Diane Howlin, MD, FACP of Chelsea Medicine and Laser in Michigan

Chelsea, Michigan Board Certified Physician Diane Howlin, MD, FACP

Name: Dr. Diane Howlin
Clinic: Chelsea Medicine and Laser
Location: Chelsea, MI
Website: chelsealaser.com

That's interesting: In 2001, Dr. Howlin founded Chelsea Hope Clinic, a free Saturday clinic for uninsured patients.  In 2008, she was named the “Howard S. Holmes Humanitarian of the Year” by Faith in Action for this charity work. In 2009, she launched another not for profit free clinic, Chelsea Grace Clinic,  for uninsured and underinsured patients in Western Washtenaw County.

I grew up in Dearborn Michigan. I played the violin in my youth and undergraduate years, touring Europe with an orchestra in the summers. That led me to learn German and be interested in cultures/language.  I went to medical school at the University of Munich in German and married an Englishman. After medical school, we returned to the US for my residency in Ann Arbor, Michigan in internal medicine. I always loved surgery and surgical procedures. But a surgical residency seemed too hard on my family as we had two children. So I chose internal medicine and did my own procedures. I'd spend evenings in the medical library researching cosmetic office procedures like earlobe repair. That led to skin biopsies, lump and bump surgeries, and seeing the cosmetic effects of this work led me to lasers. Now the practice is fully integrated with both traditional internal medicine and aesthetic medicine.

As a female physician, what are the opportunities that you have that

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Why I Quit Medical School

Why would you not want to become a physician in America?

Jeremy was familiar with life as a doctor. His father's a maxillofacial surgeon. So is his brother who's just a year or two older. Here's Jeremy's post on why he quit medical school and decided not to become a doctor. Jeremy blogs at Never Eat Soggy Waffles

Why I Quit Medical School

It hit me. Sometime around the time I was filling out my secondary application for medical school during my senior year in college… it hit me. It felt less like a swift slap to the face and more like a creeping, slinking hollowness… perhaps akin to a small but persistent elephant sitting on my chest. We’ll call him Chester. I would be able to shake this persistent pachyderm for days, perhaps weeks at a time, but he would always return. Scramble up my leg, nestle down just below my left collarbone and take a nap. Deep breaths wouldn’t make him go away.  Long runs wouldn’t shake him. Most of the time he was barely perceptible, but present nonetheless. Doubt.

Excitement and Doubt

The acceptance letter came. Rejoicing ensued. But halfhearted, fraught with thinly veiled concerns and flimsy self-assurances that this was the path I was destined to take. The letter was like a steroid injection to my ego and my newly muscled ego chased Chester away for a month or two. If medical school wants you, how can you say no to medical school. It’s a privilege, an honor even, to be one of the few and the proud… and it genuinely was. And yet, after the newness had worn off, Chester slowly slunk back to his customary perch. Doubt.

The crazy plan…

It was around Christmas break of this same senior year that my friend Bjorn Harboldt shared with me his seemingly laughable plan to travel from one end of the world to the other… in a year… quite literally. His plan was to start at the furthest southern city in South America Ushuaia in Cape Horn. Travel up through South America, Central America, and North America to Alaska. Find a way across the Pacific Ocean. Continue through Asia, up into and across Siberia to Eastern Europe. Down through Eastern Europe to the ancient shores of the Mediterranean. Cross that sea and traverse Africa to the farthest southwestern corner and the Cape of Good Hope. Quite ludicrous. Ostentatious even. A truly excessive bit of traveling.

“to live a year intentionally…”

At the mere mention of this trip Chester fled. My heart beat with a strong and assured thud at the thought of such an adventure. I did not have delusions that this trip would drastically change anything. I didn’t believe that I would “find” myself because I didn’t really feel lost. I didn’t believe that the trip even made “sense” in the traditional “sense” of the word. My parents and many friends thought that I had perhaps been given over to depravity of a most irresponsible, albeit innocent, sort. My thoughts were simply that this is what I wanted out of life. To broaden my perspective, to live adventure instead of only talking and dreaming about it, to follow the strong and clear thud of my heart, to live a year intentionally instead of following the prescribed plan, to take ownership of my actions.

Although I usually oscillate precariously over weighty decisions… It didn’t take me long to lay my cards on the table and tell Bjorn that I was “all in.”

Planning, saving, selling possessions, successfully attempting to get companies to give us equipment and unsuccessfully getting companies to give us money, getting medical school deferrals, graduating from college, packing, dreaming. It all happened so quickly. And then suddenly… we were getting off the plane in Chile with packs on our back, no reservations, and no real plan except to get to the Cape of Good Hope.

“It opened me up to options and ways of existing that my narrow mid-American worldview would never have even entertained.”

Traveling around the globe by any means possible...

Traveling around the globe by any means possible…

I will not regale you with the details as they can be read at http://www.thewholeworldround.wordpress.com. Suffice it to say that that year of mad capped traveling opened me up to a more global way of thinking. It opened me up to options and ways of existing that my narrow mid-American worldview would never have even entertained. I met people who were living, really living. Not just talking about pedaling a bike from Istanbul to Vietnam, actually doing it. Not just talking about riding a motorcycle from Boston to the bottom of South America, actually doing it. Not just talking about opening up a little hostel in Thailand…. Actually doing it. I met a lot of dreamers… that were actively turning their dreams and interests into realities.

The open road... the ultimate education.

The open road… the ultimate education.

First year of medical school

Chester was mostly absent during this year of exploration. The next time he showed up was the summer after I returned from the trip. He stayed with me all the way through the first year of medical school. He grew into a full-blown tusker of doubt. Doubt about the path I had taken. All the while I created a million well-crafted reasons why I was on the right path. People around me re-enforced this thinking. My own ego re-enforced this thinking. The self-denial was spread thick. I almost dropped out at Thanksgiving break, at Christmas break, at spring break, but my carefully constructed rationalizations kept me around until the end of the year.

It was around this time that I met Lindsay. She is now my wife. I did some hardcore re-assessing during this summer between my first and second years of medical school. I went to an intensive, interactive self-improvement workshop. I read a lot. I prayed a lot. I began telling myself the truth. I did some very hard and very personal growth work. And then second year medical school began….

“I realized that my life was not going where I wanted it to go.”

Two weeks in it all came to a head. The thin veil was lifted. I stopped lying to myself. There were no more rationalizations. I realized that I was in a place I didn’t want to be in. I realized that my life was not going where I wanted it to go. As strange as it sounds, I realized I had gotten there by default. I had gotten there by letting life happen to me. I was not happy. So I made a very difficult decision… I quit medical school.

“…taking ownership for my future instead of just floating towards a sensible default.”

I wish I could say that my life purpose instantly crystallized and it has been all rainbows and sunbeams since I made that decision, but that wouldn’t be true. There was an instant flood of relief once the decision was made, but it has been difficult to let go. To picture myself in the future as something other than a medical doctor. To start taking ownership for my future instead of just floating towards a sensible default. To take steps toward living more wholeheartedly. At some point during this process I realized that Chester was shrinking. Taking ownership for my path in life was causing the change.

Lindsay was with me through the whole process of leaving medical school. She was with me through the doubts, the valleys, the indecision, the oscillating, and even the tears. Six months after dropping out of medical school we were engaged.  Three months after that we were married. We had a lot of long talks and earnest prayers about what we wanted our life together to be like. Global development and humanitarian work was at the core of who we both were. We both love to travel. So we made the decision together before we even got married to do a Master’s in Global Community Development that would begin the fall after we got married. We decided to follow our interests and take ownership for our path. We decided to attempt to turn those interests into a sustainable livelihood. We decided to do this together.

I am writing this from Arusha, Tanzania. I am sitting next to my wife in a little bungalow on the grounds of the Colobus Lodge. We are in the second semester of our Master’s program. We are preparing to go to a rural World Vision project to work on building the capacity of the local office and community there. I can say with complete integrity that this Master’s program is the most fulfilling formal education I have ever had. We have some awesome prospects for international internships. I am seriously considering doing a PhD in International Development. The possibilities seem endless.

I don’t recall the last time Chester was home.

 

Dr. Michael Ehrenreich, Founder of SOMA Skin & Laser

Dr. Michael Ehrenreich, SOMA Skin & LaserDr. Michael Ehrenreich, the prime mover of SOMA Skin and Laser in Millburn, New Jersey.

Though most people know him now as a dermatologist, Dr. Ehrenreich has a broad range of dermatological interests: medical dermatology, cutaneous surgery, laser surgery, cosmetic dermatology. He is also a noted authority in tissue engineering.

Dr. Ehrenreich began his career as an investment banker. His background proves to be a critical element to the success of his practice. 


Name: Michael Ehrenreich, MD, FAAD
Clinic: SOMA Skin & Laser
Location: Millburn, NJ
Website: somalaser.com

You have a very interesting career path as you hold a BS in finance, aside from having a medical degree. Can you tell us more? 

Prior to attending medical school, I was an investment banker, so I have a strong business background. A business background is certainly helpful if you want to start and operate a practice. Although physician’s work to help people, medicine is also a business. And like any other business, it’s hard to succeed at it without some business skills. Medicine is moving away from the sole practitioner model. More and more, physicians operate as...

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Dr. Barry L. Eppley, Indianapolis Double Board Certified Plastic Surgeon

Dr. Barry Eppley Indianapolis Plastic Surgeon

Dr. Eppley is both a licensed physician and dentist. He's board certified in Plastic and Reconstructive Surgery as well as Oral and Maxillofacial Surgery.

Name: Barry L. Eppley, M.D., D.M.D.
Clinic: Eppley Plastic Surgery
Medical Spa: Ology Spa 
Location: Carmel, IN 
Website: eppleyplasticsurgery.comologyspa.com

You're using SmartLipo technology. What do you think of SmartLipo's efficacy?

It is important to recognize that Smartlipo, like any technology, is a tool and has no magical properties. It is only as good as the skill and experience of the physician holding it. When used properly and judiciously, my experience has been that it can lead to better outcomes and less bruising. One of Smartlipo's biggest claims to fame has not been particularly useful for me...being able to do most of the procedures under local anesthesia. But this may be reflective that many of my patients are looking for treatment of multiple body areas with bigger volume reductions and it is often combined with other procedures which need to be done under general anesthesia anyways. Its biggest disadvantage is that it is a very costly device and requires extra time to pre-treat the areas before suction evacuation. Thus it requires a motivated user and one who believes that the cost and extra time to do it are worth it to their practice.

How do you evaluate and make your technology comparisons and decisions based on efficacy and cost? 

I view technologies and devices as either comparative or innovative. This means does it offer similar treatments as other technologies or devices on the market (with some claimed minor advantage) or is it the only one that can produce its aethetic effects. Most cosmetic technologies are comparative and thus must be judged primarily from a business perspective on its return on investment. Every technology costs a lot more than the price tag when you factor in labor, disposables (if they exist) and marketing. One must look very carefully at the cosmetic market and have realistic projections about what it can really generate. Very few technologies fall in line with ‘buy it and they will come’. Most sales are driven and do not magically fall off the street and through the door. This understanding allows me to apply a basic capital purchase philosophy... if it can not generate in gross sales what it cost to buy in one year or less, it is not a good business decision.

Innovative technologies, uncommon as they are, are different. Because they have less competition and offer something new, being an early adopter is less of a business risk. When the market cap is undefined, it is sometimes easier to take the risk.

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Dr. Stephen Bresnick: Plastic Surgeon in Encino, California

Dr. Stephen Bresnick Encino, California Board Certified Plastic Surgeon

Dr. Bresnick discusses how he balances his teaching career and private practice after 15 years as a plastic surgeon. 

Name: Stephen Bresnick, M.D., D.D.S., M.S.
Clinic: Encino Plastic Surgery
Location: Encino, CA
Website: drbresnick.com

That's interesting: Dr. Bresnick has published nine books in medicine and science and has authored over 20 articles published in medical journals.

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Medical Spas + Student Doctors

Preparing for a future in cosmetic medicine as a medstudent or resident.

Here's a question I received from Josh:

I'm a medical student, and will be graduating med school in 5 weeks. I'm planning on doing a residency in Family Medicine, and I am curious as to what type of training is applicable to medspa's? What procedures should I try and focus on during residency? What can I do to learn more about building a practice after I finish my residency?

First, I'd suggest that any medschool student or resident check out the new community at Uncommon Student MD. We're building Uncommon as a sister site to Freelance MD by to address the specifics of how to control your medical career and lifestyle early on.

Second, I'd suggest that you take advantage of the the community here at Medical Spa MD. You may find a mentor and you can certainly find a lot of information and make some connections with physicians how have been around the cosmetic block.

Does anyone else have some advice for Josh or other medstudents who are looking at cosmetic medicine? Leave your thoughts in the comments below.