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  • Practice Management

Success requires balance, efficiency, perspective


To make patient visits as efficient as possible, Dr. Greenbaum recommends establishing up-front what's reasonable to accomplish in the allotted time.

Atlanta - While opportunities for technical education abound, too few dermatology meetings spotlight the day-to-day realities of running a practice, one expert says.

"A lot of medical meetings focus on the mechanics of medicine - in dermatology's case, the actual surgical techniques and methods. Yet practicing medicine is a lot more complicated than that because we're dealing with people, both from the physician and patient point of view," says Steven S. Greenbaum, M.D., director of the Skin and Laser Surgery Center of Pennsylvania in Philadelphia.

Finding balance

"But the dynamics of a practice change so much that there are many things that come into play every day that we must address," Dr. Greenbaum adds.

One such item is finding balance - in Dr. Greenbaum's case, between running a surgical practice, seeing patients, writing papers, teaching residents and spending time with his family.

"For me," he tells Dermatology Times, "my practice and my family are very important."

To avoid shortchanging either, he recommends focusing on whatever services or treatments at which you excel and find satisfaction in providing.

"As a dermasurgeon, there are often certain diseases or conditions that one may or may not feel comfortable in treating," he says.

He suggests instructing front desk staff to politely refer patients elsewhere if you wouldn't feel comfortable treating them. This leaves more time for work you enjoy, he adds.

Conversely, he keeps an open door for residents who may require his attention, because he says this work gives him a sense that he's giving back to the profession.

"I also set aside some time to write papers and read journal articles so that I can keep performing at the highest level possible," Dr. Greenbaum adds. "I don't go to every meeting that comes down the pike because that takes away from time with my family."

Variety spice of life

To avoid feeling overwhelmed, he advises physicians to pencil variety into their calendars.

Dr. Greenbaum says, "I do Mohs surgery every day, but I try to vary my schedule so that on Tuesdays, perhaps I'll do exclusively Mohs surgery and maybe some cosmetic surgery. On Thursday afternoon I may focus on melanoma surgery."

Conversely, Dr. Greenbaum allows himself one afternoon weekly for what he calls personal time.

"In medicine," he notes, "we're so constantly dealing with how to help someone else that we can get burned out. It's important to occasionally focus on oneself a bit."


Dr. Greenbaum offers the following pearls to help dermatologists keep smiling while simultaneously running successful practices:

"If one does that, one can't win," Dr. Greenbaum says.

"When one is starting out in practice," he explains, "start slow, build to one's comfort level and stop. One of the highest stressors we face is trying to see too many patients in one day."

For example, he says, "One doesn't want to have people checking in at the same place they check out."

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