Dr. Michael Gold, founder and medical director of Gold Skin Care Center, Advanced Aesthetics Medical Spa, The Laser & Rejuvenation Center, and Tennessee Clinical Research Center, joins host Tim Sawyer to share his insight on everything from finding the right mix of technology, fillers, neurotoxins, and skincare products, to create a world-class modern medical practice.
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Man 1: Welcome to today’s episode of True to Form. With your host, President and Co-Founder of Crystal Clear. Highly regarded speaker and two-time Inc. 500 entrepreneur, Tim Sawyer. True to Form is a podcast that highlights leaders making headway in the aesthetic, anti-aging, and elective medical industries. Learn from the experts to discover the secrets to success, and the pitfalls to avoid when it comes to growing your aesthetic revenue with the authentic, the transparent Tim Sawyer.
Tim Sawyer: Good morning. Welcome back to True to Form. My name is Tim Sawyer, your host, and today I have a very special guest with me. Dr. Michael Gold. And the only way that we could provide Dr. Gold justice, is we have to read his incredible bio. Dr. Michael Gold is the founder and medical director of the Gold Skin Care Center Advanced Medical Spa. The laser rejuvenation center, and Tennessee Clinical Research Center in Nashville. He’s a board certified dermatologist and dermatological surgeon, and oversees the various facets of the operations. A combination of medical and surgical dermatology, cosmetic dermatology, aesthetic services, research endeavors, which began all the way back in 1990. Dr. Gold has earned worldwide recognition for providing patients with leading edge technological advances in dermatology and aesthetic skincare.
He plays an integral role in the development of new pharmaceutical products. He’s an innovator and people love his feedback in medical devices through his clinical research, and presents those results regularly. He’s the only guy I know who attends more conferences than I do. Dr. Gold has authored over 300 published scientific articles, 28 textbook chapters, edited two textbooks on photo dynamic therapy. In addition, he established a Tennessee Society for Laser Medicine and Surgery, a group of healthcare providers interested in the distribution of information and proper training. We’re excited about that. We’ll be attending this year. I’ll be speaking. I’m looking forward to it. They put on an event known as Scale. It’s their 12th year, which is amazing. Dr. Gold also has helped start two international groups. The Dermatological Aesthetic Surgery International League, which aims to create a global community for the open exchange of knowledge and that’s what we’re going to do today. An innovation by a physician specializing in dermatological anesthetic surgery. And with that said, I’d like to say, first of all it is 7:30 where you are. Good morning. Hopefully you got some coffee, and welcome to the show.
Michael Gold: I am on air. Thank you. Good to be here. Thank you for having me.
Tim Sawyer: We’re looking forward to it. You know, one thing I — this isn’t on the list of ideas that we were thinking about, but I did have a question. It is going to seem kind of silly, but at what point does it make sense for a young dermatologist or Medical Spa Skin Care Clinic to actually start their own cosmetic line? I know you have the ILISSA line. Is that correct?
Michael Gold: Yeah. So, we have actually two lines. So we have — one is called ILISSA, by Gold MD. That’s more geared toward the female population. And then we also have one called BEN for men, which is obviously more geared to the guys. So, they’re my children’s names.
Tim Sawyer: Oh!
Michael Gold: It sort of worked. My children are not young. They’re in their thirties. So, but it was a great idea at the time, name wise, we thought. So … [CROSSTALK]
Tim Sawyer: Yeah!
Michael Gold: We did that. So, I mean when you get into the skin care world, I think everybody looks for what separates you or what makes — differentiates you from somebody else. There’s this whole debate out there. Should you only use branded skin care products or should use private label skin care products? I actually have both in my office.
Tim Sawyer: Okay.
Michael Gold: I find the branded skin care products from companies very useful. I like supporting companies that support dermatology. So, you know, there are brands out there that when you go to the meetings, they’re very well represented. And again, they support dermatology. I also like private label skin care, because it allows you to — it’s much more cost effective. First of all, for people out there, because price points are a little bit different. And you can actually — you actually couldn’t see a better return. But you could also — but if you do private label, you have to really be careful, and work with very legitimate companies. Again, that support dermatology.
Tim Sawyer: Okay.
Michael Gold: That are in our space, because they have to have the proper FDA type of facilities. They have to meet codes. They have to meet all the rules and regulations that exist, and that doesn’t always happen in the private label world.
Tim Sawyer: Got it.
Michael Gold: So, if somebody is interested in doing that, you’ve got to be careful and you know — and then it helps. And then, once you pick the right company or companies… [CROSSTALK]
Tim Sawyer: Yeah.
Michael Gold: You can — it helps you brand. It helps — so, you know, the ILISSA and BEN lines in my office are part of the Gold skin care brand. And we need to [CROSSTALK]
Tim Sawyer: [CROSSTALK] So, it’s been worth it for you? The journey was definitely worth it for you?
Michael Gold: Correct, and I think that as you get into this more and more, and you sort of have ideas of what you want to put in products, you can work with these companies as well. So in the ILISSA line, we have several products that, you know, after 30 plus years in dermatology, I wanted to see these ingredients in a skin care line that maybe not have been in other skin care products. Things that I like.
Tim Sawyer: Yeah.
Michael Gold: And so, we actually spent a couple of years preparing that and testing that. So, we have some unique products but we also have the private label brand of ILISSA and BEN, which again helps my brand.
Tim Sawyer: Interesting. Now, is there a company that you would recommend?
Michael Gold: So, there’s — you know, I always say in dermatology there are a lot of these private label companies. I think the ones that stand out the most in my world are — you know, there’s Brand MD. There’s Topix, and there’s Young. And those are the three companies that again, support what we do. And you know, I think that you need to look at them, and see what best fits your needs. So, I’ve done work — I’ve done a lot of work with Brand MD, and Topix over the years.
Tim Sawyer: Okay.
Michael Gold: And you know, you can find what you need, you know, by reaching out to them.
Tim Sawyer: I — we appreciate that. And, it’s always an interesting topic, and particularly in the younger practices, that’s a healthy debate. But, that’s great feedback. And so, my next question for you is — as I mentioned in the introduction, you’re the only guy I know that spends more time vesting in the community, educating, giving back, traveling. I don’t know how you do it. But as a real influencer, an educator in the space, in the aesthetic industry — what are some of the hot topics or trends that you see emerging in 2019? And what if any adjustments, are you making to the way that you’re managing the clinic?
Michael Gold: So, I think you look at what you do in the practice of Dermatology that I do — you know, sort of divided into medical and cosmetic. Okay, so on the medical side, I still do a lot of medical derm. I do that all day, and I think we’re very fortunate to have all of the new — what we call biologic drugs for psoriasis, atopic dermatitis, something called hidradenitis.
Tim Sawyer: Yeah.
Michael Gold: You know, we have drugs that we’ve never had before, and we’re getting patients better than your faster and longer than we’ve ever gotten them before. So, that’s always exciting. I think, you know, when I go on the road, and — I don’t lecture on all those all the time.
Tim Sawyer: Yeah.
Michael Gold: But I do give a lot of lectures on acne and rosacea, and how to take care of all that. And again, that ties into my medical and cosmetic world because we have some new medicines, that’s great. But, we also have devices, and I think that I’m a big device guy. So, I think that having devices that treat acne like the Aerolase Neo, the Isolaz yellow light treatment that I use.
Tim Sawyer: Yeah.
Michael Gold: We’ve had the Solta Isolaz for a long time. Those things are really helpful for my acne patients, because acne is something that we can treat, and we can treat faster with devices. So, I like that. And then, in the cosmetic world, again we have a whole slew of devices that are new and different, and play off some of the older devices.
Tim Sawyer: Yeah.
Michael Gold: But they’re better than what we had before. So, I think that, you know, I always say — and we have injectables.
Tim Sawyer: Right.
Michael Gold: So, when you look at — we will start with injectables for a couple of minutes.
Tim Sawyer: Yeah.
Michael Gold: So, obviously we have toxins. You know, we have Botox. We have Dysport. We have Xeomin, and now we have DeVeau. There are still a couple that are still being evaluated. So, we’re waiting for the data from revamps, to see if it is a longer lasting toxin.
Tim Sawyer: Yeah.
Michael Gold: Which preliminarily says it is. And, we’re looking at a toxin from a company called Hugel, which is being done by a company in Europe called Croma, all in the US. So, we’ll see how their results come out in a couple of years. But you know, we had one toxin and now we’re going to have five.
Tim Sawyer: Wow.
Michael Gold: So — and then there’s a short acting toxin, which is a Botox type E, that’s being developed — that’s sort of like this instant on — lasts a few weeks or so, and off.
Tim Sawyer: Right.
Michael Gold: So, that’s actually in development as well. So, I mean, we’re going to have a bunch of different things to offer our patients. That’s good. But, you also need to be aware that they are a little bit different.
Tim Sawyer: Yeah.
Michael Gold: And you have to learn the skill of how to inject and how to take care of these people. [CROSSTALK]
Tim Sawyer: [CROSSTALK] I was going to say — not to interrupt you, but so, as a non — I have no medical training whatsoever. And I was curious as with the different toxins. Are there different techniques, and a lot of additional training associated with using those new toxins?
Michael Gold: Well, I think what we’re going to be looking at in the next year or so, two years is — can we take our toxins that we have now and make them last longer?
Tim Sawyer: Right.
Michael Gold: That’s one of the big trends in our in our field. When we look at that, we’re actually going to be looking at different dilutions of how we mix these things.
Tim Sawyer: Yeah.
Michael Gold: And, how — and so, therefore the potential risks go up.
Tim Sawyer: Yeah.
Michael Gold: But, again it’s the skill level of the provider and it’s not cookie-cutter injection. So, you have to be careful. You have to know the anatomy. You have to know where you’re putting these. And again, this is — for the consumer out there, it’s sort of ‘buyer beware’ because if you go to somebody that doesn’t know what they’re doing, you know, you can have issues and you can have problems. So, again, as more and more of these toxins come out available, there are more and more injectors out there. And you know, you have to make sure the person that’s doing this is well-versed. Well skilled, and understands all this… [CROSSTALK]
Tim Sawyer: Yeah. Let me ask you this because you — this comes up a lot. So, I was at a show, a couple weekends ago, and it was the Medical Spa Show, and I was on stage with Dr. Najarian a and Dr. Jay Burns, both plastic surgeons. And the topic came up about, you know, the concerns of somebody who spent, like yourself, 12, 14, 16 years becoming educated and developing techniques and protocols. And so, when new products or treatments come into the marketplace, obviously there’s this mass distribution, and then it gets in the hands of folks that may or may not have invested the time, energy, and money. And I’d be curious to hear your thoughts. Real quick on how to create universal, kind of self-policing universal set of guidelines for the Med Spa community or doctors who have never played it in the injecting space?
Michael Gold: Well I think — so, I think when you look at that topic, okay, that opens the whole can of worms here. As far as who can do what, and the reality is that everything that you do, whether you’re in a spa or that kind of environment, all has to be done under the auspices of the physician. And I think that’s virtually in every state, because the physician must sign to buy the products, and so therefore there has to be a physician overseeing everything. And I think one of the things that you mentioned — we started the Tennessee Laser Society here in Tennessee because we were concerned about safety for patients. That’s the whole goal of this group.
Tim Sawyer: Right.
Michael Gold: And one of the things that we’ve done, is we’ve actually passed a few bills that we’re sort of now putting some teeth behind, where we actually — we call truth in advertising, and those kind of things. So, if you’re a Med Spa and you are run by an emergency room physician located in the other side of your state, that’s not necessarily the best thing.
Tim Sawyer: Yes.
Michael Gold: Or a psychiatrist or somebody like that. So, we don’t mind in Tennessee if you’re running — if you have a Med Spa and you have a plastic surgeon or dermatologist in the same area overseeing what you do. But, again the responsibility goes back to the doctor.
Tim Sawyer: Right.
Michael Gold: And so if something goes wrong, whether it’s an injectable or laser or any kind of procedure, the fault, yes, is on the people that are doing it. But it’s also on the physician. And so, again we encourage people to sort of do their homework, and make sure that they go somewhere that’s legitimate, and that has the right supervision. And if they don’t have it sort of posted, ask. It’s a simple thing because there are some great people out there doing these procedures. They have lots of training [CROSSTALK]. They have lots of good training. They’ve done a lot of them. They understand. But, yeah, I mean they’re not a dermatologist and they’re not a plastic surgeon. Yeah, we have years of training on how to do this. But if — you know, 35 years ago when I was in school nobody taught me how to inject Botox.
Tim Sawyer: Right.
Michael Gold: But I understand the anatomy better than most. And, therefore you want to make sure that the person that’s doing it knows what they’re doing, and the person has appropriate backup — if just in cases something goes wrong. Because anytime that you do a procedure, there is a potential no matter what you do, to have something go wrong.
Tim Sawyer: Right.
Michael Gold: And it’s when something goes wrong — you know, if something goes right, nobody — you just keep going on and on and on, but something will always go wrong if you do enough of everything.
Tim Sawyer: Right.
Michael Gold: And therefore you must know how to deal with it, and you must know how to — you know, you must have the appropriate backup to help you.
Tim Sawyer: Yeah. And I think without belaboring the point. I think a lot of people underestimate — you know, I was working with hundreds of clients. Two things amazed me. One is that I think a lot of people underestimate that there are some real potential risks as it relates to patient safety. But, then there’s also risk to the licensee. And I’m shocked that when I hear the stories that there’s a doctor overseeing, you know, 15, 20 clinics and he gets a thousand dollars a month or whatever, that’s — it’s risky right?
Michael Gold: It’s a — yes. It’s a little silly because again, they can’t do all that, and be realistic in making sure that they’re taking care of people or at least doing the proper supervision that they need. And again, it’s sort of, you know, that’s where the gray line exists all over the country.
Tim Sawyer: Right.
Michael Gold: Who can do what where and you know, if you tighten it up that it’s only doctor only, you know, that’s a problem.
Tim Sawyer: Right.
Michael Gold: With certain procedures. I’m not doing, you know, I’m not doing laser hair removal in the bikini area to my patients. [LAUGHTER] That’s not going to happen. You know?
Tim Sawyer: Yeah!
Michael Gold: And so — so therefore [CROSSTALK]
Tim Sawyer: And you know what? From a business standpoint, you don’t need to be doing that right? I mean you should be doing things that leverage the best use of your time, and talent.
Michael Gold: Right. So we do — I do the procedures that require — that have more potential risks or they have more potential downtime or they’re more invasive. That’s what I do.
Tim Sawyer: Right.
Michael Gold: And you know [CROSSTALK]
Tim Sawyer: Let me ask you this. I want to circle back on a topic because this is really important, and when I talk to people about — I mentioned I was going to talk to people because I make sure to ask them. What’s your process that you go through for picking a device? Because you said you’re a device guy, and I know you’ve got a lot of [CROSSTALK]
Michael Gold: Yeah. I mean I’m different. I mean, I — you know, to start with. So, if you come in and again, let’s pick, you know, let’s pick fat reduction. Okay? Which is a big topic in today’s world.
Tim Sawyer: Yeah.
Michael Gold: You know, the commodity product out there is cool-sculpting. Right? And we know and again, I think people who are out in the community don’t understand provider wise — Cool-sculpting, you know, if you look at all the clinical work, is what causes about a 20, 25 percent fat reduction with each cycle that you do in the area that you treat.
Tim Sawyer: Yeah.
Michael Gold: So, you’re not getting 100 percent fat reduction. So, you know, sometimes one treatment isn’t enough. And I have patients come to me all the time. I went to so and so, and they did cool-sculpting it didn’t work. Well you had one treatment, and you need more. [LAUGHTER] And so I think part of it is consultation wise. So, we have cool-sculpting. We have something called sculpture.
Tim Sawyer: Yeah.
Michael Gold: Which is another device that does fat reduction through a laser, and then we have ultra-shape, which does fat reduction through ultrasound.
Tim Sawyer: Okay.
Michael Gold: So, you know, so we have — I have three different devices here. And to me they all work. They all work well, otherwise I wouldn’t have them here. So, it gives me the opportunity to sort of look at my patient and say, you know, this is an area that I think cool-sculpting might work the best. This is an area that maybe cool-sculpting may not work, and therefore I want to try sculpt — I want to use sculpture or I wanted to ultra-shape and again, I get to pick and choose based on what I think is the best for that area. And so, that’s important to me.
Tim Sawyer: Right.
Michael Gold: When it comes to like, something like laser hair removal, one device is nice but having four or five different devices with different wavelengths allows me to treat everybody.
Tim Sawyer: Right.
Michael Gold: Safely and effectively. So, I have a lot of devices. I — you know, I get to pick and choose what I think works best for that patient.
Tim Sawyer: Yeah.
Michael Gold: We’re doing it. With acne scarring — do you need micro needling pins with radio frequency or do you need micro needling needles with radio frequency? So I can offer them both. Then again, it depends on downtime and other things.
Tim Sawyer: Yeah.
Michael Gold: But that’s part of what I — the consultation that we do here. And again, we can — we all talk about customizing the treatment.
Tim Sawyer: Yeah.
Michael Gold: If you have one or two devices, you’re not customizing anything. If you have 50 or 60 you can customize the treatment.
Tim Sawyer: Right. Now is there one device that if you’re comfortable that sticks — so let’s say you’re getting started, you know, first year. You’re a dermatologist. You want to get into aesthetics, and you’ve got to go get that one device that can start generating some revenue, would be popular, and you could train on it quickly. Is there one device that you say I would do this first?
Michael Gold: You know — so, my early laser experience was with an intense pulse light, which is not a laser. It’s a light source.
Tim Sawyer: Yeah.
Michael Gold: And I’m a true believer in IPLs. I think they are very versatile. They allow you to treat red, brown collagen, and you can do photo rejuvenation and you can do a lot of different things with them. So I’m always a big believer in IPL. And I think there are some really good ones out there.
Tim Sawyer: Okay.
Michael Gold: And again, I think you need to go — the people out there need to look at which company is going to support them best.
Tim Sawyer: Right.
Michael Gold: They — most IPL today are actually part of platform devices. Platform devices have great advantages and one disadvantage. So, advantage wise platform device let you put one, two, three, four, five, different platforms on one device.
Tim Sawyer: Right.
Michael Gold: So, not only can you have an IPL, sometimes they have hair removal, sometimes they have tattoo removal, sometimes they have leg veins. Sometimes they have resurfacing. All those are great. And so, you can pick what you need for the different indications you might see in your clinic. The biggest — the only disadvantage of a platform device is you can only use it once at the time. You can only do it once.
Tim Sawyer: Right.
Michael Gold: In the same room that — for that patient. So, you can’t have two or three rooms going at the same time with different devices. That’s not a big deal, but that’s, you know, I try to make sure people understand that you can’t do everything, but you can do a lot.
Tim Sawyer: Right. [CROSSTALK]
Michael Gold: And again, I think when you’re looking for platform devices, you know, the Lumenis has the M22, it is a great IPL. They have non-ablative fractional device. They have a Q-switched device. I mean, those are great. Rohrer Aesthetics is another company that people don’t know much about.
Tim Sawyer: Mark Rohrer, a friend of mine. [CROSSTALK]
Michael Gold: We have something called the spectrum.
Tim Sawyer: Yeah.
Michael Gold: And it too is a great platform device. And so, I think you just got to go out there and see what’s there, and find what works the best for you.
Tim Sawyer: That is great feedback, and I do love Mark Rohrer. So, we have a few minutes left, and I want to talk about Scale.
Michael Gold: Okay.
Tim Sawyer: I know you’ve been putting a lot of time, energy, effort into that, and we’re pumped to be there this year. I know you’re excited about it. So, tell us what we can expect from Scale. What would be exciting and…?
Michael Gold: So, you’ve mentioned Scale and that’s great. And thank you. So scale is — we’re actually in year 14. You said 12.
Tim Sawyer: Right.
Michael Gold: We’re actually in year 14, and [CROSSTALK]
Tim Sawyer: Congratulations.
Michael Gold: And, Scale is a — has become one of the premier medical, and cosmetic meetings in dermatology in the country. We have one of the — we have a hand-picked incredible faculty that is very readily accessible to everybody. And we’ll have 125, 130 exhibitors here this year.
Tim Sawyer: Wow.
Michael Gold: It is at the Music City Center, which is the national convention center and it has just become one of those — what I like to think of “Go to meetings” for people.
Tim Sawyer: Yeah.
Michael Gold: We’ll cover [CROSSTALK]
Tim Sawyer: We’ll be there. We love it.
Michael Gold: All the medical diseases. Newest treatments. Best faculties. And then on the injectable and laser side, we have everything. And again, we do lots of hands-on. We do lots of things. We also are offering a cadaver course. The first morning.
Tim Sawyer: Okay.
Michael Gold: Which is one of the most popular things we’ve ever began here, where we actually have some of the world’s experts coming in to teach cadavers. In other words, teach anatomy through cadavers, and that is — when we did it last year, people were standing on the sides of the room because we didn’t have enough seats. We’ll enough seats this year. And then, the other thing that we do every year, is we have a guy named Pat Clark from Medical Laser Dynamic in Dallas.
Tim Sawyer: Yeah.
Michael Gold: He’s one of the true brains of lasers. And he gives a course every year called lasers 101. So, people that are just starting.
Tim Sawyer: Yeah.
Michael Gold: They need to understand the physics, the safety, and what is an IPL? What is a laser? He actually teaches it in probably the easiest understanding method I’ve ever heard, and again we’re in year 14, and I think this is his 14th year too.
Tim Sawyer: Well, what are the dates on that again?
Michael Gold: So it’s May 9th to May 11th, in Nashville Tennessee, and if you’ve never been to Nashville — Nashville is the most happening city in the US right now. And so, it’s a great city. It’s a great venue, and it’s really — it has become one of the really important meetings in dermatology. So, we hope people will come.
Tim Sawyer: Yeah. And as some — I have no financial interest in it, but as — I can say as a vendor, we’ve been there several years in a row, and it’s — and shows are tough. You know this right? And as some — a company that goes to 80 shows a year, it gets tougher and tougher but Scale does a nice job of, first of all, getting great company of people there, as you said, getting great speakers. And it’s an engaged constituency and that’s really important as a vendor because you want to talk to the doctors and get to know people. And so, [CROSSTALK]
Michael Gold: I always tell people, I spend more time with the exhibitors than I do sometimes with the attendees because we’ve got to — we do engage the attendees to spend lots of time with the exhibitors, and to learn what they do, and what they can offer to the people that go there. Because if they — if you just go to a meeting, and just sit there, and don’t learn — not only from the faculty, but from the vendors, you’re not getting the most out of a meeting, and as you said , we go to enough meetings. So you know, we want to see our –we want to see people with the exhibitors. We want to see people with the faculty. You know, we just don’t want the faculty coming and giving their lecture and then, you know, going shopping or something. That doesn’t do me any good.
Tim Sawyer: Well it sure — I can tell you, like I said, as someone who’s attended personally, it shows in the commitment. People genuinely appreciate it. And I’m looking forward to seeing you there. And, where would somebody, if there is a practitioner, Doctor, Dermatologist that wants to sign up — they go to the Scale Web site?
Michael Gold: Yeah. So, it’s w w w dot Scale Music City dot com.
Tim Sawyer: Okay, so w w w dot Scale Music City dot com. I encourage you guys to check it out. It’s definitely — it will be a great time but more importantly you’re going to get something out of it. Hopefully, you make a friend. And first of all, Dr. Gold let me say, in closing, that I really do — I know it’s early in the morning, you probably have a massive day planned, but I really appreciate you taking the time this morning. As always, it’s informative, and I know that our listeners can’t wait to get this in their hands. So, is there anything you’d like to say in closing?
Michael Gold: No, just thank you for letting me do this. We appreciate it. And again, if anybody wants to come to Scale, we have plenty of openings and for people to come and to learn. And again, the key thing to aesthetic medicine: know what you’re doing, and have fun with it.
Tim Sawyer: I think that’s a perfect way to end. Like I said, I really appreciate you taking the time this morning Dr. Gold. Have an awesome day. And I look forward to catching up with you soon.
Michael Gold: Alright. We’ll talk soon. Thank you all.
Tim Sawyer: Thank you Dr. Gold.
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