PracticalDermatology

Story Time

A self-proclaimed philosophical dermatologist who majored in English and studied philosophy as an undergrad, Dr. Day became a physician as her second career. Her first degree is in journalism (certificate in medical reporting). Having lost a sister to cancer at a young age, Dr. Day was especially motivated to fill the gaps in information around hospice care, quality of life, and dignity in the face of terminal disease. She became a medical journalist, because, “it was important to analyze and tell the stories from all those angles, because the patient and their family are inherently part of the process of both illness, recovery, grieving, and whatever is going to happen next.” Now a practicing board certified dermatologist, she continues to write books, host a radio program, and do TV appearances, “to tell those stories along with those from her practice.”

How did you come to dermatology?

When I was a journalist in the late eighties, HIV was a relatively new condition. Kaposi’s Sarcoma (KS) was a rare condition but becoming increasingly common in young gay men with a then poorly understood immune deficiency syndrome that was clearly contagious. I reported on many medical conferences where that topic and dermatologic conditions associated with what would soon be known as HIV was the focus, and I was really turned on to dermatology from there.

When I was doing my internship and residency in internal medicine, I realized that patients were much more willing to follow my advice if I told them they would look better than if I told them they would be healthier overall. For example, if I said, “Eat less salt, because you will have a lower risk for stroke or high blood pressure,” they were not entirely motivated to change behavior. However when I said, “Eat less salt, because you’ll have less eye puffiness,” they were much more likely to listen. Having done both internal medicine and dermatology, I find that I have much better access to my patient’s overall health and well-being more consistently when I focus on them through their skin issues.

How did you build your practice?

I opened my own office the day after I graduated dermatology residency. I didn’t buy a practice; I didn’t work for anyone else. I just opened an office. I rented space from a plastic surgeon and saw patients two half days per week. To make ends meet, I worked full time at Bellevue, which I negotiated as three days a week. I also worked at the NYU Student Health Center, which paid an hourly salary. As the students graduated or if they wanted a chemical peel or anything aesthetic, I was allowed to refer them to my office. Plus, many of them had families in the city and would refer them to my practice. I also joined the NYU University Physician Network. I did skin cancer screenings and lectures on skin health all over the city, which also paid by the hour. Whenever I did a skin cancer screening or lecture, I would ask patients and attendees if they had a dermatologist. If yes, I referred them back to their doctor. If they didn’t, I handed out my card. That’s how I grew my practice. It was a lot of hustle and hard work.

Now I’m in full-time private practice. I still go to Bellevue on Tuesday mornings as voluntary faculty; in the afternoons I either do research, write, or handle other administrative or personal matters. It’s incredibly helpful to have administrative time; I encourage others to do the same.

How do you balance career/family?

My goal is to live a life that I would want to live over and over again exactly the same. My first priority was to get married and have children. I didn’t think that personal life and work should be mutually exclusive. I got married and had my first child in medical school, the second after my internship at Bellevue. I made sure to marry a man with whom I had a lot in common and who would be supportive of my dreams, as I would be of his. He was already established in his career as a cosmetic dentist and had flexibility with his office hours. We moved to the same building where my parents lived, we had a nanny during the day, and everyone helped make sure the children always had the best love and support. This made it possible for me to do the things I wanted to do without (as much) guilt. My children are now grown. We are very close as a family, and my daughter goes to the same medical school I went to. Although having a family was always a priority, I didn’t think I had to make a choice of one over the other between work and family.

What is your biggest success?

My biggest success has been creating a practice and brand that I’m proud of. I’m still growing, hoping my biggest success is yet to come. I haven’t compromised on doing what I know to be right for my patients and true to who I am as a physician.

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What has been your biggest challenge?

The biggest challenge has been managing my own practice. The hard part is keeping all the pieces in place. As soon as you feel good, somebody ends up leaving the office, or you have to fire somebody or something happens where one or more pieces start pulling at you. It can get overwhelming at times with too many talks or papers or chapters due or presentations that I’m putting together, and it just gets heavy once in a while. That’s when my husband gives me a hug and says, “You always get it done and it’s going to work out perfectly!” The encouragement helps me stay positive and focus. It does all get done and it works out great. Then I get back into it and put all the puzzle pieces together, enjoying the process and learning from the effort.

How did you get involved in Doctor Radio?

I’ve been doing Doctor Radio for 12 years twice a month on Thursday, from 6:00 to 8:00pm ET. I was invited to be a host by the medical director of the station, Dr Marc Segal who I knew for years from being at NYU and from running into each other at various television shows where we happened to be guests at the same time. I started hosting right away as one of the first hosts on the station, and I’ve been doing it ever since. It’s a lot of fun. I thought I would get tired of it or run out of things to say, but that hasn’t yet happened. Each show is two hours long, broken up into four half hour segments. For two of the segments I have open phones where I take calls, tell stories about my travels and patient experiences and update with dermatology news of the day and for two of the segments I have guests- everyone from colleagues to writers or experts in a related field. I always focus on the skin, both medical and aesthetic issues. Our call lines are always full and I’m amazed at how may patients find me through the show and come to see me in the office.

If you could give advice to yourself as a resident, what would it be?

Do exactly what you’re doing. Study your ass off. Keep focused and just make it about learning the material. Learn dermatology. Try to be a great dermatologist. We didn’t have social media then, but if we did, I would tell my younger self to not get distracted with it, there isn’t enough time in a day to learn all the dermatololgy you need to know, there’s no time for distractions away from that learning.

I find that if you know your craft everything else falls in place much easier. I have never had PR, I do all my own social media posting and I just really want to be as great a dermatologist, mom and wife as I can be. I want to take care of my patients, teach my peers and those younger than me, learn from my peers and those around me, and always keep learning and growing and getting better at what I do.

Do you think dermatology is particularly conducive to career/life balance?

Balance is what you choose it to be in any career or specialty you select. In having my own business I work hard all the time and am always working on projects, presentations and pressing issues with staff and office.

I used to think that it’s great that women are now so much more free to have full careers, but, somehow we’re still expected to raise a family, and make sure dinner’s on the table, and do all the things that moms do as if they didn’t have outside jobs. The reality is, we put that on ourselves. I didn’t take a day off of work through or after my pregnancies. I worked, to the day I delivered, took whatever vacation everyone else got in medical school and residency and was back at work.

Now we have more options and women don’t have to be so limited, if they don’t want to be. There are many more options to work part time or take more time off around family if desired. For me, I would do it again the same way because I was happy being at work and in school and I had a great support system.

What are your tips for working with the media?

Speak in soundbites. Focus on the consumer—not just what they want to know, but really what they can use. If you do that, you’ll get much farther.

Be useful. Say things in quick soundbites that are helpful, and things that are different. Not just, “Use sunscreen every day;” You need an angle or a hook, something that’s going to make it stand out and resonate. You need to be interesting that way.

Don’t give in to the temptation to say something that you don’t believe. I’ve refused television appearances because I didn’t believe in a device or an angle to a story they wanted to cover. I’m not going to go on TV to say something I don’t believe to be true. But I’ll try to find an angle that will be helpful. Some of the do it yourself, home remedies may not be what we talk about in our practice with our patients, but it’s an opportunity to say, “Yes, you can do this at home, and while you’re doing it, also be sure to use great sun protection after or if you feel a rough patch, know that that could be an early sign of sun damage that could lead to skin cancers. Show your dermatologist, treat it early.” Find the angle that’s going to get you that “in” to the message you want to deliver, and you can control the interview in that way.

You don’t have good control over print. You can do your best to give information and hope the writer is good and quotes you correctly. Some will send you quotes they plan to use for you to review but many will simply put things to print without confirming with you. Also, you may have a long interview and end up with a short quote, that’s just how it goes with media.