Intergenerational Dermatologists: A Family Tradition in All Respects

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.

In this segment, the family connection extends to the unique relationship between spouses. Sandra Lee, MD, and her husband, Jeffrey Rebish, MD, met in medical school and now share a dermatology practice in Upland, CA. The two describe how they manage their personal and professional lives in their joint dermatology practice and in conjunction with Dr. Lee’s “Dr. Pimple Popper” persona and multimedia business. Dr. Lee’s father is a dermatologist (now retired) who added his perspective on his unusual introduction to dermatology and changes in the specialty.

What inspired each of you to pursue a career in dermatology?

Sandra Lee, MD: Jeff and I dated in medical school, and I probably helped introduce him to the specialty. I think he may have been interested in orthopedics initially, since he had some personal experience in this area after breaking his ankle while pole vaulting in college. However, he told me that he saw what a wonderful specialty dermatology is, and how much I loved it, and he became interested in it himself.

Jeffrey Rebish, MD: Dr. Lee had always been interested in the surgical part of medicine and dermatology, and I realized quickly that it is so much more than rashes, acne, and warts. By the third year of medical school, we both planned to pursue dermatology.

What factors influenced your decision to practice together? How has that impacted your relationship?

JR: Dr. Lee’s father had a private practice in California. She never had an opportunity to practice alongside him because he was preparing to retire. However, she would visit to perform some Mohs surgeries at his office while doing her cosmetic, surgical, and laser fellowship in San Diego.

SL: I would actually ask my father to come to the office and hang out during the times while I was in the office doing Mohs on my own on the weekends, for moral support. I would hear him playing the ukulele and singing in his office while I was doing surgery.

Meanwhile, Jeff practiced with my father in his office during that time. He worked well with my father, and Jeff and I have a great working relationship. We can work well together because we all have our own strengths within dermatology that are different and result in a well-rounded practice. We don’t work for each other but work independently, which is the key to success, in our experience. If one of us had to answer to the other it would devolve into anarchy!

How has your practice management evolved because of your appreciation of each other’s different strengths?

JR: Working with a spouse as dermatologists in a practice is an advantage. You can speak the same dermatology language and understand the frustrations and the celebrations of growing your own practice together. There is a level of honesty and respect that probably can’t be achieved between and among other dermatologists practicing together.

SL: If Jeff doesn’t agree with how I practice, he will tell me, and of course I respect his opinion. We are a team, and we want each other to do well and succeed and we depend on each other for this success.

As an added bonus, Dr. Lee’s father, Soon Seng Lee, MD, shared his perspectives with Practical Dermatology on what has changed between his entering the field and his daughter’s experiences.

PD: What inspired you to pursue a career in dermatology?

SSL: I spent my first year in medical practice in the late 1960s as a medical officer in a rural community in the midst of Malaysian jungles. While I was able to offer medical and surgical services adequately, I was frequently flummoxed by patients with skin diseases. I managed by going behind the privacy curtain to flip through a small book on skin diseases left behind by a U.S. Care Medico team who had provided medical service there prior to my posting. The pictures, some in black-and-white, helped a great deal. The book also had concise discussions on diagnosis and treatment (pre-hydrocortisone days). Every time I consulted this book, my interest in dermatology increased, until I decided that I would become a dermatologist.

How much, if at all, did you encourage your daughter to pursue a medical career in general and dermatology in particular?

SSL: I did not directly encourage Sandra to pursue a medical career, but I did encourage her to help out in my practice (as a nurse’s aide) in her later school years. Invariably each patient, upon hearing that she is my daughter, would shower her with praise of, and admiration for, her father. My patients steered Sandra toward dermatology.

What do you think are some of the greatest changes in approaches to treatment in dermatology since the time you began your career, and when your daughter entered the field?)

SSL: When I started my residency in dermatology, we had begun using topical hydrocortisone. Topical triamcinolone acetonide arrived soon after. I remember comparing them against treatments using gold leaf and magnesium sulfate.

By the time Sandra entered the field, training was available for dermatologic surgery, cryosurgery, laser skin surgery, liposuction, Mohs surgery, hair transplantation, and chemical peels, and a special certification in dermatopathology was offered. Sandra also got started in dermatology at the right moment to surf the internet wave. Now, artificial intelligence is making and impact.

What do you enjoy most about having your daughter follow in your career footsteps? Any advice?

SSL: I did not share much about patient care with my daughter, because as soon as she joined the practice, I retired to indulge in fly fishing. I used to hear patients remark that “Oh, you are Dr. Soon Lee’s daughter!” Now, I only hear “Oh, you are Dr. Sandra Lee’s father!” My only advice: keep your patients happy and you will be happy.

Are there some key differences in your approaches to treatment and/or administration of the practice that balance each other? Any areas on which you agree to disagree?

JR: We balance each other well because we have strengths that complement each other. Dr. Lee’s strengths are the surgical/cosmetic, while mine are medical and managerial. Working together has increased our closeness. Sometimes we may disagree, but most importantly we greatly respect each other’s opinion and know that we share the same goals.

SL: I joke that he is the brain and I am the personality. I’m the dreamer and he is the realist. All joking aside, I think we are a great team.

What strategies have you developed to maintain a work/life balance?

JR: We have had things happen in our practice which we couldn’t have predicted. The whole “Dr. Pimple Popper” phenomenon has brought attention we would never have imagined. Recently our practice was acquired by Forefront Dermatology, we knew we were too busy to manage the day-to-day aspects of practice, and this has helped relieve some of the stress and greatly helped with work/life balance. Personally, we are on the edge of being empty nesters, so we are approaching another chapter in our life, and we have hopes that this new chapter will be a little more relaxed. We both play golf, although Dr. Lee has put that activity on the back burner over the past decade, she has increasing thoughts about getting back to it. We enjoy each other’s company both professionally and personally, we are a real team in work and in life, and we enjoy the present while looking forward to the years to come.