but recently I've joined, I've bought in as a partner.

And so, with that, I, I, I have to yeah. You know, know more about the business side. So, I've slowly been studying over the last few years, but there's just so, much more to learn. I mean, I, I feel like I'm just scratching the surface of. Everything there is to learn, you know, to run a business.

Catherine Maley, MBA: Well, Dr. Buckingham is the perfect mentor for that. His mentor was Ed Williams. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Oh yeah.

Catherine Maley, MBA: Dr. Williams and I used to run a surgeon's coaching club together you know, called Master's Academy of Surgeons, learning the business side of surgery. So, Dr. Buckingham just really knows it well. And you also got a front row seat to how to build a building, like, from scratch. How did or does this impact your journey on going from fellow to partner?

You watched all of that, that I just had.

Dr. Erin Smith: Our new building is absolutely incredible, but it was definitely, there were some growing pains. I mean, we're, we're so, happy to be here, but yeah, there's just so, many, there's so, much red tape for that and getting, you know, we now have a quad ASF certified surgery center, but that took, you know, many, many, many, many long, long nights on days of, of just so, many, it's such a long process, but it's definitely worth it in the end.

Catherine Maley, MBA: Yeah. I didn't know you bought in. That's fantastic. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah,

Catherine Maley, MBA: That's actually a foot, right? You're not in the last month. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: My contract allowed for, you know, after I think it was two years that I was, that was an opportunity. And so, yeah, we're, we Dr. Buckingham and I have just an incredible relationship.

We are really, really good balance to each other. You know, I think we, we handle our patients similarly, but have different styles and whatnot. So, yeah, I've, I've just been very grateful to be here and. Our practice has grown. I think when I started there was 14 people and I think we're now around 25, 26.

With now that we have our surgery center. So, you know, and we're continuing to grow and we, we actually just hired our current fellow to stay on board with us as well. So, now we'll have three MDs plus our, our fellow.

Catherine Maley, MBA: So, how do you make decisions? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: With the three of, you know, he, our, our fellow isn't making decisions just yet, but he's definitely, he's incredible.

I mean that we, we probably weren't a hundred percent ready. We probably would have waited a few more years to hire somebody, but when you have a good fit, you have to, you have to jump on it. So, our current fellow is just a superstar. The staff love them. He's the patients love him. He's a great surgeon.

So, we did not want to. You know, wait a few more years to and the right candidate not come along. So, we have managers meeting every once a month. And so, that's where we all get together with our Dr. Buckingham, Myself, our current fellow who's will be joining us and then our managers. And, you know, it's all of us just, we have talking points and we all are chiming in.

So, that's really where we're all, most of the decision making happens. I definitely rely on Dr. Buckingham's expertise and wisdom. But he's, he's. From day one has just been incredible of letting me guide my practice, make decisions and, and been supportive. So, he's always open to whatever it might be, whether, you know, we finally, we were like, we have to do, we have to, you know, advance our social media.

We have to, people are looking at that and he's like, okay, let's do it. So, whatever we whatever new ideas, he's always on board for that. So, luckily, you know, there hasn't been any conflicts where we are in disagreement. I'm sure it will come down the road. That's good to have healthy, healthy conflict and disagreement matters.

Catherine Maley, MBA: So, I meant to ask you, what do you think about the cosmetic patients, the taste they have, the demands they have, have you noticed that they're changing social media and all other things, you know? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Absolutely. I mean, yeah, social media is a, it's definitely, it's been a beast. It's, it's good because it's allowing people to be more comfortable with cosmetic surgery, but then people are more informed, but not necessarily in a good way.

You know so, yeah, I mean, our aesthetic here, our, our, our particular practice is only facial plastic surgery. So, we don't do any body work or whatnot. And so, we our aesthetic is very natural. You know, I, I, I want. I want to make you still look like yourself, but you know, not to not, I want to basically get you back to looking what you used to look like 20 years ago without making you look tight or pulled or anything like that.

And so, I think that that's why people come here. I've also been very lucky in Austin, this, this particular patient population. They're all very, it's a very down to earth population where everybody wants to look, look restored. But the majority of my patients are not crazy. Believe it or not, they're not, they're not high maintenance.

They're very, you know, normal and realistic. So, that's been, I think that that's in LA, you know, my, my patient population was all over the world. We, Dr. Nassif and Dr. Azizzadeh literally had people flying in from all over the world, which was a great training, but we had, we kind of had a mix of personalities.

But Austin in general typically attracts a certain type of person people that are pretty natural and down to earth. And so, that our. We're very lucky with having that here. There’re definitely people that, you know, come in wanting trendy stuff. Buckle fat is a big trend right now.

Everybody wants to know about buckle fat, lip lifts. Those are things that are for sure trending right now. Threads, we, I don't, I don't do thread lifting just because I think that they don't last long and they're kind of a rip off, but that some people are always asking about that. But the thing that people are really.

On Instagram and wherever social media outlet, there's so, many different names for different types of facelifts. So, that's like, that's, I have even friends that are my age. I'm in my late thirties and I have friends that are like, what is the ponytail lift? What is the, the weekend lift? What is the, you know, mini lift?

What is the limited lift? And so, that's just, you know, educating and everybody knows about deep plane now. They always want to know, are you going to do a deep plane? And so, it just kind of being able to educate patients on anatomy. It's a fun part of what I do. That was a big thing I learned from Azizzadeh is that, When you go in, like when you're, when you're talking to a patient, talk to them, like they're your friend or their family member.

And you're literally just educating them. You're not trying to sell them on anything. You're just educating them on what they have. And so, I like that. I like that patients are more informed and they come in with educated questions. But yeah, overall, we're very lucky that people ultimately kind of trust us to, to help guide them.

Catherine Maley, MBA: So, just watching the practice now you've been there three years, what would you say is the biggest challenge to running a cosmetic practice from your perspective? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah. So, I mean, it's, it's a, like you said, the best word of mouth is, or the best marketing is word of mouth. And so, you know, making sure you keep your current patients happy and, in the door, and, and making sure you're always thinking about how to retain them.

And that's. That's a big thing. And then getting new patients. I mean, in general, Austin is a, it's a rapidly growing city. And so, we have a lot more surgeons that have slowly come here over the last few years. And so, making yourself stand out and, and, and staying booked out, you know, I, Definitely, there's some ebbs and flows where there's in the summer and the and the holidays I'm booked out and then I get it gets to, you know, February and August and things are slower and I start, you know, panicking a little bit.

What's happening? Is it the economy? Why is it slowing down? And luckily, you know, it that those ebbs and flows work themselves out, but just making sure we're doing the right thing to keep our practice relevant and keep our practice of being kind of the cutting-edge practice in Austin that everyone wants to come to and attracting people from around Austin.

Catherine Maley, MBA: Well, you cannot be ignored with the size of that building. What if it's 12, 000 square feet? Gorgeous. It's huge. You can't miss it. That was a good move. Let's talk about the personal side. How in the world are you growing this practice? You're growing your name in a new community. You've got a husband and three kids and a dog, and I think you'd like to be outside. How did or does this impact your journey on going from fellow to partner?

How are you pulling all that off? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: I am a master multitasker. So, I always have, you know, a paper running to do list every month. I have, I basically redo my, my paper to do list and I have a column, a life column, a work column, and then some other research column, you know, and so, I, I, I'm always having, I'm always adding and taking away from that, but really trying to consolidate time.

So, if I'm in my car, I might be listening to a podcast or I might be calling my parents. Or calling an old friend you know, I don't, I'm not just occasionally I'll just listen to music and but, but I'm trying to make every hour as productive as possible. That's been a, I would say a big thing of that I've learned over the last year and that now I do have more elective time for myself so, now that I am running my own practice or I am able to.

Achieve a better work life balance. And so, one thing that I've that it's kind of a struggle that I've been focusing on this year is when I do have downtime away from work and I am with my kids to actually stop multitasking, you know, that's, and, and just enjoy the moment. I recently read this book that I recommend for, you know, anyway, it's called happier hour.

It was, it was written by a professor at UCLA who she, she actually teaches a class on happiness there. But it's a very good It really hit, hit home with me because she's a multitasking mom and whatnot. And so, so basically learning when I can actively multitask and when I can be busy, busy, busy, and then being able to transfer when I'm with my kids and with my family and turn it off and being able to just enjoy the present.

So, that's something that I'm not, I mean, I'm not saying I'm an expert at, I'm getting better at, but then. And those times when I'm not with my kids and my and not with my husband using that time as wisely as possible. And so, that's just it's a constant balance, but really being able to use your every minute wisely.

Do you ever feel burnt out? Absolutely. Yeah. I mean, luckily, I absolutely love what I do. I enjoy, like I, I get happiness from my job. There’re days where I'll have a run of difficult patients where, you know, whether it's a skin cancer patient or even a, or a cosmetic patient. Where at the end of the day, I'm spent, you know, I'm mentally drained because I've been I typically will have one long clinic day and some days, those days are full of just happy post op patients or people who are planning to have surgery.

And those are like, very energetic, happy days, but then some days I'll have a back-to-back run of people who are. You know, sad from whatever that, you know, skin cancer they have, or they're, you know, not, they don't love their outcome or whatever it may be. Or, you know, I just feel like I'm dragging, I feel like I'm not doing my best.

And so, those days, yeah, it's not that I'm burnt out, but I, I just feel, you know, I need something to uplift me and that's where, you know, physical exercise and being outside helps a lot. So, after when I'll get home, I'll try to go for a walk with my kids or walk with my dog or just being. Kind of turning that off and being able to switch over because it's important for me not to carry that with me home.

I mean, as a physician, if you're a good doctor and you care about your patients, some, you know, it's normal to, to not be able to get that off your mind sometimes. But I've gotten better about that because I know that if you go into every day and you truly are doing your best and you truly are treating everyone like you treat, would treat your mom or you treat your, you know, family member and you spend adequate amount of time with each patient, whatever they need, because that's their time they're devoting to you.

And if you devote that time to them and you truly do not cut corners and you do your best, then, you know, nobody's perfect. And so, at the end of the day you should be, I, I, I, and I've gotten better about this, being able to turn that off and be able to devote all my time for my kids, knowing that I did.

the best I could that day. And so, there's definitely days where are harder where I, you know, I do feel burnt out or that, you know, I just feel like, oh, mentally drained. I did like this, it was just not the best day, but doing whatever I can to kind of snap out of that when I'm, when I do leave the office specifically just trying to, you know, spend time with my kids or be outside or exercise the exercise thing.

You know, that, that's a, that's a hard thing for me to try to do on my own. So, my morning time is my, you know, I, I try to get that protected for myself to exercise, but even if it's just a short walk, just to kind of reset.

Catherine Maley, MBA: I, the exercise I love it's the meditating. I don't know how you're type A and meditating at the same time. How did or does this impact your journey on going from fellow to partner?

I struggle with that and I try over and over to sit still and. Yeah. I just gave up. I said, you know what? I'm just going to meditate and walk at the same time. I can't.

Dr. Erin Smith: Yeah, it's really hard. For nature grounds me. So, we recently splurged and joined a boat club and that was honestly one of the best things that we could do.

So, Lake Austin is absolutely beautiful. It's just like, you feel like you're not even in. America. It's so, pretty with the hill country area and just being out there with my kids. I'm able to completely decompress and just like be with them in nature. Our dog can come out. And so, that's been a really kind of great thing that we've been doing on the weekends.

And that is just, it's just very healing being out there. And I'm able to turn off my brain because that's, that's the hardest thing is for the past 10, 15 years, I have been 90 to nothing to be able to Have my kids and, you know, run a household and run a practice. You have, you have to be able to do that.

You have to be able to multitask, but so, that's really my biggest learning challenge of probably the future in the next few years is being able to, to, to turn it off and, and be able to do both where you multitask when it's time, but also being able to enjoy the present.

Catherine Maley, MBA: So, any advice for anybody coming up or thinking about switching?

We talk a lot on this podcast about somebody in a hospital wanting to get out and go to private, somebody private, wanting to go back to the hospital, like every scenario on the planet. Any advice for others who are thinking about shifting? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah, I mean, I think that you, you really need to, depending on what your motivating factor, like my motivating factor, I've always loved my career, but my family is now taking it.

Luckily, I'm able, my career is flourishing, but my family is my priority. And so, I think looking inward and figuring out what, what drives you and what and, and what, what's most important. So, and then just planning it out, doing some research, our field, I mean, all of my previous mentors are, they respond in a second to an email.

And I think in general, we're all just very supportive of each other. And so, don't, if you're a burnout and you're setting, whether that be that you're in private practice and you're grinding and you're not happy there, you're in the hospital setting and you want to get out, then it just takes, you know, a few steps to plan it and getting and finding a support system and finding somebody else that's out in that field, you know, out in that where your goal is and they can definitely guide you and help you.

You know, I feel like I've spent the last 10 years just grinding and grinding and grinding to get to where I am. And I really haven't, you know, done a great job of offering my wisdom and knowledge I've gained along the years of being able to, you know balance that out. So, that's something that I look forward to in the future is being able to mentor mom, you know, residents who want to be a mom and want to be able to balance it.

And, and we're in, we're currently, you know, in, in the interview season right now for our fellows. And it's just really great to see these young people coming up and I'm excited to be able to mentor them, not only on the surgical side, but also, you know, how to, how to balance it all.

Catherine Maley, MBA: Well, they need help because there's nothing easy about what you're doing, but no, but you guys make it look easy because I always wonder about that. Like, wow, how are you doing that? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: I mean, I can't take away my spouse and my spouse is that I haven't really brought him up, but he has been an amazing support system. Whenever he proposed to me, we we've been together now, 15 years, we met in 2007. Whenever he proposed to me, we were married, we're dating a few years.

My dad, he had that, you know, private meeting with my dad and my dad. Said to him this is before I was even in med school, my dad said to him, like, do not ever hold her back, whatever she wants to do, let her go all the way. And he stayed true to that. And so, you know, his career it, it, I wouldn't say it didn't take the backseat, but cause he was, he was, he's the one who supported me the whole, all along the way.

And, and, you know, it was with the what basically the. The one who brought in the money to get to allow us to do these things that we did. But he's also been an incredible, incredible dad too. So, not only has he financially been there, but you know, he's, he's transitioned to more maternal roles when he's had to being the one that with his, with him working from home, his job's always been more flexible than mine.

So, you know, if we have a sick kid, usually it's him cause I'd have to cancel. and where he can kind of, you know, still work from home and whatnot. So, having him as a support system has been, I don't think I could have done it otherwise. So, whether it be your parent or your spouse, you know, leaning on the people in your life that love you, they, they want to help.

If I've had a conference where I'm going to need to be gone for a few nights, we'll, we'll fly in a grandparent. I mean, I would say. That's the biggest negative of being in Austin is that we're, we're not close to grandparents, but now with, with plane rides or they're an hour away, you know, so, they can get here pretty quickly.

And they see it. They FaceTime and video call. They can see our kids frequently, but having a support system is huge. I mean, I did a lot of it on my own with You know, being able to multitask, but a lot of it was having a great, a great support system.

Catherine Maley, MBA: So, I definitely to him for being surrounded by four women. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Hopefully. Oh, wow. I know. I know. And he's crazy. He would have another kid. I'm like, nope, nope. Yeah, we have our, we have our boy dogs, so, we're, we're all good.

Catherine Maley, MBA: At least he's got that. Yeah. Does he have a man cave or did he take over the garage or? How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: Yeah, I mean, he has his office. That's kind of his man, his man cave.

Catherine Maley, MBA: Yeah, for sure. So, last question, tell us something we don't know about you. How did or does this impact your journey on going from fellow to partner?

Dr. Erin Smith: I'm an avid music lover. I wish I had, I wish, I don't play any instruments. My kids are playing instruments because I want to live vicariously through them one day. But if I, if I had to retire, I would, and I could do something else in a future life.

I would want to be in a band. I you know, that Austin, the music scene here is incredible. And I that's I, I take my kids to shows all the time. That's, The great thing about the city is it's super kid friendly. And so, we are, we are constantly going to outdoor festivals and music you know, as much as we can.

So, that's, that's kind of what another thing that kind of grounds me is, is being, is hearing music, being around music, black specifically live music. I love it. So, that's another thing that can kind of relax my brain and make me just. Chill out and enjoy the moment. Do they still have Southwest-by-Southwest or whatever that was called?

Southwest-by-Southwest. It's really cool that, yeah, so, that's been a really, I had no idea what it was when it first, when I first moved here. But it's a basically a, you know, a two-week music fest. It's music, it's film, it's a comedy. Art all of the above tech and we're basically, it's a big conference, but you get to discover a lot of really cool up and coming acts all different genres of music.

So, and it's always, it's been during my, my kids spring break, which is actually a busy time for me surgically. So, we have been going at it, you know, doing a trip with them for like president's day weekend. I've been staying in town for spring break and working just because people want to have surgery there in that week.

And then enjoying the South by Southwest in the evening. So, that's been really fun. So, great.

Catherine Maley, MBA: Well, it's so, nice talking with you on your journey from fellow to partner. I wish you all the luck in the world. I'm sure I'll be watching your career as you move up the ranks from fellow to partner, and how could they get ahold of you if they wanted to get, get in touch?

Dr. Erin Smith: Yeah. So, just reaching out to the practice my practice email. I'm just [e-mail]. [e-mail]. Or if you call the practice and you can always reach me that way as well.

Catherine Maley, MBA: Okay. Terrific. Everybody that’s going to wrap it up for us on this episode of going from fellow to partner.

If you’ve got any questions or feedback for Dr. Smith, you can reach out to her website at, BuckinghamFacialPlastics.com/Dr-Erin-Smith.

A big thanks to Dr. Smith for sharing her journey on going from fellow to partner.

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.

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-End transcript for “Fellow to Partner — with Dr. Erin Smith”.

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