Ep.88: E. Gaylon McCollough, MD FACS – Former President AAFPRS, ABFPRS & AACS

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Transcript:

Beauty and the Biz

Episode 88: Gaylon McCollough MDFACS Former President

Catherine Maley, MBA:

Hello and welcome to Beauty and the Biz where we talk about the business and marketing side of plastic surgery. I’m your host Catherine Maley, author of Your Aesthetic Practice: What Your Patients Are Saying, as well as a consultant to plastic surgeons to get them more patient and more profit. I am excited today because we have a distinguished guest named Dr. Gaylon McCollough, who is a pioneer and absolute icon in the field of plastic surgery. Dr. McCollough is a Board Certified Facial And Reconstructive Plastic Surgeon who has practiced for the past 46 years. He founded the McAllen Institute for appearance and health in Gulf Shores, Alabama, and I recommend you check out his website and do a tour of his facility. I wouldn’t even call it a facility I would call it a fortress. It is amazing and impressive and it includes a private surgical center, post-op private apartments, Med Spa including non-surgical treatments, vitamin supplements, weight and stress management, and hormone therapy. Dr. McCollough has obtained international recognition as a surgeon and teacher and was recently included in the National Registry of who’s who, as well as best doctors in America and America’s top plastic surgeon. Dr. McCollough is active in numerous international and national medical societies. He’s won countless awards for his efforts. He’s also passionate about creative writing. He has authored 12 books, some are facts or fictions, consumer appearance and health, some are motivation, inspiration, theology, and politics. Dr. McCollough and his lovely wife are active in many philanthropic efforts, including being honored by the March of Dimes as Alabama citizens of the year. Dr. McCollough, it is an absolute honor to have you on a guest of duty, and I welcome you to our program.

Gaylon McCollough,  MD FACS:

Thank you. I’ve looked forward to this. I’ve known about it or you and I started talking about it some time ago. But we finally were able to get our schedules coordinated and hopefully, we’ll have a good time here for the next year.

Catherine Maley, MBA:

You are one busy guy. Can you tell me out of sheer curiosity? Your fortress is amazing. And I think your son designed it for you. Can you tell me how many square feet it is?

Gaylon McCollough,  MD FACS:

It’s about 32,000 square feet. The different amenities you mentioned, we have six villas, where our patients stay after surgery, and everyone spends the first season here, but many of our patients come from far away and some will stay a week or two weeks until they’re healed and then go home. The average person wouldn’t know they had undergone surgery. They think they had a long vacation and return home looking rested. It’s right in the center of a golf course, here in Gulf Shores, Alabama, which is a resort along the Alabama Gulf Coast. We have about 20 miles to white sugar sand that people are familiar with and Destin, Florida, and Panama City, Florida, that comes over into the state of Alabama. That’s there’s not lived here for the last 21 years and it was a great move on the stone.

Catherine Maley, MBA:

I’m out of curiosity, we’ll talk about marketing but we’re on geography, is it a resort as in? Can you sustain yourself with the general population nearby or do you need the whole world markets to keep it active?

Gaylon McCollough,  MD FACS:

Well, let me explain it and we looked at this before I came down to it. I did a lot of research. I practiced in Birmingham for 25 years, I had a scooter there that was larger than this and I sold it we’ll get into that if you want to get in a little while. I was 52 years old and thought I was going to retire and never done anything but work and I went to three and a half days, two and a half-day workweek and I liked it a lot for about six months. Then six months ago I was miserable and I tried to buy it back and they wanted more money for it and I said no. I had some non-compete clauses and I decided, no one here in Gulf Shores. Let me explain to you that our clients if you draw a line, and this is the Gulf Coast, everything North is a lane, and then everything South, is the Gulf, or the in the ocean. About one-third of our practice comes from a 60-mile radius and includes Mobili Alabama, and so forth. We’re right in the center of that arc then you go out another 300 pounds to New Orleans, Jackson, Mississippi, Birmingham, Atlanta, and probably Tallahassee, Florida, and another one-third come from that arc. The other one-third comes from all over the world. Fortunately, when I came here, I brought many of my patients from Birmingham, the ones that live far away, they followed me here. It didn’t matter whether they flew into Birmingham with flying over mobile and drive over here. I don’t think I could sustain my practice that all I had to depend on the people who live in this resort area because there are about 15,000 people who live here. But on any given weekend, or any holiday period, we might have 150,000 people in town. Many of those people have second homes here or they have condominiums here and they look for an excuse to come and spend time in those condominiums and homes and works out perfectly for them to have surgery so they can come to your stay a few days with us here at my Institute and then go to their cargo and recover then I stick them back and forth until they go home. I summer again for another course that year,  we’ll talk about this. But I think the ability to email photographs, so-called telehealth or telemedicine, I’ve used that probably longer than I should have. I’ve done that for 20 years and patients will send me photographs either before coming down for surgery or after I’ve operated on them. They’ll send photographs to me I can follow them and keep up with their progress. I spend at least an hour every day doing telehealth, communicating with prospective new patients, or patients that have already had surgery, but I’m following along and assuring down and answering questions.

Catherine Maley, MBA:

I find it to be a great time saver. I don’t mind doing telehealth at all. I love it. I like sitting still, I think there’s enough of an interaction digitally to make a connection. I’m loving it and if I don’t have to drive, I’m even better. Is it popular? Do you find that you’re saving a lot of time?

Gaylon McCollough, MD FACS:

Yeah. Not only for me but for the patients. It’s a patient from Huntsville, Alabama or Atlanta, Georgia, and not driving 6 hours round trip. Each way they can send me a photograph that one month and I can look at everything says off gosh, your incisions are beautiful and you’re doing great. Do you have any questions you may have? But many times it’s No. And if any they do, then I answer the questions. I kill every one of my patients, not a personal email, that they have access to me. That’s a reasonable thing I spend at least an hour a day, answering the patient’s questions, reassuring them as much as anything you know what we do? These patients require reassurance, patients who have the appearance enhancement surgeries and procedures to their healthy patients. They’re usually well patients when they come and have things done and we make them look worse for a while they’re more swollen and get some bruising and cemetery here and there until the healing occurs. They require a lot of hand-holding. I learned from my professors and my mentors that in surgery, your responsibility does not end when you put the last trip, you have to nurture these patients alone. Know we’ll get into the marketing aspect but I can tell you, in my experience, there’s no better marketing than when you’re sitting face to face with a patient you’ve operated and you’re reassuring them to make them feel good about the fact that they came to see you and they’ll go out and tell everybody how you work and how generous you are with your time caring you work. That’s something you cannot and you spending extra time with patients in the post-doctorate period is probably the best time that you’ll spend in your practice.

Catherine Maley, MBA:

I kudos to you and I 100% agree. I have personally been through that a couple of times and especially facial surgery. Even me I know this industry inside and out. You need reassurance afterward, you’re feeling uncomfortable with how rearranged you look. And you need reassurance for that. You need the doctor, the surgeon to care. And that’s how you get good reviews later on. So I mean, you know, everyone’s going to be fine, but they don’t know they’re going to be fine. And it’s such an emotional roller coaster when you’re going through it. Let’s get back to the business side. I’m always curious to find out. In the old days, used to open a solo practice, and you’d have your wife’s command after you’ve been embezzled, or you’d have a few staff people. And it was easy, easy, or in today’s world. You have to figure out do you go solo? Do you do a partnership? Do you bring on somebody that’s on per diem? Do you talk about that? Where do you feel like the business structure is going to be successful in today’s plastic surgery industry?

Gaylon McCollough, MD FACS:

I can speak on that because I’ve experienced in almost every type of practice. When I finished my fellowship and my residency at UAB, I stayed on the faculty for a year and a half there and was an academic medicine for a year and a half. I understand how it is to practice in the big Medical Center and practice with a big staff and your fellow count your colleagues in a department or division of surgery. I note that in the academic practice, and when I started my practice, I was in solo practice for several years, probably seven or eight years. I added one doctor as a plastic surgeon that we could be well-rounded, and I did all the face work and he did all the bodywork and someplace work. I continued to add staff. I mentioned the big center that I had in Birmingham. It was an Aesthetic Medical Center and I had six surgeons in my group that there were three of us who did Facial Plastic Surgery, there were two or three depending on what time in that period of comprehensive original plastic surgeons and also had an optimal plastic surgeon in my group. I know what it is to do multi-specialty plastic surgery. I managed that I was the sole owner then hired these other doctors to work there with me. And I sold that practice. When I sold it, I moved down to Gulf Shores and I was in solo practice for several years. Then I started adding plastic surgeons on. I have an associate, a partner who is a general comprehensive surgeon. I’ve been a multi-specialty clinic and I practice, and I’ve worked at all. I can tell you there are advantages and disadvantages to all. I honestly will tell you that the happiest days of my life were when I was in solo practice. Because we don’t have a structured that way. We don’t have night weekends. Many doctors when they come out, scrambling to get on the merchant call and have done everything. They want to avoid being on an emergency call. So I don’t have a night and we can work and I like it. We can handle it by myself. I’ve had so much now let me also elaborate on that. The doctor who left and went into his private practice is number 100. I’ve had 100 fellows down through the years. And in addition to managing my practice, and dealing with my colleagues, I’ve also had as many as three fellows at one time. That’s a challenge within itself. Every month six months or every year to have a new fellows come in and have to train down. Get them to buy into your program, buy into your system and be compliant is we mentioned earlier that it’s a lot like a football team. And I learned a lot about management skills from coach Paul Brown Bryant, atmosphere 14 play.

Catherine Maley, MBA:

In case others don’t know you were a big football player many years ago in Alabama.  Go together don’t play

Gaylon McCollough, MD FACS:  

Yeah, I was extremely fortunate. I was at the University of Alabama at a good time when coach Brown was in his heyday. Joe Namath was my quarterback. But several other big town sports figures were on my team, our teammates and Andre Perkins who go to New York Giants and Alabama and Jackson Cheryl was coached at Pittsburgh and Washington State, and then Texas A&M. Most of those guys went on and made great British themselves. I had the opportunity to go play professional football and difficult decision, I passed on that opportunity and went straight to get a degree.

Catherine Maley, MBA:

Did you always want to be a surgeon?

Gaylon McCollough, MD FACS:  

Yes, I did. Even as a child, love doing things with my hands, I put together model airplanes and model different things here. I’ve built an entire bridge four feet, long out of toothpicks on this as a science project I enjoy. I did paint by the numbers type things and I’ve always enjoyed working with my hands and trying to be creative and came close to becoming an architect. Because of football, I was recruited by several colleges, including Alabama, Auburn, Florida State, Georgia Tech, Clemson and I had the opportunity to go into architecture. My father had been in the construction business, he was a plumber, and I’ve worked on construction jobs. The only guy ever saw him on the on the job was a tie and a white shirt on. He was the architect and I was in a pitch for 60 days. I looked up and I said that’s the guy. I permitted to become an architect and coach Brown came along and I told him, he said, I’d like you to come to Alabama and play football for me. I said, well, coach, I’m honored. But I’ve already committed to going to Georgia Tech. And he said, Well, that’s not a bad idea. You’re in a lot of ballgames. You’re going to get educated and reached over on his finger, he pulled off rain and it rained, ever want to wear one of those. I went to Alabama and went into medicine the second choice I got marine and getting a pre-med degree.

Catherine Maley, MBA:

Nice. The business structure the one that I think works the best, because I’ve been to a lot of practices most don’t work, because egos clash. But the one I think that works the best is when there are tight boundaries, you do neck up, the other guy does neck down. What do you think, especially today’s What?

Gaylon McCollough, MD FACS:

I can tell you I understand both sides of it. I never intended to do anything from it. During my training or my fellowship, I trained with part of my fellowship a comprehensive plastic surgeon, Richard Western. I was trained to do breast surgery, I was trained to do tummy tucks and some of those other procedures. But I never intended, I always knew I was going to be neck up or shoulders up. It’s difficult to recruit a plastic surgeon today to come into your practice and you say, okay, everything above the shoulders you find and everything below the shoulders and your belt. A lot of them may come for a while, but it’s not going to be an active practice. Many other plastic surgeons want to do facial work as well and if you try to exclude them, it won’t be a long-lasting relationship, in my experience. You have to let them develop their practice from their body proceed. When a patient calls and they want to make a consultation, if it’s something from their up, that comes to me, if it’s something from the neck down, that goes to them, but during the process when they become their doctor if a patient wants to have an eyelid surgery, or a facelift or another facial procedure they can have that patient on their skin. They can, I don’t restrict them. But the only restriction is in the initial consultation period, but many of them build successful facial practice as well. If you tried to include a comprehensive plastic surgeon from going above the shoulders, but sooner or later that what happens.

Catherine Maley, MBA:

That makes sense. I should have clarified that for the newcomers to the practice when they don’t know who they want. It would have been that but yes, that surgeon to keep that patient, you know, for a lifetime. Give me a business mistake, one or two mistakes that you’ve made. I’m sure you’ve read a few along the 46 years that the others can learn from, there’s no need to make the same mistake again if you don’t have to.

Gaylon McCollough, MD FACS:

Okay, I can answer. It’s along the lines of what we talked about. I’ve made some mistakes because I’ve hired a couple of people I took a chance on some other surgeons and I made a mistake because I found out and not being a team player, many of them were greedy and wanting to come in and be successful quickly. And I had some that did some illicit and illegal things. I had to invite them out of the practice quickly. That’s the thing I would say to you that perhaps we need to vet our potential partners a bit better than we doctors tend to do. Vet them in every way possible. And that is, their military records, if they have a military record, their financial records, do a real investigation before you get married to someone professionally, and become a partner. I’ve made some mistakes along those lines and I regret them, I learned from them. But I would regret it. Another mistake that I made is I thought at age 52  I could retire and when I sold the big operation in Birmingham, I was going to ease into retirement because I’ve never done anything work, but work selling peanuts on my hometown streets. When I was six years old, I had to paper outs of oil, and I worked my way through to work my way through med school, work my way through my residency, as well. I thought I’ll ease into retirement. I moved down here and after six months, I was miserable. One of the mistakes I made was thinking that I could retire, not financial, I was fit financially, but I was not fulfilled. And I played a lot of golf during that period, I read a lot of books with a lot of matinees with my wife and spent a lot of time walking around Walmart. After about six months, I was miserable and I tried to go back and try the Bible. To unwind the deal and take it back and they wanted more money for it. I would say the mistake that I made was I thought I could retire sooner. And at this point, everybody asked me every day, because I’ve got some gray hairs, when are you going to retire? And my answer is when I can’t find a way to work every day. And then I elaborate on that, too, right turns out of my driveway, it takes me a minute and a half to get from my house was planning to start getting lost on the way to work. It’s time for me to hang up. I’m fulfilled…

Catherine Maley, MBA:

Yeah.

Gaylon McCollough, MDFACS:  

…I love what I do. And let me elaborate on this, we’ll talk about the business. If there’s anything at all about your practice that you don’t like, Don’t do it and you will enjoy going to work every day and not look at the calendar and say oh, well, here comes a patient with this problem or that problem, I don’t like to do those things, it’s not worth the money. Don’t do the things you don’t like to do, the things you love to do that you’re good at that you do well and spend time focusing on the things that you do well, and then it’s not a job. Then you can practice for as long as you’re confident. That would be one piece of advice I would give not only to the younger surgeons that are out there but anybody who might be up in that 40 or 50 age group and one of the things, I’m getting ahead of myself a bit. But this is something that I’ve written about in some of my books, actually cats, and there are 22 books. One of the things that I say that one of the books I wrote was called The Elite Facial Surgery Practice.

Catherine Maley, MBA:

Oh, I didn’t see that one.

Gaylon McCollough, MDFACS:  

It is published by a team and it came out about two years ago. It lays out all the things that I used to use in my practice and still use today. Anybody that would like to know more about me or my style, pick the book up and read it. And I don’t think I’ve gotten a single dime yet enjoy this. I don’t write books to try to make money. It’s because I feel obligated to share. I forget where I was going before I got off.

Catherine Maley, MBA:

Do what you like.

Gaylon McCollough,  MD FACS:

And if you are considering retirement, retire to something and not away from something. Make sure that if you’re going to retire from your practice, that you’re retired and doing something that you’re going to feel fulfilled at the end of the day and the end of the week. It’s not going to be you can play enough on golf or do enough fishing or rotten boats or whatever. If you’ve spent most of your life becoming skilled at doing this profession, scale downscale back to as much as you too, and you can have a long-lasting career.

Catherine Maley, MBA:

Well, I think the surgeons where they start using it is the unhappy patients and they start feeling the, it’s difficult to get patients than the ones I get are a hassle. They’re not happy and it becomes a spiral downward. And on top of that, a lot of surgeons still like to have a second office, they call it like the feeder office. And they’re commuting, like, you make me look at that and think you’re making this too complicated. I would go quality rather than quantity. I don’t like to make decisions based on desperation. That’s what happens. They’ve got overhead to pay for and that’s why they’re taking the patients that they know darn well. It’s not good, it’s a crapshoot, they don’t have a good connection with them and they hope it all works out.  What would you say to that?

Gaylon McCollough, MD FACS:

Nothing stuck at the office was probably the biggest mistake of a lot of people. And during the transition period, when I was transitioning from Birmingham to Gulf Shores, I was going back and forth. I’d be a week down here in a week up there. I found out that when I get back to Birmingham is the first two-three days putting out fires among the other doctors in the group, because of some of the professional jealousies and things that you mentioned earlier. The time that you spend going back and forth and then trying to manage two different offices in that time, where you are. And I think it’s the highest and best use of your time. I’m not a fan of satellite offices. I’ve even done that, I had consultations all along the Gulf Coast, I had seven consultation centers, all the way from Panama City, Florida to Biloxi, Mississippi at one time, and had a person stationed there to answer questions and give out literature, scheduled consults, and that sort of thing. And that worked well but it got to be over overwhelming for me. And I found out if I would spend my time right here in my little nest. And those are the things that we need to do and send them to patients that in the long run, you cut your overhead way back and improved the quality of your lifestyle.

Catherine Maley, MBA:

I agree. Let’s talk about marketing because it’s changed much from the days. I want to put this in context because this is also marketing. Your fellow that you’ve trained was Dr. Paul Nassif who’s on Fox…

Gaylon McCollough, MD FACS:

I do both full interviews with me. But blacker fool I didn’t take took another outstanding person. And but I know Paul ever since the interview with me.

Catherine Maley, MBA:

I saw him interview you for your latest book. And I thought he said he was trained by you.

Gaylon McCollough, MD FACS:

Not by me, he never trained with me. We’ve been dear friends and we always get together meetings to talk about things have a great relationship, but you’re not wishing I could take credit for trying to call because he’s extremely well-known today. He’s been good for our feet. Many people might or may not realize Paul Mastic was good for facial because people become aware of some of the problems. Yet he gives the patients hope, though he gives hope to those patients that have been distraught and don’t think there’s anything that can be done for them. And that’s a great service. It would be nice to have someone you could refer a patient to and let me pick up on that a bit to Catherine because I think this is important. This is something that I did early on. I’m glad I did. When I went back to practice, I was a young guy. People would come in and ask me to do all kinds of things. I probably wasn’t ready to do though, for example, revision route. But it takes years to learn to revision route. When a patient would come in with a difficult nose, I would send them to my mentor jack hands. And tell them this is the doctor who I think is best qualified to treat your condition and they would get a good result. Then Jack would send those people back to me and I would follow them. I end up doing Facebook Lives and other things on them. Then I could do the other revision on Rhinoplasty but I think sometimes doctors make a mistake because they want to do these procedures, perhaps financially or ego-wise, and we may not be ready to do them. Sometimes the best thing that you can do is to get the patient into the hands of the person best qualified to solve their problems. And if you do that, you’re stock is going to go up in the face time, and they’ll come back to you for you don’t lose the patient. I found that to be true. And it was a practice that I followed carefully until several years into my practice, and it served me well.

Catherine Maley, MBA:

Do you find that the patients are a lot different in today’s world? Obviously, with social media and the internet, you can Google anything you want. But how has that affected your consultation with people?

Gaylon McCollough, MD FACS:

I asked them what sources they’ve been to for their information and some of them will bring copies of internet articles that they’ve read, and they quote back and forth about things they saw. And I listen to them carefully. And I tell them, every doctor has a little different way of doing nice, and I use samples that people can relate to. Let’s say, for example, you have a bit of a dish, let’s say, chicken parmesan, okay. If you ask pinchos to prepare chicken parmesan, chances are it would be a little different from membership. And then I say, I have my recipe, and I understand what’s out there, but I have a way of doing it, that type of thing. It has worked for me, in my recipes worked for me. And I know that you have this other information but I want you to follow my plan. If you do that, it puts an end to all the things but the patients come in. I won’t necessarily say that they’re better informed, but they have a lot more information. Unfortunately, a lot of the information they have is not valid information. We all have to spend a lot of time trying to explain why some of the things that patients are reading about and see don’t work, and that we don’t recommend. So the patients know a lot more than they used to. And it’s difficult from that stand on but I think the main thing, and I’m going to answer your question because this is one of the first things that I tell the fellows when they come in training on day one, on the first consultation that we are going in to see. I asked the fellows out, what do you think we’re going in there for? And they know more and eventually, they come up with well to schedule surgery and I say the wrong answer. We’re going in there to evaluate this patient, but also the specialist on evaluating me. And the objective here is to see if we want both of us to enter into a long-term professional relationship. And if you’ve developed that relationship, if you develop trust, if that patient trusts you at the end of that consultation, then they’re generally going to do what you recommend that they do. If they don’t trust you, they’re not going to do and they’re probably going to go somewhere else. And the other thing is that once you win the patient’s trust, never valid. Never do anything, never lie to patients, never tell the patient you did something you didn’t do, or vice versa. You make a mistake, if you got a problem pointed out first, say okay, we’ve got a little issue right here, this area is not feeling quite as well as it needs to, we’re going to, we’re going to stay on top of this, and we’re going to get this field up. And if we need to do a little touch-up stuff down the road, we can do that, go ahead, go ahead and address the problem, the worst thing you can do, and I’ve had patients come in and say, look at my nose, it is crooked after Dr. Jones will operate on I went back and instead, watch my nose perfect. He said I don’t see anything wrong with it. If you do that one or two things patient knows even your line or your bladder so you lose the patient’s trust. I know I’m rambling on some of these things. But these are lessons that I think that maybe the people who are tuned in to this, write those things down, they’ll serve you well.

Catherine Maley, MBA:

Well, and there’s another point that I have hung my hat on for the last 21 years. That is the lifetime value of a plastic surgery patient. And I find that most surgeons want surgical patients, they want new patients period. And I say, gosh, there’s an easier way to do this if you would look at the patient as a lifetime patient, rather than as a one-time hit. I know you believe that because that’s why you have created an atmosphere for that patient to return, again and again, no matter where they’re on the ladder of facial rejuvenation. Can you speak to that? 

Gaylon McCollough, MD FACS:

It dovetails into what I said about establishing that patient long-term patient relationship doctor-patient relationship. I have I’ve been in practice with you said no more than 47 years. And I have patients that I did Rhinoplasties on when they were teenagers, she stopped praying on one last week, did Rhinoplasty on her when she was a teenager and I’ve done food facelift and a facelift and a taco bar system. And I still use paper charts. Some of my charts are Volume One and Volume Two. I can tell you that once you get that patient into your practice, don’t ever let them go. Keep them there and that’s just found money. You don’t have to do any additional marketing because they’ll do the marketing for you and they’ll come back once you build up this backlog. I would say that in a week, probably 25% of the patients operated on, every week of patients I’ve operated on previously that are coming back to happen, new procedures…

Catherine Maley, MBA:

Then what about the…

Gaylon McCullough, MD FACS:

…you have the time that you have to invest in evaluating the patient and getting another patient that’s already been invested. Keep them there that don’t chase after the new patient. Man, am I eating man, the fields and the patients that you’ve already got is what I’m trying to say, spend a little extra time maintaining that relationship. And we’ll come back to the state.

Catherine Maley, MBA:

…how many of those patients came from word of mouth from your other patient?

Gaylon McCullough, MD FACS:

Probably half.

Catherine Maley, MBA:

Why nobody. I feel like I’m fighting a losing battle on that. Because I love patient retention that’s where your leverage is and I don’t think anybody wants to hear that. They want to hear the internet guy says okay to 10 new surgeries a week. And no they won’t, they won’t. They’ll say it. They say they will but I don’t believe that in today’s world, it’s too competitive. That patient isn’t going to see you if it’s Google, they’re going to see you and three others. They’re going to show up with all the quotes and they’re going to negotiate. I think that’s a tough way to run a practice. Especially…

Gaylon McCollough, MD FACS:

It’s not a smart way, it is a tough way. Patient retention is something every doctor has the ability to do.

Catherine Maley, MBA:

Then, why don’t they?

Gaylon McCullough, MD FACS:

It might require more time and treating them differently. I know I’m elaborating. Well, thanks. But when I look at my schedule, and I’m seeing my patients in the morning, something I learned from one of my mentors, Jackson. And we saw this planet faces in the morning, operating afternoon. And I love that schedule. It’s what I’ve done ever since I’ve been in practice, I’m looking at my schedule every day. And if I see 12 or 14, post-up patients a day along with a couple of consults, that’s a busy morning for me because I spend a fair amount of time with each one. And I like to look at that sheet and say, Gosh, get on [Inaudible]. My best friends in here today, I can’t wait to see this one and this one and this and this. And if you get to a point where you say, Oh my God, I Miss So and So coming in today or Mr. So and So is coming in today, you missed on the front end, you probably shouldn’t have operated on that patient in the first place, if you dread seeing them come back. And once you do that you get to know about their family and their children and their grandchildren and their hobbies and everything. And it makes that postdoc visits pleasant. And if you have a little problem, and you tell them, you know this is going to be okay, that little luck will go away, that will smooth out they don’t believe you if you’ve never lied to them before. And it makes it easier. You’re not in a defensive mode, because you already have long-term relationships.

Catherine Maley, MBA:

So what’s the marketing strategy? Because I have to get tactical here. Have your marketing strategy is clever that people don’t notice it probably. And you’re doing it innately. So you’re involved in the medical societies involved in your community, philanthropic, all of that, and books. All of that leads to PR. More eyes on you, you know more presence online and I don’t know if you do that on purpose as a marketing strategy. But if you were to pick one that works well for you, in today’s world, what’s attracting patients to you today?

Gaylon McCollough, MD FACS:

Well, I think that as a physician, we’re somewhat of a mystery to the public at large. And they like to know about us, and they’d like to be around us a bit and pick our brains. If you live in a community, you should be community-minded. My wife and I had always been community-minded in Birmingham, we were, you know, lots of boards of directors and charitable events. And we opened up our home and our office to terrible events to try to raise money for good causes. You get to meet much people, your name gets out there, and people can put a face with a name. It’s one thing to hear about Dr. Smith and from 10 different people. But if you could walk up to Dr. Smith at an outing or a meeting, and Dr. Smith was nice to you and kind to you, and you put that name with that face. There’s an attraction there. I don’t think that you can be out into the community too much. I don’t mean flaunting anything, and I don’t mean a lot of fanfare, but genuine community support and being involved in worthwhile causes is important, and try to be a community leader. My wife and I have done that and both of those at the city level and state-county level. One of the things is to be visible, and be nice to everybody because you never know you honestly know knows if you happen to be a shark to a waiter or waitress, and somebody is sitting at the next table and see you be rude to them or not kind to them, they’ve been watching you all along. It’s going to give you a negative [Inaudible]. Realize that when you’re out there, you’re on stage. You’ve got to be at your best and be kind and considerate walking down the hallway, at, at the hospital. If somebody is mopping the floor, say good morning to them, or say goodie for them, they’re working to and be kind to everybody from the top to the bottom. I’ve built my practice out of you. I was there for a year and my practice was built out of that hospital because I was tried to be nice, polite, and kind to everybody, from people mopping the floor to the people delivering the food, because the nurses on the floor, the elevator operators, but when we had, you can’t be too as long as genuine. I don’t mean to be a phony, but be out there and be visible, be kind and be nice to people and they will come back to you many times over.

Catherine Maley, MBA:

I can vouch for that for you. Because I’ve been going to conferences for 21 years, I’ve seen you many times in the hallways and upfront and close and you haven’t been anything but gracious and kind to everybody you’ve encountered. It’s amazing and it’s genuine, you can tell that some people are not kind, but they’re trying to fake it or at least trying. But you can tell with you. It’s genuine and it’s nice. That must be your Southern upbringing or something.

Gaylon McCollough, MD FACS:

Well, these maybe some advantages to them. Most people wouldn’t agree but I wouldn’t take anything for my upbringing, I came from a lower-middle-class family, I guess you talk you say that because my dad was a plumber. We all work hard. We appreciate what we had, I had a wonderful opportunity to go to college on a football scholarship. And that opened the world to me.

Catherine Maley, MBA:

You have a fashion sense, like you had mentioned your dad was a plumber, but somehow you love the suit and tie. You are a snappy dresser is your wife doing there? Is that you?

Gaylon McCollough, MD FACS:

Will my wife buy similar clothes and the ones I buy she goes, why? But I do think I was talking about the image a little while ago. And in some of the lectures that I get both medical environments. I talked about that first impression when Aristotle was the first to say that a pleasing appearance is more important than any letter of introduction. That is way back. What Aristotle was saying is that when you walk in the room, or somebody walks in the room to see you, the first impression is important, you can make a good impression and build upon it. If you make a negative impression, it is possible to overcome it. But why overcome it? Why not make a good first impression or front and a list of things. Number one is the way we sit the way we stand the way we carry our account. That’s important. Number two is our way, whether we look fit, or we look unfit and unkempt. Because it says something about your discipline, your self-discipline, and whether you can look after other people as well. Then the way one wears their hair and other women with makeup. Clothes don’t have to be expensive, but they need to fit well. And they need to be well-coordinated. And then moves on down the ladder and it gets to the smile I call it the million-dollar smile, you know, you can go anywhere in the world. You might not speak the language but if you smile at someone, chances are you’re going to get a smile back and you’ve communicated and that pays big dividends and then way down on the bottom of the list is plastered. These are all things up above that you can decide to do right then I’m going to do this and it won’t cost me anything else. I’m going to pay attention to the way I look and the way I act and how I carry myself. Those are extremely important things and will pay big dividends.

Catherine Maley, MBA:

I want to tell you a story. Many years ago, it had to be more than 15 years ago, we were at a conference your wife was sitting next to you. I being ignorant, said to the guy I was talking to another surgeon. I said, Oh, so cliché, but what is that wife, number two or three? That’s what I said. And he said, Oh, no, that is it…

Gaylon McCullough, MD FACS:

Two or three?

Catherine Maley, MBA:

…Yes. That is the deal there. That’s one wife many, many decades and I thought shame on me. Number one, she looked fantastic. And my next question was, who did the work because she looks fantastic. Can I ask you? She was beautiful and I felt I should apologize to you because it wasn’t snotty it was cliché. Who did her work was that you?

Gaylon McCollough,  MD FACS:

I did.

Catherine Maley, MBA:

Oh my God.

Gaylon McCollough,  MD FACS:

She would tell she’s she speaks openly about it. And a lot of doctors have problems operating [Inaudible]

Catherine Maley, MBA:

That’s what I thought you weren’t supposed to. But I thought is she a good marketing strategy for you. Because the minute I saw her, I thought OMG, that is how you can look with good surgery. I knew she didn’t even know she had surgery. But I knew she was the first and she must have had surgery because it was fantastic.

Gaylon McCollough,  MD FACS:

She was a beautiful young woman to start with. She was Miss Alabama, of course, you had Alabama, what became the Miss Universe. But I never pushed her one bit. She came to me and said, Okay, it’s fine. But I have a bit of that and I said if you’re ready, if you want to have it. And then you maintain that. And that’s the key, you start relatively early when you start seeing problems and work along the way. That will never show you can address or be maintaining your knees but thank you and I’ll tell her you said that. But she’s beautiful inside as on the outside.

Catherine Maley, MBA:

I see you can hear her kindness coming from her. Just, you’re a lovely couple. So let’s talk about…

Gaylon McCollough,  MD FACS:

 55 years, we’ve been there.

Catherine Maley, MBA:

How many?

Gaylon McCullough, MD FACS:

55 years?

Catherine Maley, MBA:

Oh, my gosh, I don’t talk to family members that long. Yeah, good for you, that’s almost a miracle at this point in life. Looking back at your life, give me a couple of accomplishments that you’re truly proud of.

Gaylon McCollough,  MD FACS:

Having trained 100 fellows is right up there at the top of the list. When I was a fellow myself, I said I want to be a teacher, I want to have my fellowship at some point. That was a goal that was an objective. And got up close at the end of the 90s. When I said okay, I want to get to 100 at least. And we’ve had a number 100 and I got 101 coming in July and I enjoy it. It’s as much of a pleasure, is responsibility that as a pleasure? You know, there’s a verse in the Bible, in  Luke that says when too much is given much is required. I was given a lot. I was allowed to go into the offices of Jack Anderson and Water Berman and Beverly Hills and Richard Webster in Boston. These men opened up their offices to me, and they taught me what I know. They taught me not how to cut and sew, but they taught me the business aspect and I had an opportunity to see different ways of doing things. I was able to pick and I feel obligated to pass that along. I’ve done that in the book Elite Of Facial Surgery Practice. That’s the reason I write Catherine, this reason I’ve written as many books as I have is that because I  want to pass along with things that I’ve experienced. Playing under coach Brown was a real advantage. Here was one of the most successful coaches and people often ask him what the secret to his success…

Catherine Maley, MBA:

What is it?

Gaylin McCullough MD FACS:

…and I got to know the coach from a completely different standpoint, and I never would have told anybody but he did. I did a facelift on him about two, three years for he passed away. That was probably his great honor as you can imagine. I operated on two of my mentors. When they come to you and ask you to do surgery on them, it’s a great honor. And I got to know coach Bryant for that better than you don’t ever get to know your coach when you play for him. And somebody asked him a Decatur at a television show and Decatur ask him right late in life, he said, Coach Oh, what is the secret to your success? And I’ve heard people ask him that question many, many times and he looked them in the eye and he said they want to find the most curious feeling to you. But on that day, you rest back and I’m sitting there and said, he going to tell, he’s going to tell it today he’s going to tell and he did. And here’s what he said. He said, If I’ve had any success in life is because I’ve surrounded myself good people. I never hire anybody that can’t do something I can’t do. And he said, I no longer coach players, I coach coaches, and they do the teaching, of blocking and tackling. But I know how to teach coaches and the other thing was, I thought about it a lot. I was in Alabama during the segregation transition and he wanted to integrate the Alabama football program before the officials at the university would allow him to do. He was willing to change, he would change with the times his coaching style change with the times he put in different offices, different times, he used different recruiting tactics as the kids got different and use different coaching tactics. That’s one of the stories or the lessons that I took away from him is that I’ve been at this a long time myself, and we change we stay with the basic, but we do alter things and do things a different way, when we think they need to be upgraded, done a bit for what.

Catherine Maley, MBA:

How important is leadership in today’s world for your run a successful practice?

Gaylon McCollough,  MD FACS:

But I think it’s key and for number one, if your staff does not respect you, they won’t work for you or they may tolerate you, but they won’t work for you. They won’t do those extra things. There’s a way that you can lead people and discipline people without embarrassing them. Never embarrass a staff member in front of another staff member or in front of the patient, the lead artist stay with you,  they want to enjoy. You have to treat your people better than anybody else who’s going to treat them, you have to make it so that they look forward to come into work. And we joke about it here in my practice that if somebody starts saying ‘thank God, it’s Friday’, then they don’t need to be there on Thursday and I always joke and I said, ‘Oh, thank God, it’s Monday’. Because if you don’t enjoy what you’re doing, do something else. You can lead in different ways. Number one, you lead by example. They don’t protocols, we’ve got all of our protocols laid out and developed them all then we all go over them get input from the staff. And we all agree that this is what we need to do. And you need to involve the staff in some of those decisions. But you need to make sure you’re the decision maker. I would say this too, from some of the other people stay involved in the business aspect of the practice. I don’t care who you got some businessman to lead them, directly down. I sign every check that goes out of my brain, I don’t delegate the ability to sign checks to anybody else. And that’s what checks and balances. Stay up at the top whoever writing those checks, know you’re going to sign up. You’re going to look at them, you’re going to question some of them that you’re not sure about. It keeps people accountable.

Catherine Maley, MBA:

Last question. Do you have any regrets?

Gaylon McCollough,  MD FACS:

A few. I live a few patients slip by with body dysmorphia?

Catherine Maley, MBA:

How do you know so difficult to know?

Gaylon McCollough,  MD FACS:

Well, the food standard, evaluate people. But I learned a couple of those slip by and then once they get into your practice, you can never make them happy. Because they’re never met, even surgery that and I’ve told some of them this I said you know your result is one that I would love to take to my next meeting and show 300 of my colleagues out there. This is the result that team and but they’re unhappy, they can always find something wrong with it. Those are the kinds of things you do look at your schedule and say, Oh my goodness, how did I let that happen? If you’re not sure, to my colleagues, if you’re not sure whether that patient is psychologically stable, ask for help. Send them to a counselor or a psychologist or psychiatrist or clearance you owe that to yourself and in many cases, you owe it to your patient to make sure that they are emotionally and physically okay to undergo the surgery because if not they will be miserable. They will make you miss along with those, that’s probably the biggest regret that I paid.

Catherine Maley, MBA:

A lot of surgeons said most famous, especially the ones that got sued, and they said, I had a gut feeling something was off, but I’m good at what I do. I thought I could handle it and of course, I regret. Iut once you’re in the middle of it, what do you do? Do you write a check and then go away?

Gaylon McCullough, MD FACS:

No, you can let them go.

Catherine Maley, MBA:

What do you do?

Gaylon McCollough,  MD FACS:

You have to bring them in, you have to let them air out, consult them by time and by time, by time and they’ll sometimes they’ll go away, they’ll stay gone for six months to a year. Then within one week, you’ll get 20 emails from but you’re bound to them. That’s eaten, those are the patients that are easy to get to say, I don’t want to see, or you can have them away. When you do that, then they get angrier. And they can create problems for you. Whenever we have a patient with a problem, and if you operate long enough, you’re going to have some problems with seeing those patients more often than we say to patients who are doing great sliding through, somebody gets a little infection, somebody gets a scar here and there, bring them back love on it, stick a needle and at every chance, you get if they’re concerned about a little lump or a bump, take a little needle with some dilute steroid in it injected, don’t send them out and say that that’ll be okay. Because when they get home, somebody is going to say what the doctor did? And if the answer was he told me, he’s going to be okay, that’s not going to be enough. He stuck a needle in there, he gave me a free or something.

Catherine Maley, MBA:

I completely agree with do something.

Gaylon McCollough,  MD FACS:

[Inaudible] practice in medicine sometimes is as critical as more than the spine.

Catherine Maley, MBA:

Right? It’s gotten emotional and it would probably help to have a psychology degree along with your medical degree as well.

Gaylon McCollough,  MD FACS:

Jack Anderson used to say that what we do is psychological surgery.

Catherine Maley, MBA:

For sure.

Gaylon McCollough,  MD FACS:

One of the things I do when I’m interviewing potential fellows. I say, do you take a rotation on psychiatry, minimum was the idea that’s the head you liked it. I didn’t like that mistake, you don’t need to be in this field, you don’t need to be if you don’t get some pleasure out of helping people over their psychological issues in their life galaxies, then you don’t need to be in this field. I’ll tell you some of my greatest successes I look back on, not been the greatest operations I did, or the best combination, but that I helped a patient get their lives back. That’s where your team comes in. Your whole team can support those people and we embrace them and try to build them up to proceed, we take patients that are well and you bring them in and operate on bruised or swollen. You’ve got to hold their hands and get them through this and inject into suspense almost like you have a little affair with these patients. You bring them in and you love on them, like the mother, you push him out of the nest. I’ll share one of the things because I’m old, with my gray hair I’m a big project. And Jackson, when they get the idea you might be coming on to them, the first thing you need to do is you need to keep the business where the business needs to go.

Catherine Maley, MBA:

For sure. Any last parting pearls of wisdom before we go?

Gaylon McCollough,  MD FACS:

Shadow No, we’ve covered the bases. I probably didn’t get into some of the details and specifics on it. But the philosophy people talk about the plus is what you think about, but once you do is more important than that. And I would say this to any of my colleagues out there, and I’ve referred to it earlier. If you’re not happy doing what you’re doing, where you’re doing it, do something else. You don’t need to be miserable when you go to work. I’m going to venture into problems or territories I should. You’re not happy when you go home, do something else because life is short and you deserve to enjoy and leaves the world a better place than you have, to whom much is given, much is required. Those of us who can put the MD behind our names, we have a lot to be thankful for. And we should spend every day trying and make the world a better place. By doing aesthetic surgery, you get to know patients, you can change their life, we don’t necessarily improve the length of a person’s life, but we sure can improve the quality of their lives. We can do that…

Catherine Maley, MBA:

Sure.

Gaylon McCullough, MD FACS:

…then when we breathe our last breath we can say we did was a good one.

Catherine Maley, MBA:

Well, on that note, because you are right. I know a lot of this comes with age, when you’re younger, you’ll tolerate a lot more, you’ll do a lot more, you’ll pay your dues like you were told to. And then as you get older, your heart grows bigger, or maybe not. But you get more aware of what’s right, what’s wrong, and what’s right and wrong for you. Kudos to you. Thank you, you have been an inspiration, at least in my career and many of your fellows have said to me. You have taught them about the business side of surgery. You’ve made a big difference out there in the world. I know you know that already. But I thought it would tell you as well. Thank you.

Gaylon McCollough, MD FACS:

Always a pleasure to be with you, I appreciate this opportunity and I hope that some of the things I said will make life easier for the colleagues who are listening and their patients.

Catherine Maley, MBA:

I’m sure they will. Thank you everybody for joining us at Beauty and the Biz. If you would do me a favor and subscribe to Beauty and the Biz, give us a good review if you feel inclined. Then if you’ve got any questions or feedback, please leave me a message on my website at www.CatherineMaley.com or you can DM me on Instagram at CatherineMaleyMBA.

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