At a glance (for my skimmers — I see and honor you 🙏)
Welcome to this week's edition of the Above & Beyond Dermatology Newsletter. Thanks for reading. Feedback is encouraged and appreciated. If there's something you'd like to see more (or less) of here, please let me know by replying to this email. I want this to be worth your time and attention. If you have a dermatology or other health-related question that you'd like me to answer in the newsletter, let me know! Creative Blocks (The Good Kind)I was just listening to a podcast where one of the guests said she was feeling excited and remarked, "I just had a great creative block working on a storyboard for one of our upcoming features." One of the things that wore me down the most during my 4+ years of "corporate medicine" was that my schedule looked the same every day. If I wasn't in a room taking care of a patient, I wasn't actively making money for my employer. So, not surprisingly, my schedule didn't have any "creative blocks" built into it. And when we needed to have a staff meeting? Yeah, lunch. Was lunch provided? Of course not. If you've ever worked inside one of these systems, you've likely experienced how short-term-focused the leaders typically are. A doctor doing "creative work" could yield long-term results, but that work wouldn't push the Q1 revenue cycle forward, so it doesn't get prioritized, encouraged, or compensated. With all work and no play… what can you expect? I love the idea of having "creative blocks".This type of block refers to a block on your time/calendar. The act of blocking acknowledges the intrinsic importance and value of creative work. This is, of course, different than the proverbial writer's block that you may have thought of when I first said creative block. If you're having this kind of block, it means you need to fill your tank. Reliable and consistent creative output requires creative input. If you're having a block, your tank is likely empty. Start refilling your mind with things others have created. That will get you going again. If you're an employer, consider the long-term, compounding value of the consistent prioritization of creative work, especially in areas where "creativity" is not typically expected or encouraged. I bet your teams will be more engaged, more excited, and more productive in the long run as a result. To support my engagement with this train of thought, I'm excited to read Cal Newport's new book Slow Productivity: The Lost Art of Accomplishment without Burnout. I hope you'll consider joining me (hit reply and send me a quick message if you're interested in a book club). The Direct Care Derm — A Podcast from Above & Beyond DermatologyThe show is up to 1,107 listens in 8 weeks. I believe in celebrating small wins and giving yourself and your team credit for how far you've come (living in the Gain). I know there are as many podcasts as stars in the sky, but not all of them make it past 10 episodes and/or 1K listens. I'm proud to be in that club. 🥳🍾 Episode #011 is now available! Join us for the Part 2 of a wide ranging, provocative, inspiring, and fun conversation with the one and only Sarah Asch, MD, FAAP, FAAD. Chestnut 🌰 CheckersThis recurring segment was inspired by an episode of Nathan Barry and Rachel Rodgers' excellent podcast Billion Dollar Creator, in which they explored ways that some creators are playing chess while others are playing checkers. They referred to this as "chess not checkers," but Nathan mentioned that some people thought they said "chestnut checkers" and were confused. I laughed. 🤷♂️ So, where am I playing Chestnut Checkers? One of the things that frustrates me about the insurance-dependent dermatology practices in which I've worked is what I call the "one size fits none" model. In this model, a relatively healthy person struggling with mild eczema on a localized part of their body gets the same amount of time on my schedule as someone with a complex medical history, a binder full of records, and an as yet undiagnosed problem that has been coming and going for the last 5 years and is having a devastating impact on their quality of life. Coincidentally, this issue of the Journal of the American Academy of Dermatology arrived in the mail today. The second patient I described could have erythromelalgia, as depicted on the cover of the March 2024 issue. If you know anything about that dreaded disease, you know even a 15-minute consultation — a luxury to most insurance-based dermatologists — isn't nearly adequate. To add insult to illness, the second patient may have taken the day off from work to travel several hours in terrible weather to see the dermatologist (or a physician assistant or nurse practitioner) for what will inevitably feel like a small amount of time to them given the magnitude of their problem. Several weeks later, the "explanation of benefits" and subsequent bills that these two patients receive may look alarmingly similar or perhaps even identical because of the way insurance-based billing works. Since insurance-dependent practices increasingly rely on taking care of a high volume of patients to compensate for the seemingly constant downward pressure on what insurance companies, despite being wildly profitable, are willing to "reimburse" the practices in return for taking care of insured patients, the doctor has to sacrifice quality in favor of quantity in order to keep the proverbial lights on. At Above & Beyond Dermatology, we don't tolerate a one size fits none business model. It's not good for you, and it's not good for us. Lose-lose. Like Liberty Mutual, we want you to only pay for what you need. I have a lot of ideas about how we can achieve this. Not all of these ideas will end up being effective or sustainable, so I'll collect data, learn, and iterate over time. One tactic I'm using is good faith free estimates via phone. If you're a Wisconsin resident and would like one, simply send a text to 715-391-9774, and we'll get started. No strings attached. Another tactic is tiered pricing. We see tiered pricing everywhere these days. If you've purchased a car, remember the different trim options? That's tiered pricing. If you've purchased a piece of SaaS (software as a service), remember the "starter", "pro", and "enterprise" options that include progressively more features and access in return for higher prices? That's tiered pricing. Above & Beyond Dermatology will be using a lot of different levers to raise the standard of care in dermatology. However, not every person needs or wants all of these features, and they shouldn't have to pay for them. Access to patient-led peer support groups and group health coaching, for instance, could be part of a membership plan for people who are all-in with respect to achieving the kinds of transformations I know are possible. Tiered pricing is a great way for a customer to pay only for what they need and for a business to be compensated appropriately for what they are providing. Win-win. My friend, direct specialty care trailblazer, and rheumatologist, Dr. Diana Girnita, has a good example of pricing from which other docs can learn. She'll be on the podcast soon. Dr. Girnita was featured prominently in an excellent New York Times Magazine piece called The Moral Crisis of America's Doctors. The subheading of this article hits home for me and so many others I've talked to: "The corporatization of health care has changed the practice of medicine, causing many physicians to feel alienated from their work." I know the modern consumer wants and expects options and personalization. Patients may not feel like consumers these days, but I think that's because they rarely have much choice or clear knowledge about prices, so they just take what they can get. It's time to change that. It's time for a new standard of care. Treat Yo' Self!It's finally time to announce the winner of the Podcast Launch Treat Yo' Self Skincare Giveaway, courtesy of my friends at RegimenPro. This one was definitely worth entering, so be sure to pay attention when the next one is announced. Here's the luxurious 4-step regimen from SkinMedica that will soon be on its way to the winner's home. SkinMedica Facial Wash — RegimenPro's highest customer rated cleanser for all skin types. Removes environmental pollutants, excess oil and makeup, and hydrates and refreshes skin. SkinMedica Vitamin C&E Complex — Vitamin C+E Complex contains vitamins C and E in a formulation that gradually delivers high levels of vitamins C and E to the skin to provide antioxidant protection all day long. Great for all skin types. SkinMedica TNS Advanced+ Serum — This next-generation, skin rejuvenating formula improves the appearance of coarse wrinkles, fine lines, skin tone, and texture. It’s the only growth factor product proven to address sagging skin. Visible results in just 2 weeks. Results continue to improve through 24 weeks of use. SkinMedica Essential Defense Everyday Clear SPF 47 Broad Spectrum Sunscreen — This lightweight, sheer sunscreen is ideal for oily and/or combination skin, giving you the highest level of UVA protection available, along with UVB coverage in a formulation that won't clog pores. Great for oily and combination skin. Total Retail Value: $481 Big, grateful shout out to Jodi and Courtney from RegimenPro for helping put this together! Drum Roll Please.... . . And the winner is… me mum. 🤣 Hey, she earned the maximum possible number of entries. 🤷♂️ Ya gotta be in it to win it. Congratulations, Monica Lewellis, mother of the author of an obscure email newsletter. The SkinMedica Essential Regimen is heading your way! 🍾 As early subscribers may recall, chances were earned in four different ways: downloading, following/subscribing, leaving an honest review, and/or sharing the podcast. I'm a proud alumnus of Haverford College, famous (infamous?) for its Honor Code, so we used the Honor System for this. Listeners who did any of the following simply told me what they did, and I kept track of it. Any number of downloads = 1 chance; follow/subscribe = 2 chances; sharing somewhere within your network = 3 chances; honest rating and review = 4 chances. After assigning each entrant a number or set of numbers based on the number of chances they earned, I used Random.org's truly random number generator to generate a truly random number, which was 24. If it was 42, I would have had to question it because that also happens to be the meaning of life. That one was for my dad. Hi, Dad! Stay tuned for the next giveaway, and thanks to all who entered and supported the launch of The Direct Care Derm!
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I’m a board-certified dermatologist who saves lives (!) by helping people reduce their risk of succumbing to common chronic diseases by fixing their immune systems and getting great looking and feeling skin, hair, and nails along the way. My weekly newsletter is an opportunity for you to get to know and trust me by learning from what I'm building in life and business.
For all who celebrated, I hope you had a wonderful Thanksgiving with family and friends. I'm grateful to all of you who bother to open and read these notes.Instead of selling you something on Black Friday, I want to give you something.Today on my podcast feed, I released a bonus episode that contains an audio version of an unfinished e-book that I started writing many months ago. Here's the cover I mocked up over a year ago. Don't judge my graphic design skills. They've improved a bit since...
I just got off of a call that inspired me to send this note.Wouldn't it be nice if you had a board-certified dermatologist in one of your group chats? This would NOT be for individualized, formal medical advice. That's what Above & Beyond Dermatology is for. If you're looking for that and happen to live in WI, MN, IL, CO, NE, or AL, reply to this email with a bit about what you're struggling with, and we'll see if it's a good fit. It would, however, be a place where you and your soon-to-be...
When it comes to sun preferences, I don’t judge my patients or anyone else. But I do know from experience that one of the best ways to look like a grandma or a grandpa when you’re actually just a mom or a dad is to abuse the sun on a consistent basis. If you’re interested in sun protection, a great tool in the kit is a reliable broad brimmed hat that you’ll actually wear. However, functional sun hats often leave something to be desired when it comes to fashion. Fortunately, the good folks at...