Taking the Leap

Early mentors and entrepreneurial family members inspired Anne Chapas, MD, to launch a research-based aesthetic practice.
MedEsthetics March 2019

As a resident at Boston Medical Center, Anne Chapas, MD, discovered her passion for dermatology and lasers while working alongside Barbara Gilchrest, MD. “She was super encouraging and showed me that you could practice clinical medicine and also have an active clinical research program,” says Dr. Chapas. “Dr. Gilchrest set the bar high. She encouraged me to develop new techniques, become a leader in medicine and set big goals.”

While she and Dr. Gilchrest were studying the use of photodynamic therapy for basal cell nevus syndrome, Dr. Chapas was struck by the improvement in patients’ self-esteem as their lesions and need for surgeries were reduced. “I realized then that laser technologies and aesthetic medicine not only make people healthier, they also improve patient’s psychological health,” she says.

Today, Manhattan-based dermatologist and dermatologic surgeon Dr. Chapas runs her own practice, Union Square Laser Dermatology, specializing in laser surgery, Mohs micrographic surgery and cosmetic procedures. With a team of seven dermatologists and 30 employees, Union Square Laser Dermatology has a state-of-the-art lab and dedicated research team, which studies lasers, topical pharmaceutical products, photodynamic therapy, injectable fillers and neuromodulators, and offers a 12-month cosmetic fellowship program through the American Society of Dermatologic Surgery (ASDS).
Aspirations and Inspirations

From an early age, Dr. Chapas loved science. In the second grade, she drew a picture of herself as a doctor. After graduating magna cum laude with a B.S. in biochemistry from the University of Pennsylvania, she earned her MD with honors from Harvard Medical School.

After finishing her residency in 2005, Dr. Chapas completed a fellowship with Roy Geronemus, MD, director
of the Laser & Skin Surgery Center of New York.

“He was an incredible mentor at that stage of my career,” she says. “He showed me how to manage a busy outpatient private practice and sold me on the idea that private practice offers more career options, such as developing the research program that we have now, publishing and leadership opportunities. I credit Dr. Geronemus with teaching me how to balance business management, patient care and an investigative research career.”

Dr. Chapas’ family also pushed her toward opening a private practice. Both her father and grandfather were small-business owners in her hometown of Pittsburgh. “They encouraged me from the get-go to open a practice,” she says. “They would ask me all the time, ‘What are you doing working for someone else? You should have your own practice!’”

But she felt strongly that she needed to feel 100 percent confident in her clinical skills before starting a practice. “Our medical school, residency and fellowship training is focused on understanding disease processes and treatments,” she says. “You need the first couple years out of fellowship to gain confidence in your own skills and learn how to manage all sorts of patients.”

In 2011, after working with an existing practice for five years, Dr. Chapas leased an 8,000-square-foot space in New York City’s Union Square area with the goal of creating a multi-physician dermatology practice.
“Most offices in New York are 1,000 square feet,” she says. “But I like to work with colleagues. I felt that if I built it, they would come.”

But it wasn’t easy. For the first year, she was the only physician. “That was very hard. I couldn’t take time off because I had to still pay staff and rent. I couldn’t be sick,” she says. “Fortunately the next year, Dr. Jennifer MacGregor joined me. She’s a fantastic dermatologist and one of the most dedicated doctors I have ever worked with. We just clicked right away.” Each year since then, she has added another doctor.

Identifying New Technologies

With seven board certified dermatologists, Union Square Dermatology has ample opportunities to see and hear about patients’ most vexing skin concerns. These concerns guide Dr. Chapas’ decision-making when it comes to investigating and adding new technologies. “We often perform full-body skin examinations, so it’s easy to add technologies that address the problems that we see on a daily basis, such as photodamage and skin discoloration,” she says.

The doctors decide as a group which technologies are the most promising. “Sometimes we’ll see something at a meeting and we are all in agreement that we should try it out. Other times it’s something that we have already used in a clinical trial that we feel confident about,” says Dr. Chapas.

The key, she says, is to “go after a problem that you see every day, because it’s really hard to add technology for conditions that you don’t encounter regularly in your practice.”

Once the practice identifies a promising technology, they take time to learn about it through the literature and from other physicians before purchasing. “We are all big science geeks, so we want to know the basic science that supports the procedure and we want to see clinical evidence that it will work,” says Dr. Chapas.

When introducing a new technology, Union Square Laser Dermatology first tries the new treatments on staff and some regular patients to get feedback and gather before-and-after images. They then introduce the new technology to a wider audience through a dedicated newsletter, social media, brochures and a PowerPoint presentation used during patient consultations.

“We discuss with patients how the technology works, results and recovery time,” says Dr. Chapas. “While there are many ways to market a new technology to your existing patient populations, we go through a systematic process to ensure we launch something well. We use a checklist for every new procedure to make sure that we have pre-op instructions, consent forms, post-op instructions, pricing and educational materials for patients and staff in place before the launch. We don’t just bring something into the office and hope it will be a hit.”

Meeting the Challenges

Although the practice continues to grow, Dr. Chapas stresses that every day is a challenge when you are running a business. During her fellowship, she remembers many sleepless nights wondering how a patient was doing after surgery. “Now what I worry about most is the day-to-day management of the practice,” she says. “We had so many challenges—things you can’t predict and things you never could predict.”

For example, two years into private practice, Hurricane Sandy hit New York. Lower Manhattan was without power for more than a week, and no one knew how long that was going to last. “We couldn’t get in touch with any patients and we couldn’t get into our practice,” she says. “There are so many things like that you cannot predict along with the day-to-day challenges of managing personnel and growth, setting goals and motivating staff. I’m glad I waited until I was very confident in my clinical skills before I took on this challenge.”

In addition to being confident in your clinical skills, Dr. Chapas encourages new owners to create a thorough business plan that projects your costs and revenue. “Then hold your nose and jump in,” she says. “We are fortunate to be in an industry right now where there’s a lot of growth. You will make mistakes. Everyone makes mistakes. You will experience a steep learning curve in the first year. Move on from those mistakes and figure out how do to better in the future. ”

What the Future Holds

Looking ahead, Dr. Chapas has one goal: to lead a best-in-class dermatological aesthetic practice. “My goal is to elevate the specialty of cosmetic dermatology. One of the challenges we face right now is the commoditization of aesthetic procedures,” she says. “There’s a feeling here and across the country that anyone can do cosmetic procedures. But in reality, we see very complicated and challenging patients every day. Doing cosmetic dermatology well is as challenging as any other field in medicine. My hope is, as we grow, we can spread our influence and create the best practices in this field.”

Daniel Casciato is a freelance writer based in South Bend, Indiana.

Photography by Kevin Brusie