Navigating the Corporate Structure to Get What You Need: Part 2

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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.

Presenting Your Project to a Board

Most dermatologists work in a group practice or corporate structure. When they want to make a purchase, such as buying a new laser, or hire another staff member, they increasingly need to ask for approval from not just one person but a group. If you find yourself presenting to a board, you should prepare in advance. Find out who is on the board and reach out to some members beforehand. This will give you a chance to practice your “elevator pitch:” a 1- to 2-minute summary of your project, with details ready if asked. If they tell you they like the idea beforehand, they are more likely to advocate for you during the meeting. Work with your detractors and revise your proposal to address their concerns, if possible. Having practiced and revised your pitch with feedback, present it to the board group. Call out any unresolved concerns and lay out your vision of success. Just like any good politician, do not ask for a vote until you are sure you have enough supporters.

Jason Reichenberg, MD | Austin, TX

Grappling With Generalized Granuloma Annulare

Whereas a small area of localized granuloma annulare (GA) will usually resolve with intralesional steroids, generalized GA can be a source of anxiety for both patients and providers, but it does not have to be. While there are a lot of different treatments reported, the initial management of generalized GA with the best evidence is either antimalarial therapy or phototherapy. Some patients with GA have photodistributed disease; they should not get treated with light. Generally, patients with GA in sun-protected areas, such as the inguinal folds/axillary vault, which often presents with a patch-morphology rather than the typical annular plaques, will respond well to photo- therapy. Patients with widespread GA that is neither photodistributed nor in photo-protected areas can be treated with either option. There is continued emerging literature supporting some novel treatments, and recent papers provide some evidence-based algorithmic treatment approaches for patients who fail to respond to initial options.

Misha Rosenbach, MD | Philadelphia, PA

Minimizing Bruising With Fillers

The best way to reduce bruising when administering fillers is to use a blunt-tipped cannula rather than a needle. My favorite is TSK ultra thin wall 18 gauge and occasionally 26 gauge for things like lips. Using lidocaine with epinephrine before making an entry wound further reduces the risk of bruising.

KC Smith, MD | Niagara Falls, ON, Canada