Cameron Hemphill hosts the “Medical Millionaire” podcast, featuring Mary Beth Hagan, CEO and founder of Titan Aesthetics Recruiting. Hagan discusses her extensive experience in the medical esthetics industry, including her tenure at Allergan and her founding of Titan in 2017 to address the growing demand for skilled injectors. She emphasizes the importance of professionalism, credentialing, and proper training for esthetic providers. Hagan highlights Titan’s role in screening and developing new injectors through a comprehensive training program, including facial anatomy and patient consultation skills. She also addresses the challenges of compensation and retention in the industry, advocating for a balanced approach to practice growth and patient safety.

Transcript

This is medical millionaire the podcast, helping your Med Spa increase in status, visibility and profitability. Join your host as he dispels myths, shares trends and gives you actionable steps today that will take your medical practice to the next level. Here’s your host, expert marketer and founder of growth 99
Cameron Hemphill,
hey everybody. Cameron Hemphill, here your host for medical millionaire. Hey, first off, thank you so much for taking the time to tune into our podcast. Our goal is to give incredible value and insight into the medical spa market. So if you’re an injector, you’re thinking about getting into this specific industry. You’re thinking about scaling your practice. We want to help you take your practice to the next level, wherever you guys are at. So today, I have a guest, a friend, somebody that has been in the industry for years, and she is, is really like somebody that is an inspiration. She has a tremendous amount of history with Allergan, so she understands this industry in and out, right? And so currently, I want to welcome Mary Beth Hagan, the CEO and founder of Titan esthetics, recruiting Mary. Welcome to the show.
Thank you, Cameron. It’s so great. I have a son named Cameron, so love that name, and great to be here with you this morning. So
yeah, thank you so much. I know how busy you are, and I really appreciate you taking the time. And so do me a favor, I think for the audience, like, I want to learn more about your background, and I think the audience would love to hear because you’ve been at Allergan before that. You’ve been in the industry a long time.
I’m old, yeah, that’s I was very lucky to come into the esthetic market in 2005 I did no idea what I was interviewing for. When I first interviewed with medicines, which was the original distributor of wrestling, and James Sanders, who was the hiring manager, you know, said, Well, I found your name through networking. And I got talking to him, and I said, No, wait a minute, you’re talking to me about a job where I get to do marketing and help create awareness in a market. You’re talking to me where I get to do patient education and help people understand more about what the options are. And then you’re talking to me about being able to really do a lot of clinical work and training with esthetic providers, and you’re going to pay me for this, like, this is like my dream job. So yeah, I started with medicines back in 2005 and was very blessed to come into the esthetic specialty pretty early. Botox Cosmetic was approved in 2002 and then wrestling was approved in december 2003 and then launched in 2004 so I thought I was kind of Johnny come lately, but it was a wonderful time to come into the specialty and really watch it develop. So I was a medicine for about three and a years, and then went over to Allergan right about the time that they launched Latis, and was lucky enough to work with the most amazing group of people in the upper Midwest. So manage Minnesota, North Dakota, South Dakota, Iowa, Nebraska, Kansas, Missouri, Southern Illinois, Western Kentucky, and a little bit of Upper Peninsula, Michigan and Wisconsin through the years. So always joke that I’ve covered more than, you know, a good bit more than a fifth of the country. But you know, the best part about what I’ve been able to experience in the different companies, is I’ve been able to see how we look at the specialty from more of a provider or business owner perspective, since I don’t have just one company’s perspective, and I’ve held roles ranging from sales to sales management to marketing. I was the Botox Cosmetic professional marketing manager, and then I started the national account team at Allergan. So got to work with the big dermatology roll up groups, with the National, multi state Med Spa groups. And what I really saw in all of that Cameron is that there was a demand, a growth in this specialty that we were not going to be able to meet simply by how the the specialty was growing on its own, and so because I was blessed enough to work with a lot of the really amazing injectors and trainers throughout the country in my various roles, I started Titan in 2017 just to, very specifically, help bring new injectors into the market and help support the non position injectors in esthetic medicine in the United States.
Got it? Got it? Very cool. Okay, so, so you basically, you identified a future issue, right? There is, basically there’s more demand than what there are, is in terms of providers, is that? Is that right? Okay, so you saw that coming. The obviously, like the entrepreneurial spirit in you, right? I had to have been like, Hey, I see a problem here, and I want to help solve it. So talk to us about, you know, the transition from, you know, working at Allergan to opening up your own business. And you. Like the struggles with that, obviously, I think would be super cool to hear and and obviously the successes and the impact that it’s
had. Well, let’s not give me too much credit. I waited until my kids were out of college and were settled on their own before I was brave enough to do this. And because, you know, anytime you identify a need, that’s great, but it doesn’t necessarily mean that people are going to pay you for it. And I think when you look all of us who have had backgrounds in working in corporate entities in the United States, we’re very used to looking at recruiting companies and, you know, going out and finding people. But one of the things that’s so different about specifically the injector world in esthetic medicine is that there’s no academic training, there is no residency program, there is no internship program, there is no national organization that certifies or creates credentials for everyone who does non esthetic or non surgical procedures. And you know, we have ice fan, which is an amazing organization if you’re a nurse or nurse practitioner, but it doesn’t include physicians who want to be injectors. It does include pas. We have a lot of physician organizations that address medical esthetics as a whole, but there’s really nothing out there that supports the injector in the medical esthetic specialty. And so that’s really what we tried to do. And it was born out of just those of you who’ve worked with me for years know, I’m, I’m pretty good at saying the king has on no clothes, and kind of saying, Okay, it’s great that all this stuff can happen, but, but here’s a need, so let’s go figure out away. And I was, I was very blessed enough to work with medicine, with Allergan, and, you know, have been able to continue some of those relationships with Metasys is now down tarpa, and certainly they are amazing organizations within this specialty. But when you look at whether it be all of the, you know, other ones that have come when you get rebates and you’ll get Evis, and you look at MERS, and look at palinium, and what the different companies do to support the market. That’s the industry, but we really don’t have a lot within the specialty to support injectors. So that’s where Titan really tries to be a cradle to grave Support Agency for non physician, esthetic injectors got
you, got you so really focusing on the specialty of the actual search. Yeah, talk to me more about the specialty like I’ve heard you say that a couple times now.
Well, you know, it’s funny. Julie bass Kaplan, many of you know her as jubilant. Julie was on faculty for our meeting that we just did learners and legacies up in Chicago. And what we really wanted to do was bring some of those legacy injectors, the ones who’ve been doing it for 1520, 25, years, and let them be mentors and guides for some of these new injectors who’ve been injecting for less than one to three years. And as we were doing a planning call, you know, one of the things that I’m always thinking about is, how do we keep the professionalism in medical esthetics? And, you know, it’s esthetic medicine. It’s not esthetic entertainment. And I think there’s a lot of people who have said, Oh, I have to be funny on Instagram, or I have to have, you know, things that are controversial and and, no, you know, Julie said we have to start calling, stop calling this an industry, and we need to start referring to it as a profession or a specialty, you know. We don’t call it the infectious disease industry or the dental or the the ophthalmology industry, you know. So why do we say the esthetic industry? Good point, and I think some of it is just because a lot of this is developed because of the companies that have really helped develop medical esthetics. But I think it’s really time that those who are providers, who have spent years and 1000s, if not hundreds of 1000s of dollars, learning about the specialty, we need to give it the medical credentialing that it deserves as being a true specialty in medicine. So that’s kind of where my so that’s where, you know Titan really stands for top injectors treating anesthetics now, and we don’t take that lightly, because when you think about the majority of the injectors that have been doing this for 1520, 25 years, they didn’t have residency programs. They didn’t have schooling programs. They weren’t given curriculum of things they had to learn. They weren’t told, this is how you do it. I mean, the early injectors were really plastic surgery. Nurses, when collagen came out and, you know, the doctor said, this is a needle. Nurses, nurses, do shots. You do this. This is not what I do, right? And that’s really what started, you know, injectables. And then, as we started seeing, you know, other products come to market. You know, the core four really developed, because you had plastic surgeons and facial plastic surgeons doing work in esthetic medicine. But it really wasn’t until the Carruthers and. Doing research and development of Botox that we started seeing the dermatologist and the ophthalmologist come into what’s now considered the core four in the medical esthetic specialty. So it’s pretty interesting thinking about kind of how this specialty has developed, and also it’s very different how it developed here in the United States versus other markets around the world, and I think that’s something that we need to really make sure that new injectors and new clinicians of any sort coming into the esthetic specialty now understand where we’ve come from and what some of the responsibility is of making sure that we maintain that professionalism in this specialty as we go forward.
Wow, that was, well said, I could learn so much from you, like that was, it’s, it’s really, it’s nice talking to someone like you, because it also helps me, right? You’ve obviously been in the industry a lot longer than I have, and in my company, we come into it from a technology standpoint, we say terms like industry, you know. And so we’ve, we’ve helped create tools to help the specialty, right? And, but you’re exactly right. It is a, it’s a, it’s a profession, and it’s a serious profession, in the sense of, like you
are touching the body with with needles, right? Like
you are, you are changing the, I mean, you’re changing the appearance and enhancing the overall look and feel. And so I like that you said that I was gonna ask you a question. Is that, like, why do you capitalize the T in in tight, we
capitalize all of Titan every time I write it out, because it is an acronym, top injectors treating anesthetics now, and I feel very strongly about that, because Titan, really, we started out looking to be a placement and a screening agency. You know, I was very lucky. Early on in my career at Metasys, there was a wonderful physician who looked at me one day and said, you know, Mary Beth, I have all of these pas who work in my practice, doing dermatology and esthetics, and I train them the same way to do esthetics, and some of them get it, and some of them just never do. Can you help me figure out how to determine which ones are going to get it before I spend all this time and energy training them? And you know, it was such a great question, because if you talk to most really strong esthetic providers, whether they are physicians or non physicians, they have a lot of characteristics and aptitudes in common. And so what I tried to do was look around. I was covering five states at the time, and I tried to say, these, these amazing injectors. What do they have in common? Is there anything that could help us identify and that is what the Titan esthetic screening was born from. And you know, so when we first started Titan, it really was, can we screen people to find out if they have esthetic aptitudes? So that before a practice hires a new injector and put some into a training process we know if they have those aptitudes. So we have a four part screen. It’s proprietary to tighten. We do a right left brain quiz, we do a aptitude conversation, we do a picture assessment, and we do a hobby overview. And really what we’re looking for is, do the candidates that we’re talking to have the ability to communicate well, do they have the ability to see esthetically? Do they have the ability to balance out being a very good and safe medical provider with being a an artist? Because all the best injectors and esthetic providers will tell you, is the blending of art and medicine, yeah, and, but both sides are in, you know, medicine is always going to be the most important, because we have to be safe, right? So, yeah. So we started, and then we started with placement, but then pretty soon, people started calling and going, I’ve been to this weekend training program, and I, you know, I’m like, 10 or $1,000 in debt, and I learned all of this stuff, and I’m certified, and I saw my resume to every place in town, and nobody will hire me. Can you help me? And you know that was really an aha moment of Okay, hands on training is one piece of the development of becoming an esthetic provider, but when you’re looking at injecting, literally, injecting itself is probably 10 to 20% of the profession, and nobody was teaching that other 80% and so that’s where Titan has really grown from being just kind of a screening and placement agency to being a full cradle to grave Support Agency for esthetic conjectures,
gotcha. Gotcha. Okay, so you’ll have if, if I’m right. So when I when it comes to servicing your client, customer, there’s one aspect where, hey, I’ve gone to the hands on training, I’ve sent out my resume. I need help. Can you, I mean, you’re creating a fit. Is that right? Like your other clients could be XYZ, medical, esthetics practice, and then you have Cameron the injector that’s looking like you. Do the matching. Is that right? Is that fair to say? I always
joke I’m a matchmaker, not a headhunter, because there’s so many things that go into creating a successful Win, win partnership between an injector and a practice. And let’s be honest, the first couple of years of running Titan, I got this phone call all the time, Hi, I am looking for my injector. Just left. I need you to find me someone who has five years of experience, who can come in, who already has a book of business, and can come bring it to my practice, and I’m going to pay them like, $100,000
a year. Like, no, that. That’s
doesn’t happen, you know. And then you would talk to them and say, I’ve run an ad, you know, online, and I’m getting all these resumes. And I’m like, Let me guess half of them are, Hi, I’ve been injecting in the hospital and I’m tired of COVID, or I’m tired of the hospital, and, gee, I just got Botox for the first time, and this looks like this could be a really great job to just stand in a room and inject botox all day long, right? Yeah, not the job. Or, Hi, I’m 25 I just finished PA school, and I’d love beauty and everything about it my whole entire life. And I want to get this job and I want to get free product. I’m going to stand in a room and I’m going to in a room and I’m going to take selfies. I’m going to be Insta famous, not the job. And so what we’ve really tried to do with Titan, my clinical director, is an amazing injector named Kevin Harrington, and maybe many of you have had him in your office training. Kevin is truly a true legacy in this profession. Kevin started off in research and teaching history, went back and got his RN degree, did a lot of research, went into sales, was one of the early Allergan reps with Botox. He then went back to his NP, and he’s had to his own practice for many years. And Kevin’s on faculty for both Allergan and gal Derma. He is on advisory boards for many of the esthetic injectable products. He’s on faculty for Chris Cirque Academy for injection anatomy cadaver course, and Kevin as the clinical trainer for Titan. Shares my vision of, how do we help new people who want to come into this profession or the specialty, or people who are already injecting, but maybe they missed that foundation of knowledge that helps them have that good understanding of the job. How do we help them fill in those blanks? So Kevin and I developed something called the Titan injector development program to help kind of meet that, that void in the market, because there aren’t any academic training programs. You know, if you’re a nurse and you go to nursing school and medical school, you don’t start out going right into clinical rotations, right? You learn the why, you learn about the profession, you learn the things you know. And so that’s what we’ve tried to do with the Titan development program. So we have two courses. The first one is called Preparing to be an esthetic injector. It’s a book I wrote just because I tired of answering the same questions over and over. It’s available on the Titan website in the shop section, everybody asked, I hopefully get it on Amazon soon, but I just haven’t had time to get there yet. And then we partner with the complete Face cadaver app. Steven Lu and Peter Callen and Emma Williams created this amazing cadaver app. It’s an online app because the videos, to be quite honest, you know, in the tech world, they’re way too big to put on any personal device, so they live on their server. But this is literally a an essential foundation for learning facial anatomy, for the injector, and they really cover the anatomy, the adverse events, the tech injection techniques for upper face, middle face and lower face. And this app is available that once you buy it, you have it as a reference throughout your entire career. So course number one is the book I wrote. It’s got about 65 links in it. It really is kind of how to create your own residency program and learning the history of the esthetic profession, or the esthetic injector profession. It is a checklist of things that people can do on their own to show a prospective employer that they’ve invested in themselves. And then it’s the complete Face cadaver app. So that’s only $700 if people want to have Titans help and support with coaching and how to get a job and how to do your resume and how to interview, we offer that same course for $1,000 but it gives you support. So if you’re looking to get into the esthetic specialty, we can help with coaching. If you already have a job and you just need to develop your foundation, we have this great resource that gives you what you need to get started now. So we have about a 40% dropout rate between course one and course two, because I think there are a lot of people that think this is a lot easier than it is. It’s not an easy specialty. There is so much to learn and it’s hard. I mean, you look at the Botox in any of the neurotoxin package inserts, the word death is in there. Nobody wants to think about that when you’re thinking, Oh, I’m just going to learn five insertion points for a neurotoxin, right? Not the way this works. So that’s why, course, two really goes into understanding the why. How do you use that anatomy that you learn to understand facial aging? How do you understand what different treatment modalities are available to help achieve the patient goals? What are the adverse events that you’re going to see? And it’s not a matter of if, it’s a matter of when, if you inject enough. Right? And then looking at that patient conversation, and you know, whether it’s a consultation, whether it’s a treatment plan, whether it’s putting a retention strategy in place, all of this is part of the esthetic provider job, not just learning those five insertion points for a neurotoxin. That makes sense?
Yeah, yeah. No, it does. And it’s very well said. And I think, you know, when I, when I look at the specialty, right now, I’m going to start using that, that term, I appreciate you educate. When I look at the specialty, I think it’s, you know, I came into it, you know, in 2016 and I’ve just seen insane growth, a lot of excitement around it. You know, I think, I think there’s a lot of reasons why it has grown. But I, I also see some people getting into the industry, sorry, the specialty, that’s just that that maybe shouldn’t be and maybe they’re getting into it for the for the wrong reasons, right? And I, I think that you know what you say is just a great point, like creating that foundation understanding, you know, the risk factors first, the safety, first, the anatomy first, you know, before you start going into, like the social media world, right? I think a lot of you know, especially like, since the COVID, the stay at home stuff, more people are on their devices, yeah, and they’re just, they’re they’re scrolling, and oh my gosh, so and so is has so many followers in in such success. And I’m going to do that, you know. And so I think that the the audience would love to hear you, you kind of talk about that, because you’ve seen the transition take place, right? A lot of people are getting into this, this world that maybe shouldn’t be
Well, I never want to
judge somebody’s desire for what they want to do with their career. I always want to say that we I guess, just want to make sure that if this is what you want to do, make sure you know your why. You know, I think most injectors, who really are amazing injectors, will tell you, and physicians as well, they don’t do this for Instagram fame. They don’t do this for the money. They don’t do this to be a bomb podium and get limelight. They do it because of the mirror moment, that moment where you hand that patient the mirror and they get to look and see their reflection, and for maybe the first time, they like what they see. And that’s why I really try to highlight some of these legacy injectors that have been doing it for so long and doing it for that mirror moment, to help newer injectors really see this is a medical profession, and it is very collegial. And if somebody’s in your market telling you that it’s competitive and you can’t, you know, we don’t talk about it being competitive in family practice, we don’t talk about it being competitive. You know, in other areas of medicine, we shouldn’t talk about this being competitive. I mean, yes, patients do pay cash. Yes, you know, it is a little bit different in terms of how they may find out about a practice. But I always suggest that people think about your online presence as being, you know, your magazine ad from back when I was growing up. You know, we used to get magazines and we’d flip through them, and we’d see ads, and we’d see articles, and you’d get this blend of education and awareness. And I guess I look at Instagram and some of the social media as being, you know, like being a magazine, and you want to make sure that what you’re putting out there is real. You want to make sure that it is relatable. You want to make sure that it’s relevant. You want to know who your audience is. One of the first things that I tell new injectors is, when you’re creating posts, who are you creating them for? Are you creating them for? You know, other social media, you’re creating them just to create followers. Are you creating them to educate your patients and prospective patients? You know, one of the things we talk a lot about is, what do you call the people who are visiting your practice? You know, because I see a lot of people, they will say guests or clients, and I’m sorry, you still have to have them sign HIPAA forms. And if somebody signing HIPAA, they’re a patient. You know, these aren’t stores, these aren’t boutiques. These aren’t, you know, these are medical practices, and you can use whatever advertising and whatever marketing words you want, but we still have to stay within the guidelines of the medical profession and not a medical provider. Don’t play one on TV. So please, I try to be a sounding board and a sound bite. I try to be ever, I ever, I don’t know what increase awareness for my my medical profession friends, so, but that that is something that I, I just throw out for thoughts. So, yeah, if you, if you want to get into this specialty, learn your why first and because you. It’s not just learning insertion points, it is learning all the products, all the procedures. The best question I always tell prospective patients to ask when they’re looking at going to see a new provider. I don’t want to hear, you know? What I really want to hear is, when something goes wrong, how do you handle it? Yeah, good point, because that’s a provider that’s going to help you.
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Yeah, that’s, that’s the clinical side coming out right the the the safety first. It’s, it’s funny to talk about the why our first episode that we recorded on this podcast was learn your why, actually, and and we talk about, you know, there’s going to be great days, there’s going to be bad days, and if you really understand your why, it’s it’s going to help you get through those hard days, and it’s going To help you understand the reason you’re here. And I think a lot of people get into any business, whether it’s whether it is, you know, this specialty or another, they can lose track of the why, as they continue to grow their practice, or as they continue to grow in their life, you know, and and I feel like every year or shoot at this current age, I feel like practices are having to, you know, reinvent themselves every month, every six months, every year, because they are growing very fast. This specialty is growing very fast. And so a lot of times I I see, you know, people potentially getting burnt out, or they struggle with maybe building up somebody like this was one recent is I’ve seen an injector go to practices and do a wonderful job and learn how to run the business, and then they go start their own, you know? And so I’ve seen in really, hey, maybe being an entrepreneur is great and having your own practice is great, but it could also be great where you were and that’s how you got there. Maybe that’s your why. And so I think people really need to understand like, and I like that you bring up the why. It’s very important to understand that for me personally, I actually carry my why in my pocket, you know, like there why I’m on, why I’m on this podcast for for example, you know, why I do what I do every day? I mean, I have several roles. I’m a husband, I’m a father, I’m a business owner, you know, I’m in this specialty servicing, you know, practice owners that need help growing their practice. And so a lot of times I have bad days, like we all do, right? And if you don’t know your why, you have nothing to fall back on, it’s going to help you say, okay, here is, this is why I’m here, right? So I’m glad you brought that up. So I got a question for you,
if you are
getting into the esthetic space, right? This specialty.
What is the best advice you can give somebody that is looking to get out of the, you know, the hospital or whatever they are doing? What is the best advice you
can give them invest in yourself so that someone else can invest in you? I tell new injectors all the time because they’re like, well, that’s a lot of work, and I don’t know if I want to pay that if somebody’s not going to hire me. And I’m like, You know what? If you don’t have enough faith to invest in yourself first, why should anybody else invest in you, and you need to understand this is a different specialty. This is not, you know, going to a weekend training to learn how to do manicure, pedicure, not, not to say anything against that area of care. It’s wonderful, but this is a specialty of medicine. And you don’t just need to learn how to inject a toxin. You need to learn how to talk with the patient. You need to learn how to do facial assessment. You need to learn how these services work into the overall continuum of care with a dermatologist or with a plastic surgeon or with a functional medicine specialist, because we really don’t do these things in a vacuum, they are part of taking care of your largest organ in your body, you know, your skin. There’s also a large mental health component in this, and so understanding how I mean, most esthetic providers don’t take mental health training, but I’ll tell you almost every one of them that I know deals with some mental health issues. One of my jokes when we’re doing the Titan screening, as I try to see, you know that an injector candidate is not crazy because, God knows, we have enough crazy patients. We don’t need crazy injectors. And that sounds horrible and flippant and funny, but you know, there’s some truth to everything that we tend to joke about and you know, one of the biggest things that I found is that make sure you know what you’re getting into before you make a decision to do this. Training doesn’t start with doing a hands on course. There’s some amazing hands on courses out there. And if you go to the training tab on the Titan esthetic recruiting website, you will see amazing clinical hands on training opportunities. They’re all by injectors who are actively practicing, injectors who are national trainers, who have very well documented training programs with discoverable faculty, and so we really work hard to give a continuum of development so that a new injector who goes into a practice has that foundation that allows them to get up to speed very quickly once they are hired. So invest in yourself, if you expect anybody else to invest in you, and it shouldn’t cost my Be careful. Even look around, get references, go online, ask because there are courses out there that are ridiculously expensive, and then also ask for the person who is doing the training, make sure you get their credentials. Can’t tell you. Last week, just heard a story of somebody who went to one of the legacy injectors for a training course, and she said, a month later, I got an email on site, and she had now started her own training company. She got trained a month prior, and now starting our training company. So, yeah, I
see training companies starting all the time. You know, some are doing great job and but I see I, I can second that. I see that as well, you know, or maybe they don’t have the legacy experience that they really should. I mean, you should be you should know everything about you know what you’re doing before you can start training others like so I agree with that
well, and I’m a big fan of really having, you know, for new injectors, don’t just go shadow somebody for a day. That’s great, but that’s not repeatable. You want to go to a hands on injector training course that gives you established curriculum, that gives you learning objectives, that gives you an assessment, so that when you’re done and you’re going to talk to a prospective employer, you can say, here is what I have done in my development and that’s why we do the Titan development program the way we do. You’ve got your checklist. We’ve done all these. Here are your assessments for doing your cadaver course. Here’s what I’ve learned in facial anatomy. We’ve got the projects that they do every single week of the six weeks during the teaching your brain to inject course. We’ve got the final consultation project. We have the pass, fail exam, and then you go to hands on. And you should have, here your objectives and what you pass. And so if you have all of that, and then you go into interview, you can say, Yes, I am naive to working as an esthetic provider in a practice, but here is how I have invested in myself so that you feel comfortable taking a risk investing in me. And that’s also Cameron, why we work with many of our employers to create a injector residency program for the first three months of employment, because we want to set up expectations on both the employer and the injector side, and we want to have MBOs that people meet. You know, those objectives are very important. And then we also say, Okay, now you want this injector to stay with you. I heard you talk about, you know someone who they come in, they learn the business, or they start running the business, and that’s a really interesting thing. I can’t tell you the number of times I have a physician who will call and say, I want somebody who’s really motivated, and they’re going to come in here and they’re going to run this business, and
they’re going to build this business and and I’m like, why do they need you if you want them to do all of
that, and I don’t mean to be, you know, flippant with that, right? If you’re going to employ an experienced injector, it has to be a win, win. So that’s also why we do a lot of work with retention for providers. We do a lot of work with creating development plans and how to run for. Performance review processes. Because, I mean, when I place someone, I want that injector to stay there. And I tell all of them, if we place you as a new injector, you’re going to stay there two to five years. Because someone who hires a new injector, they don’t even break even for about two years. So that’s where I really want both sides of the equation. And we talk a lot about compensation, because, you know, my my other standard line is, if there’s no revenue coming in, there’s no revenue to pay you. So you’re not going to make a lot of money your first year as an injector until you learn how to do these treatments and learn how to sell these products, and you build a patient base, and that’s your responsibility. And you know, if you’re an employee, yeah, your employer should help with that part. But that’s where that, that win, win has to come in. So
do you guys help build comp compensation plans and structures then too,
I do. I always, we have run the Titan injector compensation survey for the last five years. It was very interesting. When we started Titan, I use the royal we it is myself, and then Kevin, and then I have a lovely placement director named Wendy Collins that supports us with the placement side. But you know, the thing that we found right away is that about half the calls I got were, how much should I be making as an injector? The other half were, how should I be paying my injector? And we actually used Gordian Solutions Group to run our market research. And the very first year, Brooke said, Oh, don’t worry, we’re going to find that there are trends. You’re going to find that there’s, you know, some processes and some trends and some some foundations in place. She called me when we got the data back the first year, and she said, I know you’re not going to be surprised about this, but I’ve never seen this in all my years doing market research. I truly don’t think there are two injectors in the United States that get paid the same and so we’ve tried to do a lot of work. My explanation is that a injector needs to bring in about a half a million dollars in patient revenue to justify an employer paying them between 80 and $100,000 in a total compensation package. I think most people don’t realize how high the cost of goods is. I don’t think they realize how many expenses there are. You know, they want to pay you. You know, everything that gets paid for in a practice, the money has to come from the products and the procedures that the providers bring in. And so it is, there’s not nearly as much profitability in esthetics as I think a lot of people think there is, maybe for some of the big industry companies, yes, but on the med spa or on the practice side, they’re pretty lean margins. So I want to help both sides understand that,
right, right? No, that’s really cool, and that really helps set expectations on the practice owner standpoint, and then also, you know, on the individuals that are that are getting into the into the space. So now that makes sense. And so, all right, just want to pivot, just for a sec. And I appreciate you know, everything that you’ve shared, and I know the audience is, is going to get so much value from this. So if, if you are, let’s say you’ve owned your practice for, you know, five to seven years. And I hear right now, you know, sometimes practice owners are struggling with maybe opening up a second location, third location. You know, maybe they’re at a, let’s call it a standstill, right? Revenue is flowing in. They but they’re they’ve kind of stopped growing like, what advice do you have for somebody in that range?
I always joke that I don’t give advice as much as I ask the questions, to help people figure out the answers on their own. And I’m going to go back to what we talked about earlier. First question I’m going to ask them is, why do you want to open a second location? Why has your revenue stalled? Why? Why do you want x? And I think there’s a lot of push in the market right now. Obviously, there are a lot of private equity firms that are looking at the esthetic space and saying, oh my gosh, this is a very fragmented market, and nobody really owns the space. And there’s not, you know, there’s the opportunity for us to come in and to, you know, really consolidate and build and grow and scale, and then we’re going to turn around and sell it. And what I try to tell people when, because many of them call me and say, I’m going to open 100 practices by the end of the year, I’m like, No, you’re not. And I don’t mean to be mean, but what nobody understands is there aren’t that many injectors. And if you don’t have an injector, you don’t have a practice, and I get calls all the time from franchise owners who have bought a franchise somewhere, and they’re like, Oh, we’ve got our space and we’ve got our chairs and we’ve got our marketing and we’ve got our website. And I’m like, so tell me who’s your medical director? Well, who’s your injector? Well, that’s why I’m calling you. Okay, when are you opening? Do. Six weeks, yeah, and, you know, you’re laughing, and I try hard not to, I get the same stories. I get the same and this is where, you know, that’s why I really feel like it’s important for people to understand. This is a medical specialty. You start with your medical providers, and if you I mean, I have one amazing client that the physician wanted to open a med spa, and he called and we chatted, and I said, Okay, here’s my recommendation. We’re going to find you a naive injector. And this physician did not have any experience in medical static procedures, either. And I said, the two of you are going to spend this next year learning and learning together and learning what is she going to do and what are you going to do? And then, you know, when you’re six months down, then you’re going to develop your practice, you’re going to develop your menu of services. Because right now, you don’t even know what you want to provide, right? You’re listening and putting a menu of service together based on what somebody’s trying to sell you. And you know, that’s why it all comes back to that relationship between the provider and the patient, and what does the patient want? What does the patient expect? And you have to build everything from that. And so anyway, yeah, so if somebody wants to grow, if they want to expand, if they feel like they’re stalled, my first question is going to be, why? Because if you don’t know the answer to that, then whatever you do from there doesn’t make any difference.
Yeah,
no, that’s a that’s a good point. And I think you know, just to add to that too, is, is our company? People reach out to to our company, you know, growth 99 and and they will say, Hey, I just bought this very expensive, elaborate laser that does all of these things, and now I need to get patience and, you know, we look at that, we say, Okay, I like the bullishness of that, you know, I like the the ambition and motivation. That’s great, you know. But I see a lot of times they they should take a step back, just like what you said, and and really think about it and process it, and understand the technique, learn it. Is this really what you want to do? Do you have find out
if your patients want that service before you buy the machine?
Yep, yep, exactly. And I think it’s so easy to get creative financing, you know, like, like, get these package type of offerings, you know, to to make the entry level easier, right? And so they’ve been, they’ve been strategic on the financing aspect, but, but we see that a lot, yeah, well, and
it’s very interesting to me that practices will spend 152 and $50,000 on a device, but they won’t look to invest that much in an experienced injector. And, you know, I think we really have to stop and think about, you know, again, it all starts with the patient, and it starts with that patient provider relationship, you know, whether it’s an esthetician, whether it’s a laser tech, whether it is a injector, whether it’s a physician, because this is a very different value sort industry, because when you look at how much is out there that can be bought, that can be purchased. None of this is reimbursed by insurance or Medicare or Medicaid, and so there’s a very big industry selling to the medical esthetic specialty, and I think we really have to, and I fully respect and admire some of the people who are financing growth in the in different practices. Some of them are doing it extremely well and really starting with creating pipelines of injectors.
Yeah. So, so where do you see the neck like, where do you see this specialty going in the next couple years? There’s a lot of private equity, obviously has come in. Find it very attractive. What’s your take on that? I think we’re
going to see a lot of consolidation. There is no doubt that there are a lot of practices that are looking for some sort of exit strategy at this point. You know, we’ve got about 2025, years for a lot of practices, or for some that are ready to say, time to move on. But I think we’re also going to see a lot of the practices that may be targets, beyond by people who are not ready to sell, especially if they are injector owners, especially if they are people who would like to have more of an impact in the specialty. I think we’re going to hopefully see more development opportunities. I have to give a shout out to Corey moss and Brian beisman and Alex church. And there are a lot of physicians and injectors who are trying to work together to see if we can create some sort of organization that would be, you know, not just multi specialty, but multi credential. Um. Organization where we can say, let’s create some sort of organization to set some sort of training or guidelines or credentialing for non physician esthetic injectors, so that we have a opportunity for making sure that we keep the specialty safe and keep the patient safe. It’s going to take a lot of work. You know, every single state has different laws on who can inject and what products can be used and how they’re done, and this is not going to be an easy thing, and I think that’s something that a lot of the private equity backed organizations are finding as they’re trying to expand and grow that one size does not fit all So, yeah, we got to figure out something a little bit more with maintaining some sort of of credentialing and and I don’t think it is putting a physician in a practice, and I don’t say that negatively to a physician at all. It’s just that just because a physician doesn’t mean you know anything about injectables or about lasers. And so we really have to start recognizing this as a specialty and that there is very specific knowledge and training that needs to be done. And so, you know, if we can figure out some way to assess that and credential people based on their knowledge and their skill and not just what to do, but how to handle things when they go wrong as well, I hope we start seeing more, I guess, more opportunity to really reach through specialties and share. You know, these injectors who do it all day long, every single day, they’ve got a lot of knowledge, and there are some physicians have done some amazing research, but I’d love to see more of the actual injectors get involved in some of the research that’s being done with the New Products and Procedures, because these are the ones that they are the providers that do it every single day. I’d also like to see you know, more of an understanding as new products come to market that we’re not just selling products. This is not just about commoditizing the market, but there is a value that consumers and patients should be willing to pay for the expertise of a skilled provider. And I think the more that we really think about medical esthetics as a true specialty and not as an industry, that we’ll start getting some of those things talked about more widely and more broadly within the specialty.
Yeah, yeah. Very good point. And I think, I mean, you made it, you made a, you know, great, great point, really, in the sense of talking about hoping that the injectors themselves start getting more into, you know, collaborative feedback and getting involved in more the clinical, you know, type of type of feedback and and I think that’s important, you know, because they are the ones that are that are using the product and seeing like, first hand, you know, what the effects of the product are, right in the short term, and from a longevity standpoint. So I agree. I think that the the specialty is going to continue to grow. I think that, you know, in the next five to 10 years, I agree with you. I think there’s going to be a lot of consolidation that takes place as well. I see a lot of technology moving into into the specialty, and I see a lot of exciting things happening. You mentioned Alex theoris. You know, I’ve had been on podcasts with him, and, you know, are part of American Med Spa Association, and have, have, have enjoyed it, and really appreciate organizations like them that that have really, you know, helped out. And so it’ll be cool to see what, what organizations like, like that do in the future, on, you know, based on how fast things are things are changing so and
I think if we all just remember, let’s all work together to make this as safe and with great outcomes as possible for those patients that are sitting in the chair and that really, you know, Titans tagline has always been Titan supports great injectors and great practices for Great patient outcomes. And at the end of the day, that’s what we want to do. We want to be the esthetic conjecture support connection, to help people at any stage of their career feel really good about providing great results and safe results for patients in esthetic medicine. Awesome,
awesome. Very well said. Well, so in closing, here, where, where can people find about everything about Titan?
Easiest way is the Titan website, www, dot Titan esthetic.com or Titan esthetic recruiting.com we have both URLs. We are on Facebook at Titan esthetic recruiting. That’s where all the reviews are. I have to say, I not very good at collecting reviews. People are very kind. You can find us on Instagram at Titan underscore esthetic, underscore recruiting. You can find out about the learners and legacies meeting at learners dot and dot legacies. And what else am I forgetting? I’m too old to do Tiktok at. To get on that one. So go to the website. Everything’s there. It’s the easiest way. I appreciate
it now. It’s been an honor having you. I I appreciate everything that that you do, and I love to talk with you again and spend more time with you. Hopefully I’ll have the opportunity to to meet with you and sit down and and you know, just explore you know more on where your mind is going forward. So I appreciate you taking the time, and I know that you’re super busy. And for everybody that tuned in, please, you know, go check out the website. If you guys are, you know, in this environment seeking advice or trying to find out, you know, what is the best placement for you? You know, connect with Mary Beth. So thank you so much. Thanks. I really appreciate it. You’re welcome. All right, guys, happy ejecting you.