PracticalDermatology

We live in concerning times. Clearly, this statement isn’t hyperbole, based on news from foreign nations, news and views from our own country, and the mood of uncertainty that pervades our relationships (personal and international), as well as the angst of everyday life. Brick and mortar businesses such as Toys ‘R’ Us are shuttering, while entire segments of the economy relocate or disappear overnight, some of those segments trusted brands that only years ago were the darlings of the stock market. What does all of this mean when we consider our practices and livelihood? Is the shoe about to drop on cosmetic dermatology and the entire lifestyle aspect of medicine?

I would say that we shouldn’t worry (too) much, based on historical trends. In order to answer such questions, perhaps it is best to look at the cycles that have defined our country and how these cycles ended. If we look back 50 years ago to 1968, the mood then could only have been one of devastation, with two assassinations (Robert F. Kennedy and Martin Luther King, Jr.) on the heels of President Kennedy’s assassination just five years earlier. These events were as impactful then as any we have seen recently, including even 9/11 and the housing/economic debacle of 2008. As an eight-year-old in 1968, living in New Haven, CT, I recognized but could not fully understand the basic fundamentals of what was happening. I was only a stone’s throw away from anti-war demonstrations at Yale University and casually observed posters for the musical Hair as well as other “hippie” and counter-culture activity in my town and on visits to New York City. It’s important to note that I felt safe, and hopefully the children of 2018 feel likewise. We can withstand many things as adults, but one can only hope that there is still a certain naivety that shelters kids from the ongoing bitterness.

I remember, too, that a mere eight years later, when I was in my teens, I longed for more interesting and meaningful times and wondered how it all became so boring. How quickly things can change! But then again, this may be due to the fact that I consider myself an unrelenting optimist. That could potentially have clouded my judgment and response to the sets of trials in the 60s and 70s. In some ways, I have always felt that change will enhance our lives in some ways, though I still have yet to find the benefits in the constant immersion in electronics that our younger generation (and to some degree, the older one) experiences now.

One can look at 50 year cycles as barometers of unrest, with occasional spikes within the 50 years. Think back to 1915-1918 (WWI), 1861-1865 (Civil War), 1812 (the War of 1812 and the burning of the White House), and the 1770s (Revolutionary War). Basically, every recent 50 year period has contained the significant amounts of our most desperate of times as a nation and people, excluding the 1930s (Depression) through 1941-1945 (WWII), yet even these times were followed by relative calm and happiness. Hopefully, this will be the case with the present situation.

My hope and “prescription” for us as dermatologists, along with our families and loved ones, is that we get past this unpleasant point in our lives and the life of our country and enter the stability and prosperity that has defined the “after glow” of previous 50 year cycles. It can’t happen too soon!

On the horizon for the practice of dermatology and cosmetic dermatology are hopeful signs. The advances of the past 50 years are causing their own reverberations, but recent data show that our workforce is earning more and becoming more diverse (though this is still not where it should be) and with more alternatives for practice. Additionally, new, upstart companies continue to come into our space, recognizing that dermatology is a special place with huge, unlimited potential, much of which is derived from the remarkable talent we luckily attract as a specialty. This talent surplus and innovation bedrock will always serve us well, in all times and all seasons. n