For more than 20 years, I have worked with hundreds of aesthetic physicians to help them build a better business through public relations, marketing, and consulting. My clients and I have survived at least three recessions prior to the current one, and have realized that each one brings a new set of challenges as well as opportunities.

Focus on the opportunities, and the results can be excellence in all areas of your life, especially during a down economy.

In the current fast-paced, high-stakes, competitive medical environment, looking at your practice from a “business” point of view will provide enormous benefit.

I have developed a seven-step system that can help you gain clarity and equip you with skills to navigate this new economy. By exploring various alternatives to your current methods, you will feel an increase in motivation, have a higher degree of accountability within the practice, find a greater focus, develop a clearer sense of direction, identify and enhance personal strengths, identify and eliminate/minimize practice weaknesses, have increased effectiveness and confidence, see a higher level of organization and structure, realize the ability for greater earning potential, and (take a deep breath now) still find time for family and friends.

To do this, you need to make a commitment to yourself and to your personal success, surround yourself with a strong team who understands what you want to achieve, develop a vision of your future, assess your current reality, develop a solid strategy, initiate new public relations and marketing programs, and learn how to maintain that success.

Let’s start by finding a moment of uninterrupted time so that you can sit down with a pen and paper and begin a brief analysis of yourself, your practice, and where you want to take it.


If you have ever traveled the London Underground, you will recognize this phrase. It is used to let travelers know about the slight gap between the station platform and the train—and you had better not fall in.

The same is true of your practice. Between “what you have” and “what you want” is a gap. The first step toward practice success is to identify this gap and how to safely cross it.

Most of us lack something—money, time, energy, quality staff, location, adequate space, technology, a business plan, team spirit, etc.

Start your reevaluation process by doing a practice assessment. Find your gap. When doing an assessment, consider the following areas:

  • Personal effectiveness;
  • Practice leadership;
  • Staff leadership;
  • Marketing needs;
  • Sales programs;
  • Team ability;
  • Time spent on superior skill;
  • How supportive is your environment;
  • Organization;
  • Finances;
  • Personal health and well-being; and
  • Interoffice communication.


Although none of us need a crystal ball to tell us that 2009 might be a little tough, it will take some insight on your part to develop a personal vision.

Literally, what that vision amounts to is—to paraphrase the well-known cliché—what you see is what you will probably get.

Your vision might be to take your practice from reconstructive surgery cases to 100% cosmetic surgery cases. It might be to add a medical spa to an already successfully practice. Or it might even be the fact that you want to recreate your business as one that supports your lifestyle and allows more time for friends, family, and for travel. Whatever it is, it is all yours and nobody else’s.

This vision can be as big and colorful as you want it to be. Write down your vision of you and your future, and then go back to it the next day and write it again. Rewrite it until it is the perfect vision of what you want to create. Once you can look at it objectively, you can determine just how you are going to create this vision of your revitalized practice.


Taking your own “business temperature” is not the easiest thing to do. Many of us are in denial about current situations, are operating out of fear, or are too overwhelmed with daily minutiae to want to find the time to face the facts.

However, in order to be successful, survive in a failing economy, and be the best that you can be under these circumstances, you will have to take out that thermometer, make a diagnosis, and write yourself a prescription for success.

In general, once you take out the thermometer and read it, things will not be as bad as they might seem. You will begin to see the opportunities that are placed in front of you every day.

By doing the personal practice assessment first, you should have a clearer view of your current reality. When I have gone through this phase with a physician, it repeatedly amazed me how many of their open-ended and incomplete projects were holding them back.

Armed with the introspective analysis, you can decide which of these projects are worthwhile (if any) and let go of the ones that are going nowhere. This gives us fresh ground to begin to build toward success.


Developing a strategy for your practice and implementing it can be likened to an architect creating a blueprint and then watching as the house is built.

Your strategy should include long- and short-term goals—that is, 30-, 60- and 90-day measurable action plans on the part of you and your team. This includes daily action items that should be discussed in (preferably weekly) staff meetings.

As well as including overall practice goals, your strategy should also include financial needs and financial growth opportunities, staffing needs, role designations, ideal marketing budgets and outlets, and, of course, time off for you so you can regenerate.

It is easy to build surgery and consultation time into the weekly schedule, but not as easy to include time for business building, planning, implementation meetings, creativity, sales goals, and other assessments (including the occasional round of golf) that are critical to the health and future success of the practice.

Most of us spend our days working “in” the business rather than “on” the business, when we should really divide our time between both.


Until you implement a strategy, you don’t actually know if it’s going to work. Of course, you can follow the example of others or copy things they have done, but don’t forget that this is your vision that you are creating and there is not a one-size-fits-all rule here.

Making fundamental choices to change your life may seem risky. Making grandiose ideas come to life seems risky, too, but the payoff can be tremendously lucrative and free you to enjoy life the way in which you want.

The riskiest thing you can do in 2009 is to do nothing. Inertia is not going to help you or your practice survive the current economy. Get proactive about your practice’s success—your enthusiasm and high spirits will ignite excitement, not just in you but among your staff, too.


There really is nothing mysterious behind implementing a solid public relations and marketing plan. However, in an economy that is in recession you have to stop wasting time and money on hiring the wrong people or thinking that you can do it all yourself.

“You keep doing what you do best—surgery,” I tell my clients, “and I will keep doing what I do best—PR and marketing.” Allowing professionals to handle your marketing tasks will, for most physicians, be the best approach. A minority of physicians have successfully run a practice and also spent the time necessary to adequately market themselves and their practice. Most don’t know where to start, though.

In my case, all of my clients are holding steady with practice revenues, are continuing to see themselves on television news shows, and are regularly interviewed by the media.

Implementing a sound PR and marketing plan requires a strategy that is separate from your business-building strategy. Also, you should surround yourself with people who can create a highly creative campaign that gets attention.

Public relations remains the most credible and cost-effective way to promote a practice. Appearances on television and articles written about you in newspapers and magazines offer a third-party endorsement that simple advertising and Internet promotion cannot do for you.

Now is the best time to evaluate everything you use to market your practice, from logos and stationery to brochures and your Web site, as well as advertising and branding, and events.

See also ““The Biggest Threats Facing Your Practice” by Catherine Maley, MBA, in the October 2008 issue of PSP.


Just as when James Bond takes that final leap looking battered, tired, and dusty—and we think this must be the end of him—he always comes out looking suave and debonair and ready for the next adventure.

As with Commodore Bond, you need to learn how to emerge from a scuffle, such as the current economy, and keep the “edge.”

This translates into keeping your name in lights and in the forefront of your patients’ minds, and maintaining a thriving practice.

The only way to do all those things successfully is to be vigilant about your success. While maintaining your growing success will not take as much of your time as your initial “gear up to success,” you should be constantly monitoring your overall business goals and day-to-day milestones during your weekly staff meetings. In this way, you can keep a close eye on sales, budgets, and spending; as well as return on investment.

Don’t ignore intangibles such as staff attitudes and your own quality of leadership, and take the global and local temperature of the aesthetic medicine industry.

Angela O’Mara is the owner of The Professional Image, a leading medical-specialty marketing company based in Newport Beach, Calif. She specializes in strategic marketing campaigns for small and large organizations and can be reached at (949) 760-1522.