practical derm

Although many children follow their parents’ paths to medical school, the specialty of dermatology seems to have distinctive family appeal. Practical Dermatology® reached out to several dermatologists with family connections for their perspective and reflections on the field. 

This segment features William P. Coleman III, MD, a dermatologist and cosmetic surgeon in private practice in Metairie, Louisiana, and his two dermatologist sons: W. Patrick Coleman IV, MD, who shares the practice with his father in Metairie; and Kyle Coleman, MD, a dermatologist in private practice in New Orleans. 

Pictured, L to R: William P. Coleman III, MD; W. Patrick Coleman IV, MD; Kyle Coleman, MD.

What inspired you to pursue a career in dermatology?  

Dr. William P. Coleman, III: I was lucky to have many mentors who took an interest in me. During medical school, I was heavily involved in research in the Tulane University surgery department, working for the chair of plastic surgery, Dr. Robert Ryan. He asked me to take the lead in an initiative to have medical students write a series of introductory programmed textbooks on various aspects of surgery. The idea was that someone who had recently learned a subject could more easily teach it. I was paired with various surgeons on the faculty who oversaw my efforts. I eventually co-authored 10 mini-textbooks in this fashion, including Soft Tissue Injuries, Tumors of the Skin, and Diagnosis of an Unknown Lump in the Neck, among others.

My father was an allergist who served on the Tulane clinical faculty. The chair of both dermatology and allergy at that time was Dr. Vincent Derbes, a brilliant man and dear friend of my father. He seemed to know everything about not only science and medicine, but also history, philosophy, and literature. He challenged me at every turn, encouraging my interest in research. Although I was planning to become a plastic surgeon and had begun a surgery residency, Dr. Derbes convinced me that the future lay with a combination of surgery and dermatology.

How much, if at all, did you encourage your sons to pursue a medical career, and particularly one in dermatology? 

My physician father went out of his way to discourage my interest in medicine, but I was so happy with my career choice that I strongly encouraged my own sons to become doctors. I used to say that I told happy stories of my day’s work around the dinner table. Once they were in medical school, they flirted with all the options, but eventually decided on dermatology. They had plenty of exposure to my practice, assisting in the office and in our clinical trials, so they knew the field well.

What do you think are some of the notable evolutions in dermatology training and practice since the time you began your career to when your sons entered the field? 

I started my residency in the early days of dermatologic surgery. The first issue of the journal Dermatologic Surgery and Oncology came out while I was still a surgery resident. Today, I am the editor-in-chief. I have witnessed continuous advances in dermatologic surgery over my career, from the earliest days of Mohs surgery through lasers, liposuction, fillers, neuromodulators, and beyond. I have been lucky enough to help pioneer some of these areas. My sons have entered a more mature specialty.

Since advances in technology have always been part of dermatology, I think we all have come to expect an endless output of new tools. This is no less true for my sons than it was for me. 

Also, the specialty of dermatology has always afforded a flexible work-life balance, as it does today. The difference is an increasing loss of autonomy for younger dermatologists, and a corollary of that is less excitement and engagement in one’s career.

As for patients who find questionable information online, that scenario is very much the same as their forebearers who believed what they read in popular magazines.

What aspects of dermatology training and practice have stayed the same? 

It is still all about the patient. A successful dermatologist must be a good communicator and an effective teacher to obtain the best results.

Did you advise your sons on any pearls and pitfalls of practicing dermatology?

We constantly talk about the latest advances and how they might be important to our practices. We also talk about risks, both external and internal. Every field has its landmines and knowing where they might lie is important. I am a vice president of a medical liability company, so I am by nature risk averse.

What do you enjoy most about having your sons follow in your career footsteps? 

It is a blessing to be able to discuss your job with a son as a colleague. It is a glue that binds us together in ways that would not otherwise exist.

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Dr. W. Patrick Coleman IV and Dr. Kyle Coleman share the impact of their father’s positive outlook and vast store of knowledge on their decisions to pursue dermatology.

As a child, and as a teenager, what did you think about your father’s job?  Did that impact your decision to choose a medical career?

Dr. W. Patrick Coleman IV: As a child, I knew my father had an important job, although I’m not sure I completely understood what it was. As a teenager, I became more aware of what my dad did and how important he was in the field of dermatology, as people would approach us when we were with him at meetings and treat him like he was a celebrity. How could it not have an impact on my and Kyle’s decisions to choose a medical career?

Dr. Kyle Coleman: As a child, I used to ride my bike by my father’s office to get a Coke in the summer. At that time, my grandfather, an allergist, was working in the office with my father. I never even thought about why, but even at a young age I always assumed that I would go to medical school. I think seeing my father and grandfather in a practice setting as a child and helping with studies in the office during college showed me what a wonderful career medicine is.  

Did you know on entering medical school that you wanted to pursue dermatology? Why or why not?

PC: Beyond how my father was a massive influence on my career path and how much I looked up to him, I worked during my summers in college with Timothy Flynn, MD, who was on the dermatology faculty at Tulane University.  He was the Mohs surgeon at Tulane, and that was my first exposure to surgery and the dermatology residency program.  I worked on a number of papers and a book chapter with Dr. Flynn, and this formed a strong foundation for my interest in dermatology, although I was also considering plastic surgery.

KC: Patrick and I were in school together, first at Southern Methodist University and later at Tulane Medical School. Having him two years ahead of me probably made the experience less stressful for me, because I could see what he was going through in medical school and get a sense of it in advance. 

Initially, I thought that I wanted to go into orthopedics or plastic surgery, but after rotating through the different specialties and doing electives, I realized that dermatology offers so many different paths, and after my dermatology rotation, I knew that there was no other field for me. -by Heidi Splete

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