Moderator: 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 industry. Learn from the experts to discover the secrets of success and pitfalls to avoid when growing all aspects of your elective medical practice. This week’s episode is brought to you by TouchMD, the all-in-one aesthetic technology hub that educates your captive audience in the waiting room and console room, consistently captures and manages photos, provides digital charting and consents and allows patients to take their experience home to share what they learned with friends and family via the practices patient app. Please join me in welcoming your host, the authentic, the transparent Tim Sawyer.
Tim Sawyer: Hello and welcome to True to Form, the podcast that connects you to the people, technology and hot topics that shape the elective medical community, provided to you by Crystal Clear Digital Marketing and brought to you by this week’s sponsor, TouchMD, the leading all-in-one aesthetic hub. I’m your host, Tim Sawyer. To our returning guests, we say welcome back. And for our first time listeners, we appreciate you joining us and encourage you to become a subscriber. Last week, we spoke with industry insider Christy Perry, who shared what she learned from her two decades as a practice manager, including the most challenging hurdles and why you should never lose sight of your practice’s unique value proposition, no matter how distracting things may get. If you missed it, we encourage you to check it out.
So with all that said, I’m super excited about our next guest today, Dr. Stephen Nogan and we’re going to head to Columbus, Ohio. Dr. Nogan is a double-board certified facial plastic surgeon. His practice focuses exclusively on cosmetic and reconstructive surgery of the face and neck. Originally from Western Pennsylvania, he spent the last nine incredible years training and working at The Ohio State University in Columbus. In September 2019, Dr. Nogan moved his practice to the Sullivan center and joined one of his mentors in facial plastic surgery, Dr. Michael Sullivan. The incredible opportunity has allowed him to expand the cosmetic surgical and non-surgical services. I want to talk about that too, available to both his patients and the established patients at the Sullivan Center beyond his clinical practice. Dr. Nogan is a young guy, works with several local and international charitable organizations and was recently selected as a Columbus Business First 40 under 40 award recipient and with that introduction, Dr. Nogan, welcome to the show.
Dr. Nogan: [Indiscernible] [0:02:58] excited to be here, I’ve been listening to the podcast for a few months now and just partnered up with you guys and I couldn’t be more excited about [Indiscernible] [0:03:07].
Tim Sawyer: What’s the Columbus Business First 40 Under 40? First of all, how did you become a plastic surgeon under 40? You must be an animal?
Dr. Nogan: I went straight through all my education. I didn’t take any breaks. I kind of knew what I wanted to do and I had a plan to get there and got through it as fast as I could, which certainly didn’t go very fast, but here I am. And the Columbus Business First 40 Under 40 is it’s an award an organization that’s in a lot of the major cities and just recognizes some of the younger people in the community, whether it’s business or legal or medicine or whatever may be that are kind of at least trying to go a little bit above and beyond their typical or daily job experience and engage with the community and give back and different things like that. So I was surprised and fortunate to get that award about a year ago.
Tim Sawyer: Well, first congratulations. That’s quite an accomplishment.
Dr. Nogan: Thank you.
Tim Sawyer: Now you spent nine years at Ohio State, was that – so help me understand. So they — was that in a hospital setting, where you actually obviously doing constructive surgery, right or reconstructive surgery?
Dr. Nogan: Yep, you got it. So that’s in an academic setting. So I did my residency at Ohio State in head and neck surgery, followed by a facial plastic surgery fellowship with the AAFPRS and I was under two surgeons here in Columbus or in private practice, Dr. Mike Sullivan, who I’m working with now, then also Dr. Steve Smith, who’s in Columbus as well and runs a very successful practice in the same community. So I trained with those two guys for my fellowship and got board certified, head and neck surgery board certified in facial plastic and reconstructive surgery, and then stayed on at the university for the last two and a half years and I’ve done a mix of reconstructive and cosmetic surgery for the patients of Ohio State. And it’s been an incredible two and a half years doing that, a lot of skin cancer reconstructions in the James Cancer Hospital here, some complex trauma, some other complex reconstructive challenges that have kind of pushed me beyond my training and doing all kinds of new and interesting things there and then also growing in cosmetic surgery practice within the university setting in the last few years which obviously has its challenges, and I’m sure many of your listeners could resonate with. And I’m in the middle of a big change right now, moving out more into a private practice model and getting into the med spa business here in Columbus.
Tim Sawyer: Wow. That’s a very, very popular move right now. We work with a lot of – I think a lot of plastic surgeons. I mean, we work with a lot of standalone med spas, but a lot of plastic surgeons have great med spas. The two are a little different and I’m sure you’ve given some thought to that.
Dr. Nogan: Yep, certainly.
Tim Sawyer: Now so you’re already doing some non-invasive stuff, I assume, right?
Dr. Nogan: Yes, correct, yeah.
Tim Sawyer: Okay, any particular device that you like or treatment?
Dr. Nogan: Yeah, so I do a lot of laser right now, BroadBand Light CO2 laser, Pulsed Dye laser. We – I was recently trained on the face type and body type machines we are using some of that technology and then we’ve also got therapy [Indiscernible] [0:06:29] and some other things that are esthetician [Indiscernible] [0:06:34] has been around in this practice for many, many years uses as well. So there’s a lot of good technologies out there. The ones that we kind of are using right now seem to be tried and true and really with what I’m doing right now is just trying to wrap my head around what we have, what else we need to incorporate and what would that benefit the patients in the practice now and I’m just learning about and learning meeting many of the established patients of this practice all day today and all day every day for the next few months to kind of transition myself into this new practice, a lot going on, a lot of change.
Tim Sawyer: Yeah, it’s exciting. Now a little shameless plug, although I don’t have a financial relationship with them, are you familiar with the American Medical Spa Association, AmSpa?
Dr. Nogan: I am, yeah.
Tim Sawyer: Okay. Cool, because the reason I say that is, if you haven’t already, there’re eight boot camps that they do a year and they’re one big show in Vegas. But the boot camps in particular are a great way if you’re trying to understand a little deeper the economics and also, you know some of the marketing challenges and opportunities, as well as obviously the compliance piece. They have a great app. I encourage everybody to check those out and they do  [08:08] a year and a lot of great people in it and not uncommon to have plastic surgeons there who are looking to get into the med spa side of the business. So as you think about it, so with all that you have going on right now and this is a really cool conversation to have. So with all that’s going on, you’re transitioning into private practice. What have you discovered so far that the biggest differences or the biggest challenge that you have in trying to make that pivot from, you know, more academic setting to private practice and also folding into med spa piece?
Dr. Nogan: Yeah, that’s a great question. I mean, that’s the kind of stuff that I’m dealing with every day. Most of it has to do with just changing my thinking a little bit and just kind of expanding my knowledge and all the things you have to know how to do that don’t necessarily have to do directly with taking care of patients. I’ve obviously become very comfortable taking care of some very some specialized patients and problems and challenges and that’s how I spent, you know, however many hours a week for the last decade of my life, learning how to do and to me, that’s the comfortable part of all this.
The challenging part is figuring out the business and the accounting and the marketing and the legal things and all of that. And so I’ve had three meetings this morning, accounting, banking, legal and just trying to get all those things lined up, may be trying to learn an entire new industry and many other non-medical specialties and most important thing is not me personally acquiring all this information, it is just getting the right team in place. And so we’re really dedicated to getting the right team in place, some of that team is going to stay with us from Dr. Sullivan’s practice, but we’ve — I’ve revisited every single position and all the ancillary specialists that you need to have in place to run a business and run a med spa and we’re trying to be very, very methodical and make sure we’ve got the right people in place.
Tim Sawyer: So let’s – you bring up a really good point and we talk a lot about that on the podcast and that is putting the right team together, right? And so there’s two things. There’s we always talk about the cultural component, meaning are those people philosophically in line with what you’re trying to accomplish, but also competency. Talk a little bit about your, some of the criteria or your approach to establishing whether or not this person is going to be a good fit for the new practice?
Dr. Nogan: Good question and some of that we’re still trying to work out for ourselves, you know, what is the right fit in general, you’re kind of — I’m kind of drawn to people that think like me when it comes to patient care. And we’ve got some really just sympathetic, honest, good people, both in the clinical part of our practice, but then also on the business side that really no matter what, no matter what it comes down to, I want everybody to just on a consistent basis put the patients first and so and I try to be a role model in that regard, whether it’s, you know, a personal note to a patient or an extra phone call after a procedure, whatever it may be. I’m looking for that type of a personality and that type of a commitment from each of the people on our team. And we’ve got, you know, that’s one of the things I’ve been really lucky with is there’re already good people on this team that are excited about the transition and excited about me coming on board. So thankfully, that’s gone smoothly so far. But those are the kind of things I think about when we’re putting together the right team of folks.
Tim Sawyer: Yeah, I think that’s probably one of the, you know, I go to 35, 40 last year. I went to 36 conferences and I think one of the most common refrains is that’s the biggest challenge, right, to growing type of practice is attracting good talent, keeping those people and keeping them motivated and inspired and it’s interesting because, go ahead.
Dr. Nogan: I was going to say, the other thing that’s been a benefit to me and I think is really key for a lot of the younger listeners, whether you got people listening in training or just out of training is you got to learn from your mentors. I mean, they’ve all made mistakes. I mean, the mentors that I’m working with now, as well as a few of my other key mentors over the years, they made a lot of mistakes. And if you just listen to them, and you believe them, you don’t have to repeat a lot of those. So I’m sure I’ll make some mistakes in the hiring, firing side, the personnel side of things, but hopefully a lot less than I would have otherwise, thanks to the relationships that I have.
Tim Sawyer: Well, I think that’s important. You know, I have – I strongly believe that everybody needs mentors and mentors in different areas, right? Like you said, there’s mentors in the clinical side, there’s mentors on the business side. And I wish you the best of luck and I hope you get the greatest team in the world together and you’re in a unique place, a really neat place actually because if you think about it, now is the perfect time to really define what this practice is going to be all about and what it’s going to represent in terms of your brand to the patient or the prospective patient, right.
And so, one of the things that we talk a lot about is and we spoke a little bit about it last week is making sure that as you go out in the marketplace, you want to be able to differentiate yourself and that unique, you know the USP unique service proposition, unique selling proposition or unique value proposition. It sounds to me for you it’s going to be centered around putting patients first, right and I think, so there’s two things I want you to talk about. One is, I think that’s a great idea and great philosophy and to stick to it putting patients first and then the other thing you talked about is people who are honest and creating realistic expectations, right? And how much of a challenge has that been, particularly in the era of social media. Do you find that patients are more demanding of outrageous results now? And how is that going?
Dr. Nogan: Yeah, I mean, I think that’s going well. But there’s something that comes up every single day in multiple patient interactions. I think a lot of it really comes, for me I’ve got to develop a relationship with the patient. That’s real and authentic at the initial consultation. And if I get through a 30, or 45-minute consultation with a rhinoplasty patient, for example, and I don’t feel like we really connected them, I’m having that patient back in the office again. I’ll come up with any reason to get them back in the office again so that we can have a second conversation and really develop a relationship that I’m anticipating is going to last for a number a number of years after any, you know, given procedure or treatment that’s performed.
So I’ve got to be comfortable with that relation with each patient and that helps me to educate and manage that and patients manage their expectations for procedures. And so once that relationship is in place, then we can really get into really educating patients on what they can and should expect, as well as the flip-side complications and other things that occasionally do occur in this type of a practice. And so that’s the key for me, it’s got to be real, it’s got to be authentic from initial consult all the way through and then the patients trust you. And again, it’s a real trust and they believe what you’re telling them and you’re sticking with them until they’re happy and you’re happy. And thankfully, obviously a large majority of the time, it’s smooth and easy and patients do great and but occasionally, you need to rely on that relationship that you have built with that patient very intentionally. And so that’s what I’m thinking about day in and day out with patient interactions.
Tim Sawyer: And I think that’s a great philosophy, you know, and I’m also curious, because like you said, I mean, this is surgery, right? Occasionally, very, very rarely, but rarely, but occasionally, you know, something could not go perfect. And I think it’s so important, particularly in an age where people have essentially weaponized reviews, right?
Dr. Nogan: Yeah, right.
Tim Sawyer: And it’s, in my own business, right? I mean, people doctors say things about me and I say, “Man, how’d that one get away from me?” And you know, but you really do like you said, if there is no relationship, that’s going to be the first move, right? If you don’t follow up, you’re approachable if they’re – you know it’s funny because so many people say that, you know, a lot of times, people will forget kind of what you say and forget a little bit, they forget about what we do, but they’ll never forget how you made them feel. And so you’ve got — I’ve got a lot of [Indiscernible] [0:17:06] with almost 500 practices, and I’ve got a lot of technically sound really and rhinoplasty guys in particular and that just that bedside manner creates a lot of negativity and it’s difficult, you know, if you’ve got 20 reviews and 5 of them say, hey, things have gone wrong. It’s tough to come back. And what – so have you put a process in place now as to how you – in terms of review management and reputation management, how you’re going to handle that because it’s a big thing now, right?
Dr. Nogan: It’s a huge thing it’s a huge thing we’re working through that, you know, when I was part of the university, there was an internal mechanism for dealing with reviews that come in through Ohio State patients. And so I’m branching out and doing a little bit more, more now and trying to make sure we capture reviews. At the time, we got that patient in the office and they’re happy about what’s been done for them and we’re capturing it then and there, both in written form and also in video form that we plan to put up on our new website we’re working on with you guys. And so I love video, I love photos, I want it all on social media on a website and that’s what I look for as a consumer of other types of services and that’s what makes you feel good and makes you feel you connected with, you know, you connected with a product or someone that provided any kind of service for you and it’s just, it’s really no different in this industry. And we all know and we all know what we like as consumers, it’s about replicating that in your own business than for us and our own surgical practices and medical spas.
So that’s the whole review management, reputation management process is something we’re working through right now. And the other thing that’s just interesting about my personal situation is, is this practice the Sullivan Center has an outstanding reputation in the community, not just in Columbus but miles and miles out into the small towns around the state of Ohio and that’s just from primarily word-of-mouth referrals over the course of 25-year-practice and so the reputation is already rooted and grounded in the community. And I feel like and I think my mentor feels like we share a similar philosophy and we’ll be able to kind of maintain that quality that that patients of this practice have come to expect for several decades. So that’s the other kind of unique twist of the reputation management and really preservation of this practice that I am now taking over.
Tim Sawyer: You’re the young guy coming in, don’t screw it up.
Dr. Nogan: Thanks for the encouragement though.
Tim Sawyer: I got another question for you. I’m dying to hear. You’re a young guy, where do you come down on, on guys using – doing video, live procedure videos and streaming them?
Dr. Nogan: Oh man.
Tim Sawyer: Have you done that yet or?
Dr. Nogan: I can’t really wrap my mind around that, to be honest. It’s popular, it’s well received. I haven’t done any of that. I’m a little bit maybe old school as far as my mentality goes, I think there’s still something to be said for patient privacy. And I know there’s obviously we can spend for these and everything else, but I’m not necessarily looking to self promote to that degree, you know, nor would I ever want a patient to feel like they had to, had to consent to something like that to be a patient of mine or patient of our practice. So I’m a little bit more of a slow mover when it comes to some of those kind of trends and I take my time a little bit to embrace them and see how it shakes out a little bit. So I’m not quite there.
Tim Sawyer: Got it.
Dr. Nogan: As young as I am, as young as I am, I’m not quite there.
Tim Sawyer: It always amazes me that I’ll literally and I obviously have clients that do it. They’ll live stream an entire [Indiscernible] [0:21:01] 45 minutes and you’ll see 3000, 3500 people who watch the video and I say to myself, first of all, that’s disgusting. I mean, I don’t – I get, I appreciate [Indiscernible] [0:21:12] I appreciate that, but it’s like, I don’t need to see how you got to the final product that quite frankly, but I think part of it is people are intrigued and they, it’s almost like they want to see, okay, if I do this, what does this really look like? And it’s an opportunity for, you know, the surgeon to connect kind of where the people are at on social media. So you’re not a guy that’s chased 100,000 Instagram followers?
Dr. Nogan: Not yet, Tim, definitely, not yet. You know, there are so many pros to social media and just online presence in general when it comes to building a community and not even just your patients, but other folks in the community. Whatever your goals are as a business owner and your community, philanthropic or otherwise, social media is just such a great place to create a community, create a brand, where you can expose people and educate people on not just what I do as a facial plastic surgeon, but the other things in the community that I care about, you know. We’ve done a number of things in town when it comes to, for example, opioid prescribing practices after surgeries, and really trying to educate and limit what we’re doing there, so that it’s safe for patients.
We’ve gotten into a little bit of helping out with the human trafficking situation, which is actually pretty large here in Columbus, Ohio, due to a number of reasons. And we’re just trying to figure out what we can do to really engage with the community on a level that’s just honestly more important than the facial plastic surgeries and treatments that we provide. So that’ll be my focus on social media and other things is really just creating this community and helping people to engage and something even a little bit bigger than what we’re doing inside the walls of our practice.
Tim Sawyer: I think that’s great. And it’s refreshing because, you know, I was talking about this the other day. I was like at an event over the weekend and the idea that you need to have, you know, if you do comparative living as a plastic surgeon, say, okay, guy next to me he’s got x number of followers or whatever that is, it’s actually the worst thing that you can do because you just hit the nail right on the head. All – everything is local and even social media is local and I try to tell people, I’d rather have 2000 followers, 2500 followers, whatever it is on either Instagram or Facebook, that you could actually interact with, you might bump into at the grocery store or they own a local gym or it’s a local accountant, whatever it is, and that you can refer clients to each other and that is so much more valuable than purchasing 50,000 followers so that you can, you know, show that at a conference that you’ve got a bunch of followers and it’s, quite frankly, it’s a distraction because, you know, you and I are both small business people at the end of the day and everything is tradeoffs. And, you know, the argument is always, well, you know, those mediums are free and that’s true, but they’re not free because it’s time, right, it’s time and headspace.
Dr. Nogan: A lot of time, yeah.
Tim Sawyer: And headspace. You know and you’ve got a million things going on and it sounds to me like, man, first of all, congratulations for getting to the place that you’re at. So quickly, but it sounds to me like you’re going about this with integrity in the right way and I’m hoping that the next 20 years, you don’t let that get beat out of you. How are you going to cling to that? What’s your big why? How are you gonna stay in touch with that?
Dr. Nogan: Well, I, you know, not on a daily basis, but certainly on a weekly basis, I’ve tried to just remember why I got into medicine, you know. Back in, I don’t know, 2006 I believe, I went on my first medical mission trip to Mexico and I’ve been on about 15 or so trips to Central America since that first one and I still work with an organization that introduced me to my future, so a surgery on that first trip, I know six I believe, still work with the same guys and I mean they’re retired now and I’m the one doing the surgery. Back then I was a college student and they were teaching me, so I just try to stay, you know, true to my roots and I owe a lot of that to my family, my parents, my upbringing, and now I’ve got three little kids at home all under the age of three and they’re going to keep me grounded going forward here.
Tim Sawyer: It’s a good thing that you don’t have a lot going on.
Dr. Nogan: Right, so I’m not going home and sitting on Instagram for three hours every night, Time, you know. When you talk about time and headspace, that’s where my headspace is when I get home from work so.
Tim Sawyer: And again, congratulations, it sounds to me like you’re making all the right decisions and you know, so what is, if you were to say, you know, three years we start to wind down on this, if you were to look out two years or three years and said, okay, this went right. What would that look like to you?
Dr. Nogan: That’s a good question. I would say, about two months or so into the transition, and I would say it already does feel like it’s going right, going well. If the practice has the same reputation in two to three years with me in charge for those two or three years, as it does, as the reputation is now then I’ll be thrilled and that’s to me that’s my number one — it’ll be my number one metric. I mean, there’s going to be a lot of metrics we’re following, but that’ll be number one and we want to – you want to have the right team in place outside, we’ve already talked about and I want to have a team that’s really engaged in the community and a practice that’s really engaged in the community in other ways as well. So if our reputation holds strong and we start to do some other things that are of value for Central Ohio, specifically Columbus here, then I’ll be happy no matter what the other metrics are, I’ll be happy, but you know, all the other metrics will follow. So if those things hold true, then we won’t have to worry too much about some of the other metrics, they’ll be healthy and in good shape. So that’s my big picture view point in the next of couple years.
Tim Sawyer: That’s awesome. So what do you got going as we wind down here? What do you got going for the last couple months? You headed out to any shows, you speaking anywhere, go any events going?
Dr. Nogan: Good question. We just got back from the AAFPS meeting in San Diego, which is a great meeting, great location. Actually talked to a couple of folks on your team there, I know you had somebody there, Crystal Clear had somebody there, giving some practice management talks and I actually sat in on a Ritz-Carlton talk, which was outstanding and that was well received. Yep and April was great and Travis was there as well, who was my initial contact with you guys over the phone. So I spent a few days there. My wife was there with me, my wife, the family doctor in Ohio and Columbus here and she was getting involved in the business and marketing side of things. So we were able to get a little time away just the two of us and learn a little bit at that conference, which is always a good experience. And then really, for the next number of months, I’m just going to be one patient at a time trying to transition this thing and just dig in and I’ll have the blinders up for a while, so nothing else, nothing else in the near future coming up for me.
Tim Sawyer: Well, our listeners will be paying attention. And if anybody who is listening had a question that they wanted to ask you about your process, could they email you or how could they get in touch with you? Do you have an email address?
Dr. Nogan: Yeah, absolutely. My email, my personal email is firstname.lastname@example.org and that’s just first initial and last name. And I’d love to hear from many of the listeners, whether it’s questions or comments and I’ll be quick to respond. So that would be great.
Tim Sawyer: That’d be great. Well, as I always like to ask, I only have one commitment and that is that let’s give it six months to a year to check back in with us, pop back on the show and let us know how make it out.
Dr. Nogan: That sounds awesome. I’d love to do it.
Tim Sawyer: Alright, Dr. Nogan, I really appreciate you taking the time today, best of luck with the practice. I know you’re going to do amazing things and we look forward to seeing the med spa services coming out soon. Thank you.
Dr. Nogan: Thanks, Tim.
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