Superficial Anatomy and Cutaneous Surgery

Transcription

1 Superficial Anatomy and Cutaneous Surgery 33 Things I ve learned in 33 years From Our Course Hugh Greenway, M.D.

2 # 1 To Be A Doctor Where we each began. Surpasses other noteworthy accomplishments:» Division/Department Head» CEO Scripps Clinic» Am Acad Derm Board member, Sec/Treas To Be A Doctor

3 #2 Anatomy Rules For those who have dissected or inspected many, have at least learn d to doubt when the others, who are ignorant of anatomy, and do not take the trouble to attend it, are in no doubt at all.» Giovanni Battista Morgagni ( )

4 #3 Develop Your Idea See a need Add value Sell it! (Will they (Dermatologists) come?) Concept of Superficial Anatomy and Cutaneous Surgery Cadaver Course

5 # 4 Learn From Other Specialties The Principles and dynamics of Local Skin Flaps by Terence M. Davidson, MD, and Richard C. Webster, MD»»» A self instructional package Am Acad Otolaryngology 1979

6 #5 Learning Environment Lectures Laboratory: Fresh Cadaver Workshop sessions Fun Time: Wednesday Aquarium

7 # 6 Too Much of a Good Thing! Don t Over Do It Add a second one during same summer: DISASTER Maintain value/quality Limit attendance

8 # 7 Anatomy Can Be Mastered Medical School Experience Now Derm Residency Experience (not in 1982) Cutaneous Surgical Anatomy of the Head and Neck by Breisch/Greenway 1992 Other texts by our Faculty

9 #8 Love Lasers My 1 st Laser Argon 1984; followed by CO2 in 1985; now for Dr. Ross (#30 +) Incorporated into course World is the Target OPENED THE HOSPITAL OPERATING ROOMS TO DERMATOLOGISTS

10 # 9 Mistakes Happen I have made many mistakes myself; in learning the anatomy of the eye I dare say, I have spoiled a hatful; the best surgeon, like the best general, is he who makes the fewest mistakes.» Lectures in Surgery» Sir Ashley Paston Cooper ( )

11 # 10 Scariest Chair on the Planet Defendant Chair in the Courtroom Expect; only a question of when You WILL take it personal initially Part of business of medicine today

12 # 11 The Before And After in Derm Surgery Preoperative and Postoperative Dermatological Surgical Care ; Greenway and Barrett Documentation Wrong site

13 #12 Cosmetic Dermatologic Surgery/Procedures: Must Do Dermabrasion (? How teach in cadaver Lab) Lasers/Peels/Lipo/HT/Botox/Fillers/Other Dermatologists are the premier innovators in 14 of 18 categories of non-invasive and minimally invasive cosmetic medical procedures (Dermatologic Surgery march 2016)

14 #13 Copying is the Best Form of Flattery Don t worry about others copying you Continue to be your best

15 # 14 Evening Task Place a PHONE CALL to each of that day s surgery patients. They will be amazed/tell everyone KEY: call at 8:45 PM; not 6 PM

16 #15 Be a Surgeon, Physician, Pathologist, and Researcher As he (William J. Mayo) approached the place where a meeting of doctors was being held, he saw some elegant limousines and remarked, The surgeons have arrived. Then he saw some cheaper cars and said, The physicians are here, too. A few scattered model-t Fords led him to infer that there were pathologists present. And when he saw a row of overshoes inside, under the hat rack, he is reported to have remarked, Ah, I see there are laboratory men here.

17 # 16 The World is Coming June 2006 Global Education Conference: Featured Speaker in China Global Communication Instantaneous Welcome to our Course Dermatologists/Physicians from all over the Globe

18 # 17 Medicine is a Utility Benefit Regulated Who Pays? Example: Electronic Brachytherapy for Skin Cancer: Medicare: year 2011 to 2014: 20 fold increase (1214 to 24, 325 teatments)? Economicaly driven; changes made.

19 # 18 Leading a Great Course: Love your Faculty; Colleagues; Staff Success is a team effort Committed Long-termers Inter/Intra Specialty Dialogue Remember those no longer with us: Terry Davidson MD; many others, cycle of life

20 # 19 Preserve Yourself Avoid Pedal to the Medal Lifestyle Selectively Disconnect Say No

21 # 20 Procedural Dermatology now Micrographic Surgery & Cutaneous Oncology ACGME Fellowship approval Deal with Surgery term 20 + years in making..ed Krull. Enormous Benefit(s) to specialty ASDS Evolving Cosmetic Fellowships

22 #21 Love Yields Success Love your patients Love your specialty Love your staff Love yourself

23 # 22 INVEST IN YOURSELF Do the Courses (ie You are here!) Do the Study Continually Update RUN like a Gazelle, or, RUN like a Lion, But RUN

24 #23 Fable Emperor/Wise Men/Ultimatum: You have thirty days to deliver to me a single concise sentence that I can use to serve as a solution to every problem brought to me. Do it, and you shall be richly rewarded. If you fail, you shall be beheaded. Story/Answer: And this too shall pass

25 #24 At The End of The Day At the end of the day, hopefully everyone in your office will go home happy. However, if someone(s) has to go home unhappy, who should it be?? My advice, the Physician should always Go Home Happy

26 #25 Happiness: 3 Amazing Tips from the world s oldest ongoing case study:1937 Harvard Sophmores 1. Have a Healthy Outlet 2. Don t Take Yourself Too Seriously 3. Happiness Must Be Shared

27 # 26 Value of Time Lesson: Patient Sol Price (lived 93 yrs) (Price Club/Costco) How old are you? I wish I was your age

28 # 27 People Get Screwed All the Time Book by Robert Massi (patient/friend/fox News TV legal annalyst / Property Man ) You will be wronged by:» The system» People you trusted» People you have no control over GET OVER IT

29 # 28 Change: Manage it Embrace EMR;Guidelines;Regulations Maintain yourself; your are not a provider You are a Physician

30 #29 Go Offline Ditch the cell phone at dinner Disconnect regularly when possible Concentrate on live converstion with spouse/partner Be a solo tasker during this time

31 # 30 PAC s Political Action Committee Dermatologists under fire Formerly success with RUC, etc Now must have Political support/influence Business/Practice/Personal Investment ($) Pyramid: Way the game is played

32 # 31 PAC s help Politicians Help Us People : who give & raise $ People : who give $ People : give time & support People : who support People : who vote People : registered voters People : in my district/state

33 # 32 How Do You Measure Success? Different depending on your perspective Practice/Academics/Research/Financial 92 yo mother, Kathryn Greenway, May I see you are finally successful You were in my Readers Digest

34 #33 To Be A Doctor People will not remember what exactly you said People will not remember what exactly you did People will remember exactly How you made them feel

35 Superficial Anatomy and Cutaneous Surgery 33 Things I have learned in 33 years From Our Course