Clinical (and Life) Tips for Dermatologists

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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of The Dermatologist or HMP Global, their employees, and affiliates. 

Life Hacks 
It seems like many of us can get stuck in a rut and forget our purpose; not only what it took to achieve our goals, but what it will take moving forward. The following are some life hacks to help you focus on your purpose while getting in better shape mentally, physically, and financially. 

• Exercise every day. This is not just cardio, weights, or stretching—you need a plan. Consider hiring a personal trainer and getting a walking desk or desk bike. I purchased a desk bike for home and work, and I routinely do my computer work now while moving my legs on the bike, sometimes for hours at a time. My staff members also ride the bike in the office while doing their work. 

• Take vacation. You must get out of the office. It will make you a better doctor—you will be more diverse and have something to talk about. 

• Get out of your comfort zone. Challenge yourself with something new: Read a book or listen to a podcast you would not normally listen to. 

• Ask for advice. Find someone who has been there and done that and save yourself some of the heartache they went through to achieve their goals. 

• Check your billing. We just transitioned to in-house billing and have been blown away by what was missed or dismissed when we were not doing the work ourselves. 

• Get the services and use the products you sell in your office. Not only are you practicing what you preach, but you will be better able to relate to your patients what it is like to have a procedure done or to use a product. 

• Be kind. It is a rough world out there; if you have a choice, choose kindness over being mean. We started the Las Vegas Dermatology Foundation and used our funds as a school scholarship for an applicant interested in a career in dermatology. We also plan to sponsor medical students and offer treatments for those with skin disease who cannot afford them. 

• Remember that you actually are a bad ass. Dermatology is the most competitive residency there is. The sacrifices you made and dedication it took to become you were huge. You are indeed capable of more than you think, so keep putting in the work—it will be worth it! 

H.L. Greenberg, MD 
Las Vegas, NV 

Think Lupus 
When I see a thin shave biopsy of a face or chest eruption that appears to be actinic keratosis histologically, I consider the possibility that it is a superficial biopsy of lupus. 

Steven R. Feldman, MD, PhD 
Winston-Salem, NC 

A Pregnant Pause 
I might give a 65-year-old, first-time filler patient a quote of $3000 for doing fillers. I wait for a quick moment while looking at their face to see if they grimace or make another expression. If they do not react, then I go ahead with the treatment. Some patients are taken aback at the cost because the person on social media “had everything done with one syringe.” I then explain that $3000 is for optimal results but for $2000, they can still get good results and for $1000, okay results. This allows them to choose which result level they would like to see and/or can budget for, and I explain that we can always add more filler later. For a first-time filler patient, I suggest we start conservatively and then after 2 weeks, if they would like, we can add some more, that way we keep things in budget and looking natural. 

Benjamin Barankin, MD, FRCPC 
Toronto, Ontario, Canada 

Clinical Pearls for Trainees 
It can be difficult to find time to extensively teach our residents and medical students who are working with us during our busy outpatient clinics and hospital consult days. However, in addition to teaching at the bedside when time allows, I also find it beneficial to take a couple of minutes at the end of each half day to enumerate 2 to 3 take-home clinical learning points for our trainees that are relevant to the patients we cared for that day. Not only does this more effectively engage both me and the resident/student, but it also illuminates that each patient has something to teach us that will make us better dermatologists. 

David A. Wetter, MD 
Rochester, MN