Wednesday, April 11, 2018

How to Choose your Path: Part 1

When starting a career in dermatology it is important to surround yourself with people who will help make you the best you can be. From employers to mentors, the people in your life can help guide you to become the dermatologist you choose to be.

This webinar featuring Drs. Mary Maloney, Alexa Kimball, Carrie Covarik, Jane Grant-Kels, Elizabeth Hale, Zoe Draelos, Barbara Gilchrest, William James, Roopal Kundu, Rachel Reynolds, Lynn Drake, Keith Greathouse, Lorraine Young, and Abrar Qureshi goes into detail on what questions should you ask of your future employer, advice for searching for a job, and the importance of mentorship in career development.

Continue watching the WDS Webinar Series by following the WDS YouTube Channel

The WDS Webinar series is brought to you by the Young Physician Committee
and sponsored by Galderma

Tuesday, March 27, 2018

A Female Dermatologist’s Guide to Being a Leader

A Female Dermatologist’s Guide to Being a Leader
By Azeen Sadeghian, MD

“Leadership is not about titles, positions or flowcharts. It is about one life influencing another.” ~ John C. Maxwell

Being a physician equips us, in a way, to naturally become leaders. Many of the traits needed to exemplify excellent patient care are also traits that are seen in strong leaders. Not only that, we are expected to step into our roles as archetypal leaders. We are held to a higher standard in serving. Medical decision making is not the only thing expected of us. For example, many of us serve on dermatologic or medical committees, volunteer in our communities, or manage clinical personnel.

The reason why leadership is something we should talk about is because it’s something we all face as physicians. The leadership role we encounter is not limited to the business realm of being a manager or owner, it exceeds that.

A friend recently loaned me an article from the Harvard Business Review. The article’s author outlined multiple leadership styles that were frequently seen, (i.e. coercive, authoritative, democratic, etc.) However, they found that the best leaders were not reliant on one style. In fact, they frequently used different styles at different times and scenarios. (Goleman, D. (2000) Leadership that gets results. Harvard Business Review, March-April.) What did I take away from this?  As leaders, we have multiple key traits and should be able to know when to use them. We should be able to match them to individual situations and different people. We need to be dynamic

Be a Visionary and Bright Light

Leaders are visionaries. Pull your team together around a shared vision or goal. Show the initiative to be ready to seize new opportunities. Paint your vision of a great tree and allow them to draw in the leaves. This will help team members share your vision and call it their own. How about that for a strong bond?

Visionaries also turn negatives into positives. Every negative situation has a silver lining. Even awful ones in the workplace. Why? They provide an opportunity to grow or fix something. Turnarounds don’t happen until something bad has happened. Successes typically don’t happen without a few bumps in the road. So be a bright light when the lights go out and show by example the great things that can happen as a result. 

Another way to be a bright light is to praise. Know when to praise publicly and privately. Negative feedback may be necessary, but can leave people drained or resistant to change. Positive feedback and praise are often needed first to acknowledge someone’s contributions to a team. Who doesn’t want to feel appreciated or valued? (By the way, I appreciate that you’re reading this article when you’re so busy!) My husband taught me his technique as a project manager. Positive feedback first, then negative (i.e. correction or instruction), then positive feedback last - he has coined this: the “ice cream sandwich approach.”

Be a Human Not a Humanoid

Leaders do not need to be cold, sterile, or demeaning. They can be empathetic, honest, and a safe haven. 

For example: How do you respond when someone is going through hardship? Do you let them know how it negatively impacts their job? Or do you support them so they can get back to their job? Either or both responses may be applicable given the situation, but this example is meant to spur some internal thought. 

Empathy is a skill we hone with our patients, but it’s equally as important to use it outside of our clinical scope. This ability helps us gauge others’ emotions, thoughts, and perceptions.  It can be helpful in instances of individual turmoil or navigating system related friction.

Just as we don’t avoid the truth with our patients, we can be honest as leaders. Apologies are allowed. Honesty can serve to acknowledge a difficult situation and yield fruit.  

Lastly, we are a haven as leaders. I went around my office and asked a few people what they thought a good leader should entail. I was most impressed when someone answered “haven,” because it instantly made me reflect on some of the best leaders I worked with. Great leaders often exhibit this ultimate skill. They are a place of safety when needed, of growth and recovery. A source of nourishment to grow despite mistakes and conflicts.

Mirror, Mirror on the Wall, Who is the Most Objective and Fair of Them All

The counter side to being human is to be objective and fair. Not letting our emotions and projections cloud our judgment. Often, we need to take a step back. Sometimes we have our “go-to” person (or people) and have another person who we don’t trust as much. The reasons may be complicated. That can sometimes lead you into a rabbit hole when you’re holding everyone accountable. For example, sometimes you crack down (or avoid cracking down) on the negative Nancy more than the others. Dish things out as fairly as possible. Frequently take a step back to re-assess if you’re being fair.

Accountability is a difficult subject but is made more complicated if fairness and objectivity are breached. Team members should have clearly defined roles in your organization. Don’t assume that because their title is XYZ and their job description says XYZ; that they know to do XYZ. Clearly communicate their roles and explain your role. When you give a rule or have expectations, everyone (including yourself) should be held accountable.

Empower Your Team to Grow

You’re likely reading this because you are a self-directed and motivated learner. Your growth didn’t stop after you achieved your goal of applying to medical school or finishing training. Instead, you kept at it. Growing in different vectors. This is an admirable trait that physicians have, and I strongly encourage that you keep it. Great leaders are not born overnight and in fact, seem to continually seek improvement.

Just as you grow, encourage your team to seek growth, - both together- in terms of interpersonal bonds and strength, and individually – in terms of independent growth.

I’ve been fortunate enough to work with amazing leaders. The trait I most admired about my Chairman (correction, Chairwoman!) was her ability to empower each of us individually. She would support us through any endeavor that encouraged personal growth. She turned us from residents into potential legacies.

Step Back to Review Your System

A trait that distinguishes leaders is their ability to look at an overall system and gauge interactions. Systems encompass a wide range of definitions, but can include human interactions, work flow, policies or organization models.  If you give feedback, take the opportunity to receive it. Then, synthesize where the disconnect is, take two steps back to look at the systems picture, and offer solutions to help equip the other person you’re working with.

For example, an issue of a squeaky wheel may actually be a car alignment issue instead of a wheel issue. (Okay, maybe I’m not a car expert, but you get my gist.) Yes, you need to be concerned with the outcome (i.e. a patient, committee, revenue goal) but also with the organization or team assemblage it took to get there.

An anticipated outcome of many systems is the potential for conflict. We are dealing with humans after all (humanoids if you haven’t had your coffee yet), who individually all have a complex set of emotions and thoughts. Conflicts can happen and are obtrusive to systems flow. The ability to resolve conflicts is key to a harmonious team.

Emotional Intelligence is Key defines emotional intelligence as a ‘skill in perceiving, understanding, and managing emotions and feelings’. There are many traits positively associated with emotional intelligence. These include social and communication skills, amongst others.  But I think of emotional intelligence in yet another light, being intelligent about your emotions.

For example, when I started this article I had a pang of anxious fear. What if this article would be rejected by the reader because I’m not a renowned leader or because they know of my failures. But, here’s the kicker, no one told me that- I thought it. And I had to hit the ‘ignore’ button so it wouldn’t weaken this article.

What are your insecurities as a leader? Are they valid? Every person reading this has been in a funk, gotten frustrated or angry, gotten negative feedback at one point (hello, the dreaded negatives section on the evaluation form). Don’t project your own emotions or frustrations onto your team, particularly not with your communications, actions, or decisions.

Bossy Pants or a Servant Leader

Yes, sometimes you need to be a stereotypical bossy pants. But keep in mind this can hurt morale if used often or in a derogatory way. Directing a person is not the same as demanding. But in times of a crisis or emergency- this style of leadership is sometimes needed.

Instead, a servant’s outlook is a great way to earn your stripes as a leader. Think of the best leaders you’ve worked with. They likely exhibited this trait, they were willing to get involved in any task or role. Just like those seasoned leaders, don’t be afraid to get dirty!  

So, there it is- my tips for leadership. You already have these traits, just bring them to the forefront of your leadership thought process. Trust that you know what to do and when to do it. Your skill set as a physician has already empowered you to be an excellent leader.

Tuesday, March 13, 2018

Building A Brand

Starting your career in dermatology can be challenging. It is important to know your passion. Listen to the advice of experienced WDS members as they share pearls  for building your brand.

This webinar featuring Drs. Mary Lupo, Elizabeth Hale, Lynn Drake, Cheryl Burgess, Keith Greathouse, David Goldberg, Doris Day, and Jean Bolognia goes into details on how to set yourself apart by creating and promoting your own brand, what is most important for young physicians to do when first building a brand and a career, building a reputation and a niche, and building a brand online and on social media.

Continue watching the WDS Webinar Series by following the WDS YouTube Channel

The WDS Webinar series is brought to you by the Young Physician Committee
and sponsored by Galderma

Monday, March 5, 2018

Young Physician Spotlight - Alexander Means, MD, FAAD

Alexander Means, MD, FAAD is an assistant professor at the University of Wisconsin School of Medicine and Public Health. His clinical interests in infectious disease dermatology and dermatoepidemiology began early in his academic career, receiving his undergraduate degree in bacterial genetics from the University of Wisconsin-Madison after which he worked in emerging infectious diseases at the CDC. He graduated with honors from Loyola University Chicago, Stritch School of Medicine and stayed in Chicago for his dermatology residency at the University of Chicago, after which he did a fellowship in Dermatoepidemiology in Rhode Island at the Providence VA Medical Center associated with Brown University. In 2015, Dr. Means was also awarded the WDS Academic Research Award for his project on psychosocial morbidity in hidradenitis suppurativa.

Dr. Means is an active member in the American Academy of Dermatology, the Women’s Dermatology Society, and the Society for Investigative Dermatology. He is dedicated to mentoring medical students and residents, and improving access to dermatology for the underserved.

How did you become interested in dermatology and what led you to where you are now?

I never saw a pediatrician growing up, only dermatologists—my acne started at age 13 and is still going strong! Thank God for isotretinoin. I actively explored other medical disciplines, and had the best summer of my life at UCLA looking at sleep quality in older veterans where I fell in love with that most grateful patient population, but after meeting Dr. Aisha Sethi, MD (current Associate Professor at Yale), it became ‘derm or bust’.

Until Dr. Sethi’s wonderful and precocious daughter, Aliya, was born, she would travel to Malawi for one month each year to function as the country’s only dermatologist, seeing hundreds of patients in a single week at clinics and refugee camps, and meeting with government officials to advocate for social justice causes like protections for people with albinism*. I was lucky enough to accompany her and Dr. Chrys Schmults, MD (current Associate Professor at Harvard) in 2011 with, then-trainee rockstars, Drs. Una Miniter, MD; Laura Boger, MD; and Rebecca Kaiser, MD. The experience motivated me to make social justice a cornerstone of my career.

On my return to the US, serendipity placed Dr. Becki Tung, MD (current Chair at Loyola) into my life.  She is someone who has similarly dedicated her life to volunteerism at home and abroad, whether sponsoring SPOTme® clinics in Chicago or performing Mohs in Brazil, and was the first to sit me down and say “let’s make your dream [of becoming a dermatologist] come true”. Her recommendation letter got me into residency. It is not an understatement to say I owe these women—all active WDS members—my entire career.

What are you working on now?

I am in the process of creating longitudinal relationships with some of the Native tribes in Wisconsin, in the vein of the AAD’s Native American Health Service Resident Rotation Program which I participated in during residency. This is much more economically and personally feasible for me than a month abroad at this stage in my life, and there are fewer cultural barriers to circumnavigate. I would like to spend at least 1-2 days volunteering at tribal clinics each month, with the goal of better identifying and addressing dermatology disparities facing these populations. Ultimately, I hope to provide opportunities for trainees to live out social justice in dermatology, much as I started to do after accompanying Dr. Sethi all those years ago. I am also one of about 400 physicians nationally—almost all of whom are in primary care or psychiatry—who conduct pro bono asylum evaluations for victims of torture and ill-treatment. I would like to encourage dermatologists’ participation in this important work, as most physical torture sequelae manifest on the skin, and we are in a uniquely important position to provide informed legal testimony regardless of current immigration and customs enforcement uncertainties.

What are your interests outside of work and how do you strike a work-life balance?

Somewhere in “Lean In”, Sheryl Sandberg mentions that she always eats dinner at 6pm with her kids. I don’t have children yet, but they shouldn’t be the only justification permitted for drawing boundaries. I almost never respond to work emails or patient care issues after 6:30pm, and never on the weekends. To be honest, I don’t think any physician in any specialty should ever have to be “on call” for anything other than an Emergency department or inpatient consult that would change management. There are already personnel trained to evaluate and triage time-sensitive emergencies. Things continue that we allow to continue.

Regarding avocations, my mom was a home economics teacher so I am constantly experimenting with and reading, writing, or talking about food. I love road trips and street festivals, and never visit the same place twice except to see friends. I’m probably the only person left in America who doesn’t run with headphones, and can’t wait to do another marathon. Being from the Midwest, I also love planning and attending weddings and have even officiated a few (though if you need someone in a pinch, my divorce rate is unfortunately no better than the national average).

Wednesday, February 28, 2018

4 Key Takeaways from the AAD 2018 Annual Meeting

As members of the Young Physicians Committee, we look forward to the AAD’s Annual Meeting because it offers time to catch up with friends, network with colleagues, and to expand our knowledge base.

My name is Kachiu, and I’m entering my third year in practice. I am an academic dermatologist at Brown University, practicing a mixture of medical and cosmetic dermatology. I completed residency at Brown University, and a laser/cosmetic fellowship at Massachusetts General Hospital afterwards. Upon graduation, I returned to Brown University to start the cosmetics division, and currently serve as the Director at our interdisciplinary laser and aesthetic center, where I work closely with plastic surgery and oculoplastics. I am dedicated to the WDS, and currently serve as the Chair of the Young Physicians’ Committee. Outside of work, I am a busy mother of 2 young children (ages 4 and 2 years), and struggle to juggle my work/life responsibilities on a daily basis.

My name is Mara, and I am a grateful member of the WDS and have been since the beginning of my residency (6 years ago!).  I have served on multiple WDS committees in the past including the Service Committee, Academic Committee, Social Media Task force, and currently as part of the Young Physicians Committee and Media Relations Committee.  I completed my Dermatology residency training at the Cleveland Clinic, followed by an ASDS certified Fellowship with SkinCare Physicians in Lasers and Cosmetic Surgery. I spent a year in Private Practice in NYC before joining the Faculty as Assistant Professor of Dermatology and Dermatologic Surgery at the University of Rochester Medical Center where I, like Kachiu, am starting the Cosmetics and Laser Center for the University and the Residency training program. I am passionate about teaching residents, mentoring medical students, and serving my community. I am also a mother of 2 little ones (ages 1 and 3) and try to soak up every waking minute of time with them while home, all the while, being as productive as possible at work!  It’s a daily challenge but so rewarding.

1.      Physician burnout.
Dr. Lee: Physician burnout is a real issue, with increasing burden of administrative tasks and spending too many hours at work being prominent reasons for burnout. Difficult patients can also have an effect on our day, and as a young physician, I often struggle with managing the “customer service” aspect with the “patient care” aspect. Having a strong group of peer-colleagues amongst the WDS’ Young Physician Committee helps me to navigate tricky situations and helps me realize that I’m not alone in this uphill battle!  At the end of the day, it is a privilege to serve patients and my ability to help them feels fulfilling!

Dr. Weinstein: A mentor once told me – “there is no such thing as work-life balance.” At first I was disappointed to hear this and struggled with trying to figure out why physicians would strive for something that doesn’t exist.  But then it dawned on me – we continuously beat ourselves up for not living this so-called “balanced” life, and then feel guilty for not being present enough at home (while traveling to meetings), or not being as productive as we can at work (due to exhaustion, being over-committed) – or not getting to the gym five days a week. The hard truth is that finding this balance is a daily challenge and we need to adopt a more open mind about what exactly this means to us on an individual level.  I’ve learned to structure my life whereby I prioritize the things I enjoy doing the most and outsource as best I can, the things that I don’t enjoy doing. This is easier said than done, however, it has made a tremendous difference in my daily routine, and allowed me to put my best face forward in both clinical and home settings.

2.      Chemical peels are back in style!
Dr. Lee: Not only are chemical peels back in style, but combination treatments with chemical peels, lasers, and microneedling are providing great results with melasma. One of my favorite talks was presented by Dr. Jaishree Sharad at the International Peel Society meeting, where she reviewed the evidence for a treatment of melasma in skin of color with a combination of microneedling + topical transexenmic acid, followed by biweekly glycolic acid peels.

Dr. Weinstein: What a great topic, and certainly there is a re-emerging buzz around chemical peels.  For those finishing residency, starting their own practice, or joining a new practice- not only do chemical peels provide a low-cost way to get your cosmetic practice up and running, they can also be used as an adjunctive treatment for acne, melasma, hyperpigmentation, scarring and facial rejuvenation. Treatment regimens for superficial chemical peels require bi-weekly to monthly office visits providing a great way to build rapport and trust with your patients. They will be your greatest advocates after you’ve worked so closely with them to help improve their medical condition.

3.      WDS offers an unmatched level of mentorship and networking opportunities!
Dr. Lee: Attending the WDS networking event was a great way for me to connect with my peers and mentors. I love the openness of all of the members, and their willingness to help. I had a tough managerial situation that I was going through, and was able to seek out the help of a WDS senior member for advice. The WDS really offers an unmatched level of mentorship and networking!

Dr. Weinstein: I am so grateful to the WDS for providing networking and mentorship opportunities at every level.  I’ve found WDS mentors to be the most generous with their time and genuine in their passion for mentorship. The AAD provides a rich didactic environment with multiple modalities for learning, and you can be in a “session” from 7am until 7pm if you so choose. It’s so important to plan your meeting to allow adequate time for learning, but also time for networking. It’s in these moments that you meet the most fascinating people or have the chance to speak to the Past President of the AAD or WDS or choose your leader – pick their brains and be at ease in an informal setting. I’ve always been surprised after each WDS event about how many esteemed Dermatologists I was able to connect with and learn from. 

4.      The ‘Tipping Point’
Dr. Lee: What is the Tipping Point for dermatologists? What differentiates our specialty from others? What differentiates the care we provide compared to those of a mid-level provider? To me, being a dermatologist means so much more than just caring for my patients in clinic. It also means giving back to my community through monthly beach skin cancer screenings in the summer, fostering a new generation of dermatologists through teaching in academics, and volunteering my time for organizations that I believe in, such as the WDS. I am proud to be able to put my talents to use, not just for my patients, but also for my community.

Dr. Weinstein:  Malcolm Gladwell wrote about the tipping point and then presented his thoughts in San Diego on what the “tipping point” for Dermatologists and Industry might be as we launch new technology, new pharmaceuticals, new toxins/fillers, new cosmeceuticals or just ourselves….as we launch ourselves into this ever-changing landscape where our competition is deeper and more complex. It’s so important to differentiate ourselves from physician extenders and mid-level providers – not because they cannot provide quality care to our patients, but because we provide this and so much more. Our level of training is unparalleled, but we don’t hang our hats on that alone. In addition to sharing our knowledge and providing excellent patient care, we are giving of ourselves to the broader medical (and non-medical) community. How many of us volunteer, give back to the community, educate, travel and serve internationally? How many of us are artists, musicians, researchers, book writers, and parents? The list goes on.  It is as important to expose these unique parts of our lives and connect at this level with patients, as it is to list our educational credentials when thinking about what sets apart.