Where is the greatest proportion of money invested in your practice? Why? Is this by choice or by necessity?

Michael Somenek, MD: Incorporating various technologies into the office has been where the largest proportion of our money is directed. I am always looking to expand our menu of services so that we are offering the latest technologies for our patients, which they appreciate. I certainly have a choice not to do that, but in the interest of being on the cutting edge, I choose to do so.

Tina Ho, MD: I am currently an LLC independent contractor, so I do not directly hire/fire staff or directly pay for overhead. The greatest proportion of money is directed toward my insurance coverage—disability insurance, malpractice insurance—by necessity. The stand-alone category where I invest most right now is marketing with an SEO website company and ads by choice. I feel it is worthwhile in the long run to invest in marketing, particularly for my website.

Joe Niamtu, DMD: Investing in your practice is indirectly investing in your life, your happiness, and the ability to stay in the top tier of what you do. In my practice, my first investment is in my staff because above all this is what will make or break so much of what you do and make your life easy or hard. My second tier of investment is in my physical plant. My discipline is cosmetic facial surgery, and my office has to resonate to that population that is largely to an upper class female population.

Flora Levin, MD: SEO is the biggest investment (about $13,000/year). Otherwise, investing in good staff, having fewer of them—just what’s needed and paying them well.

If you could re-allocate the investments in your practice, where would you spend the greatest proportion of your money?

Dr. Niamtu: Like most doctors, I would love to have more space, add more toys, i.e., devices, however sometimes what we wish for and what we need are very diverse.

Dr. Levin: I might hire someone to do my social media professionally, instead of doing it myself.

Dr. Somenek: Training the staff on best practices and the best ways to deliver our luxury brand consistently. I think all too often we want our staff to implement so many ideas and policies that are great ideas. However, it gets so chaotic that we ourselves are not effective at enforcing those ideas.

If you were gifted money that you had to invest in your practice, where/how would you do it?

Dr. Somenek: I would take the staff on a retreat and pamper them, because nothing empowers someone more than making them feel appreciated and that they matter to the practice.

Dr. Niamtu: I feel that I have a very nice set-up in my practice, and it is safe, efficient, and fun. However every once in a while you see a picture of somebody who has taken the cosmetic surgery office to the next level, way above and beyond what most offices are like. It would be great to do that, so if I won the lottery tomorrow I would up my game in terms of my ability, my space, devices, and benefits for my staff.

Dr. Levin: Then I would definitely invest in professional social media, and expand services by having a PA or an RN do non-invasive procedures. I’d still do injectables myself.

Dr. Ho: Marketing, with a higher tier company, and equipment, e.g., FaceTite.

Looking back over your practice, where would you say some of your least worthwhile investment has been? Why?

Dr. Levin: Ablative laser (non-fractional) has way too much downtime for most patients to undertake as a stand-alone procedure. Also, collaborating with some “influencers” has been hit or miss. Some bring patients in; others don’t.

Dr. Ho: Investing in an online consumer-facing marketing/education platform. Otherwise, it’s too early to tell with my practice and given my LLC status.

Dr. Somenek: I think most people would look at this question and have a comment about a capital investment. I’m very cautious when bringing devices and other large capital investments into the practice so I don’t have any that have proven to not be a worthwhile investment. However, I think investing and bringing in employees that don’t believe in our brand has been the least worthwhile investment for us. There have only been a handful that have come and gone, but it was a failure to see that they just weren’t a good fit for our practice.

Dr. Niamtu: I am a pretty skeptical person and I have researched most of my purchases wisely before investing. I have seen friends waste hundreds of thousands of dollars on devices that did not do what the company or rep said they would do. I guess that I would reallocate some of my marketing efforts that seemed like a great idea, but did not pan out.

Thinking beyond your practice toward personal finance, do you have any advice on investments for cosmetic surgeons?

Dr. Niamtu: I started working as a paper boy helper at age of eight. Someone told me to begin saving early and that has stuck with me. My advice to new docs is to take profit and do the following. Save one-third, allocate one-third to pay taxes, and spend one-third. This has been a good formula, and longevity is the most important thing about investing. Small amounts in your early career can have amazing compounding results decades later. Discipline is important. We all work hard, so make sure you embrace your passions. Just make sure you save a certain amount.

Dr. Levin: A good accountant. Someone who does this professionally—allocation of resources and investments. Doctors are good at being doctors, not always at making good financial decisions. Keep your business small and control your overhead. Don’t grow too fast. Consider ROI when buying equipment.

Dr. Ho: I have a CPA attorney who is crucial in starting my LLC and giving me advice as well as doing my tax return.

Dr. Somenek: I would say if you are going to invest in a capital purchase to the practice, make sure you have patients and a plan of how it is going to sell and work for the practice. I think what commonly happens is that a physician will purchase something that is a great device or product because it looks good on paper. They then get it and then start to develop a plan which is the exact opposite of how it should work.