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Ep.70: Interview with James Marotta, MD

Dr. Marotta, consistently voted Best Cosmetic Surgeon on Long Island since 2013, specializes in facial/endoscopic plastic surgery, rhinoplasty and hair restoration.

He’s a volunteer with the National Domestic Violence Project and Faces of Honor. He is also a researcher who’s published scientific articles and medical manuscripts.

Visit Dr. Morotta’s Website

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Beauty and the Biz

Ep.70: Interview with James Marotta, 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 Your Patients Are Saying and consultant to plastic surgeons to get them more patients and more profit. Now today’s guest is very special is Dr. James Marotta of Marotta plastic surgery specialist. Now, Dr. Marotta is a Board-Certified facial plastic surgeon in private practice for the last 15 years. And he’s actually in Smithtown, New York, which I didn’t exactly know where that was, but I thought it was upstate but actually it’s about 45 minutes outside of like New York or Great Neck it’s Long Island if for all of those people who know their boroughs. Now, he attended Columbia University as well as sunny don’t Brook School of Medicine, and he trained at Yale University in Head and Neck Surgery. Dr. Marotta then completed additional subspecialty training as a fellow in facial cosmetic and reconstructive surgery. He specializes in Facial Plastic Surgery, endoscopic Facial Plastic Surgery, rhinoplasty as well as hair restoration. He’s published several scientific articles and continues to conduct research and write medical manuscripts. Now, Dr. Marotta has consistently been named the best cosmetic surgeon on Long Island since 2013. And he volunteers his time and surgical expertise to the National Domestic Violence projects, as well as faces of honor. So, he helps the VA, by the way, his practice purpose is to do good. I love that. And we’ll talk more about that in a minute. So welcome to Beauty and the Biz, Dr. Marotta.

James Marotta, MD: Hey, thanks for having me. I appreciate the invitation. And I’m very happy to be here.

Catherine Maley, MBA: Absolutely. So, can you start us off by talking about your practice and stuff like give us the journey of where you started and how you ended up in private practice just some of those details so we can get a feel for what your practice is like?

James Marotta, MD: Sure. I mean, you gave my background I went to undergrad at Columbia. I wasn’t intending to go to medical school I just kind of you know, I was economics and philosophy major as an undergrad and then I did postback. I did some traveling traveled abroad in Europe and I just had an epiphany that I want to be a doctor came back to the states and was Columbia postback and then SUNY Stony Brook for medical school Yale residency and fellowship with Dr. Patel and facial plastics and that was you know, a very formative year and not only that I learned a lot about becoming facial plastic surgeon in the surgery itself but actually having duct Patel as an example of the quintessential Facial Plastic Surgeon entrepreneur opens my eyes to what it is to be actually an independent surgeon running a facial plastic surgery practice and, and what and the really more than the post back beauty of that of being an independent provider not only from a surgical perspective, but also being able to run your own business and he was just a shining example of what post back you can do. And I said no, I want to be just like him and so when I graduated from fellowship you know, says it’s a gem you know, you can be anti me Don’t be both do one of them, you know, and I picked being a facial plastic surgeon so what did you know really, what did you do at that point at a fine job so I looked for academic positions I looked for private practice situations are most of the hiring ability was in et groups at first they wanted you to take some EMT call as well and do some meaty sinus surgery. And I just wasn’t into any of that. You know what I’m going to listen to vetos advice and just do be a facial plastic surgeon. So, I you know, sanely enough decided I’m gonna hang a shingle years ago I got an SBA loan applied for myself started with, you know, patients move to where my wife is a dad resides in Long Island because my wife is actually from this local area. I went to medical school here met her during medical school she’s an attorney but not and so then I just said you know; this is a good place to shop set up shop. It’s a very populated area, you know, and demographically do, you know, my demographic studies, the guide alone on tables table and just started with myself and one employee and know; built it from the ground up and here we are, you know, 25 employees and in a brand new Building a six year old building from, you know, a place that was a rental to a self-owned surgery center or to ours and multiple physician positions at one point an hour in transition getting more another physician in here, but, you know, just really kind of a big journey of growth over the years. So, a lot shared out the business unit.

Catherine Maley, MBA: So, you’re not from New York?

James Marotta, MD: I’m from Westchester County, which is– I’m from the other side of [inaudible 05:35] town, so I’ve worked with– New York. So, when of my I met my wife, she said, Well, we can move to where your parents are from or where I’m from, and I’m the one who’s going to raise kids. So, you know, when so– I’m still married.

Catherine Maley, MBA: Right? So, when you started to practice, it’s not like you knew anybody there like you’re really fresh? Hum, by the way, how much business sense Did you get from that fellowship versus medical school? I mean, was that just imperative for your success to have had that year of role modeling? Somebody who’s actually been there done that?

James Marotta, MD: Yeah, I don’t think I absolutely, I don’t think I would have had the confidence, the just, I don’t know, in New York service, but you know, to do something like that. And just, you know, looking back at, it’s really crazy, but when you see I have a model of somebody who’s done it successfully, so why not do that? Okay. foolishly enough. I thought, yeah, I can do it. And you know, blood, sweat, tears, a lot of heart ache. downs, and you put in time, you know, you make it work, you know, I–

Catherine Maley, MBA: So, on the business side, what are some of the mistakes, just a couple of the mistakes you made that maybe could help others not make them? For example, keeping book, or hiring somebody? any of that? Like, what was the most difficult part of running your own practice? Because I’m assuming you didn’t know, like, legal stuff or accounting stuff?

James Marotta, MD: Sure. I mean, I think that, you know, I mean, everybody goes into this is certainly having brains. I mean, you’re obviously hugely intelligent people who can do the research, know, the basics of accounting, get good advisors behind you. Listen to you know, I was raised to have, you know, accountant who’s not only an accountant, but really my confidant and business advisor, you know, 15 years later, and still, you know, really one of my most trusted advisor and best friends. And so, I was lucky to find him very early on somebody you can turn to and say, Hey, is this you know, crazy? Or am I, you know, can I take this loan, buys a piece of equipment, hire this extra person can do these things, and just bouncing off him is a fight from a financial perspective. So again, I think one of the most important things to learn, especially as a surgeon is, we’re really taught to be independent thinkers, and to be a rely upon ourselves our own hard work, our own, you know, skill, our own brains. And really, the business world was the opposite. You want to seek out mentors, trusted advisors, you want to, you know, in one book, I talked about, you know, establishing your, you know, your Genius Bar, people, you know, you go to collection mentors, whether it’s, you know, a good a great attorney, a great accountant, you know, a great somebody who’s done this before somebody who’s already a business mentor, business leaders, it’s time to fellowship director to somebody else. Your, you know, your co fellows or wherever it’s going before you and don’t ever shy away from asking advice, mentorship, along the way, that’s one of the probably the keys to doing it. And even after remind myself, always, now, in fact, it’s been 15 years is that, you know, even now, I don’t have all the answers, as I’m trying to where I am at my stage in life and trying to scale and scale and scale. You know, I’ve done positive business courses and read so many business books and but I’m always learning about that part of it. And I still have a lot to learn and, you know, never stopped doing that reaching out to people find mentors, don’t is, don’t be the rugged individualists that most surgeons think you need to be. And that’s good for being a surgeon, you know, but it’s not good for the running successful business.

Catherine Maley, MBA: So how was it– when it got time to managing people, because now you get to be the independent thinker, but you also get to be the manager, the visionary, the– So, how do you figure– there’s an art to managing people You will know, how did you figure all of that out? And when did you know? You couldn’t do it all? Like, how do you get out of that? and say, Okay, I’m going to need some help here. Who do I need? Do I need an operations manager? Do I just need an assistant? Do I, you know, there’s so many questions or pathways to go. Is there anything you could teach us there about how to scale?

James Marotta, MD: Yeah, one of the business courses I saw is, you know, it’s called Strategic Coach, and, you know, dance all events, great, you know, great, great course. Yeah, I’ve traveled to it. I used to travel, obviously, once the Chicago independence seminar, and really a lot of people in different fields, you know, I’m in business and accounting, and, you know, most financial advisors less on the healthcare side. But, you know, one of the things is the dance thing is, it’s not how it’s– Who can you get to do what you’re doing today, so that you can dedicate your time abilities, function on the things that you’re best at? So, we all can you, you know, take an action inventory of your life, like, what are you doing today, that you don’t necessarily need to be doing? It’s not benefiting your practice. I mean, one point, I was sterilizing my image, answering my own for phone calls, I was sweeping my own or floors. I was I had a secretary in me that was that and I had an independent operating. So, I was doing my surgery. And then, of course, I needed a surgical assistant that was basic, and I didn’t care I’m just come in. But you know, growing from there was well, yeah, well, you need more people to answer the phones. And now, you really can’t do your own bookkeeping, it’s not really a good function of my time, I should be seeing consults doing surgeries. And now it’s to the point where I have people doing marketing for me as an independent, you know, I have people doing the basics of the research for me, and I have, you know, it’s never, never about my unique ability, in my role currently is the CEO and visionary of practice, and to be a surgeon. And that’s my two roles. And anytime I find myself drifting outside those things, it’s Who can I hire? How do I have to pay them? How do I structure the job roles? How do I hold them accountable? How do I keep them, you know, doing those things and make me more productive? Because I think that’s the number one motivator for us individual. Yeah, it may seem daunting to say, you know, I’m gonna pump down, you know, another salaries for this individual to do this, you know, and, but think about how much time it’s taking you through all those individual tasks and how much you’re taking away from your surgical practice how much more revenue, you can generate, focus on the things that you’re good at, and delegate the things that you don’t need to do. And that concept really is distilled in our entire leadership team. So, people want my leadership team, I’m getting them to the point where I’m saying, you know, what, look, you got to let go of, you know, you’re this, you know, you’re the CFO, but you got to let go, you know, basic bookkeeping, we have to hire a bookkeeper to do that. So, you can focus on, you know, financial vision, as opposed to doing the day-to-day front work. And that’s one of the keys to growth for everyone is to realize that you need to, you know, have that we take the investment you’re making financially or in terms of time, or teaching somebody else to do those functions that you need to be doing. Okay, our dividends, unbelievable, they should be able to grow and sell at a much quicker rate. That was one of the occasions for me was that degree I could delegate and to the degree I could get things off my plate and not do all the things I was thinking that was dictating the rate at which I would grow, you know, and when I realized that it was like, wow, you know, not only is great because you grow faster, but it’s also great because you don’t necessarily need to do the things that you don’t like doing. So, if you’re, you know, a surgeon, you’re five years of practice and you’re doing your own bookkeeping, you hate doing it. And it’s So, a drain on your energy time and you’re going to see a consultant. And you know, you don’t have the energy to compose that consult. Well, you know, get rid of things you don’t like doing today. And as I said, having the courage to make that financial time investment in another individual will pay huge dividends. And that’s the key growth.

Catherine Maley, MBA: Can I ask where injectables fit into this. You are a facial plastic surgeon some of them say I don’t want to do those I just want to do surgery Some say I like doing injectables because it develops a relationship with the patient what what’s your take on that?

James Marotta, MD: Yeah, my take is you know, as I my practice has grown and it’s especially the surgical practice with post COVID surgeon so much I’ve had to add surgical days and I’m more and more doing more surgery than ever, as opposed to injectables and cutting down my injectable days and I had nurse injectors in New York you’re allowed to do that. And you know, I’m gonna custom hire another position will also offload some of that injectable load for me, I’m injectables at the point where I’m, you know, probably going to start charging just an injectable minimum see me because it doesn’t pay for me to take up any of my time and do you know, a single area Botox patient, you know, we need to so I think injectables, you know, is a weird practice, the jury is certainly at a point where you can generate the same amount of revenue yet delegate that to somebody else, that’s what you want to do. I think that’ll work out fine. If you want to focus on surgery. But if you don’t have a successful injectable following that you’ve developed as individual Mo, you’re not going to be able to delegate it to anybody. So, I think doing injectables on your own, always keeping it a little bit party practice. Oh, she oversees individuals. So, if you don’t know what the newest, you know, if you don’t know what gnosis injectable is, what the with the G prime is and what the you know, areas of use are and you can’t really intelligently meter injectors, if you don’t have your hands in it. So, have they ever stop injecting totally fail just, you know, become less and less of a role? Because, yes, unique, unique ability as a surgeon is to generate those certain pieces, and floated that you don’t let business dictate to you. You know, because earnings, you want to pay yourself, visualize yourself into an area. I mean, I know, Kathy mentioned, you know, just focusing on surgery, but I know, a few years ago, I heard somebody say, Well, you know, maybe I can make more money with a syringe and that candidate scout born, they’re going they went the opposite direction, becoming almost a non-surgical doctor, and there’s some facial plastic people who’ve done that. Me. That’s the thing that worries me more, because I think nose commoditize it’s going to become and who knows how technology is going to dance to the point where injectables become a non-issue, or I don’t think surgery is going to be replaced anytime soon. So, you know, it really depends on your individual life. But I think what I realized over the past few years is that the injectable pool of patients is not limited. It’s not a limited pie projector you have the more injectable patients you can have not you know so me I’m at the point where I’m even though I’m hiring, almost, you know, hiring another non-issue physician who I’m going to give some injectable practice to my dental practices that diminish as a result of delegating. Jacko, jack and most other providers, it’s actually grown pies grown. So, you don’t have to choose between giving up and adding up. You can grow it, you know, on all cylinders, surgery ends, and you’re not a full practice.

Catherine Maley, MBA: So, let’s talk about revenue generators. Because I love that you’re not the only one in quite a few practices. That surgeon is the only revenue generator they have. So, there’s no going on vacation, there’s no being sick, none of that. So, you’ve done a very good job of failing, bringing on other service providers. But what kinds of lessons have you learned or missteps? Have you had bringing other physicians on board? Because not you don’t always play well together. So, how’s that going?

James Marotta, MD: Yeah, yeah. I mean, we’ve, um, you know, unfortunately, in that department, I think, you know, in terms of lessons learned, and that’s really one of the toughest things about businesses that you can, you know, make plans and God laughs You know, so, and you can do all the right way you think or all the right things, but we So, have a pretty stringent vetting process of hiring and it applies to anybody we hire. I mean, if you want to tip there’s a great book called So, who method of hiring by Jeff smart. And it really is a very detailed process. You know, ours is grown from those basics, but You know, for interviews and people who hire as administrative assistants or medical assistants are like, oh my god, this is an excellent interview process like this. It’s like I, you know, they, they can’t believe that the extent at which we, you know, that people prior to so I want you to know that we don’t you know, certainly with hiring surges and due diligence was multiplied, but you can’t account for people’s personalities, you can’t account for people’s focus can’t account for how you’re going to interact with them. And you’re going to make some big mistakes. And we have, you know, in the past few years, we’ve been through a few associates, and they haven’t really worked out for various reasons, which I won’t go into. But you know, you’ll never 100% No, you know, and don’t beat yourself up about that. That’s what I’m really, because oh, of course we do, you know, you play Monday morning quarterback and say, how could I have known? Could I bet this person better? What mistakes Did I make, what lessons that I learned, and at the end of the day, it’s all you can do. And, and in the process, learn from it, grow from it, and, and just know that, you know, your, your business is gonna go like this, and this and that, up and down. And but oh hopefully, you know, even though there’s ups and downs that, you know, mine is gonna be like this, you know, in terms of growth, you know, and you’ll have your big setbacks. But if you don’t, you know, nothing ventured, nothing gained, you have to have that entrepreneurial spirit and say, you know, everything we’re doing is a learning opportunity to grow and become a better business person, a better surgeon, I mean, some of it comes with big financial risks, financial risks, or risks, reputation. So, it’s not to be done lightly, and I’m not making light of it. And say, it’s all cancer because I’ve had a lot of heartache and a lot of pain and a lot of, you know, just be honest and regretted some of the decisions I made. But you can’t really live in the past, you know, Monday morning, quarterback not gonna help you, you have to say, Okay, I learned from that experience and get your running shoes on, like, you know, was a story from Who Moved My Cheese, that’s another book, a little book about telling you how to not sit down. No moldy cheese, you move on from those moldy cheese experiences, and just keep running as a business person.

Catherine Maley, MBA: Where do you even start, though, especially if you’re looking for a specialty outside of yours? Um, do you put an ad in that medical society’s newsletter? It’s not like you can go to the conference and start telling people I’m looking for So, another Facial Plastic Surgeon? How do you even start that?

James Marotta, MD: Yeah, I mean, depending on what yeah, I mean, certainly you there’s a whole bevy of recruiters that you can use is, of course, a paid on and, you know, they’ll demand fee depending on what, you know, level, professionals going to be anywhere from 15 to $20,000 for a hire. And if they work out, usually they have some kind of guarantee. So, if they don’t work out in a certain period of time, they’ll get a resume. It’s not necessarily that they’re great, can’t you know, always those top notches, Candace, but certainly that’s resume a source. Now doximity has Doc’s MD talent finder, which, you know, through a paid service actually links to positions more directly so you can get your ad in front of physicians, or especially by focus geographic area, certainly, indeed, there’s a website called MD search calm there is then also just putting it out there putting out I put it out there on LinkedIn, a lot of plastic surgeons, a dermatologist or in my area are in that you know, you never know who’s gonna want to jump ship gather their own practice situation or, you know, and do that. So, all sources you source from really everywhere, for internal sourcing, like your own staff, and that that is the biggest challenge of any, any, I don’t care what any business staffing is the number one challenges, the biggest source of pain probably drives most people out of business, you don’t want to deal with people hiring, firing, in people’s, you know, in drama, and just saying, you know, we just come to work every day and you just do your job. Yeah, you know, and it doesn’t work that way, unfortunately. But, um, you know, building an internal referral system where you develop a place that’s a great place to work. You know, and Williams is another one of my mentors and he always, you know, was very proud of the fact that one of the Better Business Bureau you know, top places to work and local region Albany. So, he, he’s right though when you have reputation for being a great place to work, you attract, you attract top talent, people want to work for you, and your employees become your best advocates for you. So, if you have good employees in the method, you know who mess or hide or call them players, so you have a fighter, a player, no other a player, the best employees know people like them, and that’s you want to hire them may not necessarily be their friends, maybe people they work with other practices, other situations. And so, we have an employee recruiting program where we pay our employees, if they refer somebody, and we hire them and working out for a certain period of time, we pay them a referral fee is actually much less than one of recruiters [inaudible 25:56]

Catherine Maley, MBA: And it’s a better-quality referral any day. I mean — your own staff who do you people know who would fit with our culture, they’re not going to bring in some love, because it’s their credibility on the line. So, I just think it’s the always easiest way to go.

James Marotta, MD: 100% 100%. And that that is a, you know, an incentive program for them. And if you’re, you know, again, throwing around money, but it’s, it’s never been better spent. Every employee you hire to fire you know, cost you 10s of 1000s of dollars.

Catherine Maley, MBA: And the mental energy has that of a toxic person, it’s just not even worth it. So, talking about culture, I just want to mention something. When I was on your website, you have your mission statement where your purpose is to be good, or do good. But you also had core values. Because I think that’s the secret to a lot of the culture thing. You need to have people on board who share your same values. And you literally write out your values, we are a patient centric model. attitude is everything, commitment to care, and team players are a player. So, you’re literally telling everybody, this is how we roll here. You know, if you can agree to that you’re on you’re in? Or you’re not good if you can. So, is that how you have built? You’re like, what else have you done to build your culture? Because I think you’ve done a pretty good job with [inaudible 27:90]

James Marotta, MD: Yeah, yeah, those are really, you know, as a core principle are, obviously, core purpose core values. You know, we have a big, big, hairy, audacious goal. And we have all these things posted and plastered all over the practice you have in a digital format, in our, you know, they come up in our meeting rhythms and MIDI constantly, you know, we meet weekly meetings, bi weekly meetings, we have a meeting, we just had a quarterly meeting this morning, this is our, you know, pose of our quarter, or priorities, you know, for, for everybody for the quarter where projects are working on and engage the entire staff. So be honest. And you’re right, absolutely core values are what we live by is what we try to guide our staff by and, and it’s also something that, you know, people, people don’t buy into what you are as a company, they’re not going to want to work for you. And we’ve had people, you know, self-select out from the interview process and say, Whoa, this is like too much for me, I’m out, you know, this seems like a call, you know, and which is great, because, you know, you don’t want somebody who doesn’t share your core values, and you want to run your company your way that, you know, speaks your heart and speaks to the heart of the employees that work there. And so, put it out there, use it in your lingo, have all your staff, very familiar with it, we have programs and incentives around core values around core purpose, culture dictates, you know, action and action dictates results. So, if you don’t think the corporate culture is important to business, then I don’t have mentioned it is just believing it as corporate cultures, you know, sounds fluffy sounds like pie in the sky. But it really can solve that other problem that we’ve talked about. Endless we’ll have staff, staffing, hiring and firing. And some believing guys fall that way. I mean, I know, you know, a pretty well-known plastic surgeon and, you know, in my local area, who is I concentrate mill of hiring, firing, and they don’t that’s the they don’t care about that, you know, that’s the way they run their practice. But you know, you can solve some of those frustrations by building a strong company culture and ultimately, you know, what do you want to do you want to contribute to society and the world as a whole. And for me, you know, you give back Your patients, as a surgeon, every day, you’ve impacted a million so many people’s lives. And you sometimes you appreciate that. But I can go home and also say, Well, I impact the lives of, you know, 25 employees that I have, and make them happier, and then give them a good place to work and have their, you know, have them, you know, provide for their families. And that gives me a sense of accomplishment beyond being a surgeon. That’s the entrepreneurial part where it’s kind of feels good to–

Catherine Maley, MBA: Well, let’s switch gears now to marketing. And that’s my favorite topic. I love business. I love marketing, for marketing, here’s my new spin on demand. I think, because of the way we’re set up now in society, I really think plastic surgery has become an essential. It’s shocking the surge of patients who have run in, like everybody I know throughout the United States is so booked, almost everybody is booked with surgery. So, I’m thinking either it’s essential, or I’ve been asking them, what are the patients saying to you? And they’re saying, Oh, well, I work at home now. So, I have downtime. All right. If that’s true, then I want it. I never want to hear again. Oh, it’s all about price. It’s all about price. is it all about price? Apparently, it was about that time. So, then I say if that’s true, and you believe that? Then you better start thinking about what can we do to delay or minimize the downtime? I spend more time on that end and trying to figure out how to discount the surgery. You know what I mean?

James Marotta, MD: Yeah, that’s So, a great insight. Really great insight. Yeah.

Catherine Maley, MBA: So, what [inaudible 31:40] For the demand?

James Marotta, MD: Yeah, that’s– you know, how to add surgical days and–

Catherine Maley, MBA: Crazy.

James Marotta, MD: Two and a half month turn after three months, you get a consult for surgery consult days. Yeah, the demand is out of control. And certainly, we had our you know, when we came back that month, we had a, you know, a record revenue month by, you know, good 20 20% or so was insane the backlog of patients, obviously. But, yeah, the demands been great. And that’s what we’re hearing and I was wondering how you know, it played out in different parts of the country we happen to be in a pretty affluent area where people are was disposable income and I think, you know, asking people how’s it how’s it going work? Well, I’m working from home ain’t no one’s selling well, awesome job. Here from few people, but not as many as you expect. So financially, you know, as the other part of the coin I that most people are saying. You know, yeah, it’s more because I have downtime. I’m wearing a mask I can get in the news. And I’m just amazed at how many people are obviously essential virgins because you know, what are the prospects of the stock market dropping thin industries laying off cadres of people is obviously there, they’re not worried financially and this is important to them as anything because they’re spending their money now is uncertain financial times on, you know, our luxury purchases, obviously it’s not.

Catherine Maley, MBA: So, do you have a typical marketing plan that you normally follow? And do you stop it once you’re busy? Do you keep it going? What’s your marketing strategy?

James Marotta, MD: Well, I have a– you know, our marketing strategy is like you know, all out all in everything we do everything we do, you know, we do you know, obviously, organic is big like if you look at my phone, I looked it up for me we’re gonna have this discussion looked at Topsail six weapon referrals, you know, the website organic searches on you know, Google and things like that. Then, you know, referred from sites like real cell Instagram, Facebook posts, social media to our website, that’s number one. Second, referred by a patient, so word of mouth, and patient referrals is a huge third is like form fills in the website, which are driven by content that we generate. So marketing, I have a marketing director, you know, and he’s in house, we have a couple of staff who double as admins or pay skateboarders and also have part time marketing. So, like, maybe a department is free, free people who are just in-house working in marketing, and we have partnerships with outside marketing firms. So, and they do you know, between that and then would come Vegas, really, you know, I always find that annoying when I go to a website. So that chatbot feature, you know, pocket and help you. We had one of those now, and that was a huge success. And we did that darn COVID and I always thought that was crazy. It would never work. That’s actually now number two. Five on the list. Oh, that’s huge. And then there’s, you know, not to give a, you know, there’s an online imaging company that, you know, we have in house imaging that we have, you know, cameras and we have extra 3d modeling. But having the ability, somebody take the picture online, and then you know, send you their image that’s been a huge marketing, new marketing referral source, so, and then we were social media, you know, savvy, and we had everybody the old packs engaged in social media, marketing director puts out social media content, but then all the providers to anybody who’s doing injectable medical says, you know, video testimonials or we have, you know, use So, technology to get your team kind of working together, we use Microsoft Teams, because I’m a Microsoft guy. And everybody collaborates in different teams on that stuff. So, people can post put out there, whatever content they’ve obtained throughout the day, right in this one drop area and get it out on you know, social media and on the web and things like that. So, engaging your whole team in, you know, in marketing becomes more fun to for them from a social media perspective.

Catherine Maley, MBA: Are you doing TikTok yet?

James Marotta, MD: Ah, no, I’m not. But you know, I don’t know what it is. But you know, I’m not the biggest–You know, if you had to rely upon me to do social media, and to be the guy who’s done all the posts and things like that, you know, it’s not my strong suit.

Catherine Maley, MBA: But the [inedible 36:46] here is you’ve delegated it to somebody, somebody has to do it. It’s just the way it’s done today. So, you either have to hire agencies to do it, or hire staff to do it in house. But the secret there is that you have to do it. And you have to be everywhere. Now. The content is king. It always has been but now the content is not just King on your website. It’s on Instagram, Facebook, and it’s all over the place on the blog and have a podcast by itself. It’s just relentless, but that you just have to figure out how do you enter this new competitive world? How are you going to do it? Are you going outsource it or you can bring it in but manage it? You’ve got to figure that out. On the reason I mentioning Tick Tock and frankly, kind of I’m not a big social media person. I know I do it but a regard for grudgingly it just seems kind of silly to me. I don’t have enough time to talk to you. If we’re doing igtv and I have 20 seconds or something. It’s just going so fast. I don’t see how we’re building relationships. And now TikTok is even faster and now you have to dance. Like they’re took saying, if you I haven’t been to TikTok, but my nephews and my niece are on it all the time. And watching them. Go scroll. I thought I was scrolling fast on Instagram. Oh my god. They’re like four times faster. And it’s all fun. It’s all dancing, dance. Everything’s dancing and video. Highlights going on and, and things. It’s very fast paced. And I think, dear Lord, if this is where we’re all heading, I don’t see how we’re going to bond with our audiences, I don’t. I am struggling with it actually.

James Marotta, MD: Yeah, I agree. I’m that’s not to me. Not a real human interaction.  That’s just contributing to the attention deficit disorder– most people.

Catherine Maley, MBA: All right, so let’s talk about your new book. Because I’m all about how do you differentiate yourself in a very saturated marketplace, and I did a podcast on write a book, it will immediately pull you out of the fray of people who haven’t written a book. So, tell me what was that journey like? Because it’s not easy to do it unless you figured out an easy way to do it.

James Marotta, MD: Right? Yeah. No, it’s not an easy process. I just I have a white word right, put up on the board. And writing the book for patients was kind of like way in the background. And I just said, I don’t want that to stand up. You know, this year, I want to do something big if I can get like something big done. Like kiss the frog. The big thing though, then other So, things on the whiteboard. It’s easy. So, pick Ryan’s book this year. And yeah, it was definitely a labor of I don’t know not love, that’s for sure. Yeah, I mean, again, with the with the theme of going with people who know what they’re doing and mentorship, there’s whole different ways of sit down and read a book and publish it and do it all yourself. There’s, you know, you don’t publish this whole company. All those companies will help you do that. You can get ghostwriter, I didn’t do it, I wrote, I wrote the book myself, you can do some hybrid of that, where, you know, you write it, and it gets edited by somebody else. And then, etc. So, you’re gonna look for, you know, this huge number of companies, which will help you write books. So, and you’re going to have to make an investment. Yeah. So, my, you know, differentiating myself and really as, as you guys seen, from our core values, core purpose, all that, you know, it’s all about me, it was always, it’s always about core customer, you know, you who, how do you put yourselves in the shoes of your patient or your customer and appeal to them. And so, I wrote my book more from the perspective of patients than from the perspective of being a physician. And one of the things I always heard from, and I continue to hear on a daily basis was, you know, mostly, you know, I mean, from so, older patients, you know, they, they’re kind of like, they always have this level of guilt, you know, like, why am I doing this to myself? Why do I spend so much money on this? Am I doing am I, you know, why would I go through this surgery, or why would want to go through repetitive needle injections, and, you know, and, and then people would just heartbreaking stories, I mean, I did surgery, this is like, maybe six or seven years ago, and I did surgery on this woman, her whole family, like, basically their own versions and tears in recovery? And, you know, it was just a horrible, heartbreaking, you know, experience for her and the guilt and shame and whole process that patients sometimes have to go through to justify why they want to change their appearance or look better, for themselves, or to their loved ones is just sometimes heartbreaking. And so, my book is like almost a love letter to patients who go through the process of struggle with guilt and shame. And taking that and title, my book is, you know, you’re not a vanity purchase, don’t feel bad about looking good. You know, it’s about the drive, the people have the biological drive pretty much to appear as healthy and viable as they possibly can and to attract other people, not only obviously, from a sexual perspective, or from a sociological perspective, and psychological perspective, there’s so many drunk drivers to why you’re in the midst of a national pandemic. First, people sometimes first place a per patient is gone. It’s my office. And this book describes not only the journey and processes that people go through that pain, but also what are what are the biological drivers know of that, you know, what are the sub psychological, sociological drivers of that strong, strong impetus to improve yourself? And why? Why does guilt and shame and or culture exists in this country, as opposed to you know, and a lot more as opposed to countries abroad where plastic surgery is venerated and celebrated? And there’s not as all kinds of puritanical notions of Oh, your dad, because you got, you know, you got Botox, your dad because you have changed your face. So, surgery, you know, and those so, oceans still exist in America as much as people, you know, talk about, oh, plastic surgery is no longer taboo. And it’s not, there’s still a huge taboo, think about, you know, as official plastic surgeon or plastic surgeon or dermatologist is watching. How many of your patients say Oh, yeah, put me on Instagram, Facebook, and you know, share my pictures with everybody? Next to zero. I mean, yeah, mostly everybody wants medical records only I wanted to know if this, you know, let’s talk about it. Nobody wants to, you know, so there’s still a great taboo around it. And so, this book kind of explores all those issues.

Catherine Maley, MBA: I think our industry should absolutely think the Kardashians as well as the housewives. They have changed this dramatically. And the more that stigma diminishes, the more everyone’s willing to talk about it, that guilt and shame are going away. And by the way, what I’ve learned is just in my own journey, I have so many different reasons. Patients have so many different reasons for having cosmetic rejuvenation at certain times in their life. When you’re younger, you’re trying to add more probably like you didn’t get something you wanted. But then as you get older, it’s much more I’m trying to buy some time here. You know, like the clock’s ticking. It’s like whoa, what happened and I think COVID helped with a big wake up call. You know, our life we have one life and we’re going to live it and enjoy it or so much emotion goes into this. That’s why I feel for you surgeons. It’s not about the surgery. It’s a bit about the surgery, but it’s the emotional journey of an aesthetic patient. Holy cow. Nothing. Yeah, yeah. So Alright, so did the book come out yet?

James Marotta, MD: Not yet. Um, I’m in the final editing is completely done. We’re preparing the images and the publishing is going on now. So is due to come out in January of 2021, Writing time New Year’s.

Catherine Maley, MBA: You did the hard part, this is now the best asset that you have, I call it an asset, because you put in the tough work. How true is this? If you do something that nobody else does, because it’s a pain in the neck, that’s the differentiator, that’s what makes you bigger and better. So, if you had that book, you’ve done the hard part. And now just market the heck out of it. I’m sure you see; I use my book. I’m like Flint with my book. Because see; I was the only one who had one for a really long time. And that thing has just catapulted my credibility, my image, you know, all of it, you, whoever puts in the time, that’s a great asset. So please market it because– Congratulations to you, I know It’s–

James Marotta, MD: Great advice. Thank you, Catherine. I appreciate that advice coming from you. That’s the key now, that’s the next face.

Catherine Maley, MBA: So, are you using any other–? Well, I guess you don’t do any events right now huh? Like, I don’t know–

James Marotta, MD: Yeah, no, we’re not doing um, yeah, no, no events– You know, because we have to kind of limit the, the exposure patients come, you know, we don’t have, you know, the protocol that we have is we don’t even have patients loved ones coming into the office anymore. Just the patient visually. So, you know, big things like that. Yeah, no, I can’t– I did a lot of virtual events and zoom events.

Catherine Maley, MBA: Are they as good as–? Are they okay?

James Marotta, MD: Well, yeah. They were okay. I mean, we had some engagements, and people were just shell shocked that they were home and people were furloughed. And so, you know, they had time to do, you know, we did some Instagram Live, we did some, you know, a webinar, I think people, you know, did engage us, you know, it’s not the same as face in person contact where people get the meeting providers or see machines or see the facility. But, you know, they help, I was, you know, in terms of, for us for our marketing strategy. I know, events can be hugely successful for certain practices, we were never really that big on hosting events. You know, I did some my first started in practice, because I had the time, but then, as I’ve gotten the practice maturity is guys level, it’s almost like you taking away from time where you can generate revenue to host an event to try to generate more revenue if I hadn’t, you know, I just never, you know, when you have, I think, you know, vacancies or you have a way of generating buzz in your need to because your marketing is not as efficient in other areas, then events might be a way, the way to go. But I’ve never really been that big on events.

Catherine Maley, MBA: One last question about marketing, and you would be the perfect person to answer this. A lot of the practices I consult with say, oh, by the way, I got a hair transplant, or a hair restoration machine and now what do I do with it? And I would have said, Let’s back up. Let’s think about that. Because it isn’t the reality of our industry is still what 85% female who want cosmetic rejuvenation, if you throw in a whole new hair restoration angle, it’s a new profit center, but it’s also a new marketing channel, a new patient emotional state wants needs, how did you handle that? Because I normally it’s a whole different business. So, can you just address that?

James Marotta, MD: It’s a completely different animal. And in fact, you know, from our perspective, we split off hairs a separate corporate entity, because you want to know your So, prop your p&l on your on your hair transplant practice versus your surgical practice versus your aesthetic practice. Because one can eat is and the other you can think you’re doing well in one area and you’re borrowing from Peter to pay Paul. So that’s from an accounting perspective, that’s important to do but from a marketing standpoint, you know, your 95% is interested is women are and hair loss concerned about it. You know, 95% of your surgical practice is going to be hair transplants, male and a as a whole different approach when it comes to you know, bringing him in and you know, actually closing a deal with them. More about, you know, transactional, it’s more about, you know, you’re gonna have to compete on cost more with them, they’re going to want to see before and after results consult is going to be more brief, it’s going to be more to the point, it’s not going to be touchy feely, you may want to have a male in person doing, you know, the consultation, because they might be embarrassed to talk about hair loss with a female. So, the whole different world seems attractive to get into. And then in this day and age, it becomes difficult to differentiate yourself because of machines, right? So, there’s a robot or a robot, he spent $80,000 on robot and the thing that’s going to bring in patients neograft, you know, you don’t have to be there. And you can delegate tasks that come in from somewhere else. But how much are you involved in the process? And how can you differentiate yourself from some outside practice providing So, hair transplant? Yeah, something not to any machine. You know, any, I always go into the mindset of machine isn’t going to make money is the practice is going to make money. And, you know, we’re going to make this machine successful. So, if you plan to do that, then don’t buy the machine. Because I’ve never had the experience. While Wow, I bought this machine and all these consults are coming from their pay per click directed advertising. And the machine is just, you know, running itself and generate notes, the lease payment every month that you’re plunking down about whether you have a patient or not use it. If you have the market in your current patient base for it, probably not a good idea to venture into.

Catherine Maley, MBA: For sure. And then let’s talk now– It’s been a while; we’re going to wrap it up soon. Let’s talk about mindset because I love that. How did you start thinking like a businessman versus a surgeon? How did you make that fit?

James Marotta, MD: I think we talked about it a little bit before, it was that that transition from rugged individualism to team, you know, it’s not me, it’s not– I’m surgeon I’m boss on this. It’s, you know what, I’m part of a team. And I can parse collected, you know, abilities, talents, brainpower of team, to create a business that’s bigger than me, you know. And I think that is a growth mindset. And then teaching yourself and others how to grow and let go and delegate in such that exponentially your team’s talents, abilities, etc., grow. And that’s how you grow the business.

Catherine Maley, MBA: So, did you always have that abundance mindset? Were you envisioning you having your own practice, your own building, lots of staff? Did you envision that?

James Marotta, MD: No, I shouldn’t say no, I shouldn’t say I didn’t envision that, it wasn’t– you know, I started from square one, which is okay, pay the bills. Once the bills are paid, okay, well, maybe I should get like an esthetician. situation going because of the surgery. And so, I went from 1500 square foot rental space. And I rented the upstairs to 1600 square feet. And then I got more hiring more staff and then grew that rental and grew out of that rental space, and then said, Well, okay, now, if I own the building, and I’m paying or rental payment every month, why not pay to equity, so that when I retire, sell the building, and then I bought my own building, and so that is become Okay, now, well, we’re in a space and we need to fill it. So, we had to hire more staff. And now we have, and now it’s okay, well, here we are, in one practice location to make more practice locations, because, you know, you can only do so much with your own hands, you know, and you have the potential and the ability to grow a much larger business. It’s not easy, and it doesn’t come at a major, major price. But I think the dividends are me has been much greater than the price paid will be settled, remember? So, and I find that in the world somehow, even though you’re dealing with more moving parts and more people become simpler and simpler, the higher the bigger the organization grows, not more So, complexes, which you think because you have multiple people to rely on multiple people doing different things that you were once doing. It was much more complicated when I was [inaudible 54:49], the protocol writer ,now I have people if I have a clinical post op instructions, That don’t seem to jive or, you know, five years old and something says, I want you to do this on day five, well, my nurses will notice that and rewrite the whole protocol and then put it on my desk and I’ll review it and say check, you know, I used to be the one doing all that stuff, you know, now as he, you know, that’s the dream to go build yourself self-managed team so that you could potentially walk away at some point, and the practices still generating revenue and doing well in [inaudible 55:29]. That is the ultimate goal.

Catherine Maley, MBA: That is so true. That’s easier said than done, but I would think that would be the ultimate goal if we set up a system, that you have peace of mind and clarity, and everyone’s doing their thing and you’re overseeing you’re not doing your, your, you know, you’re leaving it good for you. Last question. Tell us something we don’t know about you. That’s pretty darn interesting.

James Marotta, MD: Wow, that’s it. I mean, I lived in Italy for a year. Yeah. I lived in Germany for a year. I love traveling, I love culture. I speak both of those languages. I can’t wait to travel again; we’re supposed to go to Africa on safari and it got canceled. So, looking forward to you know, broadening my horizons, learning about different cultures and getting to travel.

Catherine Maley, MBA: I have Africa on my list too, that’s far So, away.

James Marotta, MD: 

Now, I can’t wait for that. I’ve heard it’s phenomenal.

Catherine Maley, MBA: I will thank you so much, Dr. Marotta, I appreciate it. And if anyone wanted to get ahold of you, should they just like go to LinkedIn or go to your website, Marotta? I think it’s

James Marotta, MD: Yeah. Okay. Yes, sure. Send me a– message me, I’m totally fine.

Catherine Maley, MBA: Okay, thank you so much. All right. And with that, we will conclude Beauty and the Biz for this time. And if you would, please subscribe, give me a good review if you feel so inclined. And then if you’ve got any feedback or questions, please just leave me a message at my website at or you can always DM me at Instagram at catherinemaleymba. Thanks so much.

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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.


Beauty and the Biz is for Plastic Surgeons who know they don’t know everything and are open to discovering the pearls to grow and scale a sellable asset when they’re ready to exit.

Listen in as Catherine interviews surgeons who talk about the business and marketing side of plastic surgery and listen to Catherine’s pearls from consulting with plastic surgeons since Year 2000.



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