Solo Practice, No Debt. — with Philip Robb, Jr., MD (Ep. 214)

Beauty and the Biz

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and how to be in solo practice with no debt.

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 "Solo Practice, No Debt — with Philip Robb, Jr., MD".

People develop different money mindsets based on their upbringing, beliefs, attitudes and behavior.

And there are many money mindsets to choose from:

Scarcity, abundance, thrifty, growth, generosity, materialistic, and entrepreneurial mindsets.

Knowing yours helps you make decisions that you are comfortable with and that align with your goals, values and aspirations for a healthy relationship with money.

This week’s Beauty and the Biz Podcast guest is Philip Robb, MD, a facial plastic surgeon in private practice for the past 7 years located in Alpharetta, GA where he was raised.

Dr. Robb embraces the thrifty mindset which has paid off for him (pun intended). He sleeps better being debt free, so he stretched his resources and made prudent choices.

That has allowed him to build out his own surgical center while doing surgery 5 days/week on his terms…No Debt!

That didn’t happen by luck. It was mindset.

Visit Dr. Robb’s website

P.S. Earlier this week, I talked about following up on leads and that starts with your receptionist. Get 87% OFF front desk training with this one-time offer….

📲 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/

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Transcript:

Solo Practice, No Debt. — with Philip Robb, Jr., MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and how it’s possible to be in solo practice with no debt. 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 guest is Dr. Philip Robb, who’s in solo practice with no debt. He's a cosmetic and reconstructive facial surgeon in private practice, for the past seven years, in Alpharetta, Georgia; where he was born and raised.

Now, Dr. Robb is a second-generation facial plastic surgeon. He attended Medical College of Georgia, did a surgical residency at the University of Arkansas for medical sciences, and also did a fellowship with Dr. Achi Chen, one of the country's most well-known facial plastic surgeons. All before going into solo practice with no debt.

Dr. Robb, welcome to Beauty and the Biz.

Philip Robb, Jr., MD: Thanks Catherine. It's a pleasure to be here. Thanks for having me.

Catherine Maley, MBA: Yeah, I wanted to talk to you for a while because you're one of the more up and coming. Lately, I've been talking to a lot of the guys who are kind of, you know, thinking about exiting, but not you.

You're just, you're still fairly new at this. So, first of all, how did you end up in facial plastic surgery? I did read in something on your website that I thought was really interesting. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah. So, my dad is an ear, nose and throat surgeon here in in Alpharetta, which is just a little bit, 20 minutes North or so, of Atlanta.

And so, I, through medical school did, wanted to do anything except ENT. And but ultimately, I think, you know, the fields and the specialties have a way of kind of choosing you. And so, ENT was it for me. So, that was, I went into an ENT residency, did not plan on. doing facial plastic surgery at that point.

And then it was my third year of ENT residency. I was on call and a patient came in with a bad trauma and I don't know how graphic or how detailed you want me to get. And so, anyway, my one of my best friends and I, along with one of the attendees kind of worked on her all night long and she was married about six weeks after that.

This was a, this was an injury that completely. Would have could have completely marred and scarred her facial appearance and for life and but she healed great. And it was in the news. It was a really great story. But through that, I learned the positive and significant effects that. facial plastic surgery can have on people.

And so, that really stuck with me and some of the things that she said to me throughout her recovery really stuck with me. And that's what kind of ignited that spark that you really are transforming lives.

Catherine Maley, MBA: I know we talk about vanity a lot in this industry and of course it's vanity, but the way I look at it although the reconstructive is much different, but just the you want to look as good as you feel kind of thing. How did or does this impact your ability to be in solo practice with no debt?

There, there's a lot to be said for that because I think of it as, come on, we, we wouldn't live in a house where the paint's falling, you know, peeling and everything's falling apart. We wouldn't drive a car like that. So, why would we live in a body like that? That's how I see it. And who better to do it than people who know what they're doing, you know? How did or does this impact your ability to be in solo practice with no debt?

So, good work. Keep, keep it up.

Philip Robb, Jr., MD: Thank you. Well, one of the things I always tell my patients, you know, this is after the surgery, but You know, people spend money on a lot of things, and a lot of these things are, you know, a car or a vacation or a watch or whatever that is for you. And, and those are all great things, but when you invest in yourself, you know, a new nose or a new neck and jawline, facial rejuvenation, these things go with you wherever you go.

They go with every outfit, they travel well with you, and so, it's an investment that really, I feel like, has its returns.

Catherine Maley, MBA: It's absolutely an investment. I hear here. I can vouch for that over and over and over. So, so, here you are, you're an ENT or you're, you're not wanting to be an ENT. How did you go from that into cosmetic? How did or does this impact your ability to be in solo practice with no debt?

Well, how did your father feel about that? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Well, yeah, good question. So, I so, decided I wanted to do facial plastic surgery and he, my dad was always kind of just like, you do whatever you want to do. He, he wasn't, he wasn't pushing me toward ENT or anything. So, went and did fellowship, which was a great experience and then came back home.

And basically, I simultaneously started my facial plastic surgery practice, its own entity, its own thing. But then I did a little bit of ENT as well, kind of through his office and, and really how I. In a perfect world, I would have kind of kept doing that. I, there's some aspects I love about ENT and there's some aspects I, you know, love about facial plastic surgery.

And so, I did that for a year or two, maybe, maybe two years or so. And then the, the, the facial plastic surgery practice just got to. Too busy. And I couldn't, I felt like I was living two lives, you know, with the ENT life and trying to keep those patients happy. And then the facial plastic surgery life and trying to keep those patients happy.

And then the, my time in the operating room, I didn't have my own surgery center at that point. And so, you know, in the operating room, you only have a fixed amount of block time and then trying to get additional time is difficult. And so, I made the jump you know, shortly after doing some ENT to. Full facial plastic surgery.

Catherine Maley, MBA: Okay. So, logistically you're working with your dad, what it sounds like maybe once a week, but then you had another office where you were doing facial cosmetic. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah, it was actually a really sweet deal. So, we were different. Entrances from the hallway, but they connected in the back. And so, it couldn't have been any of a sweeter situation.

And so, yeah, I, that air, that space became available kind of, I guess maybe a year or so, before I was ready to get it. So, I, we snagged it and then I built it out, you know, had people kind of build it out and customized it. How I how I wanted. And yeah, so, that's, it was, it couldn't have been better.

And then when I stopped doing it and T my dad's practice expanded into that area and he hired some new providers. And so, it was kind of all a seamless situation.

Catherine Maley, MBA: All right. You, so, you were literally in private practice, like from the get go. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Day one. Day one.

Catherine Maley, MBA: Was it helpful to have your dad nearby? How did or does this impact your ability to be in solo practice with no debt?

That's really unusual to, like, usually you play the hospital game for a while, you join another practice and you hate that after a while. And like, just out of sheer frustration, you end up saying, okay, that's it. I'm going solo. You got there much faster than normal. So, how did that happen? And can others do what you did?

Philip Robb, Jr., MD: Well, yeah. I think so. I think the biggest thing is, you know, it was certainly helpful that. My dad was there and he's been in the community for 30 years. And so, our name you know, around here, I feel like is, is pretty well known and well respected. He's excellent at what he does. And so, I think that was helpful.

And I really thought, Catherine, that the ENT practice would fuel. The facial plastic practice, right? So, a mom brings little Timmy in to get his ear tubes checked and maybe she'll get Botox. It saves her a trip maybe to the, to the facial plastic surgery office or but you know, that didn't happen. And it, it happened occasionally, but people come into a medical office with a completely different mindset, right?

It's what am I going to have to pay out of pocket? Why isn't insurance covering all of this? And so, I found that it didn't really work. Like I thought it would. There's certainly some symbiosis there, but, but not, not what I anticipated.

Catherine Maley, MBA: Oh, I've tried that for years for decades. I've tried to take an ENT practice and they put a facial plastic surgeon in there or a plastic surgeon.

And we've tried to market them. It's just a different mindset when that patient has an insurance card and they know you as an insurance card. And now you're saying what you want my credit card. It, that's a, a big hill to climb. So, it's not the best way and you, and you learn that. Are you still doing ENT at all or any reconstructive at all? How did or does this impact your ability to be in solo practice with no debt?

Or you're just all face?

Philip Robb, Jr., MD: I do only so, I don't do any ENT at all anymore. I'm on no insurance programs or contracts at all. And I still do, I love doing Mo's reconstructions. And so, every once in a while, I did a news anchor some time ago of her Mo's reconstruction. And so, all of. The news anchors, I feel like, if they have to have something removed from them, I end up doing them, and that's all just kind of out of pocket.

And, and so, there's been some, a good amount or some things like that, but as far as like a steady stream of Mo's, I don't even do that anymore.

Catherine Maley, MBA: Would a newscaster be a good referral source for you, or are they willing to talk about that online? Because if you can get a few of them in the community, you are golden. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: I know, I know, I, you know, I've never. I, I kind of feel funny sometimes about trying to pull, you know, pull those strings or so, I, I just, I haven't, I haven't asked, I haven't, I haven't asked if they'd be willing to do that. I haven't asked if I could do a little segment on their channel or I just haven't asked about any of that.

Cause I, you know, it's. It's delicate.

Catherine Maley, MBA: I feel like, well, here's what you do. You, you turn your wife into the PR director temporarily and she's your third party and she would be the one who, and she's literally the PR director and she's the one who broaches the topic and just says, would you be open to, and then she gives them some ideas and that way you're not involved. How did or does this impact your ability to be in solo practice with no debt?

And she looks professional and all feels professional. That's how the, that's how the big guys do it.

Philip Robb, Jr., MD: All right. That's great. I like that advice. Thank you.

Catherine Maley, MBA: Yeah. Tell her she got it. She's got to get out there and help you. Yeah. All right. So, now we're back at the building. Now, did you buy or lease that space that you have? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: The space that we're currently in is a lease. I tried to buy it and they wouldn't, they wouldn't let me.

Catherine Maley, MBA: Yeah. I was wondering who gave you all this money? Like, I mean, isn't it more getting more and more difficult to borrow money to Set up shop. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Well, that's another interesting story. So, I don't know about, I, I actually believe it or not cashflow to everything.

I do not like the debt thing. And I know a lot of my colleagues, you know, are like, that's silly, you know, that's great. And it just makes me uneasy. I can't sleep well at night. And so, when I knew that we were going to actually, it's a crazy story how we ended up in this place, but it has to do with COVID.

We were going to move somewhere else where the, the kind of close to where I used to operate. It was in the same building that the surgery center that was owned by the hospital here in town. And so, they say you can't, you know, they own you if you live there because they say no surgery centers, you know, if you bring in another doctor, they have to be on staff at our hospital.

They can't be on, you know, they just, it's very confining. And so, there we were. Going back and forth with our attorney and the hospital's attorneys and all that stuff for months and months and months and months. And, and so, finally we get something that my real estate attorney's like, Hey, this is good.

This is, you're not like so, tied down. This is to bring somebody in it's reasonable. And then that was March of 2020. We all know what happened then. And I was like, literally had the pen in my hand and I just said, you know, Let me let me hold off on this and I just put it into my drawer. And then of course I've, you know, that happened and then this place came available.

And this is, we are, we have a freestanding building because one of the issues in my old office was parking. There was a parking garage. And so, people would have to get there 15 or 20 minutes before their appointment time, and then there was a couple of different buildings on that campus. And so, it's navigating that Catherine here.

It is. You pull right up. You walk eight steps into our lobby. Our surgery center is attached. That's a separate entrance in the back. And, you know, you can see maybe behind me there's woods behind me. And so, it's very private. It's nice. It's, it's perfect.

Catherine Maley, MBA: That's exactly what we want. We want comfort, convenience, privacy, and safety.

Boom. You have all that. So, I did notice you have the name of your practice is Robb Facial Plastic Surgery, but then this surgery center is called North Central or something. What's the thought process there or what's the business model? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Well yeah, great question. It's called North Point Surgery Center.

We're on North Point Parkway. Yeah, no problem. And so, I, when I built that, My initial thought was that I'm going to have other surgeons come operate here. And so, we built it out like that. So, in the surgery center itself, there's nothing Robb at all. So, it's completely, anybody could go there and you know, and it doesn't, it's not like they're in, in my kitchen.

But after, after building it, then and we just kept adding more and more surgical days. And I really, I tell my colleagues who are like, should I build an OR? I tell them it's like operating in your own kitchen, you know, where everything is, you know, and then the people I operate with, I operate with them every single day.

So, then I started thinking, you know, I don't know if I want somebody else to come in here. You know, and so, no other humans have ever operated here and we operate five days a week typically. So, it's just been, it's been fine.

Catherine Maley, MBA: I heard a talk on this a while back, the efficiency of the same staff, the tools are in the same place, the processes and the protocols are the same.

There is a lot to be said for that. It cuts down so, much on mistakes, inefficiency just the lagging of what's where, who's doing what. Congratulations. If you can have that, nobody has ever said, boy, do I regret building that thing out? Not one person has ever said that even when they were they were 8 million in saying, nope, you know what? How did or does this impact your ability to be in solo practice with no debt?

I'm okay. He had a vision. He did want to bring other surgeons in. I will tell you that is more of a headache than most realized getting another surgeon to use your facilities, your way. That's a whole other headache. So, if you can avoid that good for you. So, good for you. Are you, are you completely happy with your setup? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Oh, I'm so spoiled and I like it's, it's great. I mean, yeah, it's, I couldn't, I mean, you know, and, and where I used to operate, those people are great too, but the big issue, just like you, you hit the nail on the head is. You know, I would have a different scrub tech every day. So, every day is the, is the first day, or there's some times where we have a really long day.

And so, I'll say, Hey guys, can we, can we start at like 6am as far as like, you know, let's like roll back at six. And they're like, great, let's do it. And those there's, or there's been one time where I'm trying to leave town on a Friday and I'm like, Hey, can we start at six? Just, just so, we can be done earlier and I don't feel like I'm, you know, rushed or anything.

Sure. And so, there's like flexible and freedoms and, you know, that you can't maybe get at a hospital center.

Catherine Maley, MBA: For sure. So, you're not at all connected to a hospital. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Like physically or physically or legally?

Catherine Maley, MBA: No, no relationships there. Are they, are they trying to buy your or no — ?

Philip Robb, Jr., MD: No. Nobody has come asking to buy it at all.

I'm on staff at several of the hospitals. And I. I used to take call there, like ER call. I don't do that anymore, but I still keep my staff privileges just in case I need to go there for something. But, but no, I'm not, I don't do things regularly at the hospitals anymore.

Catherine Maley, MBA: Oh, good for you. Congratulations.

Things are going well, huh? Just give me one mistake because it sounds all too easy right now. Give me one mistake you made that you really learned from, but you lost some time, money or sleepless nights over it. Regarding the surgery center? Anything you're just building, building in this practice from the ground up. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah, I think so. I think one of the big lessons that I've learned through this is if you're going to, let's say you're going to do anything kind of a partnership or an affiliation with anything, anybody, any, any organization, you want to get everything in writing signed. Before you do anything and I've learned that and so, you know, just you're excited to do things and you start telling, you know, telling people and then things, things don't pan out and, you know, it looks kind of silly.

So that'd be, that'd be 1 thing is, is, is really just kind of take, take the time. And always, always, always get legal counsel on everything.

Catherine Maley, MBA: No, good, good point. Everybody has always said when this, when the stuff hits the fan, the only thing that that judge cares about is what did you have in writing.

And who, who signed what, and if you look at it that way, it's so, true because it's so, easy to bypass all that when, when everyone's happy and when they're not, it gets really detailed very quickly. So, yeah, congrats on that. So, regarding anesthesiologists. I'm hearing that's getting to be a challenge.

Like, have you had any trouble with that? Or are you using, what are they, nurse anesthetists? Or what are you doing about the anesthesiology part? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah so, we have three anesthesiologists that are, you know, that work with us regularly. And it's kind of, that's, there's a, they have a company and they'll go to different, different sites.

And then there's about 15 or 20 of them in this company. And of those we'll, I only, I only want three. And so, there's the, these three are just awesome and they know exactly kind of what we do. And it's just, so, that's been great. And so, they've been they've been with us, you know, since we started here and They're in, it's just, it's awesome.

And I, and I think the big thing is I, I treat them literally like part of our team. And so, we do team events. I'm sure we'll talk about the team and all that, but we do team events and they're at every single one. When we do Christmas presents and that kind of thing, they get those things too. And so, they, they're literally a part of our team. And I, you know, think of them that way.

Catherine Maley, MBA: Then let's talk about the team because I think you've got an NP, a couple of nurses, probably estheticians. What is your setup? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah. So, we have an esthetician, we have a PA, we have two nurse injectors and, and then three other RNs in addition to that.

And then, and then a medical assistant those are kind of like the clinical people. And yep, and then we have, you know, the marketing and front desk and patient coordinators, that kind of thing too.

Catherine Maley, MBA: So, how much of your practice is surgical versus non-surgical I assume, because it looks like you're pretty heavy into the non-surgical. How did or does this impact your ability to be in solo practice with no debt?

Would you say that's almost a necessity in today's world to develop that patient for life kind of practice or, or stick to the one and done? Absolutely. Absolutely. Absolutely. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah, great question. So, our practice itself when you when you expand to the other providers, I'm going to say is still, you know, 70% surgery or so.

And then when you're talking about me, it's probably 90 plus percent surgery. And I love doing the injections. It's just that there's only so, much. You know, and I'm trying to figure this whole work life balance thing out and there's not enough hours in a day, you know, to do that, all the things and, and to have enough time to do all the things.

And so, so, yeah, we so, those are the kind of the, the different things. And so, we offer, you know, the spa has lasers and laser hair removal and hydrofacial and, you know, all the, those different treatments were now currently investigating radio frequency devices. So, if you have any advice on that, I'd love to, love to pick your brain on or off the air.

Catherine Maley, MBA: I think it's enough of RF I like IPL plus RF microneedling and I do it quite often. And I, it's just a go to limited downtime, keeps everything where it needs to be. So, far so, good. Yeah. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Excellent. Excellent. So, yeah, that's what. That's kind of the next thing for us is that is the RF world, but I do think that you know what I want to what I'm what I'm striving to create here.

Catherine is a is a place where patients can come. They know they're going to get the top quality of care, that's truthful and honest. So, about every day. I'm telling, I see a patient who wants X, Y, or Z. And I say, you know, I don't think you need that. I'm not going to do that for you. And you know, we can do the other thing that you, we were talking about, but you don't need that.

And you know, it always what, I mean, I say, I say, I'm sure you can go this way down the street or this way down the street and find two or three people to do it for you, but I don't think you need it. And I don't think you're going to be happy. And I think if you spend a hundred bucks on it, it's too much.

And, and so. But then, you know, the same, the same thing. So, every patient gets my cell phone number who we operate on and just check in on patients. And so, you know, we're definitely not the cheapest and sound, we hear that sometimes, but you know, it's the, just the quality of care. And so, from injectables to surgery, I just wanted to be you know, the absolute best that we can offer.

Catherine Maley, MBA: Well, on your website I noticed that it said 24 7 nursing care and they would actually change bandages at your home or hotel If that's true I would pay anything for that If I don't have to go out after surgery and I can stay put and other people are running around. How did or does this impact your ability to be in solo practice with no debt?

Oh my god I hope you do that because that is such a good differentiator.

Philip Robb, Jr., MD: Yeah, and so, it used to be me doing that and I would do I would do home visits And I would well, for our out-of-town patients, I'd go meet them at the hotel, usually a couple of different times. And now it, you know, that's impossible.

And physically, I feel like, you know, Atlanta is such a sprawling area, but in fellowship, we gather, we literally, we would visit people at their homes every day. We'd start the day at 5 a. m. and we would go there. To one or a couple of different people's homes. And of course, that's a smaller town than Atlanta is and then operate all day.

And then usually maybe a stop on the way home at somebody else's house. And so, that really taught me a lot about just, you know, service. And so, yeah, for our out-of-town patients, we have nurse that can stay with them because some people don't have, you know, family who are able to come or friends who are able to come either.

And so, we've got, we've got those channels kind of all. All ready to go.

Catherine Maley, MBA: Well, that has to help your reviews. I don't know how you've done it. So, I'm going to ask, how did you get 366 Google reviews at 4. 9 rating? And I commend you for 4. 9. I'm sure you wish it were 5. 0. It would look inauthentic if you did have 5.

1. I hope you know that that is the best you could hope for 4. 9 and it'll be something silly. Like you made me wait too long. How in the world did you get 366 Google reviews in less than eight years? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah, we that's a great question. I so, I have this thought and You know, so, I, I have a couple of little gifts over here from patients and to me, a patient brings a gift when the value that they received from you and your office is higher than what they paid.

That's my thought process. I don't know if that's right or wrong, but that's my thought process. So, they fill that gap oftentimes with a bottle of wine or, you know, a president or something like that. And I think Google reviews in a, in a, in a kind of a funny way is pretty similar to that. And so. And if, and if we read through our Google reviews, I think a good amount of them would say, you know, I texted him on a Saturday and he texted right back.

It's those kind of things that maybe aren't quite the norm but I think are important. And so, when the patient receives that, those kind of services, they're like, well, shoot, I mean, at least I can do is leave a Google review. And we do ask, you know, them to. But it's frustrating. And I don't know. We got to figure something out because the Google monster and the Google machine is we have I have a lot of reviews that patients are sending us screenshots that they completed, but they're not popping up there.

And it's not a, it doesn't make me feel warm and fuzzy because we have no control, no power. We've, we've called Google and good luck with that. You know, they, so, that's a tough thing and. You know, I know that Google reviews, of course, are powerful and people look at them. And so, it's a, I don't know what the long term, you know, answer for that is.

Catherine Maley, MBA: I have the same issue. I have doctors who gave me a review. Do you know how difficult it is to get a busy surgeon to stop what they're doing and give you a Google review? And they, they won't show it. And it's like, are you kidding me? I can see maybe consumers, you know, like you'd have more trouble with them, but these are doctors and you can tell I work with doctors. How did or does this impact your ability to be in solo practice with no debt?

So, what in the world? Would be filtered out on that one. I hear you. But are you, so, you're asking, are you asking or are the, is the staff asking or is there some kind of process you have. Because that doesn't happen by accident for you to get the number? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: No, I ask. I ask And, and if, I don't think, if, if the surgeon doesn't ask it,

And so, we've made it easy and we send links to patients through kind of our, our software and, but I say, you know, we, I just saw a patient before hopping on with you and she's three weeks out from lower lid bleph, fat transfer and laser. And she's like, she's like my husband. Keep telling me that I look so, incredibly amazing.

That's the best. And so, we're looking at before and after pictures and I'm like, you know, it would, it would really mean a lot if you'd, you know, if you do a review and she just share whatever you're willing to share and she's like, are you kidding? I don't know why I didn't do this 10 years ago. And I'm like, well, somebody's waiting.

So do that Google review and I can't wait to read it. And so, we have team meetings every week and I, and we all read. The reviews to the staff. So, I read them if it's about me or a surgical result, I read it. But if it's one of our nurse injectors, they get to read it. And I think it's really important to connect routinely and frequently.

What we're doing here and why we're here. And, and, and, you know, those are the results that, that fuel us.

Catherine Maley, MBA: Well, you know what else talk about staff motivation. If you're going to just complain to staff constantly that you're not doing something right, that's not very motivating. The other side is celebrating the wins. How did or does this impact your ability to be in solo practice with no debt?

I love that you're having weekly meetings. Meet with your staff. They are everything to you. They're your revenue generators. They're your practice building assets. Like, I don't know how else to say that. And if you go over reviews with them, and especially when they're naming, the patients are naming your staff by name, first name.

I mean, that's just golden and like talk about acknowledging your staff and encouraging them to keep up their best customer service skills. That's how you do it. You don't have to throw a bunch of money at them, throw accolades at them. Isn't that helpful? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: It is. It totally is. And we, you know, we give out gift cards and do fun things.

And it's, it's, it's a lot of fun. And I think, I think that's totally, you know, there's so, much truth to that is what you're saying is absolutely. And I, and to be honest, I, a lot of it I've learned from you and your podcast. And so, thank you for that.

Catherine Maley, MBA: What do you do for fun? Because that's another thing that doctors get caught up on.

They're like, we don't have time for fun around here. You know, we're busy. And I think you better get, I'm busy here. I mean, it doesn't take a ton. But what are some of the things like I always say have the taco truck roll up for lunch today. You know, that took no time there. It's what an hour and it can go really far, but what other kinds of things can you do that are fun? How did or does this impact your ability to be in solo practice with no debt?

They're not so, disruptive to the practice.

Philip Robb, Jr., MD: You're talking about, like with the staff in the office kind of thing? So, one of the things is we, we have fun. And so, you know, if you, if you follow us on Instagram, there's, we're laughing. It's like, we have a good time. And so, I think that's, that's really important.

And then. At least every quarter we do an evening out with our staff and so, what we just got a couple weeks ago we went bowling and So, we go we eat together. We have some beers and we bowl together and it is so, fun the time before that we went to top golf and so, we did the same thing except we were golfing We've done a simulator thing where you go and you can play all these different Or it's in the simulator.

We've gone out to fancy dinners. We've gone to different malls by party buses. And there's like, it's, it's fun. And I, I really, I really think that's a huge, it's an investment because these things, of course, aren't cheap when you're doing it for a good, a good number of people. But when. When the team is cohesive and they're friendly and they're friends, the patients can tell and it just kind of brings everything together.

Catherine Maley, MBA: Any tips on hiring or where are you finding people? Are you having any trouble keeping staff or having any turnover issues? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: No not, not currently. I most, I heard the number the other day. Like, I think, I think like 80% of our people have been here longer than a year. And. But early in the COVID thing, I've lost two nurses total to the travel gig, one of which after doing her travel gig, wanted to come back.

And, and so, so, that's the thing for sure. And you know And of course they don't ask me my opinion on it. Like, hey, I'm struggling with the fact that I could go travel. The thing is, you know, travel nursing, you can make a lot of dollars, but there's a reason why they're paying so, much, right? You're going to this; these undesirable places and you're going to be doing undesirable tasks usually.

And that's what, that's what happened to this one nurse. She's like, life was miserable. And, you know, and so, you know, there's, there's that. And I, I just think. As far as kind of keeping staff, you know, we're a family. And so, we treat each other like a family and. You know, we celebrate victories. One of our nurses just is pregnant and she's been trying to get pregnant for a while.

And so, we had a gender reveal party last week, which was super cool. She's having a girl. Okay. I thought it was going to be a boy, but yeah. But she's having a girl, and that was a huge, that was so, fun, and you know, this is a, this just, this will, this story will kind of encapsulate the family. So, one of our, our front desk, and she's kind of our aesthetics coordinators, she lost her father on Christmas Eve.

not this last one, but the year before. And which, you know, something like that happens on such a, it was a tough, it, it made for a tough, long, long time. And so, her brother plays college football and they were playing in the bowl game in Hawaii. And so, one of our nurses. Her boyfriend works for Delta, works for airline.

And so, she, our, our employee said, Hey, can you get me like a buddy pass or something? So, that maybe, just maybe I could go spend holidays and Christmas time with my family and watch my brother. And, you know, especially be with family that during this tough time. And so, the buddy pass thing was never going to work out because those flights are booked.

So, our entire team donated and we presented her with. Round trip ticket to Hawaii for Christmas time so, that she could go be with her family, watch her brother play in the bowl game and it's stuff like that. That you know, that, that, that's just really special to me. And it kind of gives me the chills every time I say it.

Catherine Maley, MBA: I just hope everyone's hearing that this is all an investment. It is so, much cheaper to keep your team intact. Then then have strife and drama and conflict with a team that doesn't work well together. It costs you money. It definitely costs you sleepless nights. It's a headache. I just investing in your team is everything, especially in today's world when it's so, competitive.

They are your competitive advantage, you know, so, I don't know where you learn this. Well, where did you learn this? Because you know, most doctors are not Up to, up to that part. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: You know, I've learned so, much from podcasts just like leadership podcasts or different kind of things. And always, and I've learned a ton from, you know, you mentioned Ed Williams.

I have learned so, much between the hours of 10:00 PM and 1:00 AM at, at a, you know, restaurant or something with him. And I, I, you know, any time that I can get around, somebody like that, or, you know, just somebody who's a little bit further along. It doesn't have to be somebody like that, but just, I love learning from everybody and anybody.

And another good tip for, for your listeners is food. And so, supply food for your team. We have a Costco, we do a Costco run every whenever we need to, and just. We just fill up. We have a big break room and just fill it up and the staff just, you know, I think that makes a big difference.

They don't have to bring lunch all the time. There're snacks, you know, they have a drive home. There's, they can grab a Coke on their way home. It's, it's. That's a big deal to another investment.

Catherine Maley, MBA: So, let's talk about marketing because I was wondering how competitive is it in your area? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Well, we're in Atlanta, so, I mean, I think I, I, I super competitive is, is the answer, but the way that I don't think of it, like, I don't think of the other plastic or facial plastic surgeons as competition.

I just talked to one on the phone for 20 or 30 minutes yesterday. Like we're friends. There's just so, many patients and different people have different aesthetics. You know, my noses look different than somebody else's. And so, there's going to be a certain number of humans who like their nose is better.

And there's going to be a certain number of people who like my nose is better. And so, those kind of all distribute out. You know, and, and so, you know, while yes, there's a lot of people who do what I do, I don't feel like a cutthroat competition with anybody.

Catherine Maley, MBA: I think you a lot of the surgeons waste a lot of time and energy you know, worried about the competition where I, I would rather focus on just doing your best, excel at excellence and it'll all work out.

Do you have a hyperbaric chamber? I, I love, I did it I mean, it's no secret, I've had two facelifts actually, and one, I was, I had a time crunch and the surgeon said, you've got to go to that hyperbaric thing and I thought, well, it ended up being, I don't know what was 1, 200 or something. I can't remember now because I was completely out of my mind at the time.

But I was going in there, sitting in there thinking. This is great. This is weird. It's great. I'm walking, I'm watching movies and I've never sat around so, long doing nothing. And I thought, is this really working? And then, I mean, I was up and gone and out the door ready for prime time in 10 days. And I thought, I think it was amazing.

And if nothing else, it's a huge differentiator because if you're offering that, because there was a pain in the neck. I had to talk about going outside. I had to go to this center to have it done. It's just a pain and get somebody to drive me and all that. If you have it in your office and you offer it as a package to go, like that goes with your facelift.

I hope you are because Huge differentiator, don't you think? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Absolutely. It has been. It's awesome. So, yeah, and I, I did a ton of research beforehand and talked to a bunch of my colleagues and then I actually, Catherine, I put it in my house. For about eight months because I wanted to use it, I wanted to test it for what?

And well, I, so, what I did was and, and I didn't have a way really to like write this up or objectify it as much as I would need to. So, but I ride road bikes, right? And so, Saturday morning is, is our big ride every week. And it's intense. It's super intense. This is not like a little joy ride. It's like super intense.

And so, I began spending two hours on Friday evening in the chamber on one week, and then I would take a week off. And then the next week I would be back in the chamber for two hours on Friday night, and then I would take a week off. And on average, my heart rate was about 15 to 20 beats lower. when I was in the chamber the night before, and the bike can measure how hard you're pedaling, and my, my power would be higher with a lower heart rate.

And at first, I was like, this is placebo. This is not real. But it, it continued and, and the results just kept It kept continuing. And so, you know, I did that for about four months straight. And so, I was like, all right, I'm a believer in this. And then one of our other employees had had some knee issues where if he sits at a restaurant for an hour, his knee stiffens up and he has to take like a good five minutes or so, to kind of loosen up his knee and he started hanging out in the hyperbaric chamber.

And that. Went away completely. So, it, you know, those things. And then, of course, patient stuff we've had, I've had some other people in the community, like if a filler got a, an occlusion event. And so, you know, she calls me on a Saturday and is like, Oh, my gosh, can you please, I need to get this person in hyperbaric chamber.

So, you know, turned and that was, you know, a night and day difference between kind of how I saw this patient initially and then how she was upon leaving. It's a game changer for sure.

Catherine Maley, MBA: Does anybody else in your community have one? Can you use it as a differentiator in your marketing? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: I don't think anybody has one.

There are centers around. And I think it'll, it'll be a, it'll be a moment, just a period of time before. People all get one. And so, I don't think it's something that we've really flexed as of yet, as far as marketing goes, but it's certainly probably an opportunity that I'm missing.

Catherine Maley, MBA: I would definitely get it in your Instagram and talk about it because the general public doesn't really understand it at all.

And if you can explain it to them and the benefits are you're up and running much sooner than you would have been without it. Or you're literally running, apparently, it's good for your joints too. I didn't know that. I just know it helped me get up and back. Back up into life much, much faster than I would have normally.

So, all right. So, what, what's working for marketing? What, how did you get so, busy? I want to know what your secret is. What are you doing? Did you, I mean, you're doing some social media. Is it a lot of time spent there? Is that where all the marketing efforts are going? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Well, no, I think, okay, so, my biggest secret.

Is just doing one thing at a time and when and so, the patient that's in front of me, it's 1000% of me in that moment. And so, my only focus in in the day in and day out is taking the absolute best care of the patient right in front of me. That's, that's my thing. And so, and, and so, that's kind of, it all kind of stems from that.

You know, you just play the next play, you just focus on the next thing to do. And so, that's kind of been my mantra and that's kind of how we've, how we've built what we have. As far as marketing goes. I think Instagram is really, really awesome. I saw Rhino Plastic Consult today. She found me on TikTok.

We don't do a ton on TikTok, but that's great. Word of mouth is, is great too. And so, you know, but I think definitely I do my own Instagram. I would say I would put an asterisk on that. We have Nicole runs our Instagram. Like she's the brains behind it, but then I put my captions, you know, on it and I write that and then I respond to a lot of the direct messages myself on Instagram.

And so, it's been, it's been great. And so, I do these Instagram lives on Wednesday. And so, my whole thing. My whole thing is just educating patients, right? So, so, far, Catherine, I've done like, I don't know, 20 or so, of these Instagram lives on, on Wednesday evenings. And so, far I've helped five people who have five people have written me and said I was going to do But now I'm not because of what you taught me.

And so, I've, I've at least helped five. And so, I, you know, every evening when I'm doing that on a Wednesday evenings, I say, if I just help one patient, then this was worth my time. Because it can, you know, people can make. make big mistakes out there. So, just educating patients and, and kind of trying to uncover the veil of, of, of plastic of facial plastic surgery.

And there's been huge advancements, you know, whether you're talking about ultrasonic rhinoplasty, or you're talking about deep plane facelift, these things are like massive paradigm shifts that I want, you know, the public to understand these differences and these nuances.

Catherine Maley, MBA: And do you find that because your reach is much bigger when you're on Instagram, it's all over the U.S.; all over the world. Are they coming in from all over? One of my issues with that is, that is more of a one and done. They love you, but they're also much more cost sensitive, I find, than the, the local patient who, who's heard your name, who's on your website, who isn't so, sticker shocked, just, that's just my thought.

But what, what do you say to that? Are they coming in? Like, are you able to track any of this? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah. So, over half of our patients now don't live around us. So, they're coming in from out of state and just kind of thinking off the top of my head just this morning. Neither one of the patients that we operated on were close to us.

One lives in Ohio. And then the other one, I'm not sure exactly where she lives, but yeah, so, people just are, are traveling and last Thursday patient was in from Tennessee and she kind of, she, you know, she's in her sixties and had done a ton of research and said, you know, if, if traveling down here might definitely makes me more comfortable cause she's watching me on Instagram and she kind of, I've taught her a lot of the things of, of how we do it and what to know what to look for.

She's like, I'm just more comfortable down here. It's not a, it's not a bad drive. And, and so, you know, it's they're down here for a week, 10 days, depending on what it is. And then boom, they're back home. It's just like, it never happened. It's a crazy thing.

Catherine Maley, MBA: That's fantastic. Are you doing any other kind of marketing? How did or does this impact your ability to be in solo practice with no debt?

I know you're probably doing SEO. You have a great website. I know who did it, you know, they're, they're the right people. You, that was an investment, right? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yes. Yeah. And that's a funny, funny story. You know, we had, they'd been kind of talking to us for a long time and I, those they're great, great people.

And, you know, built a. Built a beautiful site, and I think that a website is a good thing to have, and it should look nice. It should kind of match your brand but I really think that the social media stuff is more important, probably or at least. I would should say it's probably a little bit more effective at grabbing that patient maybe and driving them to your site, but I we don't do really any other marketing so, I don't we don't do any print ads or any of that we it's mainly just that.

Catherine Maley, MBA: But all those videos you're doing have you hopefully started a YouTube channel and you're. Adding all of that on. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yep. We've got a YouTube channel and, you know, it's the kind of thing, Catherine, I don't know if you, I, if you remember that old alligator game that kind of like the little alligators and you, and you hit the hit one and another one pops out.

That's kind of how I feel like with the social media.

Catherine Maley, MBA: I'm older than you. So, we didn't, they weren't alligators. I think they were cats or something.

Philip Robb, Jr., MD: Well, you know, I just feel like, you know, you, you, you put your neurons on. On Instagram, and then, and then you're like, Oh, but tick tock, you know, and we, Oh, okay.

And so, then we like allocate some resources to our tick tock. And it's like, well, we need to allocate, we need to put all these and compile, comprise all these things and put them over to YouTube. And, you know, it's, it is a lot. And so. Yes, we're working on that and it could always be better, but our team does an awesome job at, at kind of getting all that because just like what I've learned this actually from you is, you know, get the patient saying something and, you know, you can use the whole video on YouTube.

That's a longer. You know, your longer time, your longer videos, break up little pieces and put those in Instagram or Facebook things. You know, you can write a blog post on it. You know, you can use one piece of content for multiple things.

Catherine Maley, MBA: That's from you. In different ways. Yeah. When I learned that, I thought, wait a second, this is just protocol, like everything else.

So, I got my team together and I said, you guys, we're working too hard here. I'm doing 500 videos and nothing's happening. And then we learned, I get it. You have to break it up and you know, and, but you're constantly repurposing content in a different format. It's just so, it makes so, much sense because it's not, it's not that much extra work for the content.

Growth or spread that you'll get from it. In today's world, you just have to be everywhere. It's so, frustrating. And just when you think you have it figured out, you know, here comes tick tock. Oh, great. Now I have to figure that out. Are you a dancer or anything? Are you into that? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: No, I have not. I have not.

No, I think yeah. If I started dancing on Instagram or on Tik TOK or whatever, first of all, we would have zero followers and would be disturbing for everybody to see. So, no, it would be painful.

Catherine Maley, MBA: So, I have to ask this because on your website, and I don't know if this is a sensitive topic or not, but you're definitely talking about your faith, and I personally love that because you're calling out who you are, you know, your values who you are, your philosophy, has that worked for you against you? Has it made any difference? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah. Good question. Yeah. I, you know, it's who I am. And so, that was definitely, you know, when, when I was making my first website, you know, that's the question is, do you put that on there?

Do you not? And I'm like, you know, it's who I am. And, and so, what I have found Catherine is, is the more you can be you on social media and your website that will select the kind of people who come to see And so, the more you, you are, then the more your people will, or people that That value, those things will come to you, right?

And I think when that occurs, then you have a higher likelihood of making them happy. You have a higher likelihood of being friends with them. And, and so, I think it's really worked, worked for good. But I don't know how it's. You know, if it's hurt me, it could have people might be seeing that every day and saying, Oh, you know I'm not going there, but we, we, it certainly doesn't mean that I only treat patients with the same faith that I am well, we take care of everybody for sure.

But yeah, so, I, I don't, that's, that's a good thing to, to ponder, but I kind of. Decided like good or you know, it's gotten me this far. You know, and so, I’m all in.

Catherine Maley, MBA: I've been marketing for a long time and you learn early on You're better off putting that flag in the sand of this is who I am If you want to detract those who are not like you and you want to attract those who are like you, that's a really good way to attract like-minded people.

But you have to let go of the part where some people can't stand that or some people hate you for that. You have to let that go because all that you care about in marketing is who gives you money and Are you happy with the outcome? Are you happy with that group that you're serving? And let the rest go.

You can't make everyone happy. And it's such a mind game going, but they hate me, but they say bad things about me on Instagram. And you just, they're not your people. That's all there is to it. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Yeah, you can't make, somebody much smarter than me said, you know, you can't make everybody happy even if you're selling ice cream.

You know, somebody's going to be mad about something. I think it was Steve Jobs who had some kind of comment like, unless you're giving away free ice cream, you know, 24/7 and you're never closed, you're going to make somebody unhappy.

Catherine Maley, MBA: Yeah, that is so, true. So, is there, is there any, we're going to, we're getting close to wrapping up.

Is there any advice you would have for others? Because you are definitely doing things. Right. Any advice for others up and coming or even open around for a while? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: Like, yeah. Well, I think that there's, there's kind of two avenues I would say one from kind of a business perspective, I think it's incredibly important that you align yourself with a good Team and a good and so, that you can hand things off, which is not easy for us to do as surgeons.

Like I w I wanted to do everything myself at the beginning and to delegate is, is difficult, but you have to also be patient enough. Teach. the people who you're delegating so, that they do it the same way that you would do it or close to or maybe they do it even better. And then as far as for the surgical side of things, I, I never stopped investing and, and spending resources on becoming a better surgeon and learning the new frontiers and the new techniques, even though it's not comfortable.

To, to learn new things and to try new things. And so, you know, I've gone to cadaver courses and there's another one I'm, I'm signed up for later this year. And, you know, we have right now, I feel like it's such an exciting time. Like I was mentioning in facial plastic surgery because of the, just the innovations, I mean, rhinoplasty innovations over the last couple of years have been incredible.

Incredible. And before that, there wasn't really many big, you know, changes or paradigm shifts in hundreds of years. And so, you know, that, that's a huge, huge thing. And so, I tell patients, you know, I'm kind of, I just do nose, neck and face only. So, I'm a super, super, super specialist in these things. And so, I'm kind of like a three-trick pony.

And if that's all I do, I better be really good at them. And so, that's my kind of my commitment to my patients is to keep learning, and you know, keep getting better.

Catherine Maley, MBA: For sure. So, tell us something we don't know about you. How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: I knew you were going to ask this. And so, there's a couple of things that I was that I was.

Toying around with, but I think a cool story is that I have played craps with Jon Bon Jovi in Las Vegas.

Catherine Maley, MBA: No, did you know it was him?

Philip Robb, Jr., MD: So, no. Not at first, I did not. But and this was years and years ago. I was in college, but, and then I started singing the song for him. not really singing, but just kind of play singing that he did not sing.

And so, it was, it was a really funny thing. And so, yeah, that's my claim to fame.

Catherine Maley, MBA: I don't get it. Why are you singing to Bon Jovi?

Philip Robb, Jr., MD: Well, we were, we were playing craps and we were having fun. And so, I didn't realize that it was him. And so, a lot of people start coming around and then we start, and I, I had shorter hair and there may have been a little product in my hair.

So, he may have called me a backstreet boy. And then I, I started singing a song that I thought he sang, but he didn't. It was Def Leppard, some other, some other song. And so, yeah, that was it. We've been best friends ever since.

Catherine Maley, MBA: Did you get his autograph?

Philip Robb, Jr., MD: No, no. But that's something that's interesting about me for sure.

Catherine Maley, MBA: Well, and you have a wife and three girls. So, what's it like? Is the dog at least male?

Philip Robb, Jr., MD: Yes, he is.

Catherine Maley, MBA: You are surrounded by females. What did you grow up with females or was this all new to you? How did or does this impact your ability to be in solo practice with no debt?

Philip Robb, Jr., MD: No, I grew up with two sisters and a brother. So, there's four, four kids in the family. And so, yeah, I think.

Yeah, my, my three daughters are amazing. And my wife's amazing. And, and, and then the majority, we have a couple of guys on our staff which is good. And then, yes, we do have a boy dog, which is, which is critical. But yeah, that's just kind of my, I don't know anything different, Catherine. It's just kind of like, it's where I am and it's, it's, it's great.

I can't complain.

Catherine Maley, MBA: Oh, well, you're just doing such a great job. I'm excited to just watch you grow more because all your moves seem, I mean, it seems like it's been easy sailing for you. I don't normally hear this. It's usually a rockier road. So, but yours seems to be fantastic. So, so, far so, good. If somebody wanted to get ahold of you, what would be the best way?

Philip Robb, Jr., MD: They can email me at [e-mail], or you can go to our Instagram. We're @robbfacialplasticsurgery, and you can DM me there and happy to interact.

Catherine Maley, MBA: All right. Well, thank you. So much.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on how to be in solo practice with no debt.

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

A big thanks to Dr. Robb for sharing his experience on how he got into solo practice with no debt.

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 “Solo Practice, No Debt — with Philip Robb, Jr., MD”.

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