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Ep.109: Randy Waldman, MD

Welcome to “Beauty and the Biz” with Randy Waldman, MD – Where we talk about the business and marketing side of plastic surgery.

I’m your host, Catherine Maley, author of “Your aesthetic practice – What your patients are saying”, and consultant to plastic surgeons to get them more patients and profits.

Today’s episode is an interview with someone I have known for many years and have the utmost respect for.

He’s Randy Waldman, MD; a double-board-certified facial plastic and reconstructive surgeon in Lexington, KY who has been in practice for over 30 years.

His articles are published in scientific journals and he has been the editor for two medical books on facial plastic surgery.

He has also given over 500 presentations at cosmetic surgery meetings for the past 25 years in the United states and Europe

Dr. Waldman has grown his private practice to 4 surgeons + Quad A certified surgical center + medical skincare center + many staff

And he has been voted as Central Kentucky’s Best Cosmetic Surgery Practice for 7 years!

However, his even bigger claim to fame is his unique ability to organize and coordinate over 45 major medical conferences.

Currently, he is the founder and director of the Global Aesthetics Conference in Miami Beach, Florida which is held in November at the Loews Hotel.

Welcome to the podcast Dr. Waldman.

✔️ Learn more about the Global Aesthetics Conference coming in November

✔️ Learn more about Dr. Waldman

Click here for all the strategies for Plastic Surgery Marketing: What’s Working Now.

📖 Get a Copy of Catherine’s FREE Book
​📲 Schedule a FREE 30-Minute Strategy Call with Catherine


​➡️ Robert Singer, MD FACS – Former President, The Aesthetic Society
​➡️ Grant Stevens, MD FACS – Former President, ASAPS
➡️ E. Gaylon McCollough, MD FACS – Former President, AAFPRS, ABFPRS, AACS

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Ep.109: Randy Waldman, MD

By Catherine Maley

July 27, 2021

Welcome to beauty and the biz discover how to grow your practice with effective cosmetic patient attraction, conversion and retention advice from author, speaker, trainer, and cosmetic practice, business and marketing coach Catherine Maley.

Catherine Maley, MBA

Hi everyone. And welcome to Beauty and the Biz. I’m your host, Catherine Maley, author of, Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons to get them more patients and more profits. Now, today’s episode is an interview with someone I’ve known for many years and have the utmost respect for its. Dr. Randy Waldman. He’s a double board-certified plastic and reconstructive surgeon in Lexington, Kentucky, and he’s been in practice over 30 years.

So, his articles are published in scientific journals and has been the editor for two. Uh, medical books on facial plastic surgery. He’s also given over 500 presentations at medical conferences, which is where I first met. And he’s been doing that for the past 25 years, all over the U S as well as Europe.

Now, Dr. Waldman has grown his private practice to four surgeons, which we’re going to talk about. Plus, a quad, a certified surgical center, plus a medical skincare center, plus many, many staff. And he’s been voted central Kentucky’s cosmetic surgery practice for seven years. However, his even bigger claim to fame is his unique ability to organize and coordinate over 45 medical conferences.

Currently he is the founder and the director of the Global Aesthetics Conference in Miami Beach at the Loews Hotel in November. And we’re really excited to be there. So, Dr. Waldman, thank you so much for joining me.

Randy Waldman, MD

Well, thanks a lot, Catherine. I appreciate, uh, those very, very kind words. And we have known each other for, for many, many years.

It’s, it’s been, uh, uh, great to know you over that period of time. And you’re certainly one of the outstanding, uh, Uh, people I know in the field of, uh, management, marketing of aesthetic practices, uh, I see your little book in the background there and, uh, you know what, I, uh, I give that to every new person on my staff, uh, to read over, uh, even after all these years, uh, it’s probably been 10 years since you’ve written that book, but, uh, it’s still as applicable as it always is.

Catherine Maley, MBA

Thank you so much. I actually wrote it to stay timeless because I knew if I put technology in there, it was going to change. So, I just went with the fundamental. So, it’s thankfully it stayed alive and well, so let’s talk about what has been happening now in the world, because I haven’t seen you for a couple of years now because of this whole COVID business and I’m in California.

So, we’re still a little hindered here, but Kentucky seems to be up and running and flourishing. And, um, I just, I, you know, I talked to him. Is all over the United States and life after COVID has been really good for cosmetic surgery. So, what’s been happening on your end.

Randy Waldman, MD

Well, it’s really great that, you know, just last week, I think, or maybe June 11th, the governor lifted all the mass restrictions and, uh, uh, you know, it’s, it’s so nice to see people’s faces in my office.

Again, that’s one thing that we’ve missed then that’s, you know, we’re in the business of, of looking good in aesthetic surgery and yet. Uh, you know, you have to remind patients to take their mask off in an exam room. And so, we’re really excited about that. And things have opened up you’re right in Kentucky.

I think we’re down to less than 200 infections in the entire state per day. And, uh, in the middle of November, it was 5,000. So, um, you know, it’s really, uh, settling down and it’s, uh, it’s just a great feeling.

Catherine Maley, MBA

What do you think, do you think it’s going to last this incredible surge of patients wanting your services?

Randy Waldman, MD

Yeah, that’s, that’s a, that’s a whole different discussion. And so, you know, you start looking at the reasons for that and some of those reasons, uh, won’t last in some way. Uh, one of the things that we noticed really early on is all the people working from home. And so, they could have procedures done without taking time off of work.

Uh, and, uh, that’s not going to continue I think, and that, but that’s been a godsend because really then we didn’t have to manage our schedule and their schedule. Uh, they were on a sort of a permanent at-home vacation, uh, if you will. And, and we’re starting to just see signs of people going back to work now and going back to the workplace.

So that, that part of it won’t last, the zoom dysphoria. It’ll be there for a while. We’re still doing zoom calls and people are still looking at themselves critically. Uh, the stimulus money, uh, you know, certainly some of that stimulus money has found its way into our practices, uh, particularly on mommy makeovers, uh, with the, the child, uh, care, uh, uh, tax credit, um, and people with three and four kids.

But. Uh, you know, that that’s also kind of a temporary thing. So, I, I tell my partners in all of our doctor meetings, uh, you know, that look, some of this stuff is a little bit of pools go, don’t get too comfortable, but right now, yeah, we’re all in a boom, uh, plastic surgery. Boom. I haven’t talked to really any of my colleagues who are not experiencing, um, a real boom in their practice.

Uh, I think, uh, Uh, Charles Dickens said it best in the tale of two cities. Uh, it was the worst of times, but it was the best of times. Uh, and you know, they go on to talk about, uh, uh, different things in that quote, but it’s so true with what we’ve just been through. Uh, it was a season of darkness. It was a season of light and we saw all those ups and downs.

Um, During the past 16 to 18 months. And while we’re not completely out of it, I think we’re all feeling much better about life right now. Uh, I think that, uh, we’re seeing a light at the end of the tunnel. I’m excited to get back to seeing my colleagues and you and other colleagues that live meetings.

Those are still an important part of our world. And, uh, I’m really excited for that. Uh, really excited about, uh, our next meeting in November in Miami. Uh, I’ve really got one of the best programs that I think I’ve been able to put together. Uh, out of maybe 45 meetings, I’ve done. I’m going to put this one in the top four or five in terms of content.

Catherine Maley, MBA

Wait, we’ll get back to that in a minute. Let’s go back to the business side to a plastic surgery, because both of us were around during the recession and all the crazy stuff. And even the things that happened in your own practice, whether it be major staff changes or some kind of there’s all sorts of things that happen.

How do you handle just all the years you’ve been doing? How do you prepare for these ups and downs? This particular time? The plastic surgeons made out like bandits, but other times plastic surgery took such a beat. Um, and so how do you prepare for that?

Randy Waldman, MD

Well, it’s interesting. I, I go, uh, I go by our business, but out there for the future, I also go about how many people are contacting us through our website.

We call them online contacts and we’ve been doing just incredibly well with those still. So, the boom is still continuing. Uh, with, and just talking to my partners, you know, I, I tell them that, you know, I’ve seen so many ups and I’ve seen some downs and I can think back to 2008, I can think back to 1993, uh, in that early nineties period, uh, there was some other down, uh, cycles that we’ve had.

So, I think that you just have to do things, uh, judiciously, uh, I don’t think that you should over it. Uh, based on what we’re seeing right now, uh, I think that you just need to stay conservative. I don’t even think that you should overhaul right now. Uh, the tendency is that people, you know, it, first of all, it’s very difficult as you know, uh, to hire this environment anyway, particularly the person that’s making between 18 and $25 an hour.

Uh, those people are considered home and often make that much. Uh, you know, off of the government. So, it’s been a little bit of a difficult, um, uh, to hire qualified people, uh, in small businesses, like, like the practice that we run. But I still say that, you know, you have to really keep an eye on the future and say this boom, uh, as we know it, uh, it’s not a permanent fixture.

Catherine Maley, MBA

I agree. There are so many things going in your favor right now. And one thing was just the lack of being able to spend money elsewhere. There’s all this money floating around and money has to go somewhere. And when the public started stopped traveling and stopped eating out, boy, they just lined up for plastic surgery instead.

I thought that was amazing. And so, it may not last, but it definitely, I think plastic surgery is becoming a necessity. This point, like it used to be such an, um, a luxury. And I think now there were general populations, like, Nope, I really need this done. So, kudos. I sure hope it lasts for a while.

Randy Waldman, MD

I do too.

But I think that you just have to say that we probably, you know, we, there, there are peaks and valleys and everything, and let’s just hope that, uh, the, the peak stay close to the peak and that we don’t see the valleys, but I think realistically, um, Uh, the economy goes up and down and, and we kind of followed the economy.

Uh, we follow the stock market sometimes. And, uh, so I just think that we need to be wary of, of history and, and remember that, uh, any boom, uh, is not going to continue in depth.

Catherine Maley, MBA

Okay. Um, so tell me, uh, you now are up to four surgeons in your practice. You have a beautiful building in Lexington. It’s gorgeous.

And, um, I mean, you have a pretty big boat to float there. Um, how any pearls for managing that many surgeons? Because when it gets to be four and there were four egos, four personalities, um, how w any pearls on how to make that happen?

Randy Waldman, MD

Know, it’s not, it’s never easy. I just think that you, you, you have to treat people with respect and you have to make sure that, uh, there’s a certain organization in place and certain expectations are met, but it is harder every time you increase the size of your practice, it’s harder that the, I think you need to make sure that you have the required space, which we did.

We built this practice large or built the facility large enough for. For MDs. Uh, we don’t like a lot of practices have done really well, Katherine with extenders and, uh, other people that are income producers, uh, really in our practice other than skincare, uh, our doctors are the producers. So, we’re a little bit different in that regard.

Uh, I know that philosophically, we may not be in the mainstream, but it’s what we’ve chosen to do. So, um, It, it it’s complicated and it does complicate it. The more people that you bring on board, the more personalities, uh, but we’ve been able to make it work. And as you know, we’re a multi-specialty practice.

I can’t emphasize that enough. We have two facial, plastic surgeons and two plastic surgeons. And, uh, we all get along really well. One of the keys, uh, we’re all pretty good friends. Um, we don’t necessarily socialize all the time together, but, but, you know, we enjoy seeing each other at the office and, uh, Uh, we all share a lot of the common beliefs and philosophies and, uh, that’s kind of what makes it right.

Catherine Maley, MBA

Nice. And then what about staff? Any staff tips that you’ve learned along the way in your 30 years? Because staff can be probably, would you say it’s one of the most frustrating aspects of running a practice? I really get it straight. It’s like, can you start it? Everyone’s running like a well-oiled machine and then somebody gets pregnant or somebody moves away.

Cause you know yeah.

Randy Waldman, MD

All those things for sure. Um, it is frustrating and it’s the hardest part about running any type of small businesses? Uh, I’m sure it’s not unique to what we do, but there is, you know, there are periods of stress, uh, in what we do. There are periods where it’s a little bit more hectic and that puts a little bit more stress, uh, on, on the practice.

We tend to hire mostly college graduates for almost every position in our office. And, uh, you know, A lot of times, this is not the final job for a lot of these younger people that we hire. They’re, they’re looking to get into pharmaceutical sales. They’re looking into some of them, uh, you know, I’ve taken great pride that some of them have gone back to nursing school.

So, on that become nurse practitioners. Uh, we’ve had a couple that actually went to medical school. Uh, and so I take great pride in mentoring, a lot of young people along into medicine. Um, uh, you know, I’m. Uh, incredibly honored to, to have had wonderful staff people over the years. And, and, uh, we know that they’re going to move on some of them that this is not their final job.

So yes, it is important to get the right type of people in here. People that can relate, uh, to our patients, uh, that’s really important to me, uh, and people that can represent in our practice very well. And again, that’s also very important.

Catherine Maley, MBA

You know, as a consultant, um, I, I know firsthand how difficult it is to find the right people for the right practice.

I do a lot of that myself and I’ve noticed just in general, it’s gotten very difficult to get somebody to commit, you know, they won’t even show up for the interview.

Randy Waldman, MD

Oh, that’s true. I should, I should have mentioned that, that a lot of people will put in their application for positions. I think we’ve had; we had a couple of positions open as coordinators, uh, patient coordinators, and, you know, a lot of those people would apply and we we’d look at the application.

They looked pretty good. And yet when it came time to interview, they wouldn’t show up for the interview. So, I think a lot of people are just submitting applications to. You know, kind of cover themselves with the governmental entities. Um, and they prefer to stay at home with their children and get paid to do that.

And it was particularly top up for you guys out in California, but also for us in Kentucky, because a lot of people found themselves now. Uh, without childcare school was the childcare. And so, if they could get paid, um, stay at home, take care of their children, uh, then that became a routine for many people and almost a habit.

And so, we’re still trying to buck that trend. I think that, uh, hopefully eventually the government ends there. Um, uh, Yeah, you program where, um, what is the word that they use for the unemployment, uh, enhance that employment, uh, and where they add additional money to the typical unemployment. And unemployment’s been going on now for a year and a half and you know, maybe it’s going to end in September.

Uh, but previously it was like six months. So, people, uh, a lot of small businesses, restaurants, small businesses like medical practices. Yeah. It’s been tough with them to get employees.

Catherine Maley, MBA

We know, and I’ve been suggesting to go back to the, like what I used to do a million years ago, I would give the staff of the finder’s fee because staff knows better than, you know, they know if their friends are a good fit or not.

So, but, but here’s how I did the finder’s fee. Um, and, and it’s a good one. It’s a thousand dollars, but you get two 50 each quarter that they stay. So, it’s two 50 on higher you than another two 50 a quarter. And that just seems to work very well when. Um, you need a qualified person who, who, um, uh, matches your values.

You know, it’s just an easier way to do it. So anyway, that’s what I would suggest.

Randy Waldman, MD

That’s a, that’s a really interesting idea. And it’s something that, uh, I may, uh, I may even try at some point.

Catherine Maley, MBA

Well, you know, we are very money-driven, so we’ve all learned. Um, it works, it works very well and they care that this person fits well because it hurts their credibility.

If they don’t and the self, they’ll help them along. Um, so I think it’s a good idea. So, are you marketing any differently now than you did pre COVID?

Randy Waldman, MD

Not really. We really haven’t. We’re not a. You know, a heavily marketed practice other than the obvious the website. Um, really, I’ve been looking and we, we lost our, our social media expert, uh, in, in January to, uh, uh, to pregnancy and, um, And so we’re, you know, we really haven’t done as much with social media as a lot of practices do.

I’d like to, I think it’s important. And I know a lot of my colleagues, uh, get a lot of patients from social media, but that hasn’t been what we’ve been doing. Uh, most of our patients come from our website and from word of mouth. And as you know, 85% of patients by at least studies years ago came from word of mouth.

It may not be that many anymore with social media, but it’s still a very high percentage. So, because we’ve been in practice for so long and, uh, have a loyal following, uh, then, uh, for us, uh, the website is our major marketing. You know, that’s

Catherine Maley, MBA

interesting because if you study SEO and, and you’ve heard the talks about SEO is dead, and I get that.

If you’re not willing to do the content that it takes to get people to your website, that’s going to be a challenge for you. Otherwise, you’re um, you have a lot of different arrows pointing to your website, so they might start actually. I don’t think word of mouth has gone anywhere. I think it’s been diluted because of the way people communicate.

So, I think there’s still the girlfriend telling the girlfriend, but there’s also her sharing on social, her, um, texting somebody, her, you know, it’s just got more digital and it gets lost in the actual, like where did that referral? However, um, so when she does that first, the girlfriend tells her about Dr.

Waldman. Then she says, oh, let me go check out Dr. Waldman. And they usually will go to your Instagram. Cause a lot of us just go straight to Instagram to check out your photos. So that’s what we want to see. And then they go to your website. So, it’s if you’re a young zigzaggy road nowadays.

Randy Waldman, MD

Yeah, I think, I think that, uh, you know, there was, uh, a really good study that, that talked about, um, how people find you.

And, uh, uh, it was something that was through one of the online sites. So, they, they were basically talking about millennials, but I think they could really have been talking about it, any group. And they said the number one thing, uh, that, that drives people. Uh, to your office is, is photographs and pre- and post-op pictures.

But surprisingly, the number two thing, and this was about five years ago. So, it was a little bit before, you know, it became a necessity. The number two thing is his reviews and, and then the number three thing gets into pricing. But, you know, I, I think the pricing, uh, For some people might be an issue, but I don’t see people price shopping as much as they once did.

And it maybe I’m being naive about that. But I don’t see people seeing the number of people that, you know, I used to have people coming in to, I’ve seen four other doctors and I just don’t see that very much anymore. Again, maybe I’m not asking the right questions, but, um, but I do think, I do think that pre- and post-op pictures.

Sure. So, and reviews are the two critical things in my mind in today’s world. Uh, even it was millennials in that study, but I gotta tell you, well, by more mature patients tend to look at reviews.

Catherine Maley, MBA

For sure. And I’m also watching these practices, put their pricing up on their websites. And I’m going to ask your opinion on that because here’s mine as a patient.

If it, to me that looks like, oh, okay. You just care about them. So, I guess I should just care about price and I just think that’s a conversation you don’t want to have with that patient. If they think it’s all about price. Talk about commoditizing yourself. I mean, I don’t, I don’t get that. I like to still have that phone call and give them their, the fee start at or range from, and we offer affordable pay plans that you’ll learn more about it, your consultation.

So, let’s see when we can get you in here. I think you’ve got to have chiller phone skills rather than. Make it that easy to say they don’t even have to call anymore and say, how much is it? You’re telling them everything up above or up upfront. How do you feel about that?

Randy Waldman, MD

You know, it’s, well, I feel very strongly that, uh, about that and I think you’re absolutely right.

It’s sorta like, uh, the billboard that says $200 Botox. Uh, I don’t, I don’t know what that tells somebody. I think that one of your really good lectures that you used to give, I don’t know if you still give it is on credentialing, the physician, and that can occur, that can occur on the phone or it can occur in person.

One of the challenges that I was going to, and I’m hoping. To find the answer from you. But one of the challenges that we had in the heart of this, when we, when we were really, uh, there was a point about, uh, four or five, six months ago, where I looked at the number of calls that we were getting per week, uh, or the number of calls, and some of them had to do with COVID.

Issues and lab work and all this stuff. So, it was a lot of different things, but we can look at our phone system because it’s a digital phone system. And I can tell you on any given week, number one, how many phone calls did we have coming in? Uh, and then I can tell you, number two, how many, uh, uh, abandoned phone calls did we have?

Because we have, we, we don’t have a certain number of lines anymore. Run a digital system. So, we have as many lines as we have telephone. Theoretically, uh, and that’s made things more complex because now 23 of 23 computers in our office now 23 people can call it the same time. So now you really have a credentialing problem because you’re, you’re having to expand the number of people who answer.

Different phone calls. One person can’t do it. Two people can’t do it now. You’re taking messages now. You’re you know, so when we were, when we were thought we’re not, I don’t think we’re doing a thousand phone calls a week now. Maybe we’re, we’re down to 800. Uh, but those are the things I look at to try to see.

You know what I need to staff the office with and how I need to distribute that. Whether we need to rearrange, who, who answers it, how they answer it, but it’s become a lot more difficult than just having one or two people answering the phone. For sure.

Catherine Maley, MBA

I actually work with they call centers like yours that have over a thousand calls a week.

And boy, the secret is technology is everything script the heck out of people. They get a two-minute phone call, not a 12-minute phone call and you’re, you’re just monitoring everything. And just when you think everyone’s trained, they go right back to their bad habits and bring them right back again. And, and you, you know, it’s, it’s a constant, never ending.

Um, training with accountability attached to it, but I’ll tell you that’s how you do it. Otherwise. W what’s the other alternative, you just turn into this website that that becomes the receptionist and oh, you want to know the prices? Here you go. And then, oh, did you want to, did you want to schedule or no?

And just leave it up to them? I don’t, I hope that’s not where we’re heading and I know some areas in Miami. It’s getting very much like that. It’s um, they’re not even meeting the doctor until the day of surgery.

Randy Waldman, MD

It’s become very personnel. I’ve heard that. I’ve heard that from, you know, a couple of sources that there are practices where you don’t meet the doctor until the day of surgery.

I just think, I don’t know. I that’s so dangerous to me because I don’t even know that you can defend that, uh, on a liability basis. Uh, you know, there’s, there is the. The whole thing, uh, that, uh, you know, even with informed consent that, you know, many, many people feel that informed consent really can’t be given or signed on the morning of surgery because the patient theoretically is very stressed.

And, and so, you know, we try to do all of our informed consent two to three weeks before surgery, uh, in a well-orchestrated surgical planning session or education session. And we have. One nurse that that’s her sole job is to make sure that our patients, uh, are good to go for surgery. And that they’re well-educated, we’ve, we’ve made videos, uh, uh, of, uh, planning sessions and, and, uh, You know, we’re not completely through the video cycle yet, but we’ve made a lot of really good videos that have helped cut down the amount of time that somebody would have to spend with a patient.

But we’re very insistent that, uh, our patients are well-educated and that our informed consent has occurred well before surgery. Uh, and that our patients are, you know, healthy because we do. Most of our surgeries, like 97, 95, 7%, whatever. Uh, in our own surgical center owns, uh, we have an accredited surgical facility, as you know, and the only patients we tend to take to the hospital, uh, are patients with, uh, you know, BMI issues or health issues or, or whatever.

So, most of our patients are done here, but at the same time, Uh, you know, we’re under a different standard. We have to, we have to perform better than the hospitals we have to. We have to be a little bit better. We, we really can’t afford to errors and, uh, or bad outcomes. So, we’re really pretty good. Pretty strict on the front end, as far as health issues and other issues that relate to pre-op planning.

Catherine Maley, MBA

Well, as a patient, I love the privacy and convenience of your in-house surgical center. I can’t imagine going through a hospital. That sounds horrible to me. Um, but I also can’t imagine going somewhere where I hadn’t met the doctor. I don’t understand, uh, there’s a certain group. Patients who just don’t think the doctor’s important or I don’t know what their mindset is to say.

Oh, sure. I’m just going to meet with somebody on the telephone and they’re going to schedule all this for me. And I don’t even know what’s going on or what’s, I just don’t, I don’t get that. And I hope it doesn’t catch on because if we take the relationship out of this and we, all we have left is price.

Um, that’s not good for anyone. Yeah.

Randy Waldman, MD

You know, and the other thing is we kind of want to know a little bit about our patient too, don’t we, you know, it’s, it’s, it’s not a one-way street. It’s really a two-way street. I probably one of the only, I mean, I probably the only negative review that I’ve had in the last year, uh, came from a patient who basically I turned down, uh, because I really.

You know, she was, uh, a rhinoplasty consulate, and I really felt like she had, you know, expectations that I couldn’t, I couldn’t achieve. And, uh, and she’d already been to one other doctor and brought me an imaging pictures from this doctor and said, this is the nose that I want. And I looked at that nose and I really think it looked very good.

So, I told her, I said, no, you know, I’m not going. Not going to go there with that. I think that you really need to, you know, I did it nicely. I thought, uh, she wrote a review and said she ran out crying and she thought that I was going to be the, the choice and the right person, because she liked the noses that she saw, you know, on our website.

But, you know, I, I think that we reserve the right and we should, uh, turn down, uh, patients. I’ve got a lecture coming up at a, at a meeting in Nashville that Michael gold puts on it. Uh, you know, it’s, it’s the second time I’ve given a lecture on body dysmorphic disorder, but you know, after 40 years of doing what I do, you get a good feel for body dysmorphic disorder.

And, uh, I, I find that the final slide on that talk, Katherine, is that there are, there are. Crazies, and there are bad crazies. And what you’d like to do is cultivate the good crazies in a way, because you can be very helpful for good crazies there’s studies that show there at least 50% of the people that come into our practice that probably could be classified as having body dysmorphic disorder.

On the other hand, the bad crazies, those are the ones that come in and shoot. Uh, those are the ones that write the horrible reviews, uh, that you see. And those were the ones that just dog you. Uh, and so, uh, you know, that’s why seeing the patient, the morning of surgery, doesn’t make a whole lot of sense to me because, you know, I eliminate, uh, not a lot of patients, but I eliminate some.

Catherine Maley, MBA

For sure. Um, uh, one question about nonsurgical, um, you, when you run your P your, um, conferences, you see all the new technologies coming out and there are more than ever. How is that? How are non-surgical treatments affecting your surgical procedures?

Randy Waldman, MD

No, I, I I’m sure it does because it’s number one, use of discretionary money and, uh, limited resources.

So, somebody else is getting that discretionary money. A lot of times might be a metal spawn somewhere and the old, the old. The parable is that, uh, if you only have a hammer in your toolbox and everything looks like a nail, well, if you’re a Metta spa and you can only do noninvasive stuff, then you’re going to say that every person’s a candidate for that.

And realistically, that’s just not true. And we know that. And so, we tend to get a lot of unhappy patients that. Uh, you know, had false expectations. They, uh, they, they didn’t, they were promised one thing and they got something else. They were promised, uh, a surgical result and, and they got, uh, the typical sort of less invasive or non-invasive result.

And so, there’s the danger. Uh, and I, I don’t know how to temper that. I can tell you that, you know, we have a lot of these tools and stuff, but, um, I think minimal downtime, minimal result. I’ve always said that minimal downtime, minimal results, long downtime, probably a more aggressive result. And, uh, it starts with little light resurfacing procedures versus the, uh, the gold standard.

The, the, uh, The, uh, you know, fully a blade of CO2 laser resurfacing. Well, that’s a long recovery, but it’s a major wow result and you can’t get that with anything else. And so, I think that because we have so many people now that that attempt to do or do what we do, but only have a limited amount of tools that they could use, uh, that you, you tend to see a lot of, uh, dissatisfied or unhappy patients, uh, because.

Catherine Maley, MBA

I have such a mixed feeling about it because as a patient, I have I’ve entered every door. You can enter into this industry. And I started personally 23 years ago with microdermabrasion. You know, I just got my little package of micro-German. I got to know the esthetician and it. Um, just a relationship kind of thing.

And it was a fun thing to do. And boy, then I just move right on to Botox and filler and IPL laser. And, um, so many times I tried to fight the surgery with the nonsurgical and, but it was helpful cause it kept me in the game. It’s just you’re right. My disposable income went to nonsurgical until it couldn’t anymore.

And then I jumped to surgery, but then it went back to non-surgical if I could, you know, so, um, I think it’s, it’s, it’s complicated for the patient. And I almost think you have to meet them where they are. If you want to develop a relationship with them, just meet them where they are, and then they’ll stay with you.

Randy Waldman, MD

If indeed you are. And like everything, if you’re honest about expectations and you temper their expectations, you’re absolutely right. It’s an entry point. And, uh, you know, grant Stevens was always fond of giving a lecture called patients for life. And part of that is to you, you can’t operate on, uh, you know, every six months.

And so. Uh, for us as surgeons there, there has to be another, for some people, there is an entry point. You have to let them test the water suitors form, get a comfort level with you. And, uh, but, but that starts with realistic expectations. If they, if you ever make promises that, uh, because you need to do more procedures with something, because your RI has some big gut with a piece of technology that you bought, uh, then you’ll lose that.

And you’ll lose their confidence and their trust. So, whenever we look at, uh, you know, uh, technology, we’ve gotta be sure that it works for us. And it’s something that, uh, provides an entry point. An example would be, um, we were on the forefront of micro needling with radio frequency. We’ve been doing it now for several years.

And some really nice results with that. It’s not a substitute for surgery. If we have a person though, that’s unhappy, we tell them on the front-end look where you should have three of these procedures. If you don’t think it does enough for you, then we’ll apply half of it to your Facebook.

Catherine Maley, MBA

That’s what I don’t mind as a patient.

Yep. Um, and I think some of these technologies, they, they need you to come back 12 times. I will just tell you as a patient and as a human being, I, I think it’s a struggle to get people back 12 times. I think three is about the limit. And, um, so some of this stuff is, uh, it’s, it’s difficult in today’s world is difficult to.

LA, I get the point of it. It’s a nice long-term relationship, but only if they keep showing up and I think it’s different.

Randy Waldman, MD

Oh my God. It’s sort of like injectables, you know, again, I always describe it to my associates is a means to an end. Uh, and I feel like, uh, it’s never, you know, because we don’t use the standards.

We don’t, we, we have a limited amount of time that we’re in the office where most of us are in surgery three days a week. So, we have two long clinic days and. It can be exhausting. Um, but, uh, during that period of time, uh, when I’m doing injectables, uh, fillers or toxins, I like to do it myself because I would say on, I don’t know what the percentage is.

I should look at that one day, but it’s a high percentage of people over the age of 40 that become a surgical patient, uh, uh, because of, of my attentiveness. You know, to what, to their, to their issues, uh, you know, using injectables and some people they don’t want to come in and even talk about their almost, it’s kind of a weird thing.

And of course, I live in Kentucky and California. Everybody’s coming in, they’re pointing out the exact type of facelift that we want, but in Kentucky, they’re coming in and they’re almost. You feel that they’re almost a little embarrassed to start the discussion. I want to face them. That is the point that they’re nasal APL pearls.

And they’ll say, can you do something about this? Um, you know, do you have something on your objective or something? And as we get to know each other, the second or third time they come in, they’ll start pulling out their face and say, you know, I’m really thinking about having this done. So, it’s a little bit about relationship building.

Catherine Maley, MBA

Uh, that’s so true. I listened to a lot of industry calls and I’m surprised at how many women cannot. I need a facelift. They will they’ll skirt around it and say, you know what? I’m just feeling a little, um, I need a little something maybe. You know, maybe a little something there, but maybe, but like, they just will not say they either facelift.

So, uh, it’s just something to know, you know, so let’s talk about your meeting because it’s the global aesthetics meeting it’s in Miami, in November, which is such a perfect time to be in Miami. So, tell us about that conference. I personally speak there and I love the conference. So, what can we learn at this conference that we have in, or what can the attention?

Randy Waldman, MD

First of all, we love having you.

Uh, I always try to convince you to, to follow me through all these meetings. And I don’t know how many of my meetings you’ve, you’ve been a part of, but I know it’s more than that. 28 to 20, again, we’re looking forward to that. Uh, you know, it’s, it’s a, it’s a true multidisciplinary or multi-specialty meeting.

And, uh, you know, I started, uh, Kind of into the multi-specialty world all the way back. Uh, uh, when I had the Newport beach meeting, Catherine and, and the 1990s, and we took that idea to Las Vegas and developed it into something really big there, uh, where we, uh, you know, uh, in 2019 we had a couple of thousand attendees.

So, it was a large meeting. Uh, but the one, the one thing my philosophy audit was that no matter which of the four core specialties you were in, there was always something for you when you. In the door at every moment of the day. So that a true specialty meeting means that there’s something for everyone all day long.

There is a venue for you. So, we have a multi-track meeting as well as a multi-specialty meeting. Uh, and we have different things going on in different rooms. I like to have a surgically oriented room, a less what I call not non-invasive. But less invasive that covers a little bit more so a less invasive room, a surgically oriented room.

A lot of people want more in-depth presentations rather than short presentations. I really don’t like presentations that are less than 15 minutes for no matter what. Cause I don’t think you can get much out of it. But I also know that a lot of people like more in depth presentations and so we have what we do.

Developed way back in 1991 and that’s called master seminars. Uh, and that’s where we have somebody that’s a real expert giving a 30-to-45-minute lecture on something that people can really take home with them. So, we have the, the room with master seminars and. Uh, you know, uh, involved or in-depth presentations.

And then I, I would be remiss if I didn’t, uh, brag about our practice management and marketing sessions, which are often the best attended. Uh, you know, what’s interesting about that. I had a long discussion, Catherine, and you’ll, you’ll really appreciate this. I had a long discussion yesterday with ours. Uh, CME provider, uh, and talking about the new ACC, GME, uh, regulations and requirements and policies.

And there’s a few things that have changed, but you know, what really struck me as, uh, uh, interesting is that they’re now moving and saying to some of these practice management marketing lectures can actually be Percy on me now because they think that, uh, the actual management and making a facility.

Patient friendly and more efficient, uh, is an important part of what we do. So even the, the thinking of the ACC GME people is changing. But back in 2004, we started a practice management, marketing, and depth. And now, uh, our program, uh, is one full track of three and a half days of practice management, marketing lectures, uh, and talks by the, by the country’s experts, including, uh, yourself.

And to me. Uh, every doctor should be bringing their staff to these meetings, uh, and, uh, and getting their staff to believe in what they do and see how other people do it and network with other offices, uh, and listen to the experts. It’s just worth so much to do that and a great perk for your staff as well.

So, I encourage people to bring their staff, but yes, we have a full track in practice management marketing. So, our meeting right now is a four-track meeting. Uh, we also have sponsored workshops to make it a five-track meeting, uh, and that really provides something for everyone all the time. And that’s a real multi-specialty meeting, not just having a couple of specialists of each type there, but we have a full cadre of, uh, of dermatologists that are experts in cosmetic dermatology, oculoplastic surgeons, facial plastic surgeons, and of course, plastic surgery.

Catherine Maley, MBA

And are there any, uh, COVID restrictions? Can we go mask lists?

Randy Waldman, MD

And actually, but the last time I talked to the hotel, we try to talk with them once a week, once every two weeks. Anyway, uh, right now it’s wide open, uh, Florida is wide open. Uh, it has been for a while. There are no mass requirements except for their own staff.

Uh, it’s up to us if we want to require mask. And we’re not going to, uh, I would encourage people that haven’t been vaccinated, uh, to either get back sedated, which I would encourage, uh, or to, uh, to wear a mask during the meeting, but we’re not going to require that. And I think the majority of, uh, our colleagues have been vaccinated and are looking forward to, uh, a mass meeting and, um, Uh, as far as, uh, restriction of, uh, numbers of people, there are no restrictions right now.

So, let’s, let’s all keep our fingers crossed. And, um, you know, I have great confidence that the authorities in Florida will, uh, you know, we’ll maintain the same place.

Catherine Maley, MBA

And is it open now for registration by going to our website of, uh, GA conference or global aesthetics

Randy Waldman, MD

Uh, GA is, uh, another URL that we have.

So, GA and, uh, you know, uh, if you need to call us. You can certainly call. I don’t even know the 800 number right now, but you can call our office (859) 254-5665. And, uh, or you can write to me personally as our [email protected]. I still, I know, but you know, it’s sort of like changing your phone number.

I could say you’ve had the same phone number forever, so I’m afraid people won’t be able to find me if I go to something else. So, it’s Sr Walnut, ALS. I have a Gmail address, but I don’t even look at it. So, um, I’m kind of old fashioned in that regard, but it works for me. All right.

Catherine Maley, MBA

And is the meeting completely living or can you come, can you go virtual?

Randy Waldman, MD

Or is it all, it’s an interesting subject and, you know, I talked to a lot of industry and I have a lot of friends in industry, as you know, and I try to keep abreast of what they want, what is important to them?

I think the virtual meetings. I think that that cycle is tapering off. And so, uh, we may have a couple of elements of the meeting that we, uh, that we beam out, uh, like the live injection session. Uh, we may, uh, put that law. But we’re not going to charge for whatever we put live. We’re not having a segment of it for CME, uh, that you can take virtually.

I’d like to see everybody there. Uh, I want, I think that is a principle that I’ve lived with and we’ve gotten through, uh, COVID uh, we’ve actually. Pretty much Catherine, um, stopped doing virtual consults in our own practice. And I know a lot of people still do that, but we were, we were finding that, um, that we were just seeing them twice anyway, that we would see them virtually and talk with them and then they would come back in and we would forget a lot about what we said they would expect us to know.

So, we’ve, we’ve pretty much gone back to my consultations without any resistance at all. Uh, the exception is out of state people, we will do. Virtual consults on because we know that they have to come from a long distance, but I, I still insist on having everyone, even on a how the Tom patient coming in the day before.

Uh, so we can do an appropriate planning session to have plenty of time to do that. Uh, I don’t like the idea of meeting on the morning of surgery. So, um, You know, maybe that’s the old-fashioned part of me, but it’s worked for a lot of years, so we’re going to stay with it. But yeah, uh, we, we would encourage everyone to look at our program.

It’s I, I don’t know what you think of the Katherine or what you think of the practice management part, but I, I really like it this year and I think it’s very dynamic, uh, and I’m sure it will stray off of the beaten path and we’ll have lots of COVID post COVID discussions, uh, that we never intended. Uh, maybe when somebody submitted the talk, but it’ll veer off the line a little bit, but I really like our program.

I think it’s very complete. And, uh, the content to me, uh, is still the most important part of putting together a program. Uh, it may be a website too, but I think that the content is so important in a program. And I think a lot of people have gotten away from that. They put a lot of sponsored things on there.

And, and I think people want CME content and, and CME hours. I think we give, well, I think we give over 30 hours of CME credit for a lot of states. That’s all they need for the whole year. Uh, in Kentucky, that’s all we need. So, um, and I would encourage people to take a look at the program and, uh, you know, forget about the fact that it’s in Miami beach and the weather, 75 date industries, and the restaurants are great.

The ocean is right behind us. It’s really not. Right. Uh, the important thing is the content to the meeting and the people that you’re going to be around. And really, it’s about getting out around people again and getting used to that again. And I personally think that’s something that we’ve all really needed and, uh, and hopefully, uh, you know, we can all come together and they’re not going to be any, any new, uh, crazy strains of things, uh, that, that pop up or anything like that.

Catherine Maley, MBA

Well, I can tell you I’m so excited. I haven’t been out yet. I haven’t traveled yet, so I will start traveling again a couple of months and then I’ll be, um, the global aesthetics. This is my favorite meeting because you know how to run a meeting better than anybody else. You’re so right. There’s always something going on for you.

If you’re not loving this section, go to another section and you’ll love that. And your food is always really good too.

Randy Waldman, MD

The food is really good down there. Yeah. And the thing is we, I, I just think that the corporate mentality, you know, is one thing, but that’s, that’s not, you know, we, we, we feel like we’re hosting people into our home.

We’re into our practice. I have people visiting our practice a lot, you know, I, I think you have to treat people in a certain fashion. And so, I, when I go to other meetings, I really look at that. And, uh, you know, I, I, I saw. Preach that to my staff. Uh, and I choose my staff for that reason. I choose the same type of meeting staff, uh, that I started with using my own office staff for that.

But now my meeting staff are the same people. These are the types of people that I would hire in my practice to receive our patients. To me, uh, you know, we, we talk about external PR, but you taught me years ago, the importance of internal marketing and internal PR. Uh, and, and in my experience, that’s proven true that the, you know, the TV ads and all that kind of stuff, you know, it’s that, it’s about how you treat people and then don’t go out and talk about it.

And then ultimately it gets down to reviews and how you treat people. So, um, I I’m going to leave with that, or I don’t know if you’re finished, but there was a story. The last time I sat with you, I sat there and talked about him. You said, you know, how’s your practice going? And you know, you asked me about reviews.

And I said, well, we’re doing pretty well with that. We’ve got like 500, 600 Google reviews. You remember talking to me about that? And you said, well, let me look at that. You opened it up and you looked at it and you said, well, this is not good. And I said, well, what’s the problem. What’d you say, Hey, you need to find some bad reviews.

I said, I said, so that patient that came in that got mad at me because I wouldn’t do her nose up. Know, so maybe that was scripted. I don’t know. Did you send her in to see me?

Catherine Maley, MBA

I should have, because you know what? Those are the kind of reviews you want. If that’s the biggest problem you have is that you are honest with a patient and said, I don’t think I can make you happy.

That’s what we want to see.

Randy Waldman, MD

Yeah, I’m not sure what the hell that is. Somebody writing about a bad surgical outcome or something like that. So, yeah, but that was, that was the last time we sat together. It was what you told me about. We talked about reviews sites. I still tell everybody at my practice about that. Uh, uh, so that was pretty funny.

No, I don’t. I think we’re still at five points, oh, I think it’s not diluted enough. Uh, you know, cause we have, we have a lot of them, we we’ve, we’ve been able to, uh, my staff’s really good about, uh, generating reviews. We have a little contest in the office that we give little rewards, uh, for people that generate more reviews and that kind of thing.

So that works.

Catherine Maley, MBA

As a great tip. Very nice. All right, let’s wrap it up now. Thank you so much, Dr. Walden. I cannot wait to hang around with you in Miami, in November, or maybe in Kentucky in October, if we can.

Randy Waldman, MD

Well, I hope I hope you can make it here. And, uh, we’ve, we’ve had you here before, uh, you didn’t mention that and you visited us and, uh, it was a great pleasure having you you’re, uh, truly one of a kind.

And, uh, so I always enjoy it. Uh, you know, going back and forth with you and, uh, so it’s been a great, it’s been great.

Catherine Maley, MBA

Good then I’ll see you in the fall and twice in the fall. Okay. My phone again. I’m so sorry everybody. Let’s wrap this up. Um, thank you so much. And if you enjoyed beauty and the business, please head over and give us a review and subscribe on iTunes at beauty and the beast.

If you have any feedback or questions for me, please leave them on their or feel free to DM me at Catherine Maley MBA at Instagram. Thanks. And we will.

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Catherine Maley

Catherine is a business/marketing consultant to plastic surgeons. She speaks at medical conferences all over the world on practice building, marketing and the business side of plastic surgery. Get a Free Copy of her popular book, Your Aesthetic Practice: What Your Patients Are Saying View Author Profile.


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