, is a distinguished facial plastic and reconstructive surgeon who is well known around the globe as one of the leading educators in the field of aesthetic medicine and surgery. Over the past 25+ years, he has expertly directed more than 30 multi-specialty aesthetic conferences and is the Founder and current Director of the annual multi-specialty Global Aesthetics Conference in Miami Beach. Now, Dr. Waldman brings his industry expertise to the Aesthetic Authority as the Editorial Director.

Randolph Waldman, MD

What a difference just a couple of months can make. Things were rolling along and our practices and lives seemed to be getting back to some sense of normality. The pandemic had run its course. The pandemic seemed to be slowing…then along came the Delta and Lambda variants.

Now we are left to wonder whose statistics to believe. How many individuals have really been vaccinated? It seems as though I am seeing more unvaccinated patients than those who have received one of the vaccines.

More importantly, which vaccine is the most reliable and for how long does it really provide solid protection? I am hearing from vaccinated friends who were sick within the past month.

In recent days, it seems that many of my colleagues have already received their booster injections. All the while, the CDC is now making available, or even recommending, a booster no later than 8 months after the second injection. You have to wonder whether the immunity provided by the COVID-19 vaccine is not more in line with that provided by the influenza vaccine, because 6 to 8 months seems about right.

Personally, if this is what we must do to put this dark chapter in history behind us, then I am all in. This highlights the need to ask specific questions about our future in the pandemic, including the following:

Should we be forced to receive the vaccine if we wish to dine out, fly, attend a concert, go to a ball game, or even attend a live medical conference?

Moreover, should we require all our employees to be vaccinated to safeguard our patients, fellow employees, and prevent the practice from closure should an infection spread among key employees?

Should our patients and staff be required to mask up when entering our practices?

Should our children be required to mask up to attend their schools, or should schools be open at all?

Should we require polymerase chain reaction (PCR) testing for all our surgical patients? What about our injectable patients? Should they be tested?

At least 1 of our colleagues sadly passed away after acquiring COVID-19, conceivably from a lip injection patient. In Kentucky, the COVID-19 infection rate in mid-August exceeded all previous highs and the positivity rate was over 12%—also a record. What to do?

I know what we are doing in our practice, and that is protecting our patients and our staff as best we can. However, we are moving forward with our lives. The practice continues to encourage the unvaccinated among us to get vaccinated, but we do not believe it should be forced on anyone.

We continue to test all surgical patients within 36 hours of a procedure with a PCR test and confirm the morning of surgery with a rapid test. We test all patients who are receiving injectable filler treatments with a rapid test while they are awaiting the treatment. Additionally, masks are required for everyone entering the office.

I am very much looking forward to creating a safe environment in Miami’s South Beach at the Global Aesthetics Conference in early November. It is important to continue living our lives. Sharing time with trusted and likely vaccinated (many with boosters on board) colleagues is always much needed in this chaotic world.

Articles

In his latest editorial, Randolph Waldman, MD, discusses the Delta and Lambda variants of COVID-19, complex questions about vaccinations, and what boosters mean for the pandemic’s future.

There’s Nothing New About This “New Normal”

All signs and data point to the fact that we are finally turning the corner on this horrible pandemic. Our practices have not only weathered the storm but most ultimately thrived. Stimulus money, vacation time, Zoom dysphoria, and other factors have certainly played a role. However, is this sustainable long term? Will there be new challenges ahead?

Most of our practices are small businesses, and the small business environment in our country is challenging for many reasons, such as COVID-19 compliance; difficulty in keeping and finding employees, given enhanced unemployment benefits; rising health care costs; rising material and supply costs; and the threat of an escalating tax burden.

Now it is time to be wise and prudent and consider many dilemmas:

How do we ramp up staffing without a significant effect on our bottom line?

How can we be wise and prudent in future buying decisions without exceeding our cash flow?

How do we change our message regarding team safety?

Are there new services we should consider?

Should we be focusing on our younger patients, people of color, or people of diverse gender?

Will we be working more and taking home less?

Just as many of our colleagues in other fields were acquired by hospital groups, we are finding that many of our own practices are being courted by private equity. Some practitioners are coming to the conclusion that the advantages of independence are not as clear as they once were.

How will that affect our industry, our societies, our conferences, and the way we practice in this new decade?

In the end, however, the strong will survive. Those that work the hardest and spend the most time will be rewarded. We have come to understand that the number of providers will continue to escalate, but we must also believe that the cream rises to the top. Those who offer patients the best care and the most consistent result will succeed. In today’s world, this is measured empirically rather than by clever marketing. Reviews are now perhaps the No. 1 reason many patients choose to come to us.

Practice management and effective marketing have risen to a new level of importance. The premier meetings spend as much time on teaching these topics as on making clinical presentations. It is crucial that we include our staff members in this new awakening.

We must also be mindful of the increasing threat of cybersecurity breaches and related issues. I hear of more and more practitioners who have been affected by these criminals, and some have even been forced to pay large ransoms to secure their data and photos. To combat this, we must learn from experts and help one another. We must inform and train our respective staff members. That is why Global Aesthetics Conference will make this an area of focus in November.

We must insist that our societies be proactive rather than reactive. Societies must expand their role and provide tangible member benefits or they, too, will continue to lose momentum and strength.

In his latest editorial, Randolph Waldman, MD, discusses the challenges of running an independent medical practice, including cybercrime, employee deficits, and the threat of escalating tax burden. 

The Challenge of Running a Small Business

When the COVID-19 pandemic was first recognized, none of us knew how all of this might play out. We feared for our families. We feared for our employees. Could our practice survive a lockdown?

Our lives were threatened if we returned to work after state and local lockdowns, while many of us knew colleagues, friends, and relatives who succumbed to the dreaded illness. However, we did what doctors and other health care workers do. We returned and collectively learned how to practice in a pandemic. We adapted, as in previous crises, by seeking advice from trusted advisers, colleagues, friends, and industry experts.

And as a result, our practices not only survived but many of us experienced record numbers as a result of extended vacation time, decreased discretionary expenditures, and the “Zoom Boom.”

Business is good for the overwhelming majority of practices. With increased income, it’s important to invest in our practices. And this is happening to some degree. Imagine the excitement over learning about all of the new advances once we are able to safely attend live meetings and see all of the new technology that has been developed over the past year! New injectables have been approved, new light-based technology has been introduced, and new business strategies have been formulated for incorporation into our practices. Exciting times ahead for sure. There is a bright light at the end of this long tunnel we have been navigating.

I cannot wait to try the new intense light technology and some of the new fillers and toxins. We might have some help for the difficult issue of cellulite management and it sure seems as if we may have a light-based technology to safely reduce unwanted fat.

There is no reason that the search for the fountain of youth will slow down in the future. In fact, we live in an era where technology is advancing at break-neck speed.

Let’s buckle up and continue doing what we in medicine have always done: Pay attention to the science, listen to trusted colleagues, participate in organized CME, and adapt our practices to newly accepted standards and standards of care. Most importantly, we should have a full toolbox to offer our patients all or most of the options available for their particular concerns.

In his latest editorial, Randolph Waldman, MD, looks back at the past year of COVID-19, the initial panic, learning how to practice in a global pandemic, and the surprise of increased business.

1 Year Into COVID-19

There is no question that zoom calls and working remote has resulted in a somewhat unexpected boon for many of our practices. Many of us are busier than before COVID-19, but even so, our lives have changed dramatically.

Many of us have dealt with illness among our staff, friends, and family. Wearing a mask all day long and all of the other pandemic precautions we are taking in our personal and professional lives is wearing on all of us. Importantly, will we face more shutdowns this winter?

We have been told a vaccine is our only real hope. Despite some bureaucrats who have tried to convince us that a vaccine is years away and any vaccine developed in less time will likely be ineffective and even dangerous, both Pfizer and Moderna have released the early results of their respective phase 3 studies, which were nothing more than amazing. The vaccine that was years away is now ready for distribution to millions, and it appears to be more effective than even the common influenza vaccine—95%! An amazing testament to the work of our outstanding colleagues in the pharma industry and the partnership formed between government and industry when it was most needed.

So major kudos to all involved in Project Warp Speed. We are so proud and thankful of those who designed, administered, and volunteered for the various clinical trials. Hopefully, the negative narrative for the vaccine propagated for political reasons will not provide a blockade to universal participation. We as physicians must set the right example. And while we may not be able to celebrate a completely normal holiday season with family and friends in 2020, perhaps we can all soon come out of hiding and remove the pandemic-specific signs and protocols from our offices.

Finally, what changes that have occurred will stay with us post COVID-19? Will virtual consultations continue to play a major role in our practices? Will the current boom in our practices remain and, if so, for how long? What about the economy and the effect of rapidly accelerating national debt? Can we survive another major economic downturn? Will live CME conferences and meetings return to normal anytime soon? Can our respective societies and organizations regain strength? Will member participation ever be the same? And, most importantly, will the COVID-19 virus still be around a year from now?

Those questions remain to be answered. One thing we can be sure of: We are all ready to put 2020 behind us and see if we can find any normalcy in 2021.

In his latest editorial, Dr. Randolph Waldman looks forward to 2021 and how COVID-19 will continue to change the aesthetic specialty. 

Looking Forward to 2021

Fall is around the corner and I sense that there is a true sense of optimism in the air among both colleagues and patients. Just like the stock market and real estate market, most of our practices seem to have made up most, if not all, of the ground we lost during the mandatory shut down. It seems as if it should have been just the opposite, if we believed in the “sky is falling” narrative espoused by much of the country’s mainstream media. Reality is reality and many of us have been through major slowdowns in both the 80s and 90s and post 9/11, as well as the housing bubble collapse. The effect on our practices mirrored the fear of those times, but not this time around!

So what is the difference? Surely high unemployment and increasing reliance on government bailouts would put all of our patients on the sidelines and tank the various markets. However, it is clear that the fear mongers have not prevailed and most of us in medicine can see a light at the end of this dark pandemic tunnel. Our practices are often bellwethers of what is perhaps around the corner.

Most of us refused to be frightened to the sidelines and returned to work as soon as the government allowed us to reopen our doors. We not only did we open our doors, but we provided a beacon of light and hope to our patients. We did things the right way. Yes, we masked up, socially distanced, washed our hands a hundred times a day, geared up with PPE, provided leadership for our respective staff members, and reassurance for our loyal patients. We should be very proud of how we all reacted amid this crisis, and together we have strengthened our specialty.

There will still be bumps in the road. The winter will still offer confusion. We are not out of the woods yet, but the light is shining in through the tall trees. We have confidence that Operation Warp Speed will produce an effective vaccine in less than six months and then we will meet the next challenge of getting this vaccine to hundreds of millions of patients around the globe. We are also confident that our brightest minds will also come up with additional therapeutics that will reduce the veracity of this horrible disease.

Meanwhile, we will keep doing what we are doing. The “new norm” is not necessarily going away immediately, but hopefully we will start seeing normalcy return to our lives within months, not years. Between colds, influenza, and COVID-19 infections, hospital beds may once again be filled. However, let’s all be proud that our profession has not succumbed to fear and instead has chosen to restore as much normalcy as possible and set the example for others to follow. I feel proud every time I see a sign that says, “heroes work here.” Our profession has avoided the politics and done what we have always done and that is take care of patients.

From shutdowns and unknowns to allaying patient fears and reclaiming professional lives, indeed, the private practice goes on.

Strength and Success in Our Specialty

The recent pandemic has affected everyone in one way or another. It has certainly been a time of reflection on life in general but also our practice life. Many of us have experienced what it is like to have our livelihoods put on hold, not to mention the incessant fear of contracting the coronavirus. No, these are not normal times and certainly not something most of us in the medical world even thought possible. But here we are. The reality has set in.

Most of us have reopened our practices but with some limitations and an abundance of caution — caution to protect ourselves but, just as important, our patients and staff. There have been countless webinars helping guide us through a landscape that is continuously changing. I have now collaborated with the 

 on four of these, all of which were developed with 100% editorial integrity and no outside sponsorship influences. We did it because we wanted to do our part: colleagues helping colleagues; professionals helping professionals. The Medico-Legal Panel was particularly sobering, as we live in the only country in the world with more attorneys than physicians.

Now we move forward and inch toward normalcy or, hopefully, something close. We will continue to network with one another, and this publication will continue to do its part in helping us navigate these treacherous waters. At this point, let’s hope we have seen the worst that mother nature can offer and that we all stay healthy and are in a position years from now to talk to our younger colleagues and grandchildren about the Pandemic of 2020.

But for now, remember to look at the process of rebuilding our practices as a marathon, with an eye on the months to come. Our focus should be on making certain that we do things the right way and should consider all of those who work so hard for us as well as those who love us. Wishing everyone health and happiness in the days ahead. And, hopefully, my favorite Beatles song, "Here Comes the Sun," paints a picture of where we go from here.

In his latest editorial, Dr. Randolph Waldman reflects on practicing aesthetic medicine during the pandemic and paints a picture of hope for where the specialty goes from here. 