Meager Beginnings to 1,500 Facelifts with Joe Niamtu, DMD

Meager Beginnings to 1,500 Facelifts with Joe Niamtu, DMD

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, as well as consultant to plastic surgeons, to get them more patients and more profits. And today’s special guest is very special because I’ve known him for a very long time and he’s very hard to track down.

So, it is Dr. Joe Niamtu. Now, Dr. Niamtu an internationally known cosmetic facial surgeon, teacher, and author in private practice in Virginia for a very long time. I think it’s 1984. Now, Dr. Niamtu has lectured and teaches all over the world. He has written hundreds of publications. Seven textbooks and even 30 chapters to other textbooks.

Now, Joe Niamtu, DMD is very active in the AACS and that’s where I met him. And he’s pretty much an icon in that organization. And he’s appeared regularly in magazines, news, print, and TV. Now, Dr. Niamtu is also very committed to numerous charitable organizations to help third world children with facial deformities as well as women dealing with domestic abuse.

So, Dr. Niamtu welcome so much to Beauty and the Biz, It is a pleasure to have you.

Joe Niamtu, DMD: Good to see you. I seven textbooks. You’ve got an old bio, but –

Catherine Maley, MBA: You’ve got to be the hardest working surgeon I know.

Joe Niamtu, DMD: I’m the hardest searching work, hardest working surgeon. I know you’re the hardest working person in what you do as well. You’re everywhere. And everybody knows you actually, you know, you’re like, Cher or Bano or Sting you just say, Catherine people know you’re talking about.

Catherine Maley, MBA: Well, and that’s, and that’s why we’re talking because it takes marketing and business to be good at surgery.

And so, I’m here to help you surgeons get good at the business and the marketing side. So, you can do your surgery. I’m going to help you with the other side because they’re both, they’re all important. So, can you go ahead and describe your practice? You’re in private practice in Virginia, it’s super competitive, but why don’t you just describe your practice and how you’re set up? And who’s in the practice

Joe Niamtu, DMD: I’ve been doing cosmetic surgery for about 21 years. I practiced longer than that. My background, my residency is an oral and maxillofacial surgery, and I always had an interest in. Trauma and facial reconstruction. And during the 1990s, mid 1990s, a lot of things happened, Botox, fillers, liposuction, laser endoscopic technique.

And there were so many things happening in cosmetic surgery that, you know, people who’ve been in practice forever didn’t have that, that training. And so, I started getting involved and I really liked it. And I felt I was good at it in 2004. I moved my practice efficient surgery. And so, it’s been a good run here.

And I, I feel like I’m at the top of my game right now. I don’t say that area, you know, of anybody that knows me, knows that I’m not arrogant. It’s just when you do something long enough and you work hard enough and you’re passionate enough, it kind of all comes together. So, I’m at that place where I can work.

I work four days a week that works well because by Sunday, I’m excited to go to work Monday and get my, get my fingers wet. Okay. So, I’ll do this as long as I have that feeling. And again, I have a mature practice and believe me, I went through all the bumps and lumps and hard knocks that people do.

And I’m at a place now where I can, like I said, I can kind of work the days that I want. I can see the type of patient I want. I cannot see the type of patient I don’t want. I can charge what I want. And I think when young practitioners, restorative practice, hopefully they have a vision. I mean, if you go up to any doctor, who’s just starting.

If you say to them or their staff, what’s, what’s your vision, 2020. If they can’t answer that, then they’re not going anywhere because it’s like a roadmap. If you ran a marathon, you’d have to know where the finish line is. And if you don’t have a. Then you have random chaos and that’s what takes down so many practitioners and, you know, football teams go and quarterback calls a play and everybody knows what to do.

So that’s kind of like a mini vision. Their vision is winning super bowl. So, you know, my vision was to have a full-time cosmetic facial surgery practice and to the things that I, that I really liked. And she could kind of patients that I liked and back to what I was rambling on. So, if you ask somebody their first day of practice, where would you like to be in, you know, five years, 10 years, 20 years I’m at that place.

And again, I know that sounds arrogant, but it’s been a hard, hard journey that I’ve been passionate about. And it it’s a good feeling. The problem is by the time we get to that a lot of people, you know, I’m retired, but I want to do this. And as long as I can,

Catherine Maley, MBA: that’s the holy grail to do what you want when you want to do it, charge what you want and work with patients that you really want to work with.

That’s it? That is the whole point. So, can you give us a few pearls? I know it took you 20 years to get there, but any, let’s just start with this when you’re not at work. Are you the only revenue generator or are you set up to make money when you’re not there?

Joe Niamtu, DMD: Yeah. So, for the last four years, I have trained my nurses to in jail prior to that, I was the sole revenue generator.

And you know, I still am surgically. I mean, But injectables, you know, are good part of my practice, but my practice was 90% surgical. And I always say if my fingers are bloody, I’m not producing revenue. And that’s true. Did you

Catherine Maley, MBA: ever think about adding associates or somebody to help take some of the slack off the surgical.

Joe Niamtu, DMD: Yeah. So, I have, and lot of my friends have fellows and residents and that sort of situation, and you have to let them operate. Okay. Otherwise, they’re not going to get experience. And you know, one of the first things that my patient asks is who’s doing the surge and also, I’m kind of a lone Wolf.

I’ve got a lot of journal articles and publications, which I usually do by myself. We have a large practice on the oral and maxillofacial surgery side. They only do oral and maxillofacial surgery. I’m in a separate location. I only do cosmetic facial surgery and I’ve kind of trained a couple of those guys possibly to do this.

But, you know, it’s, it’s really hard to find somebody that has. And there’s a lot of people that want to be cosmetic surgeons or, or whatever or nurse injectors or assistance, you know, where are you going to call it? You’ve got to have the passion. And so yes, I’m the only revenue generator in my practice.

I have a couple other little side business hobbies. I teach courses at my office. I have an online video series. For a position, but that’s, that’s kind of hobby money. Any serious income comes from me with doing surgery Monday through Thursday. Okay.

Catherine Maley, MBA: So just, can you give us a couple tips on how you got there?

How did the point where you can charge what you want, see who you want and work where you want?

Joe Niamtu, DMD: Yeah. You know, you’d have to be unconditionally and many people see somebody who’s successful in anything and same thing, what you do. And, you know, they think that the person just woke up one day, it was handed to them.

They have no idea. So, number one, you have to be passionate about what you do. And that means that you’re going to be unconditional committed. That means you’re going to be committed to do things, whatever it takes to get your practice to where it needs to be. And you’re going, you know, that may have included working Saturdays.

It certainly included, instill, influence, coming home from work and doing my own social media. It includes treating patients better than anybody else. I mean, every patient has always had my cell phone. I am so sensitive about how patients feel about me and what their experience is in our practice. And you know, the road to getting here starts one drink at a time and you have to be, you know, what did they say available?

That’s number one. You have to be affable. You know, you got to be a likable person. You got to be able to relate to your patients and you have to be able, you have to have ability. In other words, you have to be good at. And all of that just comes by, you know, largely a trial-and-error process. It’s a very competitive industry.

And you know, there’s a lot of competing specialists that I think eat their children, eat their own, whatever, whatever we say, you know, and it’s unfortunate because there’s plenty to go around for everybody. And that’s always been something when I see a doctor that talks bad about somebody that that’s just their own insecurities.

So, one thing that I’ve done is ignored the haters because I don’t care who you are. You know I just saw a thing the other day about lady Gaga, you know, I mean, so, you know, the Beatles, everybody have haters that the better you do, the more jealous people get. So, you ignore them, put your head down, you decide what your vision is and you don’t let anything come between that, but it takes incredible work and incredible availability.

And, you know, every year you could do better and better. And, you know, I mean, there’s, there’s hard knocks to you. Maybe at first, don’t understand what may constitute a bad patient or somebody that’s going to be a problem. You know, you learn how to see red flag. You’ve heard me lecture about that, and I’ve heard you lecture about that.

Catherine Maley, MBA: So just on that, because your talk on that is really good. You want to just give a couple of tips on how do you handle an unhappy patient? And the, your issue is kind of, I think bigger because you’re doing facial surgery body, body surgery. It’s important, of course, but it’s easier to hide.

Joe Niamtu, DMD: Yeah, you can do mediocre at the face there’s nowhere to run.

You have, you have to do well and you know, Sure say they don’t have complications or humble down to earth successful people. And they’re going to tell you, yeah, of course, you know, you have a problem with patients or situations that need revisions, but handling the unhappy patient. And for some reason, this is one of my more popular lectures.

First of all, you have to identify cosmetic surgery is elective. Nobody needs it. Nobody’s going to die without cosmetic surgery. And so, when you see people that, that sends you and you know, so much has changed just in the years that I practice with the ability to you know, internet based on zoom, everything, but when a patient contacts you and they’re overly concerned about some insignificant thing, you know, they have a couple little crow’s feet wrinkles and they tell you they can’t go out of the house.

Something like that is a really, really big red. Young patients that want older patients’ surgery is, is frequently a red flag as well. Patients that don’t smile and aren’t trending. Okay. They’re just some people that, you know, they’re just kind of deep and, and that’s their hobby. And if you talk to their kids, teachers or their neighbors, they’re going to say, yeah, there, there are difficult patients that won’t listen, won’t let you talk.

They interrupt patients that tell you what surgery they want, right. Because they’re on the internet. I want a high mass activity, whatever patients that really think are important, they’re actors, or, you know, they, they don’t want you to take pictures of them or they try and bypass your normal protocol patients that aren’t reliable or dependable.

They’re late. I mean, Goes on and on and on and having the ability to recognize that is paramount. And I liked that lecture because I can tell younger doctors, you know, what I learned the hard way. And other people told me, because, you know, you need, I don’t care what you do. You need a mentor. Right. And that’s why, I mean, I lecture I’ve lectured on six continents.

I lecture all over the place and I enjoy it. But my favorite lectures are talking to young people that are just getting into this because they’re, they’re like a sponge they’re very impressionable and you can tell them, you know, it’s almost like if I drive down the street and my I have a pretty fan, I liked cars, cars, but I certainly have, and if I hit a big bottle and break my.

That’s terrible, but so I got the knock there, but if I can tell other people, Hey, don’t go down that street. Cause there’s a big bottle. You know, it’s, it’s the same analogy. So, you want to find happy, fulfilled patients that are doing the right procedure for the right reason and have stability in their life.

You know, patients that come in and they can’t afford and, you know, listen, believe me, I grew up with six people in an 800 square foot house. You know, I don’t add, didn’t have the things that I have now. And I worked very hard for them, whole family. Did you know, my grandparents came here, didn’t speak English.

They immigrated from Romania on one side and Italy on the other side. And I have that immigrant work ethic. All right. That’s one of the topics or your previous question, but in any event, you know, patients who can’t afford it their health history doesn’t allow. Gosh, we could talk all day just about red flags when something is off, something just doesn’t seem right.

Another thing is don’t operate on somebody you don’t like, and you know, we’re all human. Sometimes you have patients that there’s just such a handful, you know?

Catherine Maley, MBA: Yeah, they’re unpleasant. So, you want to just use your staff as well?

Joe Niamtu, DMD: I learned the hard way to listen to them. There were times when I said, Hey, I wouldn’t touch that patient.

They’ll be okay. They’ll be okay. So yeah. And again, back to the roadmap of success, you know, having the right staff, which is where we get into the business side of this, you know, that’s one of the biggest challenges, but it’s also one of the biggest rewards. So, like I have patients that are mean to the front desk.

Catherine Maley, MBA: Right. Nice.

Joe Niamtu, DMD: okay. That’s one red flag. You call the office, you talked to the receptionist. Then you come in for an appointment, you interact with that nursing staff, and then you interact with the coordinators and schedulers. And if two of those people flag that patient

Catherine Maley, MBA: and other women’s bad behavior quicker than you can probably. So, I would do,

Joe Niamtu, DMD: at least my practice is 85% female and my staff is a hundred percent. And so yeah, they’re more, probably more attuned to that.

Catherine Maley, MBA: So, regarding staff just currently right now, I don’t know what’s going on in the world, but I’ve used to be a killer HR kind of part-timer I could find you as a coordinator, like no one’s business or a receptionist, because I love to find them and then train them for you too.

So, you have a professionally trained person representing. This past year has been ridiculous. Have you found that you can’t find people or they’re leaving or they’re unreliable or any of that happening over there in Virginia?

Joe Niamtu, DMD: When we, when we look back in whatever, five years, 10 years, a hundred years about this virus that went through the world it changed everything physically and mentally.

A lot of people didn’t work cause they got paid for not working.

Catherine Maley, MBA: All right. That’s amazing. That’s going to come back to haunt them because there’s a really big black hole there for two years, three years, if you say so what have you been up to? Oh, I was taking care of my mother all of a sudden.

Joe Niamtu, DMD: Right, right.

And you know, the hospitals suck all the nursing and a lot of healthcare workers. They were needed so badly in some of them have like local pendants where they could go work in Texas or whatever for incredible wages. So, we’ll probably get you a major, but I have two severely disabled children, cerebral palsy, and each, each side to my two songs.

Each one has around fuck nursing. And the home health is, you know, it’s dissipated. I mean, it’s just, we can’t, you know, it’s really hard to find nurses. And so, my, my wife is having to do all these nursing shifts without she’s not verus, you know but without notice, I mean, you know, she may work 24 hours in row the next day, you know, somebody calls off at the last minute.

So that’s been very difficult. The restaurant that I’m going to this evening, they just, it. They couldn’t, they didn’t have people to work. It’s a crazy situation. And I’ve heard a lot of people talk about, you know, why it is. Some people just decided they could work virtually other people decided this is a good time to find another career, but there’s that missing gap that you just talked about?

I don’t know where the hell they are, you know, I mean, because there were people that had jobs before, so hopefully they’re coming back into the situation.

Catherine Maley, MBA: By the way, did you hear about that app and I’m not here to promote anything, but there’s an app that you can find a nurse quickly. It’s kind of like Uber for nursing and surgical staff.

Joe Niamtu, DMD: I don’t think I have, but you know, again, you got to find the right person. And medical practices, doctors have a very unpredictable employee because it’s largely young females are, are available and they want to do really unpredictable things, like get married and have babies, or they get engaged and move or something.

So, it is a little instability with that group and finding the right people and keeping them is huge. But to underline what you just said. Yeah. It’s really tough for any business to find right now.

Catherine Maley, MBA: So, would you say staffing is probably one of the biggest challenges to running a solo practice?

Joe Niamtu, DMD: When I lectured a residence and that you know, used to have a Blackboard or whiteboard or a flip chart and I’d say no.

Okay. What are the, what are the biggest problems you’re going to face you a practice? Right, right. And what they did, and it was like insurance losses, income, bad debt to note your own biggest challenge is staff finding and developing right. Staff, keeping them and hiring and firing, which you know nothing about.

So yeah. Staffing is a huge challenge.

Catherine Maley, MBA: Any pearls to help with that?

Joe Niamtu, DMD: A lot of pearls. You know, when I started out, I had two people, one surgical assistant and one front desk person. And the other part of my practice, which I started hoping, you know, we have a hundred employees, so we have a CFO, we have seven offices, so we have a manager in each office, but again, I’m in a different building.

I have nine staff. All right. So, my first. Probably you need to find somebody to be a good manager. If you have enough people that you do that because doctors are not good at dealing with staff issues because they’re emotionally involved and it’s like fish, can’t see water. Cause they’re in it. And doctors want to be good guys or good girls, and they just don’t have a business acne.

And you know, this is a real litigious area, as you know, I mean, you know, you can give me two really easy and not just, you know, me to sexual Amanda, but just so many things where, you know, doctors or any successful students is a deep pocket. And you know, somebody can see that as a lottery ticket. You know, wrongful discharge, so many things that you can fall into a trap.

So, as you can afford to find somebody who’s good at that, that has some HR background, then you let them be that off. If you want to talk now or later about hiring, firing.

Catherine Maley, MBA: No, we should do it now because one thing I’ve learned, I did a talk recently on the good to great, like what makes a great practice versus a good one.

And 10 out of 10, they had a right-hand person who handled that part of the business. Right? All the HR stuff. They stayed the good guy. The man at the manager got to handle all the crap and this one that just bogs you down and you don’t need to be.

Joe Niamtu, DMD: I did it all at first. Now I, I’m not involved in hiring and not involved in firing.

I mean, when we hire somebody. I get to meet them, but so, all right, let’s talk about higher, right? So, what do I look for? Well, you know, it’s just kind of like the patients we were talking about. You want to look for something that’s joyous, unconditionally committed and not just committed to you, but committed to the success of your practice.

So, if you come in and you’re in a bad mood and be in an ER, they’re committed to you, they they’d say, yeah, that’s right. It is terrible. You know, if they’re the practice, they’re going to bring you up and say, doc, you got a smile. People are going to read that negativity. You have to be presentable. They have to be willing to learn.

I keep going back to joyous, you know, fulfilled and smiling. And obviously you can’t hire everybody who has the Barbie doll line, but you know, a lot of people. That we talked about, you know, they’re maybe financially strapped. They may be going through a divorce. There’s a lot of things that play into it.

So, stability is really important. Hiring somebody that’s supposed to your office for. An hour and a half away. And if you had a hematoma or something, you know, they could say they couldn’t come in there.

Catherine Maley, MBA: That’s literally the first question I ask, let’s talk about your commute. How far, how many miles are you from the office?

Oh, no problem. I’m an hour away, but no problem. It’s a problem. You know, I want them close. I want an easy, convenient, and I’m the word I look for is I want them to have that likability factor. You know how you meet some people they’re not Barbie dolls, they’re not gorgeous, but they, you just love them.

They have such a great aura about them, that kind of an employee we’ll just, we’ll bring sunshine instead of

Joe Niamtu, DMD: they will. And I’ll tell you, I have an employee that’s been with me on and off for about three years. She’s currently on, she just, she’s got a free spirit. She’ll move to Florida and moved back. So, she never is off because of the negative reasons, but, and she’s, you know, 62 great mix.

If you have some young employees, cause they’re. Impressionable. And they’re so excited and they’re, you know, in terms of nurses, they’re very contemporary and then to have some over employees, and this is an old guy saying this, right? Because they have wisdom, the flavor of your practice can make a difference.

So, I have friends that they have injectable practices and, you know, they treat the Kardashians, you know, young, young people that want fillers and Botox and aren’t have to talk in Instagram. And, you know, I have a facelift, most of my patients are old. So, to have that mix of age group is important and diversity is important too.

That’s just, I think a big thing in hiring and firing and always has been.

Catherine Maley, MBA: Although, when you have a facial plastic surgery practice, I would skew to the more mature staff being of a mature nature myself. It is difficult to have a coordinator who’s 25 years old and I’m talking to her about my, you know, my emotional leads of wanting to look better.

You know, I it’s, it’s more difficult to connect, so I like that you have a variety there. Yeah.

Joe Niamtu, DMD: And in that version, you know, it’s great to line up your staff members with age-appropriate patients. I think that helps, but I’ll tell you sometimes they, the younger people hit off really well with older patients and vice versa.

Again, it’s just hard to get people in general, younger or older, and the younger patients, you know, again, they have children at home that can call off more, you know, it’s just, there’s just more.

Catherine Maley, MBA: You know, what element I think is missing in a lot of practices that I think we need to introduce, and that is, and I know I hate to use the word fun, but whatever you want to call it especially after COVID most practices got super busy and it became very intense and the environment has been more like a pressure cooker than it used to be.

And now we know that’s not going to last forever, but while it’s going on, a lot of staff is not used to working under pressure like that. So, do you take the time or have you figured out how to get everyone to exhale and work together, but then play together or celebrate together? Is there anything you’re doing to keep them motivated so they don’t leave?

Joe Niamtu, DMD: Yeah. So, I’ve always said you learn from your losses and you celebrate your victories. And you have to take care of sometimes financially, the bonuses we bonus our staff during COVID the people that stayed in work. We have employee appreciation things that we do that building events, where we all participate.

It may be going through a pistol range or racing go-karts or going to an amusement park at Christmas. So, we try and do that orderly. You know, you got to be careful also, you know, we can get to the firing part of this. You want to be friendly with your staff. You don’t want to be best friends.

And you know, these are your work lives and you spend more time with them than you do at home. And, you know, you can have fun. We usually have. But, you know, what I do is serious and we also sometimes do our own anesthesia. I’m licensed in that state of Virginia. So, you know, surgery and anesthesia for the life and death situation.

So, you got to have fun, you got to be serious, but at the end of the end, you know, there’s going to be days when I’m sure there’s going to be days when they’re short, but at the end of the day, or at the end of the week, everybody should be smiling. And I think that’s what, that’s what usually happens.

Catherine Maley, MBA: Good. Just give me after all the years you’ve been at this, and if the younger people are listening, give me a mistake that you could help them avert.

Joe Niamtu, DMD: Well, getting too friendly with your staff. You know, I used to have parties at my house for my staff and, you know, then somebody gets drunk or something and then they’re fighting with somebody else.

Again, you wouldn’t be friends. You don’t want to be best friends. W we’ll start on the thing of fire in here. Okay. So, the first person I fired, I sent flowers to, I felt so bad. Okay. Well, that’s not how you do that. Okay. Second person that I let go, came back and said that I pushed him against the file cabinet or something else, which that never went where coincidentally, I had three people in the same family, big mistake.

The ancient Romans knew don’t steal from your office. Don’t have two sets of books. Don’t hire a relative. Don’t hire somebody. You can’t find. No don’t hire achieve to do an Indian’s job. Okay. So those are all mistakes, probably everybody is made along the way. So, I’ve talked about hiring what to look for.

Let’s talk a little bit about firing. So first of all, that’s not something that doctors should do. A doctor hiring and firing is like driving without a seatbelt in a way. No, because you might not get hurt, but if you do, it can be really bad. And in today’s climate of business climate, you’re just open to too many things.

And so, firing someone is a hard job for doctors and probably many people. So, in my practice, I, somebody needs to be a 900. Okay. On a scale of one to gender and they’re not going to work out and I’ve let go of people that were six, but they may have been a 10 and Joe average practice. Okay. My practice I’m striving for excellence and I demand a lot from my employees, but no less than I demand from myself.

And so, you, you have these, these people that are starting out a lot of times, it’s their first job and, but it just not working. Okay. And you have to find it. And it’s very hard because you’re emotionally. Whereas the human resource person, they go to work now or somebody, they fire somebody. And I tell this HR person too, if I was lecturing.

So, when you let somebody go, first of all, that’s going to be a tough thing for them as well. I mean, I, I got fired from one of my first jobs as a car house. It crushed me because all my buddies worked there and all the girls from high school would come in, but any, you know, I was fired basically because I was missing time in any event, nobody wants to be fine.

And so, you’ve got control of it. Okay. And you’ve got to be careful. You couldn’t give you talk so much about. And I learned so much, there was a company. I don’t know if they’re still in business, but it was, it was called Kendrick Mercer then was called Mercer. And I learned some of the best practice man.

They were in Santa Barbara, California, and I learned some of the best. Some of the things that I talk about, you know, some of these pearls I learned early on, but so you got to let somebody go because it’s not fun for them. It’s not fun for you. And what I do, you’re going to give me so many times again, use the word vision.

I tell them that I think you’re a tremendous person and I think you’d have a lot of talent, but you are not going in the same direction. I am towards my vision. Okay. And nobody can argue with that. If I tell somebody, well, I’m firing you because you were late 10 times, they can say, well, Sally was late.

You didn’t fire Sally. And what if I just tell somebody that we’re not going in the same direction, they can’t harm when I was doing it, or I think it’s a good idea. You do it on a Friday afternoon. No. Give somebody two weeks because you’re giving somebody two weeks to sabotage you or, or get your charge or whatever.

And people do that. No, Friday afternoon five o’clock was in my office. Listen, sorry. This isn’t working out. I think you’re wonderful. First. You’re not following my vision. I need credit cards. I need the keys. Okay, cool. Another problem is letters of recommendation. I wrote her a letter of recommendation for a patient dialect though.

And I got a letter from attorney saying that, well, she was so good. Like your letter why’d you fire her. And again, heavy is the head that wears the crown. Okay. So, none of these students have ever gone to fruition, right? They weren’t even students. They were somebody trying to ruin kind of extort you, you know?

And they, they just, you know because they were frivolous, but we learn a lesson from them. So, in our practice, if somebody asks for a letter of recommendation, unless it’s somebody that was really, really good and they moved or something like that, then I would give them an extremely flowery letter of recommendation.

But otherwise, we just say, you know, especially if somebody’s been fired a hundred percent, say they worked different this day to this day. That’s what I’m saying. And if somebody was calling me and I thought that they were getting witness person, I would say, I’d love to give you a recommendation. But my attorney is, is giving me advice, not to comment on this patient.

That pretty much tells the story.

Catherine Maley, MBA: So, would you say staffing is your biggest mistakes made or are there any other like a lot like another big mistake is I wish I had bought the building. I worked in for 20 years, you know, instead of putting it, do you have one of those mistakes?

Joe Niamtu, DMD: Okay. And it’s, you know, this stuff is like, like a scale. So, when you first go to practice, staffing is a, you know, it’s a big problem. And then as you, as you get experience, it’s less of a problem and something else, a problem is a problem. Whether it’s you know, patients that debt I have bought the buildings and all my partners, again, in the global practice, we own our, all our buildings magic.

That’s a great move because that will provide retirement money after you retire. And it’s, you know, it’s crazy to pay rent that, or I wouldn’t have bought my house. So, it, it. And the current environment, I think that that’s still stands. You know, listen, I’ve made mistakes in handling patients. They were unhappy and I got mad at them, not so much that I got mad at them.

I did listen to them and I was so serious about trying to do well if they were mad at hurt my feelings and, or even if they were totally off base, I ended up arguing with, and that’s the worst thing that you can do. Okay. And Jonathan sites, I’m sure, you know, in my, my new textbook cognitive facial surgery, third edition, it’s going to be released by Elsevier in may here.

Nice. And that’s remained one of the largest medical books selling books on Amazon. So, I’m proud of that, but I I’ve got some really good. Contributing authors. John Sykes is really good at that. He has a great chapter in my book about reflective listening about, you know, a patient saying I’m unhappy because I have extra skin half my face.

No, you know, you have this or okay. I’ll we can fix it tomorrow and they cut the patient off. They’re not listening. All right. And sometimes I’m happy patients.

Catherine Maley, MBA: They just want to vent 80% of the time. They just want to complain and that’s okay.

Joe Niamtu, DMD: And it’s human nature. And I’m so sensitive about my brand and my reputation that I get from, you know, emotionally involved.

And they can sense that. And when in fact, you know, you’ve got to sit there and one of the things that John says, and I’ve got, I made some great pictures of this in my book when you’re seeing a new patient and you’re in the selling mode. Great. If a non-medical person looks interesting. Oh my God, they’re talking about profit in that this is medicine, you know, profits, not a four-letter word loss and any successful doctor has to have a profitable practice.

So, when you’re in that introductory mode, you need to be big room. You need to be up there. And hi, I’m Dr. Niamtu and I’ve done 1500 facelifts and I’ve been, you know, not overbearing in that presence,

Catherine Maley, MBA: Knowing your breath,

Joe Niamtu, DMD: you have to be smaller. You got to be tiny and shriveled up and listened to them and not be arrogant or not, not arrogant, but not be in that big brand mode.

So, listening to the patient, and one of the things that really, I learned from one of my managers, she would always go in and shit, those patients, she would, she would live. And then she’d say, what can I do to make you happy? And that’s what I do. Some people just want an apology, you know, I’m really sorry.

You’re feeling that way. Or I’m sorry that we have to redo this. I know it’s a hassle, but you know, its surgery, it’s not an exact science is mother nature that they want a little bit of a piece of you, of your time, face to face, or just hear you say other people they’re scared. They want to know what’s going to happen.

You know, you did this face back here. Okay. So, wellness, I’m going to take care of. Okay. And they want to know it’s going to cost them. Okay. These are things that should be all have been discussed preoperatively in a mature practice. So, they just want a solution. Okay. And then there’s that very small group of people that you’re never going to see.

All right. And once every two years I’ll refund. And, you know, knock on wood. I’ve never had a catastrophic anesthetic or surgical situation, but you know, when you, when you do up to 6,000 islands, I’ve done 1500 Traceless. I’ve done, you know, not, you know, 15, 20,000 cosmetic procedures. You’re going to have, you know, you can have things that you need to correct or things that didn’t go the way you want to.

And if you can’t satisfy our patients or if you want that patient out of your office, out of your life, sometimes you have to cry. Uncle I’ll gladly refund them if they have, for

anybody listening, not to ever, ever refund anybody without having even a happy patient sign, a waiver saying that they, they hold you harmless. They won’t anywhere. Right. And you know, does that stuff, is it iron plaid waterproof in court? Probably not, but I’ve never had any. No, I’ve had some people say, well, I’m not signing.

Okay. Well, you know, I’m sorry we can’t refund your money. And then they now one of my friends eat issue, the refund check. It had the reason they signed the release. Okay. And you know, I’ve had some patients that I’ve refunded just because it wasn’t, you know, they didn’t want me to operate on the gem and it wasn’t fair.

I didn’t get the results I wanted. I didn’t want to keep their money. And, but usually honestly, it’s just, you know, and not having patients, we probably can’t make them happy and it’s just better if they move on and you move on

Catherine Maley, MBA: and you don’t need a two-year drawn out in courts. And oh my gosh, the energy that would take, I would say, just make that go away.

If you can, as quickly as you can.

Joe Niamtu, DMD: I have only consumed one time in my career before I was doing cosmetics and we were victorious. Every doctor should get. Okay. You guys, you know, some doctors they’re like, well, whatever, you know, the patient that had complication the patient posted negative review, and they’re going to see the doctor.

I didn’t do anything wrong. I am not refunding their eyelid surgery. I’m not doing that in about the fifth day of depositions when you’re out of your practice. And some lawyer is telling you how bad you are, you know, you’re like, oh my God, that was $5,000 I could have given them. Oh, gosh, there’s so much to talk about in terms of that kind of stuff.

Catherine Maley, MBA: Well, can we switch to a more fun topic and that would be marketing. Yeah.

Joe Niamtu, DMD: And what are the things that I’m best at?

Catherine Maley, MBA: You’re really good at marketing. So, I remember before you used to be everywhere, you are in every marketing channel. So how do you do it now? How do you market in today’s world? And I love that you specialize because what I normally would say as well, how are you differentiating in such a competitive environment?

And I love that you’re doing faces because you’re known as the face guy and it’s super helpful.

Joe Niamtu, DMD: Don’t you think? Well, I think it is sure. I mean, you know, whatever your specialty is, but marketing is broader than that. First of all, I’ve always been a good, I’m not a good dancer. I’m not a good singer, but I can mark it.

Okay. Why can I mark it? Because I am excited about what I do. I love it. I love to tell people what I do and I don’t do things that I’m not good at or things that I don’t like. I don’t do those. Okay. Not because I’m not good at it. I just don’t do them. I don’t like rhinoplasty, you know? I don’t do hair transplants, obviously.

There are things I don’t do because whatever I, I just don’t, you know, with the things that I do, I’m good at, and I liked them and I want people to know that I’m proud of what I. If I were the hot dogs and everybody know I being busy and you know, if they, if they tell their neighbor, you know, they’ll get one free, blah, blah, blah.

So, marketing’s for me was always very simple. It was, you know, making your brands, simply telling people what you do. I ask people, I go to meetings, Hey, give me one of your cards. I don’t have any, or I don’t know. I’m going to beat you every time. And

Catherine Maley, MBA: The way I love your business card on your, you’re not kidding you.

It literally has your cell phone on that card. And I remember thinking that can’t really be his cell phone, and then I texted you and it was, yeah,

Joe Niamtu, DMD: I probably two times in my life, if I, if I had an inappropriate call,

Catherine Maley, MBA: you know, do you think everyone’s going to bother you? And they don’t. They’re just so surprised that you offer that

Joe Niamtu, DMD: that’s right.

They, they respect that. So marketing is free. Every patient that walks in here. It’s a marketing opportunity. And is it going to be a good marketing opportunity or bad marketing opportunity? Is your staff courteous? Are they well dressed? Is your office clean? Does it smell like smoke? Does it smell like do you, you know, do you have nobody has magazines in the room anymore, but are they outdated?

I mean, I could name all this stuff. That’s negative marketing, positive marketing, all the things we’ve talked about, friendly, joyous staff, clean, sterile environment, friendly doctor available doctor, what type of ups person came in. And they said, you know what? When I come in here, I hate to leave because it’s so nice in here.

Everybody’s so nice to me. And then I have to go to other places. People are mean. So, you know, marketing is not just, you’re not smart and the practices 24 7. And when you go out to eat, when you do anything, you should be marketing your practice, logos uniforms. You can’t see it here, but you know, I mean, you know, we have logos on, on everything and you know, my staff markets too.

So, before the internet you had press marketing yet yellow pages, you had you know, television, radio, things like that. Well, the internet changed everything. It’s so funny because the people watching this that, you know, I used to feel bad for my parents because they didn’t have TV, the technology, the radio Dell, my God, I feel so bad for them.

And of course, now somebody, you don’t, you didn’t have the internet. Oh my God. How did you live? So social media has changed everything. Okay. And you know obviously having a website is like the old yellow pages. If you don’t, if you don’t have a good website, not representing yourself, but oh goodness.

You know, Facebook, Instagram, tick. Well, you know, on and on. So, I do always have done my own marketing and I do my own webpage. I have 21 million views on my YouTube channel and I have hundreds of videos and I do them all. I shoot them on a green screen. I, you know, I’m talking on their rating and I go home and edit them, put it together, publish them.

And I put that on my Facebook pages, my first, well, my professional page and do a little thing on Instagram. I not big on it. And some of these other things, my patients aren’t looking at that. So, you know, a shotgun approach is great at any one time. I have TV ads, radio ads. I had a billboard. Signs on my office.

I had, I sponsor sports teams, women’s events, charities, high school auctions, baseball games, and I’m giving a Botox for their, for their auctions. I mean, marketing is 24 7. The only time it’s hard marketing fun because I’m just, I get to tell, you know, if I can find it, I’ve always said, give me, give me a group of five women.

Let me tell them what I do. And you know, they’ll come to me. What do you have to be? Cause anybody can mark. So, number one, you have to be able to back up, you know, if you talk the document, we’ll walk the walk. A lot of people that market, and they have unhappy patients and they get bad reviews. You’ve got to be good at what you do have to back it up.

And you know, it’s just a shotgun approach. You probably can’t be everywhere, but some people are everywhere and they usually have felt I do it all myself and the people I have had tried to help me. I don’t know. I’m not going to do it the way you want it. Nope. You’re too much. And they’re right.

They’re probably correct. So, marketing should be fun. It should be honest. It should not be cheesy. I always tell, be I started, I put 20% of my production for marketing and there was a time when my marketing budget was low, but the other free stuff was free. Okay. And you know, as I got busier, I started doing more print ads, newspaper, radio, TV, and I had a billboard and I took it down.

Nobody ever said a word about it until it was dialed.

Catherine Maley, MBA: Well, it’s hard to crack that it’s not the first place I could go nowadays because I prefer to track everything. But the billboard is one of those things that you can’t put your finger on it unless the patients are mentioning, oh, I saw him on the road.

Joe Niamtu, DMD: Yeah. And you know, marketing’s like underwear, it’s, everybody has different types.

So, when you see somebody let’s just say that they are saying to me, Hey,

you know, I do three a week and it’s, I love going to work. And I love doing that. And if somebody has to come off like that, and that’s not, their personality is going to be fake. Right. And one thing that I’m really, again, even though I have some good friends to do it, man, singing, rapping, dancing, operating room.

I want to tell you something. My staff, I was at a meeting and they sent a video of them cleaning the operating room. So, they all had mops and Aniceph gates and they were cleaning them thoroughly, but they were dancing and singing into the mops and everything. And I made a bullet down because to me, the operating room was like church it’s reverence it’s, that’s not a place to screw around.

And I don’t think patients want to see that, you know, somebody that’s 18 or 22 and somebody, you know, rapids in the operating room. And there’s somebody sticking up in the background while they may think that school, but I can guarantee you most patients, they don’t want to be in that operation. And so, you always have to be tasteful.

Catherine Maley, MBA: It depends on because some of those do very, very well with that, but that’s their demographic. The demographic that there’s choosing is a, it could be a different social economic demographic, then you’re looking for oftentimes. So, you just have to know yourself, you don’t know themselves and how far you’re willing to go, but then you have to be responsible for who you attract you because that attracts a certain patient.

Do you want that patient or would you prefer somebody else more serious?

Joe Niamtu, DMD: And then the other thing is, so right now there’s such a generic branding and marketing on all those formats that I’ve mentioned that it’s almost all the same, the dancing boxes and singing back there though wrapping back there and the whole key to marketing, differentiate yourself to be different than.

Right now, it’s just a race to who can get the most dancing videos up or whatever. And you know, I think you do better if you tell people why you’re not like everybody else and why you’re different, but so couple things about marketing. You have to be sincere. You have to be able to back it up. It’s non-stop, you know, in the old days, you know, you bought your referring doctors or whatever had a party or a Christmas ham or so, and that was your marketing 24 7, because if it’s not good marketing and its bad market, wherever you go, your marketing, you go to a restaurant you’re rude to a waitress.

One of the guys in my hometown that inspired me, I went and watched them do facial surgery. He said, always tip big in your hometown would be the biggest difference. People remember that, you know, that guy makes all that money and he, you know, but so my point is you’re always marketing and you know, when I started.

There’s a river that goes through Richmond, the James river. I would always see people on one side of the river because Richmond, Virginia is just old stodgy, blue blood banking people. They crossed the river. And then I started seeing people from all over the city. That’s my practice got bigger around the state.

And then I have an international practice. Now, 40% of my patients are from out of town. And you know, this is just the fruits of my labor. I don’t care who you are. Some things you just doing the right thing at the right time, being in the right place at the right time. There’s a lot in all of us and everything we do so much marketing just has to do with patient.

You can dance and rap and do everything you want. But when you’re face-to-face with patients, the first thing I do when they come here, I walk in, I shake their hand. Now we’ll give it fist bumps. Right. And I say, hi, Yep. And I never wear dress shoes I ever get right here. Right. I threw all my ties away years ago.

And you know, some doctors like white coats and ties. I’m not that guy. Okay. First thing I do is I ask the patient something about themselves. So, what do you do sometimes? They’re so taken back because so many doctors are just perfect. Okay. Today we’re talking about this and I want you to tell me about your family or your job or whatever.

And I’m so excited about what I do. I want to be telling them, you know, I want to hear what they’re excited and if they can’t tell me that may be a red flag, you could mark it all you want. And it’s important. And it’s really important now because people look at you, they look at your reviews, they look at your online presence.

And I have friends that they’re not on any social platforms and they, they do well. They have a boutique practice that, you know, I have people that never check their reviews.

I’m always afraid. Jason’s a bad room, which everybody will get once in a while. There’s no single recipe for success. It comes in so many ways shapes and forms, and it’s a little bit different for everybody. You know, I know that there’s probably doctors out there that say, ah, Joe’s a nice guy, but he’s, you know, he’s always bouncing around and, you know, whatever.

And I’m not for everybody. They’re not for everybody. You’ve got to find that happy medium. And you know, when a patient comes in, I say, Joe, I’m Joe Smith. Okay. Put the brakes on here. I got to, I got to tone myself down and. You know, a little bit more still and they’re more conservative and I need to be a little bit more concerned, right? I don’t want-

Catherine Maley, MBA: you’re fine. Just the way you are. I’ll tell you what you’re doing differently than anybody I’ve ever seen that before and after photos. How many before and after photos do you have on your website?

Joe Niamtu, DMD: I have 10,000 pictures on my website and my wife for decades. Let me tell you this. Every before and after photo is made in my spare time and I’ve done asleep, but you know, that’s why I love, I get so much done on airplanes.

I know you do. Nobody’s bothering you. Your phone’s not ringing. And I’m made those before and after pictures. And you know, you know, when I had a hundred, she said, how many did me? I had 500. What? I had several thousand. I’ll tell you what people come to me. And they said, well, you don’t want this. This other guy has got.

Oh, man, he’s supposed to be the deal. Everybody talks about him, everything, but he’s got nine before and after pitch. And he said, well, his patients won’t let him use their fish. Come on. You know,

Catherine Maley, MBA: I need to interject here because I get at least that complaint weekly. I say, where are your photos? And they say, oh, my patients won’t agree.

Then how was Dr. Joe neon to able to get 10,000 people to, to approve photos?

Joe Niamtu, DMD: Yeah. So, it’s probably not 10,000 people because I might have four views, but it’s,

Catherine Maley, MBA: what’s the secret. Well, how are you getting them to say yes,

Joe Niamtu, DMD: I can tell you this. If I could use everybody’s pictures, I’d have 20 minutes. So, here’s the deal.

You can never use somebody’s picture without telling, or you are a lottery ticket. All right. A lot of people got in trouble. I asked people. I say, gosh, I I’m so happy that this worked out this way. I’m so excited. I think you looked great. Would you, would you let me use him for an app? And some people will say, I’d say a fourth of the people said use whatever you want.

And so, some will say, and then I’ll say, well, now pull out a picture where the top of its base is hit and I’ll say, well, what about if I just use bottoms? And some of those people will say, okay, okay. And then there are some people that they look at you like; your hair is on fire. They’re like, are you kidding me?

Use my picture. No, you can’t ever use my picture. So, they ask you a question. How do you get used people fixture? You ask them.

Catherine Maley, MBA: Yeah.

Joe Niamtu, DMD: I’m the only doctor, you know, that takes all their before and after pictures, everyone. As I’m taking a picture, I’ll say, look, how look your profile looks like you’re 30 right after I took those pictures and face. Correct. Can I use any of your pictures? And I say, I’ll email them to you. And you let me know, and then I haven’t signed whatever.

Yes. I could use them or I can use them if I crop them or I can’t use them at all. So, you just have to ask your patients, listen, most docs. It’s just too late. It takes me a good 25 minutes to put together before and after series for a facelift and all of that. A hundred percent of it’s in my spare time, I do it at night.

I do it between cases. I do it on airplanes, but that is paid off. You know, that I pay what that’s like. That’s like putting money in the bank when you’re young and you have exponential growth interest, you know, compounding interest.

Catherine Maley, MBA: So, It’s giving back. It’s like a cash cow. And it’s the one thing that you don’t get the advantage, right?

That second, you don’t get the point of why am I going to waste my time doing this? Unless you do it. And you reap the benefits of it. That’s the best marketing you could ever ask for is to have patients showing off their scraper

Joe Niamtu, DMD: sold, and you have to have standardized pictures. I see so many terrible pictures.

The oldest trick in the book you take the before picture without a flash. So, it’s all shadowy. Then you take the picture with a flash. Some people that had small, the head’s big. I have standardized pictures and my patients know that. And yeah, photo photography in cosmetic surgery is everything and pictures and videos.

You know, if I had to get rid of everything else, all the things we talked about, marketing, the only thing I would keep as much as my before and after pictures. And you know what people. I see them all over the place. Other electric. Well, yeah. And that’s, you know, If you have any sense at all, you can Photoshop a lot.

I’m in a lecture and I see what am I faced with patients? And somebody saying that’s there,

Catherine Maley, MBA: but you know what? There’s another copy. They wouldn’t be saying yes, unless they liked you. So, this started way before you asked for the photos, you tarted, when you said hi, I’m Joe, you know, receptionist said, good afternoon, welcome to our practice. You know, it, it, it all goes hand in hand. And I just do think a lot of surgeons get that, that it’s the whole continual patient experience from beginning to end.

Joe Niamtu, DMD: I think, look, most of my friends that I’m really close with, you go to a meeting and you can’t wait to see him and you vacation with that. You, your wives and their wife and that sort of thing. They’re all fulfilled. You know, they’re all doing, I don’t want to say what I’m doing if they’re doing what they’re doing to be successful, but there’s a lot of just grumpy, unhappy doctors.

I know friends that they wait for two things. They wait for Friday, they worked for retirement and that’s no way to go through lines. You know, some people don’t get it. They just want to go to work. And they’re just going to go to work. They’re going to keep going through. They’re going to repeat the same mistakes, maybe busy enough just because they’re in Northern North Dakota or something.

Nobody else is there, you know, whatever. So,

Catherine Maley, MBA: all right, then let’s let some work. We have to wrap this up soon. Let’s talk about mindset because yours is so incredible. You have that growth mindset versus fixed mindset. I mean, you see the opportunity and –

Joe Niamtu, DMD: I want to be able to come here to show you one of, one of the big reasons.

Catherine Maley, MBA: Hi, how are you? We would just talk about you because,

Joe Niamtu, DMD: and when we close, when we close this, we’re going to talk a little bit about why she’s such a supermom. But another thing about marketing is having you can’t market by yourself. You need other people, the more you involve, the more stuff you do by yourself, the more you take away from that person in their time.

So, they have to be incredibly on board with.

Catherine Maley, MBA: So, can we just talk a little bit about what drives you and you’re very to the charitable organizations, but also you have special needs children that you’re doing. God’s work on that one. I, I commend you. I admire you from afar. Is there anything you want to talk about about that?

Joe Niamtu, DMD: Yeah. Well, the story is, you know, I didn’t get married till I was it took me half century to find a girl in my dreams. And of course, every father, you know, I wanted to have a son. I wanted to you know maybe have them take over my business someday, throw a football, teach them how to hunt fish.

And my first son was born with severe cerebral policies. His doctor said he would never walk. The dog would be tube fed and be in diapers. And, you know, it’s an incredible set. I can’t even describe. Challenge for special needs. Parents is something would happen to you who would take care of that helpless child.

So we went through high risk, you know, and they tology, and don’t want to have the second child to be the guardian for Joey. And, you know, they said they did all these tests and everything. They said, having this happen together, it’d be like winning the lottery twice. And we had the same thing happened. So, my other son, Evan Joe is 21 11 19 same things.

So yeah, it was a beat down. I can’t, I mean, I don’t know, I don’t know how I made it through those first years. One of the reasons was that my wife is so incredible and sees such the positive aspect here and take such great care of these guys. They’ve had over 30 operations combined when other parents were going to soccer games and school plays and, you know, We were in emergency rooms and doctors, offices, and ICU.

But you know, we go to very active, you know, you mentioned a lot of the charity stuff I used to do. Most of my stuff now is guided it if you know, children special needs children and which it has been before I, especially anyhow. But we go to groups and events and I see situations where there’s people that have it worse than we have it.

You know, there are single moms that are barely making it. They live on the second floor and they don’t have in advance. And so, I’d be lying to you if I did say that, that just gutted me, just gutted me. But you know, it’s like, and my step wary and you have to find the joy that you can. So. You know, like children, I’ll never hear the word, daddy, they can’t walk or talk, but I, they smile.

We watch TV together. I’ll play my guitar and make them laugh. And to me, that’s, that’s the touchdown. That’s the soccer ball. That’s the, my wife is just so amazing at taking care of them. And I don’t think she knows their special needs. You know, she dresses up on holiday leave and everything else,

Catherine Maley, MBA: styling and photos, they seem super happy.

Joe Niamtu, DMD: Yeah. And you know, so there’s a big pearl here is that life’s not easy and we’re all going to have challenges. And there’s some people that have worse challenges. And, you know, is that going to define you or is that going to be, is being able to deal with that and move on, going to define you? That’s what you have to do.

Catherine Maley, MBA: Well, I, I don’t even know what to say because I can’t imagine. I can’t imagine. I mean, some people have challenges that was a major, major challenge that you have somehow turned into, you know, the lemonade from the lemons, or however that saying goes. But I just want you to know people admire you from afar.

You know, they just don’t know what to say to you, but it’s amazing what you’ve done with what you’ve been given. Congratulations.

Joe Niamtu, DMD: I’m just one person doing what they love, trying to do it well and trying to make the best out of the cards that they’re dealt. And that’s the advice that I give to everybody.

So, you’re the same. I think we have a lot of the same aspirations and successes and being able to enjoy it and the true love of teaching, telling other people, you know, good thing and trying to help them. And that’s what you do.

Catherine Maley, MBA: That’s why you’re famous. That’s how we met each other way back when I wish I were as famous as you are.

That’s for sure. I’m afraid to give people your contact information. Cause I don’t want everyone to be bugging you to get to know better. How do you

Joe Niamtu, DMD: reach out? My website is https://www.lovethatface.com/ and my email is [email protected].

It’s been great sharing this time with you and I’m sure we’ll see each other soon in person now that there are first meeting,

Catherine Maley, MBA: that’ll be darling. I’ve never had a doctor playing guitar before.

Catherine Maley, MBA: Thank you so much for your time. I really appreciate it.

Joe Niamtu, DMD: Enjoy. Okay,

Catherine Maley, MBA: everybody. Thank you so much for joining us today. I hope you got a lot out of that. Would you please do me a favor and head over to Beauty and the Biz? And if you haven’t subscribed yet or give us an, a, a review, please do, then if you’ve got any questions or feedback for me, please leave them at my website at https://www.catherinemaley.com.

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