How has your practice fared in terms of Electronic Health Record adoption?

My practice is 60 percent medical and 40 percent cosmetic, which means that the penalties and incentives associated with attesting to The Centers for Medicare & Medicaid Services’ Meaningful Use matter to us. I had to allocate more staff to comply with the regulations. Initially I was concerned that going to EHRs would be difficult and result in a series of problems, but it has been quite the opposite so far. We have had our Nextech electronic medical record in place for the past seven years and it has improved efficiency, allowing us to reclaim 1,000 square feet of space in the clinic. Space is something that is precious for us as we are landlocked in our building and moving isn’t a great option. Despite some challenges (the usual issues with setting up an EHR system such as making templates and ‘owning’ the system), I am delighted that we did it. Nextech allows for the integration of photos within charts, which has the added benefit of increasing patient satisfaction and thus, retention. I can show patients the progress they are making with treatment and time, and the results that I see make me happy multiple times a day. I truly think it has led to happier patients and better reviews.

Do reviews factor in to your marketing plan?

Yes. Reviews are everything now. Reviews and review sites should not be ignored. Happy and satisfied patients won’t give you good reviews … unless you ask for them. By contrast, unhappy patients and disgruntled staff or ex-staff ALWAYS will. I am very happy to ask if a patient will be kind enough to review us, and I have a staff member who will follow up with these patients to make the process as seamless as possible. Prospective patients do look at reviews and a series of bad reviews can make or break your practice. They are the new word of mouth. Ignore at your peril.

How do you handle delegation in your practice?

Delegation is another hot button issue for dermatologists. I do every neurotoxin and filler procedure. Not a single one is done by anyone other than me, and my patients appreciate that. The physician assistants and I are the only ones who perform the majority of laser- or energy-based procedures. We do delegate laser hair removal to nurses. This is strictly in accordance with state rules and regulations. These rules vary dramatically from state to state, so my advice is to know the facts and adhere to the rules in your state. If you don’t agree with them, get involved in legislative efforts to help change them. n

Why is marketing so important for dermatologists today?

Marketing is critical as we seek to differentiate ourselves from the plethora of non-dermatologists and aestheticians who are offering aesthetic procedures often at cut-rate prices. Our specialty is under attack by less informed and poorly trained competitors who rely on price as a distinguishing characteristic. These practices commoditize aesthetic dermatology procedures. Our best defense is a strong offense. We need to promote our specialty, our expertise and our training to patients in a way that is approachable and easily understandable, without being negative.

That’s a tall order. How do you manage that?

Largely through credentialing and patient education. It is critical to include our credentials and those of our staff in the pre-consultation, consultation, and beyond. We offer tours of the office to new patients. Someone from my staff will take them around and introduce them to the team. This allows for an enhanced personal connection and a better overall experience and impression of the practice. Of course, this underscores the need to hire staff who are friendly and willing to interact and smile at/welcome new patients.

Let’s talk about Maintenance of Certification (MOC).

MOC has set up some hurdles for us. Several prominent doctors have been calling for the elimination of all MOC requirements for dermatologists who have passed the American Board of Dermatology (ABD) certification exam. MOC is being streamlined and the overall trend is toward simplification of process. I am optimistic that this will make for a better process and one that can easily be observed by most of us.

I am particularly pleased that the leadership at the American Academy of Dermatology (AAD) took the reins and worked to develop a new policy out that is more palatable to most dermatologists. Dermatologists are probably some of the most conscientious practitioners out there, but the onerous nature of the previous system made it untenable. Immediate past president of the AAD Mark Lebwohl, MD, professor and system chair of dermatology at Mount Sinai Hospital in New York City, did a great job of creating a win-win situation with the ABD. n

Joel Schlesinger, MD is a dermatologist in private practice in Omaha, NE. In addition to being the Chief Cosmetic Surgery Editor for Practical Dermatology, he is president of Lovely Skin, a cosmeceutical company with a brick-and-mortar location in Omaha and an online store, past president of the Nebraska Dermatology Society and the founder and organizer of the Cosmetic Surgery Forum in Las Vegas.

Watch Dr. Schlessinger discuss tips for navigating the cosmeceutical market on DermTube Journal Club: http://dermtube.com/series/dermjournalclub/navigating-the-cosmeceutical-market/

Read Dr. Schlessinger’s latest editorial, “Drug Companies, Insurance Companies, Pharmacists, the Government, Doctors and…Oh, Patients!”:

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