Practice pulse: Cosmetic surgeons weigh in on how the economy is - or isn't - affecting their practice

Practice pulse
Cosmetic surgeons weigh in on how the economy is – or isn’t – affecting their practice

Karen Nash
Staff Correspondent

While experts debate where the United States is on the slide toward, or down into, a recession, and gas prices rise, forcing up the cost of other necessary commodities, cosmetic surgeons are looking at what effect the economy is having, or could have, on their practices.

Cosmetic surgery, by definition, is not considered a necessity of life. But just as the experts can’t come to a common assessment of the country’s economic status, neither are cosmetic surgeons around the country experiencing the same effects on their practices.

Reported Discrepancies
Even cosmetic surgeons in Southern California don’t have identical experiences , according to Ron Moser, M.D., who practices in San Juan Capistrano.

“I don’t know if people are being honest, but everybody I talk to tells me something different. This is the worst I’ve seen it in the 20 years I’ve been in practice. Other doctors tell me this is the best it has been for them in 20 years.

“One of the odd things is that it seems the more expensive the doctor is, the busier he is. I know doctors charging $20,000 for a breast augmentation and they are booked solid.”

Because Dr. Moser’s practice initiated plastic surgery financing 20 years ago, it has historically targeted a different type of clientele — one that relies on financing — and, as a result, he’s had to find a different way to cope with the economy.

“The people who are attracted to financing are also attracted by marketing. They tend to be middle-to lower-middle class patients. That’s because the upper-middle class buyers find their surgeons from referrals not from the yellow pages or TV ads.

“We’ve lowered prices almost 40 percent just to do the same business we were doing a year or so ago. But even there we are seeing a change. People are trying to avoid financing procedures because everybody’s credit is shot around here.”

Midwest Measure
On the other hand, in Tulsa, Okla., not known for being a cosmetic surgery Mecca, Angelo Cuzalina, M.D., says the teetering economy has barely caused a blip on his screen.

“I’ve been fortunate. I think it’s being in Oklahoma, which is an oil state. Even when the overall economy of the Untied State is down, Oklahoma hasn’t been hit as hard. There is a certain percentage of the population in Oklahoma who make a lot of money when the price of oil goes up.

“Oklahoma, specifically, and the Midwest in general, have lower prices, and that could be a factor too. We have some of the lowest prices in the country — charging about half the price they charge in California. We are actually seeing more patients traveling here from other states including California and Arizona.”

Dr. Cuzalina has a new associate who has struggled because of the economic turndown, but the practice has taken action to address the problem.

“He is so early in his career that he felt like he was slowing down a little bit, so we increased our marketing efforts and it has picked up.”

Dr. Cuzalina has noticed a change in the procedures patients are choosing. “We are seeing fewer smaller procedures that are temporary, and bit of an increase in the larger, more permanent procedures. People don’t want to ‘waste’ money and have to keep coming back.”

Baby Steps
That experience is quite different than the situation in the practice of Gregory C. Roche, D.O., in Bloomfield Hills, Mich.

“The economy has definitely cut the number of people having elective cosmetic surgery by almost 50 percent here. It has also driven people down other avenues, where they are getting smaller procedures — procedures that are more like buying time.

“That sometimes works out nicely because people take more time to evaluate what they want. Then when the economy turns around, like it usually does, patients end up having those bigger procedures done.”

Although Dr. Roche began to experience effects of the slowing economy only in the past few months, he says it’s been affecting other practices in his community over the past couple of years because of the struggling automobile industry.

“There were severe cutbacks by car manufacturers and ancillary businesses, but there is hope. Although GM recently announced a loss for last year, Ford made a $100-million profit. Things have started picking up this spring — it’s not super busy, but busy enough that we can keep going.”

Dr. Roche says, without compromising quality, his office has been working to operate more cost efficiently, and has added new procedures such as SmartLipo to broaden his patient base.

Tweak Trend
In Boca Raton, Fla., a noted center for cosmetic surgery, Hilton Becker, M.D., says the economy is definitely affecting his practice.

“We’ve definitely seen a downturn in surgery, but we’ve seen an increase in nonsurgical procedures, such as injectables. People want to do something, but they don’t want to spend money for expensive surgery. We’ve been doing a lot more injectables than we’ve ever done in the past.

“I’m not certain if it’s the same patient that would have had a facelift before or if we’re developing a different patient base. It’s still too early to tell.”

Dr. Becker says there will be competition for that patient base. He’s seen more nonplastic surgeons picking up the injectables as a way to offset their dropping insurance reimbursements.

Clearing Skies?
In Hartford, Conn., Stephen A. Brown, M.D., sees the possibility of a break in the slowdown in surgery.

“It’s been interesting. Things got slow from early fall through January. Then things picked up in February — I have no idea why. It’s not like it was before, but it is improving.

“One interesting factor is that it’s not picking up among people who are wealthy. Quite the opposite. It’s picking up with hard-working people. All I can figure is that if they’re down a bit, they just decide they need a pick-me-up and decide to do something for themselves.”

Dr. Brown’s approach is multi-pronged. He hasn’t cut rates but only offers financing through Capital One because they vet the patients. And he’s upgraded his Web site.

“I have a wonderful guy running it after I dropped one of the big companies that charged a lot, but offered very little in service or results.”

He also hired a new office manager who, he says, is great at keeping the overhead in check.

His advice to other cosmetic surgeons? Remember the three As — availability, affability and ability.

“If you are really a truly caring person, and you’re willing to treat new patients well when they come in, you can lock in people who don’t get that treatment elsewhere.”

When fewer patients are spending less money, Dr. Brown says that’s a wise practice. CST