In this episode, we are joined by the dynamic husband and wife duo, Steven and Sara Camp. Steven Camp, MD, a renowned plastic surgeon and owner of Camp Plastic Surgery, and Sara Camp, Head of Operations for the practice, share their experience starting a business. They outline essential resources for new business owners, key individuals to rely on during the startup phase, and important considerations for plastic surgery and aesthetics practices.
Listen to the full episode using the player below, or by visiting one of the links below. If you have any questions or would like to learn more, email us at info@byrdadatto.com.
Transcript
*The below transcript has been edited for readability.
Intro: [00:00:00] Welcome to Legal 123s with ByrdAdatto. Legal issues simplified through real client stories and real-world experiences, creating simplicity in 3, 2, 1.
Brad: Welcome back to Legal 1, 2, 3 with ByrdAdatto. I’m your host, Brad Adatto with my co-host Michael Byrd.
Michael: Thanks Brad. As a business and health care law firm, we represent clients in multiple business sectors, especially health care. This season, we are diving deep into the exhilarating and terrifying process of opening a business. Our theme this season is starting a business.
Brad: Now Michael, starting a business is just one season of a business. For those of you who it’s your first time, will you just give us a quick overview? What are the other seasons of a business?
Michael: There are four other seasons of a business. [00:01:00] There is the building season – starting a business. There is the operating season – running a business. There is the scaling season – growing a business. [And] There is the buying and selling season which is exactly what it sounds like – you’re ready to sell your practice. So this podcast season we have been living in the building season.
Brad: Yeah and today I’m real excited. We have our friends and longtime clients on the show with us to share their story about starting a medical practice.
Michael: I know the audience is going to love hearing this real life perspective but Brad I have some important stuff to go over with you first.
Brad: I didn’t do it. It wasn’t me. Am I in trouble? Well, first off am I in trouble?
Michael: You’re not in trouble, Brad.
Brad: Okay good. If it happened, it was an accident.
Michael: Uh-huh, uh-huh. I’m getting suspicious. You do have that look on your face. No I want to revisit a conversation [00:02:00] you and I had recently, and I thought this needs to be on the air.
Brad: Uh-huh.
Michael: You were telling me about your son Ellis’ birthday party, and I realized that you and I are at the end of an era with our kids being grown up.
Brad: Yea, it’s kind of crazy my son is a senior in high school and when they start getting that age they start shifting with what they want. He decided to get the gang back together and they were going to go to Dave & Busters. Which for those not familiar with Dallas, it a place where you just pour money into game cards and machines and kids get something out of it. We ended up having it on a snow day here in Dallas. So not only were schools closed, but people were afraid to drive because there was like a slight bit of white powder on the ground, but people showed up and we had a good time.
Michael: Well that sounds very similar to the types of parties my kids went through growing up. For those that don’t know, I have an army of kids, five of them and mostly grown up. [00:03:00] My two oldest kids are actually old enough that they had a couple of Chuck E. Cheese birthday parties. They also got game cards, Brad but it was different than that. I heard a stand up comedian say Chuckie Cheese was actually where Covid started.
Brad: Well you know the funny thing is, and I’m sure most parents who have done the Chuckie Cheese experience, I don’t think we have a had a party there, but I know I went to a lot of them. I still remember one young kid at the party who completely started freaking out when the curtain went up and the rat starts singing and playing the music, man they didn’t know what was going on.
Michael: Between the kid getting freaked out by the rat or back then when they still sold alcohol there…when the line for adults to get a pitcher of beer was longer than the line to order food, and rightfully so.
Brad: Yeah.
Michael: Alright so talk a little bit about some of the most [00:04:00] memorable birthday parties you put together for Madeline and Ellis, or the most memorable ones you attended.
Brad: Um, I think during Covid, Madeline had a birthday party at our house once people were allowed to starting getting back together. We had a zoo at our house. We had a kangaroo in our house, we had monkeys in our house, we had hedgehogs. I mean we literally had a kangaroo with a diaper on just bouncing around our house and started opening our cabinets and stuff. So I literally had to watch this kangaroo bounce around my house. So that was a lot of fun because it was kind of the first thing you could do after Covid. Although it was still at our house, we literally had a zoo at our house.
Michael: I know for me, like, in 7th and 8th grade for my daughter who is now 26, I know all of a sudden she had, for two years in a row, a party where the entire school was invited. It was like at a church gym. [00:05:00] It actually wasn’t expensive at all. It was insane. I thought we were done with birthday parties and it went to this extreme deal where I was chaperoning birthday parties. It was crazy.
Brad: Yeah, I mean, I guess speaking for parents in the Dallas area they probably have all heard of Little Gym. We’ve been to a lot of little gym parties I remember a one of Ellis’ party some kid falling down and screaming in pain that he was hurt. The parents were like oh you’re fine, you’re fine. Well when I got home, I got a text from the mom saying he broke his arm. How about you? Do you have any horror stories?
Michael: The Little Gym, I mean the birthday parties where all the dads are standing there staring at each other while the kids are doing their thing. Those types of parties I do not miss at all. [00:06:00] Well I brought this up today Brad because I read an article. I kept hearing about these over the top kid birthday parties that have escalated in recent years so that they can be posted on social media platforms like Instagram. You know what social media is?
Brad: I’ve heard of it. It’s the thing where people put things on right?
Michael: Yes, Snapchat and TikTok. So I read an article about $100,000+ being spent on birthday parties for kids.
Brad: Okay, I guess you invited hundreds and thousands of kids to your birthday parties. Is that your idea of outlandish?
Michael: It was not $100,000 worth. Close, but yeah.
Brad: Alright, well our guests for the show have been patiently waiting to try and figure out what is going on. Maybe we should bring them on and start talking with them about starting a business.
Michael: [00:07:00] Okay, yea, let’s do that. Today, joining us are Steven and Sara Camp, husband and wife team. We’ll start with Sara. Sara is a nurse practitioner. She is a TCU undergrad specializing in nursing.
Brad: Go Frogs!
Michael: She has two masters degrees from the University of Pennsylvania, Financial Accounting certificate from Harvard. She blends some time on the clinic side an primarily manages the business and marketing for Camp Plastic Surgery and she has two children with Steven: Zoe and Winston of Instagram fame. I keep up with them actively through that route. Also joining us is Steven Camp married to the mentioned Sara. He is a Texas A&M undergrad, Texas Tech school of medicine, he did his surgery residency at the Carolinas, [00:08:00] he was at the University of Utah – Plastic and Reconstructive Surgery as a Chief Resident, and he did his Fellowship with Dr. Dan Mills. I hope I did you guys justice. Sara, Steven, welcome.
Sara: Thank you! We are so glad to be here.
Brad: Well we started off with some pretty hard take sports opinions. Have you guys ever thrown one of those outlandish birthdays for those kiddos?
Sara: Have we? I tried to think when you were talking about it.
Steven: Yeah no, I can tell you that we have been to a lot of kids parties. We’ve been to those indoor bounce house arenas like Pump It Up. [00:09:00] We have thankfully aged out of them. Our kids are like 10 and 12 right now so we have done small group gatherings. I’m trying to think of a birthday party with more than 10 or 12 kids. It’s all been fairly tame. Listening to you guys I feel so blessed. You must be touched by the light. I’m worried about next year though.
Michael: Well Ft. Worth is a pretty grounded area. Alright so I’d like to hear from each of you about Camp Plastic Surgery. Talk a little bit about your practice that has been in existence for a while now.
Sara: Steven, you kick it off.
Steven: So this is about 11 or plus years of being out of residency training and essentially practicing plastic surgery and it initially started in a group practice. [00:10:00] We really felt fortunate to find a situation where we could walk in and essentially try and cultivate patients and grow a patient following and spend some time in emergency rooms and doing the spectrum of plastic surgery. It includes a lot of things like breast cancer and injuries in the emergency room. The things I do now which is obviously cosmetic surgery. We are dealing with facial aging, post pregnancy related changes, and the whole spectrum of skin care. You know, injectables, laser therapy which we’ve really gravitated towards and so my practice was very broad at first and I have had from the beginning a very focused interest on aesthetics and facial aging. [00:11:00] Fortunately, my patients have gravitated towards those components and I was able to focus my practice on that. I made a decision to really try and craft the experience and cater the appointment time and one on one discussions. I am customizing treatment plans in a way where I’m not being pulled in tons of different directions. So that was the impetus for what I wanted to do. So that’s what our practice is. It is a comprehensive practice dedicated to facial aging, skincare, and moms. My big demographic is moms – mommy makeover patients. They want breast lifts, tummy tucks, and ten years later they are all worried about their necks and their eyelids. So it’s kind of grown into that fusion if that makes sense. What we wanted was a by appointment, comfortable, discreet setting, that can be very patient centered and patient oriented [00:12:00] without any external distractions. So that’s how I would kind of summarize our practice, but it was also the driving force behind me needing to do something like this on my own.
Brad: That’s a great explanation about who you guys are and I ant to take a step back since the them of the show is starting a business. So when you started your practice a few years back now what was the first thing you did when you decided to start this practice?
Steven: So the first thing I did was say, you know, what’s my vision. So, my vision is I want my patients to be able to, come visit us, learn about our procedures and treatments, and essentially be seen quickly, comfortably, and at an extremely high level. [00:13:00] Just like you would at hotel or a nice restaurant. I wanted a different experience of medicine than most of medicine where there is an exchange of nice cards and a lot of back and forth. I wanted this to feel different and very welcoming. So I think the first thing I said is, “I want the experience to be different than going to a hospital.” So how am I going to create that experience and what do I want around me? I’m a surgeon and I know how to do surgery and some aesthetics treatments, but what do I not know how to do. So the first thing I said is “ what are the things I want, what’s the vision?” “What are the things I don’t know how to do?” I don’t know how to answer phones. I don’t know how to create service menus. I don’t necessarily know how to do accounting. I don’t know what I’m supposed to do [00:14:00] when I offer people to work for me; in terms of benefits and salary. I don’t know how to hire employees. So I asked other people in other businesses namely Sara’s dad who is not in medicine but ran businesses for many, many years. He asked me who was going to help me with my numbers. He goes, “where is your accountant and your accounting team?” So, I go, “well I don’t have one I just file my return at the end of the year.” He just starts shaking his head and he goes, “How about your legal?” So I was like, “well my dad’s a lawyer, this, that, and the other and my patients are happy with me.” He was like, “No not malpractice you idiot. How are you going to hire people? What are you doing?” I said, “I don’t know.” He was like, “Okay who is financing this?” So it became very obvious how much I did not do, how much I did not know, and what external resourcing I needed. [00:15:00] So I needed legal help, I needed banking and financial help, I needed accounting help, and then I needed infrastructure within the practice. So we basically defined, this is what we want to do, but how are we going to get there. So it started out with making a list of all our deficits and then that translated into, “how are we going to fund all of this?” This is kind of a nice segue into, “we need to figure out who our supporting team is going to be and how to build a business plan.” Those are the things that within literally five days I realized I had no specific training in and no existing help. So I’ll let Sara kind of chime in on this. You know she had a lot of skills that she brought to the table from her work as well too which I’ll let her describe.
Sara: Yes, I’m a nurse practitioner and I had been working in cardiac surgical and critical care, but six years before I went out on my own [00:16:00] I had been working for the American Heart Association as a national director. I had been working in corporate development, and in marketing, and in research. The national office kind of throws you wherever they want and where they are seeing you grow. So I had been writing business plans, I had been writing grants, I had been learning how to put budgets together, just all sorts of cool stuff. I was looking at stuff that Steven was doing and his find his group and thought you know we could go off and do this on our own and be a lot more happy because both of us really are entrepreneurs. We aren’t W-2 people. I kind of felt that way even in high school and college. I always knew I wanted to own a business but didn’t know what that business was. Nursing was kind of interesting but I spent about a year just studying and learning about plastic surgery [00:17:00] before I told the AHA that I was going to quit. I think it was really hard for me because I loved my job but I loved him more.
Brad: Congrats, Steven!
Sara: Haha yeah, so I was working full time for the AHA but at night I just really fell in love with plastic surgery. The elegance of it, like it being more like a high end restaurant or high end hotel, like he said and that entrepreneurial spirit that we both have. So I started writing our business plan and I started doing, like he said, I didn’t have an understanding of how to put together a balance sheet because I’m not at the accountant level and I was not a lawyer. We needed experts to help us. So that is when we made the phone call to y’all.
Michael: I have vivid memories of that time together and they are good memories. I felt it was a privilege to be by your side with that.
Sara: Thank you! It was actually one of the things [00:18:00] when you asked the question, “What do you need if you are going to do this?” What I said was, “If you do work in this type of business you need an advisor who is willing to talk to you like you [Michael] did.” At night and on the weekends because sometimes that’s the only times that we were free and or it was when I was having a complete panic attack. You were there and I could just call. I remember being at Disneyland with our kids randomly and thinking I need to call Michael. You were so gracious to take my phone calls and just walk me off the ledge. I was standing outside the Ariel ride and just thinking “oh my God”.
Michael: There’s lots of emotions that go with starting a business. I’d love to hear a little bit from both of you guys because we have lots of audience members that are maybe thinking about starting a business and it’s not for the faint of heart. Not only do you need to have that entrepreneurial spirit but theirs a lot of emotions [00:19:00] that go with leaving a current known quantity and starting on your own. I’d love to kind of hear y’all’s journey.
Sara: We were making a great salary, we were both fully protected in that way. Our kids were in private school. Like let’s just jump off a cliff and not have any money. That’s crazy! We were going to have to commit to it, and it’s still this way, like 24/7. It never stops. It’s been eight years that we have been on our own. Someone texted me the other day and said, “it’s so easy for you guys”. It’s fun but it never stops. If you want to do it, it’s a lot of work.
Steven: You know, one of the thing that [00:20:00] has happened since we decided to open up our own practice and our business, if you will, is kind of learn how to surround ourselves with good resources. That can come in many different forms. There isn’t one way of doing it. There isn’t a requisite list of things. One of the deficiencies that I ran into is and that I found is a lot of people who have been in practice that I have leaned on and were my mentors, if you will, had been doing it for quite some time. I was 35 years old starting a practice and taking advice from people at 55 and 65 years. And you guys talk about these seasons of different practices…there is this portion of time where you almost have amnesia of what the start-up and growth phases are really like. [00:21:00] I think the thing when I am talking to people who are leaving residency, or trying to contemplate it is tempering the excitement with the terror. She [Sara] described being excited about being an entrepreneur and I remember being terrified. Part of it is because as a surgeon I was used to understanding that I don’t do anything without a system and a requisite plan for my treatment. So essentially I was never walking into anything feeling like I don’t know what I am getting myself into. I think when it comes to taking financial chances on a building and correlating how many people are going to visit you on a given month translates into the real numbers. That’s how businesses work. That is not how the physician’s mind works at least not out of the gate. It’s not in your mind at all. [00:22:] So you’ve seen your mentors do it, but like how exactly did they get started? What was the process of getting started? What was the process of evolving. Those I think are the things that we learn along the way. A mistake I see a lot of people make is saying, “Well you need to budget this, you need to budget that” and they skimp on the help. They try to do too much of the accounting on their own and they try and have incomplete human resources programs and employee manuals and other tools that can really be streamlined with the right help. So I think we go to these conferences and even our professional society which I know you guys participate in, as an aside thank you for that. There’s this presentation and it’s almost an insinuation after you listen to speakers talk about finance, about practice management, about employees, about EMR that you basically just unpack each one of those and then put it on your other jump drive and you make it happen yourself. [00:23:00] I think that’s the gap. It’s realizing what are my advisors going to look like and how close do I lean on them. To the credit of what you guys helped us do and the friendship that’s ensued from that, find people that are responsive. If you can find that they are responsive people that means that they are invested in your goals. They believe in you and their success is your success and vice versa. I don’t know if that’s in line with what you are looking for but those are the things that I learned. Yeah we learn about planning for the future and writing a business plan. There is a time of course of when you should do these things. That’s what I have learned along the way. They other thing is that people get impatient. I want to remind [00:24:00] anybody that starts a med spa, a business, or a plastic surgery practice that what you’re doing in all of medicine and being a life long student is that you should approach this in that vein. It will help ease some of the fear and allow patients to enter into the equation if you put yourself into the phase of permanent development. So people will ask me, “Your practice looks so successful, it looks like it’s gotten better, how did you get there?” So the question is a very binary question. How did you get there? My answer really is reductive in the sense that it’s constant development. So if I am developing myself and I am developing my employees and I am developing each facet of my practice we can’t help but spontaneously and organically grow the way we are supporting each other. I think the biggest takeaway for me is becoming a developer of myself, becoming a developer of my team, and don’t look for people who have everything. No one has everything. I don’t have everything and no employee will have everything either. [00:25:00] You have to have the people with the right mindset. When we put that together, that creates our culture. The development and the consistency of having a culture in the office is all a by-product of that thinking and the resources that help.
Michael: Sara do you have any final thoughts or advice before we go on to a commercial break?
Sara: On that question or advice on business plans?
Michael: Or any final piece of advice for anyone thinking about starting a business.
Sara: I think my best piece of advice is just be good to your staff. I think it’s really my most proud achievement. We’ve had almost zero turnover in the seven or eight years we’ve done this and we’ve grown from a staff of three to 25. I consider them family and they come to me with what they need and it’s so easy to be kind. [00:26:00] I have my slip ups, I have my moments when I am having a bad day and when you have that you have to apologize immediately. I know that there are bosses out their that treat their employees poorly and they have high turnover rates and it shows in those offices and we have a great office and we love our team. So that’s my biggest piece of advice. Treat your people well.
Michael: Amazing! Well I can’t believe our time just flew by. You guys were incredible. Thank you for sharing part of your story. I think it will be incredibly helpful for people to kind of hear the realness of what it is like. What we will do next is we will say goodbye. We’ll go to a commercial break and Brad will do a quick little legal wrap up.
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Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host, Brad Adatto, with my co-host, Michael Byrd. Now Michael, this season, our theme is starting a business. We’ve been really camping out in the building season, and just hearing the Camps talk about how terrifying it can be being an entrepreneur, finding that right people in this journey, and how hard that can be for them. At the end of the day they actually needed a business entity to start. [00:28:00] So maybe you can just give a little more information on camping out on building a business entity.
Michael: Sure, so from a purely blocking and tackling business perspective forming an entity requires two big steps: 1) is you form something in the state. In this case it would be a professional entity if you are providing medical services. It has to be something that’s allowed. Then you have to get an EIN number. Now what I will caution everyone and we have talked about this at various points in other shows is that there is some strategy that goes into it. I would spend more time talking about it, but there is a new law coming out that I would love for you [Brad] to talk about. It’s the Corporate Transparency Act (CTA).
Brad: Yes, so audience members if you don’t know about the CTA, Corporate Transparency Act, this is a new law that the federal government came up with that means to make your life miserable. [00:29:00] It’s extremely and heavily administrative and it’s really there to help detect if these entities are real or not. There is certain information that you will have to share on this federal website and a lot of people are like, “Well does it apply to me?” In the vast majority of the closely held entities in the United States, it probably will. So like your certain Limited Liability Companies or your corporations or professional entities as Michael said most likely will qualify. Certain things won’t like your Apples or your IBMs, they won’t qualify, but your typical mom and pop shops do. All it is, is a notification requirement that you need to file some documentation, a lot by the way, audience members, with the federal government that is in charge of this, and you have to do it by the end of this year if your entity was formed before the end of last year. [00:30:00] If you were formed in 2024, which is this year, you have 90 days to do it. Then going forward for all those in 2025, when you form a new entity, the federal government expects that you give them this information within 30 days. I won’t bore you guys to death with all the moving pieces. You can go to the website to learn more about the Corporate Transparency Act and what you can file and that part is free. There are third party vendors that are out there that are trying to be in a situation where they can help. Ultimately, at the end of the day, if you don’t do this you could get fined some serious money and that’s why we are trying to let you know about it. Before we talk about next week, Michael do you have any final thoughts?
Michael: Well I mean the Corporate Transparency Act reminds me of the scary mouse at Chuckie Cheese. Getting that stuff filed sounds like the beer line at Chuckie Cheese.
Brad: [00:31:00] Well audience members, next Wednesday we have a special for you guys. We will have a live audience here in Dallas and we will have former Navy Seal, Ryan “Birdman” Parott and he is discussing his new mission on saving others. It is going to be a really great one because we will have that live audience.
Outro: ByrdAdatto is providing this podcast as a public service. This podcast is for educational purposes only. This podcast does not constitute legal advice, nor does it establish an attorney-client relationship. Reference to any specific product or entity does not constitute an endorsement or recommendation by ByrdAdatto. The views expressed by guests are their own, and their appearance on the program does not imply an endorsement of them or any entity they represent. Please consult with an attorney on your legal issues.
