The Medical Practice Playbook
PRIVATE PRACTICE IN DERMATOLOGY,
My Perspective
by Timothy S. Brown, MD
Dermatology in an era where health care systems grow larger and more impersonal, private dermatology practices remain a vital force in delivering personalized care. This essay explores why I chose a single specialty private practice, what makes it rewarding, how our practice defines its mission, the tools that drive our successes and the challenges we continue to face in a rapidly changing health care environment.
In the late‘ 90s when I was looking for a job, there were only a few choices in the dermatology marketplace: solo practices, single specialty groups, multi-specialty groups or academic medicine.
After I finished my fellowship in micrographic surgery and cutaneous oncology at the University of Louisville, Associates in Dermatology offered me a job that provided me with a higher percentage of collections, more support staff, an opportunity to replace another surgeon leaving instead of having to start a new Mohs surgical practice from scratch and a clinical teaching position at the University of Louisville. My other two offers were from smaller private practice dermatology offices that required either more travel or much less support staff.
During my training, I saw how deeply skin disease can affect people not only physically, but also emotionally and socially. It is one of the few specialties where what a patient sees in the mirror can affect every part of their well-being. I realized that the best dermatologic care takes time, attention and continuity, and those attributes are often difficult to maintain in larger, corporate systems. I ended up joining the single specialty academically affiliated group that trained me both as a dermatology resident and as a Mohs micrographic surgeon. The group I joined is one that I feel exemplifies the best aspects of medical practice: collaborating directly with patients, being able to teach young physicians and working on a team that is running a successful business.
The most satisfying part of private practice for me is continuity of care. We are so fortunate to be able to follow patients throughout their lives – children with eczema, teenagers with acne, adults managing psoriasis and autoimmune diseases, older adults with skin cancer or those focused on prevention or cosmetic rejuvenation. Watching those patients grow and thrive creates lasting relationships that define the heart of this profession.
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