From Graduate to Practice: Your Guide to a Career in Plastic Surgery

July 2, 2024

Written by Katrina Whitehair, Elizabeth Monroe

Imagine this: You’ve just completed your extensive training to become a plastic surgeon and are about to embark on your journey in medicine. This blog is your ultimate guide to launching a career in plastic surgery, packed with valuable insights and considerations for every path you might take. We’ll explore different models to help you make an informed decision about your career path. 

Clinical staff, particularly registered nurses, are indispensable in ASCs. Regulations require a registered nurse clinical director for Medicare-certified ASCs. Beyond regulatory requirements, nurses play a vital role in patient advocacy, ensuring patient safety and compliance with health standards during surgical procedures. Their presence allows surgeons to focus on their specialized tasks, knowing that patient care is in expert hands.

The nurse leader’s responsibilities extend beyond clinical duties, as they often manage the operating schedule, optimize collections, and control inventory costs. These tasks directly impact the ASC’s bottom line. By understanding and efficiently managing these areas, nurse leaders maximize revenue and reduce expenses, driving the ASC’s financial success.

How Do I Enter the Job Market?  

Based on your life and training experience, you may have a strong grasp on your vision and goals as a plastic surgeon. This is a great starting point. Ask yourself: If I waved my magic wand and could have anything I wanted, what would be my ideal work environment? What are the goals and milestones I want to achieve in my career? Write them down to start your journey.  

Practice Models 

Starting a Private Practice

If you are entrepreneurially inclined and desire to be a business owner, operator, and provider, this challenge may be right for you. You have the freedom to create your own vision by controlling and implementing your custom brand, marketing, and operations to align with the patient experience you want to see.  

The challenges of starting your own practice can be exciting for some and overwhelming for others. When starting a practice, there are many decisions to make, such as clinic location, equipment, software, staffing needs, start-up funding, and proper legal and financial counsel. What you may lack in work-life balance, you could gain in the fruits of your labor when executed well. This selection represents greater risk and a potentially greater reward. 

Employed Physician in a Private Practice

If starting your own practice does not feel like a good fit, joining an established private practice can be a great place to start your career. All the decision making and practice responsibilities do not weigh on the employed physician but instead roll up to the owners. As an employee, you support the existing brand’s growth, and can focus primarily on patient care and experience—not managing the practice itself.  Associate physicians also benefit from stable income, more work-life balance, and regular benefits. After a while, private practice owners may offer partnership in the group.  

Private Practice Partnership

After a physician has spent two to five years employed and in good standing, a private practice may extend an offer to buy in and become part of the practice’s ownership and decision-making team. There is a level of prestige in being a part-owner of a business. In addition, the physician has an opportunity to receive future profit share for their continued efforts in providing patient care as a part-owner. Practices may own a physician clinic, medical spa, or surgery center and offer some or all buy-in opportunities.  

Partnership terms can vary widely. Some practices may offer shares and a set percentage of ownership, while others may have a long-term plan for full ownership if the founder is seeking to retire in time. Some determining factors in assessing the terms may include the organizational and legal structure, assessment of the practice value and practice entities, and the physician’s revenue productivity contributions. 

Buying a Closing Practice 

Some retiring physicians will sell their practice to an interested physician rather than permanently closing their doors. Although patient records cannot be sold and require patient consent to transfer care, physicians may opt to create a transition of care plan for an existing patient database. Patients can transfer care or receive records, so it’s important to plan carefully. This may be an attractive option for a physician because there is already an established practice and patient base to start their career. 

Hospital Employment  

Graduating plastic surgeons are most familiar with hospital-based care because of their extensive training. Being employed by a hospital has many benefits. Access to hospital resources and their vast, built-in referral network will ensure you are productive in seeing patients immediately. Hospital employment guarantees income, benefits, and a predictable schedule.  Taking hospital call can be financially advantageous and quickly enhance your surgical skills by exposing you to a wide variety of cases. Depending on the position’s setup, you may focus more on reconstructive plastic surgery cases and work extensively with medical insurance. Sometimes, you may not be able to build a cosmetic practice. In addition, there is little to no autonomy or decision-making authority as a hospital-employed physician, which may or may not be your preference.  

Academic Employment

Working for an academic institution and training program can offer its own set of benefits. Research and clinical trials are abundant and can be very fulfilling for physicians who desire a research and education focus. Study and participation in clinical trials are not exclusive to academia; however, they are most prevalent in these institutions. Like hospital employment, there is very little autonomy and decision-making power for an employee, which can benefit or deter physicians.  


Regardless of your chosen direction, the industry also offers many opportunities for surgeons to consult and train others entering the field. Consulting for a pharmaceutical company, lecturing at a national meeting, or coaching other surgeons on the latest techniques can produce additional income and bring the reward of giving back. 

What Does This Mean for Me?

One model is not exclusive to the other, and a combination of transitions from one model to another may be in the physician’s best interest. Your personal preference, finances, and desired strategy and goals as a physician will influence your decisions.  

If you’re feeling overwhelmed or need assistance in planning your career, remember that you’re not alone. At BSM Consulting, we’re here to provide the guidance and support you need to navigate the complexities of the plastic surgery job market. Don’t hesitate to reach out to us—we’re ready to help you succeed!  

Categories: Uncategorized

De Novo or Acquisition? Strategic Considerations in Medical Aesthetics

June 18, 2024

Written by Glenn Morley

The aesthetics industry has grown significantly over the past few years, driven mainly by investor-backed consolidation of practices. Whether large or small, buy- or sell-focused, organizations focused on growth should explore acquisition and de novo development strategies. Aligning the right and best growth strategy with your organizational vision is critical and requires an examination of the strategic advantages both options can offer. 

Robust Aesthetics Market Consolidation 

Aesthetics practice consolidation typically refers to the trend of medical aesthetics practices and medical spas merging or being acquired by investor-backed organizations. Consolidation in medical aesthetics has gained momentum over the past five years for several reasons: 

  • Profit margin opportunity: Medical aesthetics practices typically offer an attractive, cash-based investment opportunity with good margins. 
  • Market growth: The medical aesthetics market is worth between $15–16 billion and growing. Based on today’s growth trend, it could reach $50 billion in the next five years. 
  • Future planning: Baby Boomer owners are feeling pressure to plan for succession or retirement.  
  • Cost efficiency: Smaller private practices can leverage economies of scale to reduce operational costs and negotiate better prices with vendors and strategic growth partners. 
  • Access to capital: Consolidation often provides access to needed capital, which can shore up infrastructure and fund facility development, provide access to top talent, and offer a small business myriad opportunities to benefit from administrative and HR expertise, advanced technology, and more sophisticated marketing. 
  • Streamlined management: Consolidation typically leads to centralized management services, relieving owner-operators of financial management, administrative and operational burdens, allowing them to focus on patient care. 
  • Strategic advantage: Organizations can gain access to diversified services and strategically position themselves to compete better in their markets through consolidation. 
  • Advanced training and development: Providers and staff can both benefit from a broad range of training and development opportunities geared specifically for their niche, in collaboration with partners. 
  • Clinical depth and breadth: Opportunities for clinical collaboration can lead to better decisions when purchasing capital equipment or considering new service lines. 

De Novo Strategy 

The de novo strategy is the process of opening a new practice or medical spa or expanding to a new location from scratch. When choosing the de novo path, it is crucial to understand your business model. You need to identify the target market that offers the most significant probability of success in your area. Key population factors to consider include age and financial bands, and the competitive landscape. Consider launching a target market analysis to focus on your ideal region and region and entail customers. You can also evaluate the demographic data in your practice management system, complete focus group research, or hire experts to ensure there will be demand when you build.  

A de novo growth strategy can offer compelling advantages, including control over branding, culture development, service offerings, and management. This also allows you to initiate your build with the retail mantra: location, location, location. A de novo strategy may also require a lower initial investment than an acquisition. However, this strategy can be challenging and time-consuming due to factors such as building a patient base, recruiting providers, and a team willing and able to build from scratch. A less arduous approach to de novo location growth is securing an anchor practice poised for expansion, a target geographic location, or an organization with expertise building de novo in other sectors. 

Acquisition Growth Strategy 

An acquisition growth strategy involves purchasing established medical aesthetics practices and integrating them into an existing organization. While this approach offers immediate access to an established patient base and can provide a steady revenue stream, it comes with its challenges and risks. When a business is acquired, careful due diligence is required to ensure the revenue streams, operations, and systems are reliable and scalable. It will also require integrating many components, starting with culture, HR/personnel, marketing, and operational and financial systems. 

Assessing Options  

Owners looking to expand to multiple locations should carefully evaluate the pros and cons of both de novo and acquisition strategies. Furthermore, it is critical to align these strategies with long-term goals, your current organization’s ability to scale, risk tolerance, and existing market opportunities.  

Many growth-minded medical aesthetics organizations seek expert guidance in this process. Engaging industry professionals, including financial advisors like VMG Health and BSM Consulting, can offer invaluable insights and steer you toward informed decisions that align with your strategic expansion goals. Once you have a plan, creating a model of your new acquisition or de novo location is essential for a thoughtful approach to growth. 

Whether you build a practice from the ground up or acquire an existing one, you must complete thorough due diligence, including examining financial health through day-to-day operations. Early phase due diligence will reward you with greater prosperity and less disruption. 

Acquisition or de novo growth strategies offer excellent business owner opportunities; the choice should align with your practice’s risk tolerance and growth goals. Regardless of your chosen strategic growth plan, stay abreast of the changing landscape and dynamics in the expanding medical aesthetics marketplace. 

Categories: Uncategorized

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