In this episode, plastic surgeon Grant Stevens, MD joins us to share his passion for industry relationships and his latest ventures in the technology space. In part two, Michael and Brad share key takeaways from Dr. Steven’s experiences and how to navigate compliance challenges that come with the speed of technology.
You can listen to Dr. Steven’s Podcast, Technology of Beauty, at https://technologyofbeauty.libsyn.com/.
Listen to the full episode using the player below, or by visiting one of the links below. Below is the episode’s transcript which has been edited for readability. If you have any questions or would like to learn more, email us at firstname.lastname@example.org.
Intro: [00:00:00] Welcome to Legal 123s with ByrdAdatto. Legal issues, simplified through real client stories and real world experiences. Creating simplicity in three, two, one.
Brad: Welcome back to another episode of Legal 123s with ByrdAdatto, I’m your host Brad Adatto with my cohost Michael Byrd.
Michael: As a business and healthcare law firm, details matter. This season’s theme is Zoom In. Once we know our big picture, vision or strategy, we have to roll up our sleeves to get the work done. With each episode this season, we’ll have our typical stories and make sure we talk about specific actions to focus on for 2022.
Brad: Michael, have you ever heard the expression, the second time is a charm?
Michael: Uh, no. And I know what you’re doing there. The actual expression is third time’s a charm.
Brad: Alright. You got me there.
Michael: You’re trying to shoe horn in an expression so that you could make the point that [00:01:00] this is the first time we’re having an outside guest on for a second time.
Brad: That’s correct. You got me there. I was trying to keep things, you know, close to the chest.
Michael: Okay. Yeah. See what you’re doing, dad joke and all. But seriously, I love the Yogi Berra, misused expressions. They make me laugh every time I hear someone use them. And it’s, I mean, my wife, who is a very smart person, does it all the time. But Brad, it is actually keep things close to the vest.
Brad: Yes. You got me there. Yeah. It actually comes back from poker. If you can believe that cause you used to keep your cards close to your vest and it’s the expression to keep obviously your card secret. And over time, people kept switching it from vest to chest. And I wonder Michael, is that because people don’t wear a vest anymore? Maybe they do or I’m not sure, but what is your favorite misused expression?
Michael: Well, that’s easy. Cause I’m a 13 year old boy at heart. It’s when people say [00:02:00] nip it in the butt, I hear that all the time instead of nip it in the bud. And they mean that the same way, which is to halt something early on, but the true origin of the expression comes from, based on D budding plants.
Brad: Yeah. Knowing you are a man, but you are really a teenager at heart. I can see you going crazy with the word butt.
Michael: Yeah, pretty much. Yeah, I heard it just a few weeks ago on local radio station. And the guy said it a few times, nip it in the butt and I was laughing the whole way in and just cause he was misusing it.
Brad: Well, you know, that goes back to as you said, you like Yogi Berra and there’s so many good Yogi bear comments. But one of them would be, we made too many wrong mistakes.
Michael: Yes. Very profound, Brad. Let’s get on with it. Let’s get our guest on before we go too far with this one.
Michael: So our buddy is joining us today, [00:03:00] our longtime friend and client Grant Stevens. He’s coming on for the second time. Grant is a plastic surgeon to the stars leader among his peers, when you go to a plastic surgery conference, you can easily find Grant because there seems to just be almost like a spotlight, following them around with a hoard of people nearby. Grant is a proud University of Oregon undergrad graduate. He went to Washington U School of Medicine. He founded the Marina Aesthetic Surgery Fellowship. He was a, I’m not sure if he’s still active as the USC division of Aesthetic Surgery, but he was a mainstay with that for many years. Past President of Aesthetic Society and has published countless scientific research articles to better the field of plastic surgery. And most importantly for today’s [00:04:00] episode for what we’re going to be talking about, he has his own podcast that’s amazing called the Technology of Beauty. Grant, welcome.
Dr. Stevens: Thank you gentlemen, for having me. I appreciate this second opportunity to be on your show.
Brad: Yeah. And I don’t know if we should be jealous of Grant’s studio or not. For the TV audience who’s watching this, Grant’s outdoing us with this studio. So Michael, I definitely think we need to up our budget because that’s a pretty nice looking studio you got there, Grant.
Dr. Stevens: Well, thank you. This is the home of the Technology of Beauty. Where I get to interview the movers and shakers of the beauty business.
Brad: We’re going to get to that one. Well, again, we’re excited to have you back for a second time. Over the years, we’ve had these great, cool conversations, just with you about a lot of different things, but today we’re going to really focus on your relationship with technology. And when I was preparing for today, I actually started thinking that you and my dad would get along great. When my dad was a young physician, his nickname became gadget man, because he loved [00:05:00] all these different types of medical devices. He was one of the first ones in New Orleans to get an MRI and CT machines. And he was one of the first one that goes digital MRR. Like there were so many things. I started thinking like, gosh, if Grant and my dad got in the room, now you would not understand a word he said, Grant. Because you think I talk fast, and he talks fast and stutters. So you wouldn’t understand anything, but I kept thinking about your love for technology that made me think of my dad today. But let’s talk about, you have that podcast called the Technology of Beauty. And as your attorneys, we know that’s also the name of your practice that you’ve used many years. Tell us how you got interested in technology. What started that?
Dr. Stevens: Well, when I think back in my early training, even in medical school, I was sort of captivated by technologies just in general. And then lasers started coming out. And in the early eighties, I was able to start playing around, just [00:06:00] messing around with lasers, in the lab and so forth. And then in 1983, I got to actually use a pulse dye laser. On a Port Weinstein a vascular, issue on a patient. And I just was amazed at the ability of non-surgical intervention to actually change a person’s life. And then I started studying about lasers and wavelengths and then energy-based technologies. I was just captivated by it. I went into practice in 86’ and soon thereafter, started a med spa. And I had professors telling me, that I was a surgeon. What was I doing? What was I doing with these needles and topicals and so forth. And I can remember Dr. Zim, Harvey Zim, God, rest his soul. I remember him calling me and he was one of my mentors and past chair at UCLA. And he said, Grant, you’re a surgeon, you’re not a dermatologist. [00:07:00] I said, Dr. Zim I’m just trying to optimize the skin of my patients and help people in every way, not just surgically. So anyhow, I was always swimming, a little upstream on the non-surgical stuff. And then eventually my specialty caught up with me.
Michael: And you probably have one of the OG med spas. Of course, they weren’t called med spas until the last dozen years at most.
Dr. Stevens: Yeah. You know, and I remember why I did it. I literally, had done my mother’s facelift and she was a Southern Californian, mom please forgive me for admitting it. She’s not going to sue me for HIPAA, I don’t think. She looked great, everything was done properly. I was very proud of the job I did, but one of my brothers said, I thought you were going to get rid of mom’s wrinkles. And I said, no, I did a facelift. I tightened up her neck and her jaw on and on. He goes, I thought you were supposed to get rid of wrinkles with the facelift. [00:08:00] And I had gotten rid of some of them, the ones I removed, but the skin itself wasn’t smoother per se. And I got to thinking about that. And then I thought, what can I do to optimize the skin of these patients? And I coined the phrase, the icing on the cake, and I started developing different approaches, both before surgery, during surgery and after surgery. And then embracing various technologies, topicals, and energy-based to optimize it. And now we talk about the icing on the cake with all of our patients. We throw it in as a complimentary service to all of facial rejuvenation, surgical patients. And I talk about optimizing the paint job because you take your car into the shop. They get the dents out and they fix the body work, but they always paint the car and they give it to you all nice and shiny and painted. But as plastic surgeons before we were optimizing the skin. With various modalities, we would give the patient back and they’d still have brown spots or red spots or tiny wrinkles, or a photo [00:09:00] aging and the various things on the paint job, if you will. And now by incorporating that into the plastic surgery practice, as a part of the surgical regimen, patients are optimized and they look a lot better.
Michael: That’s amazing. And a lot of what you do for the optimized or the icing on the cake is, is technology-based stuff. Has that changed over the years on what you use?
Dr. Stevens: Oh yeah. It’s changed a lot in the old days when we just had the first few lasers, like CO2 full-field lasers, it was like torching the face. But it has become so much more refined. And when people say something, they used the word laser, like there’s one like, oh, I can’t have a laser because of X or Y. I always say, look, if I say car, you could think of a Volkswagen or a Yugo, or you could think of a Lamborghini, they’re both cars but they’re totally different. Or if I say transportation, a skateboard as a form [00:10:00] transportation, but so is a space shuttle. But they have very little to do with one another. They just, they are forms of transportation. Lasers are that vary and whether or not it’s fractionated, or full-field or ablative or non-ablative and what the wavelength is, what the target is? In other words, the color, and that’s how lasers work. And it’s beyond the scope of this program, but lasers are far more effective, far more gentle. And yet it’s far more effective. So imagine that, less downtime and more effectiveness. But it’s not just lasers, its using radio frequency using ultrasound, other energy based devices to optimize lift rejuvenate, a clarified skin.
Michael: Amazing. Well, your passion for this topic is palpable. That’s awesome. So obviously we mentioned earlier that you were [00:11:00], a past president for the Aesthetic Society, and one of the many things that you were known for leading up to and during your leadership was your relationship with the industry and that obviously connects so deeply to this idea of the Beauty of Technology, your podcast. I’d love to just hear a little more about, what you saw with what industry does to support your specialty.
Dr. Stevens: Thank you, Michael. Industry is our friend in my opinion. First of all, I’m a serial entrepreneur. And had been since I was four years old, when I started my first tomato route and then egg route and I’m a capitalist. And I’m an unembarrassed, capitalist and entrepreneur who happened to go to medical school. I also am passionate about being a physician, but I don’t think they’re mutually exclusive. And I know some of the socialists amongst us somehow think that to be an entrepreneur and a capitalist [00:12:00] is somehow contrarian to being a physician. I couldn’t disagree more. Without industry, we do not have new products, new goods, new services, new technologies, because it takes capital and it takes risk to try to develop new technologies. Then I’ve always been fond of industry because they take the risk. They take the time to spend the money, to help us with new products. And that’s why we have better fillers, better modulators and better technologies that I just referred to. So given that I’ve embraced in industry my entire career, and to that end with the Aesthetic Society, I was actually the chairperson, chairman of the industry relations committee. I was chair of the exhibits committee. I spent a lot of time developing and nurturing relationships with these big industries and small emerging industries. I went around and met every one of them from the small startups to the giant [00:13:00] allergens of the world. Now, Abby if you will. And not only that, with the Aesthetic Society we started partnering with industry, because industry also is a great partner, in terms of our pursuits of patient education, doctor education and patient safety. And I’m happy to report that. Now we have 12 industry partners, premier partners. And when we started, we had one and we’ve been getting larger and larger during my presidency. We added four more. We went from eight to 12. And they give us financial contributions towards education, and to facilitate residents and fellows coming to our meetings and educating patients about safety and effectiveness in the aesthetic pursuits, both medical and surgically. So I’m passionate about partnering with industry because I think responsible industry is healthy for our physicians and healthy for our industry. It’s that commitment to patient safety and optimization by [00:14:00] industry that helps us with our members. So I am a friend of industry and that out of that group, the Technology of Beauty and I have a lot of industry CEOs and giants on the podcast, as you know, as well as some physicians. And we bring some of the top flight aesthetic physicians under the program also.
Brad: I heard there’s a rumor that you brought on two attorneys once.
Dr. Stevens: Yes, the two of you, and you’re not only my attorney’s, but you’re the attorneys for many of my friends, my previous fellows, some businesses that I work with such as Orange Twist. You guys are the best and brightest in the business. And that is why I recommend you to anyone that asks me about it. And I noticed you quoted me at AmSpa. Brad, I noticed you have a quote at the bottom of that AmSpa thing. About something that I said, I don’t know exactly what the quote is now.
Michael: We’re [00:15:00] always recording you just in case, including right now.
Brad: We never know when something brilliant is coming out of Grant’s mouth. Well, you talked a little bit about it, but you know for our audience, that’s listening. And again, we did have a chance to be on your podcast, but I love the fact, you have this passion obviously coming through, which everyone can hear you as you talk about it, but this passion for technology and passion for the industry itself, and it’s all seems to be coming great or beautifully through the Technology of Beauty podcasts. Anything else you want to add on to what you were just talking about?
Dr. Stevens: Not really. I’m sure something will come up. We’re doing a lot of things working with a number of companies right now. I’m working with a company called Engaged Technologies. And they asked me if I would help them out as the chief medical information officer, they’re out of Boise. And it’s a novel form of communication, both from physicians to patients, and from staff to patients, [00:16:00] and industry to industry, and industry to doctors. It’s a whole new emerging form of communication. And I’m really excited about that. It’s not just an aesthetics business. It’s also in ocular and dental and other medical things, such as spine and hip and knee replacements. And I think it’s going to be a way, which we communicate even in the legal business. I think it will become used in law and real estate and veterinary science and all sorts of other fields.
Michael: I’ve heard you describe it almost like, you know, frictionless education or frictionless communication.
Dr. Stevens: Yeah, it is. I have called it frictionless education, frictionless excuse me, communication. I would ask you and all your listeners, how many of you don’t have your cell phone within your arm’s length? Here’s mine sitting right here on the [00:17:00] table. This is our most trusted device. It seems that we’re all, when you misplace that you panic and I’m sure very few people listening to me right now, that don’t have their cell phone on them are probably listening to me right now on their cell phone. That’s number one. Number two is almost all of us prefer text messaging over anything. We are so over emails, we’ve been spammed to death and invaded in our emails. And we even prefer text over speaking on the phone, most of us. I’ll never forget when my daughter texted me while sitting next to me at the dinner table. And it was before I fell in love with texts, but I remember giving her some grief about it. And now I realize I do the same thing. I’m in the same room as somebody, and sometimes I’ll text them. So if this is our beloved device and we like texts for communication. Wouldn’t it be nice to seamlessly be able to text? Because the other thing, I think there’s nobody on this [00:18:00] program who likes their passcodes. I always forget my passcode and maybe, maybe you two don’t, but I certainly do. And I have to then go look it up and so on and so forth. I hate having to put in passcodes. Well with the Engaged Technologies approach. It’s seamless. There are no passcodes. You can get off of it just by hitting, No, if you want. You can get on it with a QR code or a four-digit code on text messaging and then you have information flowing at you in short drips. The other thing is we don’t like long videos. People don’t even like this answer I’m giving because it’s too long winded. People want 60sec, 90sec little drips. And that’s what engaged does at Engage Technologies. And you’ll hear more and more about it. I believe it’s going to be the future of frictionless communication.
Brad: You know Grant, before we jump to the next company, I’m just curious, I’m sure the audience is too. How do you find a [00:19:00] technology like that? Did they come out and reach out to you? Or are you just constantly because you’re so involved in industry, you hear about it, you seek them out. Which way does it go, they come to you or you find them?
Dr. Stevens: It goes both directions. In this case, they wanted to go into aesthetics. They’d already done dental and ocular and some medical stuff. And they asked around and they spoke to people in the business, in the industry, if you will. And my name kept coming up. And then they called me and I thought it was too good to be true. Challenged them to come here to LA. They came here across the street from where I’m talking to you, I’m in Manhattan Beach right now. I brought my lawyer and I brought my banker and a couple other people into the room. I wanted to hear their presentation and I frankly, was blown away and remained over a year later equally blown away. At this exciting form of communication. So to answer your question, Brad, they sought me out and that’s generally what’s happening now. But there are a few technologies I’m working with now that I heard about. And I [00:20:00] went after them because I thought, Hmm, if you could deliver molecules through the skin and get blood levels of chemicals through the skin and throw away a needle, that sounds pretty unbelievable and pretty exciting. So, you know went after that one and so forth. It’s a two-way street, Brad, but lately it’s been more, they’re reaching out to me.
Brad: Now we’ve talked about this new type of media platform. Let’s move over to cybersecurity. Tell us about Critica Security.
Dr. Stevens: Yeah. Well, first I hope that none of you have ever had a cyber-attack of the nature I had. I had a very significant cyber-attack. And yes, for all of the doubters, I owned all of the technologies you had. I had Norton, I had everything you have, but when they want to break in, they can. I mean, Microsoft had a cyber [00:21:00] attack and you think any of you have what Microsoft has? States have been broken into, hospital systems and so forth and on and on, the petroleum industry, gaming and people who have all kinds of built in protection. And the problem is with these cyber hackers and cyber attackers, as they invade your computer with a spider. That spider sits there and they have, what’s called a dwell time as its getting information from that one device. And then it moves on through your system to the other devices and it can do it through the cloud. It could even come through your Phillips light bulb, believe it or not. And it creeps around and it gets all of your information. In my case, the dwell time was 67 days. The average dwell time before attack is now almost 200 days. So it’s 180, 170 days. That means it’s sitting there and these zero time attacks. What happens, it’s been sitting there and when they attack you, they [00:22:00] don’t have a previous harmful virus that it attacks you with. So the Norton, I’m not picking on Norton. All the other devices, spot known spiders, known attackers if you will. They recognize an enemy and then they alert you. You have an enemy, but they first have to recognize the enemy. And that’s what they’re built on historical enemies, not on zero time attackers. Unfortunately, I know too much about this lately. Well I was attacked. And when I was attacked, one by one sequentially 38 computers went dark, but not before money was being transferred out of my personal bank account overseas, all of my photos were taken. Everything was hijacked and I was shut down. I was reduced to a day-timer and pencils. I didn’t know who had scheduled, who had paid, what was happening tomorrow, what was happening next hour? Imagine your world being shut down in [00:23:00] whatever job you’re in. It was terrifying. I have to tell you, I didn’t think it could be that bad. Within a week or less, I had two US FBI agents. I had a hostage negotiator and four or five other people brought by the insurance carrier that I happened to have at that time. That helped me so much. I was asked to provide over $500,000 of Bitcoins to get back some of my information. We had to negotiate that down. I spent nearly a million dollars repositioning and reprogramming everything and obtaining things. It was absolutely the worst time for my business. And thankfully we did get everything back to my knowledge and I was forever affected by the whole concept of cybersecurity. Since then, I know of two plastic surgeons that have gone bankrupt over it. I know of two or three [00:24:00] others that have been attacked. They’re not bankrupt. And now I’ve been giving some talks about it. Fortunately, one talk somebody heard me talking about it and came to me from a company called Critica. And Critica has a technology that allows early detection and early warning. Had I known within a minute that I had been attacked, I could have killed the computer, just taken it off my system, and that would have ended everything right then. My bank accounts wouldn’t have been invaded. My emails wouldn’t have been invaded. They would have ended the whole thing. I would’ve just thrown it in the trash or just destroyed it. Now, you don’t have to necessarily do that. There are other things you can do once you know your attack. There are companies that do that. That’s not the role of Critica, Critica is early detection and warning. And no, it doesn’t exist yet. But with Critica it does and they are in the University of Nevada, [00:25:00] with the gaming industry. You could imagine the gaming industry is very interested in this technology. And it’s being written now in word. And it is in another language right now, it escapes me. But I’m very interested in this technology. I’ve been asked to be on their board. I frequently am asked to share my own experiences and I’ve given you believe it or not an abbreviated version of my experiences, but I’m really excited about the future with Critica. And I think it is the first answer, because you can’t protect yourself, unless you know, you’ve been attacked. So early detection, leads to protection. So that’s what we’re looking for. Early detection and warning system.
Michael: That’s really cool. Well, as we wind up our episode today, we get to turn the tables on you Grant, because we’ve been a guest on your show before. And you famously asked your [00:26:00] guests at the end of each of your episodes to look into the crystal ball and talk about what they see in the future of aesthetics. And we want to hear what you see in the crystal ball for technology.
Dr. Stevens: Thank you. I think that one can look into the future by looking back into the past and what’s happened. And I see, an interest in non-surgical and minimally invasive procedures. And I think that’s going to continue, it’s growing exponentially. So in general, from 40,000 feet I think we’re going to see more and more development in the field of minimally invasive and non-surgical procedures. I also think there’s going to be more research and development in the field of body as opposed to face. Face will continue to advance. But we’ve made huge headway and strides in facial rejuvenation. I think we’re going to [00:27:00] see some of the chronic problems with the body approach and they will be things like cellulite, stretch marks, and skin laxity, non-surgical skin tightening. And then finally, also more development in fat reduction. It will be based on energy, I’m not sure what that energy will be. It will show a combination of things such as radio-frequency, ultrasound, radiation, excuse me, cold as in cryotherapy. And of course, lasers there’ll be other technologies. I’m aware of a few coming down the pipe right now for cellulite, that haven’t been announced. So that’s where I think the future will lie and then novel forms of communication, which leads to education. And I think COVID has taught us that in terms of looking at how much time we spend now on Zoom calls as we’re doing right now. And yet, if you had asked me about Zoom two years ago, [00:28:00] I wouldn’t have known what you were talking about. So I think distant learning, remote learning, will also flourish and that’ll be also teaching physicians and teaching physician extenders, how to do certain things. There’ll be a lot of remote learning and that’s where something like Engage will come in. Also education of patients just what’s available and patients are demanding more effective treatments with less down time. And that’s what I see happening.
Michael: Well, I think Brad was actually right, I hope this isn’t being recorded. That the second time was a charm. So it was awesome having you on again, Grant. We look forward to the third time in the future. What we’ll do next is, we will let you go, and we’ll break for commercial. And on the other side, Brad and I will talk about our legal observations on technology and health care. But until next time, Grant, thank you [00:29:00] so much for joining us today.
Dr. Stevens: Well, thank you very much to both of you. I appreciate the opportunity to be on your show. I look forward to having you back on my show, the Technology of Beauty.
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Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host, Brad Adatto here with my cohost Michael Byrd. Michael always love having Grant on with us. And man, he has so much information to provide in such a short period of time. And it really was, I thought fascinating about [00:30:00] technology’s advancing so fast, that you know, he was talking about freezing the fat or using different ways. Let’s talk about the legal impact though. Let’s Zoom In here and get in the details as to, how’s the law handle all these technologies?
Michael: Well, that’s the crazy thing. And probably the Zoom In is to just evaluate if you’re a medical practice, what are the newer technologies that you have? And take something, like even this communication system that Grant was talking about with Engage media and making sure if you have some alternative form of communication that you look at it. Do you have the right patient consents? Is it HIPAA compliant? Are you safeguarding your information? Or if you have devices, understanding are those devices considered medical or are they considered non-medical devices? Because it impacts compliance at its [00:31:00] broadest form. I’d love to hear kind of your Zoom In thoughts as well.
Brad: Yeah, I mean, so the details matter with technology and it’s not only is it a medical device and how your state views it. But who can actually then use that medical device. Unfortunately there’s a lot of assumptions that, you know, anyone can be trained to use it. It does not mean anyone can actually use it. And so there’s as much as we love industry, as Grant was saying it’s tough because in some states, someone can fire a laser, who’s not a physician or even an RN. And other states, they have requirements because it’s a medical procedure, only those medical trained, certain medically trained individuals who are licensed, can do that. So technology has allowed a lot of people to enter into the cosmetic and aesthetic world, which is amazing and wonderful. But just be really careful as you approach that and hit the pause button, get those [00:32:00] details. Cause it’d be really silly for you to spend a $100,000 to $200,000 for a machine that turns out number one, you can’t own. Or the people you were going to employ to fire off that machine, can’t use it.
Michael: Yeah. I mean, I would just end it with this butchered expressions are really funny. Butchered use of technology from a compliance perspective, not funny.
Brad: Totally agree with that. And join us next Wednesday for our show in which we’re going to discuss Technology in the medical industry again, with our special guest, Ryan Miller, the CEO of Etna interactive.
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