Episode #770 - Why Learning From Failure Is Key to Success with Dr. Chad Deal

Dr. Eli built a medical aesthetics practice by learning from early mistakes, especially over-trusting staff. His intensive surgical fellowship gave him high case volume, and he explains why med spas are profitable targets for private equity consolidation.
Welcome to this edition of the million Dollar Mastermind podcast. This is where we pick the brains of high achievers from all walks of life and get their hard earned real world insights on winning. I'm your host, Larry Wydell.
It's a matter what you enjoy and you can't change that. And, like, just because other people enjoy other things. But I kind of feel like Jay Leno in the sense that he said people talk about traveling the world, seeing the sights, especially going to the beach, you know, on the resorts and the sand. He said, he said, he said to me, that's my idea of hell. You know, I agree.
I didn't know he said that. And I agree. I mean, I'm, I was just like, I was shocked. I, you know, I, I sit there and I had, I had a partner at the time, before I ended up taking over. And, and, and I remember him and his wife and me and my wife at the time. And I set up this. Hey. Because I was so bored on the beach, I was like, hey, guys, I set up this really cool tour that we're gonna go to some crazy place, and we were in Puerto Vallarta, I think in Mexico. We. They saw that I got this cruise and then they changed my cruise because it looked a little too adventurous to just a booze cruise. So I'm like, you're just, just floating around. I'm like, so wait a minute. So we've basically been sitting on the beach all day drinking alcoholic drinks and, and getting sunburnt, and now we're gonna go on a boat and float around and drink. I'm like, I, I mean, I, I enjoy good bourbon or red wine, but I, it's gonna drive me nuts if I'm not, like, doing something. And I, well, you know, even traveling, when I go and I see, oh, there's the Coliseum. Yeah, it's really cool, but I want to walk in it, I want to touch it, I want to something. If I go and I see a picture and I stand next to it and someone takes a picture, I'm like, well, it looks the same on Google Images, right? Like, why did I even travel if I'm not going into the vineyard, right? And really seeing how they do these things. And so I, I, you know, I say these things and it makes it sound so, so rich and beautiful. But I mean, I really think that's a blessing that I feel that way because I see that maybe I'm just unusual in the sense that everyone else is just loving it. And boy, they just here's something. Okay. I found out, reading a research study that most people have so much happiness with vacations leading up to the vacation, they get so, like leading up to it, and then when they're in the vacation, they kind of have a letdown. This is what I, I've learned. I can't remember the research, et cetera. They were looking at serotonin, you know, the levels, things like that. Here's something funny about me. All of a sudden there's a big trip to Hawaii or there's something going on and it's like tomorrow. And my girlfriend will say, oh, you know, Hawaii's tomorrow. I'm like, oh, that's tomorrow. I don't even anticipate vacations. Like they will be upon me and I'll go, oh, oh, we're heading to Spain. That's cool.
Yeah, well, cool.
And then I end up having a blast because I don't have all these expectations of exactly the way it's going to be and the way it looked on social media. I'm actually in the moment, kind of really enjoying it. I really love my job. I live that so much. I love climbing that ladder and fighting. And even though you have some losses, you come back stronger and dealing with that. And then when I do have these vacations, I don't. Not even anticipating them. So it's great, it's cool. But I don't know, just a little bit of an insight into me and I don't know.
And of course, if I can encourage you, you're not alone. And so there's no reason to apologize for. Because I won't tell these stories again. But it comes up again and again that the people who rise to the top of any given thing, they just love what they're doing a whole lot more than everybody else. And that's why they put extra time and energy and they just love it, you know. And you.
You hear that a lot that you think.
No, no, no, I hear it all the time. And I, I can go on and on and on from, you know, years back and, you know, but people who've lived, lived in those, some of the most elite worlds of the past, high achievers and all and just the observations. But as you went, you had to have yourself. It's a lot easier to get things done when you have role models to copy. When you came and started your practice, was there a role model out there that you, you liked, you know, or how much of an idea did you have of how this thing would go? Or did you kind of put it together yourself.
I would say instead of having one specific role model, I, I took things from people that I thought that they were exceedingly good at. Right. Like my mom's work ethic. And, and, you know, I just, I kept picking things that I thought were really good and, and doing my best to, to take that and, and, and how do, how can I climb with it with that information?
But how about your practice? How about setting up your practice?
No blueprint. I started to begin with, this was with my ex at the time, and she did have a degree in marketing, A little bit about business. But we just did it. I didn't mind making mistakes, right? I mean, even what forms to fill out to start a business in a business, I didn't mind making mistakes. I think so many people kind of stop because before they want to do something because they want to plan, plan, plan, so they're not going to make mistakes. They never, they never move forward. Like one of the things that drives me nuts, in other words, has to do with the same thing, is I, I. If you want to get a pet peeve of mine, I, I cannot stand to have a meeting, to have a meeting so that you plan the meeting for next week's meeting to discuss the items that were all discussed. And then we'll have a meeting about those later on, maybe a summary meeting after that. I mean, it's just like meeting after meeting after meeting and like nothing ever gets done. For fear, for whatever it is. I would rather just go make mistakes and then fix them and go make mistakes and then go, okay, I may have looked like an idiot. I'm a little embarrassed because, oh, I didn't realize something so obvious. Okay, fine, made a mistake. Go. And so when starting this business, I made all sorts of mistakes. I mean, I.
What are the biggest ones that you can remember that you made, you know, good intentions, a lot of energy behind them, but just wrong.
I would say amongst the business, amongst the biggest was trusting everyone. In my heart. I wanted to believe everyone's good and wonderful and blah, blah, blah. I would give everybody the company card. Oh, if we need something, just purchase this, purchase that. Right, Yeah. I mean, just blatantly trusting and people will rob you blind. I mean, rob you. I had no idea how many people just, just, I'm talking professionals. Your friends. They're supposed to be your friends.
Yeah. Your relatives. I'll. Oh my gosh.
Will absolutely rob you blind and take advantage of you. In fact, they'll see your success. Forget all the 27th grade and everything you did. And I worked out 105 hours a week. It felt like in my general surgery residency. It was awful, right? That 40 hour work week, no one ever really enforced that too much. I mean, they, they started to some, but you still were going way over that, that work week that they were enforcing. But people would just continually take advantage in every form of. I could give you so many details, not just stealing right straight out of the register, but so many sneaky ways of taking money from you and the company, which is, which is from you and then also from their other, you know, co workers. And that probably held me back more than not because I wanted everyone to succeed. I wanted everyone to be a leader. I wanted everyone to just continue to grow in salary. And, and what I had to realize was not just there was a subset of people that were bad and had bad intentions. All right, but then there's also some people who just want to come in, work, clock out, and their life is at home.
Right?
They don't.
That's exactly right.
Yeah. And to me that seemed like I wanted to make everyone in growth. They didn't want to do that. They just one day now they'll tell you that.
And the, and the other side of that chat is if you sit down and talk with them and say, what do you really want to do? Do you want to just have a job and everything and go, or do you really want to do something great, you want to have a chance with, to elevate yourself and to get, you know, maybe we can expand the business and I can get some people underneath you and you'll be in charge of the division, you know, what do you really want to do, Eli? And they'll say, oh, I want to knock it over the moon. I want to make a million dollars, I want to do this. And then they go home and cook a pot of spaghetti and forget about it. And you have, you go home with, you know, trying to come up with a game plan where they can make a million dollars.
I'm thinking more about their future than they're thinking about. There's tenfold, ten over. And I really do work seven days a week. And that's not, that's not a pity. I love it. I go home first thing I do. So my typical day, because I like to sleep in late, get my coffee in the morning, go through my emails, texts, etc, so I'll start operating around 10 and I'll go to about maybe 10 to 4, 4:30. And I'm also shooting social media videos during the Day I'm promoting, not just me, but the whole practice. I'm working on my med spas, all the meetings, legal meetings, accounting meetings, et cetera, et cetera. Everything down the line.
Yeah.
Bouncing around my office all over the place. Now I'll then ultimately finish the day, get home maybe 6, 6:30. I work out for an hour six days a week. Love hitting the gym. It's just a big part of my life, mentally, physically. I wouldn't change a thing. I've been doing it now six, seven years, six days a week with the occasion. If I go on vacation, it's difficult to find a gym. I'll just do some burpees or something at the. And literally with the hotel room. Yeah. So with that mindset, I then start either cooking or go out. And I'm on now my phone calling people business, business, business. And some people like my calls and some people don't. I literally have companies, they love the fact that I'm talking to them and this. And other people are like, why is this guy calling me at 9:30 Eastern? And we're on the east coast too. And I'm talking about, hey, let's set up this, let's do this, blah, blah, blah. And I could tell that they're annoyed to even have the conversation with me. I'll do it on the weekends. I'm like, it's Saturday, it's Sunday, let's go, let's go, let's talk, let's set this up. Because during the day I'm operating or I'm in a meeting here, or I'm doing some social media. I do so many media skits. It's how we drive most of our business.
Yeah.
That I don't have time to sit down and have a strategic, calm discussion with someone. That's the best time for me to do that. Get myself a glass of wine after my workout. Get on the phone and let's talk strategy about doing something big, setting up some event, et cetera. And that's my best time to do it. And so I'll typically start to really shut down around 10, 10:30. I usually follow, I start watching YouTube videos. I just. Various ones. Interesting. Find a way to fall asleep sometime around midnight. And I naturally just wake up like 8, 9 and just repeat the day. And that's just kind of the way it is. And I know there are people that get up really early and go to bed early. That's fine. I just tend to be more like that.
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How long after you started your well let me ask you this. Why'd you choose Chattanooga?
So that wasn't like I specifically honed in. I first came back to Birmingham for about six months to open private practice by myself and I was focused mostly on the body aesthetics.
Like you said you had been out to Vegas.
Correct.
And that was towards the end of.
Your and I was focused. I wanted to be very good at body. My background was general surgery. So it was most of the body. So breast surgery, augmentation, lifting, tummy tucks, the mommy makeover stuff, buttock body sculpting. I really wanted to be extremely good at that, be very focused. So I had a blessing of a fellowship. I had more cases than any fellow that that year than any other.
What's a fellowship? I'm a dummy on that. So what's the fellowship?
You're already finished with your primary training. So I'm already a board eligible general surgeon taking my board certifications. Fellowship is now you're going to go your specialty training. Right. So I'm going to do my specialty training and aesthetics and I got almost a thousand cases when most people only required. Yeah, like the average plastic surgeon. Back, back was it six, seven years ago? They changed. It was to graduate in plastics you only had to have 55 aesthetic cases. 55? Yeah.
Really?
And I had a thousand. Right. Because I went to just an aesthetic fellowship. In fact, unfortunately, I mean I don't really have this problem with the plastic surgeons and the cosmetic surgeons. They kind of battle for, you know like turf rights and stuff and you. It's. It's silly. I've got so many friends on both sides but now I think they've upped it. What is it now? 2, 3, 3, 50. So anyway, something like that. But so I got this incredible training with almost a thousand.
Why did you have a thousand? Why, why was that?
We operated first of all, this guy was the busiest plastic surgeon that I knew of in Las Vegas. And we operated from about 9am to, in many cases, midnight Monday through Thursday. Wow. Typically on Fridays, we'd stop around five. So we just were lights out. Operating crazy all year. And then I saw all sorts of very complicated cases. And it, it got me to be really good at a very young age to be set up for success. So I wanted to focus on body. Came back to Birmingham, and then all the face cases that were coming to me as consults, I referred to a cosmetic surgeon that I met through my academy who was living in Chattanooga. He also had an office in a smaller town, Calhoun, Georgia as well. So from that regard, I started sending him. He realized, my gosh, this guy's sending me so many cases. He just got started. How is he already getting all these cases? Plus, it was easy for me to get hospital privileges, which sometimes is difficult in this field. I got him immediately, and he saw the value we combined together. So he was focused more on. On head, neck. I was focused on body. He was facial plastics. He did some body. I did tiny little bit of face stuff. But mostly that's how we started. Since then, I, I took over the company. Much more focused on business. Ended up hiring a bunch of other surgeons. Like I said, grew the med spas because I, I really, if there's one thing I'm excited about in this industry, and I think it's almost a scam, it's so easy to make money. It's med spas. It, it's, it's a legal monopoly. Med spas, because you can only be a MD or do to own one. The AMA in the medical schools, they limit the number of doctors every single year. So they're telling you only this many people can graduate every year, and then you can't even own one if you're not a doctor.
Wow.
It's a legal monopoly. And then if most doctors never learn anything about business, they go into the hospital, right?
Yeah.
So they know very little. In fact, MDs are notoriously bad at business. So if you even happen to be decently good and there's a monopoly on the amount of people that can even own them, it's a slam dunk. Despite this last data, I saw 41 of all med spots were going out of business. Why?
What?
What? Don't know anything about business? You get those that know something who just demolish the ones who don't know anything. Oh, literally. I could show you. Like, probably the biggest example is they'll go literally buy a piece of equipment. I Hate to even. I'm not going to mention the company's name. I don't want to slam them. But there's a piece of equipment you put on your face and it just contracts the muscles of your face. They want over $300,000 for that piece of equipment and the doctors pay it and all it does is contract the muscles in your face. You could go for $10 on Amazon and stick some little tens pads on your face and contract your muscles for 10 bucks. But they're using electromagnetic pulses and no blah, blah. Oh, give me a break. And then you have to finance that and you'll get a financing company that wants a 30% front load. Right. The loan, even if you pay it off early, it doesn't matter. Well now your 300,000 becomes right, almost 400,000. And doctors are buying that kind of equipment set up at med spa. They can't make any money. They go out of business.
So the med spas are where they're doing all kind of therapies like the cryotherapy and the hormone replacement in the test.
Think of it more or whatever. Yeah, so. So think of it more as the, as the meat and potatoes of most medical spas. Not spas, but medical as toxins and fillers. So like Botox, the wrinkles and all that and the fillers, the lips, the cheeks, you know to some extent by the aging. And then they'll have a lot of lasers and lights for like hair removal, tattoo removal, skin resurfacing, getting rid of wrinkles, pores, etc. And then some of them getting get into wellness as well where they'll do anti aging labs, testosterone functional medicine type though. Right. But most of the medical spas are focused more as the primary on the toxins and fillers and then the lasers and lights.
Okay.
Versus the wellness clinics. Now those are good and they're great, but they take a lot more time because people really to get matriculated in patients for wellness. That's like a patient for life that loves you and you love them versus someone that just wants to come in, get their botox done and boom. Yeah, right. A true convenience place versus a destination place. So I love the med spa industry. I think it's easy to offer incredible products.
Let me get this, clear my mind. The med spa and we've got one right down the street from where I live is like the functional medicine. And that reason they can be more, more continuity. You know, you're going to get blood work several times a year and adjust the supplements that Type thing. Right.
So those are. You see often more medical spas doing the aesthetics part.
Okay.
And you do the functional. There are many that do functional, but the medical, when you to traditionally say medical spa, they're doing aesthetics. Oh, okay. And then some of them basically low hanging fruit and they'll come in and they'll, they'll want to do the functional stuff maybe as an addition or you might just get functional only places. And that's what they do and they focus on. And those can do very well as well. But to me it's like, boy, what a slam dunk. You know, someone comes in, they sit down for Botox, right? 40, 50 units, I don't know, $12 a unit, six, $700 or so. It took you 10 minutes. Your cost on that is about $6 and I don't know, six and a quarter plus you're going to give maybe 20%. You know, that's pretty common, is on the gross sale to the, to the, to the injector. Right. Usually a nurse, some states like Florida wants to be a nurse practitioner, finally get 20%. The rest is all profit. 15 minutes, boom. Several hundred dollars profit. Wow, it's extraordinary. Yeah, it's absolutely extraordinary. And you know, that's why we're growing these med spas like crazy. And I think a lot of PE has actually caught onto this and they're starting to throw big money taking over med spas, all the mom and pop med spas and combining them. You're seeing this huge corporate takeover right now of medical spas across the country.
Oh, is that right? Pretty, pretty interesting.
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