Steering the Ship

The decision to return to work within 48 hours of giving birth may have been partly influenced by Dr. Alster’s personality and work ethic, but it was mostly driven by practical considerations for a solo practice owner. “I did it because there was nobody steering the ship, so to speak. If I wasn’t there seeing patients, who was going to be seeing patients?” Dr. Alster notes that she worked up to an hour before giving birth and felt fine to go back when she did. Still, she admits, “that would not have been my first choice.”

Tina Alster, MD, a pioneer in cutaneous laser surgery, got involved in the field by chance. She was a resident at Yale when a patient from Manhattan presented seeking treatment for a large facial port wine stain (PWS). Dr. Alster had recently reviewed a publication that outlined the first study using the pulsed dye laser to treat PWS. Since no one at Yale was performing laser surgery, she had to research it. And she got hooked. She completed a laser fellowship in Boston in lieu of her last year of training in New Haven. “Basically, this woman changed my life,” Dr. Alster says. “But I eventually changed hers, because during the course of my fellowship year, she came to Boston and got her port-wine stain removed.”

A successful practice owner, researcher, author, philanthropist (she founded two scholarships at Duke for women in medicine and a fund at Yale), and lecturer, Dr. Alster was one of the first women in a field dominated by men. She says she was often included by male peers who needed to play fair. She had to work hard. “I had to be out there all the time and basically beat my own drum. But once I got in, I think it made it easier for others to follow in my footsteps. I paved the way and if anybody was going to do it, it was going to be me.”

Among her greatest accomplishments, Dr. Alster says, has been “marrying both home and work successfully and doing it on my own. I don’t really have to thank a lot of people outside of my family and my own fortitude. That’s been really validating for me to know that I could do it by myself.”

Why did you establish your large and successful practice in DC on your own?

Dr. Alster: When I finished my fellowship in 1990, there were no independent laser centers in the world...Nobody wanted to hire a laser surgeon, because they didn’t want to pay the money for the laser equipment. So that’s the main reason why I went into practice by myself. But I didn’t have any money.

I had to secure a small loan to get my first laser. I didn’t have a house—I only had a paid-for car, so I used that as collateral to buy my first laser. And the rest is history. I really had to bootstrap it in order to do what I did. It paid off in the long run, but it was not easy going, and I wouldn’t tell somebody to do that today. There are so many other choices for laser acquisition now available that are much easier. And there are mentors, as well. I didn’t have a mentor back then. Essentially, I was my own mentor. And I’ve been trying to pay it forward ever since.

What were the greatest challenges in working with industry and doing trials?

Dr. Alster: The biggest challenge was just getting out there, establishing a practice, without any backup singers. Nobody was really fanning the flame for me. And, of course, I had to yell pretty loudly for people to take notice. Once I got on the bandwagon and became known by one laser company, I think others followed. So that was helpful. There are a lot of followers in the field, so that’s worked to my advantage.

What do you view as your greatest challenge to date? And how did you overcome that?

Dr. Alster: I think my biggest challenge to date was not having a safety net of any type. When I started in my practice I had $2,000 in a CD account. I had a paid-for car; that’s it. And I had tremendous school debt…I didn’t know how I was going to reconcile that. It’s not like I had a plan...I begged and borrowed as much as I could. I paid very high interest rates for my first loan. I did whatever I could to get it done. So I’m most proud of that. I think that’s my biggest accomplishment outside of, again, saying that I was able to marry a great guy who supports me emotionally and takes care of things on the home front when I’m on the road at professional meetings. That’s been really helpful for me.

What three words would you want a mentee to use to describe you?

Dr. Alster: I don’t have three adjectives. What I’d like mentees to say about me is that I inspire them to be the best they can be.