Valley Forge, Pa. — So it's time to expand. After years of training for a lucrative and challenging career in cosmetic surgery, and more time spent building a business, the time often comes when an established practice needs an infusion of new blood — or perhaps just a facelift.
According to John Downing, principle of Downing Associates Inc., a consulting firm for cosmetic surgery practice transition planning and sales headquartered here, adding a new doctor can reduce the burden of overhead costs, allow a growing practice to handle the influx of new patients, provide a partner to share the experience with or simply give a retiring surgeon a way out without closing down the practice. However, if you're not careful, it could just give you a headache.
Mr. Downing, who also oversees http://PlasticSurgeryCareers.com/, an online community that brings new-to-practice cosmetic surgeons together with established ones, tells Cosmetic Surgery Times that the most important factor in creating a successful relationship is realistic, mutually-compatible expectations."It all starts at the beginning," Mr. Downing says. "What does the established practitioner want? What are the real objectives? The issue is that many people tend to call something as 'what they want' before they know what the options really are."
The key, he says, is bringing in a surgeon whose needs mesh with those of the practice — as a successor, an associate partner or a highly-paid employee.
"None of these is right or wrong, but each option has it's own unique dynamics and you must select the one most appropriate for your situation," Mr. Downing says.
Your own needs first According to Downing, step one is to assess your own requirements. This means taking an inventory of the strengths and weaknesses of your practice as well as potential opportunities and threats.
Mr. Downing says this approach applies to deciding what type of business relationship you need with a new associate. Without knowing what you need, you won't get it.
"If you're 40 you might be looking for an employee or maybe a partner, at 50 you might be looking for a partner and, after that, you're probably looking for a successor. Why is that?" he says. "Are you looking for an investing partner to help with the overhead, or just another doctor to share the growing patient load? Will the associate bring skills you don't have, or are you preparing an exit strategy?"
Choosing the right relationship Once you've determined what your needs are, it comes down to the simple definitions, Mr. Downing says. An employee gets paid to do a job, a partner is a team member who shares the load and the profits and a successor learns the ropes while paying you a substantial amount of money for the value you've been building so that you can retire.
There are different risks and rewards for both parties in each of the three relationships — employee, associate partner or successor. The unique dynamics involved with each will shape the positive outcomes as readily as the potential dangers, according to Mr. Downing. But, in the end, it reduces to the same thing: A happy marriage where everyone is getting what they want, which fosters continued growth; or dissatisfaction, usually resulting from unmet expectations, which, in turn, arise from unclear or unrealistic goals on one or both sides.
"If you hire a doctor as an employee and promise to pay a salary of $250,000 a year plus benefits and bonuses, can your business handle that?" Mr. Downing asks. "If the employee wanted to become a partner but you change your mind, will he or she be happy with that? No."
The same holds true in reverse: If you hire an employee in the hope that they'll become a partner or successor, and they leave, you will be left holding the bag. "When the new person has one idea of what they're getting, and the established doctor has a different idea, that's a disaster waiting to happen," Mr. Downing adds.