Laser Focus

Jill Waibel, MD’s interest in science was piqued at a young age. Both of her grandfathers were pharmacists, and she regularly entered science and technology fairs as a student. But it was an invitation to be part of one of the 20th century’s biggest healthcare-related news stories that flung her full-force on a path toward medicine. “As a junior in high school, I was elected student body president, and the summer before my senior year I got a call from the superintendent of schools asking me to come into his office,” says Dr. Waibel.

A new student was coming to the district—a 15-year-old named Ryan White. As she knew from news reports, White—a hemophiliac—had contracted HIV from a blood infusion. He had been kicked out of his previous school due to fears of contagion among students and parents, and his family had faced threats from their local community.

Musician Elton John purchased White and his family a new home in Dr. Waibel’s town of Noblesville, Indiana, near the Riley Hospital for Children where he was receiving care.

In the meeting, the school superintendent was joined by Otis Bowen, the head of Health & Human Services in Washington, D.C., and a former governor of Indiana, as well as Woody Myers, MD, the head of the Indiana State Medical Association. They enlisted Waibel’s help in speaking to students and the local community about HIV and AIDS prior to White’s arrival.

“For three weeks, we educated students so that they wouldn’t be nervous that Ryan was going to be contagious, and through that I gained this incredible insight into a new disease,” says Dr. Waibel.

During her senior year, she got to know Ryan’s family and helped his mother, a factory worker, by taking him to doctor’s appointments. “When I met Dr. Martin Kleinman, Ryan’s pediatric and infectious disease doctor, I thought, that’s it. I want to be a doctor,” says Dr. Waibel.

During her senior year, she appeared on Nightline and spoke in front of Congress. “I met and got to know Surgeon General C. Everett Koop really well. He actually wrote my letters of recommendation for both medical school and residency,” says Dr. Waibel. “Ryan was extraordinary, and the experience set a new path for me personally. I saw that medicine was a field in which you could really make an impact and help other people.”

A Passion for Lasers

Today, Dr. Waibel is director of the Miami Dermatology & Laser Institute, a combination general and cosmetic dermatology practice that also performs research and clinical trials. She is a leader in the use of lasers for traumatic and burn scars and helped to pioneer many of the treatment protocols used today.

Her passion for lasers started early in her career. As a medical student at Wright State University, she fell in love with surgery. “That you could have a patient who was so sick with a bad gall bladder or appendix, take them into surgery and remove it, and then they were fine, was incredible,” she says. So when the head of surgery, Colonel Robert P. Turk, MD, recommended dermatology, she was a bit taken aback.

“He said ‘You’re really smart and you have really good hands, but you should be a dermatologist. I want you to go to the University of Cincinnati and spend some time with Dr. William Hanke,’ and I did, because I admired Dr. Turk,” she says.

The first day, she watched Dr. Hanke perform a laser treatment on a pediatric patient with a port wine stain. “I was like, that’s it, that’s what I’m going to do,” says Dr. Waibel. “I went into dermatology just so I would be able to work with lasers, and now I have 40 of them in my practice.”

Photo by Tom Clark.

It Takes a Village

Dr. Waibel opened her practice four years ago and over the past two years brought in Jacquelyn Dosal, MD, and Kathryn Kent, MD, to help her handle her growing patient base. “The biggest challenge right now is we’re growing so fast and we’re all so busy. You have to stay on point, you have to be organized and you have to work together. Medicine is a team sport,” she says.

The practice, which is 50% cosmetic and 50% general dermatology, is currently conducting 13 clinical trials. “In addition, I’m breast feeding my fourth child, Dr. Dosal is pregnant and two of our medical assistants are pregnant,” she says. “You can’t bring that to work, you have to handle it. But we can all support each other in recognizing that part of womanhood.”

Early in her career Dr. Waibel did a mentorship through the Women’s Dermatologic Society (WDS) with Tina Alster, MD, and Elizabeth Tanzi, MD, in Washington, D.C. “I come from a family of stay-at-home moms, so I didn’t have a role model for how you can be a busy doctor and have children and make it work,” she says. “I spent time with Tina and Liz and also Mary Lupo, MD, in New Orleans. To this day, they have been great mentors to me. I can pick up the phone to ask a question, and they will be there.”

In addition to helping her grow her skills as a dermatologist, these mentors helped her decide that she could run her own private practice. “Just seeing that you can be a married mother and run a successful practice gave me a lot of confidence,” says Dr. Waibel.

She purchased an existing dermatology practice and began building her own patient base. “The thing that surprises you is how much work it takes to run a business. There are so many moving pieces, and it takes years to make a fabulous office,” she says.

On the advice of a consultant, Dr. Waibel hired a cosmetic coordinator to help her create a booming aesthetic practice. “Derm offices move really fast, and we have a huge conversion rate from our general derm to cosmetic patients,” she says. “One thing we noticed is that a patient would come in for a total body exam and ask about fillers or neurotoxins, and my response would be, ‘We can book another appointment for you.’ The consultant said, ‘No, no, no. You never want an interested cosmetic patient to leave your practice.’”

Today, the cosmetic coordinator can be called in to speak with the patient and discuss the practice’s treatment options. “Then the physician goes in and makes specific recommendations, and the cosmetic coordinator wraps up the appointment,” says Dr. Waibel.

The practice’s clinical trials are also valuable in building patient loyalty. “We don’t use clinical trials to bring in new patients, we use them as a reward mechanism,” she says. “I’ve done three laser resurfacing trials in the past year—and these treatments cost anywhere from $3,000 to $5,000—the patients get it for free, so it’s a really nice perk. And it’s my passion. I like being in that innovative space—working with new technologies and seeing where the industry is going.”

Building a Team

As the practice has grown, Dr. Waibel has created several administrative positions to help her manage the facility day to day. She has a practice manager, Michael, a clinical trial coordinator, a VIP patient coordinator and a burn patient coordinator. “Michael has been in the industry for 10 years, and he really runs the operations—we call him the operations guy,” she says. “He has regular meetings with all associates and he is the point person for all the doctors to make sure they are happy and don’t have any issues.”

Photo by Tom Clark.
In addition, the practice has a physicians and leadership meeting every Thursday. “We meet for an hour, and that meeting is never cancelled,” says Dr. Waibel. “We identify issues in the practice, come to a consensus and then set deadlines. I’m a big believer in deadlines.” To keep the meeting efficient and on track, Michael sets a 10-minute timer for discussion of each topic.

“We do iPad messaging and, at least once a month, we have an all associates meeting,” says Dr. Waibel. “It is important to have regular meetings with your staff, so you’re all going in same direction.”

Like many practices, Miami Dermatology & Laser Institute’s most successful marketing strategy has been to focus on word of mouth, especially for cosmetic treatments. “What we find is we get these clusters of women,” says Dr. Waibel. “If a woman leaves your practice looking great and goes to play tennis with her friends, they all want know: ‘What did you do? Who did it, and when can I get an appointment?’ We have a group of about 50 tennis women in Miami, a group from Weston, and even groups of patients from Boca Raton and Palm Beach that drive to see us. So, first of all, just do excellent work and take good care of your patients.”

Dr. Waibel calls every cosmetic patient the day after their procedure to make sure they’re happy and not having any problems. She also gives patients her cell phone number, so they can reach her at any time. “It’s really comforting for patients when they know that they can get in touch with their doctor,” she says.

When Dr. Docal and Dr. Kent joined the practice, they listed themselves on ZocDoc, a mobile app that allows patients to go online and book appointments available within 24 to 48 hours. “We get a lot of new, really quality patients through that,” she says.

To make sure patients are aware of the wide range of procedures offered by the practice, Dr. Waibel purchased large screen DVD televisions for every room in the facility. “Patients see the loop DVD with all the different things that we do, and we pick up about six cosmetic patients a day from that loop,” she says. “It’s a really cost-effective marketing tool.”

Charting a Path

A big believer in both deadlines and goal setting, Dr. Waibel is currently focused on expanding her facility to keep up with the growing demand for its services. “I have a vision where we’ll have a medical side and a cosmetic side and, in the middle, there will be a big Lazy Susan where we put our lasers, so we can move the laser rather than the patient,” she says. “We have a great location, but we need more space and we’d like to add a couple more providers, so we’ll have to build out. That’s our main project for the first quarter of 2015.”

On the advice of an Allergan consultant, she has opted to expand her existing facility rather than launch multiple locations. “Every time you add a new location, you have a huge increase in overhead costs. The more efficient thing to do is have several doctors working in the same space,” she says. “Your revenue increases faster than your overhead. Plus, we have a great staff and management team. If we were to open a second location, we could lose that momentum.”

She encourages new dermatologists to chart a career path early and take advantage of all the resources available, including great staff, business consultants and industry manufacturers. “I love interacting with CEOs and the engineers who develop these technologies,” she says. “When you interact with these people, it makes you a much better doctor. This is true of getting involved in research and publishing as well. Have a compass on where you want your career to go, and focus on the big picture. Don’t let the details distract you from the goal.”

Inga Hansen is the executive editor of MedEsthetics.

Photo by Tom Clark.

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