Dr. Susan Stuart - La Jolla Plastic Surgery & Dermatology, CA

Dr. Susan Stuart values education and training to progress and become unique in the field of aesthetics in our interview with the dermatologist.

Dr. Susan Stuart - La Jolla Plastic Surgery & Dermatology, CAName: Dr. Susan Stuart
Clinic: La Jolla Dermatology
Locations: La Jolla and San Diego
Website: https://www.lajollaskin.com/

What can you tell us about your staff and methods to hiring staff?

We have a very close staff who have been with us for many years. We all strive to give all our patients the best care because our staff were carefully chosen and share our mission. We have weekly wrap around meetings where we discuss each upcoming case to make sure all issues are addressed and treatment plans are fully implemented. We have frequent staff meetings where everyone provides input into how we can improve the patient experience. Frequent retreats allow us to create team building and improve morale. We just had a wonderful retreat where the staff enjoyed an afternoon of competitive bowling in a trendy downtown alley...

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The State of Aesthetic IPLs & Lasers

In the last few years there's been an explosion of new IPLs and cosmetic lasers.

While that's generally good for clinics - inducing some competition and pricing/sales pressure - it can be a problem trying to find the right system to invest in.

READ: Cosmetic IPL & Laser Reviews & Comparisons Forums

In 2011, Dermatologist Dr. Goldman wrote a journal article about using what kind of laser should be used for the practice. In the present, there are devices that have multiple modalities and treatment options, you can have a single laser device instead of two or more. These devices are now made convenient for physicians and practitioners.

Lasers are steadily gaining traction in the aesthetic field. Many aesthetic devices have been launched, and various companies continue to upgrade their devices or create breakthroughs. Physicians are able to choose devices, which is suitable for their practice, as there are many ranging from skin rejuvenation to fat melting to even vaginal rejuvenation. At the same time, not everything has been met with praise, as lasers have its downsides for the patients or the physicians or practice itself. Thus, it is best that physicians and practitoners practice laser treatments with care.

Multiple treatments are common in many practices. More and more aesthetic companies are making more integrated systems with multiple modalities. Alma, Sciton, and Cutera are some of the aesthetic laser companies that have begun or launched a multiple modality device for one’s practice. No studies have been made about the efficacy of using multi-modality systems, but the technology is promising.

Having multiple modalities could mean multiple or combination treatment options. Effectiveness has been proven in several studies. Prior to multiple modality in a single device, physicians have been combining treatments.

Findings:

  • In a dermatologic setting, treatment of non-melamona skin cancer with laser and photodynamic therapy was proven successful and effective. Er:YAG and ALA-PDT had the most efficacy rate with 98.97%
  • Goldberg, 2012 suggests that IPL is better at removing hair considering it will be done with multiple sessions
  • As for skin rejuvenation, an alternative to fillers would be repeated Erbium:YAG laser mini-peels (El-Domyati et al., 2013), leaving patients with an average of 88% satisfaction rate after the treatment.

Lasers remain to have some controversy over lawsuits filed by patients and complications brought about by its usage. One common issue faced by practices is negligence or mishandling by a non-physician administering the laser procedure. Several state laws allow non-physician practitioners, so long as the doctor is present in the practice. However, unhappy patients experieince some adverse side effects possibly due to poor handling and patient screening.

Training is important to avoid any of this concerns to rise and be the cause of lawsuits. According to E. Victor Ross, dermatologist, vigilance is key when administering laser treatment.

In 2016, a study was published by Dr. Gary Chuang, noting that fumes were present in a laser hair removal system. There are 13 carcinogenic compounds present in the laser hair removal plume. It is a cause for alarm as it could affect the respiratory systems of those performing the procedure and those receiving it. The researchers suggest that better ventilation systems and protection would help prevent any further issues.

Aside from this finding, Laser Service Solutions provides us with a list of common issues with laser devices. Technical issues like LCD screens and circuit boards should not be taken lightly. Other problems include: water issues, calibration, and handpieces.

It is expected that despite issues and problems, aesthetic laser procedures will still rise according to several market research reports.

REFERENCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390232/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376014/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632833/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100114/
http://dermatologytimes.modernmedicine.com/dermatology-times/news/laser-fundamentals?page=0%2C1
http://jamanetwork.com/journals/jamadermatology/article-abstract/2532614
https://www.laserservicesolutions.com/most-common-aesthetic-laser-issues/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390232/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376014/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632833/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100114/http://dermatologytimes.modernmedicine.com/dermatology-times/news/laser-fundamentals?page=0%2C1http://jamanetwork.com/journals/jamadermatology/article-abstract/2532614https://www.laserservicesolutions.com/most-common-aesthetic-laser-issues/

Dr. Michael Law - Michael Law MD and Blue Water Spa, NC

Dr. Michael Law shares about his experience in aesthetic medicine, and how he runs his clinics with wife Kile in our interview with the Plastic Surgeon.

Dr. Michael Law - Michael Law MD and Blue Water Spa, NC

Name: Michael Law MD
Clinics: Michael Law MD/Aesthetic Plastic Surgery and Blue Water Spa
Location: Raleigh, North Carolina
Website: www.bluewaterspa.com, www.michaellawmd.com

Brief Bio:

Michael Law MD is a plastic surgeon certified by the American Board of Plastic Surgery. He received his M.D. degree at Emory University, where he graduated magna cum laude, second in his class of over 100 graduating physicians, and was inducted into Alpha Omega Alpha. He elected to pursue a rigorous ten-year training program that includes general surgery residency at the University of California Los Angeles (UCLA), plastic surgery residency at the University of Southern California (USC), and a plastic surgery fellowship at USC. His ten years of formal training following medical school amount to twice that of some plastic surgeons.

How did you get started with plastic surgery?

I knew I wanted to be a surgeon since childhood. I elected to become a plastic surgeon for several reasons: for the creativity required for practice of reconstructive surgery, for the procedural and anatomic variety of surgeries performed, and perhaps most of all for the opportunity to be artistic in my life’s work.

I practiced plastic surgery in Beverly Hills for several years after completing my surgical residency and fellowship. While there, I started working with aestheticians. I realized early in my practice that good skin care was a great compliment to aesthetic plastic surgery. When I made the decision to move to...

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Dr Preema Vig - Dr Preema London Clinic, London

Dr. Preema Vig, London based Physician recounts her journey to aesthetic medicine and shares her experiences in managing her own practice in our interview with her.

Name: Dr. Preema Vig
Clinic: Dr Preema London Clinic
Location: Devonshire Place, London
Website: http://drpreema.com/

Brief Bio:

Dr Preema Vig is an Advanced Aesthetic Doctor and former General Practitioner specialising in Non-Surgical Facial Rejuvenation. Her accolades in the industry include being featured in Tatler’s Finest, Tatler Beauty & Cosmetic Surgery Guide 2014 as well as Conde Nast’s Brides Cosmetic Beauty Guide 2016. As a result of such high profile exposure, Dr Preema is in demand with a wide-ranging clientele including models and professional athletes, to TV personalities and actors. Her private practice, Dr Preema London Clinic, at 35 Devonshire Place, London, is a mecca for those seeking the very best in non-surgical aesthetics.

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Why You Should Review Injecting Techniques

Injectables are one of the many popular non-cosmetic procedures. Around 45% of the aesthetic/cosmetic procedures done in 2015 in the US was injectable procedures. It ranks high as an alternative to cosmetic surgery, and it is expected to rise in the coming years. These procedures have received praise by many patients. However, there is a constant need for reminder on injecting dermal fillers and botulinum toxin on patients. It is all in the [method of] injection, declares all practitioners. Additionally, some studies and researchers have emphasized the importance of administering procedures.

Some patients have reported that they have issues with fillers, which have caused adverse side effects like disfiguration of the face and vision loss. These side effects should serve as reminders to practitioners.

In the latest study by Scheuer, Sieber, Pezeshk, Campbell, Gassman, and Rohrich (2017) the authors present how to minimize problems in administering soft tissue filler injections. The authors suggest to inject slowly with small doses. In addition, a serial puncture technique is best in high risk areas. They cover six regions, which are considered danger zones.

Even with experience, physicians and certified injectors could still make mistakes in administering these injections. Thus, physicians must remember these safety concerns and administering of injections.

 Brow and Glabellar Region

  • Digital injection must be applied.
  • The authors recommend that intradermal injections must be done for this area.
  • Blindness and tissue loss are common serious side effects in this region.

Temporal

  • The measures of the danger zones in this area are 2.5 mm lateral and 3.0 mm superior to the peak of the brow (Scheuer, Sieber, Pezeshk, et al., 2017).
  • Deep and superficial injections can be done in this area,
  • The adverse side effect when injecting in this area is blindness.

Infraorbital

  • Practitioners should refrain from injecting deeply
  • Authors suggest to inject laterally and pushed medially
  • Tissue necrosis is an adverse side effect in this region

Lips/Commissure

  • On the commissure, the linear crosshatching method in injecting is safe.
  • Injections done in either lips must be done superficially with around 3mm deep.
  • Tissue necrosis is a serious side effect in these regions.

Nasolabial Fold

  • Intradermal injections can be administered as well injected in the preperiosteal plane.
  • Injections on the deep and superficial subcutaneous and dermal areas in the nasolabial fold are safe
  • On the alar base, only intradermal injections should be administered.

Nose

  • Fillers should be injected deeply and greater than 3mm.
  • As suggested by the authors, any injections done on the tip and dorsum should be in the preperichondrial and preperiosteal planes.
  • Tissue necrosis and visual loss are some of the adverse side effects.

To learn more about the injection techniques, you can watch the video provided by the authors here: http://journals.lww.com/plasreconsurg/Pages/videogallery.aspx?videoId=972&autoPlay=true

New Botulinum Toxin Undergoing Clinic Trials: Daxibotulinumtoxina

More competition might be coming for Botox, Dysport and Xeomin.

Three cosmetic injectables are currently available in the market (Botox, Dysport, and Xeomin). A fourth one is shaping up as the next competitor against the botulinum toxins. Revance Therapeutics Inc. is gearing up to produce the newest in the botulinum toxin market. The daxibotulinumtoxina is the newest to gain interest.

The neurotoxin is currently undergoing trials since early 2016. It claims that it will have a longer effect on the face against those available in the market. A 2011 study have found the effects of daxibotulinumtoxina for injection (RT002), which shows its efficacy and longevity.

How would this affect the three existing neurotoxins?

So far, Botox is the popular choice of neurotoxin, it being the first and proven effective for treatment of glabellar and lateral canthal lines. Xeomin and Dysport treats Cervical Dystonia and the glabellar lines. Many have expressed their concerns with the existing neurotoxins, most specifically with the possible side effects (e.g. ptosis).

Why does it matter?

Revance will include a peptide technology called: TRANSMTS in their (what they claim) a highly purified botulinum toxin to produce a longer-lasting effect. Aside from treating any aesthetic concern, daxibotulinumtoxina will also treat plantar fasciitis--- which is also undergoing study— and cervical dystonia. The neurotoxin will also come in a topical form.

Peptides have been used also for some cosmetics, with some calling it as an alternative to Botox having anti-aging effects for the face. Most studies regarding peptides are focused mostly on cosmetic products (i.e. make-up).

Botox, Dysport, and Xeomin have been met with their own criticisms from patients and physicians. The daxibotulinumtoxina could be a game changer in the market. Trials are underway for the daxibotulinumtoxina. Not much can be said about the trials but so far, the sample has not experienced any serious or adverse effects. According to clinicaltrials.gov, the study for the efficacy of daxibotulinumtoxina will be released on 2018 at the latest.

References:

http://www.revance.com/pdfs/diffusion-and-duration-of-new-type-a.pdf
https://clinicaltrials.gov/ct2/show/NCT03014622?term=DaxibotulinumtoxinA&rank=4
https://clinicaltrials.gov/ct2/show/NCT02973269?term=DaxibotulinumtoxinA&rank=2

Dr. Peter Jenkin - Dermatology Associates of Seattle, WA

With more than 30 years of experience in Dermatology, Dr. Peter Jenkin shares how he got into cosmetic medicine and his approach to staffing and marketing.

Dr. Peter Jenkin - Dermatology Associates of Seattle, WAName: Dr. Peter Jenkin
Clinic: Dermatology Associates of Seattle
Location: Seattle, WA
Website: https://www.daseattle.com

Brief Bio:

Dr. Jenkin completed his dermatology training at McGill University in Montreal in 1980. He was in private practice for 20 years in Canada before moving to Seattle and worked for PacMed and Virginia Mason until he purchased Dermatology Associates in January 2010. Dr. Jenkin is an outdoor enthusiast, loves skiing, hiking and racing cars. When he is not treating patients he can often be found speaking about skin diseases at local seminars or visiting his grandchildren.

How did you first get into cosmetic medicine?

My interest was piqued in cosmetic medicine back in the mid-1980s when I started to use a CO2 laser which was followed in 1987 by the development of the first pulsed dye laser. I was always fascinated by the new advances which extended the range of things we could do to help patients with their cosmetic concerns. That trend has been followed by making those treatments less invasive and safer.

None of these treatments were available when I did my dermatology residency...

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Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Starting out as a Primary Care Physician, Dr. Jenny Weyler branched out to aesthetics, exclusively practicing the field since 2010 in our interview with the Physician.

Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Name: Dr. Jenny Weyler
Clinic: Aponi Aesthetics
Location: Worcester, MA
Website: http://aponiaesthetics.com/

Brief Bio:

I am a Board Certified family practice doctor, who graduated in 1992 from the Medical College of Pennsylvania (now part of Drexel University) in Philadelphia, PA. I completed my family practice residency in 1995 at the University of Massachusetts in Worcester, MA. I practiced as a primary care physician from 1994-2004, and then worked in an Urgent Care clinic from 2004-2010. In 2010 I started taking classes to learn aesthetic injections, and I opened my own business in December 2010. Initially we did some primary care here, but I loved doing aesthetics so much, and that part of the practice grew so quickly that we became exclusively aesthetic providers in 2014 and changed our name to Aponi Aesthetics.

How did Aesthetics interest you and it influence your practice?

When I was doing primary care I always loved doing procedures: stitches, mole removals, biopsies and any minor surgical procedure. Learning aesthetic injections was a great way to incorporate my love of procedures with the excitement of learning a whole new field of medicine. The results are so obvious, amazing and gratifying. People love the results, so the clients are enthusiastic and how could I not love making people look and feel better? As I honed my skills in injections, I started to learn more about lasers and skin care products and we added that to our repertoire as we went along. I have logged well over 100 hours of direct hands-on training in injectables and laser safety and use, as well as many more hours of lectures on the same subjects. Aesthetics is constantly evolving and advancing, and I love...

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Dr. Jennifer Trent - American Dermatology Associates, Florida

With more than 10 years of experience under her belt, Dr. Jennifer Trent practices medicine and writes journal articles and text books in Dermatology, in our interview with the Florida-based Dermatologist.

Dr. Jennifer Trent - American Dermatology Associates, Inc., FloridaName: Dr. Jennifer Trent
Clinic: American Dermatology Associates, Inc.
Location: Sarasota, FL
Website: http://www.americandermatology.net/

Brief Bio:

Jennifer Trent, MD FAAD completed a 6 year combined BS-MD at the University of Miami with an undergraduate major in biology and a minor in chemistry. While in medical school, she interrupted her formal course to participate in a 2 year research fellowship in Dermatology at the University of Miami. The focus of her work was hos-pital care of dermatology patients, toxic epidermal necrolysis, and wound care. Dr. Trent graduated from Medical School with research distinction as well as the Univer-sity of Miami Department of Dermatology’s medical student of the year award.

She completed her internship in internal medicine and her residency in Dermatology and Cutaneous Surgery at the University of Miami/Jackson Memorial Hospital. Dr. Trent has presented her research on toxic epidermal necrolysis and methicillin re-sistance staphylococcus aureus several times at the Society of Investigative Dermatol-ogy and the annual American Academy of Dermatology meetings. She was recipient of the Celia and Samuel Resnik Award for dermatology research from the University of Miami Department of Dermatology and the prestigious Young Investigators award for research from the American Academy of Dermatology for her work on toxic epider-mal necrolysis. Dr. Trent has also received several awards for teaching from the Uni-versity of Miami Department of Dermatology.

At what point in your life did you discover your interest in cosmetic medicine?

Ever since I started medical school, I was also fascinated by the skin. How it exists as this beautiful intermediary between the harsh environment and our delicate bodies. It is a strong but vulnerable gatekeeper. During my residency at the prestigious University of Miami Department of Dermatology, I learned that dermatologists are artists. We can “re-sculpt”...

Dr. Jennifer Trent - American Dermatology Associates, Inc., Florida
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Labiaplasty... Where's The Line Around Genital Cosmetic Surgery

Labiaplasty... Where's The Line Around Genital Cosmetic Surgery

What's going on with the growing trend of labiaplasty and genital surgery?

aesthetic labioplasty

There's been a pretty dramatic increase in genital aesthetics in the last decade. What's up with that? Is it market demand or are aesthetic clinic just getting better at marketing to a deeply personal fear.

In the United States, it's being circulated that a labiaplasty surgeon can earn up to $250,000 a month (which seems unrealisticly high). Simone Weil Davis, professor of American studies, told Shameless magazine in 2005 that surgeons are perpetuating the idea that there is a right way for women's genitalia to look; because most women see only their own vaginas or pornographic images, it is easy to make them doubt themselves, and for cosmetic surgeons to provide an answer.

But not everyone is on the hooha beautification bandwagon...

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Quick Rundown on How Negotiation Can Help You

In recent studies presented by Medscape and Doximity, women earn less than male physicians do. Gender gap remains unaddressed, considering the Equal Pay Act, which had been in place.

Quick Rundown on How Negotiation Can Help YouSince the 1960s.

It is surprising to learn that it has been more than 40 years since the regulation has been enacted, but why are women physicians still earning less?

Even in other professional occupations, women still get the short end of the stick. It’s more difficult for women of color. It is believed that men are predominant in medicine, but times have changed, and more women are getting into the field. The issue remains prevalent, and women physicians may need to learn how to negotiate for themselves.

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Physician Burnout in the Cosmetic Medicine Community

Physicians are under immense pressure, which could lead to exhaustion that may cost their time in the practice but also their patients. In this article, we tackle the causes of burnout in the field of cosmetic medicine.

Physician Burnout in the Cosmetic Medicine Community

It is not uncommon for any working adult to say, “I’m tired, I want to quit”.

Physicians may feel this burden heavier others considering the amount of pressure over a career.

Medscape has done a study on physician burnout and bias last January. Measures of burnout were based on low sense of personal accomplishment, feeling of cynicism, and loss of enthusiasm for work. In cosmetic medicine (i.e. dermatology and plastic surgery), the top reason for burnout is bureaucratic tasks. Other reasons cited were computerization of practice, outcome of the Affordable Care Act, and lower received income.

In an article by dermatologist, Dr. J. Michael Knight, he points out the causes of burnout for aesthetic medicine practitioners (i.e. dermatology and plastic surgery). He further elaborates on the causes also enumerated by Medscape, which contribute to the physical and mental exhaustion of a doctor in cosmetic medicine. Bureaucratic tasks and adoption of telemedicine seem overwhelming to cosmetic practitioners. Time is mostly dedicated to patients, and the growing use of technology in the clinic seems a never-ending race. 

Patients are also a key factor in physician burnout. In cosmetic medicine, old procedures evolve and new procedures are implemented. With the increase of insecurities brought upon by social media and peers, more individuals look to aesthetic practitioners for their source of self-esteem. That demand increases, making it difficult for some physicians to fulfil a patient’s request. That could have a butterfly effect as that one patient could network to more individuals seeking treatment, which could mean less inquiries and walk-ins for new and potential patients. 

As similarly pointed out by the surveyed doctors in Medscape, low income is a cause for physician burnout as well. Some physicians know that costs are piling up, yet are paid less than most. In an example by Knight, they overshadowed by the deals presented by online sites that would entice their patients to purchase cheaper procedures done by non-physicians. Knight adds that it does not help they are working more hours with lesser pay. 

One way to prevent this from happening again is to educate and inform the staff about this occurrence. Acknowledging that physician burnout is important. The fact that other physicians take notice, staff could be made aware of the pressures faced by physicians whether it is medical or practice related. 

Another way is to make time for other activities. It will be difficult considering the demanded number of hours, but it is always recommended to make time for yourself or the activities that you once did which could help take your mind off work. A recommended activity is exercise, as it is one of the best ways to relieve any stress.

Aside from this, Mayo Clinic presented nine strategies to avoid burnout and you could find the resource here: http://www.mayoclinicproceedings.org/article/S0025-6196(16)30508-0/pdf

Article Links:

http://modernaesthetics.com/2016/06/physician-burnout-careers-in-crisis-part-1
http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview
http://www.medscape.com/features/slideshow/lifestyle/2016/dermatology
http://www.medscape.com/features/slideshow/lifestyle/2016/plastic-surgery
https://wire.ama-assn.org/life-career/avoiding-burnout-strategies-senior-physicians
http://catalyst.nejm.org/physician-burnout-endemic-healthcare-respond/
http://medicaleconomics.modernmedicine.com/medical-economics/news/what-price-physician-stress-and-burnout?page=0,0

Patients Do Better With Female Physicians?

Female doctors patients may have lower death and readmission rates. Does that have any relevance to your clinic?

JAMA Internal Medicine published a study about patients favoring women as their doctors. The study is centered on readmission and mortality rate among the elderly. The authors selected random data, in which a third of the physician sample were female. 

For the study, researchers examined hospital readmissions and mortality data for a random sample of traditional Medicare beneficiaries 65 or older who ended up in acute-care hospitals from Jan. 1, 2011, through Dec. 31, 2014. Those data consisted of slightly more than 1.5 million hospitalizations, in which patients were seen by 58,344 physicians. About a third of those physicians were women.

The researchers adjusted the data to account for different characteristics of hospitals and patients, as well as physician characteristics that were not based on sex, such as experience level. These types of adjustments ensure that the study's findings do not simply reflect a situation where male physicians are seeing sicker patients, for instance.

The female physicians tended to be younger––their average age was 42.8 years, compared with 47.8 for men. They also were more likely to have training in osteopathic medicine and to have treated fewer patients.

Findings:

  • Patients treated by women had mortality rates of 11.07%, compared with 11.49% for those seen by men.
  • Readmission rates were 15.02% among those seen by women, compared with 15.57% for male physicians.

Dr. Ashish Jha, co-author of the study, also can’t figure out the discrepancy, raising concern about how men could be thought of not being better practitioners. In addition, he suggests that issues like gender and pay gaps should be further discussed finding the latter unacceptable. 

In the case of cosmetic medicine, a study by Huis In ‘t Veld; Canales; and Furnas, with the latter two being plastic surgeons part of the research as well. The sample consisted of 200 patients, all of which were female. In addition, the study delved in which areas of concern that the patients want to undergo on.

Study findings:

  • Among the sample, 26% chose a female surgeon, and another 12.5% chose the female surgeon (Furnas) in the study
  • Area of concern for those who favored a female surgeon: breast, body, face, and genitalia
  • Generally speaking, gender did not matter so long as the surgeon had a reputation and experience

In another research, a study was published in 2015, modelled from an older study conducted to British patients. The sample consisted of 515 women, with only 500 accomplishing the provided questionnaire. Similar to the above research, gender also did not matter as knowledge and experience were the major factors for choosing surgeons as well. 

Study findings:

  • Among the sample, 190 patients preferred female surgeons.
  • More than half (59%) had no preference to which gender. 

This raises the question as to why patients choose female physicians, which could pose a gender gap issue in practicing physicians. For cosmetic medicine, a reason linked for female patients choosing female doctors is due to the intimate areas of the body. In addition, patients favored female doctors because of more comfort and lesser embarrassment. 

Studies cited:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131538/
https://www.ncbi.nlm.nih.gov/pubmed/27913412
http://www.modernhealthcare.com/article/20161219/NEWS/161219912

Dr. Bertha Baum - Hollywood Dermatology, Florida

Dr. Baum shares how she got into cosmetic dermatology and some management and marketing tips for fellow physicians in our interview.

Dr. Bertha Baum - Hollywood Dermatology, Florida

Name: Dr. Bertha Baum
Clinic: Hollywood Dermatology
Location: Florida 
Website: www.drbaum.com, www.hollywooddermatology.com

Brief Bio:

Dr. Bertha Baum is a Florida based board certified dermatologist & cosmetic surgeon, considered a skin care expert who provides her patients with the most current and advanced treatments for all conditions which affect the skin, hair, and nails. Throughout her career, Dr. Baum has built a reputation as a top cosmetic dermatologist by providing leading-edge treatments, dedicated and personalized patient care, and excellent aesthetic results.

What can you tell us about Hollywood Dermatology?

We do a lot of internal marketing, for example once or twice a month we run an event and a promotion for our loyal or VIP patients. Also we offer our patients the benefits of the Brilliant Distinctions program or the Galderma Aspire rewards. We have done some marketing on local magazines but we truly believe in word of mouth because our patients are satisfied and they send more patients and thats our success. We have Instagram and Facebook and try to be as active as we can promoting new procedures or the latest in skin care products.

Dr. Bertha Baum - Hollywood Dermatology, Florida

We do a lot of Botox, Dysport and some Xeomin; also all the fillers available in the market. Laser can be a big source of profit once the machine is paid because you are able to charge and not pay for the product. Plasma PRP is also another great source of income with excellent results

We still do clinical dermatology in our office so it was a very busy day at the office and I told one MA that was not with me in the rooms at that moment to get blood from a patient for plasma. After 5 minutes I go back into a clinical derm patient it was actually a full body exam and their first visit and I see the patient had a band aid on her arm freshly placed and as soon as I introduced myself she says “wow I’ve been to a lot of Dermatologist and they have never done bloodwork on my first visit, you are very thorough.” I realized that the MA had done in on the wrong patient and explained to the patient there had been a mistake, thank God the patient understood the situation and then told the MA she had gone to the wrong room to get bloodwork for plasma. I’m grateful this was not a big mistake but we definitely learn from...

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8 Rules in Finding Patients (and Saying No!) in 2017

With 2017 coming up, more and new challenges are afoot in managing practice and performing cosmetic procedures. You may encounter new patients who have no idea about cosmetic procedures or get quirky ones who have jumped from one physician to another.

Before all that, here are three things to evaluate in the upcoming year.

Practice ways you can market

Marketing will always stay a crucial factor in getting patients. Whether you are marketing through word-of-mouth or social media (SEO), strengthen that further.

Not getting your desired results? Try a different approach. There are other marketing approaches other than basic marketing in social media. You could mix it up in other social media platforms. Read more about our Marketing Strategies in 2017 here.

Set your current policies and rules

This one deals with mostly updating your current guidelines to staff and patients; this is in dealing with new patients and caring for them. It could act as a refresher to old staff or new information for your new staff as well.

Organize a list

For what, you ask. Everything you do and will do in your practice, and now that you have probably figured out which services you want to keep, it’s best to know which new procedures you could do with existing ones. That includes updating your menu of services.

Promote services that keep your practice alive. Don’t let your old devices collect dust in the corner. Sell them while you still can or probably re-use them.

Considering having your staff undergo training? Enumerate it there. Do not only expand your experience, give them opportunities to make them grow.

Now that you have set-up, what about the new patients that would come in your office come 2017. The holidays are finally over, and they would need a new look over the new year. Some would come with the weirdest requests while others would come in without knowing anything. This is where you come in and educate them about what you offer and how you manage your practice.

Have a sit down with the patient and assess the situation objectively

Allow them to come to your office and listen to them. Ask them where they got the idea to get the new treatment. Once you have heard their story, discuss what options they have or recommend what other alternatives for their desired treatment.

Explain the expected outcomes (for their preference and of your assessment)

Many patients come in the clinic without expecting risk at all; most would think it would only enhance them. As their physician, it’s your responsibility to inform them of everything involved around their favored procedure.

For example, if their desired procedure or treatment is attainable in another way, offer that one instead. Spare no details of the risks and costs involved. This way, your patient knows the effects of undergoing the procedure, rather than leaving you with a bad review. Yikes!

Stand your ground

This comes hand-in-hand with the policies and rules you have prepared, and later we will briefly elaborate on saying no to your patient. Don’t be a pushover to your patient, and approach them as to how you will be performing the procedure without being aggressive either.

Remember to ask about their history

Patients may forget to disclose their past surgeries or physicians they have gone to, and from there you can determine how you could work out your process in treating them.

Get insight from past patients

Learn from your past and apply it in your present. You might think that this one patient was similar to someone you have encountered before, tell a background about how some patients reacted to the treatment.

Saying no can be a daunting task. Most aim to please their patients, which could be a factor to getting good reviews, but not all procedures and treatments are plausible or doable, as they pose risks to your patient and to your practice. In order to avoid that, politely apologize to avoid any misunderstanding from the patient; the prospective patient may not appreciate your initial turning down. Thus, elaborate why you will not perform the procedure, and how risky and costly it could be.

In doing so (and saying no), remember three things in mind.

Empathize first

Many patients would undergo a procedure just to enhance a specific area of concern, and this could be a valid reason. Some others would do it for other people, and not for themselves. Let them know that surgery would not be the immediate answer to their concerns. Instead, offer them an alternative.

Offer other options

Their procedure may not be attainable, offer alternatives as to how to achieve similar results or that would greatly benefit them. Another scenario is after you have assessed them, and recommend the treatment that would suit them best.

Stay firm

In the case where the patient is insistent on getting their wanted procedure, assert and assure that the options you laid out would be the safest. Emphasize how the treatment won’t be achievable. Remind them as a physician all you want to offer your patient is better care and services.