In Depth: A Conversation with Regency Specialties
Arizona Physician's Editor-in-Chief, John McElligott, MPH, sat down with Jason Mussman, MD, FACS, co-founder at Regency Specialties to discuss how they have become one of the most successful plastic surgery and dermatology practices in Arizona.
ARIZONA PHYSICIAN: Dr. Mussman, can you tell us the origin story of Regency? Why did it emerge?
Dr. MUSSMAN: It was always an idea of mine to transition to something that I loved, which is skin cancer reconstruction and transition away from trauma. Trauma is very interesting. But it’s a young man's game. You can't keep up seven days a week. At that point, I had worked three years in a row every single day. Then I met Dr. Betty Davis, who is number two in the nation as far as dermatology and skin cancer treatment and reconstruction. And we realized the synergy and increase in patients we could help.
ARIZONA PHYSICIAN: How did the meeting come about? Did you know about each other?
DR. MUSSMAN: I wasn’t the first person in the nation to combine dermatology and plastic surgery. I had a building being renovated. I interviewed other dermatologists and then Dr. Davis called. Of course, I knew who she was. I pulled my car to the side of the road and said, “I’ll meet you anytime.” We met for dinner that night and hit it off right away.
Regency Specialties by the Numbers:
Founded in 2017
5 Physician Associates
2 Surprise locations and 1 in West Phoenix
Dermatology services include:
Skin cancer detection & prevention, skin cancer treatment, cosmetic & medical dermatology
Plastic surgery services include:
Face, breast, body, reconstructive, and pediatric
Other services include:
Matisse Med Spa that includes aesthetic injections, facials & peels, facial waxing, lasers & devices
Visit Regency Specialties at regencyspecialties.com
ARIZONA PHYSICIAN: Sometimes, creating a larger practice can be a merger of equals or an imbalance of the workload and management. What's the perspective the two of you take for the practice in your interactions with one another and also the balance of patients you see?
DR. MUSSMAN: The balance of patients is probably 90% dermatology and 10% plastic. A lot of our dermatology is not just skin cancer. We have about six dermatologists now and several mid-levels who extend their work. They have specialties in allergy and immunotherapies. And then, I think you can tell as soon as you walk in that we work from the patient backwards. We want to measure everything against the quality of care, patient experience, and patient satisfaction with the process. Our success just kind of follows that. As opposed to our main competition in the field that usually works from the financial outcome towards the patient.
ARIZONA PHYSICIAN: How? Please share some examples of how that plays out.
DR. MUSSMAN: From the first moment we met at dinner, Dr. Davis and I decided that we would always have a live person on the phone. Prompts are cheaper. They're more economical, but no one likes prompts. We have 15 people answering the phone, including the call center, which she tried to set up at her last practice for five years and was shut down. And she was the head of the entire Banner Medical Group before she came here.
ARIZONA PHYSICIAN: What happens when patients call after 5:00 PM or whatever your closing time is?
DR. MUSSMAN: They can get a provider 24 hours a day. An actual provider not an MA or a nurse. There's one for dermatology and one plastic surgery.
ARIZONA PHYSICIAN: You mentioned you were working every day for several years. What's it like now?
DR. MUSSMAN: I’m now down to 80 hours a week, which is like a like a vacation compared to what it used to be. I used to eat 50% of my meals at QT gas station. I slept at every single hotel in this town. I’d sleep for three hours to go back to work. Sometimes, I wouldn’t be home for days. I was the number one trauma physician in the state.
ARIZONA PHYSICIAN: That must have had an impact. Outside this complex you built, your daughters are permanently enshrined, and you’ve named the area after them. What has scaling back given to you as a father?
DR. MUSSMAN: Well, the naming was because my daughter got cancer. She's in remission now and doing well, but that was a shot across the bow. I knew I needed to spend more time at home and, you know, I guess I just always thought I had more time. You're one person before your child has cancer and you're a totally different person after. We immediately started slowing down the trauma and then I hired people to help me with it, but that didn't really work out because people just hate taking call. It's a grueling life. I said let’s forget it. I shut down the trauma and it ended up being a good thing, because now the main work has no distractions, and it's been a period of growth just focusing on outpatient dermatology, plastic surgery procedures, and a lot of our cosmetic has really picked up too. And we've added vein treatment recently.
ARIZONA PHYSICIAN: Your principles for the practice stood out to us. It's helpful when organizations understand their mission, have a vision for the future, a game plan to get there, and then act on it. But the principles really shape things. Which one or two are the most important principles to leading a successful practice?
DR. MUSSMAN: That's the thing about principles. You can't really choose just one or two. But I think the key to growth at Regency is the decentralization of the leadership. A lot of our leadership started with us at other jobs. Similar to Apple and the Steve Jobs autobiography, he talked about hiring MBAs from the outside. I went through the same process, and it was a complete disaster. Then, we hired from the inside. Now their families live a vastly better life. At the same time, they go out in the community and they’re liaisons, ambassadors for Residency. And it's that personal touch. Hundreds of more patients find the right doctors, find the right care, and we pride ourselves on availability. Many plastic surgery and dermatology practices take pride in the fact of having a wait list of three months - it must mean they're so great. We have always fought against that as hard as we can. You get same day appointments with availability for emergencies. Otherwise, we try to get people in under three weeks.
ARIZONA PHYSICIAN: Is that what you market, to say, “We are available”?
DR. MUSSMAN: We try to. We can walk into a family medicine office and say you can trust us with your patients, view us as an extension of your practice. We're here to help. Then they'll try and if you’re like, sorry, we can’t get you in for three months, that’s it. They lost your number forever. We have a meeting every Tuesday at 6:30 in the morning. Everybody's invited, all the providers, all the managers are on the call and about half the staff jumped on the call. They’re on the way to work. You can hear kids in the background. And it’s a great way to recenter. We call it the One Vision call. We run through all of the departments and we have essentially no meetings except for that 15 to 30 minute meeting each week.
ARIZONA PHYSICIAN: Wow, that probably helps with retention. Let’s talk about some of the hard times. What would you say are some of the most difficult hurdles to growing a practice today?
DR. MUSSMAN: The hardest time was when my daughter got cancer because I was so depressed, I could hardly breathe. Just crushing depression. That was three weeks after we opened, she was diagnosed. Dr. Davis was getting offers daily for about five times more than what I was paying her. Because that’s who she is. She's an incredible person. And so, she called me, and she said, “Don't worry, I'm not going anywhere. I'll build the practice. Just take care of your daughter.” And she never left.
ARIZONA PHYSICIAN: She carried a lot of that load while you needed time.
DR. MUSSMAN: She did. I'm eternally grateful for her. Eight months we were in the hospital. Eight months! That was definitely the hardest time in my entire life, which had to be the beginning of the practice. Then, we had significant turnover during our commitment to trauma. Turnover has gone to zero since we ended trauma. But I just had fought so hard to develop that practice for so many years that it was I guess I had an emotional attachment to it.
ARIZONA PHYSICIAN: It's the founder’s curse. You can't let it go.
DR. MUSSMAN: COVID initially was a problem, but we never shut down. It ended up being a 30% growth because all the hospitals canceled their contracts. We were able to bring in two or three great plastic surgeons during that time. We could just make an offer on the spot. That's the nice thing about it. They can just call me. I'm the decision maker, so I don't have to run it by committee. You can just negotiate the contract and sign it.
ARIZONA PHYSICIAN: One final question, what motivates you to wake up and care for patients? Is it management or individual patient care?
DR. MUSSMAN: On the management side, it’s a tremendous burden and responsibility that I take very seriously to be a steward for the company. I make sure we see what's on the horizon so that a lot of people are taken care of – not just their children, but their families, like their parents who might need financial help and so the impact of this company is vast. Hundreds of people are affected every day. I try to make sure we stay on the right track. Nothing makes me happier than who are super committed. To some, it’s a paycheck and I don't blame them for that, but the people who don’t see it as a paycheck, those who bleed our colors of black and gold. I like seeing them prosper tremendously within the company. On the patient side, the nice thing about doing less sophisticated surgery than the trauma surgery is they’re awake. Every week, I learn something about the community, about myself, from what they say because most patients are elderly. Some of them have really built the nation, and now they're retired and in Surprise and Surprise is kind of a collection of kind of go-getters, people who still want to remain active even though they're getting up there in age. They’re playing pickleball all the time. So, these are really cool patients. But taking care of patients on a whole, after you've done 10,000 or 15,000 surgeries, I start looking at metrics like complication rates, satisfaction rates. These kinds of things make me happy now. It's hard to get too excited about the surgery when you've done it 10,000 times. That's just the reality of it. But we are adding new things, which is super fun. The vein work has been exciting because it's just a new skill and we did some training in Georgia for that. We're always growing, always learning new skills, and refining old skills. We always listen. You know, I think Visa has said the customers will always tell you when something is wrong and that's where the call center came from. Sometimes people say I was on hold for five minutes. And then it got to be two or three people a day saying that. I did some secret shopping and then I also had third parties do some secret shopping. I hired people to make some calls. And I learn we're losing 30-40% of people on hold. Within a week we got a whole call center set up and now we monitor daily how many people were sent to the overflow. Now, I can’t remember the last time it was not zero and we get roughly 1000 phone calls a day. We pride ourselves on that. Just quality of care from the beginning all the way to the end. We have about 20 billers here and that's a whole thing, too, because the deductibles are high. Before patients have a procedure, we try as hard as we can to educate about cost. That takes several phone calls, letters, counseling at the front. We can tell patients what their responsibility will be so there's no surprises. People hate surprises. They get told five different times, including in writing, what their financial responsibility will be, and if they can't afford it, we do have a credit. And if they can't afford the credit, then we have charity care, so we can still get them help. It it’s $1, then it’s $1. Either way, we get them help and we don't turn anybody away.