# Private Practice Is Not a Straight Line β€” James Rough, MD (Ep. 369) Page: https://stenobird.com/podcast/beauty-and-the-biz-581032/private-practice-is-not-a-straight-line-james-rough-md-ep-369 Text version: https://stenobird.com/podcast/beauty-and-the-biz-581032/private-practice-is-not-a-straight-line-james-rough-md-ep-369.md Podcast: [Beauty and the Biz](https://stenobird.com/podcast/beauty-and-the-biz-581032) Published: 2026-07-03T19:41:00+00:00 Episode link: https://www.catherinemaley.com/podcast/private-practice-is-not-a-straight-line-james-rough-md-ep-369/ Audio file: https://traffic.libsyn.com/secure/catherinemaley/One_Patient_At_a_Time_Still_Works__James_Rough_MD.mp3?dest-id=1247585 Processing state: not_requested JSON: https://stenobird.com/v1/public/podcasts/beauty-and-the-biz-581032/episodes/private-practice-is-not-a-straight-line-james-rough-md-ep-369 Duration seconds: 2669 ## Resource πŸ“• Get Catherine's new book: Beauty and the Biz Practice Growth Playbook: https://bit.ly/4cZNSuD πŸ“Š Schedule a Practice Performance Audit: https://bit.ly/4dC2znZ ⬇️ ➑️ James Rough, MD, shares his journey into private practice and how it is not always a straight line to become successful. Hello, and welcome to "Beauty and the Biz," where we'll discuss the business and marketing side of plastic surgery. As always, I'm your host, Catherine Maley, author of "Your Aesthetic Practice – What Your Patients Are Saying." and consultant to plastic surgeons, helping them get more patients and more profits. Private Practice Is Not a Straight Line β€” the business lessons behind building a boutique plastic surgery practice. First, this week on "Beauty and the Biz," I talk with Dr. James Rough. Indeed, he is a board-certified plastic and reconstructive surgeon in private practice in Tucson, Arizona. Admittedly, Dr. Rough has an interesting story. After all, he didn't just jump straight into a solo cosmetic practice with everything figured out. Initially, he started at the VA. Next, he built his surgical experience. Then, he joined another practice. Consequently, he learned what worked and what didn't. Eventually, he used those lessons to build his own boutique-style practice. Truly, I appreciated his honesty about the journey. Occasionally, you make a decision that looks good on paper. However, you realize later it wasn't the right long-term fit. Similarly, a difficult partnership still teaches you invaluable lessons. Furthermore, COVID, market shifts, competition or staffing force you to rethink what you are building and why. Thus, in this episode of "Beauty and the Biz," we discuss several topics: For instance, we talk about transitioning from reconstruction to a cosmetic private pract… ## Actions - request_transcript: `POST https://stenobird.com/v1/public/podcasts/beauty-and-the-biz-581032/episodes/private-practice-is-not-a-straight-line-james-rough-md-ep-369/transcription-requests` β€” Idempotently request low-priority transcript generation for this episode. - read_markdown: `GET https://stenobird.com/podcast/beauty-and-the-biz-581032/private-practice-is-not-a-straight-line-james-rough-md-ep-369.md` β€” Read the agent-friendly Markdown representation of this episode resource. A page view does not enqueue transcription. Agents should invoke `request_transcript` explicitly when they need this episode processed. ## Transcript Full transcripts are not published on public pages unless there is a clear rights basis.