Marc Mitton, DO shares his experience with Mark Taylor, MD
Working with Dr. Taylor has been an eye-opening experience. He owns a large medical, surgical, and cosmeceutical dermatology practice with over 60 lasers as well as several other devices. He also precepts as the main attending for an ASDS cosmetic dermatology fellowship. During my week with him, Dr. Taylor and his fellow, Dr. McClean, performed several procedures that enhanced my training including full laser resurfacing, upper and lower blepharoplasty, acne scar revision, light facials, pico facials, tattoo removal, hair removal, as well as several other modalities.
Dr. Taylor’s knowledge of lasers and other devices was that of a master. He has dedicated years of his life to studying the basic science and practical use of these machines and his patients reap the benefits. Since 1984, when he decided he would become a laser expert, he has been building both his knowledge and expertise as well as his exquisite practice. Each time a new laser was used during our week together, he was able to explain what the laser was, important settings and why he would adjust them, and other options he could consider for treatment and the pros and cons of each. He took time out of his day to make sure I had a good experience. He gave this same focus to his patients. Each patient was given his full attention and knew all of their options and the pros and cons of each before the end of the visit. He was fair and ethical in his assessments and recommendations. He provided an excellent patient experience.
Before this preceptorship experience, I had used IPL, PDL, and CO2. I had studied the theory and basic practice of other lasers. While I learned several things during my week with Dr. Taylor, one important fact I learned was that the knowledge required to successfully run a laser-based practice is vast and requires years of training and practice. It is no easy feat to meet a patient, discuss their needs, and determine the laser, settings, and the likely number of treatments that will best fit the situation.
I believe this experience will enhance my general dermatology knowledge and practice as well as my understanding of other treatment modalities available. There was a patient that came to the practice who wanted to have some of his thickened and scaly skin on his face, neck and chest repaired. After examining him, the conclusion was reached that he had a significant amount of sun damage as well as a large number of actinic keratoses. In my training, I have had several discussions with patients on the treatment options for actinic keratoses. This typically includes liquid nitrogen, topical chemotherapy agents, and blue or red-light treatment. However, Dr. Taylor expanded on this to include several resurfacing lasers. The cost, risks and benefits, recovery time, number of actinic keratoses treated, as well as after-treatment care required were all discussed. Patients at many general dermatology offices I have worked at often choose one of the first three options or no treatment. However, the shorter, though more intense, recovery time combined with the anti-aging effects led this patient to choose laser resurfacing. Beyond this one patient, I was introduced to several new treatment options for conditions often seen by a general dermatologist including acne, sebaceous hyperplasia, and irritated seborrheic keratoses.
Beyond the new treatment modalities mentioned above, I was also introduced to a new practice paradigm; cash-based practice. A large part of dermatology is learning how to work with local and regional insurance companies and what they will and will not cover. This was non-existent at Dr. Taylor’s practice. He does not accept insurance and all visits have a cash value assigned to them, including general dermatology visits. While he had monthly specials on many of his services, patients were willing to pay his prices in order to avoid working with insurance companies and paying for their services. They knew the price they would pay upfront and appreciated the open nature of the practice. While I don’t believe this would work for every, or even most offices, it has been very successful for Dr. Taylor and was interesting to learn about.
Overall, this week has been one of the most enlightening weeks of my residency. My knowledge of lasers and devices, understanding of treatment modalities and ability to work well with a more cosmetic-minded patient population was deeply enhanced. Dr. Taylor was excellent to work with. The ASLMS preceptorship program has been a great opportunity to learn more about the amazing field of dermatology and will continue to enhance my practice for years to come as I apply the things I have learned.