Dr. Michael Edwards is a board certified plastic surgeon, a lifelong learner, a leader, and a longtime champion of patient education.
For those who believe delivering the best possible consultation is the single most important factor for practice success, hear Dr. Edwards’ essential advice, including:
- How to truly listen to patients and not just wait to speak
- The first thing you should do before you invest in technology or software
- Why patient safety should always be a top priority
- The importance of including staff in training and implementation of anything new
Listen
Watch
Guests
Michael Edwards, MD, FACS
Plastic Surgery Vegas
Dr. Michael Edwards is recognized as one of America's and Las Vegas' top plastic surgeons and served as ASAPS president in 2014. He is a trusted expert in breast revision, breast augmentation, breast reduction, and breast lift.
Learn more about Las Vegas plastic surgeon Dr. Michael Edwards
Follow Dr. Edwards on Instagram @drmedwards
Learn more about TouchMD
Host
Tyler Terry
Director of Sales, MedSpa at Nextech
Transcript
Announcer (00:06):
You are listening to the Aesthetically Speaking podcast presented by Nextech.
Tyler Terry (00:11):
Hey guys, welcome back to the Aesthetically Speaking podcast presented by Nextech. I'm your host, Tyler Terry, and today we not only have a very special guest, he's one of the most prestigious, in my opinion, plastic surgeons in the country, and one of the best, somebody that I would trust my friends and family with. His name is Dr. Michael Edwards, and I'm so excited to have him share his wealth of knowledge on the podcast. Dr. Edwards, welcome to the show.
Dr. Edwards (00:42):
Thanks. Great to be here.
Tyler Terry (00:45):
Yeah. Well, I want to kick it off by turning the time over to you to just tell us a little bit about you and your background and your practice.
Dr. Edwards (00:53):
I am in a group plastic surgery practice in Las Vegas, Nevada. I have two incredible partners. We have a dermatologist, Dr. Allison Tam on staff. We have three nurse injectors, four aestheticians, and a host of incredible support staff. We have operating rooms upstairs, so it's really a wonderful place to work somewhere where I think any plastic surgeon would be honored to be a part of. So that's where I am now. I've been in the medical field a long, long time. I started off as a medical assistant. I was a house orderly. I pushed gurneys around the hospital. I used to assist with autopsies, culminating in going to nursing school, working intensive care and ER nursing jobs while I was then in undergrad for medical school and I went to medical school through the Air Force, and so I went to a medical school called Uniform Services University where in addition to medical curriculum, we learned all about tropical medicine and wartime medicine and really enjoyed that. I grew up in the military. My father was in for 23 years, so nothing foreign to me. I always knew I wanted to be a surgeon, so I started training as a general surgeon and then worked my way into plastic surgery and I'm sure we'll talk more about those details in a bit. As you mentioned, I've got an amazing wife of over 45 years, Kathy, and some great kids that are in medicine as well, and grandkids. So living the life, living the dream.
Tyler Terry (02:21):
Yeah, definitely. Well, first off, thank you for your service and for your father's service. That's amazing. Something that I very much appreciate and admire. And again, going back to just your history and becoming a plastic surgeon, a board certified plastic surgeon, what made you choose plastic surgery?
Dr. Edwards (02:44):
Yeah, that's a good question. And so things happen for a reason I think, but as I went through my general surgery training, I didn't know what I wanted to do. I enjoyed everything. I enjoyed everything from vascular surgery, just being able to make changes for patients. There's a difference between an internist and a plastic surgeon and the internist will turn to dial and watch for what the changes are made with the patient, change of medication or what have you, whereas a surgeon, we used to joke cut to cure, and so it allows you to use your hands and make changes in someone's life. As a general surgeon, it could be a matter of saving someone's life, gunshot wounds, wartime entries that we've dealt with. As time went on, I realized though that I really liked working with my hands. So surgery was definitely what was in my future, but as I got more exposure to plastic surgery, I realized that as a plastic surgeon, I know that you know, but the average listener doesn't know that plastic surgeons are really trained to operate virtually head to toe for somebody, whether it be hair transplants, whether it be to work on the scalp, rotational flaps from cancer, all the way down to the feet.
(03:54):
You get to use all your knowledge base. And so I did all that when I came out of my training in the military, I did breast cancer reconstruction, I did lower extremity and upper extremity reconstruction, but as time went on, I realized that my really true love was breast surgery. And so what's happened over the course of my almost 30 year career, is I've focused solely on all aspects of aesthetic and revisional breast surgery. I'm fortunate to have learned a lot and gotten to befriend a number of really very talented surgeons who've taught me a lot. And so now I get the chance to lecture and share what I've learned over the past, almost as I said, 30 years. So aesthetic surgery is a gift to be a part of. You are helping to restore not just function but form as well. But in our practice, as I mentioned before, we have a large group practice.
(04:48):
I have two great partners. So we offer everything from facial surgery to body contouring to liposuction, all the above. We offer the full gamut here. When I got out of the Air Force back in 2003 and opened a private practice, I took all comers, I did insurance cases as well as cash pay patients and found that, I don't know that the desires and wants are much different. I think that over the course of time women, who I primarily care for women and men, but women have become a lot more educated in what their options are. I will say that that's good because they need to ask questions. I tell every patient when they leave my office after an hour visit, I say, I want you, you're welcome, number one, to come back because we've typically have talked a lot about a lot of moving parts in a surgery.
(05:35):
But I'll say as you think of questions, write those down so that when you come back, you can make sure every one of your questions gets answered. I'm not a salesperson. I like to educate patients on what their options are. And so that's something I've always thought was critically important from the get go. But also I will say that there's a lot of bad information out there on the internet and social media as well. So sometimes it's a matter of having to educate somebody about what is really best for them, at least in my opinion. So I think that although they've become more educated, I think that there's bad information out as well. So I encourage patients that are watching this to let your doctor be the source of the true information for what they think that would be best for you.
Tyler Terry (06:17):
So what are some things that you can share with the audience on how you curate content, how you're empowering the patient to go home and gather questions, but hopefully they're able to take them back to you and not to chat GPT or to Google or whoever the case may be.
Dr. Edwards (06:35):
So for me, and you and I go way back and our relationship started with TouchMD, which plays an incredible role in my practice, and it's to the point where now where if I come to work and there's a power outage or I don't have internet, it's almost like I say, okay, time out. Let's cancel the day, I can't see patients today without my TouchMD. Well, the benefit of it is that when I tell patients, when I meet them that I'll start from the very get go. Everything I ask them, I'm trying to learn more about them and then I'll talk as I go through a consultation, kind of how I'm in my mind, planning out how I would do their surgery. And again, probably 70 to 80 plus if not 85% of my patients are revisional or redo surgeries. And so using TouchMD go through, I start off my consultation with a very comprehensive questionnaire.
(07:26):
I really want to know everything about a patient. I want to know their medical history. I don't want to just focus in on their breast because there are facets of their health that will affect what we do, how it's going to affect their anesthesia. What I do in terms of perioperative and postoperative care, as I go through and do that, patients are oftentimes very amazed that I'll ask questions about their thyroid or about other GI issues or what have you. But that's the benefit of having had the general surgery training before. And then as I go through, I like to draw on my images, the patient's images on TouchMD, and they're each and every one saved. And we make it very clear to the patients that they have access to those images that they can go home with their spouse or loved one or whoever wasn't able to make it to the appointment, they can pull those images back up. And again, I emphasize to them that they can write questions down if something wasn't discussed before. And so education is ongoing and it includes post-op education as well. We try to do that ahead of time, but it's a process. It's never just, Hey, how you doing? Great, alright, see you in two weeks. It's a process and it takes a time commitment really does.
Tyler Terry (08:36):
Yeah, definitely. What I love is that you flip the script of selling to educating and when you're educating, you're empowering and then your patients feel empowered to go home and to relive and retain and to share it and then to come back to you, their trusted source to gain even more knowledge or more clarity into whatever the case may be. But being able to retool and reconfigure that mindset, to shift that to educating and empowering the patient.
Dr. Edwards (09:06):
And I think it's also really important when somebody comes in for a visit, it's a good idea to have somebody come with them, somebody that when a woman is sitting there in front of you unclothed and you're examining them, it makes it harder to think of the questions that you had thought about before. And so that's the other benefit of TouchMD. I examine them, I take my measurements, I get as much history as I can. We take their images and then if we're going to try implants on, in a primary case, they're, they put a robe back on, so they're covered up and at that point we scoot up to the Touch MD screen and go over all this information. I believe it's much easier for a patient to understand and feel comfortable asking questions when they're covered up. It makes no sense to try to have them sit there unclothed or naked and to try to understand what you're saying.
Tyler Terry (09:55):
Yeah, that makes sense. So I'd love to unwind a little bit, and so we've talked about patient education, we've touched on a little bit of software, but one thing that I've learned a lot from you is how you give a consultation and there really is this art that I've discovered just from watching you and others. So what are some things that you can share with not just patients that are listening as they're thinking about which surgeon that they might want to consult with, but to our med spas, to our plastic surgeons, to our dermatologist, to any aesthetic professional listening to this podcast on the consultation?
Dr. Edwards (10:36):
Well, there are a number of them, and I think number one is it's important. It sounds somewhat cliche, but that patient needs to think or they should think and they should be the most important person in the room. So I think it's really critical that we make sure that they know that they're listened to. And so listening is not waiting to speak. We've all heard that before, but that's so critically true, listen to the patients to hear where they're coming from, what they've been through, if it's revisional surgery, I make it very much a point to not dig into them speaking poorly of a past provider. There's no benefit gained there. And so I think listening to patients, making sure that they know that they're heard, I don't ever, it made a big impact on me, another thing I read years ago is you don't talk to a patient with your hand on the doorknob. It is just like being at a dinner table with friends and you've got your phone in front of you. Where's your attention? Your attention is not on your friends. It's not on your spouse or your kids or whoever. So by no means am I perfect, but I try really hard to have patients know that what they have to say has value.
Tyler Terry (11:42):
What are some things that you do each and every time, no matter who the patient is or what the procedure is about?
Dr. Edwards (11:50):
It's really important to engage them, the consultation, engage them and allow them the ability to ask questions. I'm not speaking down to or over somebody if they have something to say, I'll listen and incorporate that into the conversation. I do take pictures at each visit to include post-op visits. Those are kept in TouchMD, and we provide a small index card or business size card that tells patients how to access their images. And the last time I talked to the folks at TouchMD, I had a pretty high revisit rate by patients to go back to it. And so I encourage them. I said, go talk to your husband, your boyfriend, your girlfriend, your mom. They can get on with somebody across country if they want to go over those images again and you can share data with them.
Tyler Terry (12:41):
Yeah. So you've definitely become a master of your craft, obviously as a surgeon, but then you become a master of actually using the technology, the TouchMD technology. What are some things you can share with a provider or an owner of a practice on how to adopt technology and knowing that you're not going to become a master really fast, but what are some things that help you get to the point to where you're at today?
Dr. Edwards (13:07):
Well, I'm not really big on technology. I can play around with computers and I'm not a programmer. But we keep talking about this like it's a touch of the commercial, but that plays such a big part in my practice, I think it's important. So there are times that I'll be at a meeting and somebody will come up to me or whether I've talked about it in a lecture I've given about how I use it in my practice, somebody will come up and one of the first things that I say to them, if they're going to adopt something, let's use TouchMD. I'll say, great. You could be excited about it, but you have to have your staff be excited and use it as well. Whenever we hire new personnel into the office, one of the first things that I do if they're going to work on my team is we come into the room and I make sure that they are comfortable moving around in TouchMD to include getting comfortable with my before and after gallery that they can pull up and show patients.
(13:57):
We always make it a point to tell patients that each and every woman that we're showing them pictures of has given us permission so that they know that their pictures are not going to pop up on an Instagram post or the internet or somewhere like that, certainly without their permission. So I think that before you adopt a technology, you should do your research. I don't have a lot of fomo as they say, or fear missing out, so I don't jump right to technology when it first comes out. But I'll never forget the day that Jason came into my office so many years ago and put the first iteration of TouchMD up on it. It wasn't even a touchscreen, it was a big Hewlett Packard screen, and as he showed me how you move around, it just, my wife was running our practice at that time and I just looked at her and I said, this is coming on board.
(14:43):
The other thing that is important as one of the questions you guys had asked about was technology for a new somebody coming into practice, whether they be getting out of the military as I did, or they're just coming out of training. I think that your practice management software is critical, right? And for us, we're large Nextech practice and as you well know, and your listeners know that TouchMD and Nextech are synonymous now. And boy, it's been less than a year, but my times have changed. And so those are two pieces of software that I can't imagine practicing without. There are lots of bells and whistles out there when you go to the aesthetic marketplace at our annual meetings and you'll walk by and see the newest fanciest laser or the new cellulite machine. And I'm not saying that those don't have a role or utility, but do your research before you spend your hard earned money, whether you're borrowing that money or what have you, to do that. Listen to other colleagues that you trust, go to a lecturer and learn as much as you can before you bring something on board and think about how you're going to implement it into your practice.
(15:49):
I'm telling you, I really feel like as much as I use TouchMD, I think I use just a fraction of its capability. I mean, I do use the homework function. So let's say somebody comes in and I say, because it's my habit as well, at the end of every visit I ask patients if they do self breast exams. Again, all I do is breast surgery. And it astounds me sometimes that women say that they don't do a self breast exam even if they have a family history. And so I built into the homework section of our TouchMD a sheet on how to do self breast exam. And so I will go click, click, click, and I say, I just sent you, or I'll have my staff send you some homework and this is what I want you to do. But you can put, it's just limitless on the educational information that you can put TouchMD and doesn't mean that your consult takes an hour or an hour and a half to show them that data.
(16:41):
If you're with the computer and I use the touchscreens on the wall, some doctors like to use the iPads and maybe Apple Technology projected up to a screen. I like to use the touchscreens and have the patient right there with me side by side as we look at this. So use the technology and just know that boy, especially, I think it's so exciting as young plastic surgeons to come out to into seeing this done because when I first laid my hands on the technology, there were a couple screens deep and that was it. And now it's just like it's matrix. It goes way back and you see the green screen coming down. So I think it's funny. It gets me excited, obviously.
Tyler Terry (17:24):
Yeah, I love how passionate you are about it. Obviously I'm biased, I'm passionate. I think that it's something that every practice can benefit from, even in the ways that you said things you haven't even mentioned, which is using it as a digital menu or using it as a sales aid, but there are so many aspects to utilize.
Dr. Edwards (17:43):
You can do your informed consent and the beauty of the mobile app, the SNAP app allows patients send me pictures back and forth in a HIPAA compliant fashion if they need to share some ideas. I use it as something we haven't talked yet about is virtual consultations. So I insist when somebody has a virtual consultation for whatever breast surgery they have, primary breast surgery or not, number one, I make sure that they fill out their intake paperwork before the consult. I won't see them without pictures and their intake paperwork. I'm going to make this worth their and my while. And I will literally, when they send pictures in, we forward them an image of say, these are the series of pictures I want you to send. No face, arms down, arms up, all these different things. And when those pictures come to me, I get them easily the day or two before their consult, and I'll sit down and draw on them at that time, and then those go back into their gallery so that during the consultation I can pull those up and say, here's your anatomy.
(18:41):
This is what's different. These are the implants I think would benefit you, and this is why, et cetera, et cetera. So again, great technology. Another technology I use, just to be fair so this isn't a TouchMD commercial completely, is I've really adopted breast ultrasound as a tool. And so I encourage plastic surgeons to pull that on board as well, it's something very easy to do.
Tyler Terry (19:06):
Yeah. Can you tell us a little bit about that?
Dr. Edwards (19:08):
Sure. So a number of years ago, as we well know, when we survey silicone implants for what's called an occult or a silent leak or rupture, I hate the term rupture because implants don't explode, but to know if an implant is disrupted or not, it was recommended at the initial approval that they have a breast MRI. Well, many years go by, secondary hearings are held by the FDA, and very few patients are having MRIs unless it's something that their insurance took care of because it's not, it's rarely covered by insurance and aesthetic cases.
(19:43):
So I learned thanks to very smart people that I am friends with, fortunately Mark Jewell, Brad Bengtson and others, Patty McGuire and Caroline Glicksman, we all have adopted using ultrasounds in our patients, and there are many more, trust me, Bill Adams is a big user. And so it's so easy to do at bedside and I use a Clarius. There are other options, but clarius is a wireless ultrasound. I can slide a stand into the room and I have an iPad there, and I talk to the patient, says I'm pulling it up and I show them what I see. Then I can see the images and if I want, I can import those images into TouchMD. So they're kept there as well. So it's something that I highly encourage plastic surgeons to use. Now, you mentioned med spas earlier. There's a push with Clarius and other ultrasound devices to use it for facial injecting, to look at anatomy. You can look at vessels, you can try to avoid an intra-arterial injection and cause not only harm, but hours and hours and days of lost sleep on your part. So safety, it brings safety into a whole nother realm when it comes to that.
Tyler Terry (20:49):
That's actually the first that I've heard of it being used for injectables and fillers and facial anatomy. That's incredible.
Dr. Edwards (20:56):
Yeah, the ultrasound is a great tool and there's no radiation. It's sound waves. And again, Clarius is a company that I've worked with and they're very responsive. That's the one thing I always brag about when I talk about going back to TouchMD, is that I could have an early consultation, and I always laugh when I go back and see some of the early rudimentary drawings that I made, and I'll call Ted at TouchMD and I'd say, Ted, we need to be able to do X, Y, or Z. And within a week and a half or two weeks, he'll say, Hey, reboot your computer and try it again. And sure enough, there it is. And you guys are so nimble. And I kind of get the feeling as I talk to more leadership in Nextech that I think that they're in the same mode as we go along with looking at the electronic health record and record report generation, et cetera. So being nimble and being responsive to your customers I think is huge.
Tyler Terry (21:49):
I would like to shift gears a little bit and talk about the Aesthetic Society. You are a past president, I believe it was in 2014, you were the president, so I'd love for you to number one, tell us about the Aesthetic Society, and number two, tell us about your experience as the president.
Dr. Edwards (22:09):
About 60 years ago, there were some very forward-thinking plastic surgeons. The Aesthetic Society did not exhibit, and I should know exactly how many years, but it's been maybe a little over 60 years. There was ASPS, the American Society of Plastic Surgeons, great organization, good for education, but there wasn't a big push on aesthetic surgery. So some very forward thinking and brazen surgeons chose to branch off and develop this concept of teaching aesthetic surgery. At that time, there were actually surgeons that said every cosmetic surgery that will be ever developed has already been developed and discussed. I mean, it was so shallow of an approach. And so again, thanks to these pioneers, the aesthetic meeting began, literally, the society began on the back of a napkin at Harry's Bar in Venice. It was a travel club of plastic surgeons that got together. And so thanks to them and their leadership as we've gone on, the Aesthetic Society or ASAPS as I prefer to call it, has developed into the world recognized number one source of aesthetic education.
(23:16):
And this is not to demean isaps or other organizations that have been developed, but A-S-A-P-S has always prided itself in the quality of its aesthetic surgical content. And so I got involved with that. I was still in the military at the time, and I got involved and was asked to play a part in a very small committee. I've always liked leadership. I was in leadership in the military and doing different things. I helped to command a field hospital in the Gulf War conflict, and I enjoyed that. And so as I got involved, before you know it, I'm on virtually a phone call with a society in one committee or another three to four times a week. So I want the listeners to know that when you see somebody who is involved in the leadership, it doesn't just happen overnight, it has to do with a lot of dedication and time, time away from your family, time away from your practice sometimes.
(24:16):
But I just enjoyed being part of it. I've said to my wife jokingly one day, she goes, why are you spending so much time with these people? And I said, gosh, number one, like-minded like me they like, I think patient safety is something we'll talk about in a bit, but that's very important to them. Getting the best education out there is important. So it was fun being involved. And before you know it, I got a phone call one day. I'm very much shortening it, and I've tapped on the shoulder to be a president. I mean, what an honor to represent the Aesthetic Society. I was fortunate to travel virtually around the world to meetings and got to meet some amazing people, many of whom I'm proud to still call good friends, representing the society, giving talks, giving updates on the society. And one of the questions I'm often asked is, what impact did I make during my time as a president?
(25:07):
Everyone comes in and they have a goal of what they want to achieve, and I'd like to think that I just kind of kept the ship steered in the proper direction. When you run a board meeting, you don't go in and pound your fist and start dictating things. You listen to your board members and you see what's going on and you get your committee reports, and it's your job to shepherd the society into what the right way to go. And so I think if anything else, that was something that I played a part in and it was as I'll say again, it was a true honor of my part. And I still think, and it will always be the premier, a source of aesthetic surgery education. And Kiya Movassaghi is our current president out of the northwest, and he's a high energy guy. And I think that the society in good hands.
Tyler Terry (25:53):
Where do you see the society going over the next 20 years and their importance to the industry?
Dr. Edwards (26:02):
There are two societies that are sister societies. There's the Aesthetic Society, which focuses on the education and membership and all those rewards, but there's also, they rebranded it, renamed it, and it is ASERF, the Aesthetic Educational Research Foundation. And so what's happened in the period of time that I've been involved, it was important at the time and research was being done, but they have come light years in terms of supporting papers. Onelia Garcia is the current president of the Aesthetic Research Foundation down in Miami. And Onelia is a researcher. He's a brilliant plastic surgeon. And so you can get funding for educational researchers for papers to get new data out there, papers on anaplastic large cell lymphoma, papers on breast implant illness, things that are current and foremost. And so they are constantly moving and evolving and responding to the needs of our membership and to the needs of our
