Male Speaker 1: Welcome to today’s episode of True to Form with your Host, President and Co-Founder of Crystal Clear, highly regarded speaker and two time Inc. 500 entrepreneur, Tim Sawyer. True to Form is a podcast that highlights leaders making headway in the aesthetic, anti-aging, and elective medical industries. Learn from the experts to discover the secrets to success and the pitfalls to avoid when it comes to growing your aesthetic revenue with the authentic, the transparent Tim Sawyer.
Tim Sawyer: Hello and welcome to the True to Form podcast that connects you to the people technology and hot topics that shape the elective community, brought to you by Crystal Clear Digital Marketing and I’m your host, Tim Sawyer. To our returning guests, we say welcome back and for our first time listeners, we appreciate you joining us and encourage you to become a subscriber. In our last episode, we spoke with Dr. Daniel Lehman and his Marketing Manager Ruby Leon about the importance of leadership and teamwork to create an award winning culture inside your practice. I know we’ll be speaking with both of them again soon and if you missed it, we encourage you to check it out.
And so with that said, it is my pleasure, my honor to introduce today’s guest, Dr. Mary Hurley and wait till you hear her biography. Dr. Mary Hurley is the President and Owner of North Dallas Dermatology Associates, a gorgeous building, gorgeous practice I visited myself. She is a board certified dermatologist and graduate of Vanderbilt University, with a Bachelors of Arts cum laude, she attended Tulane University Medical School, and was selected in her junior year to the Alpha Omega Alpha Honor Society. In 1997 she completed her internship in Internal Medicine at Northwestern University Memorial Hospital in Chicago, Illinois; and then came to Dallas for residency training in Dermatology at the University of Texas Southwestern Medical Center.
During residency, Dr. Hurley served as Chief Dermatology Resident at Parkland Memorial Hospital in Dallas. There she conducted clinical research on the efficacy of chemical peels for the treatment of melasma, a skin condition characterized by brown facial pigmentation that is particularly common among darker skin types and pregnant women, also known as [indiscernible] [00:02:15] or the mask of pregnancy. Dr. Hurley’s research on the subject is published in the Archives of Dermatology.
Dr. Hurley has served as clinical instructor at Children’s Medical Center of Dallas. She has been selected as one of the best doctors in Dallas by D magazine for 15 years. She served five years on the board of the Texas Dermatology Society and one year as Vice President. She has also served at Dallas Fort Worth Dermatologic Society for two years as Vice President from 2005 to 2007 and one year as President in 2008. As of July 2015, Dr. Hurley became part of the Speakers Bureau of Kybella, a very popular treatment. With that all said and as impressive as that possibly could be, we’d like to welcome you Dr. Hurley to the program.
Dr. Hurley: Hi Tim, great. Thank you so much. What an incredible introduction. It’s my pleasure to be here.
Tim Sawyer: Well, we’re happy to have you. And so like I said, we want to have some fun today, we want to let people get to know you a little bit better. You and I have had the opportunity, the pleasure of speaking about the incredible practice that you’ve created. But one of the questions I always love to ask is, what was it that happened, and at what point in your life did you say, “Hey, you know what, I want to be a world class x.”
Dr. Hurley: Well, I knew from an early age that I always wanted to be a doctor, and I don’t really know why. I had no immediate family members in medicine. But I do feel I had a calling ever since I was a young girl and I always knew I wanted to be a doctor. So I just hoped that I got into medical school as I really did not have a backup plan. And growing up and at that time it was in the ‘80s, so you might not remember this, but step aerobics was really a big thing at the time, so my backup plan if I didn’t get into medical school was to be an aerobics instructor. And so fortunately, I got into medical school and it all worked out. And people often will ask how I ended up in Dermatology, and it’s kind of serendipitous, but I was actually planning to be a neurosurgeon and was looking for an easy elective, my fourth year of residency so I could fill out my application.
So I selected Dermatology because there was no call. And it was, again the beginning of my fourth year and I had my path planned out and I wanted to do Neurosurgery. And I took this rotation and I fell in love with the field of Dermatology and the patients were happy for the most part and the doctors were happy. And what I liked about it, it’s very procedure oriented. And as I like to say you never know what’s behind door number three. So for example, you could have one patient with acne, you could have the next patient with lupus, the next patient with skin cancer, the next patient something cosmetic, and you treat young patients and older patients and so there’s a wide variety. And I love my job and I love what I do and it’s never a boring day. So I did-.
Tim Sawyer: So let me ask you this as a follower because I want to ask you a thought question because I’ve seen the practice and you’ve got this gorgeous building, and you’ve got lots of providers and you know, you’re truly a top 5% dermatology practice; was there any one event or person who kind of influenced you to not only want to be a dermatologist, but to be an amazing dermatologist, the top 5% dermatologist? Where did that come from?
Dr. Hurley: So my stepdad who was retired Army Colonel always taught me to follow my dream and to never give up. And I can definitively say that I would not be here and have the practice that I have, had he not given me the confidence to believe in myself and know that I could get into medical school even though I really didn’t know if I could, and know that I could get through it and follow my dream. And he always told me that keep your eye on the sky and look up, not down, and walk the middle of the road and you can do whatever you dream to do.
Tim Sawyer: Wow. There you go. So was there ever a time, obviously to become a dermatologist it’s not an overnight thing, right? It’s a process that takes many years, was there ever a time that you questioned the road and said, “I don’t know, am I doing the right thing?” Or were you just head down, driving the hallway.
Dr. Hurley: I don’t think I ever had any doubt or reservation; no. Like I said, I knew I wanted to be a doctor early on. I didn’t know in what arena or field of medicine, and I was one of those medical students who every rotation, liked that rotation, thought I was going to do that one. And then toward the middle of medical school when you have to start thinking about which path you want to go down with and what residency you want to pursue, I loved studying the brain and neuroscience and was planning to be a neurosurgeon. And like I said, and then I fell in love with dermatology, and I could say I probably would not have five kids if I were a neurosurgeon.
Tim Sawyer: [Laughter] So how is that, I’m glad you brought that — I know how hard you work and I know what an amazing practice you have. Is there any advice that you have, particularly for a young dermatologist balancing that, you know that work-life balance, managing a family of five kids and having an amazing practice? How do you do that?
Dr. Hurley: Wow, well work-life balance. What does that mean? [Laughter] [Indiscernible] [0:08:06]. What they say, just when you think you are in balance, you are in balance, you are in balance, right? There are not enough hours in the day. And it is a delicate dance between being able — I have three jobs. So I run the practice. There are eight doctors, and we have three estheticians, and about 50 employees. And then I’m a provider, so I see about 40-45 patients a day. And then yes, I’m a mom of five kids. And that’s the hardest job of all, and to be able to make them feel accessible to the mom, and yes, that’s the [crosstalk] [00:08:54].
Tim Sawyer: It’s pretty impressive, I’ll tell you what, it’s pretty impressive-.
Dr. Hurley: Thank you-.
Tim Sawyer: And for those younger listeners, who you know, think — I don’t want to use the phrase can’t have it all, but you know, because there are tradeoffs clearly. You know, you’re dialed in and you make it work, right? So you can do it. I always say if you can dream it, you can do it.
Dr. Hurley: If you can dream it, you can do it. It’s a lot of hard work, and work sometimes doesn’t sleep, and neither do I. But you do what you go to do to get it done.
Tim Sawyer: Right. And-.
Dr. Hurley: But I love what I do and I think not many people can say that in medicine anymore, like I love my job. I love driving to work every day, I love pulling in the parking lot, and I really enjoy what I do.
Tim Sawyer: That’s amazing-.
Dr. Hurley: I love my craft and I love treating patients and it’s fun. I never want it to be boring.
Tim Sawyer: So clearly you’ve demonstrated that if you can dream it, you can do it. And that’s what leads me to my next question because when we visited Dallas I was so grateful for that. You have this ambition inside you, where you talk about wanting to be the best dermatology practice in North Dallas and the surrounding communities, and you want to provide a world class patient experience. If you can kind of share with our listeners in your mind’s eye, what does it mean to be the best dermatologist and what does a world class patient experience feel like too you.
Dr. Hurly: Well, that’s a difficult question. But I think being a great dermatologist and doctor in general is being a good listener. And I think what is important is to listen to what patients are asking for in their treatment goals, in my case their skin care goals. And if you listen carefully, patients are usually very specific in what they are trying to achieve. And sometimes they come in and they ask for it. They know what they want. But sometimes they don’t really know what it is to ask for. They don’t know what questions to ask. But if you listen very carefully you’ll be able to dissect it out.
And so I think being a good doctor is like being a detective. And you have to put all the pieces together to make the puzzle fit. And so it’s the physician’s job to carefully guide patients along their health journey. And so I think as their provider- and so there’s more to listening or somebody who thinks they want to be a doctor or who is a doctor, don’t take that job lightly. You are their healer and your patients come to you and they are seeking your professional advice, and so it is your job to take the time and listen and give them your best medical opinion and not to rush them out the door. And I think that is a big job and one not to be taken lightly. And so [crosstalk] [0:12:10]-.
Tim Sawyer: And requires some patience. I think that’s the hardest thing right? It’s to find [inaudible] [0:12:14]-.
Dr. Hurly: Some patience, right, literally.
Tim Sawyer: That’s the hardest thing-?
Dr. Hurly: I think it is.
Tim sawyer: So how — think about this. So, obviously the world we live in, change is evolving rapidly. And if you had to kind of pick a few things that have changed in — particularly in the way that you care for patients in dermatology, over the past five or ten years. Talk a little bit about that.
Dr. Hurly: So my care philosophy I think it’s probably the same, which as I mentioned is to be, try to be a good listener. My area of expertise is on Cosmetic Dermatology. So my approach is to get patients a very natural look where they look refreshed, they look a few years younger. They look like they’ve had a great night sleep but not look like they’ve had anything done. And that’s how I built my practice. But my practice has definitely changed and evolved over time and I am now seeing a larger percentage of patients. I’m actually treating the complications from other providers. So there is a spa where people are doing Botox on the corner — people who are not physicians or they went to the weekend course to learn Botox or Laser. And cosmetic medicine is serious business. And again we have a lot of doctors and providers and people that are not doctors doing it, dentists and any specialty you name.
So what I recommend to my patients to be savvy consumers is not only do you want to find a really good provider who is highly skilled in doing the treatment and highly knowledgeable on facial anatomy, but you also want to find someone who is also knowledgeable at how to treat any potential adverse effects. So there are probably a lot of people who can inject Botox and fillers, but I think finding somebody who can do it very, very well. But again you want to find somebody who can treat the adverse effects. So if I had any [crosstalk] [0:14:22] all the bad Botox and bad filler and one eye up and one eye down, and lumpy filler and burns from lasers. So somehow these patients have come to find me and that’s how I built my practice over the last ten years or so. And I will say it’s much harder to correct somebody else’s work than in getting it right the first time.
Tim Sawyer: Yeah, I can imagine. And is it, I feel like because the landscape has changed, and you know, it’s relative, I wouldn’t say easy but there is not a lot of barriers to entry in terms of somebody grabbing a needle and doing injections right? And I think it feels like to me that could be confusing for the consumer. And, you know, particularly when-.
Dr. Hurly: It is.
Tim Sawyer: Yeah. And so how do you deal with that-?
Dr. Hurly: It is confusing and [crosstalk] [0:15:13]. Well a lot of times they’re looking for the best price. And I tend to try and educate them and to be a savvy consumer — one of my expressions is, “You don’t want to be in the group on special when it comes to your face.” And so if you’re looking at Botox and it’s really, really cheap there is probably a reason why. Botox is a commodity now. But-
Tim Sawyer: Good point.
Dr. Hurly: Again you want to find — I think Botox is one of the hardest things to do, to get it done right and to where it looks natural and to not look frozen. And every face is different and it is not a point-and-shoot. And I use Botox all over the face. I think it works great in the right hands. It’s very precise. I have another expression, “There are very few sure things in life, three of which are Botox, death, and taxes. Botox gives very precise and predictable results in my hands. And again I think it gets amazing results when done correctly. But if done incorrectly, you can — like spots or have a droop or [indiscernible] [0:16:29]. And you probably notice that it’s also one of the most [indiscernible] [0:16:32] toxins on demand.
Tim Sawyer: And so one of the things people talk about now, I was listening to something today, people talk about combination therapies, right. So in other words, to get perfect results they combine two or three different treatments. Do you have your own favorite protocol that you like for combination therapies or-?
Dr. Hurly: All of it, everything and all of it. So I like all of it. And I do like to combine tools. So yes, I have a much broader augmentarium than I did years ago. And again every face is different and so you need a variety of tools to get the outcome that you’re looking for. So I use Botox, I use a variety of different fillers. I use them all at the same time if need be. There is filler for — different fillers for fine lines, for deeper folds. I use Sculptra to help draw out collagen, I use Kybella to help melt fats away on the chin. Some of the treatments are off label. So, you know, they’re not specifically FDA approved for that. But yes, combination approach in my opinion is the way to go if need be.
Tim Sawyer: Got it. And are you still using many lasers in the practice? Is that part of your mix of your bag of tricks?
Dr. Hurly: Yes. And there is all kinds of different lasers that you can do for skin health and rejuvenate the skin and taking care of brown spots or acne scars. We have all kinds of tricks.
Tim Sawyer: I get. Now is there, without mentioning any brand names, unless you want to, so because what I think the question that I get a lot, particularly folks starting new practices is, you get overwhelmed with marketing from the laser manufactures; some are amazing, some less. Is there a kind of a vetting process, you know in two minutes or so that you can, you know, say one of the things you want to look for in making a decision to buy a laser?
Dr. Hurly: It’s a big decision. Some of these lasers are like buying a house. So I think you need to pick one — and I would not purchase a laser on day one. I would hone in on your skill set and your patient base and get some patients in door, because just because you have a laser sitting there doesn’t mean that patients show up. And then see what you have a need for and a demand for. And if you have a need for a vascular laser and you have a list – I always have a list of like 40 to 50 patients before I purchase a laser so that when the laser shows up that I can use [crosstalk] [0:19:25]-.
Tim Sawyer: That’s by the way a very good advice – to have a built in demand before you go out and spend all the money then try to create the demand.
Dr. Hurly: Exactly. And a lot of the lasers now have a multipurpose you can get — like for example for the facial and there is a hair removal and maybe some skin tightening, all in one box. But a laser is a big investment and it’s serious medicine as well. And back to the combination approach, one of the things I think is fun is doing, we call it a liquid facelift. So it’s a nonsurgical facelift using combination of Botox, filler, Kybella. And it can be — a lot of times it can be done all at one time to allow and maximum bang for your buck. Or it can be done slowly over time, like kind of baby steps. Nobody knows you have anything done. And so there are all kinds of new things. There’s always something new in dermatology. And that’s another thing I love about my field; it is a constant changing area. Again, you just never get bored. You can study — every day there’s a new lotion or potion or laser or a new injectable and there’s just always something new.
Tim Sawyer: [Indiscernible] [0:20:42], right-?
Dr. Hurly: Yes. And that’s the point. It’s confusing for the patient like which one and which filler and that’s where they need to trust their physician or their provider that they are going to help guide them down their skincare journey and not spend a lot of unnecessary money on something that’s not going to be a benefit for them.
Tim Sawyer: Right. Let me ask you this — because this — one of the things that I find most impressive about you, and that’s why I was excited to do this was, you seem to have some business activists, where does that come from?
Dr. Hurly: I don’t know anything about business. It’s been on-the-job training. I think that they should teach business in medical school. And I’ve been saying that for a long time. Again, it’s been on-the-job training. I wish I had some business background. My practice has grown as you know about me. So I had no grand plan. It was not — it was just a little candy shop and that was my plan. I was just going to hang a little shingle and have my little candy shop. And slowly over the years we have grown and added a second provider and then yet another one. And now we have eight doctors, and like I said, three estheticians and 50 employees and have about 17,000 square feet of space. And so I’ve had to learn as we grow.
Tim Sawyer: Well, I could tell you’ve done a great job. I’m super impressed. And so I got to ask you this one question that I want to get to start winding down with some of the questions to what you see coming. So I was in a practice in Beverly Hills this week talking to the patient coordinator and they said, “Managing expectations is so important.” And, this was interesting to me. He said, “The two times we get in trouble is when-” and this speaks to your approach about a natural look, is the patient, you know, gets their treatments done. A month later someone says, you know, “Oh no, I don’t notice you look any different,” after that they say, yeah, they got something done.
So when they say you don’t look any different, the person gets frustrated. Or the person says, without soliciting, “How do I look?” Says, ”Oh, I noticed you’ve got a treatment done.” And the person freaks out about that. And it seems like it’s tough on both sides of that spectrum. So it seems like managing patient expectations must be a huge part of that equation. And I’d be curious to hear, you know, quickly how you approach managing expectations. I know you get world-class results, but managing expectations and are you using before and after to kind of show the patient, “Hey, you know, this is where we started. This is where we are at.” And what’s that process like for you?
Dr. Hurly: It takes a lot of time that I think it’s really important, and you nailed it on the head. If somebody comes in and they need a facelift and you think that you can promise them miracles, they are going to be sadly disappointed and they’re not going to be happy. So I think spending time with them, explaining what you think are realistic outcomes so that they clearly understand it. Before and after photos are important, educating your staff to not oversell a laser or the treatment or the procedure. So for example, with laser, let’s just say acne scars, I tell them, “All of your scars will not be gone. They will not look 100% back to normal skin.”
So you’ve heard the phraseology undersell and overdeliver. You are happy with the outcome and pleasantly surprised; same thing with the brown spots. You know, all of your brown spots will not be gone. You will need future touch-ups for maintenance. So again, help them understand and it’s important to train your staff that way-.
Tim Sawyer: That’s tricky. It sounds — seems like that’ll be tricky.
Dr. Hurly: Yeah. It is tricky. Establishing rapport with the patient which takes time as well. And I think go with your gut. If you ever get a sense that I’m just not going to make this person happy or there’s not anything, no amount of Botox in the world that I can do that’s going to make this person feel beautiful. It’s okay to say no. So if I don’t think that I-
Tim Sawyer: I think that is a great philosophy, and people struggle with that.
Dr. Hurly: Yes. If I don’t think I can significantly impact the patient’s care with my hands, then I refer them on to somebody who I think can. So back to your point; yes, it’s very important to set realistic expectations-
Tim Sawyer: And so now that we’ve talked about the past, let’s talk about the future. What do you see as kind of the big changes coming down the road in cosmetic dermatology? I know you said — or really any type of dermatology. Is there any-?
Dr. Hurly: [Inaudible] [0:25:36]. Yeah, there’s always something new. There’s a new train coming down the track. So I love that about my field. I think that there will probably be a true nonsurgical facelift and/or neck lift without having to go under the knife. And one of the procedures I’m currently spending a lot of time studying, it’s using threads. And so there’s a variety of different types of threads, they’re sutures that absorb into the skin and it’s about as good as we can get without going under the knife. And so we can get a nonsurgical brow lift, we can get lifting along the jaw line or the neck, the marionette lines, we can get smoothing of lines under the eyes and compression of fat pad. So that’s one of the areas that I’ve been focusing on and I’m really excited about it, and it’s amazing how significant of results you can get for somebody who either is not ready for a facelift or wants to buy time till they need it and/or want it.
Tim Sawyer: That’s a game changer when you think about it, right?
Dr. Hurly: That’s a game changer.
Tim Sawyer: That’s a game changer.
Dr. Hurly: Yeah.
Tim Sawyer: Are you doing that now? Do you do threads now?
Dr. Hurly: Yes.
Tim Sawyer: Yeah-
Dr. Hurly: And it takes — I think it’s something again that takes time to get that feel under your belt.
Tim Sawyer: Yeah. It’s a lot of training-.
Dr. Hurly: It’s a game changer. It’s exciting.
Tim Sawyer: It’s all exciting. What do you mean? I can’t — by the way, I don’t think there’s enough Kybella in the world, but you and I met, I got to do something under my chin. So the next time I’m in North Dallas, we got to hang out a little bit. You got to think of a combination therapy that can work miracles and manage my expectations all at the same time.
Dr. Hurly: Okay. We can do that. I think we can come up with something for you.
Tim Sawyer: We’ll come up with something. And so lastly, you’ve been at this for a fair amount of time and like I said, you know, we meet with a lot and we work with hundreds if not thousands of providers. And you’re in that top 5% if not 1% on many levels. Are there any lessons that you — some wisdom that you would like to share with our listeners and say, “Hey, you know, couple of things you want to think about from the past,” you know, or going forward that you would want to share?
Dr. Hurly: And so would this be to other providers?
Tim Sawyer: To other providers or anybody. You’ve learned a lot and I think everyone listening to this program would love to benefit from some of your wisdom.
Dr. Hurly: Well, so my thoughts would be to be open. Be open to exploring new and/or different aspects of medicine. So, as your field of medicine would likely change over time, so for example, what you learn in residency is probably not what you’re going to be practicing 20 years later. For today, you can stay abreast. But if that works for anything in life, I think to be open-minded and to be present, I practice yoga and meditation, and I try and incorporate that into my busy lifestyle. And so, not to say that I don’t get stressed, but I try and minimize the brain damage, and I think having that helps keep me centered and try and stay grounded. It doesn’t always work that way, but that’s my goal. And so again, to be open and to stay centered and to try and stay present.
Tim Sawyer: I think that’s great advice. So what’s coming up for North Dallas Dermatology? What are you excited about in the next six months to a year, and also are you going to be visiting any shows? Where could people find you? Are you speaking anytime soon or let us know where we can find you.
Dr. Hurly: Let’s see. Where will you find me next? I will be in Chicago at ASDS in the fall. And that is my favorite meeting of the year, it’s American Dermatologic Surgery meeting, and there’s always something new like I mentioned. And as far as what’s on the horizon for the practice, I think we will continue to grow. I wish I had a crystal ball. I have always tried to stay abreast of new technology, and so I think we will continue to offer like new lasers, new technology as time develops. And stay current on trends and continue to try to offer the latest and greatest that is backed by science.
So I am a big believer, if not this with the laser rep the same. And then there’s a joke and I hope nobody takes offense to this, but how do you know that the laser rep is lying? His lips are moving. So just because they come in and say that their laser is the latest and greatest and it’s going to cure all your wrinkles, do your research. And, you know, I like to see science and I like to see studies. But I think we will continue to offer a full comprehensive array of dermatologic services for all ages-.
Tim Sawyer: And keep a foot in traditional dermatology, right? You still love that?
Dr. Hurly: Yes. So we have a comprehensive array of surgical, medical, cosmetic, pediatric, we treat all ages; the full array of services.
Tim Sawyer: Well listen, I don’t think, you know, in the — you’ve done a great job and I’ll be the first one to say, congratulations on what you’ve accomplished in a, comparatively speaking, a relatively short period of time. And I can’t say his name, but full disclosure, one of my best friends is your patients, you know that he loves you. And so I have firsthand knowledge that the practice is amazing and we obviously really appreciate you taking the time today. And where would if — in terms of your website, where could somebody find you on the website? It’s in North Dallas. What’s the website again?
Dr. Hurly: Website is northdallasderm.com our Instagram is the same northdallasderm. Facebook is North Dallas Dermatology Associates. And if anybody has any specific questions, they can email us at email@example.com.
Tim Sawyer: Well, and I — by the way, guys, I encourage you, if you have a question, if you’re going to be at the show in Chicago, stop by, tell Dr. Hurly how much you appreciate hearing her. I’m super grateful and I wanted just a quick shout out to Kim for working on the logistics with us. We really appreciate you having us, and I only have one favor to ask.
Dr. Hurly: What’s that?
Tim Sawyer: Six months from now, you come back and do this again.
Dr. Hurly: Deal.
Tim Sawyer: We got a deal.
Dr. Hurly: We got a deal-.
Tim Sawyer: All right. We really appreciate you taking the time, Dr. Hurly. I know you’re super busy and you want to get home to those kids, so have a wonderful night and we appreciate you taking the time. Thank you.
Dr. Hurly: It’s my pleasure, thank you Tim. We’ll talk soon.
For convenient listening on the go, feel free to subscribe to True to Form on your favorite music apps!