PracticalDermatology

Business Savvy

The daughter of two physicians, Dr. Jegasothy had an interest in medicine but was also drawn to business. When her parents learned she was considering a career in finance, they enticed her to go to medical school by offering financial assistance throughout her schooling. “Since I liked business a lot, I have really enjoyed the business of running a practice, so it all worked out well,” she says. “When you have great staff, you can be a business person as well as the doctor.” Today, she says, “I am happy with the choice and with the life that it has afforded me.”

How did your father’s dermatology career influence your decision to become a dermatologist?

My father, along with his post-graduate colleague Dr. Rick Edelson at Yale, was instrumental in developing photopheresis for cutaneous T-cell lymphoma. This treatment made CTCL, previously untreatable, very curable.

Since he was a rapidly “rising star” in dermatology academia, my father’s career took a front seat to everything else in our family dynamic, so we moved and started a new school every four years. My father was at Yale first, when I was in elementary school. Then he was at Duke, so we lived in Durham NC, when I was in junior high school. Then he was at Penn, so I went to high school in suburban Philadelphia, and after that he moved on to chair the Dermatology Department in Pittsburgh, while I went to college at Harvard. Although this can be tough on kids socially, it has created an unshakeable resilience in me. Also, it was nice having a father who people knew in the field, and it was particularly nice during my dermatology interview circuit, because I had met most of my interviewers when I was a child.

What challenges did you face building your practice?

I finished dermatology residency at the University of Miami Miller School of Medicine in 1998. I loved Miami, so I wanted to stay. I also had the feeling that this would be a great breeding ground for a very advanced aesthetic dermatology practice. I started out working for a high volume and moderately aesthetic practice for about 16 months. Pretty quickly I saw that aesthetically inclined patients gravitated toward me and I liked them, so I decided I could go out on my own fairly quickly. I signed the lease on a space in downtown Miami, the Brickell Avenue financial district, and basically hung up a shingle.

In those days, the biggest challenge was getting onto insurance plan physician networks for medical dermatology, and 30-40 percent of my revenue in 2000 was medical dermatology. I just had to keep trying and keep calling the same bureaucratic insurance people over and over and frankly, anything you want can come to you that way. People will ignore you; they won’t return your calls. But if you call them often enough, they will then help you because they want you to stop bothering them!

Did you always think of running a business as part of practicing medicine?

I always have thought about it that way. That’s why I was never going to go into academics as my father did. I love the business aspect of running a practice. I feel like a lot of ancillary marketing companies, businesses, and vendors that operate around physicians are missing the boat when they suggest they know what I need and how to best market my practice—and know these things better than I do. I’m always shocked, because I’ve been marketing my practice and running things for 20 years and they’re maybe all of 25 years old themselves!

The assumption is also often made that doctors don’t want to do anything except see patients, and that couldn’t be further from the truth for me. I like doing the other jobs in my practice—marketing, bookkeeping, and office design. I love those things as much as I like seeing patients. So when somebody reaches out to me and says, “Oh, let me do this so that you can just do what you want: see patients,” that’s an assumption they’re not qualified to make and they’ve already missed the boat. I’d love for these people to know that not every physician is like that. In fact, many of the more successful aesthetic and medical private practitioner dermatologists love to be involved in all aspects of their businesses.

Why emphasize charitable work?

My family was very religious; I was raised in the Protestant Church. There is a Bible verse from the Book of Luke on the charity page on my website: “To whom much is given, much is expected.” I’ve always believed that. Because I have been so blessed with many gifts, a great family, and have had a great life, I feel beholden to give back to people who may be less fortunate than me. And it started I’d say when I was seven or eight; I always collected the most in my class for UNICEF at Halloween and it went from there. There hasn’t been one summer since seventh grade that I haven’t volunteered at a hospital, or at a children’s clinic, or some sort of other charitable organization.

What unique perspective do you feel that you bring as a KOL?

Because I have a solo practice and it’s fairly lean, I’m able to “steer the small ship” quite nimbly. Whenever a new procedure comes on the scene, I can try it quickly and can generate my own data so that I can have a good idea how it works, or whether it works at all, sooner than many other big practices. I find that very useful.

I always tell my patients—and I love this aspect of what I do—that Aesthetic Dermatology is maybe one of the few careers that women can actually get paid more for the same work than men, because frankly we understand the largely female clientele and we understand the detail that is required of the job more than men. I’ll even go out on a limb and say that I think that women are more detail-oriented than many men and that trait has enabled women to excel in Aesthetic Dermatology. We also understand other aspects of beauty, such as makeup application and skincare, because we have always used these things more than men, often since childhood.

Who were your most influential mentors?

Obviously my father was influential in terms of helping me with the dermatology match. He was also a great mentor for any of my academic pursuits. If I needed an SAT tutor, or if I needed someone to help me with my college applications, he was always there to do those things and outsource if necessary.

My grandfather, my mother’s father, was my mentor in terms of learning. He taught me how learning is valuable not just for excelling in school and your career, it’s also a valuable pursuit unto itself. And I think that unless you feel that way about learning, you’re never really going to excel. You have to love it for itself. You have to embrace intellectualism as its own pursuit, separate from your career.

My grandmother, my mother’s mother, was a nurse, and my mother was a doctor. Growing up in a family where everybody is in the medical field is very reassuring. You always feel as a child that they will collectively be able to handle any medical issues you have, and so it’s a nice comfortable village in which to grow up. I think it would be nice for many more children to have had that kind of comfort growing up.