I really enjoyed the editorial by Joel Schlessinger, MD, “Reflections on 25 Years of Private Practice” in the June edition of Practical Dermatology® (available online at PracticalDermatology.com/2017/06)!

Here are some random pearls from my 15 years in practice:

Sit down and talk to patients, literally eye to eye; avoid standing over the patient.

There is a magical quality to fresh baked chocolate chip cookies served to patients, and the aroma melts everyone’s heart.

A Keurig coffee maker is probably the best “device” physicians can have in their offices.

Consider having a five- to 10-minute staff meeting once a week where all staff are kept accountable for specific goals (related to efficiency, patient service, patient care, billing, etc.). Document these on a whiteboard displayed in the kitchen/break room. Everyone, including the doctor, declares at the next meeting whether they achieved the goal or not, and they then produce another set of small goals for next week.

Consider selling generic medications in the practice (i.e., topical and oral antibiotics), if permitted by law. Patients will be grateful for the convenience, especially after surgery.

Consider using the unused absorbable dyed sutures for your top epidermal sutures. The savings are significant over time.

Handwrite a thank you note to each staff member at the time of her/his bonus(es); highlight why you specifically enjoy working with her/him.

Personally call post-op patients two days after their surgery. Avoid calling the night of or the next day when all they will talk about is their pain. Prepare them with a good post-op “expectations” sheet that addresses pain.

Two Tylenol and two Advil taken together is essentially equivalent to one Vicodin.

Give out your cell phone number on your practice card. In my experience patients will rarely if ever call you, but the gained trust, reassurance, and your availability will pay dividends.

Consider creating a post-op goodie bag, including Vaseline, nonstick gauze, paper tape, and instructions.

—Adam Rotunda, MD, FAAD

Newport Beach, CA

I wanted to submit a correction to the article “Dermatologists Are Taking Action in Their Fight Against MOC” in the August 2017 issue (Available online at PracticalDermatology.com/2017/08).

Time limited certification began for those of us who completed our residency in 1991. I am in this group, and have taken my board examination, and passed it, three times. I am certainly not looking forward to the time, preparation, and cost of retaking my board exam a fourth time.

I also agree that the grandfather clause is contradictory to the underlying purpose of MOC and that all practicing physicians should be required to participate.

I hope that the MOC process will become more simplified and less onerous.

—Elena Martinho, MD, FAAD
Templeton, CA