Patients, Employees, Profits — with Ryan Neinstein, MD

Patients, Employees, Profits — with Ryan Neinstein, MD

Hello, and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery, and patients, employees and profits.

I’m your host, Catherine Maley, author of Your Aesthetic Practice – What your patients are saying, as well as consultant to plastic surgeons, to get them more patients and more profits. Now, today’s episode is called “Patients, Employees, Profits — with Ryan Neinstein, MD”.

As a cosmetic surgeon, you can play it safe and rent a small office to keep your costs down and play it safe, or you can swing for the stars and go all in.

That’s what Dr. Neinstein did 4 years ago when he made personal guarantees on prime real estate, with a 2-year build-out and a vision for a patient-centric practice.

His new 6K square foot office sounds spacious until you consider it holds 3 surgeons, 30 staff and (2) OR suites with views overlooking Central Park in NYC.

To build his dream practice and team, he needed a way to get all of those people working together to create a culture, and that’s what Dr. Neinstein prides himself on.

⬇️ Click below to watch “Patients, Employees, Profits — with Ryan Neinstein, MD”

This Saturday’s video is an interview I did with Ryan Neinstein, MD, a plastic surgeon in solo practice managing a lot of moving parts.

He’s got very clear ideas about running a cosmetic practice and here are some of them:

  • He has (4) core values all his staff live by to keep their culture healthy and happy.
  • His priorities are Patients | Employees | Profits and in that order.
  • His strongest marketing channels are blog content, IG, TikTok, Patient Stories, PR and backlinks.

We also talked about his biggest mistake so far (he’s been in practice 9 years), how he feels fear but is not afraid, and how he handles the pressure of playing bigger.  

P.S. A professionally-trained patient coordinator is worth hundreds of thousands dollars to you. Doesn’t it make sense to invest in them to represent you like a pro so they fill up your surgery schedule? Click Below to Get Started.


Patients, Employees, Profits — with Ryan Neinstein, MD

Catherine Maley, MBA: Hello and welcome to Beauty and the Biz, where we talk about the business and marketing side of plastic surgery, and patients, employees and profits. 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 profits.

Now today’s guest, this Dr. Ryan Neinstein, and he’ll discuss patients, employees and profits. He’s board-certified by the Royal College of Physicians and Surgeons in Canada. And a faculty member at the Lennox Hill Hospital in Manhattan. Now, Dr. Neinstein is in private practice on the Upper East side of Manhattan where he specializes, speaks and writes on the topic of modern body sculpting techniques and liposuction safety standards. He’s also very savvy on the topics of patients, employees and profits

He also serves on the Safety Committee for the American Society of Aesthetic Plastic Surgery, also now known as The Aesthetic Society. So, Dr. Neinstein, welcome to Beauty and the Biz. It’s a pleasure to have you.

Ryan Neinstein, MD: Well, Catherine, thank you so much for having me. I’m very much looking forward to this and I have been following your work for quite some time, so it’s an absolute pleasure to talk to you today.

Catherine Maley, MBA: Oh, glad to hear it. Now, how did you go from Canada to decide to come to America to the most incredibly competitive area in the United States? How did that happen, in regards to patients, employees and profits?

Ryan Neinstein, MD: Well, you know, I’ve always been in search to learn from the best, and after my amazing training in Canada and general surgery and plastic surgery, I came to New York to learn cosmetic surgery.

I was lucky enough to be accepted to the fellowship here where they, Uber was very limited and tough to get in. And when I landed here, I immediately fell in love, the culture of America. I fell in love with the people of New York and I knew that I wanted to spend the rest of my life.

Catherine Maley, MBA: Wow. That’s great. Did you meet your wife here and how does that relate to patients, employees and profits?

Ryan Neinstein, MD: Yes, of course. My wife is a fitness instructor from Connecticut. We actually met on a yoga retreat in Nicaragua, of course, and the love story has continued since then.

Catherine Maley, MBA: Aw, that’s very sweet. Okay, so we’ll talk more about that later, including patients, employees and profits. Right now, we’re going to talk about business because ok, you’re very young and from what I can tell, you’re building quite a little empire over there with all of your expertise on patients, employees and profits.

And so, I’m trying to figure out where are you going with that? It looks like you’ve got two other surgeons working with you. What are they? Are they associates? Partners? How are you set up? Because it is Neinstein plastic surgery.

Ryan Neinstein, MD: Correct. And you know, I’ve always loved the team atmosphere. I played competitive sports growing up.

I played competitive sports in college. It always, you know, it always drove me to be the best version of myself working with others in a competitive environment. And you know, I’ve recruited Dr. Chris Bundaberg and Dr. Anna, Steve and we all, so Dr. Steve just does breast surgery and Dr. Vanderberg is like me.

We are a hundred percent body and breast surgery. We do nothing from the. We have three people who are a hundred percent focused on the same procedures, and it provides a lot of intellectual inertia. We’re able to do research projects. We’re able to have a big infrastructure and team, which means we’re giving a better experience to the patient, both in the operating room after the operating room, and in total.

So that team environment with a hyper-focused mentality creates an inertia to a better. They’re associates of mine.

Catherine Maley, MBA: Gotcha. And it is the goal to keep adding more providers, or where are you going with that in regards to patients, employees and profits?

Ryan Neinstein, MD: So, I think, you know, this is it. So, we built the space. Like I always say, you know, I like to think of them, what’s the magic?

And then work backwards. So, the magic to me was the space. It’s, you know, almost 6,000 square feet on top of Bergdorf Goodman overlooking Central Park. It has enough space for two operating rooms. I think three surgeons work well at two operating rooms. We work backwards, and I think the biggest. Thing that I’m always concerned about is this undisciplined pursuit of more, and we’re not looking to grow.

We’re not looking to bring on more providers. We’re not looking to grow more offices. We want to keep maturing and being better at what we do. Focus, focus, focus on patient experience. So, there is no. Future for another office. All the future is, is just enhancing and increasing the capabilities and abilities that we have right now.

Catherine Maley, MBA: One of the biggest challenges of surgeons is working together. And I find personally the dictatorship seems to work better than the free for all or trying to have everybody agree on something. I’ve just, the, the groups I’ve worked with where we’ve tried to make decisions together as a group has on patients, employees and profits.

Not been great. Egos get involved. All sorts of things get involved. How well does it work for you? Number one, how did you find the right people to come on board? Did you, do you have tips for how do you find these people that you’re going to have to work with 24 7 and get along for years to come?

Ryan Neinstein, MD: So, these are all good things.

Number one, I think it’s important that there’s someone who rules but not reigns. That’s a quote from the late Queen Elizabeth. So, there’s a difference between someone being the leader and someone being a dictator. So, in my office or in our office, I take the leadership role from the operations outside of the, or the organizational structure and the operations point of view.

And that’s something that my associates. Me doing something I take great pride in. That’s something I, you know, I use mentors and consultants from around the world to help me continuously improve the culture. And that creates a frictionless interface between me and our other surgeons. And we’re all, we have a common goal, you know, we want to work together to provide patients with the best experience.

So, in that sense, you know, They have autonomy in the, my, my associates have a unique amount of autonomy for being an associate for how they grow and develop their own practice within the practice. And I talk about, you know, using Frick as an example. Frick worked with Carnegie, right? And Frick has his own museum here in New York.

You know, Steve Bald. My, for Bill Gates and Steve Ballmer owns a basketball team. So, you, you can create immense success within a bigger organization and use that structure and foundation that a leader that you believe in trust and can create. So, I don’t think you need a dictatorship, and I also don’t think you need everyone to be equally weighing in on every aspect.

When we have a northern star and a moral compass that we’re all agreed upon, someone can take the lead on.

Catherine Maley, MBA: But what happens when you need to make big decisions on patients, employees and profits? Things like, what are we going to do with the profits this year? How are we going to divide them up? Are we going to put them back into the practice? The big decisions on patients, employees and profits, how are those made?

Ryan Neinstein, MD: So, everything you know, I do believe in a meritocracy and. Merit is not all about revenue generating. You know, there’s, especially in medicine, the quality of the outcomes is not about how much revenue’s generated. It’s like, how happy are the patients. So, we have multiple street tiered levels of key performance indicators that help, you know, our bonus and cost structure.

Catherine Maley, MBA: And then how do you divvy up responsibility on patients, employees and profits, you know like the, the one woman she focuses on breast, you two guys are focused on body when the leads are coming in, like, does she ever want to do anything other than breast or the boundaries are so set with you. You have, you three have this so figured out and dialed in that there’s never an issue with leads or I’m getting more than you are getting, or she —

Ryan Neinstein, MD: Oh, I think when, when someone says never or always, they’re probably lying.

You know, we have pretty clear goals for each of us and what we like to do. And you know, we do a lot of these hybrid cases where Dr. Steve does the breast and I’ll do the tummy tuck and because they want that expertise at both level, and that works really well. But primarily, you know, Dr. Steve’s breast surgeon, she has all the, you know, world class training and breast surgery and likes to do complex breast surgery, and she primarily focuses.

So, if someone is interested in doing, you know, a big body procedure in breast, we usually will have two surgeons involved and they’ll get a, a, a particular expert in each side. Mm-hmm. And is it complete? 100% cosmetic? A hundred percent cosmetic. But you know, yes, I’d say so. Sometimes, you know, even though it’s cosmetic, we’re still helping people with skin cancer, lumps, bumps, rest reductions, things.

Catherine Maley, MBA: But when you’ve got three surgeons who need to stay busy, that takes some, some leads and automation and lead generation processes, so, correct. Who’s, who’s the marketer there to help with patients, employees and profits?

Ryan Neinstein, MD: I, I mean, we all contribute. So, the way we look at, and I, you know, what do they say about marketing? Half of it works. You just don’t know which half, but.

What we listen, we have a clear, concise message, right? There’s a lot of clarity with what we do. You know, I, when you go on a lot of plastic surgeon’s website, you know, they’re an expert in non-surgical and surgical rejuvenation of the face, breast and body, and you’re already like, I don’t understand.

Right. Ours, you know, ours is super clear. Breast surgery, body surgery, basically like with 360 tummy tucks and breast surgery. That’s it, you know, and any combination. So, the clarity is key in terms of putting out the message. Number one, we’re very, we’re very strong with our blogs and we like trying to do bottom of the funnel blogs versus top of the funnel.

Top of the funnel is more building audience. Bottom of the funnel are people who are really looking to convert into a. And they’re ready to go. So, we do a lot of blogs based on things people are actually searching for. How do I pick my breast implant size, mommy makeover recovery. That generates a lot of trust because you’re getting real organic information.

That’s one. Two, it’s through social media, both Instagram and TikTok. We have a very consistent, serious message about how we present what we do, and we’re all about telling stories, you know, it’s not just like, look how great I am. It’s this. We make. We try to think of ourselves as hero makers. The patient’s the hero.

We want to show this story because we want people to recognize themselves within that. And they say, she’s just like me. She’s just like me. I have the same struggle. I’ve been down that path, and you guys are able to provide a solution. So, through blog and online, creating the content through social and then through our PR and the various media outlets, which creates the links and the back.

We’re able, you know, to get the word out. And luckily, we’re in a high-density area. I mean, there’s 20 million people in the New York area.

Catherine Maley, MBA: Yeah. There’s no shortage of , would be patients for sure. Do you all go use the same website to help with patients, employees and profits or does everyone have their own social media account, or is it all —

Ryan Neinstein, MD: Oh, we have, we have one mother mothership website and we all have our own social media, but we’re all kind of, we have the same coherent message within.

Social media and everyone’s saying the same thing every day. And with the overlying, with the, with the foundation of the mothership of the location, the team altogether.

Catherine Maley, MBA: And then speaking of the team on patients, employees and profits, how, what kind of numbers, how many people are working under you?

Ryan Neinstein, MD: We have about 30 full-time. Oh, And we’re expanding.

So, I mean people, a lot of surgeons don’t understand. Listen, we are about the patient experience and that requires support staff, and I’m talking nurse practitioners. I like the maturity that comes with the master’s level. You know, we run two ORs. I have a 10-person surgical team. I mean, we’re, we’re more staffed than the hospital.

Yeah. And from an admin side, you know, I think we provide a concierge service that the Ritz Carleton across the street would be jealous of. And I don’t think that there’s any, we have no limitations in growing support staff for our patients. We have people who run around town 24 hours a day, seven days a week, dropping off garments, getting anything, they want from a pharmacy.

It’s a full-service operation and I, I would just keep adding more support, more support, more support. Patients deserve and want access, deserve and want support.

Catherine Maley, MBA: Well, I commend you for that in regards to patients, employees and profits. Everybody tries so hard to work with at least amount of staff as humanly possible. If they go on vacation, the whole thing falls apart.

Cause they’re so lean already. Good for you for pulling that off and. I’m sure you’re charging accordingly though. I did notice on your website, and I love this it said like FAQs, how much would be a tummy tuck? Well, it’s anywhere between 20 and 75 grand, you know, and I thought that was really good because obviously it’s a huge range, but it totally told the segment who you are in terms of patients, employees and profits.

You’re, you’re not going to be the two for one er kind of guy, you know?

Ryan Neinstein, MD: Well, listen, we charge a lot. We give. Well, I think it goes hand in hand.

Catherine Maley, MBA: I don’t, I think you’ve got to go both in relation to patients, employees and profits.

Ryan Neinstein, MD: Yeah. About 30% of my patients are out of state and out of country, and we give a lot. It’s an, it’s an incredibly mature relationship with the doctor and the patient.

It’s not transactional. We’re all in, you know, we visit the patients every day that are across the street in the hotels. We have these long-term relationships. It is not a transactional factory, I don’t think. There’s nothing, anything wrong with that for the, you know, certain people that’s the way they want to have their surgery and that’s fine.

We are, I know what over the years, patients that we love, we love to work with want, and they want all of the, the experience in aftercare. And to us, that just means a big, committed team of, you know, passionate, caring people.

Catherine Maley, MBA: Now, I know you’re big on teamwork and I’m sure building culture. Yeah. Any tips on that for patients, employees and profits?

Because I would say that’s probably the biggest challenge of almost any practice are the people. It’s tough managing people, especially if you’re a surgeon who never was taught any of that leadership and culture and all of that. Now, where do your tips on it and how do you learn it

Ryan Neinstein, MD: Well, you have to find mentors. I don’t think you can go a straight line in life without a ruler. And you need to find mentors who can help you go from being smart to wise and also understanding that you’ll, there’s never, there’s no end point on wisdom. So, to me, smart is, you know, you can read a lot of books like when we all Finish school.

We’re very smart. Everyone’s smart. We can read lots of books on business, we can read lots of books on HR, but wisdom is that traveling and actually implementing all that. So, you got to just keep asking questions, keep trying anything with the team, you know, with your people. It’s, you got to seek first to understand if you want to be understood.

So, you got to get to know your team and you have to create, like, we have a, we have a core values. So, to come work on our team, it’s not for everyone. We set the core values. Hey, everyone here believes in these four things. Number one, they’re going to be an expert in what they do. So, whether or not you want to be.

You know, a scrub tech or a nurse or a front desk, you got to be an expert coming in. Number two, you got to be a lifelong learner. We have Book of the Month Club. Everyone has to take a course every year. Everyone has to keep getting better. This is not a check-in checkout. Number three, you have to graciously share what you learn.

We have. 30 people learning things every day. You got to be walking around and sharing them. There’s no hiding knowledge. Number four, you have to accept feedback, okay? So, you have to be willing to have all these checks and balances, but when you have 30 people moving in the same direction, all in the same page, that’s the culture here.

And it’s a really culture that it’s patience first, employees, second profits. Third, never lose sight. Patients, employees, profits. That’s the algorithm. You can’t go the other way. You got to take care of the patients. You got to take care of your team. And how often are you meeting? So, we do a full like town hall meeting once a month.

And then the individual teams, the clinical nurses, the surgical nurses, the admin, the patient coordinators do weekly meeting.

Catherine Maley, MBA: I don’t know why people don’t do that to help with patients, employees and profits. You’ll save yourself so much time and grief if you’ll check in 30 minutes a week versus waiting till everything goes sideways.

Ryan Neinstein, MD: Yeah. That, that doesn’t happen.

I mean, each, each clinic, each team texts and has a meeting once a week. The leaders from each of those team check in once a week, and then we have a town hall once a month.

Catherine Maley, MBA: No, I understand. Yeah. But I mean, you have to meet the, the people working together have to meet at least weekly to check in with each other, which helps with patients, employees and profits.

And then there’s the big meeting where there’s more division and, and where we’re going.

Ryan Neinstein, MD: A hundred percent the front. Yeah. The, and I also think it’s important. Everyone knows everyone and everyone knows everyone’s name and everyone knows what they do. The front desk knows who the nurses are. The nurses know who, you know, the administrators are.

there’s nobody working in silos. It’s a free-flowing communication.

Catherine Maley, MBA: Have you had any issues with staff since Covid, pre Covid, post Covid, in terms of patients, employees and profits?

Ryan Neinstein, MD: No. Listen, I think you’re always going to, some people are always going to have life experiences outside of work that impact their, you know, ability at work. And, you know, we try to do our best for each and every one of them to help them along.

Catherine Maley, MBA: What’s been one of the biggest business mistakes you’ve made in relation to patients, employees and profits?

Ryan Neinstein, MD: So, I think my business biggest business mistake was not getting a big, a big enough space early. I kind of did that, you know, renting very small and slowly renting, but the actual costs, not just in the time of all of the maneuvering and moving between offices and only going up like couple hundred square feet.

Every time with the new furniture, the legal work on the leases, and, you know, it, it’s, honestly, it’s better to take a bigger swing. And, and that was my biggest mistake. It set me back financially, set me back chronologically as well. So, I would’ve just taken the elevator instead of the escalator. only. Only if you have, only if you have it in, you know, if you have it.

Catherine Maley, MBA: Right. You, you seem to have the stomach for that in regards to patients, employees and profits, because not many would take out 6,000 square feet near Central Park in Manhattan and hope to God it all works out.

Ryan Neinstein, MD: Did you listen? I have, I have fear, but I’m not afraid. Okay. Like, you know, I’m not, I’m not afraid and of anything doesn’t mean I don’t feel fear, but I’m not afraid.

Catherine Maley, MBA: So, when you were doubting yourself about patients, employees and profits, as you’re paying that rent, every month was on, did you have that period of, God, I can hope I, I can pull this off, or you just knew it?

Ryan Neinstein, MD: Of course. Well, listen, when you sign that lease and you put a personal guarantee on, you know, eight figures, it’s a big deal. But you know what?

That pressure either. Drives you or crushes you. So, it’s a driving for me, it’s a driving force for me. Pressure. It’s pr, you know, I forget which person, which, which philosophers say, but pressure is a privilege. Oh, that’s good. That’s a good way. Yeah. You should be so lucky. Yeah.

Catherine Maley, MBA: Good for you though, for having the courage to play full out to help with patients, employees and profits.

Cause that was a big deal. And that was what, nine or Well, how long have you been in the new space? The new space?

Ryan Neinstein, MD: Two years in and we, four years ago signed.

Catherine Maley, MBA: So, you signed it four years ago and you did a build out. Is that what happened to help with patients, employees and profits?

Ryan Neinstein, MD: It did a big build out. Obviously, we were held back with Covid. But we persevered, we waited it out.

We made it.

Catherine Maley, MBA: Yeah. That’s one of the issues with surgeons is it seems like your name has to go on the bottom line and you have to take all the risk. And a lot of other businesses don’t have that. And you just really have to know yourself, you know, if you’re up for that challenge for patients, employees and profits. And that’s what it is.

It’s either a challenge or it breaks you, one or the other, I guess.

Ryan Neinstein, MD: Yeah. I ex I accept all the risk and responsibility for everything, and, and I, I, I like that. I like being responsible.

Catherine Maley, MBA: Good for you. So surgical versus non-surgical, is it a big deal in your practice, in terms of patients, employees and profits?

Ryan Neinstein, MD: We’re a hundred percent surgery. We just operate.

I saw it on your website, but it does So you don’t have injectors. You’re not trying, I have it. One of our nurse practitioners does a little bit of injectables, but we’re like, you know, we’re surgical practice and a lot of our PA we. The injectables are really just our surgical patients or a couple of younger patients, but a lot of it is like our surgical patients, just like when they’re coming back for their follow-ups, they love the office and they just like want someone to do their toxin, you know?

Right. But I do zero. I do zero. We have no devices, nothing.

Catherine Maley, MBA: So, do you have any fear about the upcoming. What’s going on in the world, in relation to patients, employees and profits?

Ryan Neinstein, MD: I don’t want, I don’t know what you want to call it, you know, the economy, whatever.

Catherine Maley, MBA: Do you have any fear about that, in regards to patients, employees and profits? And just being surgical? Do you feel like you could also grab them on the way down, grab?

Ryan Neinstein, MD: Well, I think, I think it would be naive for anyone not to have any financial concerns when there’s macro-economic turmoil. That being said, I really believe in all businesses when things get rough economically. Industries tend not to shut down. So, the stronger, more predictable players within those industries tend to rise up.

You know, I do think patients will still continue to get plastic surgery even as the economic scenario deteriorates, but they’re going to be much chewier. It’s like, Hey, maybe I just won’t go to this guy or that guy. Like, I’m going to, if I’m going to do it, I want to go to somewhere a little more predict. So, a practice that has, you know, a real structural d n a, like ours should be, should be well suited.

Catherine Maley, MBA: So, regarding your demographics, is there a typical demographic that you are trying to attract to your practice and is it working to help with patients, employees and profits?

Ryan Neinstein, MD: Yeah. Listen, our average patient is 35- to 45-year-old. It’s, it’s a mother of, you know, one to three kids who lives in, in New York City. Long Island, New Jersey, or South Florida, and, you know, they have, you know, similar socio sociodemographic, you know, things that they’re into.

But we know who they are and we know how to get to them. And how’s your word of mouth?

Catherine Maley, MBA: Because it’s all working, in terms of patients, employees and profits. If you can get those people, especially, I love the tummy tuck group because they’re usually older, more mature, right. They have the financial wherewithal more than the 20-year-old breast aug patient and mommy’s that they hang around with who also need your services, which can help with patients, employees and profits.

Ryan Neinstein, MD: So, so I’m almost a hundred percent mommy makeover is my operation. That’s almost a hundred percent because of the tight-knit c. And I just find it provides such a deep, meaningful impact to people because they have real physical, structural changes that cannot be changed with diet or exercise. So, there’s a low psychological burden to surgery.

It’s not like, Hey, I just want to look better. It’s like, you know, my core doesn’t work. The skin is, is stretched and torn. Mm-hmm. So yeah, we have our key demographics that, you know, we choose in terms of your question based on word of mouth. So, we have the date on this. We’re about 75% word of mouth, but I think the word of mouth has changed or matured a little bit.

Typically, what happens is someone will get my name from either their doctor or another patient, and then they’ll follow us on social media for like three months. Then they’re probably following. Lots of doctors and they are almost like interviewing you. They want to get to know you, see what your practice is like, see what your home life is like, see what kind of things you do.

They so that’s, that’s the typical story. Hey, my friend gave me your name and then I followed you for three months and now I’ve decided to make a consultation.

Catherine Maley, MBA: Right. And do you think they still got to your website or do you think they stopped at social media. How does this relate for you, in terms of patients, employees and profits?

Ryan Neinstein, MD: So, I think, I know we get a lot of traffic on the site and I actually think on, on certain pages, like the blogs that are deep dives into specific questions they have, I can, I know, I can see they spend a lot of time on those, on the generic pages.

I’m not saying they’re generic. I mean it’s all custom content, but like we’re not going to write anything that’s groundbreaking on breast augmentation versus every other plastic. But our custom deep dive blogs really give you more insight into what’s happening in here and how it relates to the patient.

So, people do go to the website, they just do it in a different way.

Catherine Maley, MBA: Yeah, I, I honestly think nowadays, in regards to patients, employees and profits,, a lot of times a girlfriend mentions you, they go to your Instagram, then they go to your website, then they call or fill out the form. Yeah. It’s gotten very zaggy and it’s very difficult to tell. And a lot of times they tell you one thing on the phone, they tell you something else when they get there, then they tell you the real story when they get to know you better.

Ryan Neinstein, MD: So, well, it’s important for the message to be cohesive, clear, and constant across all your mediums. So, it doesn’t really matter if they get you on Facebook, Instagram, TikTok, or your. Everything looks and sounds and smells the same.

Catherine Maley, MBA: Well, you’ve done a good job with educational marketing to help with patients, employees and profits. I like that a lot.

Ryan Neinstein, MD: Cause that’s, I’ve built my whole business on education. I all, all we want to do is be educational, informative and show a little bit of our personality so people get to know us. Yeah, pretty straight. That’s pretty much it.

Catherine Maley, MBA: Do the patients ask if your wife had a tummy?

Ryan Neinstein, MD: Everyone asks everything. And you know, that’s just human nature.

Catherine Maley, MBA: Yeah. Well, she’s really a good walking, talking testimonial, and I wouldn’t say if she did anything or not.

Ryan Neinstein, MD: You know, it’s just, I mean, she’s really a good she, she’s the love of my life and I’m grateful to have her as the mother of my children and my life partner. Yeah. And you have a little boy and a girl.

I have a little boy and a girl, and there’s nothing, you know, best thing I’ve ever done is a surgeons become a father. Not, it just, it, it helps provide such clarity in life.

Catherine Maley, MBA: Right. You probably get your priorities in order after that, which ultimately help with patients, employees and profits.

Ryan Neinstein, MD: Yeah. Life’s straightforward with kids, you know.

Catherine Maley, MBA: Yeah. Well, and I, it’s, it’s chaotic, but straightforward I know you’re showing them off on social. Some people don’t. You do? Yeah. What’s your philosophy on that and how it relates to patients, employees and profits?

Ryan Neinstein, MD: It’s part of my life. It’s who we are. We love our kids, you know, and I respect and everyone’s opinions and choices on, on all.

Catherine Maley, MBA: They, you might change your mind as the kids get older and say, I don’t want to do this, you know, then —

Ryan Neinstein, MD: A hundred percent correct. Exactly.

Catherine Maley, MBA: So, what is, what else is working for patients, employees and profits? So right now, the content is working, the social media’s working. You’re doing a good job. You’ve got 46,000 followers, so you’re doing something right there.

Ryan Neinstein, MD: At the end of the day, there’s only one thing that works is being an excellent surgeon and an excellent physician, just taking excellent care, being available.

To communicate, to be there for patients when they need you. That’s, that’s what, you know, everything else is great, but that’s the real quintessential thing that matters. You being a person of, of, you know, real trust and compassion to the patients.

Catherine Maley, MBA: That’s it. You need both. You can’t just be a good surgeon in today’s world to get patients, employees and profits. Who’s going to know that?

Ryan Neinstein, MD: Someone’s going to know you. You’ve got to, no, you got to get the word out, but great surgeon, you’ve got to do some good marketing

Catherine Maley, MBA: Take really good care of that patient so they don’t say anything bad about you. And they might even, you know, ring your bell, you know, and tell everyone else about you.

I just think you have to have it all in today’s world for the long run to help with patients, employees and profits.

Ryan Neinstein, MD: If you’re in this for the long run, every patient should be treated as the, the one patient that you a hundred percent, a hundred.

Catherine Maley, MBA: It’s too difficult to screw this up, you know, or not. No, it’s too easy to mess this up, in terms of patients, employees and profits. That one patient, have you ever had that patient from hell and —

Ryan Neinstein, MD: No. I don’t want to characterize again, you know, people, it’s hard to see the world through someone else’s lens. Mm-hmm. So, we don’t allow any type of terminology around here, like difficult patient, tough person. We just, you know, they’re. How do you meet ones that aren’t, aren’t feeling good to you? Well, I think everyone gets a little bit of a fighting sense, similar to, you know, dating and, but not everyone’s a good match for each other, and that’s okay.

Catherine Maley, MBA: So, I think you get a set to that, you know, one of the nice, or do you just increase your price or how do you handle that and how does that impact patients, employees and profits?

Ryan Neinstein, MD: No, I don’t, I don’t believe anything deceptive. Just, you know, Honesty, life’s too short. You know, sometimes you’re with a patient and you’re just like, you know, I really don’t think I’m the right surgeon for you.

I just don’t think I can do what you want.

Catherine Maley, MBA: Do you know how many times they have given a bad review because of that? They’ll literally say that, and it’s like, I’m trying to be honest here, and I just don’t think we’re a good fit. And they’ll say, Anne, he wouldn’t even see me and he wouldn’t help me. Anyway.

Ryan Neinstein, MD: Well, there, you know, Hemingway said there’s a big difference between being defeated and being destroyed. So, everyone takes some hits and everyone takes some losses. You can’t win everything, but you can be just, and, you know, honorable and ethical in every scenario. And then you, you know, you let the cards fall sometimes, you know?

But when you do that, you’re going to win more than you lose. And if anyone tells you they don’t have any losses in life, they’re lying.

Catherine Maley, MBA: Yeah, for sure. Oh no. Everyone does the problem with social media and all of us where everyone’s got their game face on, you know, and that’s why I want to be more authentic and say, these are the issues that happened in this industry, which directly affect patients, employees and profits.

Like what would say your biggest challenge has been growing a practice. What has been your biggest.

Ryan Neinstein, MD: This is not enough time in the day. There’s, I just, I want more time for patient care. That’s it. You know, when you’re running the practice and you’re in an operating room, you’re being pulled, you know, to do things to help with the business and surgery, and you want to spend more time with the patient. So that’s a difficult balance.

That’s the hardest time. Just need more time. That’s why I get up to four in the morning, try to give myself an extra.

Catherine Maley, MBA: I hear you. I, I get up at five and I, it’s, it’s the only peace and quiet I get and I love it. I’d rather do that and, but then I have to go to bed at nine, you know, I definitely need eight hours. I’m not the four hours.

Ryan Neinstein, MD: Those are choices we make, but for a good reason. Yeah. Yeah. I just think better at five in the morning than I do at 11 at night, as we’re Sure. Yeah. Things are clear in the morning. Make your difficult decisions in the morning.

Catherine Maley, MBA: Have you found it hard to balance business (patients, employees and profits) and family now that you have two kids?

Ryan Neinstein, MD: Well, I think balance is relative different stages in your life as long as you and your life partner understand, you know, if you’re in a growth phase like we are, that I’m just not going to be around for a while. But, you know, the idea is that I’m going to invest more time now so I have more time later as the kids get older.

Right. So, it’s important to recognize that balance, I think is a shifting structure and that, you know, I, you. Build a surgical practice working nine to five, Monday to Friday. That’s just not possible. And it’s not for everybody. It’s not for everybody.

Catherine Maley, MBA: Well, a lot of those practices I work with, I think especially the older, some of the older people just, they’re tired, which affects  patients, employees and profits.

They’re like, I, I don’t want to, you know, play this game as much anymore. But one of the issues is, or they still want to dabble in recon and do a little cosmetic, and I just say, You can do that, but that is a choice you’re making because others around you eat, sleep and drink this, you know? Yeah. And how are you going to compete when someone’s putting a lot more money into it?

A lot more effort.

Ryan Neinstein, MD: Yeah, listen, we’re 20, we have 30 people, 24 7 pumping at one message. 365 days a year. We’re relentless. And you know, we’re not going to stop. Good. Okay. Tell us, tell us something we don’t know about. I’m an excellent water skier. I was a water ski instructor in high school. It was my, it was my, yeah, it was my first job I ever had, and hopefully one day it’ll be my last job.

I’ll go all the way. I’ll circle all the way back.

Catherine Maley, MBA: Isn’t the water super cold in Canada?

Ryan Neinstein, MD: Toughens you up.

Catherine Maley, MBA: I learned to water ski in Chicago in Lake Michigan, and it was brutal, but you certainly learned how to ski quickly. But the water was always like so cold, it never did warm up. It’s a big leap.

Ryan Neinstein, MD: I always liked cold water.

Catherine Maley, MBA: Yeah. Yeah. And you don’t do much water ski in New York, do you?

Ryan Neinstein, MD: Not much these days, unfortunately, but I hope I get to break, get my kids into it as they get older.

Catherine Maley, MBA: Yeah. How’s your commute to assist in patients, employees and profits? Hopefully you live nearby, like you have a… I think everyone should have a short commute in today’s world. It’s so stressful to do all this work.

I think commuting is a shame. What do you —

Ryan Neinstein, MD: Three minutes.

Catherine Maley, MBA: Three minutes?

Ryan Neinstein, MD: Yep. That’s fine. Three-minute, three-minute walk. Yeah.

Catherine Maley, MBA: Good for you. Well, thank you so much for being on Beauty and the Biz and sharing your expertise on patients, employees and profits. I really appreciate it. And if somebody wanted to get ahold of you and like pick your brain, how would they do that?

Ryan Neinstein, MD: So, we are located at Four West 58th on the 12th floor overlooking Central Park in New York City. You can follow me or message me at Dr. Neinstein on Instagram. And our website is And you can find me at any of those places.

Catherine Maley, MBA: Do you happen to have a surgical suite that has windows?

Ryan Neinstein, MD: No.

Catherine Maley, MBA: That would be the ultimate, right? To help with patients, employees and profits?

Ryan Neinstein, MD: No, I wouldn’t want it.

Catherine Maley, MBA: You wouldn’t want it?

Ryan Neinstein, MD: No, because you should be so focusing on the patient, not the not central park During.

Catherine Maley, MBA: Oh, the ambiance. I think that sounds so good. I see. I watch a lot of the guys in Texas do that and it’s just That’s lovely.

Ryan Neinstein, MD: No, we take it, we don’t, it’s a hundred percent serious and our waiting room overlooks the Central Park and the Plaza Hotel, so I think that’s a more appropriate place.

Catherine Maley, MBA: Yeah. By the way, we call it a reception area in Yeah. Nobody wants to wait (which facilitates better patients, employees and profits). Yeah, just saying.

Ryan Neinstein, MD: Okay. Thank That’s so true. That’s excellent. Never heard of that. Thank you.

Catherine Maley, MBA: Catherine Maley, MBA: Catherine Maley, MBA: Everybody that’s going to wrap it up for us today, a Beauty and the Biz and this episode on patients, employees and profits.

If you’ve got any questions or feedback for Dr. Neinstein, you can reach out to his website at,

A big thanks to Dr. Neinstein for sharing his wisdom on patients, employees and profits.

And if you have any questions or feedback for me, you can go ahead and leave them at my website at, or you can certainly DM me on Instagram @CatherineMaleyMBA.

If you’ve enjoyed this episode on Beauty and the Biz, please head over to Apple Podcasts and give me a review and subscribe to Beauty and the Biz so you don’t miss any episodes. And of course, please share this with your staff and colleagues.

And we will talk to you again soon. Take care.

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-End transcript for “Patients, Employees, Profits — with Ryan Neinstein, MD”.


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