We are continuing our series of successful entrepreneurial medical practice owners. Meet Dr. Carol Clinton, ER physician, who founded Timeless Skin Solutions, an aesthetic practice, after 15 years of practicing medicine in a complex, high-pressure environment. After a few years it became extremely successful, becoming one of the true pioneers in the industry. And then at 42, she was diagnosed with ovarian cancer.
But she refused to let this disease affect her from achieving her dream, growing and successfully selling her practice for 5X EBITDA in 2020. The co-author of the Amazon Best Seller, Med Spa Confidential, and podcaster of I’ve Got Skin in the Game, experience her inspiring journey from busy physician entrepreneur to cancer survivor.
Med Spa Confidential: Lessons Learned from Starting, Growing, and Selling 100+ MedSpas
https://www.amazon.com/Medspa-Confidential-Dr-Carol-Clinton/dp/B09ZJ281TR
Dr. Carol Clinton’s website:
http://carolclintonmd.com
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Transcript:
Mike Woo-Ming: After nearly 20 years of being a business consultant. And just over the last 10 years, working specifically with physician entrepreneurs, I’ve heard just about every excuse of why someone isn’t able to, or don’t feel compelled to start a business. “I’m too old or I’m too young, or I don’t have enough money or money’s tight, or my fear. is I just don’t have enough time.” And we have a term for this as consultants. And it’s not the nicest terms, but they’re called entrepreneurs cuz they wanna be an entrepreneur, but something, some obstacle, whether it’s perceived or real is stopping them from actually doing it. And I don’t think you’ll have many excuses after you listen to this woman’s story.
She was a busy emergency room doctor that got introduced to the aesthetics community. Started up her own practice was really one of the pioneers in Botox when Botox wasn’t even a commonplace word after a few years built a successful practice. And then she was diagnosed with ovarian cancer at 42 years old.
And what you learn in the interview is how she was able to deal with it, how she was able to run the business, actually using one of the main principles I talked about in my book, the position physician that you can’t do everything. If you’re the. A physician and the practice owner, seeing all the patients, ruining all the patients entering on the phone calls, you’re never gonna grow in scale.
You have to be able to delegate and be able to take yourself out of practice if you want that business to thrive. And she would not only thrive in her clinic. In 2020, she was actually able to sell that for five times EBITDA, which basically is the indicator for their business performance. So that’s that statistic is a lot higher than it is in this industry.
Usually it’s like one, 1.5 profits that you’re gonna make on the business. So I really hope you, you have a chance to actually listen to, or watch this interview with this amazing physician entrepreneur, my interview with Dr. Carol Clinton on this episode of Bootstrap MD.
Hey guys, this is Dr. Mike Woo-Ming. Welcome to another edition of Bootstrap MD, the podcast for physician entrepreneurs. We’re continuing our series talking about the innovators in the cash pack, cash practices. And this week we’re talking about med spas and on the call today, we truly have one of the groundbreaking physicians in this industry.
She was the founder and director of Timeless Skin Solutions, which is a physician directed skincare practice. Dedicated to help men and women and teens look their best. How I learned about her was she had a book that came out earlier this year called med spa confidential talks about her experiences, starting up a med spas and all the trials and tribulation she did to become successful. She’s graduated cum laude from Ohio State University College of Medicine. I was born in Columbus, as we mentioned, she’s also an ovarian cancer survivor. Wife and busy moment three will get into that as well. She’s lectured internationally as an expert on lasers.
And was talking about Botox when no one else was talking about Botox. So we truly have one of the pioneers in this industry. And we’re gonna find out more about which how she got started her entrepreneurial journey and what she’s doing now. So want to welcome to the program Dr. Carol Clinton, Carol, how are you doing?
Carol Clinton MD: I am doing great, Mike, and thank you for inviting me on your podcast.
Mike Woo-Ming: This is great. I talked to you just prior to starting up the interview. I picked up your book. I thought I knew a lot about med spas the wealth of information that you get got in the book.
It’s really amazing. You guys should really pick it up. If you’re getting into this industry, it’s called Med Spa Confidential. Carol, I buy a lot of business books just like yourself and sometimes they’re great. Maybe some motivation. But a lot of times there’s a lot of fluff and your book certainly did not have any fluff. It was content. I was taking voracious notes on it. So congratulations on coming out with a very successful book.
Carol Clinton MD: Thank You! Sarah and I, Sarah, as an attorney and myself as a physician, both wanted to do this industry proud in terms of making sure that we gave advice that was worthwhile and also from very different viewpoints.
The way that I went to business and decided to do this was to do a really high touch. Sort of approach and Sarah’s was a high volume and getting a lot of people to do procedures. I, don’t think there’s any right way or wrong way to do this business other than to do it with the approach that you’re actually taking care of humans.
Be respectful of the fact you’ve been given that privilege and then make sure you do it within the legal parameters of the way that laws are written in different states on, how to approach this. But I think our book also, if you wanna scale up any business, we go through the whole process of what are the systems that you need to get in order to be able to scale up.
Yeah. So you can, as a physician who wants to be an entrepreneur, this book could help you outside of the med spa arena as well. If there’s something else you’re wanting to do.
Mike Woo-Ming: Truly. And, that’s an important word “systematize,” especially when it comes time to actually selling your, practice.
And you actually do a really good job of actually contrasting those two different styles of med spas. But I wanna talk about your personal journey into the med spa industry you got started with. Not a lot of people even knew what the word med spa was. So yeah, let’s talk about it
Carol Clinton MD: I I called
my practice a medical practice.
So I actually never used the word med spa to go along. But I know that’s the kind of the vernacular that’s out there right now. So that’s why we used it with the book yet and some somewhere around 2002, I had a good friend who was a plastic surgeon and she called me and said “Hey, do you want some Botox.” And so I went over and I got Botox for the first time for myself. And she was just honest. She said “I’m a surgeon. I need to be in the operating room. When this hits the mainstream, it’s gonna be more work than I’m able to do.” So she actually started me thinking about the whole process of, do I wanna be an entrepreneur?
I had put my name forward for several of the leadership positions in the large emergency medicine group that I was in. And. Never got voted into anything or and I knew that I wanted to be a leader. And so that’s how I started my entrepreneur journey in 2004 when the year started. I just thought I don’t want it to be 2014.
And me saying, I wish back in 2004, I had done something. So by 2000, between 2002 and 2004, I had done different trainings, felt pretty comfortable. And remember this was early days. So there was one filler at that time that I felt comfortable using it was a collagen base, but that’s, you know what first wives club showed was the crazy lips.
So you had allergic reaction. There was Botox and there were lasers, but they weren’t nearly as. As they are now and light sources. And then there wasn’t all the other electrical based machines that are out there that take a whole lot of time to learn everything that all of these different Procedures could do.
So when I started it. I don’t wanna say simple, but it was much simpler times than it is currently. When you’re having to go and pick a lot of what filler do you want, which neurotoxin do you want? What skincare line do you want? It was much easier in 2004, or I would say fewer choices. So that made it easier to, do the investigation.
Yeah.
Mike Woo-Ming: There’s a multitude of choices. . Now, Sarah talks about how she got started with a one room. Practice. How, did it work for you also? Were you working your ER shifts at the time or did you leave it and then decide to go? How did you, make it work? And, more importantly, how did you make the finances work?
Carol Clinton MD: Yeah I went to halftime and in the emergency room and then started and I did two days a week. One of ’em was in a spa that was closed on Monday. So they had room that I could take over on Mondays and then they weren’t there. So it was, just me, but that did allow me. I’m not a dermatologist. I’m not a plastic surgeon. I’m not a family practice doctor. So I didn’t have an existing patient base that would come to me. So that gave me a patient base. The second one was a physician who was a radiologist who had done a women’s only practice. So she did ultrasound and breast stitching. And I was in her office where she had extras, dedicated to other professionals that wanted to come in and help women.
And I, was in her office on Wednesday. So one of those was in Dublin. One of ’em was in downtown Columbus and after about six months, I had replaced my income in the emergency room and decided. This was a business and that I was going to be okay. Began to build out my own space, which took me about six months to do it was a year from the time I had just begun to inject Botox fillers. I had a qera laser at that time, which had a 10 64 on it and different IPL hand pieces. At the end of the year, I had my space that I opened and I had an existing patient base that I just grew from that point on.
That’s great. Now I’m sure you’ve heard the statistics. I know you talked about the book in the book. You read a lot of business books yourself at 80, or maybe give you 90% of businesses fail. The first year you were successful within the first six months. Did you have any entrepreneurial training? Did you go to business school? What kind of business?
acumen I had zero and that was really intimidating. And a a couple of good things that happened to me along the way. Number one, I’m born into a very large family with multiple siblings. One of my siblings is the CFO and had been of MGM casinos.
So as he says to me all the time, the difference between my business and yours is just the number of zeros. The principles are still the same. So he came out and really helped me set up my QuickBooks and how I did my accounting and that sort of thing, which was incredibly helpful. Then I had a patient come in one day and say to me, you do understand that you’re running a business.
You’re not just a doctor anymore. And she invited me into entrepreneurs organization, which gave me a training and background that I needed. Because I had no MBA or formal business training and took one accounting course as an undergrad. So the, those two things were extremely helpful. The third thing that was helpful is watching both that physician who had decided to just take care of women, her risk, and then the spa and how they interacted the spa had clients.
they, There was no doctor. My business was separate than them, the way they treated their clients. And I watched the way that her staff, the physician staff had systematized things to make it easier for patients because back in 2004, not a whole lot of people were worried about the patient experience.
And she was as was the spa. So they gave me some marketing and sales training that I didn’t even know I did either just watching them and observing them how they went about taking care of people. So I felt like I got really great business advice from entrepreneurs, organization, marketing and sales from other professionals around me.
And then finally, my brother really helped me with that initial step of how how I did the financial piece. And then what if I felt. And this is a, tool that I know I’ve read other people do. I feel like I interviewed people all the time, but it wasn’t necessarily a formal interview. If I would sit down and be at a meeting in school, I’d be curious about the people who were sitting around me.
What did they do? A lot of stay at home moms actually were fairly powerful executives or professionals before they left the workforce. And, to get that power from them from 10:00 AM to 2:00 PM every day, because they wanna get out and work, but otherwise they wanna be around for their kids. Was really helpful.
So I used a lot of women who helped me build my business, who were, had been stay at home moms who brought their skill set to Timeless. For however many hours, they were able to dedicate during the week. But most of them not full time. And I got the best of the best doing it that way.
Mike Woo-Ming: So when
you first started How many employees did you have and how, did it grow?
Carol Clinton MD: It was just me. And then within the first year I hired a physician’s assistant and then. On the day that I opened my medical office, myself, my medical spa a year later was the day that my doctor called me to tell me that I had ovarian cancer and we’d be going to the operating room the next Friday.
That kind of slowed the growth. I had to take care of my health. So while I opened and I went back to work after major surgery, two weeks later, I really was probably slow for a good three years. That six months I had chemotherapy, but then after that, you just don’t bounce back and are your normal self.
And because we did have three young children at home, I really had to balance where my energy was going between growing the business and managing a family as well. And when I say growing the business, I also had to stay abreast of what was happening in the field, because there were so many advancements coming so quickly from 2004 on.
So there was a lot of education that. In the medical arena as well as in the business arena. So I would say by 2008, 2009, I felt pretty good about getting ready to grow the business. And then we had that big recession and it was scary. I actually grew during that time, but I wasn’t confident that I was going to, so I didn’t fail number one, but I didn’t push for aggressive.
Which I could have at the time, but I, didn’t. And then just slowly grew organically and opened my second medical office and then scaled up the, our back office. So we could do three more offices and fairly rapid succession here in central Ohio. And then my ovarian cancer recurred. Oh. Back in 2018.
So at that point I knew that I wasn’t gonna put my energy towards. adding those additional medical spas that I needed to do something in order to allow the business to continue to grow. But do it without me and my energy. And I had a great team by that time. There were 30 employees and, they know how to run the business.
Most of them in their own league, maybe better than I did depending upon what their role was.
Mike Woo-Ming: First off. How is your health now?
Carol Clinton MD: I have my hat on because I have very little hair and it looks a little crazy, so I didn’t wanna distract anybody if they were looking at the video.
Mike Woo-Ming: I’m used to that , used to no hair,
Carol Clinton MD: so it’s OK. plus I love the Dublin Irish festival and I live in Dublin, Ohio. So I had to wear that my health. Good now in the sense that I’m stable and I haven’t had any advancement of my disease probably in the last three years. So that feels really good for a disease that kills most people within the first five years after their diagnosis.
Also, if you look behind me here, if any of you are watching on video, I have my own podcast co I’ve got skin in the game, and one of the things I do with that. We did the last one that we produced by the way was about the book. But most of the time, what I’m talking about there is unexpected life changes that maybe when you get ’em are unwanted.
And how do you shift your mindset to be able to gosh, I still enjoy my life and I have chemotherapy every week. I’ve had somebody come over last summer and say, oh, I thought you were gonna be lonely. And there were six cars in my driveway and friends all around. So I don’t, I’m not lonely. I have plenty to do.
And I have a couple more books in me, not necessarily about med spas, but just looking forward to the things and our kids are adults now. So while there’s things that I do with them I do a lot less for them and, just get to be with them, which is
Mike Woo-Ming: wonder. That’s great to hear and great, outlook on life.
So you you were able to sell your businesses, right?
Carol Clinton MD: Correct. Yes. I had many people reach out over the years if I ever wanted to sell, let them know. And so when it came time that it was obvious. This disease was not going away. I just went ahead and reached out to several people individually reached out to me and then went ahead and reached out to people who I knew were purchasing in the space as well. So that I had enough people bid on the practice that it made sense. I, as I call it as a process, we did, we ran a process and found the right buyer. And at the end of 2020 my goals, everybody has different goals when they go to sell.
My goals were to be able to have the time for me. So I wanted to be a hundred percent out. Not everybody wants to be a hundred percent. That was what I had written down ahead of time as to how I would like to exit the business. And I felt like my team was ready to, perform without me.
They did not need me in the business and kind of proven that over the two years prior with you, me having been sick and, not working during that period of time.
Mike Woo-Ming: Obviously when you get hit with such a devastating diagnosis, the tendency would’ve been to just close your practice. Most doctors who would do that would’ve closed it. Did you ever. Do that or consider doing that. And what prevented you?
Carol Clinton MD: I didn’t consider doing that except for one day. And I would say that day was somewhere between March 16th and March 20th. Back in 2020 when no one knew what was happening with Covid. I called my brother and I said, that’s it.
By the way I didn’t have to declare bankruptcy. I was dramatizing. I said, “I’m just declaring bankruptcy today. I’m done. I’m closing up.” And my brother said, “Carol, no, you’re. Every day, you get new data points. You do not have enough data points to make any decision today.” And that was really the most helpful advice from there until I didn’t own the business anymore.
You, make the decision on any day that you can make based upon the data that you have and never did my data say. “Time to close shop.” It said, find someone who can run this organization and, you don’t have to do that anymore. You don’t have to have the responsibility of it anymore.
Mike Woo-Ming: What it sounds like is you learned early on that many doctors where, why I see where they get in trouble when they have their own practice is they are, if they are not available, they’re not making any revenue.
They are their own practice. They’re not able to… i, know many people and doctors who are like a one man or one woman show. They’re the medical assistant. They’re the nurse, they’re the marketing. They’re the janitor . Sounds like you already had some loyal people in place that allow you to help you recover while they’re work in the business.
Carol Clinton MD: Correct. I, did. And I wanna say that this was intentionally done. Every Wednesday we ran with the Physicians assistants, the nurse practitioners, the other one, aesthetician RNs. We all came together for an hour and a half. The office was shut. We were all together. And during that period of time, we went over expected and unexpected outcomes. So we had people who had unexpected outcomes that were better than we predicted and obviously unexpected outcomes that we didn’t like and how we went about fixing them. So every week I ran, what, not that there’s any morbidity or mortality. That’s like our true M and M board, but I tried to run something like that.
So it was a learning experience. Every week on top of there was six months training and onboarding when anybody came into the practice. So in terms of my medical and nursing professionals that I worked alongside of, they had training all of the time. And so it wa none of them were just. Let loose to be the nurse practitioner who’s running the practice, they were all there.
And then they supported each other as well. So I was so proud of that. And so yes, it was intentionally done, but I had been what you said. Very early on. Like I was the marketing team for a while. I was the the person who did QuickBooks and exhausting myself on top of doing the medical procedures and probably somewhere around 2012.
I decided it’s time for me to do less of the medical procedures in this practice to be less dependent on me and me to educate and train more so that I know that the people who are doing these are doing a great job all of the time.
Mike Woo-Ming: Yeah. It’s an important point to, to elucidate because I do think as doctors, we do tend to be control freaks and we do want everything done and it’s can be difficult to let go, but if you want to scale and grow your, practice to 5 or 10 or whatever you wanna do, you gotta be able to delegate and to be able to trust the people that, that you hire.
Carol Clinton MD: Yeah, you absolutely do. And, but I think we all have to be careful in this day and age where there’s many, states who have independent practice for nurse practitioners, the PAs want to have independent practice. Now they do not have the training that a physician has. And it’s really important.
There are so many things that come up even in the medical spa space, where people have a medical issue and either you need to address it and let them know they need to see their doctor because it’s a problem or you at least need to know that they have it so that you can adjust whatever you’re doing to what their medical diagnosis allows you to do to them.
So I think it’s really important that you stay involved as a physician and you’re not just some own or somewhere far away and don’t have any input whatsoever as to what’s going on.
Mike Woo-Ming: Oh yeah. I see that. I I,got a call last week. Same thing. A doctor said “I’m invited to become a medical director and should they do it?”
And I go” do you have any experience?” “No.” Then do not do it! So, where we talk about the med spa industry, and I think that’ll get us into the book. So first off, how did you and Sarah meet and when did, who came up with the idea of having a book and why?
Carol Clinton MD: I think we both had the idea of a book, so I had made an outline way back in 2014 and then just never executed on it.
Sarah and I actually practice in the city with her ex-husband and we had never met in person. So in a Facebook group, she saw that I was in the Facebook group of medical aesthetic owners. And she reached out to me and just said you’re somebody that I’ve wanted to meet. And I said I wanted to meet you too.
So we… It was during the pandemic. We gave each other a call. She said she wanted to write a book. My reason for writing a book, not that it was gone, but I’m never going to use it to be a public speaker or whatever. I’ve done that before. I really have enjoyed that. I thought maybe I would do it again as I phased out of being an owner.
But now with my health, it’s just not something that I can depend on my health saying I would be able to speak at an event. So not what I’m gonna do, but Sarah wanted to do it. And it seemed for the reasons that I wanted to do it was to make sure that people who were entering this space had the right advice.
So when she said that’s what she wanted to do, I told her I was all in. I thought it was great that an attorney and an MD would collaborate like this on a book. And we had, let me tell you a good bit of fun doing it. And, Sarah, you think physicians are control freaks, Sarah is an amazing editor and has a grasp of language far better than I do.
And it was great working with her. Yeah.
Mike Woo-Ming: The book reads very well and it was really enjoyable seeing both perspectives. I’m gonna ask you the question that I also asked Sarah most practice owners. They have the one clinic. Whatever they do. They, don’t want to grow. I guess hinted systemization was very important.
What else was a big game changer? Like this was the one or two things that we did that really escalated my success.
Carol Clinton MD: Yeah. I, think two things. One of them was really paying attention to the patient experience. So from beginning to end, we knew what that was like from the time they looked at our website to the time they may have interacted with one of the recordings we did or shows that we did, cuz we still have a weekly show on one of the news stations.
That whole experience was curated all the way to the moment they walked in the door and then a whole new team would start with what the experience was like once you had the person in front of you in person, and then what was it like when they left? What, did that feel like? Did they feel like they were just one and done or did they feel like they had a plan that would take them?
And for us developing a plan with the patient was the most important thing and figuring out where they wanted to go, how long they wanted it to take. And then the second thing was just really all of the time trying to be in tune with the staff and what did they need and what did we need to do to make it work for them?
Occasionally we couldn’t, but if they would come to us and say, okay, I need to now work. Monday Tuesday, Wednesday, instead of Monday, Wednesday, Friday, whatever, it was, figure out how we could make that happen. Number one, they needed to come like this is how I see it working for the business. This is how it’s gonna work for me.
This is how it’s gonna work for the business. And if they would come with that, most of the time, we would be able to figure out how to make that work for them. So then I had longevity of staff
Mike Woo-Ming: That’s great. That’s great. I, know we just a few minutes of time I know you’re out of the industry, but you still, it sounds like you still keep abreast about what’s going on. Where do you see where this med spa industry is going? Are you optimistic? What where do you, stand on?
Carol Clinton MD: I’m very optimistic in terms of there’s lots of still potential for growth. I do see consolidation. It’s just, it’s very expensive to run a med spa and then to have a team know how to maximize.
Everything so that the patients are getting the best experience, the best price point you can offer that your med spa is getting the best price for products and your vendor relationships, all of that is really a lot to manage. So I see over probably the next 10 years, these continuing to consolidate, and there’ll be probably a couple big players. And then you’ll always have the person who is an MD, a do who, says I wanna do this, I’m gonna do it on my own run, a small boutique shop. And, that will always be there. People, like that experience as well as the bigger experiences as well.
Mike Woo-Ming: Carol. This has been a great conversation. The book is called med spa confidential. You can find it on, Amazon. Get it. If you’re even thinking about getting in, into this industry and also you have your podcast called the skin in the game and we’ll we’ll leave a link of that also here in the show notes. Just, my final question. What advice would you have someone who’s thinking about? Maybe I’m gonna take a Botox course and maybe this is something that I want to do. What, kind of advice would you wanna give to that person?
Carol Clinton MD: I would say it’s a lot more than a Botox course. And especially now with there’s being so many different electrical based devices like I said, neurotoxins, as well as the fillers, you really have a lot of work to do before you can do your opening day. And way back in, like I said, it took me 2002 to 2004 to just even get everything that needed to get in order. I don’t know that it needs to take you that long, but definitely it’s more than just a course. You’ll, need to learn some business things and you’ll need to have a plan on how you’re gonna stay educated because it, this industry does change quickly in terms of new devices that are out.
And you’ll need to know when you not just want, but you need a new device.
Mike Woo-Ming: And like I said, it changes almost on a daily or weekly basis too I’m having fine. I, yeah. And it’s definitely, there’s definitely is for those who want to become their own boss. I I don’t think there’s anything else better than I think being an entrepreneur, but that’s my personal bias.
Carol Clinton MD: I agree with you. And I think the thing that you said they’re have fun with it, see humor in just about anything that you can see humor in. It’ll take you a long way and you’ll enjoy it. And you’ll last a lot longer. If you can laugh at yourself,
Mike Woo-Ming: The book is called Med Spa Confidential, go and pick it up. Skin In The Game is the podcast. Carol, thank you again for your time today. It’s been very enjoyable and very illuminating. Thank you. And
I’ll watch you as you scale.
And everybody, and as always keep moving forward.
