In this episode of Shorr Solutions: The Podcast, “Building a Niche Empire Through an Injectable-Only Practice”, we welcome Alexa Nicholls Costa, NP, and Alexandra Rogers, NP! As established entrepreneurs and practice owners of LexRx, they discuss what it’s like having an injectable-only practice, how they have increased their skincare sales by 86%, and how proper branding can make or break your practice. Listen now to learn more!

The LexRx Team:

Alexa: I am, or both of us was, born and raised and educated here in Boston. I graduated undergrad from Boston University pre-med health science. I always knew that I wanted to end up in the field of aesthetics. I just wasn’t totally sure which grad school route was going to be right for me. I knew if I was going to work in research, which is a probable route with that undergrad degree, I really wanted to be focused on an industry that I was passionate about. I did not want to be sitting at a lab bench all day pipetting things in organisms that I had no desire to learn about. I ended up working at Mass General Hospital alongside the division chief of plastic surgery on his research team for three years and I not only learned more about the industry, but I really fell in love with the role of the nurse practitioner. He is such a huge advocate for NPs and has a tremendous squad of them working within his group. After that, I ended up at Regis college, which is just outside of Boston for their direct entry and NP program, a master’s program which is actually where Alex and I met. During my time, my clinical rotations, I was fortunate enough to be welcomed back to MGH, in the plastic surgery group where I was able to go from that research role into a more clinical role, and really fell in love with the injectable side of the industry. Alex and I were quickly best friends in grad school, we started the grad student government together. I don’t think either one of us saw ourselves working long term in a hospital or private clinic. I think we both had this entrepreneurial fire within us that we really wanted to explore the second we graduated.

Alexandra: I went to Emmanuel College in Boston for my undergrad degree and I studied biostatistics. Halfway through school there, I realized I wasn’t so sure that that was going to be my career path and I thought, I kind of wanted to switch to a nursing career but Emmanuel didn’t have nursing so I just finished out my degree in biostatistics. So after I graduated,  I got some experience with patients hands-on at Harvard Vanguard Medical Associates in the pediatric urgent care departments. That’s where I got a lot of hands-on experience and kind of confirmed I definitely wanted to go into a nursing career. I ended up going to Regis college where I got my master’s in nursing, where, Alexa mentioned, we had met. After graduation, while launching the business with Alexa, I had a retail health clinic job as well. For a few years before I ended up just kind of like fully committing to the business.

The Entrepreneurial Spirit:

Mara: So I want to talk about the entrepreneurial spirit. If there is a duo that has this incredible entrepreneurial spirit, it is absolutely you guys and I have had the pleasure of knowing you. When we look at this entrepreneurial spirit, you have a very unique business model. You are an injectable only practice so talk about how you came up with this concept and why it works for you.

Alexandra: We’ve been at this now for a little over five years, and when we first sat down, we were actually still in grad school and we thought, you know, what are we going to do? We really only loved the injectables. When we say injectables, we are talking neurotoxins, and dermal fillers. We never really fell in love or had a great passion around any of the other traditional MedSpa services, whether it is, laser facials or any sort of machine or device-driven treatment, it wasn’t where our passion was. For us, we are medical professionals first, we are not salespeople, and in order to sell something, you really do have to be passionate about it. So we decided to see if we could truly run a business being injectable only. We started very organically in our beginning and we’ve continued that as our foundation as we’ve grown over the last five years. We always tell everyone we actually started with just one box of Botox, and we have never taken out a business loan or outside investment to grow the brand we’ve remained cashflow positive since 2015, because everything that we’ve done has been very carefully calculated, deliberate and has had a lot of thoughtfulness behind it. We got a lot of pushback in the beginning. We can’t tell you the number of times that we’ve had drug reps or machine reps or others in the industry saying, “You know, you two, will figure it out. Someday, you’re going have to add x, y, and z service in order to be successful.” I think that a lot of entrepreneurs can relate to this unrelenting ability to question people and question why things are done a certain way. We always wondered like, why is it that we see the profit margins, we see the return on what we’re doing. Why can’t you out-innovate and out create others in the industry and really focus on what you’re passionate about? For us over the last five years, it’s really remained that injectables piece of the business, and we’re so happy that we stuck to our guns.

Being Young Females In This Business:

Mara: How do you think being young females has influenced everybody’s need to give you more and more advice?

Alexa: I think age and perceived conception as to who we both are certainly plays a role in those that want to give us their two cents. Alex and I are both millennials and I just turned 32. Yes, we are on the younger side of the industry, but that does not mean that what we’re doing comes without education or mindfulness, or seeking outside expertise to make sure that what we’re doing makes sense. I think people may assume that we may be naive, or just because we are nice that they mistake our niceness for being, fools. It’s not true, just because we can kill you with kindness doesn’t mean that behind the scenes, we’re not working tirelessly and fiercely to make sure that we deliver the best brand possible.

Mara: I’ve had so many conversations with fellow female entrepreneurs about this as well. And that there is sometimes that perception. One of the really strong advantages to having a fresh set of eyes is that you have this attitude of I can do it a different way. I’m going to take what works but I’m also not going to take what doesn’t work along with it just because I have to.

Alexa: I think you have to have this unrelenting commitment to innovation in order to make it work and to execute on it the right way. You have to be able to roll with the punches like Alex and I talk about this every day, you are going to be on a roller coaster ride as an entrepreneur, day to day your morning could start great, you could have a hiccup in the afternoon, and then by evening, you could be on cloud nine again. You just have to be able to pivot and adapt to what’s going on. There’s no better example than what’s currently going on in our country.

Pivoting During This Time of Incredible Change:

Mara:  Talk to me about what you did that has kept the practice going strong, and that really allowed you to stay in front of people during this time?

Alexa: I mean, March 15, it was a total punch to the gut day when we had this harsh reality of having to close, I think there was a bit of denial.  I think we just had this idea that there’s no way we’re going to get to the point where Massachusetts and Boston are shut down. I think I thought, they’re going to limit things, but we’re a medical practice so we’re going to be able to stay open.  In the back of our heads, we thought, this won’t be the first, point of friction or point in the business where we’ve had to think outside the box and we’re so thankful that we have our skincare line. This time has actually given us an opportunity to really showcase it and propel it. We’ve seen an 86% growth in our skincare line sales just in the last three months compared to 15 months ago.

How do you plan on keeping that up after, after COVID? How do you plan on keeping that momentum going? Once your patients can come see you in person, and once you open back up?

Alexandra: We’re always trying to launch new products. Every time we hear from a patient or a client, what do you have that could help with X, Y, or Z, and if we don’t have something specific for that, we try to figure out what can we add to complement what we already have on our shelves. I think that as long as we’re keeping up with the demands and we are being creative about what we add to our line, it’s going to keep our clients engaged and interested. Everyone loves what they’ve purchased and everyone’s repurchasing.  It really is a great addition to injectables,  and if you’re not interested in injectables, all of our products,  can really help with skin issues, even lines and wrinkles. So people are definitely interested in what we are doing.

Strategy For Your 86% Growth:

Mara: Talk to me about a strategy there. Were you picking up the phone and making phone calls to patients that you knew were overdue for skincare? You knew that their SPF? You knew that their eye cream had run out?

Alexandra: We’re not calling our clients, a lot of our clients are really engaged with us on social media. A couple things we’ve done are some giveaways with other like-minded businesses in the area, and kind of raising awareness to our skincare line through giveaways which really helps engagement on social and then word of mouth from there. We’ve also had a lot of discount codes available throughout quarantine.

Alexa: It was called, Lex Stay Home.

Alexandra: Getting creative with discount codes where people can get 20% off of orders over X amount. Small things like that really help. Social media engagement is huge, but we’re not inherently salesy people so to make those cold calls for us never really felt right. We want it to be really authentic and we want our clients to  buy the products because they love them, and are genuinely interested and not because they feel pushed or pressured to buy them.

Mara: At the point where a client runs out of their skincare product, do you even go so far as to send some sort of reminder that they’re overdue for that skincare? Or do you not reply and rely on them to come back?

Alexa: We really don’t. In terms of email blast to our client base, we really try to limit it to once maybe twice a month. We always tell our clients that if you want to know, up to the minute, what’s going on, our most present platform is always going to be Instagram. Follow our stories, or shoot us a DM. Another perk to having a business partner is there’s two of us tackling our account and we’re still very hands-on. Though we have tremendous expertise through our consultants, graphics design team, legal, accounting and our wonderful team of nurse practitioners and practice coordinators, Alex and I are still so hands-on in the everyday ins and outs of everything going on. We really do try to make every touchpoint of the business feel authentic and we always put ourselves in our clients shoes. I think it’s so millennial of us to think that it could come off annoying or rub somebody the wrong way that we feel better about sharing what’s going on in live time. One thing that has absolutely translated into sales is sharing our personal skincare routines on our Instagram page. The second we say, this is what I’m doing in the morning, this is what I’m doing at night on Sundays, this is my added self-care, I  like this type of sales. Neither of us have a business degree, but we can tell you exactly what provokes a sale for our business.

New Ideas That Did Not Pan Out:

Mara:  When you think about it, is there something that you said you know what, I’m glad we nixed that one?

Alexa: I think we could start all the way back at year one with our rebranding. There are so many touchpoints.

Alexandra: We started off as Lex NPs, and our name was all mushed together. People were commenting, “I thought that it was the Lex Nips.”  We realized no one really knew what an NP was. So we got some advice and we went through this whole rebranding process and became LexRx with a new logo, new branding, we worked with the graphic design team, a business consultant, and we got a new website, and social media.

Mara: I love that you bring that up because we weren’t always Shorr Solutions. We used to be, and actually our legal business name is still, The Best Medical Business Solutions. Jay created that brand when he had that company name when he first started the company nearly a decade ago. This is before I before I got involved, and it was a logo that had a globe, yet we don’t take clients out of the country. It had this very old school corporate look to it, which we are not corporate, and people never remembered the name of our company. Even as our clients would pay us every month, the checks would come in as The Best Business Solutions, Shorr Medical Business Solutions, The Best Shorr Business. This is a branding issue and we finally shortened it to Shorr Solutions, and it’s a name everybody remembers.  We now lovingly say, just like when we talk about strengths, we joke all of the time when we’re helping clients rename or name their practice, the first go-around is always Jay coming up with a name that’s probably five, six words long and we say, Jay three words or less.  So we went through a rebrand a few years ago, and it is much much cleaner.

Alexa: We are definitely happy that we shifted and rebranded when we did. I think that can be a really scary move to kind of shift who you are as a company. As the owners, it’s obviously a bit of swallowing your pride and admitting that maybe something didn’t work, which is very much fine. There’s a fear that your clients are going to be lost, and they’re not going to know who you are. Surprisingly it actually doesn’t happen, they go along with you. Rebranding can be one of the best business moves that you make. I think back to your original question about products, even this week, we’re reinventing one of our vitamin C serums. We thought,  this is getting confusing, and you have to take a step back and look at what you’re offering to your clients and say, Is there too much? No more is not always better? Is there a way that we can streamline and finesse the product line so that we deliver a much more concise product to our clientele.

Mara: I think that there’s a consistent need to constantly re-evaluate. We are doing that all of the time. We work with our marketing team, there is always a group text going and we constantly have ideas about, have we tried this, have we thought of this.

Alexa: It’s so true. And I think one thing that’s super relatable between your company and ours is that though we are working tirelessly behind the scenes, I think our core focus has always remained the same. And we aren’t spreading ourselves so thin across different avenues in different sectors where it becomes confusing, As entrepreneurs, because we have flights of ideas and all of this creative energy, it can be overwhelming and confusing to the consumer. If they see you going in a million directions. You cannot be good at everything. Just try to stay focused and try to grow what’s in front of you before extending yourself too far.

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