patient education Archives

“For a long time everything was behind doors, and everybody questioned what really is going on there. I think that also made the whole subject of plastic surgery give people anxiety, because they didn’t know what to expect.”

Marc McKee asked me on This Is My Journey why a Mayo-trained surgeon would show people what happens in an operating room. That’s how I started.

2014

“Around 2014 a few surgeons started doing some social media. A lot of them were criticized. My wife was really behind me, telling me, hey, you should really put yourself out there and start sharing your results, I think people would really like it. I was apprehensive, because that’s the way you were trained, to keep it kind of behind the curtain.”

The criticism was real. So was my training. My wife was right anyway.

“But I went ahead and started showing the surgeries, the before and afters, what patients were saying, how they were recovering.”

It started on Snapchat as RealDrWorldWide. Haute Living wrote about it in a spotlight this month and put the following past 3.5 million. This post is about the consult, though.

What It Did to the Consult

“What it became is a way of educating patients even before they saw me. They got to know me, they got to see my results, they got to see how everything is very consistent, how we treat patients. I think it took the fear factor away.”

Before:

“Before, I would have a consultation with a patient in front of me and they were so anxious and worried, and I was giving them all this information, and I think it just went in one side and came out the other. At the end of the consultation they were more confused than before.”

After:

“Now they come in and they know what’s going on. They’re telling me what they want. I start explaining and they’re like, yeah, yeah, I know, I know. It’s a lot more comfortable, and I think they are better for it.”

The Other Thing It Fixed

“That’s the toughest part of my job, telling patients that’s not possible. Realistic expectations. We have to set that from the beginning, otherwise nobody’s going to be happy. I’m not going to be happy, the patient’s not going to be happy, it’s going to be a sad story. Thankfully, with social media and the way we’ve been educating patients, less behind the curtain, patients are having a lot more realistic expectations.”

“Some patients bring wish photos and you have to coach them. You have to tell them, this patient you’re showing me is 20 years old, you’re 40. Or this patient’s BMI is 20 and you’re still at 30. You look much better than you did before, but we can’t compare apples to oranges.”

I didn’t see that one coming.

The Part Nobody Warns You About

Show the work and you get judged on the work, in public, every day. Haute Living called that out. I think it’s the best quality control I have.

“I would stay away from anybody that has one or two or three amazing before and afters and that’s it. You want to see a surgeon that’s posting before and afters every day, and they’re all consistent, and they’re all getting good results. They’re not going to all be home runs, because it depends how the patient comes in.”

#StayBeautiful

Marc asked about the t-shirt.

“This is one of the slogans we came up with early on. Everybody’s beautiful when they come in. We’re helping you become the best version of yourself, and we’re working as a team to get there, but it doesn’t mean that if you don’t have plastic surgery you’re not beautiful. There are certain things that make each person beautiful, and it’s not always the physical. The other slogan we say a lot is happy is beautiful. If you’re happy, you’re beautiful.”

“The reason I started doing this social media was to educate patients. Education and knowledge is power, and it gives you more options as you go through life and this journey.”

The loose skin and GLP-1 part of the episode is in the earlier post. The camera’s been on since 2014.

Call (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com. #StayBeautiful

Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

A reader asked whether they could use AI to get more out of a doctor visit. I am going to give the answer I actually gave, because the polite version is less useful.

“Your reader is actually right, and that’s making a lot of doctors uncomfortable. With AI, you have unlimited time and patience, and there are no interruptions. The limitation, and the benefit, is that AI can fill in the gaps during the doctor visit, but it cannot fill in what the doctor can actually do or prescribe or treat.”

Unlimited time and patience. No doctor has that, and pretending otherwise helps nobody.

What it is genuinely good at

“I feel AI is a great tool for preparation for a doctor’s visit, and it’s even a good tool to summarize and review the information afterward. It’s generally good at explaining and simplifying medical information and complicated words. It’s really good at gathering information and putting it in a timeline, which can be very helpful when you’re describing your problems to the doctor. It’s also great at putting together questions you may want to ask during the visit.”

The questions are the part I would not skip.

“This is where most patients stumble. Once the visit is over and the doctor says, ‘Do you have any questions before stepping out?’, a lot of patients blank out, and having something written down definitely helps. Doctors actually like it when patients have questions ready. Sometimes patients feel like they have to make up a question when they don’t have one.”

The hard limit

“I would never trust it with anything that requires a physical exam. AI has now been trained to recognize photos and evaluate lesions, but it cannot touch and feel the way we do when we perform a physical exam, to evaluate hernias or rectus diastasis, masses or lumps in the body or breast, skin laxity, and quality of skin.”

Skin quality is the one I would point at. Two people can photograph identically and have completely different tissue under the hand, and that difference is what decides the operation. It is the whole reason a tummy tuck plan cannot be made from a picture, and the same hand exam is what routes someone toward a MedSpa treatment instead.

“It’s also not good at predicting results, especially in cosmetic or plastic surgery, where a patient may upload a photo and ask for the postoperative result, which may or may not be a good expectation or even a possible one. This is where the surgeon’s experience and assessment of each patient’s anatomy and tissues comes in.”

The part that should worry you

“It’s really difficult to recognize hallucinations or wrong information, because AI always feels like an authority, all-knowing. I’ve had experiences where I’m researching a topic and AI comes up with completely false references to support what it’s saying. So this is really the difficult part, and the one where the doctor can come in and rectify and explain what is actually happening, or what’s actually in the literature. So many times when I’m researching a topic, after I receive an answer I’ll ask for references, and then I’ll go look for the source to see if it exists, and read about it to make sure it’s factual. Sometimes, if the information seems strange, I’ll ask again in another question, and a lot of times it will recognize that it made a mistake and rectify it.”

That is my actual habit, and I would recommend it to anyone. Ask for the references. Then go find them. It is the same standard I hold myself to when I write about a procedure here.

“And one of the most dangerous answers AI can give is false reassurance, that you shouldn’t be worried, that it’s really nothing, when in fact it may be, and only a doctor can make that determination.”

Of everything here, that is the sentence I would want people to keep.

Supplement, not replacement

“I don’t think AI would realistically replace office visits. The main factor is the physical exam, which is absent. A lot of times there’s no check of the vitals either, unless a patient has a way to measure these and upload them at the same time. I think it’s a supplement to medical care.”

“Patients worry that if they research too much and come into the office with information, it seems like they know more than the doctor, and that it may undermine the doctor-patient relationship. But as doctors, we’re up to date on the most recent technologies, and we’re aware that patients are using AI, so most of us are very open to it. I’ve always said that an educated patient is a better patient. I’m a proponent of educating patients, and the use of AI is a way to educate yourself more efficiently than going to the library and reading a bunch of books and articles.”

Privacy, plainly

“In terms of privacy, you have to assume that none of your information is private. The AI programs I use in the office are all HIPAA compliant, and we have a business agreement with each of them that protects the patient’s information. This is not the case with most chatbots and AI tools available to the public. You should really keep your name, date of birth, Social Security number, address, and anything identifiable out of it, because you have to assume the companies are using these to train their AIs and may also be sharing it, and it could end up in their own hands.”

When to close the laptop

“What I would skip discussing with a chatbot is anything that seems like an emergency. An unstable patient, chest pain, difficulty breathing, severe headache, facial droop, a new breast lump, a mole that’s changing, fever, spreading redness. If you believe you might have to go to urgent care or the emergency room, or you’re really worried about something, those are all signs that you need to go to the hospital or a doctor as soon as possible.”

Two prompts

Before a visit: “I am having the following symptoms, and I have a doctor’s visit. Can you give me five questions I should ask my doctor about?”

After a visit: “My doctor diagnosed me with [blank], recommended the following tests, and started me on the following medications. Can you explain this to me, and what questions should I ask at the next visit?”

The takeaway

Prepare with it. Review with it. Keep your identifiers out of it. Demand references and then verify they exist. Never accept reassurance from it. And anything that has to be touched, felt, or measured stays in the exam room, which is where every body contouring decision is actually made.

I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and I teach plastic surgery as a Clinical Associate Professor at Texas Tech University Health Sciences Center.

Ready to Talk?

Come in with your list. If you want a straight answer about what actually applies to you, let’s talk. Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation.