NEWPORT BEACH, CALIF. - If you think that building a surgery center requires strict adherence to an orderly, rigid plan of action, and you find that prospect daunting, take heart. The beautiful new surgery center in which I now operate exists not because I adhered to a rigid plan but rather just the opposite. If you don't believe me, read on and see.

Not long ago, I maintained an accredited single operating room suite contiguous to my office so that I could do cosmetic plastic surgery on site. I employed a full-time anesthetist and a staff of nurses to help me run it. It worked very well for a time. But there were two major challenges.