SPEAKER_00 0:00

You're listening to Confidence to Thrive, the podcast for ambitious healthcare practitioners and entrepreneurs, brought to you by Alicity Advisors. Welcome to Confidence to Thrive, the podcast helping growing practitioners and healthcare entrepreneurs navigate the challenges and risks of regulation while building brands that matter. Every episode we tackle a different issue facing healthcare practitioners or entrepreneurs. We interview a guest who's working on the leading edge of private healthcare, building something that matters in their sector or profession. On today's episode, Christopher Cloak Brown and Roger Houston, directors at Amelicity, speak to Adrian Richards, an experienced plastic and cosmetics surgeon and the medical director at Iconic Aesthetics. His previous leadership at Aurora and the Private Clinic has established him as one of the most respected figures in the aesthetics industry. And in this first episode of a multi-episode series with Adrian, Christopher and Roger discuss Adrian's career path from training in plastic surgery and NHS consultant work to pioneering private practice and building multiple businesses across training, non-surgical aesthetics, and surgery. Let's join the discussion.

SPEAKER_02 0:58

Welcome to another episode of Confidence to Thrive podcast. We are privileged today to have Mr. Adrian Richards, who is has been a uh cosmetic surgeon for many years. Just mentioning that you are one of the first to venture outside the NHS in your career. Yeah. And so you've got a few businesses you set up in your time. Could you just run us through your path and career, the businesses you set up and the kind of sectors they're in? You spend everything from non-invasive to equipment through to surgery.

SPEAKER_01 1:32

We've probably been a bit enthusiastic, Chris, over the years. Yeah, so thanks, Chris, for inviting me to the broadcast. And thanks, Roger. Pleasure. I've known you two guys for how long? Oh, 10 years-ish now. Yeah, 10 years. And uh yeah, uh class you guys as good friends, and we've worked on a number of difficult, tricky cases, haven't we, Rog? We have, yeah. Roger, it's always tricky when you get a case, isn't it? It's pressure, it's you've got to get it right. It's a bit like in golf. If unfortunately, your first shot doesn't go quite the right direction, it's really important.

SPEAKER_04 2:01

You play a second shot, yeah.

SPEAKER_01 2:04

And you've helped us with lots of second shots, getting them back on the green. Thank you. Thank you for that, Rog. So it's a bit about my career. So I'm 62, I'm a plastic surgeon. I did a traditional really training in the UK. Uh it's not traditional but untraditional, actually. So normally a plastic surgeon, it's quite competitive, you have to take lots of exams, you have to be selected. In London, there's sort of 50, 100 people for every job. It's a tricky thing to do, and you probably need a number of skills. You probably need number one is energy and ability to work hard. That's probably number one, and number two, some artistic uh merit. And that's why plastic surgeons are plastic surgeons normally, because they you could be an eye surgeon or a tummy surgeon or an ear surgeon or whatever. But plastic surgeons are normally quite artistic, and it's really the first time I saw a plastic surgical operation. I'd never seen it in my training actually, and I saw a plastic surgical operation quite late after lots of other operations, and I fell in love and knew immediately that's what I wanted to do. And it was just a little skin graft, but I knew. And then I became a plastic surgeon in State Mandeville. I trained in Oxford, London, went to Australia, went to New Zealand to train, went to America, and then I ended up in State Manderville as a consultant. So I was actually a hand consultant, I did hand surgery, breast surgery, a bit of burns, did all the trauma. People mashed their legs up and things, did head and neck cancer work. So that's what plastic surgeons do, they do everything. And I was the lead plastic surgeon in Northampton doing plastic surgery for a number of years. So then essentially that was back in 2001, and compared to other countries, we were a bit behind other countries when I came back and realised in lots of ways that training, treatment, surgery, and actually we are still not quite where we should be, in in my opinion. So I'm it's always been my life work really to try and increase the standards. Okay. You know, my working with you guys has been so great, really. Okay.

SPEAKER_02 4:21

So that really is in terms so first of all, just to pick up, it is really interesting that you mentioned the aesthetic appeal, because that's always struck me as to be a successful plastic surgeon, you must have that aesthetic ability. And I imagine you've got the ability to an artist to imagine what the end result will look like.

SPEAKER_01 4:38

Yes. Yes, so that's most plastic surgeons can draw. Yes, yes, and I actually interesting, Chris. I live in a small village which has a quite well-known art studio in it, hidden away. And I've always wanted to do facial sculpting courses, so that's on my list of things to do. Oh, brilliant to to get people to sculpt and understand what people can draw, you know. Yeah, yeah. So that's that's something I'm gonna on my list to do. Oh, okay. Um people can all stay in lovely places around the village and we can all meet for communal dinners and all learn together.

SPEAKER_02 5:12

Oh cool.

SPEAKER_01 5:12

That's unfortunately I'm an absolutely terrible artist, but I've come to attend still come.

unknown 5:20

We need you to make us look good. We can get a good section. Yeah, yeah.

SPEAKER_01 5:26

We don't need you.

SPEAKER_02 5:30

Yeah, and that's one of the questions in as you're one of the first to look to move out of the NHS privately at that time, probably. Was that quite a challenge?

SPEAKER_01 5:41

Um so first thing I got back, and then I realized really that non-surgical treatments like botulinotoxin treatments, fillers, all those things were being done in Australia. Okay, but they weren't being done in the UK. There was no training for it, Rog? No, there was no courses. So that's when we set up cosmetic courses, really, to train medical professionals to and that's where own and grown. You work with us. We're uh essentially a training company. We work with Alleghan, you know, Botox. We've got a lot of training companies. We do a lot of training on ultrasounds, everything, and all the levels three, four, five, six, seven. So we're involved in all the regulation, all the training in the UK, and really trying to get the best possible standards. That's cosmetic courses. We have a non-surgical business as well, which focuses on delivering those treatments, laser treatments and things. We work with laser companies a lot to work with them for training. But recently we started a surgical company. So there's training, there's non-surgical treatments. My main love is surgery because I'm basically a surgeon, and in Europe there's a lot of very successful group practices which are owned and run by plastic surgeons, maintaining the best possible quality, plastic surgeons who work together, get the best possible support staff, and support each other. So we would do slightly different specialities, we're all carefully hand-picked people. They're chosen by the existing surgeons. You see what I mean? Yes for quality, being able to work together and mostly being great, really looking after patients. So we actually started a clinic called Aurora. Do you remember Aurora? I do. I think we first met you around. Aurora times, yeah. So I basically had that idea, but I'm I'm really a plastic surgeon. It's difficult setting up a business. So basically, so out of doctors, nurses, and dentists, who is the or let's say doctors and nurses, he's the most arrogant and thinks they know best. All the time.

SPEAKER_02 7:51

We're gonna look at we're gonna say surgeons here, surgeons, yeah.

SPEAKER_01 7:55

Yeah, yeah. You are, aren't you? And why are they like that? I don't know. It's because they have to be.

SPEAKER_02 8:01

Yes, because they are they have to be responsible for everything in their environment.

SPEAKER_01 8:06

Yeah, yeah. So the surgeon is ultimately responsible for that pay. Everything that happens in that theatre with the patient is ultimately the surgeon's responsibility. That's why we're a bit stressed sometimes. Yeah. You've got to get it right or try to get it right. So I knew in other countries group practices worked. Yeah. So we set up Aurora as a group practice. Now I didn't have much experience in business, accounts, marketing, so how did all that work?

SPEAKER_02 8:32

How did you was that just a massive learning curve for you? Yeah. Yeah.

SPEAKER_01 8:36

You should see the photos. We were a bit we had a lot of fun, yeah, and we treated a lot of patients really well, and we did great stuff, but we perhaps didn't have the structure. And then a bigger company, the private clinic, came in, said, guys, we'd like to merge with you, you've got a great brand. So that's what we did in 2016. So we essentially Rora became part of the private clinic, yeah, and I worked with the private clinic for a number of years. Yeah. Although I did everything facelifts, eyes, liposuction, everything. I mainly now do breast surgery, in particular breast conservation surgery, preserving all the breast tissues, nerves, and mere and preservate. Now, then I was approached by someone who probably, I think is probably the cleverest person I've ever met, the best entrepreneur I've ever met, who asked me to they've done all the research. They asked me to help set up another company called Iconic in the UK. Iconic is a plastic surgery company basically aiming to deliver the best possible plastic surgery with the best possible surgeons. He said, Adrian, you've done it before, we'll we'll give you a bit more structure, a bit more guidance, I'll give you the business sense. We know the people because we're involved in every every aspect of we know a lot of people with the right structure and the right guidance and the right people doing things. We have started iconic and it's gone really well. We started two years ago. We started off with myself, we have a great surgeon called Ali R now.

SPEAKER_04 10:07

Yeah.

SPEAKER_01 10:08

What do you think? Yeah, yeah, absolutely.

SPEAKER_04 10:10

Yeah, yeah, yeah. And we know the entrepreneur you're speaking of, we've met him as well.

SPEAKER_01 10:13

Yeah, we've met him as well, yeah. It's a man with no name. So that's gone really well. So Ali's now he's a best even NHS surgeon, he became a consultant, he now is at full-time with us. Yeah, you know, and he goes to a lot of conferences, he's hopefully he's becoming well known for breast and tummy surgery, he's talking a lot at meetings, he he's really great guy.

SPEAKER_04 10:37

Yeah, and we've I've seen him from my perspective, and he's he's very good. Brilliant.

SPEAKER_02 10:42

You know, you're saying and he's going out and speaking a lot and raising his profile and presence, and that feels very much from a business perspective, that's brand building. You want him out there, you want him recognised for his skill, his expertise. As you say, you're doing some of the newest, most advanced techniques in the kind of surgery you're doing.

SPEAKER_01 11:01

Yeah. And he's really he won the prize, he's really clever, he's really smart. Uh and they say in life, what you should probably do is work with people who are cleverer than you. Absolutely. And I think Ali would probably qualify for that. Because he's the brightest of his generation, and he's also, most importantly, very good surgeon and a really decent human being. Yeah. So I can't speak highly of him enough, really. We've also got a new lady surgeon called Susie, who's absolutely brilliant as well, friend of Ali, they've trained together. She's going to be doing faces for us. She's absolutely brilliant. And our backup team are brilliant as well. Yeah. They said you choose them like you would a Premier League football team, best players in every position here, passed to. We've got a great. Yeah, I'm really pleased with our iconics going.

SPEAKER_02 11:47

Which maybe brings us to if you're advising somebody who's looking to set out and set up their own business. Firstly, I think it still is probably quite daunting if you're in the NHS because you're everything's taken care of, isn't it? So if you're the certain you are responsible for everything that happens, especially in the theatre, but the fact that there is a theatre or is insured or something to pay for, or there's dozens of things that arrive and are given to you. Yes.

SPEAKER_01 12:13

You're absolutely right, Chris. I didn't really realise that. Yeah. When you start, of course, there's finances, there's marketing, you know, so many issues as HR. But insurance and covering your you know, really making sure you're safe, it's really important. So a lot of people are involved in growing the business, but to sell the business or to move it on, you need some things because we sold Aurora through all the due diligence. And I know about selling businesses because the private clinic bought a lot of businesses. We worked to buy a lot of businesses. So I was involved in being bought and buying buying other businesses and all the multiples of EBITDA. Now, what I really didn't realize is when you are buying a business, you are looking at the risk of the business. And if you basically feel within due diligence, it's a very complicated process to do that.

SPEAKER_04 13:06

Yeah, absolutely, yeah.

SPEAKER_01 13:07

Yeah, yeah. And they look, Rog, they're looking at your risk, aren't they? They are, yeah. And if you do not have squeaky clean, everything's not really good, your documentation, they're going to cut down your multiple of e-bit are they going to do.

SPEAKER_04 13:21

Yeah, they will cut the multiplier. And they, Chris, this is his world as well. They will tie you up in representations and warranties which have a long-term effect.

SPEAKER_01 13:31

Yeah.

SPEAKER_04 13:31

Yeah.

SPEAKER_01 13:31

So if you are aiming to grow a business, any business, you need to keep it nowadays as tight and everything good. So what something I didn't realise until recently is you normally insurance goes for a broker to an underwriter. So the broker's the person you deal with. You really want to try and deal with everything with the broker. You want every incident should be dealt with documented, shouldn't it?

SPEAKER_04 13:57

Yeah, and assessed by way of whether it's going to form a long-term liability or not.

SPEAKER_01 14:02

Yeah. So we could talk about this more, but if you've got MDTs, if you've got sportive when the company buys you, they look at it.

SPEAKER_04 14:09

Yeah. So you and I and your other colleagues I attend your MDTs. We've got one coming up shortly. You know, we're probably the only broker in the country that does that. Absolutely. And the reason why is that if someone comes to say, I want some due diligence, we use this phrase data room ready, don't we? Yeah. So we know about.

SPEAKER_02 14:30

Yeah. Can we just flip back to the team building and then we'll call the next podcast? That's a very interesting and show. Just interesting in terms of the business and your voice and so you've got all these vast range of things, but the way you describe your team, so the surgeons are absolutely hand-picked.

SPEAKER_01 14:51

Yes.

SPEAKER_02 14:51

But you look at your whole team. So your ladies, amazing lady who does all your runs the business basically does your admin holy, absolutely. And then you'll have HR people and finance people and so on. And those are all hand-picked.

SPEAKER_01 15:04

Okay, well, the way we want to run it. Okay, so you have to be personal, you have to look after patients, you have to be in contact, and that is human. So you need humans. Yes, we use a lot of AI, you know, for things that you don't need humans for, but some things, you know, talking to people is a human thing. Yes, and you need humans with empathy. Yes. You understand? Because it's a big thing to have surgery. Yeah. Actually, I've said I tried to design it like a football team, actually. Yeah. So our goalkeeper is our finance lady. Okay. She will not let anything pass. She is from Belarus. They don't mess with her. And then we've got a back four, so we've got the central defender, he's like Alan Hansen. Okay. Do you remember him? Oh, we've been remembering? Yeah. Or Martin Kewn or Terry Butcher, one of those. Yeah. She's very lovely. Everyone likes her. She answers. She's called Sandy. She's in Scotland. She answers all our inquiries and everything. She's brilliant. And we've got a social media person who helps us with the actually, we just actually advertising for a social media person to come and do help us with all the because we've got a lady for cosmedic courses called Sinead, who's brilliant. Yes. But we need someone who we want to follow around and do to feature more of our patients and things, more day-to-day. Okay. So we're going through that process now. And then we've got our patient coordinators called Harriet and Lucy, who are, I don't really know how to describe them. There's some of them there. Lovely people, really lovely, smart people and warm people. Yeah, can't then Harriet joined us about three three months ago. She is absolutely brilliant. Lucy's been probably the I think one of the top patient coordinators in London. She's worked with lots of surgeons. She knows loads about plastic surgery. The rest of the team is Holly. She saw our central midfield uh holds it all together. And then Melissa, who is a great person as well. What can I say about her? So I've worked with her a lot. We set up a conic together, me and her, okay, with nothing. Everyone told us we were mad. But Melissa believed in it, actually. She was the only one. And uh big thank you to Melissa. So Melissa is an amazing person, she breeds dogs, she flies for British Airways, she's a bundle of energy and ideas, and she helps us with our stories, our patient testimonials. She's brilliant with patience. And yeah, she's just a great person. So that's basically our team. And of course, Jim, you know.

SPEAKER_02 17:30

Jim is everything to everybody everywhere.

SPEAKER_01 17:33

I'm not sure how you describe him. He's my brother-in-law. I've worked with this for a long time in business, and these guys know.

SPEAKER_02 17:39

Yeah. He's a bit of a dynamo as well, isn't he? He is. Oh god. I mean, the one thing you say about Jim is he don't he really does know everybody. You walk into a show and Jim just knows everybody.

SPEAKER_01 17:49

Yeah, everyone loves Jim. Yeah. He's one of seven. He's got six sisters, one of whom I'm married to. And he's just a dynamo, isn't he? Great energy, knows everybody. Great person, really. Yeah. So that's our team, yeah.

SPEAKER_02 18:02

So maybe to summarise, Adrian, even as you say you were a pioneer to leave the NHS. Maybe you'd be retiring after an NHS career. Any any regrets?

SPEAKER_01 18:12

So interestingly, so I've just got my NHS pension. Okay. My wife's been a GP all her life, part-time GP in the NHS. My pension has more years than her pension, even though I gave up. So over half from 20 till I was in my mid-40s. 25 years I worked for the NHS. Yeah. And hard. Worked hard. And then moved into private work. And it's such a different world. If you're in the NHS, you just don't really know. There's a lot of things you don't know because your whole world's been NHS. And the landscape's changing in the UK. Um you know we just need to make sure we do things really well. You know, the NHS is a great organisation, you know, absolutely. Uh, but I think we need to work in tandem and in hybrid. And the NHS isn't going to offer a lot of these treatments now. So when I was in the NHS, you know, we used to do skin emols, breast reductions, you know, people who lost a lot of weight, hernias, varicus veins, none of those things are done in the UK. Well, it's really difficult. I mean, you you can't get your varicose vein. There's limitations to what you can have in the NHS, and you understand that limited budget and everything. So the non-NHS things we just need to make sure we really do well. But if you are gonna be running a business, guys, it's really important to there's a few things you need to get right. Insurance is definitely once, coverage, making sure all your notes and everything are absolutely yeah, the defensibility of it.

SPEAKER_04 19:49

Yeah, yeah.

SPEAKER_01 19:50

So exactly, what are the things you've got to look out for if you build a business from your perspective?

SPEAKER_04 19:55

So it's clarity on note-taking, but also this whole idea of informed consent, the idea that you are brutally honest on risks and benefits. And I still maintain for my NHS litigation days, the majority of cases are lost by poor note keeping and poor consenting than they are in quotes won by the claimant.

SPEAKER_01 20:14

As soon as we see, because we deal with a lot of cases together, because yeah, remember, we have a reporting for non-surgical and surgical, for all the surgeons, all our trainers, everything. So we have a lot of patients. So we've try and focus on reducing the risk, but we do get it, don't we? Yeah, we do.

SPEAKER_04 20:32

Yes, we do, but we don't do too badly on on that. So I think overall you're yeah, it's very important that yeah, you grow a business, but you don't have this huge legacy of liability.

SPEAKER_02 20:44

Absolutely, really, very important.

SPEAKER_04 20:45

Yeah.

SPEAKER_02 20:46

Yeah. Thanks both. I think that's a really fascinating insight into one of the pioneers in building medical businesses. Thank you, Adrian. Thanks, Chris. Thanks for inviting me.

SPEAKER_01 20:56

Love being here.

SPEAKER_00 20:56

Thanks, guys. Thank you for listening to Confidence to Thrive. Before you go, please rate, review, and subscribe to Confidence to Thrive on your preferred podcast platform and help us spread our message to others who are making a difference in private healthcare. This podcast was brought to you by Ourlicity, insurance advisors who support your business ambitions. Our City advises practitioners, owners, and entrepreneurs of healthcare practices on mitigating risks so your business can thrive. Learn more about how Aurlicity can support you by finding the link in the show notes or visiting ourlicity.co.uk.