On Jan. 6, 2002, Maher M. Anous, M.D., of Everett, Wash., was a reconstructive surgeon. On Jan. 7, 2002, Maher M. Anous, M.D., had an aesthetic practice.
He made an overnight switch — literally — from reconstruction to cosmetic surgery.
While many surgeons look at ways of easing themselves into an aesthetic practice by starting slowly and gradually developing a cosmetic patient base, Dr. Anous advocates a rapid, complete switch."You don't ease into anything. You drop your insurance and that's it. You stop taking insurance assignments, drop all plans and switch.
"The other model doesn't work nearly as well. Just because I want more of an aesthetic clientele is not going to get me more of an aesthetic clientele, if I'm maintaining a reconstructive practice," he says.
Making the change
Dr. Anous told those attending the recent meeting of the American Society of Plastic Surgeons that it' s not that this is an easy way to make the change — he just thinks it's the best way.
"The mind of your personnel in the office is different if they are dealing with reconstructive patients versus aesthetic patients, so it doesn't work to ease from one to another, in my opinion."
Dr. Anous admits that the overnight change can be scary.
"The cold-turkey method is a frightening method — it's not for the faint-hearted. It is a sink or swim situation," he says. "My first month as an aesthetic surgeon, I made $4,000 — that wasn't enough to pay my staff."
But he says there are ways to get through the tough times — and there will be tough times — but the practice will be better for it.
"People who were in reconstruction will keep on getting their checks from their previous reconstruction cases — and that can carry you for two months," he says.
"Then you learn quickly where you have to allocate funds. You change your office so it doesn't look like an office where sick people come; it looks like a place a person can come to be pampered — a cup of coffee, chocolate, soft music and comfortable furniture."
Both the physician and the staff must be committed to the transition.
"The doctor has to change his approach to the patient, because all of a sudden this is a patient who is going to be paying you up front for care," he says. "There is no insurance company involved; nobody has to approve the treatment other than the patient."
The staff also has to change their attitudes, Dr. Anous says, but they will take their cue from the surgeon. They have to know that the practice has a goal, and they must like what the surgeon is doing. If the staff is not in sync, they will not support the doctor in taking the practice where he wants it to go.
Through the Yellow Pages, Internet and other methods of spreading the word, the surgeon has to let people know what services the office will offer.
And from his experience, Dr. Anous knows the money will follow.
"It took me a year to reach the same level of income I had as a reconstructive surgeon," he says. "But in two years I was making twice as much, and in three years, I had tripled my income. If you are committed and your staff is committed, then the growth is rapid.
"As I said, it's not easy, but if a die-hard reconstructive surgeon like me who did nothing but reconstruction for 15 years can do this, anybody can."