A packed dermatology market does not reward vague promises, it rewards clarity. We sit down with Anshul Meshwari, Managing Partner at Balanced Skin Dermatology and Aesthetics, to unpack how a modern clinic earns trust, delivers better outcomes, and grows without sacrificing the patient experience. His path runs from biomedical engineering and medical technology commercialisation to consulting across pharma and life sciences, and now to scaling a specialist dermatology and medical aesthetics practice in Newport Beach, California.
We dig into what makes Balanced Skin different: a deliberate focus on lasers for darker skin tones, where safety, device choice, and protocol matter deeply for avoiding hyperpigmentation and other complications. Anshul shares how culture becomes a growth engine, from writing a vision statement to paying above market and training for great “people interactions”. We also cover the practical balancing act of demand generation versus capacity, plus the marketing foundations many clinics underestimate: differentiators, websites that actually say something specific, referrals, and visible authority.
The conversation turns to trends shaping aesthetics and dermatology strategy, including AI in clinic operations (note-taking, organisation, imaging), the growing impact of GLP-1 weight loss on patient needs, and the rapid advance of laser technology into medical conditions as well as cosmetic concerns. We close on entrepreneurship in healthcare, cash pay versus insurance trade-offs, and a vision for a national model of care for diverse skin tones. If you enjoy this, subscribe, share it with a colleague, and leave a review so more clinicians can find it.
Guest Biography
Anshul Maheshwari is Managing Partner of Balanced Skin Dermatology & Aesthetics, a Newport Beach, California practice specialising in dermatology, medical aesthetics and laser treatments for diverse and darker skin tones.
With bachelor's and master's training in biomedical engineering, alongside experience in entrepreneurship, innovation strategy and healthcare consulting, Anshul has built a career at the intersection of medicine, business and commercialisation. His experience spans medical technology, pharmaceuticals, life sciences, corporate strategy and healthcare operations.
Today, alongside growing Balanced Skin, Anshul advises medical professionals and small healthcare teams on practice development, differentiation, marketing, operations and entrepreneurship. His broader mission is to empower clinicians to build sustainable practices that give them greater autonomy while maintaining a strong focus on patient outcomes and experience.
At Balanced Skin, Anshul and his team are working toward a larger vision: creating a nationally recognised dermatology practice specialising in the treatment of diverse skin tones using advanced laser technologies.
Links
- Website: https://www.balancedskin.com
- LinkedIn: https://www.linkedin.com/in/anshulmaheshwari/
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:00):
So welcome to another episode of Voices in
Health and Wellness, where wespeak with healthcare leaders,
entrepreneurs and innovators whoare shaping the future of
healthcare.
Today's guest is AnshulMaheshwari, managing partner of
Balanced Skin Dermatology andAesthetics.
Balanced Skin is growing agrowing dermatology and medical
aesthetics practice, andalongside that, Anshul has built
extensive experience advisinghealthcare businesses on growth,
(00:22):
operations, and strategy.
That combination gives him aunique perspective on delivering
outstanding patient care andbuilding sustainable healthcare
organizations.
So with that, Anshul, I'd loveto welcome you to the show.
Thank you very much indeed forjoining us this afternoon.
Anshul Maheshwari (00:36):
Thanks for having me, Dr.
Remind.
Dr Andrew Greenland (00:38):
So I wonder if we could um start with your
background, if we may.
Would you mind giving a littlebit of information about your
background and your journey andhow you got involved in
healthcare in the first place?
Anshul Maheshwari (00:47):
Yeah, no, definitely.
So taking you back, mybackgrounds in biomedical
engineering from training,right?
A bachelor's in biomedicalengineering, also master's.
Alongside that, I was alsodoing a fellowship in
entrepreneurship and a minor ininnovation management and
strategy.
So sort of always had an eyefor medical technology and how
to bring it to the market.
Right after my education, Ispent about a couple of years in
(01:10):
a medical startup incubator upin Boston working on
microfluidic chip technology fordiagnostics.
So again, heavilyscience-based, but also with an
eye for, hey, how do youcommercialize this thing, right?
How do you bring it to market?
And that led me down a pathreally to understand, hey, look,
you know, innovation inmedicine is great, but if you
can't bring it to the market, ifyou can't commercialize it,
(01:31):
then you know it just stays inthe lab, right?
And so I ended up uh uh workingwith a consulting company for
about uh 12 years, working witha big pharma, medical device,
life sciences, uh healthcarecompany across the entire value
chain, right?
So from um product developmentto clinical development to um
you know corporate strategy,commercial operations, uh you
(01:53):
name it, you know, I've seen it.
So um all that sort of reallywent into me thinking further
about my future on, okay, youknow, I understand the science.
I sort of now understand thebusiness, right?
Where can I sort of take thisto do something of my own?
And uh, you know, the decisionwas made uh, I want to say five
years back when I ended upjoining a pharma company, Abvi,
(02:14):
uh, in the meantime alsoencouraging my wife to start her
own practice.
And so, in parallel, while Iwas working at the pharma
company on corporate strategy,sort of understanding how you
know pharma and life scienceswould be five to ten years down
the road, um, you know,alongside I was sort of starting
this journey with my wife onstarting a medical practice.
Um, all that came to fruition,I want to say, just about a year
(02:38):
or two ago when we launched thepractice, it's doing well, and
I left my corporate job earlierthis year to focus full-time on
scaling and growing that.
And of course, working onadvisory projects on the side.
Dr Andrew Greenland (02:48):
Amazing.
So, for the listeners whohaven't come across balanced
skin before, can you give us akind of an insight into the
practice itself?
Anshul Maheshwari (02:55):
100%.
Yeah, balanced skin dermatologyis a dermatology and aesthetics
practice of Nicole Beach,California.
The Mike Alpha MedicalAesthetics, I've got a little
SLA.
Um, we uh have been around forabout two and a half years.
Uh we do quite a few differentthings in dermatology and
aesthetics, right?
So we do energy based devices,lasers, we do injectables,
(03:17):
right?
Toxins uh uh biostimulators, andthen we do a full uh set of
medical dermatology procedures,uh, and then also excision and
surgery.
So a range of range of things,but we do specialize very
specifically in lasers fordarker skin tones.
Um, we found that that was anunaddressed uh uh unaddressed
(03:38):
area in the market, which um youknow has worked really well for
us.
Dr Andrew Greenland (03:42):
So you've obviously found that niche.
Um, is there anything else thatmakes your approach of balance
skin different from you knowyour competition or people in
the neighborhood?
Anshul Maheshwari (03:51):
Definitely, right?
I mean, you can imagine when Isaid Newport is the Mecca for
medical aesthetics, we havehundreds of you know,
dermatology, plastic surgery,med spa type uh practices out
here.
And so how do you differentiateand stand out in this crowded
environment, right?
And tell you a little bit of astory where my wife used to work
at a big hospital organizationwhen we moved out here in
(04:13):
California.
And she sort of had therealization, okay, well, she
wants to start her own practice,but again, you know, the the
sort of the paperwork, thecompliance, the sort of
day-to-day operations wasintimidating for us, uh, for
both of us.
And uh, I advised her to firstgo work at a smaller practice to
really understand what thatwould entail.
(04:34):
So she worked at a practice inNewport Beach, and she soon
realized that, you know, all thepatients that were coming in
uh, you know, were coming in formedical concerns but also
cosmetic concerns, and the thefolks who are at the higher skin
type levels, right, from skintype four onwards, darker skin
tones, were being basicallyshuffled around these practices
saying, hey, look, these lasersaren't here for you.
(04:55):
If they did the laser, theywould get hyperpigmentation,
hypopigmentation.
And so my wife really sort offigured out which lasers would
work well for this population.
And she developed a protocol umto take it safe and effective
for this population.
And uh, you know, we spokeabout that quite a bit and
realized, hey, look, there'sthis is an unaddressed uh gap in
the market.
Let's sort of have aspecialized clinic around
(05:17):
addressing conditions for thisspecific subpopulation.
And so that gave rise to uh uscoming up with this concept and
and create a balanced skin,where again, I would say close
to 70% of our of our patientpopulation is Asian, South
Asian, Hispanic, AfricanAmerican, right?
So uh we we definitely havefound that niche and people fly
(05:38):
from all over the country tocome see uh Dr.
Paul.
Dr Andrew Greenland (05:42):
Very interesting.
So you told us a little bitabout what you do about the
skin, the your kind of um targetmarket, as it were.
What about the um the cultureyou've built in your team?
Tell us about that.
Anshul Maheshwari (05:53):
Yeah, no, that's a great one.
And um, you know, the the funnything here is right, when I
speak to a lot of doctors whoare looking to start their
practice, the questions alwayson top of their mind is okay,
well, how how will I beprofitable?
You know, how do I find thereal estate?
Very practical sort ofoperational questions.
But I encourage people to firsttake a step back and really
write out their vision for thispractice, right?
(06:15):
All medical practices aren'trun the same.
You make uh you can make it uhhow you want it to be made.
And so um, you know, Iencourage people to write out a
vision statement.
And so, similarly for us, whenwe wrote out our vision
statement, we clearly laid outthe type of patients we'd love
to see in our practice, the typeof employees that we'd like to
be in our practice, right?
And within that, we sort ofwrote about you know integrity
(06:36):
being a big part of it, uh,being happy at work, right?
And finding it a sort of asecond home, uh, you know, a
home away from home.
So, how do we incorporate thoseelements into the practice and
day-to-day operations was wherewe uh really focused a lot of
energy on when we're working,and that is pay dividends,
right?
Our our our employees come in,they they feel comfortable, uh,
(06:58):
they feel that they're backed byuh not only support from the
team here, but also are beingled by a doctor who really
believes in what she does, who'sa great leader.
And so those sort of things arebought up not only in our
meetings, but in our day-to-dayoperations.
Um, alongside that, we have aspecial space for them where
they can sort of uh you knowrecharge.
(07:19):
We have uh you know, snacks, wehave food, right?
So those are some sort ofauxiliary items that also make
the place more comfortable andwelcoming for them.
Um, and then of course pay,right?
We we pay them above market uhrates.
So I think all those thingscombined uh do help with
retention and um staffsatisfaction.
Dr Andrew Greenland (07:36):
For sure.
And I think you've built arelatively lean team, but you're
obviously continuing to grow.
So how do you balance that out?
You know, you've got a leanteam, you're trying to deliver
excellent patient experience,uh, but you're trying to grow.
So how does that all kind ofstuck up?
Anshul Maheshwari (07:50):
It's uh it's a balancing act, right?
I think I think the big the bigbalancing act is okay, are you
generating enough patient demandto justify having a larger
team?
But on the flip side, when youdo have a larger demand, do you
have the capacity to serve thosepatients and provide the same
experience and outcomes, right?
So uh what I've learned throughthe growth of Balance Gin is
(08:12):
build the capacity first, right?
I think um in terms ofgenerating demand, we have
figured out some really goodlevers to really bring more and
more patients in.
But uh you don't want to be ina situation where you have a lot
of patients come in and you'renot able to service them.
So um what the way we figuredit out is is we we build the
capacity, right?
We have new staff, we have anew dermatologist on board, we
(08:33):
have mid-level providers, butultimately we can turn on the
faucet on the marketing side,whether it's um you know through
paid ads or through socialmedia or through um you know
other channels, we're able tobring that demand in.
So it's a balancing act, butuh, but um it's it's one that
you sort of have to stay on topof um you know pretty much every
day.
And um I you know I don't wantto always say, like, hey, we've
(08:55):
completely figured it out, but Ithink we're we're heading in
the right direction for goodorganic growth.
Dr Andrew Greenland (09:00):
Sure.
And you mentioned organicgrowth just then.
So what is it you think thatsmall specialist practices um
like yourselves can doparticularly well compared with
larger organizations?
Anshul Maheshwari (09:10):
Yeah, yeah.
Look, for a smaller practice,um, you know, really a few
things are very important,right?
So understanding yourdifferentiating factors, right?
I'll give you an example forus.
And I did mention the skin ofcolor being a big
differentiating factor for us.
Having said that, you know,we've also laid out very clearly
that all our doctors are highlycredentialed and experienced,
(09:31):
right?
So that needs to be displayedon your website, on your social
media channels, right?
Everywhere saying, hey, look,we have credentialed
board-certified doctors onboard.
Um, we specialize in skin ofcolor, we can do safe and
effective treatments for thatpopulation.
Uh, we also have an invitingspace with great experience,
right?
And I can go a little bit moredeeper into creating that
(09:52):
patient experience.
And lastly, we want us to beseen as a center of excellence,
right?
So, what I mean by that is wealso host trainings,
conferences, we do productlaunches in our clinic, right,
to really be seen in thecommunity as at the forefront of
dermatology and aesthetics.
So those were ourdifferentiating factors.
What I do when I work with alot of doctors who are looking
(10:12):
to start their smaller practicesis really talk them through
what do we think woulddifferentiate them, right?
And so I think the first stepis really, like I said, laying
out your vision and yourdifferentiating factors and then
building on those.
And so what I mean by that ishaving all the right channels
activated.
Whether it's uh uh you know asocial media page where you need
to have some presence, right?
(10:32):
In this day and age, about 80%of marketing is done through
socials.
So you have to have presence onthere, right?
Uh that doesn't mean you needto generate you know thousands
and thousands of views andfollowers, it just means having
a presence.
So when people are looking youup, they're not only Googling
your Google Business page, butthey're looking at a social
media page, seeing how you talk,seeing, you know, getting
familiar with your style, um,you know, how you um address
(10:53):
conditions or or talk topatients.
And then lastly, I would sayum, you know, ensuring that
there is a good mechanism forreferrals and word of mouth,
right?
So you want to have a goodnetwork of doctors around that
are that know your businessexists, that you're sending
patients to and they're sendingback, but also with your
patients when they visit, theyhave something to talk about
(11:13):
when they when they go back totheir family and friends, right?
Whether it's great outcomes orthe experience they had or the
interaction they had withpeople.
So uh those are the littlethings that that we would focus
on to really sort of make itsticky for your practice and
help with that organic growth.
Dr Andrew Greenland (11:27):
Thank you for sharing that.
It's really interesting.
So you're in a very rapidlychanging speciality niche.
Dermatology and aesthetics isseems to be moving at an
incredible pace.
What are you noticing in termsof trends right now, which are
making an impact on yourpractice?
Anshul Maheshwari (11:44):
Yeah, no, this is right up my alley.
Like as I mentioned, I workedon corporate strategy with Algan
Aesthetics, and there we werealways looking at sort of what's
five to ten years out.
I'd say the big ones, you know,of course, in everyone's mind
is AI, right?
And I can talk a little bitmore practically how that uh
currently um looks today atdermatology and aesthetics
practices and what it could looklike in the future.
(12:05):
Um, you know, there's a rise ofGLP once, right, which is
really increasing that patientpool for medical aesthetics.
And uh I would also say, youknow, lasers in general, where
they're able to addressconditions that were previously
being addressed by, let's say,topicals or orals.
Um, you know, a lot of laseradvanced technology is now being
(12:26):
able to treat a few medicalconditions, not only, not only
cosmetics.
So starting with AI, I mean,um, that's an interesting one,
right?
Uh, where you know, we we arein the mode of let's start
learning and let's startimplementing where there might
be efficiencies to be had, butagain, that sort of human
interaction is still intact,right?
(12:47):
So, so let me let me tell youour perspective at the moment
with AI from a very practical uhin-clinic type uh type um
setting.
Uh, you know, I still think uhyou know AI has a role to be
played on the on the consumer,on the patient side, but I at
least our clientele, what I'veseen, prefers a human on the
(13:09):
other side of the interaction,which is fine, right?
AI is getting better and betterat sort of booking appointments
and automation, and and andthat's great for high volume
practices where you're trying toget a lot of you know people
through the door for a conciergespecialty type practice that's
sort of elevated patientexperience where you're talking
to a human and very customized.
(13:29):
Um, I'd still say AI has a fewmore, you know, uh, I don't want
to say years, I don't know howlong it would take, but has some
ways to go.
Um, having said that on theback end, right?
So, in terms of organization,right?
Uh we have a bunch of filesthat our patients upload and we
use AI agents to organize them,right?
That that increases efficiency.
(13:49):
Um, we use this one tool fornote-taking, right?
So we we we take a recording,it summarizes the the patient uh
consultation, and it puts it inthe fields within your EMR
systems.
So those are reallyhigh-efficiency AI tools that
help with um operations, but onthe patient engagement sign,
we're still yet to sort of uhimplement that uh you know, once
(14:13):
we find something that'seffective.
Where it's heading, I mean, inthe dermatology space, it's uh
it's highly, highly uhinteresting just because when
you bring the imagingcapabilities with AI, then
diagnostics becomes veryinteresting.
So currently we have a tool inthe in the in the clinic where
you know you put your face inthis uh imaging device, it takes
(14:33):
eight different photographs,right?
Um, you know, skin pore size,uh skin damage, uh
hyperpigmentation, right?
It does a range of uhphotographs and it gives an
output on where you would fitwithin um your uh population
within your age group.
So it tells you, hey, look, youhave higher than normal
sunspots, or you know, yourwrinkles are on the lower side,
(14:55):
etc.
So that combined with AI couldbe highly effective in in both
the consultation process withthe doctor, right, where there's
more quantitative informationbecause a lot of medical
aesthetics is qualitative,right?
And there are patients outthere that want quantitative
information.
So uh so that's that's one onearea.
And um, you know, uh on thatside, you know, it also feels
(15:17):
like the patient has somethingtangible they're taking home
with after the consultation.
But that's really where I seeuh more sort of deeper use of AI
in aesthetics.
Um that's AI.
I can go into GLP ones and alsouh uh you know lasers in
general, unless you want to go alittle bit deeper into AI.
Dr Andrew Greenland (15:36):
No, that I wanted to get to kind of the
general overview.
So AI is really helpful becauseit's talking about what you're
doing from an operational pointof view to make things easier
and more efficient.
I'm still so interested in someof the treatments and things on
the cards.
So maybe you could talk to thethings like the GLP ones as
well.
Anshul Maheshwari (15:50):
For sure.
I mean, with GLP1s, they'reeverywhere now, right?
I think I think um, you know,uh they not only are impacting
both the sort of metabolic typeconditions, chronic conditions,
but there's been uh you knowresearch in cardiovascular, even
addiction, where GLP1s arecreating uh an impact in those
populations.
So it's a very interestingdrug, uh at least in in my
(16:14):
perspective.
But on the flip side, right,like the after effects of GLP1s
is creating a pool of patientsthat are now looking for medical
aesthetic procedures, right?
So on the extreme end, you havefolks that undergo rapid weight
loss and they have loose skin,which needs plastic surgery
intervention to sort of get thatum that skin laxicity under
control.
But on the on the other side,right, on sort of um, you know,
(16:37):
some of the after effects you'reseeing is higher wrinkling,
right?
Some of you're seeing skinquality decline.
Um, you're also seeing a bigpool uh of patients that are,
you know, originally they werenot that focused on their
appearance, but after losingweight, now they're more and
more focused on theirappearance, right?
So that's generating apopulation that's funneling into
(16:58):
medical aesthetics.
And so what I recommend for alot of doctors in this space is
uh keep an eye for in during aconsultation to definitely ask
those questions and see whattheir broader goals are, right?
Yes, weight loss might be oneof their goals, but are they
looking at sort of after effectsthat are happening after GLP1s?
Are they not focused on otherparts of their body?
(17:19):
So uh at least in our clinic,we're seeing a steady uh stream
of patients coming from GLP1s.
Uh, so that's definitely agrowing, growing population and
something to look out for.
Um, lastly, with lasers, Imean, this is an interesting
one, right?
I was um, you know, been I'vebeen going to conferences, uh,
you know, laser conferences forthe last three to four years,
(17:42):
and every year I see new lasertechnologies that are not only
treating more sort of cosmeticconcerns, whether it's you know
spots, acne, scars, but now youhave lasers that treat medical
conditions.
So like even acne formation oracne, uh cystic acne, right?
So you have lasers that youcould treat active acne with.
And uh where it's heading is isyou know, medical conditions
(18:04):
generally they're treated bytopicals or orals.
Uh, you're seeing energy-baseddevices being able to address
those conditions.
Um, why that's interesting tome as a practice is it's a
capital equipment cost, right?
You buy a laser, but you canuse it multiple times.
Some of them have consumables,some of them don't, versus using
(18:24):
a topical or an oral, right?
Either, you know, uh yes,you're seeing, you know, getting
getting paid for theconsultation, but um, you know,
if you're buying those products,you're seeing very thin
margins, right?
So so at least from a practiceoperations perspective, lasers
seem pretty pretty interesting,but also the outcomes they're
achieving are on par by um youknow with with orals and and
(18:47):
topicals.
Um so three very interestingfields to to you know stay on
top of, and and I know we as apractice are definitely gonna uh
keep our pulse uh on the onthese three um advances.
Dr Andrew Greenland (18:59):
Thank you.
What about um patientexpectations?
How have they changed over yourtime in Balanced Skin in terms
of what they're kind ofexpecting from a practice or
expecting from your clinicianswhen they come through the
doors?
Anshul Maheshwari (19:10):
That's a great question.
Um, you know, patientexpectations are changing, and
the way I sort of um measurethat, right, has been through so
in the US, there's somethingcalled the triple aim in
healthcare.
A lot of big healthcareorganizations, uh, you know,
insurance companies, they usethis framework where they have
(19:31):
three buckets that they look atto really understand the value
the patient is getting, right?
And well, how I know that'schanging is because now they're
now that they're up to like fiveor six or seven, you know,
things that they're looking at.
So patients are expecting moreand more out of their provider,
out of their healthcare system.
Um, having said that, I stillthink the three are the main
(19:51):
focus, and I'll go over that,right?
So the first one beingdelivering the outcomes, right?
The patient is coming to you tosee outcomes, right?
Are you able to deliver theoutcomes?
Are you building confidence fora new patient that they will be
able to achieve the outcomesthat they expect from you?
So that's the core number oneexpectation from patients.
The second expectation is issort of its cost, right?
(20:14):
If you look at the hospitalorganization, a lot of times, at
least in the US, a lot of themare privatized systems.
So cost coming out of thepatient pocket is one that's uh
that's a concern, right?
And then of course the cost onthe broader healthcare system.
The way we see it in smallerpractices and cash-based
practices is value for money,right?
Do the patients see value forthe money they spent in their
(20:36):
clinic?
And the last one being patientexperience, right?
So patient experience, how theyfeel when they enter the
clinic, when they leave theclinic, what sort of impression
have you left on them?
And so for each of them, right,um, I have a very, very um
strong framework I use to ensurethat I'm addressing these three
needs for each patient.
So the first one, confidenceand outcomes.
(20:58):
I want to make sure thedoctor's credentials are very
apparent everywhere, right?
Whether it's you know uhcertificates in the clinic,
whether it's on the website,whether it's on their social
media page, I want to build thattrust by indicating to the
patient that the doctor ishighly trained and experienced
in their field.
(21:19):
Second one being before andafters, right?
So at least in our in our field,you have um what the patient's
condition was before thetreatment and what the condition
was after the treatment, andyou make sure those are on
display again, and and this iswhat the patient can expect.
That also builds trust andconfidence in their outcomes.
The third one being uh again,sort of having doctor, a good
(21:42):
network of doctor referrals,right?
When a patient hears fromanother doctor that, hey, I'm
referring you to Dr.
Paul at Bounce and dermatology,that holds a lot more weight
than them doing their ownresearch.
So having a good referralnetwork is important.
And lastly, authority, right?
The doctor needs to buildauthority, whether, like I said,
there speaking at conferencesthey have a social media channel
(22:03):
where they're talking about thethe medicine that they're
practicing right they're doingpodcasts like these right so
building some sort of authoritybecause people are searching you
up before before they come seeyou and that takes care of your
confidence and outcomes bucketsecond one value for money I
won't go too much in detailthere right because it's not
applicable to a lot ofhealthcare organizations but
really um you know that's whereyou need to figure out okay well
(22:25):
your patient population thatyou're looking at um what can
they afford right what is thethe sort of treatment how much
uh you should price it and sothose are the things around
value for money and of courseyou're delivering the outcomes
where the patient is satisfiedum the experience one again
there are three things that gounder underneath experience one
being their people interactionsright so every interaction they
(22:46):
have with the person frompicking up the phone to going to
the front desk to speaking withthe doctor that needs to be a
pleasant interaction the peopleinteraction is very important
and so again you do training tomake sure that your staff is
well trained to deliver that uhthat experience the second one
process so process needs to beseamless whether it's uh making
it easy to check in online youknow coming in and and taking
(23:09):
them to a room uh it all thatprocess needs to be seamless and
happy and sort of um withoutany kinks and the last one being
is the perception so the fivesenses when the patient enters
the clinic the five senses needto be addressed what I mean by
that is the place should looknice tidy clean you know
pleasing to the eyes shouldsmell nice you know maybe
(23:31):
there's refreshments for thepatient or some water right so
you look at all the five sensesand how do you address those
five senses in a pleasant mannerthat takes care of that
perception bucket.
So a pretty long answer but asyou can see I've really thought
a lot about how to deliver onthose patient needs and again
how they're changing and and uhyou know how we're evolving to
(23:52):
address those needs at the asthey change.
Dr Andrew Greenland (23:55):
Thank you a very comprehensive answer.
It's gives us a lot of and foodfor thought over you know
enhancing the patientexperience.
So thank you very much forthat.
So as well as doing your workin balance skin you do sort of
healthcare consultancy what arethe kind of things that you're
helping clinics with in yourkind of wider work and
consultancy in the health sectorno thanks for that question
because um like I said I've beenconsulting with big companies
(24:17):
for a while but now I'm sort ofventuring out on my own.
Anshul Maheshwari (24:20):
And you know while I do some projects with
the bigger companies I think alot of my time and energy and my
mission really is to work withindividual medical providers or
small medical teams to reallyget them more excited about
entrepreneurship and empowerthem to really seek this path as
a viable path for doingmedicine.
(24:41):
And so you know my missioncomes from the fact where you
know practicing medicine isn'tthe same as it used to be 10 to
15 to 20 years ago right a lotof my network consists of
medical professionals and theway they talk about how medicine
was practiced in the day wherethey had more autonomy they
could practice the way theywanted to there was not a lot of
um I don't say oversight butnot a lot of um hindrances in
(25:05):
their uh um interactions withpatients that has completely
changed today right there's alot of paperwork that takes
place today um medicine ishighly regulated right which is
which is again you know for forgood reason but also sometimes
it hinders uh the patient um uhexperience and also uh uh you
know the outcomes the patientcan can can see so so
(25:26):
essentially I've realized heylook doctors need to sort of
take back medicine right againbeing a little uh uh provocative
here but take back medicinefrom sort of the private equity
and the the privatized playersin the market that's especially
in the US here and the way uh Isort of do that is I'm here
someone who can help younavigate the business world
(25:48):
right I think for a lot ofdoctors they hear business
finance spreadsheets and feelscary and hairy for them and a
lot of times I give themreassurance saying hey look
business is actually commonsense okay you're a doctor
you've had uh highly uh you knowcomplex scientific training uh
business is really just twothings okay business is revenue
(26:10):
minus cost equals profit andunderneath that are a few things
that go right so volume timesprice and so so if you just
focus on that top level equationthat's the the the mathematical
scientific part of business theother side of business is
people you know how well do youwork with people you work with
patients you work with yourstaff you work with your
(26:31):
partners your vendors right soif you're able to do that part
which is the common sense youknow revenue minus cost equals
profit and you can work withpeople that's what business is
about right a lot of people inthe business world they they
muddy the waters with lingo andthat's where I come in I help
them sort of navigate that thatworld where you know a profit
and loss statement is isactually a pretty simple concept
(26:54):
um and in that um in thatregard I've helped about six
practices start up and nowthey're up and running you know
smooth.
I have two other projects thatare on the way right now
alongside that I'm working withthree professionals to help with
their uh personal brandingbecause uh you know if you're in
the business of medicine ifyou're in the business period
(27:14):
you need to have presence ofsocial media so um those are a
few things that I've beenworking on and and I think um
I'm I'm I'm excited to see moremedical professionals uh being
empowered and excited about uhrunning their own business
amazing and as part of that workare you trying to make those
practices less dependent ontraditional insurance models
(27:35):
what's your kind of take on thekind of the the weighing up
between you know cash pay versusinsurance in the US no that's
that's a great one um look atthe end of the day when you have
so many players in thehealthcare ecosystem right um
you know redundancies arecreated and costs can go up and
you know as just that's thenature of if you introduce
(27:56):
complexity there's morehandovers more time more costs
so uh if a transaction canhappen directly between a
service provider and a you knowconsumer or patient uh you know
why don't we sort of strive forthat right that's sort of my uh
you know one of my goals and uhcash pay I feel like you know is
(28:19):
is trending right of coursethere's some you know uh
services that are not covered byinsurance and those are cash
pay but now more and more as Ispeak to professionals they're
providing the cash pay option topatients that can completely
omit their insurance provider umand the way people are able to
do that they even have paymentplans now right so instead of
(28:40):
sort of paying up front you'repaying over a period of time
which allows the patient to paycash um the benefits of that are
of course you know you'redirectly working with the
patient you're sort of you knowmaybe you could reduce costs
because sometimes the insuranceproviders actually have higher
costs uh when they're providinga service so you can technically
have a lower patient cost forthe patient um you're seeing the
(29:01):
money right away right entryaccount which is helpful for
working capital helps you keepyour business afloat versus
looking at long lead times forthe revenue coming in through
reimbursement uh and and uh youknow I think I think uh it just
makes it for an easier andfaster experience the flip side
of that is of course there mightbe economic downturn and then
(29:23):
people might not be willing topay cash right and they go to
reimbursement channels so what Iencourage a lot of practices to
do is have a reimbursablecomponent right make sure you're
seeing insurance patients stillbecause you know you're in
medicine for a reason and thereare people on insurance who
still need to be seen to adoctor but um also grow your
cash basis uh part of thebusiness so what that does is
(29:44):
you know in good times yes youyou're sort of um you have the
cash flow taking place but againthere'll be times where the
economy might not be doing wellgreat and the cash portion might
go down so you're still atleast keeping your business
afloat with um the reimbursablechannel um so there are pros and
cons for both sides but um Ipersonally would like to see
(30:04):
more and more physicians uh takeon the cash pay channel as um
as one of their their ways of uhuh you know getting getting
reimbursed thank you and whenyou when you go into practices
to help them with yourconsultancy what do you
typically find the ownersunderestimate about running a
practice when you when you go inand kind of assess what they're
doing yeah yeah so so I'll putthis in two buckets right there
(30:27):
there are owners that arecurrently running a practice
that need help right and thenthere are folks that are looking
to start a practice that areintimidated by sort of getting
into it right um on thepopulation the first population
right uh owners are verycomfortable with the medical
part of of the business which isgreat you know they they they
love the medicine they love thepatient part but it's always the
(30:49):
demand generation that getsvery tricky for them right
there's always a concern heylook this month was great you
know I had X number of patientsbut can I forecast that out for
month two month three right andand there's always a worry in
the back of your head ifpatients are going to come in or
not and that's where I reallyhelp them dial in their
(31:10):
marketing efforts right and whatthat means is a few things.
First one as I said the stepone is finding out your
differentiating factorsdisplaying those differentiating
factors across all theeffective channels in marketing
right and then how do you getthat messaging right right a lot
of doctors will work withagencies you know where they
might or might not uh really hitthe nail on those aspects but a
(31:32):
lot of times it comes off asvery generic you know if you
look at the websites for a lotof doctors first thing I do is
do a full website review toreally understand what they're
positioning what they'remessaging what the
differentiators are and if itfeels very generic like the next
five websites then I reallyfocus on that first because the
website is is of course is it'sgreat for marketing but it's
actually an exercise inunderstanding you know who you
(31:55):
are what are your services whatdifferentiates you what's your
the experience going to looklike right based on just the
virtual experience that you'reseeing the website.
So I start there first.
And once I do that that helpsfeed into your other channels
whether it's social your Googlebusiness profile your in-office
sort of marketing and um thatwould be the number one thing I
(32:15):
would say marketing being a bigone right the other one really
comes out of people management.
But like I said I think that'sa skill that I can help with but
ultimately the doctors have torealize they need to be great
leaders they need to be greatpeople people people people
right to to uh lead those teamsso um you know the number a lot
of their headaches is aroundmanaging people but that's
(32:35):
something that um you know I canhelp guide but ultimately it
comes down to if they want tosort of really understand and
change the ways they work withtheir with their staff.
With the second population veryquickly right it really comes
around the sort of navigatingthe business world and really
saying hey look the the fearsthat they have in entering this
space and I call those fearsagain by providing a bunch of
(32:57):
examples saying hey look medicalpractices generally do well
right generally um they'reprofitable even even banks will
provide you a better loan termfor a medical practice versus
any other business so it'sreally calling those fears and
empowering them to start theirpractice thank you so you're
obviously incredibly grounded inbusiness you have a very good
(33:19):
business brain on you to helprun the practice but what are
the things that even you arefind find as obstacles in the
work that you do in the practiceor even the consultancy?
Yeah no at the end of the dayyou know it all comes down to to
working with people right andand people come in all shapes
sizes flavors personalitiesright so what that what that
(33:39):
means is is of course being ableto adapt to work with different
styles and so um I think Ithink you know I think this is a
struggle almost for everyoneright where you're working with
different personalities how doyou be effective to collaborate
and come up with something thatis uh you know beneficial for
for all parties involved rightand so that's where uh you know
(34:01):
as a consultant uh first step isreally getting to understand
the person or the people thatI'm working with and uh and
again that's a long processright that's uh you know I would
say that's part of the processmaybe maybe you know you could
call it an obstacle but I thinkthat's part of the process
really understanding the stylesof working and and um once you
get past that right uh and onceyou get past of uh both aligning
(34:25):
on how you work together andand um you know your ways of
working then it comes down tosort of planning and just
getting things done right so soI would say that's the number
one thing that I come acrossevery time I get on a new
project and once I'm past thatit's generally smooth sailing
but of course things happen downdownstream where you know some
new problems arise but if youhave established upfront hey
(34:47):
these are going to be my ways ofworking this is my style this
is your style then you'regenerally able to address those
uh downstream problems uhrelatively well thank you so
what does the future look likewhat what do you what what do
you want to take the clinic overthe next 12 months or so where
would you like to be what areyour kind of goals and ambitions
yeah and and like I said it allsort of goes back to my vision
(35:08):
statement right our vision is wewant to be the national
practice across the US thataddresses concern for diverse
skin tones using lasers right sothe idea would be in major
centers across the United Stateswe'd want to have a flagship
location where um you know folksthat are currently flying in to
(35:30):
see you know our doctors have alocation in their in their um
major city where they're able toget these uh conditions
addressed by uh you know bydoctors that are well well
versed in um treating conditionsfor darker skin tones so that's
that's sort of the um thevision for the the clinic right
alongside that I do also want tobring bring along doctors and
(35:53):
dermatologists uh to be part ofthis vision right so again
empower them to either starttheir practice but also maybe be
part of our vision right ifthey if they see that there's
value in our vision and and umyou know they're able to carve
out their niche and specialtywithin our umbrella uh that'd be
something great um one lastthing right my wife and I we
(36:15):
truly believe in this therethere's there's enough there's
enough for everybody so what Imean by that is you know some of
our peers so that ask us aquestion hey why are you helping
other dermatologists starttheir practice whereas you're in
the space you're just creatingmore competition right which
might be the case but ultimatelywe believe in two things right
first of all there's enough uhto go around for everyone you
(36:36):
know so so that shouldn't be aproblem secondly um if you do
find your differentiatingfactors right the people that uh
want to see you as a doctorthat want to be in your clinic
will find you and be with youright so you'll find your people
regardless of of where youoperate and so it's a
self-selective process peoplethat don't want to see you will
find another practice andthey'll be part of another
(36:58):
practice.
So I think those two thingsdrive us and and um you know
encourage us to empower otherdermatologists to start their
practices too.
Dr Andrew Greenland (37:07):
With that answer I'd love to thank you so
much for joining us today and Iwish you all the best with that
ambition is fantastic.
I've really appreciated thebehind the scenes of what you do
and it's really gratifying tohear that not only you're
building a modern healthcarebusiness but you're really
putting the patient experienceat the center of it all which I
think is fantastic.
So thank you very much for yourconversation for your insights
(37:27):
I'm really grateful to have youon the show.
Anshul Maheshwari (37:30):
Thanks Dr.
William this was a pleasure ofmine and uh thanks for the
conversation.
I hope we have a few more inthe in the future.
So welcome to another episode of Voices in
Health and Wellness, where wespeak with healthcare leaders,
entrepreneurs and innovators whoare shaping the future of
healthcare.
Today's guest is AnshulMaheshwari, managing partner of
Balanced Skin Dermatology andAesthetics.
Balanced Skin is growing agrowing dermatology and medical
aesthetics practice, andalongside that, Anshul has built
extensive experience advisinghealthcare businesses on growth,
(00:22):
operations, and strategy.
That combination gives him aunique perspective on delivering
outstanding patient care andbuilding sustainable healthcare
organizations.
So with that, Anshul, I'd loveto welcome you to the show.
Thank you very much indeed forjoining us this afternoon.
Anshul Maheshwari (00:36):
Thanks for having me, Dr.
Remind.
Dr Andrew Greenland (00:38):
So I wonder if we could um start with your
background, if we may.
Would you mind giving a littlebit of information about your
background and your journey andhow you got involved in
healthcare in the first place?
Anshul Maheshwari (00:47):
Yeah, no, definitely.
So taking you back, mybackgrounds in biomedical
engineering from training,right?
A bachelor's in biomedicalengineering, also master's.
Alongside that, I was alsodoing a fellowship in
entrepreneurship and a minor ininnovation management and
strategy.
So sort of always had an eyefor medical technology and how
to bring it to the market.
Right after my education, Ispent about a couple of years in
(01:10):
a medical startup incubator upin Boston working on
microfluidic chip technology fordiagnostics.
So again, heavilyscience-based, but also with an
eye for, hey, how do youcommercialize this thing, right?
How do you bring it to market?
And that led me down a pathreally to understand, hey, look,
you know, innovation inmedicine is great, but if you
can't bring it to the market, ifyou can't commercialize it,
(01:31):
then you know it just stays inthe lab, right?
And so I ended up uh uh workingwith a consulting company for
about uh 12 years, working witha big pharma, medical device,
life sciences, uh healthcarecompany across the entire value
chain, right?
So from um product developmentto clinical development to um
you know corporate strategy,commercial operations, uh you
(01:53):
name it, you know, I've seen it.
So um all that sort of reallywent into me thinking further
about my future on, okay, youknow, I understand the science.
I sort of now understand thebusiness, right?
Where can I sort of take thisto do something of my own?
And uh, you know, the decisionwas made uh, I want to say five
years back when I ended upjoining a pharma company, Abvi,
(02:14):
uh, in the meantime alsoencouraging my wife to start her
own practice.
And so, in parallel, while Iwas working at the pharma
company on corporate strategy,sort of understanding how you
know pharma and life scienceswould be five to ten years down
the road, um, you know,alongside I was sort of starting
this journey with my wife onstarting a medical practice.
Um, all that came to fruition,I want to say, just about a year
(02:38):
or two ago when we launched thepractice, it's doing well, and
I left my corporate job earlierthis year to focus full-time on
scaling and growing that.
And of course, working onadvisory projects on the side.
Dr Andrew Greenland (02:48):
Amazing.
So, for the listeners whohaven't come across balanced
skin before, can you give us akind of an insight into the
practice itself?
Anshul Maheshwari (02:55):
100%.
Yeah, balanced skin dermatologyis a dermatology and aesthetics
practice of Nicole Beach,California.
The Mike Alpha MedicalAesthetics, I've got a little
SLA.
Um, we uh have been around forabout two and a half years.
Uh we do quite a few differentthings in dermatology and
aesthetics, right?
So we do energy based devices,lasers, we do injectables,
(03:17):
right?
Toxins uh uh biostimulators, andthen we do a full uh set of
medical dermatology procedures,uh, and then also excision and
surgery.
So a range of range of things,but we do specialize very
specifically in lasers fordarker skin tones.
Um, we found that that was anunaddressed uh uh unaddressed
(03:38):
area in the market, which um youknow has worked really well for
us.
Dr Andrew Greenland (03:42):
So you've obviously found that niche.
Um, is there anything else thatmakes your approach of balance
skin different from you knowyour competition or people in
the neighborhood?
Anshul Maheshwari (03:51):
Definitely, right?
I mean, you can imagine when Isaid Newport is the Mecca for
medical aesthetics, we havehundreds of you know,
dermatology, plastic surgery,med spa type uh practices out
here.
And so how do you differentiateand stand out in this crowded
environment, right?
And tell you a little bit of astory where my wife used to work
at a big hospital organizationwhen we moved out here in
(04:13):
California.
And she sort of had therealization, okay, well, she
wants to start her own practice,but again, you know, the the
sort of the paperwork, thecompliance, the sort of
day-to-day operations wasintimidating for us, uh, for
both of us.
And uh, I advised her to firstgo work at a smaller practice to
really understand what thatwould entail.
(04:34):
So she worked at a practice inNewport Beach, and she soon
realized that, you know, all thepatients that were coming in
uh, you know, were coming in formedical concerns but also
cosmetic concerns, and the thefolks who are at the higher skin
type levels, right, from skintype four onwards, darker skin
tones, were being basicallyshuffled around these practices
saying, hey, look, these lasersaren't here for you.
(04:55):
If they did the laser, theywould get hyperpigmentation,
hypopigmentation.
And so my wife really sort offigured out which lasers would
work well for this population.
And she developed a protocol umto take it safe and effective
for this population.
And uh, you know, we spokeabout that quite a bit and
realized, hey, look, there'sthis is an unaddressed uh gap in
the market.
Let's sort of have aspecialized clinic around
(05:17):
addressing conditions for thisspecific subpopulation.
And so that gave rise to uh uscoming up with this concept and
and create a balanced skin,where again, I would say close
to 70% of our of our patientpopulation is Asian, South
Asian, Hispanic, AfricanAmerican, right?
So uh we we definitely havefound that niche and people fly
(05:38):
from all over the country tocome see uh Dr.
Paul.
Dr Andrew Greenland (05:42):
Very interesting.
So you told us a little bitabout what you do about the
skin, the your kind of um targetmarket, as it were.
What about the um the cultureyou've built in your team?
Tell us about that.
Anshul Maheshwari (05:53):
Yeah, no, that's a great one.
And um, you know, the the funnything here is right, when I
speak to a lot of doctors whoare looking to start their
practice, the questions alwayson top of their mind is okay,
well, how how will I beprofitable?
You know, how do I find thereal estate?
Very practical sort ofoperational questions.
But I encourage people to firsttake a step back and really
write out their vision for thispractice, right?
(06:15):
All medical practices aren'trun the same.
You make uh you can make it uhhow you want it to be made.
And so um, you know, Iencourage people to write out a
vision statement.
And so, similarly for us, whenwe wrote out our vision
statement, we clearly laid outthe type of patients we'd love
to see in our practice, the typeof employees that we'd like to
be in our practice, right?
And within that, we sort ofwrote about you know integrity
(06:36):
being a big part of it, uh,being happy at work, right?
And finding it a sort of asecond home, uh, you know, a
home away from home.
So, how do we incorporate thoseelements into the practice and
day-to-day operations was wherewe uh really focused a lot of
energy on when we're working,and that is pay dividends,
right?
Our our our employees come in,they they feel comfortable, uh,
(06:58):
they feel that they're backed byuh not only support from the
team here, but also are beingled by a doctor who really
believes in what she does, who'sa great leader.
And so those sort of things arebought up not only in our
meetings, but in our day-to-dayoperations.
Um, alongside that, we have aspecial space for them where
they can sort of uh you knowrecharge.
(07:19):
We have uh you know, snacks, wehave food, right?
So those are some sort ofauxiliary items that also make
the place more comfortable andwelcoming for them.
Um, and then of course pay,right?
We we pay them above market uhrates.
So I think all those thingscombined uh do help with
retention and um staffsatisfaction.
Dr Andrew Greenland (07:36):
For sure.
And I think you've built arelatively lean team, but you're
obviously continuing to grow.
So how do you balance that out?
You know, you've got a leanteam, you're trying to deliver
excellent patient experience,uh, but you're trying to grow.
So how does that all kind ofstuck up?
Anshul Maheshwari (07:50):
It's uh it's a balancing act, right?
I think I think the big the bigbalancing act is okay, are you
generating enough patient demandto justify having a larger
team?
But on the flip side, when youdo have a larger demand, do you
have the capacity to serve thosepatients and provide the same
experience and outcomes, right?
So uh what I've learned throughthe growth of Balance Gin is
(08:12):
build the capacity first, right?
I think um in terms ofgenerating demand, we have
figured out some really goodlevers to really bring more and
more patients in.
But uh you don't want to be ina situation where you have a lot
of patients come in and you'renot able to service them.
So um what the way we figuredit out is is we we build the
capacity, right?
We have new staff, we have anew dermatologist on board, we
(08:33):
have mid-level providers, butultimately we can turn on the
faucet on the marketing side,whether it's um you know through
paid ads or through socialmedia or through um you know
other channels, we're able tobring that demand in.
So it's a balancing act, butuh, but um it's it's one that
you sort of have to stay on topof um you know pretty much every
day.
And um I you know I don't wantto always say, like, hey, we've
(08:55):
completely figured it out, but Ithink we're we're heading in
the right direction for goodorganic growth.
Dr Andrew Greenland (09:00):
Sure.
And you mentioned organicgrowth just then.
So what is it you think thatsmall specialist practices um
like yourselves can doparticularly well compared with
larger organizations?
Anshul Maheshwari (09:10):
Yeah, yeah.
Look, for a smaller practice,um, you know, really a few
things are very important,right?
So understanding yourdifferentiating factors, right?
I'll give you an example forus.
And I did mention the skin ofcolor being a big
differentiating factor for us.
Having said that, you know,we've also laid out very clearly
that all our doctors are highlycredentialed and experienced,
(09:31):
right?
So that needs to be displayedon your website, on your social
media channels, right?
Everywhere saying, hey, look,we have credentialed
board-certified doctors onboard.
Um, we specialize in skin ofcolor, we can do safe and
effective treatments for thatpopulation.
Uh, we also have an invitingspace with great experience,
right?
And I can go a little bit moredeeper into creating that
(09:52):
patient experience.
And lastly, we want us to beseen as a center of excellence,
right?
So, what I mean by that is wealso host trainings,
conferences, we do productlaunches in our clinic, right,
to really be seen in thecommunity as at the forefront of
dermatology and aesthetics.
So those were ourdifferentiating factors.
What I do when I work with alot of doctors who are looking
(10:12):
to start their smaller practicesis really talk them through
what do we think woulddifferentiate them, right?
And so I think the first stepis really, like I said, laying
out your vision and yourdifferentiating factors and then
building on those.
And so what I mean by that ishaving all the right channels
activated.
Whether it's uh uh you know asocial media page where you need
to have some presence, right?
(10:32):
In this day and age, about 80%of marketing is done through
socials.
So you have to have presence onthere, right?
Uh that doesn't mean you needto generate you know thousands
and thousands of views andfollowers, it just means having
a presence.
So when people are looking youup, they're not only Googling
your Google Business page, butthey're looking at a social
media page, seeing how you talk,seeing, you know, getting
familiar with your style, um,you know, how you um address
(10:53):
conditions or or talk topatients.
And then lastly, I would sayum, you know, ensuring that
there is a good mechanism forreferrals and word of mouth,
right?
So you want to have a goodnetwork of doctors around that
are that know your businessexists, that you're sending
patients to and they're sendingback, but also with your
patients when they visit, theyhave something to talk about
(11:13):
when they when they go back totheir family and friends, right?
Whether it's great outcomes orthe experience they had or the
interaction they had withpeople.
So uh those are the littlethings that that we would focus
on to really sort of make itsticky for your practice and
help with that organic growth.
Dr Andrew Greenland (11:27):
Thank you for sharing that.
It's really interesting.
So you're in a very rapidlychanging speciality niche.
Dermatology and aesthetics isseems to be moving at an
incredible pace.
What are you noticing in termsof trends right now, which are
making an impact on yourpractice?
Anshul Maheshwari (11:44):
Yeah, no, this is right up my alley.
Like as I mentioned, I workedon corporate strategy with Algan
Aesthetics, and there we werealways looking at sort of what's
five to ten years out.
I'd say the big ones, you know,of course, in everyone's mind
is AI, right?
And I can talk a little bitmore practically how that uh
currently um looks today atdermatology and aesthetics
practices and what it could looklike in the future.
(12:05):
Um, you know, there's a rise ofGLP once, right, which is
really increasing that patientpool for medical aesthetics.
And uh I would also say, youknow, lasers in general, where
they're able to addressconditions that were previously
being addressed by, let's say,topicals or orals.
Um, you know, a lot of laseradvanced technology is now being
(12:26):
able to treat a few medicalconditions, not only, not only
cosmetics.
So starting with AI, I mean,um, that's an interesting one,
right?
Uh, where you know, we we arein the mode of let's start
learning and let's startimplementing where there might
be efficiencies to be had, butagain, that sort of human
interaction is still intact,right?
(12:47):
So, so let me let me tell youour perspective at the moment
with AI from a very practical uhin-clinic type uh type um
setting.
Uh, you know, I still think uhyou know AI has a role to be
played on the on the consumer,on the patient side, but I at
least our clientele, what I'veseen, prefers a human on the
(13:09):
other side of the interaction,which is fine, right?
AI is getting better and betterat sort of booking appointments
and automation, and and andthat's great for high volume
practices where you're trying toget a lot of you know people
through the door for a conciergespecialty type practice that's
sort of elevated patientexperience where you're talking
to a human and very customized.
(13:29):
Um, I'd still say AI has a fewmore, you know, uh, I don't want
to say years, I don't know howlong it would take, but has some
ways to go.
Um, having said that on theback end, right?
So, in terms of organization,right?
Uh we have a bunch of filesthat our patients upload and we
use AI agents to organize them,right?
That that increases efficiency.
(13:49):
Um, we use this one tool fornote-taking, right?
So we we we take a recording,it summarizes the the patient uh
consultation, and it puts it inthe fields within your EMR
systems.
So those are reallyhigh-efficiency AI tools that
help with um operations, but onthe patient engagement sign,
we're still yet to sort of uhimplement that uh you know, once
(14:13):
we find something that'seffective.
Where it's heading, I mean, inthe dermatology space, it's uh
it's highly, highly uhinteresting just because when
you bring the imagingcapabilities with AI, then
diagnostics becomes veryinteresting.
So currently we have a tool inthe in the in the clinic where
you know you put your face inthis uh imaging device, it takes
(14:33):
eight different photographs,right?
Um, you know, skin pore size,uh skin damage, uh
hyperpigmentation, right?
It does a range of uhphotographs and it gives an
output on where you would fitwithin um your uh population
within your age group.
So it tells you, hey, look, youhave higher than normal
sunspots, or you know, yourwrinkles are on the lower side,
(14:55):
etc.
So that combined with AI couldbe highly effective in in both
the consultation process withthe doctor, right, where there's
more quantitative informationbecause a lot of medical
aesthetics is qualitative,right?
And there are patients outthere that want quantitative
information.
So uh so that's that's one onearea.
And um, you know, uh on thatside, you know, it also feels
(15:17):
like the patient has somethingtangible they're taking home
with after the consultation.
But that's really where I seeuh more sort of deeper use of AI
in aesthetics.
Um that's AI.
I can go into GLP ones and alsouh uh you know lasers in
general, unless you want to go alittle bit deeper into AI.
Dr Andrew Greenland (15:36):
No, that I wanted to get to kind of the
general overview.
So AI is really helpful becauseit's talking about what you're
doing from an operational pointof view to make things easier
and more efficient.
I'm still so interested in someof the treatments and things on
the cards.
So maybe you could talk to thethings like the GLP ones as
well.
Anshul Maheshwari (15:50):
For sure.
I mean, with GLP1s, they'reeverywhere now, right?
I think I think um, you know,uh they not only are impacting
both the sort of metabolic typeconditions, chronic conditions,
but there's been uh you knowresearch in cardiovascular, even
addiction, where GLP1s arecreating uh an impact in those
populations.
So it's a very interestingdrug, uh at least in in my
(16:14):
perspective.
But on the flip side, right,like the after effects of GLP1s
is creating a pool of patientsthat are now looking for medical
aesthetic procedures, right?
So on the extreme end, you havefolks that undergo rapid weight
loss and they have loose skin,which needs plastic surgery
intervention to sort of get thatum that skin laxicity under
control.
But on the on the other side,right, on sort of um, you know,
(16:37):
some of the after effects you'reseeing is higher wrinkling,
right?
Some of you're seeing skinquality decline.
Um, you're also seeing a bigpool uh of patients that are,
you know, originally they werenot that focused on their
appearance, but after losingweight, now they're more and
more focused on theirappearance, right?
So that's generating apopulation that's funneling into
(16:58):
medical aesthetics.
And so what I recommend for alot of doctors in this space is
uh keep an eye for in during aconsultation to definitely ask
those questions and see whattheir broader goals are, right?
Yes, weight loss might be oneof their goals, but are they
looking at sort of after effectsthat are happening after GLP1s?
Are they not focused on otherparts of their body?
(17:19):
So uh at least in our clinic,we're seeing a steady uh stream
of patients coming from GLP1s.
Uh, so that's definitely agrowing, growing population and
something to look out for.
Um, lastly, with lasers, Imean, this is an interesting
one, right?
I was um, you know, been I'vebeen going to conferences, uh,
you know, laser conferences forthe last three to four years,
(17:42):
and every year I see new lasertechnologies that are not only
treating more sort of cosmeticconcerns, whether it's you know
spots, acne, scars, but now youhave lasers that treat medical
conditions.
So like even acne formation oracne, uh cystic acne, right?
So you have lasers that youcould treat active acne with.
And uh where it's heading is isyou know, medical conditions
(18:04):
generally they're treated bytopicals or orals.
Uh, you're seeing energy-baseddevices being able to address
those conditions.
Um, why that's interesting tome as a practice is it's a
capital equipment cost, right?
You buy a laser, but you canuse it multiple times.
Some of them have consumables,some of them don't, versus using
(18:24):
a topical or an oral, right?
Either, you know, uh yes,you're seeing, you know, getting
getting paid for theconsultation, but um, you know,
if you're buying those products,you're seeing very thin
margins, right?
So so at least from a practiceoperations perspective, lasers
seem pretty pretty interesting,but also the outcomes they're
achieving are on par by um youknow with with orals and and
(18:47):
topicals.
Um so three very interestingfields to to you know stay on
top of, and and I know we as apractice are definitely gonna uh
keep our pulse uh on the onthese three um advances.
Dr Andrew Greenland (18:59):
Thank you.
What about um patientexpectations?
How have they changed over yourtime in Balanced Skin in terms
of what they're kind ofexpecting from a practice or
expecting from your clinicianswhen they come through the
doors?
Anshul Maheshwari (19:10):
That's a great question.
Um, you know, patientexpectations are changing, and
the way I sort of um measurethat, right, has been through so
in the US, there's somethingcalled the triple aim in
healthcare.
A lot of big healthcareorganizations, uh, you know,
insurance companies, they usethis framework where they have
(19:31):
three buckets that they look atto really understand the value
the patient is getting, right?
And well, how I know that'schanging is because now they're
now that they're up to like fiveor six or seven, you know,
things that they're looking at.
So patients are expecting moreand more out of their provider,
out of their healthcare system.
Um, having said that, I stillthink the three are the main
(19:51):
focus, and I'll go over that,right?
So the first one beingdelivering the outcomes, right?
The patient is coming to you tosee outcomes, right?
Are you able to deliver theoutcomes?
Are you building confidence fora new patient that they will be
able to achieve the outcomesthat they expect from you?
So that's the core number oneexpectation from patients.
The second expectation is issort of its cost, right?
(20:14):
If you look at the hospitalorganization, a lot of times, at
least in the US, a lot of themare privatized systems.
So cost coming out of thepatient pocket is one that's uh
that's a concern, right?
And then of course the cost onthe broader healthcare system.
The way we see it in smallerpractices and cash-based
practices is value for money,right?
Do the patients see value forthe money they spent in their
(20:36):
clinic?
And the last one being patientexperience, right?
So patient experience, how theyfeel when they enter the
clinic, when they leave theclinic, what sort of impression
have you left on them?
And so for each of them, right,um, I have a very, very um
strong framework I use to ensurethat I'm addressing these three
needs for each patient.
So the first one, confidenceand outcomes.
(20:58):
I want to make sure thedoctor's credentials are very
apparent everywhere, right?
Whether it's you know uhcertificates in the clinic,
whether it's on the website,whether it's on their social
media page, I want to build thattrust by indicating to the
patient that the doctor ishighly trained and experienced
in their field.
(21:19):
Second one being before andafters, right?
So at least in our in our field,you have um what the patient's
condition was before thetreatment and what the condition
was after the treatment, andyou make sure those are on
display again, and and this iswhat the patient can expect.
That also builds trust andconfidence in their outcomes.
The third one being uh again,sort of having doctor, a good
(21:42):
network of doctor referrals,right?
When a patient hears fromanother doctor that, hey, I'm
referring you to Dr.
Paul at Bounce and dermatology,that holds a lot more weight
than them doing their ownresearch.
So having a good referralnetwork is important.
And lastly, authority, right?
The doctor needs to buildauthority, whether, like I said,
there speaking at conferencesthey have a social media channel
(22:03):
where they're talking about thethe medicine that they're
practicing right they're doingpodcasts like these right so
building some sort of authoritybecause people are searching you
up before before they come seeyou and that takes care of your
confidence and outcomes bucketsecond one value for money I
won't go too much in detailthere right because it's not
applicable to a lot ofhealthcare organizations but
really um you know that's whereyou need to figure out okay well
(22:25):
your patient population thatyou're looking at um what can
they afford right what is thethe sort of treatment how much
uh you should price it and sothose are the things around
value for money and of courseyou're delivering the outcomes
where the patient is satisfiedum the experience one again
there are three things that gounder underneath experience one
being their people interactionsright so every interaction they
(22:46):
have with the person frompicking up the phone to going to
the front desk to speaking withthe doctor that needs to be a
pleasant interaction the peopleinteraction is very important
and so again you do training tomake sure that your staff is
well trained to deliver that uhthat experience the second one
process so process needs to beseamless whether it's uh making
it easy to check in online youknow coming in and and taking
(23:09):
them to a room uh it all thatprocess needs to be seamless and
happy and sort of um withoutany kinks and the last one being
is the perception so the fivesenses when the patient enters
the clinic the five senses needto be addressed what I mean by
that is the place should looknice tidy clean you know
pleasing to the eyes shouldsmell nice you know maybe
(23:31):
there's refreshments for thepatient or some water right so
you look at all the five sensesand how do you address those
five senses in a pleasant mannerthat takes care of that
perception bucket.
So a pretty long answer but asyou can see I've really thought
a lot about how to deliver onthose patient needs and again
how they're changing and and uhyou know how we're evolving to
(23:52):
address those needs at the asthey change.
Dr Andrew Greenland (23:55):
Thank you a very comprehensive answer.
It's gives us a lot of and foodfor thought over you know
enhancing the patientexperience.
So thank you very much forthat.
So as well as doing your workin balance skin you do sort of
healthcare consultancy what arethe kind of things that you're
helping clinics with in yourkind of wider work and
consultancy in the health sectorno thanks for that question
because um like I said I've beenconsulting with big companies
(24:17):
for a while but now I'm sort ofventuring out on my own.
Anshul Maheshwari (24:20):
And you know while I do some projects with
the bigger companies I think alot of my time and energy and my
mission really is to work withindividual medical providers or
small medical teams to reallyget them more excited about
entrepreneurship and empowerthem to really seek this path as
a viable path for doingmedicine.
(24:41):
And so you know my missioncomes from the fact where you
know practicing medicine isn'tthe same as it used to be 10 to
15 to 20 years ago right a lotof my network consists of
medical professionals and theway they talk about how medicine
was practiced in the day wherethey had more autonomy they
could practice the way theywanted to there was not a lot of
um I don't say oversight butnot a lot of um hindrances in
(25:05):
their uh um interactions withpatients that has completely
changed today right there's alot of paperwork that takes
place today um medicine ishighly regulated right which is
which is again you know for forgood reason but also sometimes
it hinders uh the patient um uhexperience and also uh uh you
know the outcomes the patientcan can can see so so
(25:26):
essentially I've realized heylook doctors need to sort of
take back medicine right againbeing a little uh uh provocative
here but take back medicinefrom sort of the private equity
and the the privatized playersin the market that's especially
in the US here and the way uh Isort of do that is I'm here
someone who can help younavigate the business world
(25:48):
right I think for a lot ofdoctors they hear business
finance spreadsheets and feelscary and hairy for them and a
lot of times I give themreassurance saying hey look
business is actually commonsense okay you're a doctor
you've had uh highly uh you knowcomplex scientific training uh
business is really just twothings okay business is revenue
(26:10):
minus cost equals profit andunderneath that are a few things
that go right so volume timesprice and so so if you just
focus on that top level equationthat's the the the mathematical
scientific part of business theother side of business is
people you know how well do youwork with people you work with
patients you work with yourstaff you work with your
(26:31):
partners your vendors right soif you're able to do that part
which is the common sense youknow revenue minus cost equals
profit and you can work withpeople that's what business is
about right a lot of people inthe business world they they
muddy the waters with lingo andthat's where I come in I help
them sort of navigate that thatworld where you know a profit
and loss statement is isactually a pretty simple concept
(26:54):
um and in that um in thatregard I've helped about six
practices start up and nowthey're up and running you know
smooth.
I have two other projects thatare on the way right now
alongside that I'm working withthree professionals to help with
their uh personal brandingbecause uh you know if you're in
the business of medicine ifyou're in the business period
(27:14):
you need to have presence ofsocial media so um those are a
few things that I've beenworking on and and I think um
I'm I'm I'm excited to see moremedical professionals uh being
empowered and excited about uhrunning their own business
amazing and as part of that workare you trying to make those
practices less dependent ontraditional insurance models
(27:35):
what's your kind of take on thekind of the the weighing up
between you know cash pay versusinsurance in the US no that's
that's a great one um look atthe end of the day when you have
so many players in thehealthcare ecosystem right um
you know redundancies arecreated and costs can go up and
you know as just that's thenature of if you introduce
(27:56):
complexity there's morehandovers more time more costs
so uh if a transaction canhappen directly between a
service provider and a you knowconsumer or patient uh you know
why don't we sort of strive forthat right that's sort of my uh
you know one of my goals and uhcash pay I feel like you know is
(28:19):
is trending right of coursethere's some you know uh
services that are not covered byinsurance and those are cash
pay but now more and more as Ispeak to professionals they're
providing the cash pay option topatients that can completely
omit their insurance provider umand the way people are able to
do that they even have paymentplans now right so instead of
(28:40):
sort of paying up front you'repaying over a period of time
which allows the patient to paycash um the benefits of that are
of course you know you'redirectly working with the
patient you're sort of you knowmaybe you could reduce costs
because sometimes the insuranceproviders actually have higher
costs uh when they're providinga service so you can technically
have a lower patient cost forthe patient um you're seeing the
(29:01):
money right away right entryaccount which is helpful for
working capital helps you keepyour business afloat versus
looking at long lead times forthe revenue coming in through
reimbursement uh and and uh youknow I think I think uh it just
makes it for an easier andfaster experience the flip side
of that is of course there mightbe economic downturn and then
(29:23):
people might not be willing topay cash right and they go to
reimbursement channels so what Iencourage a lot of practices to
do is have a reimbursablecomponent right make sure you're
seeing insurance patients stillbecause you know you're in
medicine for a reason and thereare people on insurance who
still need to be seen to adoctor but um also grow your
cash basis uh part of thebusiness so what that does is
(29:44):
you know in good times yes youyou're sort of um you have the
cash flow taking place but againthere'll be times where the
economy might not be doing wellgreat and the cash portion might
go down so you're still atleast keeping your business
afloat with um the reimbursablechannel um so there are pros and
cons for both sides but um Ipersonally would like to see
(30:04):
more and more physicians uh takeon the cash pay channel as um
as one of their their ways of uhuh you know getting getting
reimbursed thank you and whenyou when you go into practices
to help them with yourconsultancy what do you
typically find the ownersunderestimate about running a
practice when you when you go inand kind of assess what they're
doing yeah yeah so so I'll putthis in two buckets right there
(30:27):
there are owners that arecurrently running a practice
that need help right and thenthere are folks that are looking
to start a practice that areintimidated by sort of getting
into it right um on thepopulation the first population
right uh owners are verycomfortable with the medical
part of of the business which isgreat you know they they they
love the medicine they love thepatient part but it's always the
(30:49):
demand generation that getsvery tricky for them right
there's always a concern heylook this month was great you
know I had X number of patientsbut can I forecast that out for
month two month three right andand there's always a worry in
the back of your head ifpatients are going to come in or
not and that's where I reallyhelp them dial in their
(31:10):
marketing efforts right and whatthat means is a few things.
First one as I said the stepone is finding out your
differentiating factorsdisplaying those differentiating
factors across all theeffective channels in marketing
right and then how do you getthat messaging right right a lot
of doctors will work withagencies you know where they
might or might not uh really hitthe nail on those aspects but a
(31:32):
lot of times it comes off asvery generic you know if you
look at the websites for a lotof doctors first thing I do is
do a full website review toreally understand what they're
positioning what they'remessaging what the
differentiators are and if itfeels very generic like the next
five websites then I reallyfocus on that first because the
website is is of course is it'sgreat for marketing but it's
actually an exercise inunderstanding you know who you
(31:55):
are what are your services whatdifferentiates you what's your
the experience going to looklike right based on just the
virtual experience that you'reseeing the website.
So I start there first.
And once I do that that helpsfeed into your other channels
whether it's social your Googlebusiness profile your in-office
sort of marketing and um thatwould be the number one thing I
(32:15):
would say marketing being a bigone right the other one really
comes out of people management.
But like I said I think that'sa skill that I can help with but
ultimately the doctors have torealize they need to be great
leaders they need to be greatpeople people people people
right to to uh lead those teamsso um you know the number a lot
of their headaches is aroundmanaging people but that's
(32:35):
something that um you know I canhelp guide but ultimately it
comes down to if they want tosort of really understand and
change the ways they work withtheir with their staff.
With the second population veryquickly right it really comes
around the sort of navigatingthe business world and really
saying hey look the the fearsthat they have in entering this
space and I call those fearsagain by providing a bunch of
(32:57):
examples saying hey look medicalpractices generally do well
right generally um they'reprofitable even even banks will
provide you a better loan termfor a medical practice versus
any other business so it'sreally calling those fears and
empowering them to start theirpractice thank you so you're
obviously incredibly grounded inbusiness you have a very good
(33:19):
business brain on you to helprun the practice but what are
the things that even you arefind find as obstacles in the
work that you do in the practiceor even the consultancy?
Yeah no at the end of the dayyou know it all comes down to to
working with people right andand people come in all shapes
sizes flavors personalitiesright so what that what that
(33:39):
means is is of course being ableto adapt to work with different
styles and so um I think Ithink you know I think this is a
struggle almost for everyoneright where you're working with
different personalities how doyou be effective to collaborate
and come up with something thatis uh you know beneficial for
for all parties involved rightand so that's where uh you know
(34:01):
as a consultant uh first step isreally getting to understand
the person or the people thatI'm working with and uh and
again that's a long processright that's uh you know I would
say that's part of the processmaybe maybe you know you could
call it an obstacle but I thinkthat's part of the process
really understanding the stylesof working and and um once you
get past that right uh and onceyou get past of uh both aligning
(34:25):
on how you work together andand um you know your ways of
working then it comes down tosort of planning and just
getting things done right so soI would say that's the number
one thing that I come acrossevery time I get on a new
project and once I'm past thatit's generally smooth sailing
but of course things happen downdownstream where you know some
new problems arise but if youhave established upfront hey
(34:47):
these are going to be my ways ofworking this is my style this
is your style then you'regenerally able to address those
uh downstream problems uhrelatively well thank you so
what does the future look likewhat what do you what what do
you want to take the clinic overthe next 12 months or so where
would you like to be what areyour kind of goals and ambitions
yeah and and like I said it allsort of goes back to my vision
(35:08):
statement right our vision is wewant to be the national
practice across the US thataddresses concern for diverse
skin tones using lasers right sothe idea would be in major
centers across the United Stateswe'd want to have a flagship
location where um you know folksthat are currently flying in to
(35:30):
see you know our doctors have alocation in their in their um
major city where they're able toget these uh conditions
addressed by uh you know bydoctors that are well well
versed in um treating conditionsfor darker skin tones so that's
that's sort of the um thevision for the the clinic right
alongside that I do also want tobring bring along doctors and
(35:53):
dermatologists uh to be part ofthis vision right so again
empower them to either starttheir practice but also maybe be
part of our vision right ifthey if they see that there's
value in our vision and and umyou know they're able to carve
out their niche and specialtywithin our umbrella uh that'd be
something great um one lastthing right my wife and I we
(36:15):
truly believe in this therethere's there's enough there's
enough for everybody so what Imean by that is you know some of
our peers so that ask us aquestion hey why are you helping
other dermatologists starttheir practice whereas you're in
the space you're just creatingmore competition right which
might be the case but ultimatelywe believe in two things right
first of all there's enough uhto go around for everyone you
(36:36):
know so so that shouldn't be aproblem secondly um if you do
find your differentiatingfactors right the people that uh
want to see you as a doctorthat want to be in your clinic
will find you and be with youright so you'll find your people
regardless of of where youoperate and so it's a
self-selective process peoplethat don't want to see you will
find another practice andthey'll be part of another
(36:58):
practice.
So I think those two thingsdrive us and and um you know
encourage us to empower otherdermatologists to start their
practices too.
Dr Andrew Greenland (37:07):
With that answer I'd love to thank you so
much for joining us today and Iwish you all the best with that
ambition is fantastic.
I've really appreciated thebehind the scenes of what you do
and it's really gratifying tohear that not only you're
building a modern healthcarebusiness but you're really
putting the patient experienceat the center of it all which I
think is fantastic.
So thank you very much for yourconversation for your insights
(37:27):
I'm really grateful to have youon the show.
Anshul Maheshwari (37:30):
Thanks Dr.
William this was a pleasure ofmine and uh thanks for the
conversation.
I hope we have a few more inthe in the future.
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