Solo Practice Within Group Practice — with Sam Jejurikar, MD (Ep. 207)

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 being in a solo practice within a group practice.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients, more profits and stellar reputations. Now, today’s episode is called "Solo Practice Within Group Practice — with Sam Jejurikar, MD".

Some surgeons dream of complete autonomy. They want to do whatever they feel like doing without having to answer to executive boards or other surgeons they work under.

They want to set their own hours, hire and fire staff and buy equipment if they feel like it.

They also want to make more money and assume they will in solo practice since they keep all of the profits and not just a percentage.

However, the flip side of that autonomy means they also get to handle their own books and inventory, while also marketing to attract cosmetic patients.

The business and marketing side of plastic surgery can be fun, daunting, uncertain and confusing.

So, is Solo or Group practice better?

Here’s a unique business model that allows you to run your solo practice as you want, but also enjoy the perks of being under the umbrella of a much bigger practice. Very interesting!

This week’s Beauty and the Biz Podcast was an interview I did with Sam Jejurikar, MD, a board-certified plastic surgeon and a member of the Dallas Plastic Surgery Institute

that includes 10 surgeons, 4 ORs, 40 staff in a 45,000 square foot facility.

We talked about their unique business model to buy into the practice but run as a solo practitioner and how they make decisions with so many surgeons involved.

Visit Dr. Jejurikar’s website

P.S. Want Catherine’s book for free? Just leave us a review, text [phone] and her book is on the way!

📲 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 Within Group Practice — with Sam Jejurikar, 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 being in a solo practice within a group practice. I'm your host Catherine Maley, author of Your Aesthetic Practice — What your patients are saying", as well as consultant to plastic surgeons, to get them, more patients and profits. And today's guest is Dr. Sam Jejurikar, who is in solo practice within a group practice. Thank you.

He's a board- certified plastic and reconstructive surgeon, who has a solo practice within a group practice, and a member of the Dallas Plastic Surgery Institute that performs cosmetic surgery, pediatric plastic surgery, breast reconstruction, and complex wound reconstruction. Now, the institute includes 10 surgeons. The Dallas Day Surgery Center of Cloisters Hope Post-Operative Recovery Facility, and the Epicenter Skincare and Laser Center.

Now, Dr. Jejurikar received his medical degree from the University of Michigan Medical School and has been in practice for more than 20 years, and he also has the most incredible podcast name that I've ever heard. So, we'll talk more about that. And he also is very involved with Smile Bangladesh, so, we'll talk more about that.

Dr. J, thank you for coming on and welcome to Beauty and the Biz to discuss on the topic of being in solo practice within a group practice

Sam Jejurikar, MD: Thanks so, much for having me. I really appreciate it.

Catherine Maley, MBA: Sure. So, just quickly, can you give us a recap from Michigan? How did you get from there to here? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, after I finished at Michigan, I actually did an aesthetic fellowship at Manhattan Eye Ear. So, I spent a year there and I kind of circuitously wasn't sure where I was going to end up after I was in New York.

And one of the opportunities that, that I had was to join this amazing group, Dallas Plastic Surgery Institute, which, Is, is really kind of unlike many other business models. And I know you've had a lot of solo practitioners on, on the show, but it's, it's basically an opportunity to set up a solo practice within the greater confines of a group practice.

And so, that was 2009 when I made my way to Dallas. And I'd actually had a, had a little stop before that where I was actually in a multi-specialty group for about three years before I came to Dallas. And that was where I realized I really didn't want to work for anybody else. I liked the autonomy of working for myself.

So, I've been, I've been at D Psi ever since. That's how, that's how that all sort of ended up.

Catherine Maley, MBA: Then and that's why I wanted you on, because it's so, unique what you're doing and I can't tell what you're doing. It looks like it's an LLC. Then I thought, oh, maybe they're hooked up with the hospital somehow, but then they have a fellowship program and I thought, what, can you just explain your business model? How did this influence your decision to have your solo practice within a group practice?

Cause I don't get it.

Sam Jejurikar, MD: Yeah. So, our business model is we are We are basically a confederacy of solo practitioners. We've got in D P S I at this moment in time, we had nine full partners and three associates, all of whom are separate PAs. But we have a common. We have a, a common holdings company that manages our group.

So, we have some economies of scale. We have a business office, which is really robust, which helps all of our individual practices and our, and our entities. We've got some shared front desk employees. We've got shared photography studios and, and, and employees all together. We have about 40 shared employees between all of us.

Then we have our own individual employees as well within our individual pods. And then we have our ancillary businesses. We've got a robust blood ASF certified surgery center that's got four ORs. We've got a really robust skincare laser center called Epicenter. We've had an overnight you know, recovery Center, which is sort of an outpatient recovery center for patients where we kind of teach them how to take care of themselves, or we have four beds as well.

So, we utilize economies of scale to, to run a really efficient solo practice within the greater confines of, of a group practice. So, I feel like I have partners, but at the end of the day, we are competing against each other.

Catherine Maley, MBA: So, does any, do the patients realize that you are all individual or do some patients call the center and say, I'd like to book a consult with a plastic surgeon and if so, divvy. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: We don't really have a main number that, that has like a receptionist that divvies that up. Like if you, we, there is, we do have a group website, which is just to have sort of a placeholder. And it hosts our fellowship. So, we have two aesthetic fellows every year. You know, we think we have the best aesthetic fellows aesthetic fellowship in the country.

Everyone. Yeah. And it, and it, and it hosts, it hosts our you know, it's, it's a portal for the fellowship clinic more than anything, but there's not really a central number for people, for people to call. There's a business office. So, every now and then you know, they might in accidentally call the business office, at which point the, the la the way the group's actually set up will, will be explained to them and then, and they need to figure out what doctor they actually want to see.

Catherine Maley, MBA: Do you own the building or is it lease? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: It's a lease face. It's a, it's a, it's something that we regret in 2008 when we moved to this building, which is in the heart of Dallas. There was an opportunity to buy the building and we did not actually take advantage of that. And so, that's actually a big focus of conversation for the group right now because we're, we're coming to sort of the end of our lease and we're trying to decide do we renew this where we're in such a, you know, fantastic location, or do we, or do we pick up and start all over again?

It's a, it's a huge source of controversy within the group right now.

Catherine Maley, MBA: How do 10 surgeons make a decision of that magnitude? So, far we have, I can't imagine. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Yeah, I mean like any group, there's some people that take more, more interest than others. Some that are leading the charge, some that are following different, you know, as you've been talking to different surgeons at different stages of their career, ones that are closer to the end of their career aren't particularly excited about doing that.

Ones who are starting their career are very excited about doing that. And so, I don't know what the final resolution is going to be.

Catherine Maley, MBA: Give me the pros and cons of this situation, because you were, I guess you'd never really been in solo practice, but you were in a multi-specialty practice. Probably.

How many surgeons were there? Was it a big one? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Oh, I was, I mean, I was with a huge organization there were in, in, in the city that I was in, there was there were about a hundred surgeons altogether for hundred physicians altogether. And then it was part of a much bigger, it was the, it was the Scott White Healthcare system before they merged with Baylor.

So, hundreds, hundreds of doctors. So, yeah. Okay. So, the advantage of where I'm at right now is I have complete auto autonomy to, to run my practice in any way I see fit. I can hire and, you know, hire and fire the employees that I want to. I can market in any way that I want to. I can do the procedures that I, that I want to, but I have the same pressures that anyone in Stella practice does, which is you know, if times aren't as busy, I have to, I have to figure out where my customers are coming from.

So, so, I think the only downside is there's some degree of uncertainty when you're on your own, but I think the, the majority of them are all, are all you know, they're all pluses. It's, it's, it's I mean, I, I think I make a lot more money this way than I, than I did when I worked for somebody else for sure.

So, I mean, I, I think and the other thing, the thing that's different about our solo practice, I know it's been a big topic on your podcast, is about how to exit your practice. Yeah, yeah. So, this is a situation where we're approached by private equity probably once a month about someone wanting to acquire our practice.

No one on the outside really understands what our practice is. What they quickly start to realize is if they, if private equity wants to acquire us, they actually need to talk to individuals within the group. About acquiring their individual practices. Of course, they want our ancillaries as well. And so, we never really get all that far.

The, the, the thing is, is we have an easy way to exit our practice, which is, When we, when we join D P S I, there is a buy-in. There's, there's two sets of buy-ins. There's a buy-in to you know, our, our physical you know, our surgery center to our, to our profit centers basically which is based off of a fair market value.

And then there's also a buy-in to the group itself, which is, there's basically a membership for you to join. You, you pay this membership fee, but you al actually get paid it out as well as you're exiting the group. So, I've paid in my membership fee, but now I'm actually at that phase of my practice where younger guys are actually buying the process of buying me out.

So, when I leave you know, whether it's a, a building that we own or whether it's our lease space, some new associate will probably take my space or they'll hire someone else to do that. So, it does make exiting the practice relatively easy.

Catherine Maley, MBA: Are there like any disbursements along the way or are you just buying in, doing your thing and then when you and it's time to exit, you just get that big chunk then? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: No, just for tax purposes, we get it as it's being bought in. So, the structure is when people are associates in that first two-and-a-half-year period before they're made a full partner a, a portion of their, of their profits go to the, the partner whose turn is to be bought out. And so, from a tax purpose standpoint, the person who, the partner who's actually getting.

Getting that that distribution pay taxes on it. And so, the group doesn't want to hold onto that money because then it becomes a liability for this holding company, which doesn't really have any income. So, so, in, instead we pay taxes on it and we get it when it comes in. So, even though I'm nowhere close to retiring, I'm fairly close to being already bought out.

Catherine Maley, MBA: Nice. Very, very interesting. How do you divvy up the overhead? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, I think there's, there's, there's two. There's overhead that's related to our common expenses. So, that's divided. You know, the denominator is a number of partners and that's equally divided. Then there's overhead that's related to our individual pods, my own individual employees, my own individual marketing expenses, my own individual rent for my individual space.

That's my own, my own to pay for. And then we have ownership, you know of our, of our ancillaries. And so, the same sort of deal, it's your, your percentage equity ownership is, you know, what, what you're on the hook for from a liability standpoint.

Catherine Maley, MBA: I have to tell you, this sounds like an accounting nightmare.

How are you keeping track of all this? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, we, we have we have multiple accountants that are full-time employees of our practice. It's actually, if you saw our accounting, you'd be blown away by the level of organization. Like we all have. We all have things that we love about T P S I, if you ask. You know, the most senior and well-known partner, Rod Rorick, he’s going to tell you it's the surgery center.

If you talk to other partners, they’re going to tell you it's our great skincare center for me. Who's, who loves numbers? I think our business office is incredible. And the level of organization and the level of detail that I know every single expense in my office would blow you away. And aren't you very involved in the accounting?

I am, yeah, I got an m MBA and so, I'm, I'm not actually doing the accounting, but I'm overseeing the reports and our analytics that go out every month for sure.

Catherine Maley, MBA: Do you have meetings with each other? Like, I, is it, does it feel like a good comradery there? Does it feel competitive? Like, what is your culture like? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: You know, I think with any large group of plastic surgeons, you deal with enough of them to know that not everyone is best friends with each other, but and we have disparate. Thought processes. There are some different visions for the group among different, different people, but there's a healthy respect for all the partners amongst one another.

I think that's, that's, that's uniformly true. We've got a leadership structure that basically has an executive committee of, of currently four of the partners altogether. I'm one of them. We meet every month. Well, we have a regular standing meeting every month. We have a quarterly meeting of all the partners to talk about.

To talk about bigger issues and if there's pressing issues. I mean, my, the surgery center, I work at my office, space Skincare Center. Everything we do is under the same roof, so, we're always there all the time. Should there be a reason to communicate more often?

Catherine Maley, MBA: That's amazing. Do you, if there is you're trying to make a decision, is there a final say? How did this influence your decision to have your solo practice within a group practice?

Is there a dictator there that says this this is how we’re going to do it, or is it a democracy? Are you voting? Because if you have four, what you know, that's, how's that working out?

Sam Jejurikar, MD: Yeah, so, if we have a two, two tie, it goes to the partnership. We don't, we don't have a dictatorship because we're not, we're not one corporation, you know, we, we, we, that wouldn't work effectively for us.

So, and if it's a big, you know, the, the executive committee of, of the four of us, we tend to make the day-to-day decisions. We tend to do sort of the relatively mundane things. Big group decisions are decided by all the partners.

Catherine Maley, MBA: I mean, the decision you have coming up that has got to be a big deal for you to try to decide, do we stay, do we go, do we, are, are you thinking about buying somewhere else or completely relocating, or are you thinking about just building in how, how many square feet do you need? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, right now we have about 45,000 in the heart of Dallas. But as you know, I mean, if you’re going to think about a time to potentially invest in commercial real estate, yeah. I mean, the market is really depressed right now, right? And so, and so, this wasn't something that had really had really crossed our mind.

More than a few months ago, but there are some opportunities right now. So, yeah, we're having lots of conversations about it. They're, they're healthy productive conversations. We, we have a five-year period of time still before our lease set would actually end. So, so, we're, we're working with a big enough window of time where we're not, we're not rushing into anything.

Catherine Maley, MBA: I would say though, if you, timing is perfect for a really long lease, if you want to stay put, I go long, long, long. Yeah. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: We're getting some pretty competitive offers. Yeah. Like, we're actually we're getting some pretty competitive in fact, the building that we owned was just sold and they really, I mean, as you know, they really want us, we're their primary lease holder.

So, they're offering us more and more because if they want to turn around and sell the building again, having us locked up. For another 10 or 15 years would make it a much more attractive building for sale. So, we'll see what happens. We don't really know.

Catherine Maley, MBA: Yeah. Oh my gosh. Out of curiosity, how does the surgery center work? How did this influence your decision to have your solo practice within a group practice?

Do you have blocked surgical times and or are you fighting over them or who gets there first? How does that working first come, first serve?

Sam Jejurikar, MD: Yeah. And yeah, there's, there's definitely, and it's busy. There’re definitely days where I can't. Get on, at least at the times that I want to get on, in which case I have to readjust my schedule to get on, or I have to work at another surgery center.

Many of us have carve outs at other surgery centers that allow us to own a piece of another surgery center as well. So, I'm lucky enough, oh, to actually have an ownership share of another surgery center that's owned by a large hospital system here in town. So, if, if that happens, I, I have another place that I can go to.

Catherine Maley, MBA: Is there an any plans for expanding to more ORs? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, that leads in perfectly into the conversations that we're having about building our own space, because right now we're locked into our building and. There's not necessarily a great way to build a fifth or even sixth or without majorly disrupting operations.

So, yeah, it's a conversation we have all the time. I think our first step though would be before we, before we actually. Before we actually build another or, or two, is we're lengthening the hours of hiring a second shift. So, we're now getting to the point where we have two late rooms that go to later in the evening and, and a second PACU shift that comes on.

So, we’re going to start with that before we start, before we start changing the actual physical infrastructure.

Catherine Maley, MBA: That's interesting. So, so, like a patient can have surgery at six, at nine kinds of thing. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Maybe not that late. I couldn't go all day. It's definitely like five o'clock. But five o'clock. Yeah. I mean, if we, we can finish at seven, that's our goal.

And we start as early as six 30. Many of the rooms start at six 30 in the morning.

Catherine Maley, MBA: Gotcha. Okay. So, the, so, the exit strategy, when people come on, they're coming out long term, like they're signing contracts that they’re going to stay put Right. Because that's the way your business model works, but just let's say it, it just didn't work out you know, a personal problem, whatever.

Yeah. How, how do, how do you, how do you unravel some of this if somebody needs to leave or wants to leave? Is there a way out? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Yeah, there is. I mean, just like any business or any sort of marriage, sometimes things just don't work out. And we've had this happen before. There's, you know, like many practices, there's a non-compete that's a certain geographic radius.

Ours isn't particularly onerous. I, I don't even know what it is, but I think it's 15 miles. And it's two years. If they want to violate that non-compete, there's a financial penalty that they would pay to stay within that zone. But Dallas Fort Worth is so, large that usually they can find a place within the Dallas Fort Worth metroplex and still not violate their non-compete.

I think we're arrogant enough to think that if you want to leave, we're still going to be fine.

Catherine Maley, MBA: I think so. So, so, let's talk about that because what was really interesting, I like to check you out as a patient would, as a prospective patient. And so, when I Googled you up comes the main website and what was really interesting was.

They immediately, there's a homepage. It's not fancy at all, it just has a bunch of your pH photos on it, and I just clicked on yours, and the minute I did that, I went straight over to your website and I never came back. Like I couldn't come back to the. The big practice. I, I just stayed with you and I thought that was a really, that was really good because now I can't fiddle around and say, well maybe I'll go to somebody, you know, let me check everybody out.

And so, I Is that what ha that I assume that was on purpose. You know, once they say you, it's you. Right. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: That's right. Our, our, our D P S I website is just a placeholder in case somebody wants to know more about D P S I. It's really common because I think, I think my partner is, Or many of my partners are amazing surgeons and, and it's, I can't tell you, but it happens multiple times a week where a patient's seeing me for a consult and, you know, they may be seeing two other surgeons who they think are, you know, are, are great people in Dallas to have the same thing done.

And it turns out they didn't even realize they were my partners; you know? They were just in the building two days before that and they’re going to be back the week after or something. So, so, yeah, I mean, in an ideal world, people didn't even recognize that some of these, that some of us are, are, are great surgeons.

I've got, my youngest child goes to a you know, a small private school and, and I can't tell you the number of my wife's friends that I meet at sporting events that are going to one of my partners for surgery. It always kind pains me a little bit. But it also makes me feel good that, that I'm in practice with such good people.

Catherine Maley, MBA: Right. For sure. So, would you say that name has been helpful to you or it doesn't really matter because you're going off of your own name? You're, you're not like trying to ride the coattails of Dallas Plastic Surgery Institute. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: I think it's incredibly helpful. I think I mean I think it, you know, you look at it when you're starting off in practice.

When I came to Dallas, I had no connections to the city of any kind. It gave me legitimacy right away. Yeah. They're like, oh, you went in this group. You must be pretty good. It helps me with, with business contacts and business opportunities because You know, we're a huge contract with Allergan.

We're a top 10 account, we're a huge contract with Citra. We, you know, we, we get approached by a lot of people within the industry who want to, you know, make us a test center for, for something they're doing. So, it, yeah, it's, it's a huge opportunity to be part of this group from an individual marketing standpoint.

Maybe not so, much, you know but, but it is certainly not a harmful thing and, and every other aspect of business is fantastic. So, let's talk about marketing

Catherine Maley, MBA: channels. Your social media. I mean, you've got over a hundred thousand followers. Are you spending a lot of time on content creation for social media or you've got a team doing that, or how's that working out? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Me personally spends very little, spends very little time on it. But yeah, I've got we, you know, we used to work with an outside company. Now it's just redundant internally within the office. Mm-hmm. I think there's different kinds of practices, some practices where they generate a lot of new patients from social media.

Mm-hmm. I don't think I'm probably one of those practices. I think people look at me and they, my social media is just sort of a check mark where they've sort of verified that I'm legitimate, that I. Actually, do exist. I've got plenty of before and after pictures that are on there, and that's how we treat it.

So, I, I don't personally spend a lot of time on it, but, but you know, there's, there's a, an employee in my office who spends half her time filming stuff and putting together videos and things like that.

Catherine Maley, MBA: That's what I, I'm, you know what I, my, the answer is it depends. It depends on your personality and your interest and passion for it.

Some of the doctors are just crushing it on Instagram and mm-hmm. But that could also, you know, shut down the minute something happens with Instagram and it goes down, you go down with it. So, that makes me very nervous. I always say to people, make sure you're getting these followers to give you your, their name, cell phone and email in case something were to go wrong because patient plastic surgery and.

And social media do not get along and it's getting worse. So, but if, but if you like doing it, do it. But if you don't, don't be spending two or three hours a day fiddling with it if it's not what you want to do, you know? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Yeah. I, I don't think I have the personality that's particularly magnetic for Instagram.

I just recognize that about myself. I think I do great work. So, that's what we focus on there.

Catherine Maley, MBA: Yeah, me too. I, I, I'm not a social media queen at all. So, let me ask you about patience. How do you see, you know, you've been around for a while. First of all, are the patients getting older and maturing with you?

So, now you're moving from just breast aug to more mommy makeovers and more to facial rejuvenation. Are you doing any of that? And does it feel like the patients are changing? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Let me answer your second question first. Definitely there's, there's a lot of patients that are in my practice that have been with me for 10 plus years.

And so, so as the, those patients themselves are maturing yeah, that what the, I'm, I'm definitely doing more facial aesthetic procedures on them and if I did a breast dog on them before liposuction, now maybe to tummy tuck or a, a bigger mommy makeover. You know, I, I do think though, with it being a major city and a major market, people tend to look for specialists and things.

And so, even though I am, I have a fellowship basically in facial aesthetics. My reputation is for body contouring. I mean, it's for breasts and Tommy's and butts and liposuction, and that's hard to escape. So, I, I do find, That like today, for instance, instead of my patients maturing, I'm operating on children of my patients.

Like today I did, today I did a breast dog and a liposuction case on two different patients, both of whom are the daughters of patients I did like 15 years ago. So, so, maybe it's not maturing, maybe it's just I'm staying in the family. I'm not sure. Okay. Nothing wrong with that. Yeah, exactly.

Catherine Maley, MBA: Yeah. And do you want to stay body?

Because I have, I mean, some plastic surgeons have said to me, I am so, done with the young, silly patient, the breast dog patient who, you know needs to be out at the, the dance club, you know, two days later. And now they're complaining about pain. Like they were just, they had had it with that kind of a patient.

So, they, they did actually transition to face. And the more mature patient the one that cared more about their skill than they did about saving money. And they were ha I mean; I know I can think of at least five. That said, I, I'm happier now because I'm matured, so, I matured the patients as well. And do, do you see that coming?

Or you're fine with all of it? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: I think my price visit matured. You know, I'm definitely not a cheap press augmentation surgeon. You know, I, I think So, I think as my, as my pricing schedule has matured, I mean, I'm pretty happy. I like my patients. I tend to like that. Like I'm not, I'm not feeling this big need to change.

I love doing facial aesthetics. I love doing rhinoplasties. I love doing faceless. I do. It's but I love doing breast surgery and moneymakers and Tommy Tucks as well. I just, I don't know. I'm not, I'm not feeling this huge push to change anything just because I like my day to day a lot. Yeah.

Catherine Maley, MBA: Well, if you are, I mean there, you know, just know thy self.

If you're happy with what you're doing, there's no need to change. Yeah. What about your patients coming back for more? Are you more like a one and done or patience for life philosophy? Where are you at with that? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Definitely a patient for life philosophy. So, I turned 50 next month. So, I'm very much, I think, in that mid-career aspect of my life and I just want to enjoy like every day.

And so, I. Like the thing that my staff complained to me about, I spend a lot of time talking to people. I get to know them really well. It's really common for me to forget the procedure that I've done on them, but I always remember them and details about them. And so, no, I, I, I mean, you know this if you can hold on to your customers that life, that customer lifetime value is so, much more than having to go out and get new ones.

And when you get to know patients that well, and you genuinely like them and, and you do a good job for them, They get very loyal to you and they tend to, they tend to send people your way as well. So, the number one and number two sources of patients in my practice are either return patients or just direct referrals from them.

Catherine Maley, MBA: Right? Do you have any tips for, I mean, honestly, the, the two most important things going for somebody who's looking for you online are your reviews and your photos. Do you have any tips for how you are collecting reviews and photos or having any success? Getting them more often than not. How did this influence your decision to have your solo practice within a group practice? Sam Jejurikar, MD: I think I think the first part is don't delegate it.

You know, people, people are really happy when they're really happy. And you recognize that as, as the surgeon, you know, they, they want to do something nice for you because you've made such a big impact on their life. And sometimes I don't think they realize that it's as simple as doing a Google review.

I mm-hmm. I mean, if you want to do a Google Review for me, that's way more valuable than. Sending me, sending my office cookies, which are just going to make me fatter than I already am. And, and it's cause it's so, good for, for our practice. So, so, initiating that conversation with them yourself, I think is really helpful.

But then having a way to make it really easy. So, we use podium, you know, in our practice. Yes. And they'll just send them a little text message with a link from them, how to do that at some point. And I find that if I ask someone to do it, more often than not, they do.

Catherine Maley, MBA: That's the secret. The, the surgeon has to ask.

They'll get a much better response than the staff. What about the before and after photos? Is that a priority for you to get more of them or what's your feeling on that? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, again, I think one of the huge advantages that I have in being in the group than I am is because we have economies of scale.

We've got a full-time photography staff and we've got. Three photography studios between two different floors with, you know, amazing setups and a great database. So, yeah, I get before and after pictures on pretty much every patient in every visit. And I think I do really good work. Again, if I’m going to show it, I usually have a conversation with the patient more than just the signed releases, making sure they're okay with it.

And again, more often than not, people in today's day and age, and its still kind of foreign to me, but they want me to show their pictures online to them. That's sort of a sign that I cross some sort of threshold that like they're good enough to, to put on there. And so, I just mentioned, you know, I'll say something like, your results really good.

It'll be really good for my business if I show your results. Are you okay with that? And., They seem to really like that more often, not. Now,

Catherine Maley, MBA: I hope everybody heard that the pearl is, you give them a compliment and then you ask for a favor. And it's very simple. The surgeon does it, it's no big deal.

Mm-hmm. And so, many practices still say to me, there's no way my patients will agree to this. They just will not there. It's much too private. And I say, then how do others make it happen? You know, there's such a mindset shift. When you look at your patients as they're partners of yours and they're, you get, you did them a big favor by transforming their life, then they're more than happy.

Many of them are more than happy to re, you know, give it back to you within a review and, and photos. So, I just, yeah, I just start thinking bigger than that, especially social media for heaven's sakes. The stigma is so, Much diminished now from before. Everyone's out there bragging about everything they have. So, I don't buy that anymore that patients are private. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Oh, I totally agree. Patients take a huge sense of pride in knowing that their surgeon is recognized by other people, is being good, and they, they get, they get more intense about it than, than I do. I mean, I, I, I've never been in it, but I, I've learned that there is a Facebook group that has a bunch of my patients that are in it.

And they're really, really just like, they're very, they're like, they're very proud of me and my results and, and then I don't think I have a great social media. Personality, but I think I've got great before and after pictures. I do think I do good work and, and I think that's been great for our practice is showing it and to the point where now very often I'll get a comment from a patient saying, when are you going to put my photos on social media?

And I'm like, I just want your swelling to go down a little bit, but I promise you they'll go on there. Like I, I mean, patients bring it up all the time.

Catherine Maley, MBA: Ah, that's fantastic. So, I want to switch gears a little bit because the reason you're on my radar is because I was somewhere probably on Instagram and I saw something called this podcast and it was called Three Plastic Surgeons and a Microphone, and that completely caught my attention and I looked at it, I said, Three surgeons on a microphone regularly.

How did you pull that up? First of all, who came up with the name? Because it's fabulous. And then how in the world do you structure it where three of you are in the same place at the same time, or at least in front of the zoom at the same time? It is very hard to corral you, you people. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Yeah. Well, so, the name, my PA actually came up with that name. Her name is Colette Collabro, and we were trying to brainstorm an idea, and I think I had just seen back in concert the musician back and like two turntables in a microphone. She's like, why don't you call three plastics in a microphone? So, that's where that came up from.

The reason why we have an easy time filming it is the other two guys, Sam Re, who's in Bergen County, New Jersey, south Paella, who is in La Jolla, California. We're really good friends. We all train together at the University of Michigan. Sam was one year senior to me; Sal was two years junior to me.

But we're close friends, so, we like each other. We like hanging out, we like we like talking. So, in the pandemic, just like when everyone else was bored and podcasts started just popping up, we. We thought, let's do this. But Sam Re in New Jersey has technologically really savvy. So, he sort of put together, like as we, he, he produces all of them.

He does everything. He does the editing, he does everything. But but he's really savvy at doing all of this stuff. And so, we started doing it in the first few podcasts. We got some pretty big guests. We've got a lot of positive feedback. Then I started getting people that were coming to see me, like from other places in the country who said they found me from the podcast and I wasn't really.

So, then we got, we both, we all, we kind of realized how powerful it could be from a marketing standpoint. So, we kept doing it and it's, yeah, we've gotten a ton of feedback. We've gotten a lot of like; you know feed Spot always Consist consistently ranked us is one of the best podcasts in plastic surgery and.

We just have a lot of fun doing it and, and it's a very efficient thing to do it. We'll typically do it on the weekends. We'll do it on Sunday mornings. We can typically film an episode in 25 to 40 minutes and we'll do three or four at a time and kind of do that once a month.

Catherine Maley, MBA: And the topics, because I can't tell who's your audience, because sometimes you talk about plastic surgery via like the patient, you know, the patient itself.

Then sometimes you have industry people on there. Then sometimes you have colleagues on there talking about like you know, procedures. Who, who are you going for? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Well, no, I think we're just like talking to each other and we're, we're still figuring it out, but Gotcha. No, in all seriousness, its patient driven.

Okay. Cause even when we have industry, it's, you know if we have the ideal implant people on this Yes, I saw that. Yeah, because we're, we're getting a lot of, a lot of patients don't want to know about it and, and Sometimes, I think more often than not, because I'm in d p so, we're all in different sorts of practices.

Sam Re is a true solo practitioner. He's a, he's a one man show. South Paella is the head of plastic sugar group for the Scripps Clinic in La Jolla. So, he's in a, in a, in a very different sort of setting. So, I'm in a group that gets approached by industry all the time. Sometimes it's a way for the other guys to learn about it.

You know, where I'll, you know, I was talking to the CEO of a financing company the other day, and. And learning about some of the things that they're actually doing and, and I ask them to be on a podcast so, the other guys can sort of learn about it. Sometimes it's just each other. We're the audience, but other people find it interesting.

Catherine Maley, MBA: Right. So, you're doing it for fun. It's not like a big marketing ploy. How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: It's turned into a big marketing ploy, but we're doing it entirely for fun. Like, I haven't put, we haven't put much money into it at all. We've turned down people that want to do, you know, endorsements or advertising that have approached us for doing it.

Mm-hmm. I definitely get customers from it, but I have no way to track those metrics. But we're doing it for fun.

Catherine Maley, MBA: We love you. That's the only thing I don't like about podcasting. You can see numbers, but you can't see the details of the numbers. And that just drives me nuts is I think, who are these people watching this?

You know? And I, I, yeah, I have to count on them to like text me or deem m me or do something to tell me who you are. So, ah, that's a little infuriating, but there's no, I don't know how else to do it other than. Just keep saying, come to my website www.CatherineMaley.com and tell me who you are, you know? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Yeah. Well, I mean, I, I definitely know when I get a, someone in my office who's a patient who's blown from another state to come see me and they say, I saw you on your pod on, on the podcast, and I knew I wanted you to be my surgeon. Those are the best consultations. Cause as you imagine, you already know they're going to, they, they feel like they already know you.

Yeah. They know your philosophy about things. They’re going to pick you to be your surgeon.

Catherine Maley, MBA: So, but that's a 95% conversion rate. I don't know why everybody just doesn't make their life easier. And try the relationship kind of selling first, you know people who already come. No, you like, you trust you.

They come ready to say yes. All you have to do is not screw it up. You know, like they're, they're ready. I so, much easier than, than that stranger patient, that internet, stranger patient, you know, with their arms crossed, saying, who are you? What do you, don't try to oversell me, you know? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: Yeah, exactly. Hundred percent agree.

Catherine Maley, MBA: Yeah, so, well, we have to talk about smile Bangladesh because that, oh my gosh. I, it's like tear jerking. I saw one Instagram post and oh, the little girl who is holding up her picture of her as a baby, as with a cliff palate, and she looked fantastic now, and I'm thinking, girl, you don't know how lucky you are.

Like, wow. I mean, that was life changing. So, what, what's that all about? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: So, it's a, it's a group based out of New Jersey. The founder of the group is an oral surgeon. He's really well known in the oral surgery world. A guy by the name of Shahi Azi, when I met Shahi, he was the he was on staff at U M D N J.

He's over the, he's now moved over to Hackensack, but back then, this was more than 10 years ago. The, the cranial facial surgeon at U M D N J was Sam Re my colleague from oh three pack Surgeons and a microphone. And, and on the very first small Bangladesh trip that went, it was Shawhead Sam and a couple of nurses.

And on the second or third trip Sam invited me along. So, so, I went obviously I'm, as you know, I'm great friends with Sam Marie, but Shahi and I hit it off really, really well. So, they kept asking me to come back. So, for every, for You know, at least once a year for the first seven or eight years, I would go and I would operate and got more and more involved.

And, and, and at some point, I actually got, they asked me to be on the board of directors. And, and it's grown. The organization, the organization has grown from being a really small endeavor to being huge, huge group. Shahi is built and, and CHAI's story is really interesting. He. He his son was a or his father was a really prominent infectious disease doctor from Bangladesh.

Shawhead had never even been to Bangladesh, but when his father unfortunately passed away, he just told him to never forget where you came from. So, SHA head Made it his mission and he funded this, this organization. And the, the trips now are usually two-week endeavors. The first week they're doing orthotic surgery.

The second week they're do, we're doing clef surgery and I don't do orthognathic surgery. So, I'll go in and I'll do a bunch of clef surgery. And then we come back and, and it's an, it's, they're very emotionally therapeutic. Life-affirming sorts of trips because you'll be people that just have nothing and they are so, grateful that you're providing these services to them.

And so, they've been incredible experiences for me. I've gotten to take one of my kids with me, my, my middle son who's a freshman in college now. And it was a huge life changing experience for him. I look forward to taking my youngest son with me in in a few years. It's just, it's been, it's been amazing for me.

Catherine Maley, MBA: I talk about a different perspective. Everybody who lives in America, who's complaining needs to go see the alternative and be a lot more grateful, you know, than they are anyway. So, any, any comments like any advice for others coming up in the, in the industry or anything you want to, any 2 cents you have that was helpful advice when you, that you were given? How did this influence your decision to have your solo practice within a group practice?

Sam Jejurikar, MD: You know what I think advice that I've heard all the time, but I kind of disregarded. Because it just didn't seem practical enough was to just do what you love. Oh, okay. And to build a practice that you want, because it doesn't seem like worth, if you are doing the procedures, you want to, you know, you want, if you are spending the amount of time you want, like, like in our group, there are guys that make, that, make more.

There are guys that make less, there are guys that see three times the number of patients. There are guys that see a third of the number of patients and, and ultimately, Just deliver really good patient care. Figure out what works for you. And I don't know any plastic surgeons that aren't successful. I mean, everyone, right?

Everyone has varying degrees of success, but ultimately it won't seem like work if you, if you build a practice that you want and you do the things that you want to do.

Catherine Maley, MBA: Such good advice. And the last question, tell us something we don't know about you.

Sam Jejurikar, MD: Don't know about me. Well, I've got three kids, one of whom is a junior in college and one of whom is in kindergarten, and there's one in between.

So, I'm never going to be without children. Same the. No. Okay. So, so, I guess the bit of advice is when your second wife tells you they don't want to have any more kids, that may or may not be true, but, but it's a, it's a great thing and it keeps you young for sure.

Catherine Maley, MBA: You got to get that in writing. Yeah. So, well, thank you so, much for coming on Beauty in the Visit.

Really appreciate it. I hope to meet you someday. I, you know, at a conference or wherever. And someday, boy, I'd love to see your practice. I tried to do a tour of your office, and it's just, it's big. You, you have quite an impressive location there.

Sam Jejurikar, MD: Nice. Well, you're welcome. Anytime. Just let us know when you want to come.

Catherine Maley, MBA: Thank you so, much. And Dr. J, how can they reach out to you if they want

Sam Jejurikar, MD: to? Probably the best way is via Instagram. They can DM me @SamJejurikar.

Catherine Maley, MBA: Sam Jejurikar, I like your name. It's catchy, once you get used to it, Jejurikar.

Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on “solo practice within a group practice”.

If you’ve got any questions or feedback for Dr. Jejurikar, you can reach out to his website at, DallasPlasticSurgery.pro.

A big thanks to Dr. Jejurikar for sharing his experience on being in solo practice within a group practice

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

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

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

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

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

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-End transcript for “Solor Practice Within Group Practice — with Sam Jejurikar, MD”.

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