James Newman MD Surgeon

Catherine Maley

Hello, and welcome to Beauty and the Biz, where we talk about the business and marketing

side of plastic surgery. I’m your host, Katherine Maley, author of Your Aesthetic Practice, which

your patients are saying, as well as consultants of plastic surgeons to get them more patients

and more profits. Now, today’s special guest I have known forever.

It’s Dr. James Newman. He’s a facial plastic surgeon in private practice in my neck of the woods

called the Bay Area, and that’s near Stanford University in California. Now he focuses on

cosmetic facial surgery and is an innovator on minimally invasive cutting edge techniques.

Now, Dr. Newman graduated from Baylor University. He then attended the University of Texas,

and then his residency was done at Stanford University, where he also joined the faculty for a

while before finally going out on his own more than 20 years ago. Now he has lectured

throughout the country and abroad on the latest surgical and minimally invasive procedures.

He’s authored over 30 publications in peer reviewed academic journals and continues to teach

and train other providers. Now, Dr. Newman is also very active in many organizations, actually

has his own medical conference that we’ll talk about a little bit, and he holds several advisory

board physicians with firms developing new technology and plastic surgery. Dr. Newman, thank

you so much for joining me on Beauty and the Biz.

James Newman

Well, Happy New Year is great to be here at the start of 2024, and we look forward to, you

know, a great new year with so many things going on.

Catherine Maley

For sure. My theme this year is Soar in 24. I just think it’s got to get better.

23 was, I don’t like that odd year. I’m happy now we’re on an even year and it’s got to just, I’m

feeling a lot better about it, so let’s see what happens. So let’s just start with, I love the part

about, and everyone likes to hear this too, how do you pivot from hospital setting to private

practice?

Do you remember, I know it’s been a while, but do you remember what was it that got you to

make that jump?

James Newman

Well, I think it’s all about wanting to give, you know, the best patient experience, and when

you’re in a hospital setting, there’s a lot of external factors that kind of control the schedule, the

timing, the setting, and when you really start thinking about, you know, doing more elective

things than the necessary reconstructive things, patients have a choice and they, you know,

they want to feel like they’ve been listened to and that they have attention, and so the only way

we could really match those patients’ goals was to kind of establish a private practice where we

didn’t have the constraints of, you know, timing and, you know, getting bumped on the OR for

other things, so that’s why we really created our own surgical suite to match convenience for

the patient and give that kind of more private experience, and so I still did a lot of

reconstructive surgery for many years and just kind of slowly, you know, transitioned, and

when you do that, you just get all encompassed by your private practice, and so, although we

still have fellows that come and spend some time with us from the university, we also train a

fellow in the American Academy of Facial Plastic Surgery, so I still have that connection with the

younger people coming in for their training and whatnot, and we attend a lot of conferences,

and as you mentioned, we’re very active in trying to put on some of these conferences just to

keep up with the changing, you know, technologies that are occurring.

It seems that every month, you know, I pick up, you know, a magazine or whatnot, and there’s

something in it that I had never heard of, and it’s just a matter of kind of weeding through, you

know, what’s what with that, and that’s what we try and do with our California Society of Facial

Plastic Surgery. We try and filter out some of the noise and really provide our members with a

succinct analysis of what are the new things that can really impact their practices.

Catherine Maley

How important is the surgical and the non-surgical? Because it looks like you have really

focused on both at this point.

James Newman

Correct. As we all know, non-surgical technologies and procedures have been going up

logarithmically, and certainly during COVID, we were very busy in surgery because patients had

that downtime, so that was a little bit of an anomaly, but in the real world now, non-surgical,

less invasive procedures are far outpacing the traditional longer-term surgical procedure, so we

spend about probably, you know, two and a half days in surgery, and I would say of those two

and a half days, one day is devoted to, you know, the traditional heavy-duty facelift surgery,

rhinoplasty types of things, and then on the flip side, we have about a half day where we’ll tack

on some minimally invasive procedures where patients might come in to do, say, just a fat

transfer with some exosomes, mixing up with like a little bit of some laser technology and

trying to improve their skin quality, and then we’ve also seen some of the totally new

technologies such as softwave and all therapy and thermars. Those technologies have

improved over time, and there’s new stuff coming out, you know, each and every week, and

there’s a demand that the patients want to, you know, do those non-invasive things, not that

they’re always a candidate, but it’s important from a facial plastic surgeon standpoint that we

can honestly tell the patient, you know, will some of these less invasive technologies help them?

Is it worth it to do? Sometimes it might postpone the eventual day where they might come in to

do their full surgery, and certainly, I think that’s a trend that many plastic surgeons have been

seeing, whereas the average age of a patient, you know, coming in for a facelift surgery, say 20

years ago, was really kind of in their early 50s. Now, shift that down a whole decade, it’s really

like an average age is more like around 60 to 65, because patients have a lot of different

options.

And they’re doing some of these other types of whether they’re more advanced fillers, or noninvasive technology, they’re delaying the need to do full facelift surgery. So the average age of

a patient coming in has increased in our practice. And I think that’s a trend that we’ve seen, you

know, across the country as well.

Catherine Maley

Yeah, I’ve also seen that a lot of the younger people are getting facelifts earlier. And I just think

if you’re having trouble, you know, with your face at 40, 45 years old, wait till you get to be 60

and 65 years old. And another trend is once you’ve had a facelift, I’m taking this from personal

knowledge, it’s not like you’re done.

That facelift, you’ve handled the structure of your face, but you still have all sorts of little pieces

that you can’t stand. So there’s, there’s so much more, I call it the long tail patient. Anybody

who cares about how they look, they’ll care today and tomorrow and 20 years from now and 30

years from now.

And there’s just so much more to do other than like, I love all this new skin tightening, I hope

that they have made it a lot less painful. Because I’ve had all of that and I didn’t appreciate the

experience. And I thought it was a little subtle.

But on boy, they could hurry up and work on that technology. Right. It’s like that post, whatever

you want to call that post facelift tightening, or, you know, it’s gonna be a combination of some

of these different technologies.

James Newman

We’re still kind of figuring that out. But to your point, the impact of social media, for younger

patients, knowing that they can have an early facelift, you know, to kind of nip things in the

bud, we have seen that with patients coming in wanting to do more, quote unquote, you know,

minimally invasive incisions, or even endoscopic surgery, where small incisions are made back

in the airline, and we can use endoscopes to go in and do some of these things. So there’s a

number of our colleagues who have popularized some of these procedures, and social media,

you know, makes more awareness. And so you do see some patients who, you know, mostly in

the LA area, or New York, kind of on the on the coast, primarily, where they do kind of look at,

okay, I want to look as good.

And whether they’re in the entertainment business, or they are in tech business, and they just

don’t want to age and they’re working with younger people, they will tend to come in a little bit

sooner and and see about, you know, doing, for example, like the might elevate procedure with

some skin tightening. Certainly eyelid surgery is very, you know, common, because it shows

signs of aging earlier on. So we still see younger patients coming in because they’re seeing

themselves on the on the phones and on social media, they see the shadows and everything.

And that’s driven many things, you know, for us.

Catherine Maley

For sure. Now, since I’ve known you, you have grown quite a little empire there, you have lots

of providers, a few other doctors. So can you describe your practice and who has joined you

since I’ve known?

James Newman

So we have we’re in the San Francisco Bay Area, mostly on the peninsula. So we have, you

know, two main offices that have two operatories, one in Palo Alto and one in San Mateo, that

draws, you know, patients from San Francisco, Marin, all the way down to San Jose, as well as

East Bay. So we have a lot of reach and we have integrated oculoplastic surgeons as well as

general plastic surgeons who focus more on breast and body to kind of give comprehensive

care to our patients where they can come in and get everything.

So we have three plastic surgeons who are quite active in our practice. And, you know, I think

you know some of them as well. And so they come in.

And just for example, today, for example, the lady who I operated on today had had a tummy

tuck back in 2018 by one of my associates. And now she’s coming in for some facial work. And

that works very well.

And of course, we’ve also seen the growth of nurses and PAs, extenders, who can get very

adept at doing filler injections, neuromodulators and some of the office based procedures. In

fact, I think the trends are showing that, you know, surgeons were just too busy and

dermatologists have the time and they’re doing well. But we are seeing in plastic surgery

offices, a lot of the injectable types of things being done by our extenders, whether they’re

nurses or PAs.

And so I think we have three different nurses that work in our practice and they all have their

own, you know, techniques of doing things and they have a following of their patients, you

know, as well. So I think you’re seeing that trend, you know, a little bit more. And then we also

see the explosion of the medspas.

Okay. And I feel that the best medspas situation is one where you do have a core physician,

whether they’re a plastic surgeon or dermatologic surgeon or facial plastic surgeon that is

really on site, kind of monitoring, you know, everything and getting the best of both worlds.

Just because we have the depth of knowledge to offer, you know, different types of treatments

for the patients and make an accurate diagnosis on what the patient would benefit from.

So there are the other types of medspas that are, have a more of a corporate feel where they

tend to push more, you know, fillers or devices, you know, over and over again. And sometimes,

you know, patients don’t get the full consultation as far as what’s happening. So like, for

example, just today, I saw the spouse of a physician and she had been going to a particular

national chain medspa and just doing the same old things.

But she kind of reached a point where you know, she still looks tired and aged and wants to

know what else to do. And we have the ability to make that assessment and and take her to the

next level. So I think that, you know, that’s a challenge that many of us in our practices have.

And but as surgeons, we do tend to embrace the use of our nurses and PAs to enhance our

practices. And that’s one of the things that we’ve been focusing with our California Society of

Plastic Surgery is to make sure that there’s good training for our nurse injectors and our PAs.

And that’s part of what we do at our California Society meeting, which is coming up in February.

And that’s kind of a mission that we have so that practices can rest assured that, you know,

whichever nurse or extenders in their practice has the best tools and training. And I think that

it’s a win-win situation for people in industry who kind of make these products. It’s a win for our

practices where patients have a demand for these things.

And and then our nurses and PAs can actually do take more time with the patient and do these

types of things. And because they’re in our setting, they have a knowledge of well, what surgery

can do or what some of these other minimally invasive procedures can do and they get a higher

level of education. And I think you’re going to be seeing that, whether it’s the Aesthetic Society

or our Facial Plastics Academy and certainly dermatologic surgery and our American Society of

Lasers in Medicine and Surgery.

So there’s a whole post-graduate, post-training type of world out there where we’re trying to

kind of find some pathways so that people can get standardized training on some of these

things.

Catherine Maley

Well, then let me plug your meeting that’s coming up because I’ll also be speaking there. It’s

the it’s on February one through four. So it’s coming up soon.

It’s called Skin Aging Facial Plastic and Aesthetic Surgery. And it’s in Lake Tahoe, California. For

those who love to ski, this is the greatest meeting.

You get up early, we meet, then we go skiing, then we come back and meet again later. It’s a

really fun meeting. Lake Tahoe is gorgeous at this time of year.

But you want to talk a bit about your meeting and what to expect there?

James Newman

Yeah, I think that you’ll find that we have nasty, recognized experts like you, Catherine, who are

going to share very important pearls of wisdom and in your experience. And we have a number

of practice marketing people who know about some of the new trends and, you know, search

engines and social media and what are the trends kind of going forward? Because I think for a

lot of younger docs, they get most of their patients from social media now.

And the days of just having an ad in the phone book, you know, are gone. Those of us who are

more mature practices, we do rely more on our word of mouth referrals from our extensive

patient database. But I think that the types of speakers that are going to be at this meeting,

we’re going to encompass practice management with wonderful speakers.

And then the latest advances in our surgical techniques. And then we have a wonderful

demonstration of some of the new injectables that are out. And we do live injections with high

definition cameras.

And we have a number of faculty from out from throughout the state of California who are just

they do these types of pillars day in and day out. So whereas I may only do, you know, a filler

once a week of a certain type, these folks are doing it day in and day out. And I always learn

little pearls about how that’s being done.

And then we also have a showcase of the latest new technologies that are out there because a

lot of people here, you know, buzz terms like soft wave or my elevate or matrix pro and

microneedle radio frequency. We kind of really have a number of experts from our

dermatology colleagues who have done some of the research and explain why some of these

new technologies are better than the old technology. OK.

And it’s just hard to keep up. So people can come in. You can see that real time in the meeting.

And we video everything in this archive. So, you know, our registrants can go back in time and

you can look back 10 years ago and see what the state of the art was and the things that we

were discussing. So we built up a nice video library of these trends that have amassed over the

past year.

So we’re going this is going to be our 22nd year. OK, so that just tells you how long we’ve been

doing this. And we get wonderful support from our partners in industry.

And it’s a great social setting, as you mentioned. You’re an excellent skier because I’ve seen you

on the slopes before. And you just got about a foot of snow here in Lake Tahoe.

So it’s going to be wonderful. And our meeting is pretty much sold out. But if you’re trying to

get up there, you can still go to our website and try and see if there’s some additional space.

Catherine Maley

The website name is called S as in Sam A F P A S Lake Tahoe dot com. I would just Google Lake

Tahoe anti-aging or skin skin or facial surgery conference. It’ll pop up.

Yeah, it’s a really good meeting. I love the injectables. Watching how some of the doctors have

used injectables to turn them into signature packages.

They are thinking outside the box, super creative. That’s been really interesting, too. Getting

back to your business, though, from a business perspective, you are so right on becoming the

one stop shop for an aesthetic patient who wants to look good now and 30 years from now.

No patient that I know who has the wherewithal, who has the money, typically they also don’t

have the time. If you don’t have money and time, usually, you just have one or the other. And to

make it easy for a patient to get to know them surgically and non-surgically, they will give you

money over and over and over.

I am that patient and I just think I don’t know why more people don’t do that. You’re a facial

plastic surgeon. You then partnered with a body plastic surgeon.

So you have nice boundaries. Do you all get along well, hopefully?

James Newman

Yes, we do, you know, because there’s enough work for everybody, you know, this old adage of,

you know, you know, when you’re first starting out and everything. You know, there was some

turf wars back in the late 80s, early 90s. Those are passé.

And I attribute that to kind of the younger generations of surgeons who have learned in a

multidisciplinary panel, which was really started, you know, by my good friend, Dr. George

Brandon down in Newport Beach and Dr. Randy Waldman, who carried on the multi-specialty

meeting in Las Vegas for many years. And, you know, Dr. Waldman is a part of our program in

Lake Tahoe, as well as our spring meeting. So you see that true multidisciplinary format.

And so when you’re in meetings and you’re seeing each other and doing things and, you know,

and you’re giving that patient the excellent care is wonderful because, you know, many of us

kind of focus in on our specific procedures and whatnot. Even within facial plastic surgery, there

are some of us who we just primarily do rhinoplasty now or, you know, facial surgery or laser

surgery. Everything’s getting sub-specialized, you know, to a degree.

And you can come to the meeting and see how all that works. But we want the best thing for

our patients. And I think that, you know, our practice, which is known as premier plastic

surgery, kind of encompasses, you know, that multidisciplinary approach and because we have

ophthalmologists, dermatologists, plastic surgeons all together.

And we have estheticians on site as well. And we also partner with a lot of the local estheticians

who have, you know, you know, their skin care spas and whatnot. Space is a premium, right?

So you can’t, you know, that’s the one thing is that, you know, when you’re trying to think about

developing a practice for the future, you got to think about, well, how much space do you need

and what are you going to, you know, put there? And we’ve just been fortunate in that we’ve

been a little bit ahead of the curve and we’ve got, you know, things established. And it’s really

we have fellows that come in.

We have different doctors that come in and spend a year with us or two. And in patients just

kind of, you know, we’re we’re primarily word of mouth. We don’t really have to spend much

money on marketing, which is wonderful.

Catherine Maley

Well, and your word of mouth referrals are also in-house. If you would just cross promote to

each other, you have like a beautiful microcosm there that’s working internally. I think it’s

brilliant.

I think that’s the best business model going in today’s world if you can get it to work, you know.

So tell me what some of the challenges are, because that’s a lot of different variables trying to

work together and that’s not always easy. What are some challenges?

James Newman

Yeah, so I think the challenges are, you know, there’s different personalities. So our situation is

one where we allow each physician member to maintain a certain level of independence, OK?

So they’re not tied in financially to one big group.

So you really feel that you can kind of share in certain expenses, but you still have that, you

know, independent identity. And so you’re always striving to kind of build on that. You’re not

trying to hide behind just a big label.

And we’ve had some people who, you know, over the years who have excelled more at that and

being kind of a team player and not letting your egos kind of get in between things. So those

are some of the challenges. But I think that once people see that there’s plenty of work for

everybody that, you know, and the camaraderie that can be established amongst the staff and

whatnot, you know, it’s a win-win situation for everybody.

And so some of our physicians, as I said, they have their other private offices, OK, as well. And

they might just spend like one day per week with us in our office to see some of the consults

and whatnot. So I think giving that flexibility for those practitioners works really well.

And and so, you know, I’d say sometimes it’s hard for some entities like especially now with

private equity coming in and wanting to kind of control everything and make everybody fit into

these molds. As a private practitioner, we can maintain that level of control and independence

and and not be burdened by, you know, some large group that are primarily looking at

numbers and that sort of thing. So we still want to be smart and not overspend and do things

that are reasonable.

But giving that level of independence allows our providers to go on vacation when they want

and feel like they’re not taking a big chunk of overhead that they have to kind of make. And so I

think that works out pretty well.

Catherine Maley

And what about I know you have four different locations. Is there any room for growth or and

those private equity people must be after you. So are you are you tempted at all?

James Newman

Um, not at this time. I mean, I think that when I’ve talked to some of my colleagues and who

have gone the private equity route, you know, it never as rosy as you think it’s going to be that

second bite of the apple.

Catherine Maley

Yeah, right. There’s a big question mark on that one.

James Newman

And I think that we we run things, you know, very efficiently because we’re responsible for

everything and our other two locations are just small offices which are convenient, one on the

coast and one down in the South Bay. We have Esthetician Station at all those offices. So there’s

always people coming in and, you know, they can kind of we can see the consults over there

and that sort of thing.

And it’s just we have like a little feeder system that comes into, you know, our main providers.

But we’re not looking to expand more. I mean, there’s only so much that, you know, you can

do.

And if you start spreading yourself too thin, then you just can’t cover all the bases and stuff. But

I think private equity in the future, if it’s the right model and things, we could look at that. But

right now, I just don’t see that because if you you go in, you’re basically marrying your practice

to another practice.

And then you have to look at, well, how they’re running their practices in the same way you do.

And oftentimes it’s not. And it’s difficult.

So and I think that within a cosmetic practice, the people are really looking for you as the

individual and the brand that you’ve built, whereas it might be different in dermatology where

you’ve got the reimbursable types of recurring, you know, treatments and diagnoses that are

going through and in the cosmetic stuff is like a little extra on the side. So those models, they

want like predictability. And I tell you, you know, there’s not as much predictability in the

cosmetic world, you know, as in the reimbursable world.

So I like maintaining, you know, some degree of independence. And so maybe I’ll look at things

again in another few years. But right now we’re happy.

Catherine Maley

OK, that’s great. So let’s talk about branding for a minute, because when you come together

like this, are you still your premier plastic surgery dot com? But the others are independent

more or less is the for when it comes to social media or when it comes to the web, is everybody

separate?

Does everyone have their own branding?

James Newman

Yeah, everybody has their own branding, but, you know, they all have a page on premier plastic

surgery and they can. You know, people can find them a number of different ways. So we

encourage people to have as many, you know, social media things as they want.

And, you know, because we don’t really go out and buy a lot of marketing and that sort of

thing, it’s just served us well. And, you know, although we have kind of an overall brand name,

it allows us to, you know, change physicians periodically. Somebody retires, somebody moves.

There’s that, you know, reminiscent name recognition, just like a university would be. OK, so we

hope that we’ve been able to build a reputation in the era that people know that if they come to

premier plastic surgery, they’re going to get somebody with a high level of education and

experience.

Catherine Maley

Right. And do you have? Do you think there’s anything the patients, the patients and the trends

and what they want and don’t want?

Like we already talked about some of them are getting much younger, some are getting older.

But what do they want nowadays? And do you find it constantly changing?

And what’s your consultation like nowadays? Is it a lot different than it used to be?

James Newman

Yeah, no, not really. I mean, it’s still they want to look, you know, they they’re they’re noticing

the aging that’s taking place. And so I think the big thing is they want to look themselves in our

area of Northern California, which tends to be a little bit more conservative and, you know,

definitely lip fillers are a lot more conservative up here compared to down in Southern

California or Arizona, for example, or Texas.

And I would say that, you know, patients want to look natural. That’s their biggest concern. And

when we can kind of put them in context and explain to them why we do different things and

we always look at their pictures from before and we go over that and we explain what things

have happened, you know, in the process, whether they’ve lost you know, fat, collagen.

They’ve got like a lot of sagging and the different things that we have to address. Patients just

want to look like themselves, like a fresher version of themselves. And, you know, a lot of times

they you know, I think there is a little bit of filler fatigue out there where sometimes people

have relied on fillers to do much.

And then you hear about people, then, you know, some celebrities who have gone in and

dissolved some of their fillers because they just went a little too far. You start losing kind of a

frame of reference of who you were. And so we typically don’t let that happen, you know, with

the patients.

And so I would say that our average number of, you know, volume of syringes that we do for

typical filler patients, probably half of that where, you know, of some of the other big practices

that, you know, especially like some of the med spas and whatnot where they’re financially

motivated to, you know, make profit. And the way they do that is by doing more and more and

more. And in our book, that’s not the best way.

And that’s why we have, you know, patients who are with us for life and they please stick with

us.

Catherine Maley

From a patient perspective, if you overfill me, I’m not coming back. I look ridiculous, especially

in photos. And you get a reputation for that.

I would be very careful with that. Less is more. Let them come back more often for little versus

one big dump.

I don’t think that’s good business. What do you think about photos? Any secrets for how you

get the patients to approve their photos, give you a good review, give you a video testimonial?

Social proof is just more and more important as SEO gets tougher and all of that. Any tips on

that?

James Newman

Yeah, that’s been a challenge because most of our patients are private. They don’t want to have

their picture shown. And I’m always amazed how some of my colleagues can get, you know,

people just to show off on social media quite a bit.

So, you know, it’s just the nature of our practice. And so we have, you know, sometimes

patients will let us show the bottom half of their face, but not their eyes, that sort of thing. And

to us, you know, we have enough pictures that people can kind of get an idea of things.

But, you know, some people give like discounts, you know, to patients to let us use their

images. And some of our younger surgeons coming in, they try and do that so that they can

build a little bit of a presence on it. But there’s just different psychology amongst some

patients.

Some people are just so thrilled. They want to have their face out there, and that’s great. I

would just say that in our practice, in our area, that’s not the case, you know.

So we just have to kind of, you know, bite the bullet and just have a few images of things to look

1. We do let patients talk to patients who’ve had procedures done where they don’t have to

show their face. And I think for us, that’s worked very well because they have trepidation about,

you know, things that were going on.

And, you know, when patients go through a full facelift, chemical peel, fat transfer, they can

look terrible, you know, during the first few days. And being able to talk to somebody who’s

gone through that is more important when you’re trying to kind of close the deal and get some

trust that everything’s going to be OK. And so it’s tough.

It’s not I mean, I think that social media minimizes kind of the downside. They just show all

these wonderful pictures, you know, for and after. And and that’s great.

But, you know, there’s a little bit more recovery, you know, that we all know that takes place. So

we always show patients some of those, you know, recovery pictures so that they’re well aware

of what they’re in for. So there’s no surprises.

Catherine Maley

Are you are you participating in social media or staying away from it?

James Newman

Um, I say I’m pretty minimalist, you know, on social media. I think it’s always fun to kind of see

what your friends are doing and that sort of thing. I like some of the travel sites to see what’s

going on.

I try not to bother our patients too much, you know, so we’ll post something maybe once every

few weeks, but not certainly every day or several times a day, like some people do. So if we do a

post, it’s like once every two weeks.

Catherine Maley

Holy cow. Yeah, it’s every day thing. They want to know you.

They want to see you. I’m telling you, if you had somebody following you around and directing

you, you know, to make you look good, it’s the day in the life of a plastic surgeon. So much

content every day.

It’s amazing.

James Newman

So yeah, it can be a little invasive on your life. I tend to, you know, I have kids. I have a pretty

busy life and other interesting.

I don’t I don’t want that, you know, constant spotlight, you know, sort of. So I feel bad for some

of my friends who, you know, are in that spotlight because I don’t think they can truly relax, you

know, sometimes, you know, when you’re an influencer and you know, a lot of them and and

stuff. So it’s all consuming.

And if you go off, people think you died.

Catherine Maley

Yeah.

James Newman

So so this way, I kind of just keep a low profile, which is amazing.

Catherine Maley

Let me the last question. Tell me, do you have any crazy patient or staff story that would be fun

to share?

James Newman

Well, I mean, it’s amazing. I mean, like I had a patient today. It was a mouth out from her

procedure, but she she actually wrote me this thank you note.

OK, and I’m going to read the first paragraph. And this is just what your patients sometimes

think. It says, dear Dr. Newman, that was a wild ride. I had someone come up to me and tell me

I look sad. I thought I looked mad and fat. I honestly thought I had a botched procedure.

I’m so very grateful I’ve gotten to the point where I am glad that I had the procedure done and

I can sincerely thank you for your great work. Thank you. So I mean, that’s an example of

where, you know, patients during the first couple of days what’s going through their mind.

They think that, you know, maybe they’ve been botched or something like that because they

have extreme swelling or something. And it’s very important that you have, you know, some

kind of, you know, good patient communication, you know, with these folks. So so I mean, this

is just, you know, from the gal.

And of course, he’s very happy. She looks wonderful. But, you know, just to know that during

the first couple of days she thought she was boxed because of all the swelling and, you know,

her lips were swollen and that sort of thing.

It just reminds you that, you know, patients need a little bit more hand holding, you know, with

things.

Catherine Maley

If you wanted my recommendation, if you can get a patient to do a daily diary, daily photo diary

and then you have a little photo book in the office and it’s a, you know, a pre-op thing. You just

show, you know, because it’s an emotional roller coaster.

James Newman

Right.

Catherine Maley

This whole deal. And if you can just prepare them ahead of time for that because she went

through a couple of days of questioning you, you know, and you don’t want that. Yeah, you just

want her to be forewarned.

You know, you’re going to hate life for a minute and then you’re going to love it. That’s right.

James Newman

That’s right. So, you know, I mean, oftentimes we get a little cavalier of a surgeon that, OK, this

is, you know, another facelift, the patient should be fine and whatnot. But you’re absolutely

right that, you know, everybody handles things a little bit differently.

So I just think you just have to be, you know, aware of that. And sometimes, you know, you

don’t know how stable some people are. But she’s a very lovely lady and she’s extremely happy.

But I was just like, whoa, you know, that she thought she had had a botched procedure.

Catherine Maley

You know, I love that she shared that with you. Yeah, that is so important to know because you

would never you don’t want to hear that on your review. You know, that’s right.

James Newman

No. And so she gave me a great review. But, you know, we had that in the past where, you

know, some patients are a little bit immature and, you know, if they they jump on and do a

review like within the first day or two when they’re still swollen, it makes no sense.

You know, so. We tend to have, you know, nice, stable reviews with everything.

Catherine Maley

So we’re going to wrap it up now. But overall, because you’ve been around and you see what’s

going on and you’re part of what’s happening, what’s coming down the road. Where do you see

all of this going?

Because it has changed overnight. This whole private equity thing has changed. New people

coming on, new surgeons who don’t want to work 24 seven.

They do want to have a life and go home for dinner. Where do you see all this going?

James Newman

Yeah, you know, I think it’ll it’ll vary by market a little bit. I think that, you know, there’s the,

quote, fear of missing out, you know, and I think that there’s going to be a little bit of not

backlash, but I think the private equity stuff is going to kind of die down a little bit when when

you talk to people who’ve been in it for three years and they go, are you happier now or when

you had your own practice? You know, it’s you know, I think there’ll be some shifts in that.

So not the private equity people are bad people. They’re just, you know, business people and

they’re looking at the numbers and making everything work. And, you know, but I think you will

see a little bit of some of these private equity groups kind of fade away a little bit and get out of

of Madison a little bit.

Catherine Maley

And do you think solo practice is going to go away and people are going to start grouping

together to pay for things?

James Newman

No, I think the I think the model of like we have of, you know, sharing some expenses together

and having a multi-specialty, multi-disciplinary clinic will be the model. And especially now with

the young people, you know, there are a lot less throat or competitive than it’s like right now in

medical school, first two years of medical school is all past fail. So that kind of mantra of I got to

get ahead, I got to be ahead of this person, that person is kind of fading away.

And when you know that you’re all in it for the good of, you know, taking care of everybody,

that will kind of improve. So I think there’ll be less kind of cutthroat behavior and people tend

to coalesce and and go into practice together a little bit more. It just takes the right kind of

vision.

And you have to get along with people and check your ego in at the door. You know, okay.

Catherine Maley

Yeah. If anybody wanted to get a hold of you, I know your website is

premierplasticsurgery.com. Is there any other way you’d prefer to be contacted?

James Newman

You know, if they want to get a hold of me, they can always, you know, talking about social

media since I’m not on it that much, but I don’t get that many messages on social media. But if

you go to at Dr. James Newman, you can just ping me a message. And, you know, I look at it like

once a week.

So I’ll usually get back to you.

Catherine Maley

Okay. All right. Well, thank you so much, Dr. Newman. I can’t wait to see you in a few weeks in

Tahoe. By the way, if anybody wants to attend that meeting, just find it online or DM me.

Actually, that’s a good idea.

You can DM me at Catherine Mayley MBA, or you can leave me a message on my website at

kathramayley.com. And if you mention it, you can get 10% off the registration fee, but you’ll

have to tell them because we don’t have a special code for it right now. But, and everybody

that’ll take care of it for us today, if you have enjoyed this, please give us a nice review.

We sure would appreciate it. And then if you’ve got any questions or feedback, honestly, put

them on my website at kathramayley.com. All right.

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