Oculoplastic surgery deals with the reconstruction and cosmetic surgery of the eyelids, eye sockets and surrounding structures. I find it an exciting field because of the numerous challenges it presents. As an Oculoplastic surgeon I see people of all ages from infants to geriatric patients with a wide variety of issues. The specialty is particularly fulfilling because I can literally see the outcome of my work, as can my patient. For many specialties the changes happen inside the body whereas oculoplastic results are easily recognized and present me with instant feedback on the operation.

Otorhinolaryngology is a specialty with a mix of medicine and surgical decision making that allows me to look at my patient’s issues through two different lenses and choose the appropriate path for the specific situation and individual. This is what intrigues me most about Otorhinolaryngology. When treating the head and neck I can approach the situation from the mental problem solving side as well as using my hands and surgical skills. I enjoy using both avenues in my practice.

Internal Medicine focuses on thinking through a problem. This is the main reason I chose internal medicine as my specialty – I like thinking about medicine. My father was also an internist and that of course helped me make my decision when it came time to choose. I’ve been practicing for 30 years and it is the challenge of thinking about the issues I come across that has kept me engaged and moving forward.

Many of my patients are older and often present very complex medical issues to consider, continuing my excitement about my specialty and my patients. With each new issue I have more to learn. And, since medical research plays a big role in internal medicine, I am continually presented with more information, new protocols, medicines and approaches. While keeping up keeps me busy, each new discovery gives me a better chance of helping my patients by offering more options to consider.

Dermatological conditions are visible to patients as are the improvements with treatment, which is my favorite part of practicing Dermatology. Since this is an external experience, people can see when there is an issue and how they are responding to treatment. Together both the patient and the doctor can watch recovery take place. Within my practice, I specialize in the diagnosis and treatment of skin cancer. The ability to cure a form of cancer can be one of the most fulfilling experiences for a physician. Today, using some of the advances made in the last few years, we can cure more dermatological conditions than ever. However, it is the advances in early detection and the growing awareness of skin cancers as well as their causes that has made the biggest impact in the field.

Change is hard. I’ve been practicing medicine for 30 years. I’ve seen many different changes in medicine, especially in the way physicians are reimbursed. These changes have greatly affected the way we practice and how our patients view us as a profession. I began my career with fee for service, then went to a discounted fee for service, followed by managed care with HMO’s, and back to a fee for service based on RBRVS, a relative value scale which pits doctor against doctor to split the shrinking health care dollar. Although I can long for the day when our contract was with our patients, and not with huge third party payors, we can’t force that toothpaste back into the tube.