Last month, I wrote about resolutions that you might want to make for the new year. Essentially all of the resolutions that I proposed could be applied to all plastic surgery practices—or all medical practices, for that matter. Left unsaid, however, were the specific ways that your practice might change in 2006 and beyond.

Of course, maybe it won’t change. Maybe you’ll perform the same surgical procedures and the same ancillary services, use the same hospital or ambulatory surgery center, practice with the same partners (or stay solo), and employ the same staff as in 2005. It could happen. But look back to what you were doing 5 years ago. How many of these aspects of your practice have changed? What makes you think that they won’t keep changing?

So it’s a good bet that changes are on the way. Some you can’t control, such as a colleague leaving to start his/her own practice or a valued assistant moving to a higher-level job that you don’t offer. (Good employees have a habit of doing that.)

But, for the most part, you are in charge of your career and your practice, and you want them to improve. So you want to be on the lookout for ways to make your business practices and the medical services you offer better. (That’s one reason you read PSP.)

Fortunately, there are trends in our industry that you can use to your advantage. On the business side, diversification is the name of the game. I used to be involved in the petroleum industry. In the 1970s and 1980s, every major oil company was gobbling up every other company it could get its hands on: mining companies, chemical companies, you name it. Mobil Oil Corp acquired the Montgomery Ward department stores, for goodness’ sake!

By no means is this an exact parallel to the plastic surgery industry. For one thing, your practice isn’t a giant megacorporation. But you get the point, I hope. More and more practices are starting or acquiring medical spas, nutrition centers, fitness centers, and even psychotherapy offices. Some of you are becoming one-stop shopping centers for treating the whole human body.

All trends subside eventually, or morph into something different, but this one appears to just be gathering steam. Most of the surgeons I talk to have already branched out or are making plans to do so. But others are determined to stick to what they do best and leave the all-inclusive practices to someone else. The most important thing is for you to decide whether it’s in your best interest to follow the trend or buck it.

And don’t lose sight of Mobil and Montgomery Ward. Within a decade or so, Mobil divested Wards. Today, the latter is completely defunct and the former has itself been taken over by an even larger corporate giant. As Kurt Vonnegut, Jr, intones ad infinitum in his novel Slaughterhouse Five, “So it goes.”

At some point, the business model for plastic surgery practices will head in another direction. That probably won’t happen in 2006, and a year from now I—or you—could be saying, “It probably won’t happen in 2007.” The only sure thing is that one of these years, we will be wrong. For all we know, plastic surgeons will begin to make house calls.

Sorry, I didn’t mean to scare you. The point is that you can never, ever think that you’re operating (forgive the pun) in a vacuum. The economy will change, the technology will change, someone will come up with a great new business model, and off we will go again. Know this, and be prepared to make your own changes.

What about changes on the clinical side—new techniques, new tools, and so forth? Well, I was going to get into that too, but I’ve run out of space. Come back next month.