Ep.50: COVID-19 Update with Randy Waldman, MD
Tune in with Dr. Randy Waldman, founder of Vegas Cosmetic Surgery – The largest multi-specialty symposium of its kind in North America. Dr. Waldman serves on the Board of Directors of the American Board of Facial Plastic and Reconstructive Surgery, and has coordinated or organized over 45 major medical conferences in the US and Europe. He’s been named as one of the TOP 15 Influencers by Plastic Surgery Practice Magazine, and shares with you now his unique perspective on COVID-19. Learn what Dr. Waldman’s doing with his own practice to stay afloat during these turbulent times, and get sound advice and discussion on what’s working and what may come with the current pandemic.
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Transcript:
Beauty and the Biz
Ep.50: COVID-19 Update with Randy Waldman, MD
Catherine Maley, MBA: Hello and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery. I’m your host, Catherine Maley, author of Your Aesthetic Practice: What’s Your Patients Are Saying, and also consultant to plastic surgery practices to get them more patients and more profits. Now today’s episode is an interview with somebody I greatly admire, and I have known for years that he has risen to iconic status and you’ll see why in a minute. Dr. Randy Waldman is a double board-certified facial plastic and reconstructive surgeon in Lexington, Kentucky, and he’s been in practice for over 30 years now. Now his articles are published in scientific journals, and he’s recently been the editor for two medical books on Facial Plastic Surgery. Now he has given over 500 presentations at cosmetic surgery meetings over the past 25 years in the United States as well as Europe. Now he’s even in addition to that has grown his private practice to four surgeons, I can’t imagine plus a whole lot of staff, and he’s been voted one of the top 15 influencers by PSP magazine. However, his big, big claim to fame is his unique ability to organize and coordinate over 46 major medical conferences. And those include — and a lot of them. So, Dr. Waldman is the founder of a really popular meeting called Biggest Cosmetic Surgery. Now it’s the largest multi-specialty symposium of its kind in North America. And he’s also founder and current director of the Global Aesthetics Conference in Miami Beach. And that’s going to be held this fall. And it’s still on, and we’re going to talk more about it later because I want to see you there. Now, this is something Dr. Waldman doesn’t know, when I got into this 20 years ago, this is 20 years– this year is my 20th anniversary. The very first meeting I used to go to was this Newport Beach meeting with vendors and it was the facial plastic surgery meeting. And when I was there, I thought– when they said oh, he runs this meeting, I thought that meant that’s what he did for a living. Because I used to run if the California Medical associations house to delegate a million years ago, and it was a full-time job for me. So, the first year I was with him, I just assumed he was the meeting planner. It turns out, he wasn’t just a meeting planner. He also had a thriving practice. And I realized, oh my god, this guy never sleeps. So, I just thought that was really interesting. So now I realized he is a Superman. So, Dr. Waldman, thank you so much for coming to my podcast. I really, really appreciate it. I can’t admire you any more than I do. So, I’d like to welcome you. Is there anything I left out?
Randy Waldman, MD:
No, I appreciate all those compliments. It’s so flattering. And, Catherine, I didn’t realize that until tonight that you were even at the Newport Beach programs because– did I only speak at that?
Catherine Maley, MBA:
No, I was in the back then. I was still a sponge. I’m still learning the industry. And I wasn’t speaking yet.
Randy Waldman, MD:
That’s amazing. I– that you went that far back with a lot of us. So, you’ve seen a lot of us, kind of mature and our practice grow older. But those were really great meetings. A lot of people don’t remember them. But they were really– there were a lot of products including Botox. Those meetings and Botox were introduced eight years before it was actually FDA approved. And we took turns injecting each other using EMG outlets, crazy things. And we were hoping using hand shoulder you know, those old VHS cameras to beat things. I remember one time the power went down and we were doing all these lasers and, in a ballroom, and everything went dark. I mean, we and, in a ballroom, had so much different things happening but it was really a lamp. It’s something that that was a very important meeting for its time because it really was the first continuous cosmetic surgery meeting probably in the country that come different specialties. And that that’s what I sort of a base by meetings career on is trying to mold and trying to get different specialties together. Because every specialty has a special knowledge that they that they have and an to share it among different specialties is going to do nothing but make the medicine of aesthetic medicine and surgery better. And so, I really started doing that under the influence of a really great Facial Plastic Surgeon by the name of George Brennan. And George taught me a lot of what I know with meetings and so, jack Anderson taught me a lot of stuff he had in New Orleans that I when I was a fellow, I helped put together that meeting his avalanche with the fellow did then and so then I was Lorne Pastorek, who was president of the AF press in 1991. Got a note from jack Anderson and using jack was very influential. He says, hey, Norman, I’ve got this guy, I really think you’d make a great chairman for the annual meeting. And in 1991 is a very young, I was probably the youngest chair ever for that meeting, but it was in Kansas City, to exactly a mecca for meetings. I know exactly where I don’t mean, held there since then. But the number one Academy meeting of all time and attendance was in Kansas City that year. And we brought in people from outside it was really heresy to bring in people from outside. But when you think about some of the names a guy that just left St. obagi fellowship, I decided I read something that he wrote. And I was fascinated by this green pill or something. And so, I invited Mark Rubin, right out of his fellowship, to be a lecturer at this meeting of facial plastic surgeons in in Kansas City. And then there was a guy by the name of Robert Goldberg, Bob Goldberg, who was in LA, who is now one of these themed ocular plastic surgeons in the world at the Joel Stein Institute. And I invite a bomb. And so, it really was, you know, the beginnings of what then became, you know, the regular affair in Newport Beach and how I would invite in some of the leaders because it was in Southern California, I could get these California guys that would drive down. Mitch Goldman and one of our early people, dictates Patrick again, from the golden group down in San Diego, we had really Ron boy from LA was part of our faculty at turina. We had, we had people all around us that we could draw from and that was the beauty of it. And people were willing, for some reason people were willing to lay their turbine guns down. And Bruce canal was, you know, making recipes. The late great Bruce canal, one of the great plastic surgeons so brilliant in our area. And we all love Bruce, who’s a gentle, gentle giant. But Bruce taught us how to do facelift. And, and so it was really a collective effort. And I just took that, that mantra and ran with it. And that’s Newport Beach. And that’s global settings. And that’s what I base my career on is trying to get people together.
Catherine Maley, MBA:
I remember at Newport Beach; Dr. George Brennan would park his Rolls Royce in the front. And I remember thinking, who are these surgeons, they were a different crowd. I really, it was interesting. Anyway, let’s get back to the current events, which of course, we can’t talk about anything but COVID-19. And I wasn’t going to take for granted what’s going on in Kentucky because it seems so changing and regionally different. What your status there? Are you in, are you out? What’s going on?
Randy Waldman, MD:
We’ve just been allowed to open our doors really in the last week. And we’re in a phase one type of thing right now. We have a governor that’s been pretty hardcore about things. That’s his privilege, he’s the governor. And so, we follow the governor’s guidelines like everyone else, we close down and I think on March the 11th by the governor’s decree, and stopped doing surgery. We have our own surgery center; we do 95% of our surgery there. And we were forced into a shutdown. And we had months of things backed up, we were booked up several months with cases among the doctors that are grouped, and all of a sudden, it stopped. And then we had to figure out, Okay, how long is this going to go? Like a lot of people, we didn’t know. Is this one week? Is this two weeks or shutdown? Or could it be longer? It could be longer part was very, very bright, because we have a staff and they count on us, and we didn’t know what was going to happen. And then all of a sudden, we’re hearing congressional solutions to this and LPP whatever it is loans. And we’re talking about terms that we’ve never heard before, like furloughs and layoffs. And these are terms we’ve never used before.
Randy Waldman, MD:
Did you end up doing with your staff?
Randy Waldman, MD:
Well, I’ve never laid off anybody before. I didn’t know what it was. I mean, I kind of do, but we looked at it. We tried to decide for a while for the first two or three weeks. And we said no, we’re keeping our guys together, because I didn’t think it would go any longer than that. But, you know, eventually we all came to the recognition that this wasn’t this, this wasn’t to be taken lightly, and that we were maybe going to be out for months. And we corrected so they came out with all the things that they came out with that you could furlough people and that they would be able. There are some people that made more under furlough by getting the extra $50 an hour the $600 a week and, you know, deal added to their unemployment. There were there were some of our employees that actually made more money when they were furloughed. And so, we furloughed about two thirds of our staff and we kept the third on to work ahead. You know, we I sort of took my time to try to figure out projects to improve our practice knowing we’re all going to come back. So, let’s come back stronger. And it was by ideal to come back stronger and we needed, you know, some solutions to some of the issues that we had had. We wanted work on our website now was the time that we can do it. We have a videographer that works for us. It was a news reporter that was a videographer when she was a news reporter. So, we decided we’d start creating video series for our preoperative planning and discussions. And also, for our landing pages on our website. So, we decided that we would do our own videos and, and we’ve done several so far, and we’re still doing them. And you know, we’re working on the website, and we’re working on newsletters, and all the things that we thought we had to do to keep in touch with our patients during whatever down period that we had. And, you know, we So, started doing video consults, or telephone consults or Virtual consult, Steve knew he knows before this, and not really weren’t, we really weren’t. And I know a lot of practices did, but we really didn’t. I mean, there were occasions where somebody would send us pictures, they would be from LA, they send us pictures, and we you know, but not It wasn’t a regular thing, I still enjoy meeting people and talking to them. And to me, that’s, that’s half of the fun of what I do is intermingling with, with patients and, and So, talking to them and use whatever personality I have to make them more comfortable. And it’s harder to do over the phone. It’s harder to do, you know, in this type of format, even. But we started doing it. And the more we did it, the more we realized that this was going to be a thing for a while. And I don’t know, we’re back open. And I saw one of my partners today I looked at his schedule, he has done new virtual consults, we have conference room, and they go in there and they slip on the you know, whatever, they’ve got it there. And the technology we have, we have an IT person is you know, that works for us in our practice, because we have like 23 computers, and none of us know anything about them. So, we have to have somebody that’s always installing a printer or fixing something that’s down or replacing a computer. So anyway, we set this all up and the virtual consults are– I don’t you have to tell me why you’re a consultant that I’ve learned a lot on over the years. I give your book to every new book that and I need a few more right now, by the way, everybody’s taking the book, but learned you always relied on that. But it’s interesting, Catherine, our closure rate on these virtual consults is much higher than any closure rate that we’ve ever had in our I’m hearing that all over the coaster 100%. Yeah, I guess it’s a select group that, you know, that really during this whole crisis is things they’re looking at themselves and taking selfies and look into the beer that they’re stuck at home. But I don’t know, maybe you can figure it out. But yeah, it just seems that every concert is really serious. And their big question is, when can I get on your schedule? And I keep giving the same answer? Well, we’re still restricted, we’re, you know, we’ve got a backlog of three months of surgery. And, you know, we’ll probably get you on at the end of summer or something like that. And we’re hoping that you know, we can and we’re hoping that there’s no rebound on this, this ridiculous plague. And so, we’ll see. I mean, but everybody wants to book that’s the hard thing right now. So last week, for the first time we started with body cases, we decided that we would do the quick body cases that we thought would be the simplest for our staff that would use the least amount of out of profile, which is our we use everything we do everything with IV sedation, we don’t like a lot of guys in California, we don’t use general anesthetic, there’s nothing we do can be toxic, that we can’t do under kind of a deeper IV sedation with propofol and local anesthesia. So, everything we do is but so, also, we’re so, kind of, you know, the supply that we normally have in stock, and we normally keep a fair amount of stuff for you know, that that’s just for our surgery center, we know that, that sometimes they their shortage is particularly profile. So, we So, have a fair amount of profile, but we know that if we take in a new supply, which it may be tough to get, you know, because we have a lot of people on ventilators around the country, that the government’s probably going to be kind of, you know, securing as much profile as they can get. So, there’s backorders. But anyway, make a long story short, you know, we’re trying to do cases that we’re not using a ton of drugs to keep them under. So, we decided that we would do primarily all the backlog, breast augmentations and breast procedures that we have, and we’re waiting for really more effective testing to try to get us make sure that we’re safe doing a rhinoplasty because that’s probably the most dangerous procedures you know. Coronavirus hangs out the nose, Catherine. So, the most dangerous procedure that any of us would do for our staff is rhinoplasty.
Catherine Maley, MBA:
And I’m watching some of your surgeons like wearing full on face suit.
Randy Waldman, MD:
No, we’ve seen that. I just can’t do that. To me, if I have to put on armor to operate like that. I’m not going to feel comfortable of that. Rhinoplasty is a very meticulous [inaudible] by millimeter operation. And if I don’t feel that I’m safe in doing it, then I really don’t I want to do. And so, we’re kind of holding off and letting the other guys do the procedure and do their procedures. And then I’m going to try to get back involved with rhinoplasty somewhere around June the 15th.
Catherine Maley, MBA:
And are you putting any other restrictions on your surgical patients like of a certain age, you’re not going to?
Randy Waldman, MD:
That’s a good thought. That’s why we started with breast augmentation. That’s a much younger group. And we’re trying to avoid surgery on the people over 40 years of age. And so that in essence, is what we are trying to do.
Catherine Maley, MBA:
Gotcha. Okay. Now, how are you handling the testing of things, testing your staff or testing your patience, how’s that going?
Randy Waldman, MD:
And regarding your staff, I know I’ve been on some of the webinars where there was not a good answer for this, but what if your test your staff tested positive, and you send them home and anybody do it?
Randy Waldman, MD:
Every surgical patient has to be tested within 48 hours. And then we’re asking them self-quarantine, between the time of that test, they self-quarantine come in, we’re asking them to come in that a family member dropped them off. And then the family member cannot wait in our reception or in surgery, which is typically what we do. We have two reception areas, one for our third for clinical region and for the first for surgery. So, we’re just asking the family member to drop them off. And then we’ll ask them to pick them up when the surgery standard will call themselves. They call ahead. They text us; we welcome them. And then it’s just the patient. So, we do test everybody on 48 hours in advance. And we usually have a 24-hour turnaround.
Randy Waldman, MD:
That would be a tough situation. Because, you know, I think then, if we’ve been around them, then we would have to probably enlist quarantine the people that have been, you know, around them. And that we think would be subject to any type of, you know, infection. So, we’re just hoping and praying that that doesn’t happen to us, if it happens in surgery, and then we’ll probably have to bring our third for staff down surgery to fill in. And they’re certainly capable of that they’re all most of them are a lot of nurses, we have like five or six nurses that work for us. But we’re hoping and keeping our fingers crossed with everything that we’re doing. And that, you know, we’re protecting the patients from our staff and protecting staff from our patients. And doing, you know, doing things as good as we can do them. But there’s no question that that we live in fear of that we live in fear of patients that the thing that I most fear is probably a patient getting an infection from somebody in their family four or five days after the procedure, if it was one of our bigger procedures, but that’s why we’re not doing those right now. And we’re trying to limit our procedures to the smaller procedures. Because if it was somebody and they had like a tummy tuck, and they got the COVID infection pop seven days after the tummy tuck, it’d be a rough first one. We, you know, there’s some anecdotal evidence that some of the bigger procedures do lower the immune response. And, and so, you know, we don’t have much of an immune response to the COVID virus, but a little we do have I guess we probably need so that’s a tough question. It’s an interesting question. I hope we don’t have to I don’t have to deal with that. If a staff member were to get infected, how would we do things in our office? It’d be, it’d be tough. I mean, I guess, in the worst-case scenario, we’d have to shut the office for 10 days.
Catherine Maley, MBA:
And what’s happening with the Medi spa or the non-surgical? Is there a date on that?
Randy Waldman, MD:
Yeah, in Kentucky, it’s May the 25th. So, three weeks after we were allowed to open our offices. But I actually called the governor’s office and I [inaudible] contacts there, and they didn’t want to have an unfair playing field. So, they asked us to avoid the injections until the 25th to give everyone an equal playing field. And it’s like, I don’t think there’s any equal playing field anyway, I think we’re we have an unfair advantage due to our overhead now practice and on and on. But, you know, we honored that we haven’t done any injections, so we don’t plan on doing it till May the 25th. And then we’ll open the doors for So, that. But again, we’re requiring the same do they’re asking us to outfit ourselves the same way that the dentist is. So, we’re following dental protocols. And the dentists in Kentucky are in full battle gear. I mean, they’re 95, mask, goggles, visor, and then some type of scrubs and some protective clothing over the scrubs. And so, we So, couldn’t get what we call the bunny suits. They’re backordered by far and nobody can get them because they’ve been used those in the hospitals. So now they’ve created some sort of paper white gown or something that we’re using over our scrubs. And everybody changing the scrubs when they come into the office and down in the operating room. And then we’re asking them to you know, we’ll honor those. We have the service and we’re asking them to change they’re Not to Wear them out of the office and our anesthesia, people come in from outside reskin them to do the same thing. So, everybody in our office changes in the scrubs when they get there and changes out when they leave. And we, you know, we’re using 95 pounds for any type of invasive treatments that don’t include injections. And our patients are wearing masks. Obviously, if you’re injecting someone’s lips and stuff, we haven’t done that yet. But if you are, then you’re gonna take your mask off, but you’re keeping your mask on, and it goes to your [inaudible]
Catherine Maley, MBA:
It’s just going to affect that our industry is all about relationships and bonding with people and trusting them. I just don’t see how this is going to work when we can’t see each other anymore. I haven’t been out much. But when I do go out, I feel so antisocial. Because I already like, don’t touch me, don’t get near me. What’s a weird feeling. We’re all messed up. Just for right now, I hope that–
Randy Waldman, MD:
I think this is all temporary, at least not long lasting. Because I totally agree with you. And you know what I remember the transition when the dentist was there that all of a sudden, they’re wearing a mask. And also, I’m talking about before code. And you felt they were coming at you like you were this infected leper. Yes. Oh, and they’re because when I was younger, or even until five years ago, the dentists weren’t wearing all this protective stuff that had been over the last number of years. And you know, and so, in the end, I agree with you, it does take the personal touch out of all this and, and I am worried about that. It’s very worrisome to me.
Catherine Maley, MBA:
What are you going to do about the patient flow? Because the way it’s set up now, I don’t know, if you can even– can you still do half of what you used to do? The math is going to be funny on this because you’ve had all this overhead, because you’ve had so much patient flow. And if that were to be cut in half, let’s say due to all the new regulations, or you tell me Is that too much? How does the math work? Because if you still have all the staff, yet half the flow that you had due to limitations, and what does that do for you?
Randy Waldman, MD:
The math doesn’t work. I mean, the map worked very well. And that’s the whole secret to this. I mean, basically, it seems like the loan, you know, you thought you’re getting something for nothing, but you weren’t, you were really paying the government side employment, insurance to get the ball down and play the roles before you were really able to go full steam in your practicing with restrictions. And so, you know, it just is, it is tough, and we’re still working through that, I don’t think that the key is the loan, I think that’s just something that helps a little bit, if we can’t get all that forgiven, then it’s alone at 1%, or whatever, no problem in that back end. And we had a decent reserve to go into this, we were we’re not we’re not an office that has any leases on any equipment. And our debt is just our rent, and our salaries and our payments each other and all the doctors that, you know, we also, basically, you know, cut our pay in half. And, and made sure that we had plenty of reserves. So, we, we bit the bullet ourselves in our practice. And we did that early on. And so, you know, fortunately, none of us live beyond our means. And we were able to do that.
Catherine Maley, MBA:
Good for you. Because quite a few minutes pause and some of the practices who are not good business people, if you were if you were hiding, or like a fighting business, and now is the time to learn it. You know, a lot of surgeons don’t love the business side of surgery, I would say now you really need to know your numbers.
Randy Waldman, MD:
You really do. I mean, you’ve got to be a businessman, when you do what we do, it’s the hard part of it. And the younger doctors are kicking and screaming that they want to do any of that. But those of us that have been you know, through the battles, we understand that it is a business and you have to run it like a business and you can’t overspend your balance and all you have to be frugal and at the right time, and you have to spend money when there’s a good ROI. But, you know, don’t spend money needlessly, and don’t just sucker for whatever’s around the corner, whatever somebody tries to sell you. So, we don’t have any debt in our practice at all. We have no loans. And, and we you know, we live within our means and for us. Yeah, it’s not been easy, but we were never threatened with going out of practice or anything like that. We were always comfortable and I and I run a pretty tight ship.
Catherine Maley, MBA:
That’s for sure. Um, but you’ve also been through a few recessions and you’ve had a lot of adversity, would you say this is your biggest hiccup?
Randy Waldman, MD:
Now there’s no question. This is very similar to what happened. I think it was 91 or 93, or whatever it was, that was a tough period of time. 9/11 was a little bit of a tough period of time. People were dead and people are fighting now. But I live in a rural state. It’s not got the big cities that you guys have out in California in the room. There are four or five counties around me surrounding me that haven’t had a depth. There are there are four or five counties around me Maybe they’ve had a couple cases of the COVID virus on mobiles the other big city in Kentucky besides Lexington they’ve had whatever reason 10 times the number of cases and deaths that we have in Lexington, I think we’ve had 20 something guests. And that’s way too many. I had a really good friend that was on a ventilator. Doctor Who I started at the same time in practice, and that was a tough thing for all of us to see. He’s a good friend, and he was a good friend. And he’s still alive, fortunately. But he spent four weeks on a ventilator to tough illness, but Lexington hasn’t had that type of thing. You know, my daughter had, you know, as many people in the hospital that she works at in the Bronx, with COVID viruses, we have the entire state of Texas. So, every state’s different California is different, New York’s different. But we all kind of tend to the same bar at first where we all got close down. And So, you know, it’s a, it’s an interesting thing, we talked a little bit about all the medical parts of this, what this disease really does. And I think we’re learning more every single day; I think it may be that we’re going to learn a whole lot before this is over. And I have a feeling that therapeutics will trump vaccines. And that’s where our you know, that’s where I’m hoping we’ll be about the Fall is that we’ll have a way of treating this thing. So, they don’t get deathly ill they can get it but they can’t get definitely ill until we have enough people that they can’t pass them around. And we’re not good. But So, I’m hoping for our practices. That’s where we’re at. But Kentucky has been pretty strict about things. But we also haven’t been, you know, one of the states that’s had the biggest stop, you know, that we’re it’s had the biggest penetration. And for that, I guess we’re fortunate in both real estates as well. That’s estates a big difference. Catherine, we don’t, we don’t have very many high-rise apartments outside of the University of Kentucky and the universities around us. And so, we don’t live like they do in New York. Not to say it’s bad in New York, I love New York, but a different environment.
Catherine Maley, MBA:
A very different environment. I love it there. I’d love to go there in the fall. It’s pretty, it’s got the white picket fences, the horses outside in the [inaudible]. And it’s just lovely, I really like–
Randy Waldman, MD:
So, there’s much better up there right now.
Catherine Maley, MBA:
I’ll bet. I know you don’t know where things are heading. But if your crystal ball, do you think that things are going to come back sooner rather than later? I know you have a meeting coming up in the fall, you still have it planned? You assume we’re going to travel and fly again or what do you think?
Randy Waldman, MD:
No, I think that we’ve got to get past the metal part of this. We got to get past the fear factor. And like every other thing that we were faced with MERS and SARS, those of us that paid attention to that, and they just disappeared, you know, it just disappeared. Why did it disappear? I’m not exactly sure why it disappeared. But it did. And I’m hoping that by the end of summer, we’re going to see somewhere there have been no new cases of So, the virus reported and in a certain period of time, and maybe in a week or two. And once we got that, then, you know, life will be much better. But right now, everybody’s living in fear of what’s going to be the next thing that happens in travel. And obviously, the travel industry is crippled because out of fear. Maybe some of it’s appropriate. I don’t know what kind of screening goes on now, airplanes, and this system and everything that, you know, I mean, illness in airplanes just seem to go together they did before the COVID. You know, stuff went on. So, I hope they’re getting that looked at as well. What kind of filtration So, systems do they have? How do they’re circulate air? Do they have virus filters on that? So that’s something look at but yeah, I’m cautiously optimistic, Catherine, that by November, we’re going to be at a point that we can all get together again and celebrate the end of this thing, or at least a temporary truce that we’ve called with the COVID virus. And maybe, you know, there’s they’re certainly a chance that you know, we’re still a way away, even at that point, we’ll have to say, I don’t live in fear of what’s going to happen six months from now, I think we need to think that life will get better and that will normalize things in this country. I have great fear that if we don’t do that, I’m not sure we’ll have much of an economy to come back to unless we can get past this fear factor.
Catherine Maley, MBA:
So, we have two things from a cosmetic patient point of view, we have the fear factor, and they have to feel safe. And then even if they feel safe, how do they feel about their job? How do they feel about the economy? Can they afford a $10,000 surgical procedure? That’s all this uncertainty that makes this crazy because I usually want to talk about marketing. And I think, is this a good time to market? Um, have you changed any of your marketing plans? Have you toned it down? Or have you built it up? Like what is your message?
Randy Waldman, MD:
All the above. I saw an ad for meeting. I don’t want to say the name of the meeting, but I you know, I used to be involved with it and it said go viral and you know, something to go viral dash and you know, Kill it on social media. Ah, and that’s it. I mean, I had people send me that ad thinking that I was somehow involved with that had nothing to do with me I’m involved with, but that’s probably pretty tasteless. And, you know, and so I think what you have to do is be sensitive to the fear out there and work with it to inform people about why you’re creating a safe environment. And why you’re doing things really well. And that your safety, which we’ve always tried to do, even before the virus, like, you know, their safety is paramount our practice, we try to do things the right way. But I think that you know, now more than ever, the patient safety is the number one thing that you should be emphasizing. And I think advertising should be really informational at this point, and not self-promoting. And there’s a difference, you know, we have to self-promote ourselves to time I’m better than the other guy, you know, come to me, we do the best job all that. I think it needs to be information on, I think people will appreciate that. And recognize that we’re trying to do the right thing. And, you know, it’s interesting, though, I think you and I talked about this that we haven’t seen yet. I’m waiting for the phone. But our phones have never in the history of my practice been busier. Oh, good for you. Girls are getting killed with phone calls. And some of it is moving people around logistics and people want to know, for open and when can they get in front of you. But we’re also doing more consults now than we ever have. And I you know, it’s an interesting phenomenon. When you talk about money and discretionary money. I don’t know that that fear factor. And maybe because again, I live in a rural environment with the COVID has not ruled everything that goes on in our state. So, we’re a little bit different. But I’m just talking about our personal experience. So far, it’s been, I thought, Oh, God, we’re not gonna see, you know, it’s going to be a fall off. Like, we’ve never since we haven’t seen that yet. Now, I know, August and September, we may we may see a dip. But because we already see a little bit of a slowdown in August and September, mostly most practices to it, you know, but we’re, I mean, you know, we’re booked up through that period of time swimming, you know, everything goes well, with that we don’t get shut down again, I do worry about the shutdown part of it, and that it’s real. And a second wave of this stuff is very real. And I don’t know, I mean, we could get shut down in two to three months again in the winter. And I think every practice better gear up for that, and better look at what they’re doing and how much money they’re spending and how they’re doing things. But they can’t get greedy and rush into stuff now and overbooked and overdo it and surgery and put people at risk. And most of our patients want to know that I had one patient that because of Well, I’m a little worried that you guys are going to try to squeeze in more people because you’ve got a big backlog. And I shared the lady that No, that’s not what we do. I said, we’re actually, you know, we have we have a capacity to go double what we’re doing right now as a startup, because the governor’s asked us to cut back on what we do as well as the same thing with the hospitals. They’re asking the hospitals to cut back to 50% until we really see that we can distance so we can do this in the right way. And we don’t get any startup second wave in Kentucky, that that’s a devastating second wave. So, we’re trying to do things the right way, you’re sure your patients that their safety, that’s going to be so if I’m going to market, it’s going to be informational newsletter stuff, keeping them abreast of what we’re doing, and some fun stuff. What are, you know, what have we done during, you know, what have the doctors been doing? What have the nurses been doing? You know, you know, we’re all going crazy at home, this kind of stuff. And so, I think it’s going to be more informational and fun, rather than promotional and not running any specials. We’re not going to do that. And that just feels too cheap at this point. So, we’re going to keep adjusting, and we’re going to we you know, we’re going to do things the right way. I just think if you do it the right way [inaudible 33:50] okay.
Catherine Maley, MBA:
I keep hearing that a lot of practices are getting more phone calls. And the virtual consults are like fantastic. And I wonder if that’s because of time, because most of us, maybe now that we can sit still and really think straight, maybe that is helping. Because a cosmetic patient usually is scared or the money or it’s a time issue. I wonder if that time issue, we took that away and boom, here they are, maybe?
Randy Waldman, MD:
Well, there’s always more mirrors at home than there is the office. And I think that people spend a lot of time thinking about things that maybe they’ve been thinking about what they put on the backburner, and you’re right. People had time to really focus on it. And you see everybody out beautifying their yards in my neighborhood, I’ve never seen anything like it. It never looked as good. And you think well, it’s good for the neighborhood. Well, it’s kind of the same thing with personal appearance. Everybody’s kind of looking at the yard sign and it can make it look a little bit better. I got some time to work on it now. And maybe it’s the same thing with faces and bodies. So, yeah, some of what you’re saying has validity, I hadn’t thought of it that way, but it’s true.
Catherine Maley, MBA:
And one of my suggestions is put as many mirrors in your office as you have at home. Mirrors should be everywhere strategically located–
Randy Waldman, MD:
Well, I said their office, not my office. Okay, we have mirrors, we have at least two in every room and the wall.
Catherine Maley, MBA:
It’s the best-selling tool in the on the planet. Need to say a word, let the patient handle it, so handle it.
Randy Waldman, MD:
Mirrors and cameras.
Catherine Maley, MBA:
This is a different podcast, but I can’t help but I didn’t know you [inaudible 35:34], you included three others.
Randy Waldman, MD:
Facial plastic surgeons and 2 plastic surgeons.
Catherine Maley, MBA:
Holy cow, I just want to just a little touch on that. Because knowing you, it’s probably a dictatorship rather than a democracy.
Randy Waldman, MD:
My partners would probably tell you that’s true, I’ll deny it. And so, yeah, I’m an administrator, because I’m the senior person. And I’ve made all the mistakes that you can make. So, you learn from your mistakes, they haven’t made enough mistakes yet, because I haven’t let them make mistakes yet. And that’s, that is a problem for every parent, and also, for every, you know, senior partner like me not to let them kind of flounder a little bit. So, when I’ve been out of there, you know, I’ve let them go in and, but I’ve still been, you know, pretty, I think I’ve worked harder during these two months, than I’ve been at home. And I just, you know, making sure that all the i’s are dotted T’s crossed, and all the tax issues and the loan issues and all the financial stuff. And they don’t really, my partners don’t these two months take a lot of time to really have to think about that. Do they, they’re happy to defer that to me, but eventually yell, everybody has to learn and you learn from your mistakes. And so yeah, but these two months you know, I, I believe in the association between specialist surgeons and plastic surgeons, and you know, whether it’s an ocular plastic surgeon or a facial, plastic surgeon, or even a dermatologist, I think the multi-specialty practices have worked pretty well. Steve shazza has been with me for 17 years, I think now we’re not. And, and you know, it’s worth, if you stop, I think he’s the busiest breast surgeon in Kentucky, and, but he was almost from the start almost from day one. And it’s worked for him. So, it’s worked for us in our practice. And, you know, we’re fortunate to have a really good relationship. And, you know, they’re always ups and downs of any marriage, and a partnership is a marriage. Yep. For us and our gifts and that our feelings hurt at times. And, you know, we’ll disagree on some stuff. And, you know, we just got to got to get together and try to make it work. Because the alternative is a solo practice. And I think in today’s world, we’re able to be successful because of shared overhead. And because, you know, we, we have a very collegial sort of environment, and we have a great staff, but I don’t want to address the understate that I have such a great staff, but you have to mold your staff that you have to pick the right people. And no, we don’t always pick the right people. But what we try and, you know, if somebody is not the right person, that early on, we have to make a change, don’t let it linger. And that’s, that’s my best advice. Anyone. You know, negativity, you know, is contagious and be spread around and often so. But I listen, I think our staff is our greatest asset. And you saw evidence of that the other night with Morgan, who’s, you know, like a child of mine, but because she reminds me so much of one of my daughters said, but you know, I watched her start to get a certain you know, immature level when she was very young, and she’s molded into, you know, somebody that’s, it’s really helping our practice through this whole COVID thing. And that very important to us.
Catherine Maley, MBA:
And I think that’s a pearl for other doctors, you gave that job to her. And she took it and ran with it. So, she cares. Somebody needs to focus on COVID-19 you know, the precautions of processes, and she is on it. And she knows those regulations upside down, and she will keep your eye on that ball.
Randy Waldman, MD:
One of the things that I insist on Catherine, always have never very this that everybody that works for me, he’s got to have a four-year degree. It’s not the college teaches you so much but it’s a level of maturation and being able to work with others and it shows me somebody that’s interested in learning and so everybody that– it doesn’t matter whether they’re at the front desk or what, everybody in my practice has always been a college graduate and my nurses are all– I think they’re all four-year degree nurses, and they’re all very bright. And so, we hire people on personality and intelligence. We can teach them to be whatever within our practice. We love ICU nurses, we love critical care people when they’re working surgery, because they know the rhythms and they but it can be somebody that’s intelligent, give me somebody that’s personable and we can train them and everything else.
Catherine Maley, MBA:
So, let’s talk about your meeting. Because the reason I know you very well is early on, you gave me my first break and speaking. And I used to speak at every one of your biggest cosmetic surgery meetings. And then you did the global aesthetics meeting. And I appreciate that I needed the exposure and the experience of doing that. And the reason your meetings are so successful, like I mean, I speak all over the world, your meetings are the most well attended, and the culture and the ambiance of those meetings is amazing. And I think it’s because they’re multi-specialty. So, everyone’s relaxed, and they’re not so paranoid, or I don’t know what the word is, but you have a board-certified dermatologist, ocular plastic, facial plastic and plastic. And they’re just great meetings. And will you always keep it that way, the multi-specialty is that you’re–?
Randy Waldman, MD:
Absolutely, absolutely. I think that’s the key, even if I was running meetings in my own society, which I did, you know, I think I did about 10 meetings from island society as the last one being in 2005. But even then, I brought people from other specialties, because I think that, you know, we tend to get stale in our own meetings, people talk about that all the time, get the same speakers. And, you know, the same talks, the same speakers, you know, year after year, you’ve got the same group. So, I try, my mantra is to change up the faculty by 50% every year. So, I’m going to try to find 50% new people every year, that unfortunately means that there’s some people that won’t be coming back that particular year, but they’re still on my list. It’s not like we’ve crossed them off. But our, our whole thing is you can’t have the same problem year after year after year. So always try to look at it every year. It’s like writing a new book. It’s like, Okay, this is my book. And I’m going to start putting together the first few chapters. And, and it’s usually stuff that, that I’m interested in as a surgeon, and as a doctor, in order one of my partners is interested in it, and we’re looking at it just like we’re attending the meetings, I always try to put myself in a meeting, and So, trying to find new and different stuff. But by changing the faculty by 50% of the year that I’m getting new and different stuff, and I encourage the people that we invite back to also give me some new and different stuff. I’ve done that with you a number seven I upset Catherine, I need seven new talks, that you know, you actually go out and do the work to do that everybody doesn’t do that. But in some of the doctors will just give me the same talk year after year. And we eventually stopped inviting them because it’s not that I don’t think they’re good speakers or great guys are good friends. And I you know; I haven’t endeared myself to some people when I’ve had to do that. But you know what? People are paying money to come and listen to what you have to say. And so, I’ve got to give them I feel cheating. I feel like I’m cheating them. Unless I’m giving them value for their dollar. The same thing with exhibitors. I keep a ratio where I won’t just try to fill my exhibit hall unless I know I have a certain number of attendees; I never want less than a six to one ratio. Six, at least every exhibitor and attendees; you know, I’d live with that. And I know other meetings don’t do that. I lecture in some I lecture meetings where there’s 300 people there and 110 exhibitors, and it’s less than three to one. And I’m like, how do they do that? You know, and I don’t know, but I can’t do that. So. So we always try to, you know what our exhibitors are incredibly important, a lot of really good friends of mine, a lot of our really close to me, I met you know, it’s intensive, they’re good people, they work hard for a living, you know, and so I don’t just use them as a means to an end. They’re part of the show, and they’re part of the reason that people come to the meeting, people want to have a good place to shop, a good place to you know, that a one stop shop. So, everybody’s important, everybody’s got a role. It’s like, it’s like a play, you know, you’re like, I’m like a choreographer, and I’ve got dancers and actors and, and then you have to put it all together. And the satisfaction comes, the day after the meeting is over. And you realize that you didn’t did it decently that was better than last time. Now see if you can improve on it Next up a little bit better. Here’s the problem. So, we always come back to around a conference table with my staff, my staff always runs running the meeting, right? It’s not people, we don’t hire people on the outside to do it. There are our staff. And So, we’ll sit around the table. So, what would you like about it? What did you like? And what do you guys think we can do better and we debrief each other? in a nice way, you know, right after the meeting, and then we go on to the next thing.
Catherine Maley, MBA:
You do a really good job of that. What is the URL? What’s the website for the global meeting?
Randy Waldman, MD:
It’s either gaconference.com or globalstaticsconference.com. Either one gets you to the same website. And this year, it’s November 5 to eight, God willing, and would probably be one of the first meetings and hopefully out of the box of all these meetings that have been canceled. And I think industry is really counting on us because they’re, they’re really tired of being in their offices, they can’t sell stuff in their offices, you know, it’s more of a hands-on thing with industry. I think a lot of people are counting on us, you know, coming through and I’m just hoping that the travel is actually optimal and that people are able to fly. And I hope that we don’t have, you know, significant restrictions from the hotel on the beach, which, by the way, is a wonderful hotel, anybody who has been there, it’s really one of the great properties of Miami Beach, right on the ocean and Collins Avenue. And then, you know, Atlantic Boulevard and Lincoln Avenue, right, you know, adjacent there. And so, it’s kind of a triangle, that’s the best part of South Beach. But you know, I hope that, you know, that, that we get the space that you know, and that we’re able to have the same number of people that we need to make things work. And there’s a there’s a potion for making a work. And so, you know, we’re, I think they’re, I mean, the hotel is still that they don’t know what’s going on, either. I mean, they did ruin all the hotels and traveling the street, and everything’s been hurt Catherine, and you know, and so we’re all just trying to adapt to a new norm, and we’re praying for, you know, for the best things to happen. If something happens that we can’t do the meeting, then we’ll come back, and we’ll do it the next year. And it’s not like we’re going away. And, you know, you live with what you can do. And, you know, there’s so, a, you know, fate takes, you know, usually if you just kind of follow that you’ll be okay. Oh, I hope that I just want everyone that we know in our circle, Catherine, anybody that watches her stuff, and, you know, pray for safety and health, and then you got safety and health, and particularly health, then you’ve got everything.
Catherine Maley, MBA:
For sure, I have no complaints on my end, although I do miss the travel, because I liked it a lot. And that’s when I got to get out and talk to all of you in person, because I’m a big hallway person. That’s where I learned everything about this industry, what’s going on where you surgeons feel what so, are you worried about? What are you happy about?
Randy Waldman, MD:
–question that I have for you, and for the audience, or anybody that’s listening, you know, I have my feelings, I know these virtual meetings are springing up in virtual just to show that I never did it for that reason, because then you would be implying that maybe it’s just about money. To me, it’s about the, you know, collegiality or whatever the word is, be able to get with people and talk to them about their life and their practices. And it’s so it’s kind of a way of getting together. It’s like an annual reunion. It’s an annual reunion, a lot of the same faces, and people new faces, and new people to meet, and people in particular, from other specialties that people of all ages, young, middle old, and, and it’s just a way of, of enhancing your life. And it’s also a way of traveling and seeing some other places, but mostly getting together with people. And I think when you take that element out of it, you say, well, you’re going to do a meeting by sitting in front of a computer for three days, I can’t sit in front of a computer for an hour and a half for two hours. And I’m off to a different tangent, it’s like add kicks in and I can’t do it. I mean, so I get I can’t even look at, you know, a two-hour surgery online, study what they’re doing with that surgery, I get bored. And I’ll fast forward it and have played with the buttons get through all this. So, I don’t know how people could really do that. And but you know, I do think that I’ve learned a lot about webinars Catherine. And I do think that there is a role I’m doing a webinar every two weeks, as you know, you’ve been part of it with a [inaudible] which are the people that you know, with Derma, tabs and ophthalmology, tabs, medical economics. And I’m the medical editor, you know, as I told you for aesthetic 30, it’s a new, a new trade magazine. And, and we’ve been doing this every two, two weeks, and we’re getting like, well over 1000 viewers each time. So, there is a nerve there with people to see a group of doctors or as it’s going to be next tomorrow night it’s going to be its Derma going to be lawyers, and we’re going to talk about medical legal issues associated with this horrible plague and our practices and employees and everything. And I feel like that may be something that I’ll start incorporating into meetings.
Catherine Maley, MBA:
That’s a great idea. Aesthetic authority, I know that they opened up a private Facebook group, do you have to be invited to it or can they–?
Randy Waldman, MD:
Well, you kind of do, I guess I’m the one that’s in charge of it. It actually was my idea. And I wanted to open it up because I felt so alone, when we were closed down on the margin that I wanted my colleagues, I wanted to interact with a bunch of smart people. So [inaudible 49:20] this discussion group together, and I ran it by the people at the aesthetic authority, they said, well, let’s do it, we’ll do it. We’ll set it up for you. So, we’re good. You know, let’s have a dialogue. Before and long. I knew there were 100 people out there that were that were part of the discussion group. And it was interesting. I learned about the PPP loan there, I learned a lot of things there. And you know, we started teaching each other, we were all in the same boat together. None of us had ever done this stuff, or just knew what was going on. And we lean on each other and that’s what colleagues are for.
Catherine Maley, MBA:
I’ll put that in the show notes too. Aesthetic authority, I’m also on the board of it, I think, and it’s been a great new group of forward-thinking people like that’s the part I like, a bunch of ideas were going by. I love the ideas and people thinking. Nobody’s shut down here, like all of you are working harder than ever. And I also have that ADD problem. I can’t even watch a movie now. If I’m 15 minutes into a movie and I’m not thrilled, I’m out, I can’t do it.
Randy Waldman, MD:
I think that’s why I watch so much Seinfeld. It’s only good that I can get through 30 Seinfeld. I see the same episodes before 10 times and I can’t remember seeing them or something–
Catherine Maley, MBA:
When you get older, you don’t have as much time, maybe that’s what it is. I have more of a sense of urgency and I don’t want to waste it.
Randy Waldman, MD:
I just read tonight; the Ben Stiller’s dad died. And of course, Dad was George’s dad on Seinfeld.
Catherine Maley, MBA:
Oh my God, how old was he?
Randy Waldman, MD:
- But do you remember George’s dad on Seinfeld?
Catherine Maley, MBA:
Of course.
Randy Waldman, MD:
I thought it was his real dad. But it’s Ben Stiller’s Dad, I guess he’s a comedian in and of itself, Jerry Stiller. And I had no idea that it was Ben Stiller, his father that was– his father on Seinfeld.
Catherine Maley, MBA:
And he was married to that other lady forever, like, forever. As long as you get married, how long have you been married?
Randy Waldman, MD:
37 years.
Catherine Maley, MBA:
Holy cow. I can do a show on marriage. Spouses working with each other.
Randy Waldman, MD:
We have. I couldn’t have done what I’ve done without my wife.
Catherine Maley, MBA:
She is like your right hand, holy cow.
Randy Waldman, MD:
She and my son has been very important in our meetings, Matthew, I have two daughters that are physicians. And you know what? They’re doing their thing. And I feel like, you know, my daughter that’s in dermatology. And she loves to come to our meetings as you know. and she grown up in those meetings. So, she knows as many people as I do. So, it’s kind of a family affair for us.
Catherine Maley, MBA:
Good for you. So, I think we’re gonna wrap up here, if you have any last words?
Randy Waldman, MD:
Well, it’s always great chatting with you. You do a great job and you’re one of the giants in your field, there’s no question about that. If you want a great speaker, I know I can always count on Catherine to give a [inaudible 52:13] and really energetic talk and wake up the audience. And that’s an art and every person that, that we have a meeting, we’d love to have them be as good at connecting with the audiences, Catherine Maley, but most important, I think, you’ve been in the industry for so long, and you’ve studied practices, you’ve made it an art form of studying practices and learning from different practices that– you’re one of the great advisors out there. And not only that you have such a pleasant countenance about you, and I even visited Lexington before and–
Catherine Maley, MBA:
I’m going to be back as soon as the [inaudible] change.
Randy Waldman, MD:
You keep wanting to come back. Well, maybe this is the fall that you’ll be able to do. Hopefully, I would invite everybody to come to our great state. I think Kentucky is one of the most beautiful states out there. And we have fast horses. And we have great bourbon.
Catherine Maley, MBA:
well, thank you so much for being a guest on my podcast. I appreciate it. I’m going to have you back.
Randy Waldman, MD:
Everybody that’s out there listening, Global Statics, November 5 through 8, I pray that this horrible plague goes away and that we can all get together and kind of enjoy each other’s company and in a great environment and have some fun and learn some stuff. So anyway, Catherine, great talking with you.
Catherine Maley, MBA:
Yeah, and I’ll be at that meeting as well. So, I hope to see you there. I’ll put all those links in the show notes. I’d like you to also join that Facebook club, Aesthetic Authority. I think you get–
Randy Waldman, MD:
I’ll send you an invitation.
Catherine Maley, MBA:
Okay, great. Thank you so much. I Everybody, please subscribe to Beauty and the Biz. And if you wouldn’t mind give me a review because it helps me spread the word about this podcast. And then please, if you have any comments or feedback, please go ahead and email me at my website at catherinemaley.com or you can certainly DM me on Instagram at catherinemaleymba. And with that, I bid you goodnight and we’ll talk again. Thank you so much.
