With more than 30 years of experience in Dermatology, Dr. Peter Jenkin shares how he got into cosmetic medicine and his approach to staffing and marketing.
Name: Dr. Peter Jenkin
Clinic: Dermatology Associates of Seattle
Location: Seattle, WA
Dr. Jenkin completed his dermatology training at McGill University in Montreal in 1980. He was in private practice for 20 years in Canada before moving to Seattle and worked for PacMed and Virginia Mason until he purchased Dermatology Associates in January 2010. Dr. Jenkin is an outdoor enthusiast, loves skiing, hiking and racing cars. When he is not treating patients he can often be found speaking about skin diseases at local seminars or visiting his grandchildren.
How did you first get into cosmetic medicine?
My interest was piqued in cosmetic medicine back in the mid-1980s when I started to use a CO2 laser which was followed in 1987 by the development of the first pulsed dye laser. I was always fascinated by the new advances which extended the range of things we could do to help patients with their cosmetic concerns. That trend has been followed by making those treatments less invasive and safer.
None of these treatments were available when I did my dermatology residency so I have kept up by attending numerous training courses, networking with experts in their fields and maintaining a high level of CME (continued medical education).
Since your acquiring of Dermatology Associates of Seattle, what can you tell us about the clinic itself?
I own and run my own clinic which is known as Dermatology Associates of Seattle. We have other dermatologists who work with us as well as physician extenders. We also have two Master Aestheticians who do a lot of the less invasive cosmetic treatments. In addition, we have a staff of research coordinators that are actively organized in doing clinical trials for new medications both for general medical conditions as well as various cosmetic treatments.
We have over 9000 ft.² of office space. Our cosmetic treatments run the gamut from a variety of laser treatments (we have more than a dozen different lasers in the clinic), noninvasive body sculpting with radiofrequency devices, a variety of chemical peels and superficial laser peels and a variety of injectables such as fillers and neuromodulators. We also offer treatment facials for a variety of indications. We are located in the Denny triangle area of Seattle adjacent to the rapidly expanding area known as South Lake Union. Our general dermatology population includes both male and female adults as well as children. Our cosmetic patient population ranges from young adults to people in their 80s.
What are your methods in staffing, and how do you keep them in your clinic?
Maintaining a stable staff is certainly an ongoing challenge. We seem to go through periods of time where our MA staff is stable and reliable and at other times it seems like they come and go with some frequency. We have a staff of about 15 so some movement and transition is inevitable. They’re all paid salary commensurate with their experience.
Our Master Aestheticians have been paid in a variety of different methods but the one that seems to work best for us currently is straight salary. We pay them well so that they feel appreciated and will want to stay. We have decided not to pay on an incentivisation model because we wanted to differentiate ourselves from medical spas where they are short on education and long on salesmanship. Our approach is to educate the patient about what is available and what can be achieved and then help them make a decision to move forward or not. Currently this situation is working very well for us. Our patients do not feel pressured and our aestheticians do not feel the pressure of having to make a monthly quota.
Given your interest in laser devices early on in your career, which devices do you use?
We currently have two IPL systems-Limelight by Cutera and BBL by Sciton. The Cutera system was our first IPL but our staff and our patients prefer the Sciton system both for comfort and speed. We use these systems for treating chronic actinic damage and rosacea. We are also using the Sciton system for a maintenance treatment called “Forever Young”. Our IPL systems are used literally on a daily basis.
We have a Cutera XLV vascular laser which is also used on a daily basis to treat redness and telangiectasia. We use a diode laser for laser hair removal and Q-switched lasers for pigmented lesions and tattoos. We also have the Fraxel Dual for non-ablative resurfacing, the PEARL and Pearl fractional resurfacing lasers by Cutera, the Sciton Joule for resurfacing in a wide variety of depths and a Halo which is a combination of ablative and non-ablative technology. In addition, I have a fully ablative CO2 laser that I use for removing benign lesions from the face to avoid leaving a scar.
My favorite devices would be the XLV vascular laser by Cutera because of its ease of use, reliable results, safety profile and it seems to be a fairly trouble free laser from the service standpoint. The other would be the BBL by Sciton because compared to the Cutera system it is less uncomfortable and the treatments are faster. It also gives us the flexibility of the Forever Young treatments.
We have other non-laser, radiofrequency devices including Thermi and Infini. Both devices are used for different indications. In my opinion the Thermi device is the best device for labial and vaginal rejuvenation whereas Infini is as good as you can get for post acne scarring.
I can’t say that I don’t like any of the devices that we have. The only device I have ever had that I got rid of for a variety of reasons was Coolsculpting. We are so much happier with the Vanquish ME for body contouring and so are our patients.
What marketing strategies are you currently employing?
Our practice has gone through a major rebranding in the last year and that is where we have been spending the majority of our advertising dollars. We updated our logo, launched a new website and we’re working with a local agency to expand our brand to a greater demographic. We’ve discontinued print advertising because it’s very costly, has very little return and it’s hard to track. Our greatest success has been with promoting services in our office, on our website and in monthly email blasts. We hope to expand our social media efforts in 2017. This can be a very powerful tool but requires a lot of attention and consistency across the various channels.
Which procedures are the most popular in the clinic?
Our most profitable treatments are the radiofrequency body sculpting treatments, particularly the Vanquish ME. After that, I think the most profitable treatments would be the CO2 benign lesion removal and the BBL treatments. The price point on these treatments is noticeably lower but high-volume. I’m always open to investing in new technology, but it must prove to be effective for the vast majority of patients, have a good safety record and offer something I can’t already do with my current devices. For instance, I think the Celfina system is a great treatment for cellulitis however it is a treatment I have no desire to do.
Can you tell us any anecdotes in your career in medicine?
Approaching the cosmetic patient and their desires is always a challenge. Patients often come in with their heart set on a specific treatment only to learn that it is not the appropriate treatment for the complaint they have. The biggest issue however is dealing with patient expectations for outcome. I have learned that unfortunately this often bears no relation to reality. My most troublesome story comes from a male patient I treated with Fraxel laser for post acne scarring. He came in for the full series of 4 treatments. He seemed very happy at the end of the treatments. 6 months later he wrote a scathing Yelp review that the laser treatments were not only useless but had “ruined his life.” I pulled up his before and after pictures and his results were so good he could have been the poster child for Fraxel treatments for acne scarring.
On the other hand I once did full Face laser resurfacing on a woman in her 80s because she felt like she was going to die and wanted to look good for her funeral. She had such good results that 6 months after the treatment she had a boyfriend and a new lease on life. Her daughter then signed up for the same treatment perhaps hoping for the same outcome!
Lastly, what advice can you share to fellow physicians?
The advice I would give physicians getting into a cosmetic practice would be to look very carefully at the technology options and choose those that are going to give the most consistent results and not the occasional home run after numerous strike outs. A friend of mine once had a picture of one of his patients on the front page of a brochure for a particular device. At the time the outcome from this device was clearly a home run but when I met up with him a year later he had basically stopped using the device because the results were so inconsistent. The vast majority of today’s devices are very user dependent in terms of the outcome achieved so make sure you pay attention to details and don’t take shortcuts.
I would also look for technology that has a very low disposable cost. You want to be working for yourself, not the company making the device. Coolsculpting is the epitome of the physician being an employee of the company.
Finally, always make sure you understand what the patient is trying to achieve. If you have limited technology to offer make sure to treat the patients that will benefit the most from that technology.
About Dr. Jenkin
He was previously the President of the Washington State Dermatology Association and provides a full range of dermatologic care including: adult and pediatric general dermatology, Mohs surgery, skin cancer surgery and cosmetic dermatology including a wide range of laser treatments, Botox and fillers. His areas of special interest are skin cancer, laser surgery and other cosmetic procedures such as body sculpting and PRP treatments. As the owner and medical director of Dermatology Associates, Dr. Jenkin is committed to providing all patients we serve with not only the best care available but the best service from beginning to end.