Patient-Centered Aesthetics: The Art of Listening, Assessment, and Ethical Treatment

BUSINESS OF AESTHETICS | EXPERT PANEL TRANSCRIPT

Transcript

The Art of Listening, Assessment, and Ethical Treatment

Patient trust, ethical treatment, active listening, sustainable financial growth, rebooking and utilization metrics, team culture, patient education, and long-term practice reputation.

PARTICIPANTS

Don Adeesha (Host)

Full session transcript

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Don Adeesha (Host) 00:00:40

Hello, Andrew.

Andrew Miller 00:00:41

Hey, Don, how's it going?

Don Adeesha (Host) 00:00:43

Going well. How about yourself, sir?

Andrew Miller 00:00:46

Not too bad.

Don Adeesha (Host) 00:00:48

Okay, okay. So, welcome to the, Business of Aesthetics Expert panel here. Tonight, you're gonna be the star.

Andrew Miller 00:00:58

Is it just me today?

Don Adeesha (Host) 00:01:00

Yes, it is just 2 today.

Andrew Miller 00:01:02

Okay.

Don Adeesha (Host) 00:01:02

Seems, that's how things are planned out. Now, I do believe we are doing a bit of a beta testing on streaming this live to the business of aesthetics community on Facebook. Okay. So that'll be interesting, because, Yeah, we'll see how that goes. So, since it is just you and me today, it's going to be a very conversational event. Got a few questions from the registrations, as well, so we can answer those along the way. And, yeah. It'll be a more of a podcast-type situation.

Andrew Miller 00:01:45

Okay.

Don Adeesha (Host) 00:01:46

Yeah, we'll be aiming for more evergreen content with this one, it seems.

Andrew Miller 00:01:53

Gotcha. Anything I need to potentially… I mean, I know that you guys sent over the questions and have some… talking points, but any… anything I should maybe try to… Hit off.

Don Adeesha (Host) 00:02:04

Okay, yeah.

Andrew Miller 00:02:06

Or is it just really kind of open-ended, or what… Thoughts on…

Don Adeesha (Host) 00:02:11

open-ended, our audience is mainly… predominantly, they are from North America, and, they are, although they are in the aesthetics industry. Most of them are in a leadership position or, like, a business role, or practice managers. But then, of course, you know, we do have the provider, owner as well. In our mix. And, yeah, when it comes to answering questions, Andrew, if we can focus on experiential-based answers, with a little bit of a story here and there. Sure. We seem to have a bit more, sticking power. On that end.

Andrew Miller 00:03:00

Okay, perfect, yeah, that, that should be no issue.

Don Adeesha (Host) 00:03:05

Great. So, then we'll get things started here, and see where the conversation takes us. Okay. Okay… Alright. I think we are good to go here. Alright. Alright, good evening, and welcome, everyone, to the 2026 live event from the Business of Aesthetics, where your success matters. Tonight's discussion, Patient-Centered Aesthetics, The Art of Listening, Assessment, and Ethical Treatment, dives into the hidden tensions between aggressive growth targets And clinical credibility that can erode Your profitability and peace of mind. I'm your host, Daniel Disha, and alongside our featured expert, we'll uncover actionable strategies to avoid overtreatment, build unwavering patient trust, and create a practice that actually builds your wealth. Now, we'd like to start by giving a massive thank you to our Platinum sponsor, Equa Marketing, founded by Naren Arul Raja, the very same founder of the business of aesthetics community. For nearly 20 years, ECWA has helped aesthetic practice owners across the globe stop being the best-kept secret in their hometown. They believe that great care deserves great visibility. And, here's a quick tip from our team at ECWA that is important to all practice owners listening in. Let me ask you this. When potential patients in your area search for treatments that you offer, perhaps Morpheus 8, or… Botox near me. Does your practice actually show up, or are they finding your competitors instead? This is a major challenge, and you might be offering amazing services, but if you're not visible online, you are missing out. So, the good news is, with the right digital marketing strategy, local SEOs, targeted ads, and funnel-based content, you can convert inquiries into actual patients. Stick around till the end, because ECWA has something very special for you that will take your online presence to the next level. Now, let's quickly align on where we are heading over the next hour. The aesthetic industry is more competitive than ever, but today, it's about stepping back to redefine what true success looks like. We're going to discuss how to redefine beauty through empathy, and how harnessing the simple power of active listening can become your ultimate tool. to building unshakable patient trust. We'll also tackle the tough reality of avoiding overtreatment while still managing very real business pressures, ensuring that your clinical decisions always prioritize patient well-being. Ultimately, this session is about how to educate your patients to make informed choices, allowing you to build a legacy and a reputation rooted in genuine care and not just quick results. Now, let's meet our featured expert for this session. Our featured expert for tonight knows what it takes to build a championship-winning culture and a highly profitable practice. After starting his career leading St. Edward's University to its first basketball conference championship, he realized that the same exact principles Of discipline, strategy, and resilience applied to business. Today, as a senior financial consultant at Maven Financial, he helps healthcare and aesthetic practices plug their profit leagues, navigate intense growth pressures, and turn clinical excellence into long-term financial wealth. He's here to show us how to build a reputation rooted in care that fundamentally strengthens your bottom line. Please welcome Andrew Miller.

Andrew Miller 00:07:35

Thank you, Don. Happy to be here. Should be fine.

Don Adeesha (Host) 00:07:38

to have you here, Ed. Now, let's get into the discussion here. Let's see… Andrew. What are the financial patterns that show a practice is prioritizing short-term aesthetic demand over long-term patient trust in 2026?

Andrew Miller 00:07:58

Yeah, I mean, that's a… that's a loaded… question. I mean, I know that that's a good one to kind of start the discussion here a little bit. But really, and when I… I work with a lot of our, you know, plastic surgeons, aesthetic practices here at Maven, and for those that don't know, we're fractional CFO, CFOs for aesthetic practices across the country, and, you know, a lot of times, practice owners, practice managers, you know, COOs are kind of focused on the short-term lens of what do I need to do now? And a lot of times, while that's… okay, to a degree, it's really kind of best to look at, like, the long-term approach, the values of the practice, kind of where you want to end up being. So a lot of times, you know, when we're identifying, you know, that short-term demand and what they're doing. we see a lot of, like, a spike in revenue, more than anything. A big spike would kind of lead us to believe, okay, one, if it's beyond seasonality, that we'd run some sort of, you know, promotion or discount offering, which we… never really love, because again, it's not really… I guess… it's not the best patient profile, I think, for the practices that we work with, to a degree. You know, we're trying to find that patient that's going to be with us for, you know, the long haul, kind of through thick and thin, and trying to create relationships, as opposed to, you know, just trying to, like, fill schedules. So really, that's kind of the first thing that we typically see when they're kind of prioritizing that short-term aesthetic demand is, you know, did we see a spike? Why was it? Was it because of some crazy promotion? And then, you know, with that, then we can kind of see, you know, from the financial side, if there was that spike, well, are we actually profitable? From that spike, and most of the time. When there is some sort of discount flash sale, anything like that, it… Tells me that, you know, we were just kind of focusing on that short-term demand short-term push, just to try to, like, get us over some sort of hump. So, really, more than anything, it's, you know, I don't… we don't necessarily like that, because it doesn't necessarily lead us to having that long-term patient that's gonna, you know. be with us for, you know, with the treatment plan, so on and so forth. So, that's probably the biggest thing, that I've seen, and if you, you know, maybe need a specific example, Don, let me know. But, usually, you know, again, whenever… biggest time, you know, when we're meeting on a month-over-month basis, it's, you know, what can we do now? And it's really, well, it's like, well, what do we want the practice to be? And, you know, not only in the next month, but, you know, the next 12 months, or the next 60 months, whatever it may be, so… That's typically what we're seeing. We're trying to really just focus on an actual long-term treatment plan to get them to the results that they desire, obviously in an ethical way, without just trying to push, you know, this short-term demand, just to kind of put butts in seats, more than anything.

Don Adeesha (Host) 00:10:45

Okay, let's uncover some of the things you, said there. Patient profile, the ideal patient profile. How… what's the best way about going and building the ideal patient profile for a clinic?

Andrew Miller 00:10:58

I mean, I think that just… that varies. clinic to clinic, you know, and what you're doing. I think, fortunately for me, I say that it varies because, you know, working with plastic surgeons and med spas and dermatology offices, and even kind of dabbled in the dental space, which we're not really talking about now, but, you know, with my clients that are primarily plastic surgery, that patient profile looks very different than someone that's an exclusive med spa versus someone that is a combo practice. You know, a lot of times, their patient profile is someone that's coming in for Botox, and then at that point, they end up becoming a surgery patient, and they kind of go back to their, you know, aesthetic treatments post-surgery. So I think it does look pretty different, but, you know, whenever we're meeting with our clients, and, you know, our first meeting with them is usually setting those goals and, you know, trying to set up the practice for success from a financial standpoint, we always, you know, try to ask them to take a step back and say, well, what is… where do you see yourself, not only within the practice, but what does the practice look like in the next, you know, 5 to 10 years? Is it someone that's really focusing on a high level of service? You know, not trying to be the cheapest practice, you know, someone that's got a reputation for doing quality work with quality providers, or is it, you know, are we a volume practice, and we're trying to just kind of get people in and out? Most of the time, it's the former. We don't really have practices that are trying to be that volume practice, so when they're kind of identifying that patient profile, you know, it's someone that's looking for, you know, serious results, you know, over a series of treatments. And again, it's not just a, you know, come in and inject me with 50 units and be done with it. You know, there's a well-developed treatment plan, and there's follow-ups, and there's a relationship that's built.

Don Adeesha (Host) 00:12:46

Okay, now… Is there ever a good time to offer discounts?

Andrew Miller 00:12:52

I would probably say… I, as a CFO, probably would say no, but there is, you know, certain, you know. circumstances where, yes, you know what I mean? It's one of those where if we have, you know, a good amount of inventory that may expire, or, you know, we're trying to… we have a new potential device, and we're trying to maybe, you know. get that out there, get a new service line out there. So there are, you know, certain circumstances where it's okay, for us, beyond the inventory factor, so that way that inventory doesn't go to waste. We typically say, you know, let's maybe discount things in the sense that aren't very high cost of goods, so that way it doesn't affect the profitability. All that much, you know, we don't… we never like discounting injectables just because of how expensive they are. So, under certain circumstances, yes, but we also… we pride ourselves, and we tell our clients, you know, we don't really want to be a discount shop. You know, that's not… that's not the patient profile that we're looking at. Because usually that patient profile, they're going to kind of try to find that cheapest price, wherever it may be, and most of the time, it doesn't breed patient loyalty, rebooking, you know, or, you know, client retention or anything like that, you know? So, and that's also kind of prioritizing that short-term demand, is we'll see a big spike, we may see a big spike in new patients, but maybe 6 months… 6 months down the line. That rebooking rate is not great, and it's usually because, again, there's a heavy discount, a heavy promotion, and that goes back to that patient profile, Where they're just kind of discount hopping from practice to practice.

Don Adeesha (Host) 00:14:36

Checked. Nope… Andrew, if you don't mind, share a healthcare client example where growth pressure weakened judgment, and what that revealed about protecting long-term business health.

Andrew Miller 00:14:52

Where growth pressure weakened judgment. I mean, a lot… I've had this one client, it was, you know. Couple years ago, you know, they were really just so… pressed on… Trying to drive that, you know, revenue in any way that they possibly could, and it… Kind of clouded their… Judgment of what was potentially best for the practice and what was, you know, kind of the overall vision. of the practice. You know, they were trying to really cut console, you know, times down. They were trying to, you know, get anybody into the practice, kind of accepting anybody as a lead, more than anything. And sure, revenue did spike, but at the same time, it… it was not sustainable, and it wasn't long-lasting. And it kind of goes back to that first question that you had asked, where… You know, it was… I don't want to say, a call for desperation. But, you know, it was just, as quickly as that revenue went up, that revenue went back down, because of that fact, it was… they were going away from the overall values of what they wanted their practice to be, because they felt that pressure of having that revenue increase. And that growth increase. But again, just because we have that top-line increase, that doesn't always necessarily lead to profitability. So yeah, sure, our revenue numbers may look great, but our profitability usually suffers. When that happens, because again, it's usually by way of, you know, discounting, giving things away, trying to bundle too many treatments altogether. And, again, top line revenue… top line numbers are great, but profitability, and usually that question's like, we feel like we made a lot of money, but where is it? It's like, well, it's usually eaten up in consumable costs and… Other things that, kind of, people don't see. So, that one example, you know, going back to it, is they were just, you know, they were trying to… I don't want to say cut corners, but it was like, hey, let's… shorten up consultation time, let's shorten up appointment times, and in theory, that… worked a little bit, but what… what they gave up in, you know, appointment times and… or I guess increasing appointment times is they… they, they got rid of, you know, their relationship building, you know? And a lot of times in the aesthetic business, and I don't want to say people will go and visit their friends, you know, in the practice, but a lot of times, you know, we're trying to… There's a fine line between wasting time in the treatment room. but also developing that relationship with your, you know, with the provider. And people know this, it's one of those where people most patients, to a degree, you know, I think practice owners want the patient to go to the practice for the overall experience. A lot of times, though, they're going to a provider because they've developed that relationship with them, you know, over the course of You know, several months or several years. So, in this specific example, it was, again, it was plastic surgery and, you know, med spa. They were really trying to build up the med spa side of the business, and they were really trying to run it maybe a little too corporate, to a degree, and it was, you know, we have to… it's volume, it's volume, it's volume. And again, you know, by shortening up those times, yes, they were able to see more, but again, there was no loyalty to a degree. And again, that short-term growth pressure really kind of just weakened that overall, like, judgment of what they wanted their practice to be.

Don Adeesha (Host) 00:18:14

And, what specific guardrails were put in place after that realization to ensure that it never happened again?

Andrew Miller 00:18:21

So, you know, in coming from the CFO side, the financial side, you know, we're looking at KPIs on the provider side of things, and on the practice side of things, and you know, we… I always say we try to incentive… not incentivize, but, you know, give direction, but at the end of the day, the business owner is, you know, kind of responsible for those decisions. But, you know, we… we're really priding ourselves on Not only, you know, kind of bringing those appointment Overall appointment numbers down by hour. but also looking at, our new patient and our rebooking rates, too, because to me, it's one of those when we're looking at the overall metrics and the KPIs of things. And we're reviewing that with clients, you know, they're like, oh, we don't… our new pa… our new patient counts down. I'm like, well, our retention rate is way up, so that just tells me that, yeah, we want to have a healthy balance of both, but when our retention rate's really high, and our new patient you know, rate is maybe a little bit lower. That tells me that the providers are doing what they need to do, and they're doing, one, good work, and two, creating that, relationship in the room with that patient, and it's bringing them back. So… Then at that point, we kind of shift our focus to maybe some marketing, towards, okay, let's focus… let's keep on with that rebooking rate and keep doing what they're doing within the practice, but now we've kind of shift the focus a little bit. So it's one… it's looking at the overall metrics of the providers, and you know, there's certain metrics that, you know, we look at the hard data, the numbers, and the practice owners and the practice, you know, managers, they're… they're day-to-day. You know, we're typically not, so a lot of time, the numbers and the feelings most of the time, jive together. So when we're looking, you know, we're looking at the overall data, we can say, hey, look, this is kind of what we're seeing. Do the numbers kind of support what you're feeling? And most of the time, it's yes in that sense. So, you know, those guardrails are really, you know, kind of taking a step back and focusing on the quality of the work instead of the quantity of it.

Don Adeesha (Host) 00:20:15

Okay, what's a healthy rebooking rate look like?

Andrew Miller 00:20:20

So, that's another one of a loaded question, because if you're looking at it, there's two different rebooking rates, and it really depends on what the EMR can capture. You know, one of the rebooking rates is a 24-hour rebooking rate, to where, is that patient rebooking within 24 hours? And then there's an overall rebooking rate, which is, is that patient rebooking at any time? after their appointment is over with, and before they come in again. So, if we can, we'd like to pull both, and it's all really EMR, dependent, and what data we can get. So with that 24-hour metric, we typically see rebooking rates anywhere in that 35, you know, maybe 40% range is pretty good, because again, it is within a 24-hour window. of when that appointment's over with. And a lot of times, you know, patients will say, hey, double-check my schedule, you know, kids, life happens, so… That one's always going to be pretty, you know, it's going to be lower than the overall rebooking rate of, you know, rebooking at any point after that appointment. So for that second metric, we typically see that 60% to 70% range is kind of like that benchmark of where we want to be at when it's, That overall, you know, rebooking rate that's… Spans beyond that 24-hour range.

Don Adeesha (Host) 00:21:36

Okay. Now, Andrew, where are you seeing the biggest disconnect between what aesthetic practices celebrate publicly and what sustains a healthy business underneath?

Andrew Miller 00:21:49

Yeah, I think it's a lot of what we've talked about, to a degree, and I see that, and I say, and when I, you know, when you say publicly, I'm… I'm taking that as what they're kind of celebrating with the team, you know, and a lot of it with the team is, you know. did we meet our revenue goal? Did we meet our revenue goal? Or did you meet your revenue goal? Which, those are all great, you know, we look at that with our clients. Every month, we develop, you know, client scorecards, or rather, patient scorecards, so that way they can have meetings with their, providers, rather, provider scorecards, and say, okay, this was your revenue goal, this was your appointment target, this was your revenue per hour goal. So, I think a lot of that is what the focus is. Which is great, because most of the time, that's going to lead to a healthy and successful practice, but in reality, it goes back to, again, more than anything, looking at, yes, are they meeting their revenue goals, but are they doing it in a healthy way of, again, is our rebooking rate good? Is our capacity, our utilization number good? Because, again, we track that as well. So we want that utilization number to be at about 75 to 80%. Nothing really beyond that, because when you get above that 80% mark, you get… You know, there's a fear of burnout. to a degree, with a provider. So, the biggest disconnect, and again, I think it goes back to just, you know. What we see when, you know, when we're looking at it with our, clients is, you know, it's, did we meet the revenue target? Yes, and most of the time it's celebrated, but it's like, well, let's kind of take that, you know, look under the hood a little bit, and, you know, yes, we beat it, but are we actually making money on the bottom line? And then again, that goes back to, you know. Doing things, you know, correctly, treatment planning, rebooking rates, you know, not discounting anything, because we could have really high revenue months and, you know, meeting those targets, but it doesn't actually mean that we're taking home any cash at the end of the day.

Don Adeesha (Host) 00:23:51

Checked. Now, what is the most toxic, perhaps, vanity metric that's currently being accepted in the med spa industry?

Andrew Miller 00:24:00

The most toxic, what, metric, I'm sorry?

Don Adeesha (Host) 00:24:02

vanity metric.

Andrew Miller 00:24:04

From the, like, from the owner's standpoint, you think? Or…

Don Adeesha (Host) 00:24:08

Absolute.

Andrew Miller 00:24:10

Like, from owner to patient, or just owner to business?

Don Adeesha (Host) 00:24:13

Owner to business, really.

Andrew Miller 00:24:17

the most vanity, I mean… I do think it is just that overall top-line growth is probably… I don't want to say the most toxic, but it is the one thing that is, you know. anytime I get an email from a client, it's like, how far are we away from our goal? How far are we away from our goal? And again, that, I think, sometimes takes away… it's… We love the fact that our, you know, clients are looking at that. But that sometimes can be missed of, you know what, there's sometimes a bigger story of us maybe not hitting that goal, you know, and again, there's so many different factors that go into that play of us hitting it or not. You know, it could be that a provider maybe had a bad month, maybe had to take some time off. Whatever it may be. So, I do think that that is some sort of that, you know, quote-unquote. Vanity, and it could be toxic to a degree, because, the more data that we do put in front of our, our, clients, again, it's… it goes back to focusing a lot on, you know, revenue targets, which, again, it's more of how are we getting to that revenue target, and are we doing it the right way? Are we doing it ethically? And I do think that goes back to, again, you know, culture, you know, or practice culture more than anything, because we want We also, while we want them to hit those revenue goals and those targets, we want to make sure that they're being done, in a way that, you know, the practices Successful and healthy and, You know, providers are happy, ownership is happy. There's no, you know, the biggest thing that's, you know. That we see sometimes is, you know, yes, revenue targets are being hit, but there's provider turnover, we're having to replace people a lot of the times, and it's, you know, it's… it's the overall picture of it. It's, you know, again, it's not how we're… it's not what we're beating by, it's how we're getting there, and everyone will be doing it the right way.

Don Adeesha (Host) 00:26:13

You spoke there about a very interesting topic, culture, and making sure that the practice is healthy. So, What are the key signals that a practice is healthy internally in terms of culture?

Andrew Miller 00:26:27

So what we typically see is, again, going back to that utilization metric, we're looking at that pretty closely, not only on a provider level, but on a grouping level. You know, so we group our, our providers based off of, you know, provider type, whether it's, you know, estheticians, injectors, NPs, mid-levels, you know, doctors, whatever it may be. So. you know, we're looking at it and saying, okay, well, the esthetician department is running at 78% capacity. You know, let's take a deeper dive. If we have 3 estheticians, are they all running at 78%, or do we have two that are running at 90% and one that's running at 40, you know, and it's kind of averaging out to that 78% mark. So, one, we're looking at it kind of from a top-down approach, where it's, okay, what's the practice, you know, capacity? And, you know, are we fully optimized? And then our provider types, are they fully optimized? And then if they are, then we go back and we look at that provider level. And say, okay, who's optimized, who's not? And then at that point, you know, we're trying to either get the ones that are not optimized up to that 75-80% mark by, you know, trying to uncover why they may or may not be getting there. You know, sometimes they're a newer provider to the practice, sometimes they're new to the area, sometimes they're just, you know, fresh out of school, and they don't have a following. Sometimes, you know, they don't do well with patients, you know, so there's a myriad of factors there. So… more than anything, I think what breeds a good culture is, you know, one, that everyone's kind of carrying their own weight. We're looking for, you know, diversified production across the board from a practice, in the sense that We don't want, you know, any one provider carrying, you know, 50% of the workload, or whatever it may be, because we've seen that before, and that sometimes can breed resentment more than anything. And so, you know, it becomes a very, you know, toxic workplace of, you know, I'm doing all the work, and you guys aren't, and so on and so forth. So, that's kind of the first thing that we're looking for, and then I do think from the owner side of things, what I've seen, that leads to a really healthy and kind of dynamic practice is when the owner is… Takes a step back from being a provider, and is really focusing on being, you know, a coach and a leader to them, and they're almost empowering them to run Their mini-practice within the overall practice. And that, you know, I think most providers like that to a degree, the ones that want to grow, and the ones that maybe aspire to be a business owner one day. And I have, you know, one client in particular on the West Coast that it was pretty hard for the owner to take that step back, you know, and she… Her and her partners had this, you know, goal to, you know, one, expand their current space, two, move into a second location. But I said, you know, you guys are doing a lot of the work, and you guys are working in the business instead of on the business. And it was about a year and a half transition of said, hey, look, we're gonna intentionally, intentionally goal you to not do as much, that way you can focus on your team. And ever since that's happened, it's, you know, it was a little bit of a… a rough patch at the beginning, but ever since that happened, she's focused so much on coaching and developing and, you know, kind of giving her her trades of her practice, and then by that same note, the providers are kind of owning up to it and enjoying, you know, kind of, again, working, having their own little mini practice within a practice. They're investing time in, you know, continuing education, going to conferences, you know, Going to classes, bringing, you know, people over to the practice to train with them. And, you know, it's one of those where, you know, they're hitting their goal, they just opened up their second location, and it, you know. Knock on wood, I'm meeting with them tomorrow, actually, and everything is, you know, hugging in the way that it's supposed to. But again, it was… it was a… it was a kind of a… a big trust, you know, initiative that had to take place, and, you know, the owner had to trust her providers, the providers had to trust the owner that this was all going to kind of work out. So, I think the biggest thing is trust within everybody in the practice, and that's kind of, you know, led to that. Really healthy overall work environment.

Don Adeesha (Host) 00:30:41

Amazing. Now, Andrew, with regards to being a coach, what makes a good coach? Now, you spoke about continued education opportunities, as well as what makes a coach more on the inefficient side?

Andrew Miller 00:31:00

More on the efficient side, is that what…

Don Adeesha (Host) 00:31:02

inefficient.

Andrew Miller 00:31:03

are more… what makes a coach inefficient? Is that what the question is?

Don Adeesha (Host) 00:31:06

Yes.

Andrew Miller 00:31:07

Oh, man, that's, you know, micromanaging would probably be the first one that comes to mind. You know, you… a lot of… a lot of, you know, business owners, I think, want to be that coach and want to potentially be that resource, but a lot of times, too, there is a lot of frustration, and I think it… if you don't have that trust within your team, a lot of times, I think sometimes, you know, and I think a lot of people probably think this way, it's easier for me just, you know, they think to themselves, it's easier for me to do it myself. And as a business owner, you're never gonna really get to that point of, you know, trust within your team. to where they can, you know, focus on what they need to do, and that way you can, you know, focus on… say you, as the business owner, you, you know, focus on that overarching goal of where you want that business to eventually be. So, I do think that the most inefficient, you know, way to do that is by micromanaging and by not being able to trust your team to do what they need to do, and not maybe taking that step back from, you know, going from provider to business owner. Because, again, we know that, you know, when you're a provider and trying to be a business owner, that's really taxing, not only on, you know, your body, but probably family and relationships. It's almost a necessity to take that step back and to have that trust in your team.

Don Adeesha (Host) 00:32:29

Gotcha. Now, give me the telltale signs of a good coach.

Andrew Miller 00:32:35

To that same vein, it… trust, that's the biggest thing. I mean, trust, empowering your team, you know, listening, I think is more than… more than anything, you know, listening to what they want, investing in them. And that's kind of what I've seen with this practice, you know, more than anything. It's, you know, when we're talking now, it's, you know, hey, this provider wants to do this. Can we afford to do it? What's the return on investment? Go through the numbers, make sure it makes sense, and… I think that's what it is. It's listening to what your team is wanting, or what certain people are wanting, and trying to guide them to get there. Because again, every person within that team has their own individual goals, and I think it's trying to… potentially align that with the growth of the practice. So you're not only, you know, focusing on just the overall growth of the practice, you're trying to make sure that each individual, whether it's, you know, front desk to provider, is meeting and exceeding the goals that they want for themselves. So I think it goes back to that trust factor, but also listening to what they want and what they need, and then giving them the tools to succeed in their role.

Don Adeesha (Host) 00:33:43

Gotcha. Thank you very much for that, Andrew. Now, Andrew, this conversation about protecting credibility and patient trust is exactly what practice owners need to hear, but… Well, I should say, and here's the harsh reality, if patients who desperately need your high standard of ethical care cannot find you online in the first place, none of this may matter. The clinics prioritizing quick cash will win the click. So, that's why we're thrilled to partner with ECHO Marketing for this event. ECHO is, One of the most trusted digital marketing organizations in the US and Canada, supporting over 500 healthcare practices, and tonight, ECWA is offering our attendees a complimentary marketing strategy meeting worth $900. Nope. So, in your strategy session, you'll sit down with the senior marketing analyst. who already works with thriving aesthetic practices across North America, you'll get a live audit of how you can attract more clients, build your reputation, and grow sustainably. The marketing analyst will actually spend several hours researching your online presence, your competition, your local SEO, even AEO, now that AI is involved, and everything along the way. They'll come to the the call, ready to walk you through custom recommendations just for your practice. This session is designed to help you answer those questions and fix anything that's not quite working. It's a $900 valued session, completely complimentary for you tonight. You'll see a QR code on the screen, you can scan that with your phone to book your session, or check the chat for a direct link. It'll take less than a minute to book. Availability is limited since, as I mentioned, every audit involves real research into your local market. So, perhaps here's a way to think about offers like this? What's the risk if you say yes? Honestly, it'll just be your time, there's no obligation whatsoever, but what's the risk if you don't? You might be missing out on something that could really help your practice grow. So, I'll leave that with you, but truly, I encourage you to grab this opportunity, book your session with Equa, it'll be time well spent. Right. Okay, that's interesting. Right. So… My next question to you, Andrew, is when patient education slows conversion, how should practice leaders weigh near-term revenue against long-term loyalty and reputational strength?

Andrew Miller 00:36:37

That's a good question. So I think a lot of times that… it's taken for granted when that patient education is… does lead to that slower conversion. Yes, there is that potential short-term impact. But I do think there is that longer-term impact where, again, I think where business owners need to think of, you know, not revenue just today, but revenue for the next 12 months, 24 months, and, you know, not only from this current patient, but from what the lifetime value of what this patient can bring, and that's always a tough You know, metric for us to… to measure, because the lifetime value is not only what the patient is, you know, obviously bringing us, but We always say that the best form of marketing is, you know, referrals and word of mouth. So, a lot of times when there is kind of that slower conversion, you know, patients may be a little bit more apprehensive, but they are trying to make maybe a little bit more of a, you know, well-informed decision, and we, you know, there's that fine line of. Being salesy, but also, you know, trying to Push them to make that right decision, but again, you know, we want the patient to feel comfortable, so maybe if there isn't that same-day conversion, you know, it… could lead to that higher trust, better outcomes, you know, and then again, going back to that, you know, retention and referrals. So, I don't think it's… you know, whenever that question does come up with some of my clients, it's always, you know, I like to play the long game more than anything, so, I think it always helps to potentially follow up with, you know, phone call, email, text message to the, you know, patient if they are having some sort of apprehension about, you know, making that decision. So again, I do think that, you know, we always say conversion speed is not the same as conversion quality. Conversion quality usually is, a better long-term approach. to the practice overall. And again, we want that patient to come back. Refer others, be happy, and then more than anything, trust The provider and trust the practice, because it's the ultimate reputation. Of the practice overall.

Don Adeesha (Host) 00:38:44

So, trust the practice, trust the provider. It all comes down to, trust at the end of the day. Now, take us through, perhaps, how can we educate our patients to make more informed aesthetic choices?

Andrew Miller 00:39:01

I mean, I think it goes back to listening to what the patient wants and needs, and I think, you know, transparency with the provider to the patient is key. I know that, and again, forgive me for people listening, I don't know all the technology that's out there, but I do know that there are, you know, I don't know the names of everything, but I know there are those facial scans, and there's a lot of technology available to pretty much simulate what sort of treatment's gonna look like for somebody, and, you know, a patient may come in and say, I want, you know, X amount of Botox or filler done, or this treatment done. And an experienced provider may already know that that's not what the patient actually needs. So, you know, with the use of technology and experience, and saying, look, you know, and coaching the patient through the process and say, you know, I actually think that maybe this would look better, let's kind of take a look and see what, this could look like. And I think that's where… trust is formed, because again, it's, you know, it's out of respect, obviously, but it's not just agreeing to what the patient thinks that they want or need, it's actually showing them how maybe there is a alternative solution that could be more beneficial and more, you know, long-term effective to them.

Don Adeesha (Host) 00:40:18

How important is it to show these alternative solutions and not just go along with what the patient comes in through the door requesting?

Andrew Miller 00:40:26

I mean, I think that it's… That's one of the biggest conversations that we try to have to practice owners, so that way they can kind of divulge that to their providers, because it starts a conversation, and yes, that's where it goes back to where we're talking about kind of like a churn and burn practice, as opposed to having maybe some longer appointment times. But when that happens, more than anything, it starts a conversation. And with that conversation, usually some sort of goals Or parameters are outlined with what the patient is looking for. And that's where we're, you know, when we try to You know, coach the provider, not us coach, but the practice owner or, you know, some sort of salesperson coach them and say, this is where listening, active listening. comes in. So, you know, we always… when we go back to the practice owner wanting to listen to their… to their employees, this is where the provider, you know, needs to listen closely to what the patient is saying and, you know, again, what they… What outcome they actually want. And there may be a more effective solution. And again, with that, if they can see that, you know, one, they were honest with that, and they can see the results happening maybe either quicker, or there's a longer-lasting result, that's where that trust comes in. But more than anything, that conversation Just opens up, a relationship, and it opens up the idea of, hey. this is probably maybe better suited for you, based on what you're telling me. Maybe let's go through with this. And it's, it's, you know, I always like to say, too, I don't go to the doctor and they… and I tell them what I need. There's always usually questions that are asked about, you know, certain ways that I'm feeling or whatnot, so, it's not my job to diagnose what's wrong with me? It's the doctor's job to do that, and most… sometimes it may very well be that the patient is right, but, you know, from a due diligence standpoint, it's… It is, you know, it's very important for the provider to potentially, you know, to start asking those questions, so that way, you know, conversations can be had.

Don Adeesha (Host) 00:42:35

Okay. Now, Andrew, on the same line over there, How can we avoid over-treatment, or rather even overselling, aligning clinical decisions with, at the end of the day, patient well-being?

Andrew Miller 00:42:51

It's still that… I mean, it… much of the same there. You know, we… we don't want to over… that's always, you know, the biggest thing. We never want for that to happen, because that goes the other way with our, you know, trust factor there. So, I do think it's… Having that, you know, that… a preliminary consultation of, you know, saying, hey, look, this is… what is, you know, what is your overall goal as a patient here? Is it… is it short-term? Is it long-term? Is it preventative? You know, what are we trying to do? And I think laying out that treatment plan, almost having, like, a patient profile, and that's kind of what we, you know, talk about with some of our clients, is kind of having that Patient profile kind of already outlined, and some practices have that to where, you know, there's 3, 4, 5 different patient profiles, whether it's, you know, for just esthetician-type services, whether it is for more injectable services. So that's kind of the way that we try to avoid that over-treatment, is, you know, one, trying to align what the goals are of the patient, but also ethically, from the, you know, the standpoint of medicine. And not, you know, over-prescribing to a degree, not that there is prescriptions, but, you know, over-treating. So, it's really just trying to understand the overall framework and the goals of what the patient is looking for, and how that fits within the services that the practice provides, and ensuring that, you know, they're gonna You know, be met ethically.

Don Adeesha (Host) 00:44:18

Now, Andrew, you framed that really well with regards to, you know, what's ethically good for the patient. Earlier on, you mentioned that if a service provider is interested in Adding on a new type of service, or new type of treatment. they might bring it to their practice owner, and then the practice owner, to evaluate that, will bring it to you, the fractional CFO, to figure out the ROI of that. That made me really curious as to, do practice owners… overestimate their capabilities, I mean… In… trying to do all of these things at once, because if they are not coming to you, they're trying to figure out the ROI by themselves, or they're kind of going to wing it and see how things go. How has that… how have you, seen that really play out with your clients?

Andrew Miller 00:45:20

That's… that's a good question, because, you know, it usually always happens right around November and December. Whenever, you know, laser season, in… or laser selling season is happening, you know, it's… it's very, very common right around this time, quarter end, and then obviously year end is… is another time, so… Yes, they do come to us and say, you know, one, can we afford it? And then that's when we, you know, we'll jump on a quick call with them, do a quick analysis, and a lot of times what we try to kind of steer from is. Is this just a one or two patient need, or is there an actual gap that we're trying to fill? Because a lot of times, you know. Sometimes owners get excited with, you know, a patient or two or three may… ask for a certain service that we don't provide, so they think, oh, let's go and potentially buy a device now, and I'm like, well, that's $200,000, and we've had 3 people ask about it, so it's gonna be pretty tough to, justify that. So yeah, it is a common theme, and, you know, we always try to say, okay, let's break it down. What's… one, can we afford it? What's our, you know… I don't want to go too heavy into the finance side of things, but, you know, understanding what the debt position's like already, and are we going to pay for it in cash, and there's a lot of other factors, but once we get… we… get beyond the financial side of things and affordability, it's, you know, how long is it going to take to break even with this device, and what you know, what are the number of treatments? How are we going to package this? How are we going to sell this? Do our providers need any sort of, you know, additional training? How long is that going to take? So a lot of those factors are, you know, considered before new services are added, especially with services that require a device, in that sense. So, we want to make sure that we check as many boxes as we can, and that we're making the smartest decision possible, and we're not just trying to maybe fill a need for a handful of potential patients, but we're actually filling a gap For our overall base of patients, more than anything.

Don Adeesha (Host) 00:47:25

How much of that do you think is, practically, or rather reasonably, within the practice owner's, scope of work? And when would you recommend them to come to you to really evaluate, a new venture?

Andrew Miller 00:47:43

So, what we usually do is to at least try to garner the overall interest via, you know, either survey or, you know, a lot of times it's, one of my practices up in the Northeast, that they're a combo practice with plastic and, and, MedSpawn, they wanted to buy a new device, and, you know, it was, I think, I want to say maybe September of last year. And he's like, oh, we've had 2 patients ask about it. I said, well, we need to probably wait. That's not worth it. And then in October, it was, oh, we've had about 5 more people ask about it. I said, well, that brings a total of 7. So, every… every month, he kept… and it was… he took it on his own to basically write a list, and he came to me in December and said, hey, we have about 45 people that are interested. And are willing to sign up and pay. for that device, is it okay if we pull the trigger? So we ran some numbers, I said, yep, I think we're pretty, you know, pretty close to at least a break-even if everybody signs up. And then on top of that, you know, once we get some good before and after pictures and we can kind of market this, then we know that there's an interest there. So, you know, those are kind of the steps that we'd like to try to take, and unfortunately, it is a little bit of a… longer, you know, longer process to get to that point, and, you know, for us as CFOs, we're never really… we don't want to make a rash decision and, you know, a quick decision, especially one that could cost the practice quite a bit, because, you know, we don't… the last thing we want to see is a device just kind of sitting there, just, you know, collecting dust. So, So yeah, you know, that's how we try to evaluate it. It's more on overall need in that case, you know. he was out… he was able to do his due diligence and, you know, talk to his patients, but again, he did it himself as the surgeon. He coached his providers in the med spa to basically Talk to the patient, say, look, we're thinking of bringing this on. What's your level of interest? And that's how they were able to, pretty much show me, like, hey, you know, we can… we can pay for this thing. You know, our services with this new device are, one, gonna add something that we don't have, two, it's gonna add something that nobody within a 10-mile radius has, and three, we already have the patient base to at least break even on this.

Don Adeesha (Host) 00:49:54

There we go. Now, Andrew, faced with aggressive growth targets, what'll help leaders choose restraint when faster revenue could undermine clinical credibility?

Andrew Miller 00:50:08

Ugh, I mean, that's one of those where… You know, so basically we want to choose a restraint under, you know, aggressive growth target. So, you know, we want to make sure that, you know, we're balancing everything out with our revenue, you know, retention, and that overall outcome. And again, I feel like I'm somewhat repeating myself, a little bit, but, you know, it's one of those where It's really that overall balance and that long-term impact of the practice, and again, we want to… you know, one of our partners says it clearly, we don't want to step over to the dollar to pick up the penny. And, you know, a lot of that… a lot of that times, you know. We try to coach our business owners not. to do that, you know? So, you know, we're trying to grow smartly and ethically, and, you know. be… and I say ethical in the sense of, hey, let's not over… over-prescribe, or, you know, over-treatment plan, or, you know, over, you know, inject to a degree with some of these, patients. So, really, it's going back to developing that loyalty and that trust with our, providers and our patients, so that way, again, we can, you know. Yes, we want aggressive growth, but we want it to be smart.

Don Adeesha (Host) 00:51:28

Absolutely. Now, on that note, what are some of the planning rhythms that best keeps owners aligned on patient trust, team behavior, as well as financial health before these small problems become expensive ones?

Andrew Miller 00:51:42

Yeah, so, I mean, with that, you can kind of look at that a different, you know, several different ways, more than anything. So, you know. I like to kind of break it out into the way that we do things, where it's, you know, monthly, you know, we like to look at that performance to where, you know, you know, scheduling optimization, conversion rates, rebooking, kind of that patient feedback that we're, you know, getting from them. You know, beyond that, you know, when you look at that quarterly and that annual type of alignment. It's, you know, the overall brand positioning, the actual patient experience is huge. You know, that's… at the end of the day, that's what we try to have our practice owners really care about is the overall, you know, what's the experience that that patient is getting? Because at that point, again. They're very likely to tell their peers about the practice, and that is the most effective marketing, you know, that we've seen, is word of mouth. Because again, you know, friends trust their friends. It's like, hey, go check this place out. You know, they do great work. They've never shared me wrong. They actually helped me, you know, see a different path than what I was thinking about. So, you know, really, you know, when we're looking at, you know, staying aligned, it's… The stuff that we do on that month-to-month basis, again, looking at utilization, looking at schedules, looking at rebooking rates, but beyond that, and this kind of falls a little bit more on that, you know, on the practice owner side of things to where, you know, strategically, what is the brand, what's the value of the practice, and what's that patient experience, looking like? And is everybody, you know, on the team in alignment of that to kind of grow, you know, the practice and kind of grow it in that same direction?

Don Adeesha (Host) 00:53:24

Okay. Now, when you're talking about the experience of the patient and going in for referrals, you're talking about, basically, the reputation of the practice. Andrew, take me through what creates a practice, or rather, the reputation. Known for their care, rather than just the results.

Andrew Miller 00:53:47

Yeah, and that goes back to the… to the little things, I think. You know, it's one of those where, when, you know. when a provider remembers a little thing about, you know, maybe you had a milestone or a big-time life event, and, you know, when you come in 3 months later, you know, they ask about that. You know, it's… it could be a certain aromatic smell in the practice that makes you feel a certain way. So, usually the patient experience, it's, you know. Not to… not to discount people's, I guess, expertise as far as, you know, providing services, because again, that's… the med spa market, there are med spas, as the joke is, on every block now, so it goes beyond just the service, and that's why we always say, you know, those little personal touchpoints, more than anything, is… really is huge when it comes to that patient experience. And it's, again, it's one of those where it's how you make them feel, and it's putting that personal touch, whether, again, it is a handwritten note around the holidays, a handwritten note for a birthday, you know, a little birthday surprise. again, it's a provider asking, you know, somebody how, again, their children are, whatever it may be, it's, again, it's that extra mile white glove, you know, Ritz-Carlton type of service that usually keeps people coming back, because that's hard to replicate. More than anything. And if you can couple that with, you know, outstanding services, and, you know, trust within the provider, then, you know, you're gonna set your practice up for success.

Don Adeesha (Host) 00:55:22

Check. Now, Andrew, we got a question from one of our registrants here. What practical tips or insights can I gain from consulting to pick up new growth ideas? Like pearls.

Andrew Miller 00:55:37

So, just from… from any sort of consult, like, from…

Don Adeesha (Host) 00:55:41

Consulting.

Andrew Miller 00:55:41

financial.

Don Adeesha (Host) 00:55:42

Well, you're the financial consultant, so…

Andrew Miller 00:55:45

Yeah, so, so really with that one, you know, we really try to focus on, you know, the future, in the sense, and planning, so the insights that, you know, we really try to focus on more than anything is looking at the, one, the overall financial health of the practice by looking at, you know, profit… or Profit and loss statements, balance sheets, but also looking at our, overall providers. And looking at, you know, how they're doing. Are they fully utilized? Can they be doing more per hour? Could they, you know, could their schedules be a little bit more full? And at the same time, we use that data to forecast into the future. And a lot of it is based… it's going to be based on the overall goals of the practice, and the practice owner, to say, you know what, I want to maybe expand and grow into a second location or a third location, but I don't want to take out a loan for it. Well, you know what, let's plan for that and say, okay, we have an 18-month journey to get there. These are the numbers that we need to hit, again, the right way, smartly, strategically, so that way we can plan and predict cash flow, and we can make sure that we can get… set you up for success. And in that same vein, you know, we have practice owners that come to us and say, you know what, I want to sell my practice in 3 years. Let's try to optimize this, in the most efficient way possible. So again, we go back, we start looking at provider data, we start looking at practice data, and we try to plan and budget and forecast. Into the future, so that way we can try to get you to that goal. And then, you know, beyond that, it's the little insights of, you know, why do I feel like my practice is down this month? Is every one of your other clients feel that they're down? Is it seasonality? Is it geographic location? Is it economic factors? Whatever that may be. So… You know, I think the most important, I think, insights that we typically give are, you know, those little Key nuggets on a month-to-month basis from, you know, what are other clients seeing, how are they feeling, and how does my practice kind of fit in to what my, you know, all the other practices are seeing and feeling at any given point in time?

Don Adeesha (Host) 00:57:48

Gotcha. Now, as we wrap up, Andrew, what is the single most important step a practice owner can take tomorrow to align their financial growth goals with patient-centered care?

Andrew Miller 00:58:01

That's a good question. I would probably say, for that, I mean, we probably… I want to make sure that our providers, one, have all the tools in place, you know, to provide, you know, the outstanding care that they need. And again, that goes back to, you know, trust, but also at the same time, you know, we want to make sure that they're being as efficient as possible. So that way, again, we can, you know, hit those revenue targets, hit the goals, hit our profitability targets that we want. So, I think more than anything, it's making sure that each provider has the tools that they need to be as successful as they can to work with patients on a day-to-day basis. And that way, it keeps the patients coming back for a little bit more.

Don Adeesha (Host) 00:58:51

Well, thank you very much for that, Andrew, and… Right. So… Now, before we wrap up, a quick reminder, to our audience, As a… we want to ensure that your ethical practice is the one patients actually find online. So, do not miss out on Echo Marketing's $900 marketing strategy meeting gift. The link is in the chat for a few more minutes, as we wrap up. And, it has been an incredible session, Andrew. Thank you so much for sharing your expertise and, of course, showing us that ethical care and financial success are not mutually exclusive. To our audience, thank you for investing an hour in your practice's success tonight, and as you close the Zoom, a brief feedback survey will pop up on your screen. Please take 30 seconds to fill it out. It'll help us bring… It'll help us bring you the exact events, and panelists that you need. Now, with that being said, thank you so much, everyone. Wish you a wonderful evening. Stay resilient, and we will see you at the next… Next, Business of Aesthetics Expert Panel. Take care.

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