Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Welcome back to Meet the Doctor. Today we're going to meet a nurse practitioner and her name is Megan Davies and she's in Scottsdale, Arizona. Welcome to the show, Megan.

Megan Davies (00:42):
Thank you for having me.

Eva Sheie (00:44):
Tell me about your practice there in Scottsdale. What does it look like?

Megan Davies (00:48):
Yeah, I have a practice that I founded in 2015. It's called DHH Med Spa. Originally I started it as Desert Holistic Health, and it kind of evolved more into med spa, so I felt like I needed to rebrand, so I did that. And so we do a lot of aesthetics. And then in the last year, weight loss has kind of taken off, so we've also then been focusing on that as well.

Eva Sheie (01:17):
So in Arizona, nurse practitioners can have their own practice. Do you have to have a medical director or is it just you?

Megan Davies (01:24):
No, it's just me and I am actually medical director for seven other med spas as well.

Eva Sheie (01:32):
So you like it?

Megan Davies (01:35):
Yeah. I definitely love the teaching that comes with working in medicine, so I love teaching and educating and I think that's so important, the mentorship aspect. When I started in aesthetics, I was up at night just looking at YouTube videos and I didn't know who to trust and there's so much information out there now, but there just wasn't back then. So I think the mentorship is so important and I'm so glad that I had mentors when I was getting into it, so I definitely like to give back in that way.

Eva Sheie (02:10):
How did you start out and then how did you end up in aesthetics?

Megan Davies (02:15):
My nursing career started 20 years ago and I started in the hospital, then I was a hospice nurse, and then I went back to nurse practitioner school and graduated in 2013, and I thought I was going to, well, I had an interest in dermatology and I thought maybe I could get into it, but as I went to school I realized dermatology was more so there was a lot more programs for PAs versus NPs, and really the only dermatology program was in Florida. I wasn't willing to relocate and there wasn't a lot of on the job training for nurse practitioners, so I did a dermatology rotation locally and I did just feel like I probably couldn't get my foot in the door. I was still going to try. I had that interest. And then when I got out of school, I worked at a practice that was more integrated.

(03:16):
We had a chiropractor and a osteopathic doctor and a naturopath, and we had a nurse injector as well, so I kind of got to do it all. We were a primary care office, but very focused on hormones and weight loss and did some of the aesthetics. So I got a nice mix there and definitely learned a lot and then went off and was a medical director for a med spa for a short time, and that's where it kind of got a little crazy. I was working for a chiropractor that owned the med spa who told me she injured her back and that's why she wasn't practicing, but I found out she actually was in some trouble and was fraudulently billing insurance. And so at that point I just felt like if I was going to do the right thing, if I was going to keep my license, I had to own my own practice. So that's what I did in 2015.

Eva Sheie (04:17):
It's never like I dreamed of being my own boss for my whole life and I'm going to do it. It's always like some crazy thing happened and you're like, I'm going to do it. Now I have to.

Megan Davies (04:30):
I know. I knew I could be an amazing business owner at the same time. I was like, I know I'm the kind of person that's going to give my all, and that's good and bad because I'm going to drive myself crazy with being up at 10 o'clock at night thinking about the business. So I knew that about myself, but.

Eva Sheie (04:47):
How did you get good at injecting? Do you remember what you went through to get there?

Megan Davies (04:52):
Yeah, I remember my first training. So locally I went to another nurse practitioner who had her own meds spa and she was supposed to give me a manual in advance, and I guess nobody did. I went and paid the fee and I was supposed to study in advance and I didn't get that. So I show up and she's already like, well, how would you dose them? How would you do that? I thought I was coming to a class and it was already hands-on, so I left that day and I felt like I wasted my money. And on top of it, she had her baby there.

(05:28):
So she was training, seeing clients and had her baby. It was a mess, and I left. I wasted my money, and that experience has really taught me how frustrating it is and how important it is to give a good initial training. I didn't get that, and I had done a dermatology rotation thankfully before, and I saw some aesthetics, but it was only observing. So this was supposed to be my first hands-on experience, and I really didn't get to be hands-on because it just went so fast. But from that, we learned we have to do more training, so I was just studying on my own as much as I could for a while. And then I was at the practice where we had a nurse injector and she worked there and also worked at a plastic surgeons, and so she kind of helped me a little bit, but I really had to learn a lot on my own. And so I was really big on reading the best practices and so if there was tear trough filler, I was reading all the best practices. And I think that's something that is becoming lost a little bit in the industry now it's just, well, this person did it on Instagram and this is how they do it. And I really go back to that. If you really know what the best practices are, you're doing the right thing for the client. So I think that was really big for me, just doing so much research on my own.

Eva Sheie (06:55):
There are so many fillers now and there's so many choices that we have. I think it's super important that your injector knows what all the products do and has used them all before they start putting them in your face.

Megan Davies (07:11):
Yeah, definitely. And not just what a rep came out and told you. I mean, they do have to do their research and read the clinical studies, and then they do have to practice and see if that's really what's being said is actually what's out there. Unfortunately, sometimes with these fillers like longevity, it remains to be seen. A new filler comes out and it's supposed to last two years. Well, we have to kind of wait, so unfortunately, some of that is a little bit of just experience.

Eva Sheie (07:43):
How do they know? Did they wait for two years before they came out and told you that?

Megan Davies (07:49):
Yes. There's definitely some studies where it sits in a test tube, so that's hard too. And I tell my clients,

Eva Sheie (07:55):
Well, that's what they mean?

Megan Davies (07:57):
Yeah.

Eva Sheie (07:57):
It just sat there for two years.

Megan Davies (07:59):
Yeah, well, so when they hear that, okay, it sat there for two years, but when it's in a lip in a mobile area, does it really last that long? Probably not. So it's also the experience of what the injector has seen.

Eva Sheie (08:13):
Oh, that's really interesting. What do you do when you get a new product? How do you start using it before you take it to your patients?

Megan Davies (08:21):
Yeah, so it depends on the company. Some companies require an online training first so that you're trained on it. Some of 'em will give you a few samples to try and maybe you have a model day with your clients to see how it works, or they'll have a trainer come in and that has experienced it, but there are definitely some companies that it's just you have to purchase it and play around with it and see, and it's a little scary.

Eva Sheie (08:51):
Do you take usually a pretty conservative approach then to brand new products when they're in your hands for the first time?

Megan Davies (08:58):
Definitely. There are many products that have came out that I did not even bring into my office, and I'm like, I'm going to wait a few months, let's see what everybody else does. And I think that's a really smart approach to just see what everybody else is doing. There is a website called RealSelf, and sometimes that's,

Eva Sheie (09:19):
Oh, I used to work there.

Megan Davies (09:21):
Yeah. Sometimes seeing what the reviews are after a few months with the new product and seeing what the consumers are saying too. That kind of helps.

Eva Sheie (09:31):
That's a great point. Reviews anywhere that you can find them are helpful and then asking other people, but So let's do the flip side. There's other products that have been around for a long time that you trust and love, and do you want to tell us how you think about those ones?

Megan Davies (09:50):
Yeah, so I love, I would say Sculptra for sure. That's one of the most common products that I use in my practice, and Sculptra is not a filler, it's a bio stimulator, but it's been around for a long time and it's still evolving. Like last year, they came out with a way to immediately reconstitute it, and before we had to mix in it in advance, let it sit for a few weeks. We didn't know. Still, I think there's going to be things that we learn about it and new ways to use it, but the way it was FDA approved, it was actually not a great way to inject it. A lot of us had to go out and get trainings on our own, and it was just whatever somebody's experience was. So I've gone to a lot of trainings on Sculptra, and I'll tell you, almost everybody does something different. So I've learned a lot and kind of honed in on that and changed my injection techniques. And I love the product and I think we'll continue to learn more about it, but it is very important to go out there and get trained by some people that are really industry leaders on the products.

Eva Sheie (11:01):
How is the bio stimulator different from the traditional fillers that are made from hyaluronic acid?

Megan Davies (11:09):
So a bio stimulator will just stimulate your own collagen, so we're losing collagen every year. We age, unfortunately. And so it's going to stimulate your own collagen. That kind of helps that scaffold to just maintain our tissues. So it works over time, gradually. When Sculptra comes, it's a powder and we mix it with water, so I love injecting it in the temple's, cheeks, jawline, nasal labial, folds, chin. I can do neck decollete. I've injected Sculptra all over the body as well. So even crepeness for arms, legs, buttocks, you can use it anywhere. So it's amazing. So it is more gradual. And so people who want that instant gratification, they probably will start off with fillers, but this is going to also work on your skin quality and texture. Skin is going to look great. Most of my clients are willing to wait and it's going to take a few months to really see the results, but they're patient with that. They know this is going to give them the optimal results. They're going to need less filler, and it's going to keep them looking natural. Their body's own collagen. It's not a filler that's unnatural, that's sticking around for a while.

Eva Sheie (12:27):
Is it possible to put in too much or does it not work that way?

Megan Davies (12:32):
I have not seen it. I'm sure there's somebody out there that overdid it. I guess it's possible, but it would be really hard to overdo it, and I've not seen it.

Eva Sheie (12:45):
Do you ever have to do more than one treatment to get it where the patient wants it?

Megan Davies (12:50):
Yeah, so typically I do a series of three and it's spaced five weeks apart, so there's a rule of fives with sculpture that makes it really easy. So after Sculptra, you're going to massage it five minutes for five times a day for five days. If they ask you how many vials are they going to do, they're probably going to do five vials total over this series, and their full results will be seen in five months. And how often are they going to do treatments? Every five weeks. So all the fives.

Eva Sheie (13:20):
That's a lot of fives actually.

Megan Davies (13:22):
Yeah.

Eva Sheie (13:24):
Okay. So you do Botox, you do fillers, I'm using Botox as a catchall, like Kleenex for everything.

Megan Davies (13:31):
Yeah.

Eva Sheie (13:31):
And Sculptra, what else? Do you have devices there?

Megan Davies (13:35):
Yeah, we do. Let's see, we've got Ultherapy, which is a great option for nonsurgical lifting and tightening. It's been around for a really long time. We've got the pixel eight, the micro needling with radio frequency. Love that. And then I have Agnes RF which is a precision RF device that treats eye bags and can lift, can dissolve fat, so lots of uses.

Eva Sheie (14:03):
It's also my grandma's name. I'm serious.

Megan Davies (14:06):
Yeah, the maker of it, the maker of it said he was trying to get the name as he wanted a woman's name, but as close to acne as he could get. And so he picked Agnes because that's one of the uses for it.

Eva Sheie (14:20):
Where did you hear that story?

Megan Davies (14:21):
That was Dr. Ahn. He is the creator of Agnes. Yeah.

Eva Sheie (14:28):
Oh, I learned something new every single day. It's so good. Isn't the Agnes known for being really effective at under eyes?

Megan Davies (14:40):
Yeah, it is really the only thing, nonsurgically that you can do to remove eye bags. And that's the original reason I bought this machine. I got an email and I was like, wow, this isn't something I can do Nonsurgically until now. But I do have to say there is still a significant amount of downtime. People tend to get some black eyes from that, so just planning it out can be hard.

Eva Sheie (15:05):
How long does that last, the black eyes?

Megan Davies (15:07):
Yeah. I mean, it just depends on the person, how long they take to heal. We have an amazing post-injection serum that cuts your bruising in half by Alastin, so I highly recommend getting that. So a week or two, depending on the person,

Eva Sheie (15:23):
What is in that Alastin that it's magical.

Megan Davies (15:27):
It's proprietary, but there is arnica. But I went hiking one time and I got a huge bruise on my butt from falling, and I put that on and I couldn't believe the next day such a significant difference that I was like, I have to have this in my practice. I wasn't even carrying it, but I was like, I have to have it.

Eva Sheie (15:49):
Okay. So did we miss any devices? And you said Alastin?

Megan Davies (15:54):
Yeah, I also have the Emsculpt machine, and so that's equivalent of doing 20,000 crunches in 30 minutes. So I don't know why I'm not doing that all the time, but that's a nice option.

Eva Sheie (16:10):
Do you find that your patients really like it?

Megan Davies (16:13):
Yeah, definitely. I have a lot of clients that have had lower back pain. I think it's really great for functionally, and I've heard more chiropractor's offices carrying that device. So I think functionally, I don't think it's got amazing before and after results, you're going to have this huge six pack or eight pack or anything, but functionally you can feel that you're stronger. So I think your workouts are better. Reduction in back pain.

Eva Sheie (16:42):
Stand up straighter,

Megan Davies (16:44):
So I think it is a good tool to have in your toolbox.

Eva Sheie (16:50):
Well, what part of Scottsdale are you in?

Megan Davies (16:53):
I'm in Scottsdale Ranch, and so just about 10 minutes north of Old Town.

Eva Sheie (17:00):
And how do people find you?

Megan Davies (17:02):
So number one and number two, Google and referrals are really help clients find us. Yeah, I mean, there's some other ways, but I would say that's the biggest.

Eva Sheie (17:15):
Do you have any special programs for your patients, like a membership, A VIP? What kinds of things can they expect when they come to see you?

Megan Davies (17:22):
Yeah, we just rolled out memberships last year, and I think that's the way the med spa world is kind of heading, and I think it's a really great option. And so we've rolled out three options. One is the beauty bank, and so they pay 129, it goes every month directly into their account, and they can use it on anything, but the benefit is they get perks, like $50 off of every syringe of filler, a dollar off a unit of tox. So just by being a member, they get that. And then we have two options where they can get monthly facials or monthly IVs. Most of my clients do the facials, and then they also get some discount perks by being a member.

Eva Sheie (18:10):
Tell me more about the IVs. I just started hearing about this all of a sudden. It's everywhere.

Megan Davies (18:15):
Yeah,

Eva Sheie (18:16):
What can you get?

Megan Davies (18:17):
Yeah, so you can do straight hydration. We have vitamin C, magnesium, kind of like the Meyers cocktail, so good for jet lag, colds. This was one thing that I see a naturopath as my primary care physician, and he's like, you have access to these IVs. Why aren't you doing these all the time? And I'm like, I should be. And I think when I haven't done 'em for a while and I do it, I just feel better, just a little bit energized. So I think it's a great option to do, and that's something that our clients can hook up and do during a facial, even during their fillers. So it's not like they have to sit there and just get an IV so they can multitask.

Eva Sheie (19:03):
I was at a six year old's birthday party a couple weeks ago, and my friend said she got really sick during break, and the mobile IV guy came to her house and she perked her right up the next day. She was fine.

Megan Davies (19:17):
Yeah,

Eva Sheie (19:17):
They go to your house.

Megan Davies (19:19):
Yeah, there's so many of those companies out here, and I was just telling our client yesterday this story about me saving the bachelorette party because I was having a bachelorette party at my house, and we were at the pool during the day, and unfortunately the bride to be got sick, and I ran to my office and got IV supplies and went back to the house and she was able to rally and still go out that night. So they make a huge difference.

Eva Sheie (19:47):
You're the person everyone's going to want at their bachelorette party from.

Megan Davies (19:51):
I know. I'm on call 24/7.

Eva Sheie (19:56):
Yeah, that's incredible. Okay, so I have to ask you, what do you like to do when you're not at work?

Megan Davies (20:03):
I am really big into dog rescue. I've got three dogs of my own, so I love to do things with them, taking them to the park, hiking, but also being involved in the community. And just like events, I've met some wonderful people. I've been able to raise so much money for dog rescues, and I love posting dogs that are available. I have so many clients that because of me, they've adopted it versus purchasing a pet. So that's a big part of my mission with my office. My business is giving back and spreading awareness. So that's huge. So if we have an event, it usually is to raise funds, and I always, always have the option of clients dropping off products or anything that dogs need in the office. So we'll get a bag of towels and we'll go donate it. So just really big on giving back to the local rescues.

Eva Sheie (21:02):
That's great. What kind of dogs do you have?

Megan Davies (21:05):
I have a pit bull. I have a Frenchy Boston Mix, and then a white Terrier, mutt, everything Mix.

Eva Sheie (21:11):
That's a lot of personality. All three of them. Okay. So if someone's listening and they want to come see you in the office, where should they look for you online?

Megan Davies (21:21):
Yeah, dhh med spa.com. We're on social media and we have online booking, or our phone number accepts texts, so there's lots of ways to get ahold of us.

Eva Sheie (21:32):
I can't believe I forgot to ask you about this, so you're going to have to give me two more minutes.

Megan Davies (21:37):
Okay.

Eva Sheie (21:38):
One of the things that I want to talk to everyone about right now is what's going on with Semaglutide and Tirzepitide, and specifically why we should consider going to a med spa or nurse practitioner in person for this service when it kind of looks like you could easily get it online and just order it and have it show up at your house.

Megan Davies (22:02):
Yeah, definitely. So I had completely gotten out of doing weight loss for a while. I got really busy with aesthetics, and then one of my best friends got on the semaglutide and I decided to get into it again, and it's taken off and it's like our number two product besides Botox. This is what we're doing a lot of. So I got back into it, definitely did a lot of research. I had heard about it, but I was like, I'm not going to offer it. I really, again, read the clinical studies, made sure I understood it, and then, I mean, I spent a lot of time researching it. So then I kind of played, I wouldn't say played around with it with my clients, but started at a lower dose because I'm hearing all these side effects, and I thought, why wouldn't we just start people at a lower dose?

(22:54):
Why are we giving them their first dose with a medication that has a half-life of a week and these people are sick for a long time? Why aren't we starting them lower? So I decided to do that with a couple clients that were familiar to me, and we started low and I realized, okay, we actually can mitigate these side effects a little bit, and I'm having great results with it. And I just tell them, okay, don't expect to lose a significant amount your first month. Your first month. We're getting you used to it. So I set them up so that we can have some success, and I actually still go through a history with them, and I still find out, what are you doing for diet? What do we need to do? I check labs and all these things are important, and there are so many places that yes, you can just order this medication or you can go in and see somebody who doesn't have prescriptive authority and they will dispense it to you.

(23:59):
And they try to say that it is doctor supervised, but I have seen side effects with these medications, and I think of, I had a client who came in and she gained 10 pounds on it, and had she gone to somebody that didn't have prescriptive authority, would they have just said, oh, we need to up your dose? Well, I actually looked at her and she had significant pitting edema. She was retaining fluid. I needed to get labs on her, stop it and see what was going on. But she tried to push it away and say, oh, I've just been eating bad. She didn't want to stop it. This is just an example of what would've happened. And so I think it's very important that you go to somebody with prescriptive authority that can look at this and say, no, we need to dig a little deeper. This is not an expected result and something could be going on.

Eva Sheie (24:57):
I think you need to see someone face to face-to-face. It's so important.

Megan Davies (25:02):
For sure.

Eva Sheie (25:03):
And I spend too much time on the internet and I see things, so I have gotten passionate about this issue in particular because I also think that aesthetic practices are the best place to go because they care about what you look like as you lose weight too.

Megan Davies (25:19):
Yeah. One stop shop.

Eva Sheie (25:21):
If you want help with that're in the right place.

Megan Davies (25:24):
Yeah.

Eva Sheie (25:26):
I really appreciate you taking the time to tell us about yourself today, and I'm so glad that I had the chance to hear your story.

Megan Davies (25:33):
It was great. Thank you for having me.

Eva Sheie (25:39):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you heard them on the Meet the Doctor podcast. Check the show notes for links including the doctor's website and Instagram to learn more. Are you a doctor or do you know a doctor who'd like to be on the Meet the Doctor podcast? Book your free recording session at Meet the Doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, T-H-E-A-X-I-S.io.