Superficial Anatomy and Cutaneous Surgery - Amazon S3 · Concept of “Superficial Anatomy and...

Hubert T. Greenway, M.D.

Superficial Anatomyand Cutaneous

Surgery

33 Things I’ve learned in 33 yearsFrom Our Course

Hugh Greenway, M.D.


# 1 “To Be A Doctor”

• Where we each began…….• Surpasses other noteworthy

accomplishments:» Division/Department Head» CEO Scripps Clinic» Am Acad Derm Board member, Sec/Treas

“To Be A Doctor”


#2 Anatomy “Rules”“For those who have dissected or inspected many, have at least learn’d to doubt when the others, who are ignorant of anatomy, and do not take the trouble to attend it, are in no doubt at all”.

» Giovanni Battista Morgagni(1682-1771)

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#3 Develop Your IdeaSee a needAdd valueSell it! (Will they (Dermatologists) come?)

Concept of “Superficial Anatomy and Cutaneous Surgery Cadaver Course

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# 4 Learn From Other Specialties

“The Principles and dynamics of Local Skin Flaps” by Terence M. Davidson, MD, and Richard C. Webster, MD

A self instructional package

Am Acad Otolaryngology

1979

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#5 Learning Environment

LecturesLaboratory: Fresh CadaverWorkshop sessions

Fun Time: Wednesday Aquarium

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# 6 Too Much of a Good Thing! Don’t Over Do It

•Add a second one during same summer: DISASTER

•Maintain value/quality• Limit attendance


# 7 Anatomy Can Be Mastered• Medical School Experience• Now Derm Residency

Experience (not in 1982)• “Cutaneous Surgical Anatomy

of the Head and Neck” by Breisch/Greenway 1992

• Other texts by our Faculty


#8 Love “Lasers”

My 1st Laser Argon 1984; followed by CO2 in 1985; now for Dr. Ross (#30 +)Incorporated into course“World is the Target”OPENED THE HOSPITAL OPERATING ROOMS TO DERMATOLOGISTS

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# 9 Mistakes Happen“I have made many mistakes myself; in learning the anatomy of the eye I dare say, I have spoiled a hatful; the best surgeon, like the best general, is he who makes the fewest mistakes”.

» Lectures in Surgery» Sir Ashley Paston Cooper (1768-1841)


# 10 “Scariest Chair on the Planet”

• Defendant Chair in the Courtroom

• Expect; only a question of “when”

• You “WILL” take it personal initially

• Part of “business of medicine today”


# 11 The “Before” And “After” in Derm Surgery

• “Preoperative and Postoperative Dermatological Surgical Care”; Greenway and Barrett

• Documentation• Wrong site


#12 Cosmetic Dermatologic Surgery/Procedures: Must DoDermabrasion (? How teach in cadaver Lab)Lasers/Peels/Lipo/HT/Botox/Fillers/Other

Dermatologists are the premier innovators in 14 of 18 categories of non-invasive and minimally invasive cosmetic medical procedures(Dermatologic Surgery march 2016)

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#13 “Copying” is the Best Form of Flattery

Don’t worry about others copying you

Continue to be your best

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# 14 Evening Task

Place a PHONE CALL to each of that day’s surgery patients.

They will be amazed/tell everyoneKEY: call at 8:45 PM; not 6 PM

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#15 Be a Surgeon, Physician, Pathologist, and Researcher

As he (William J. Mayo) approached the place where a meeting of doctors was being held, he saw some elegant limousines and remarked, “The surgeons have arrived”. Then he saw some cheaper cars and said, “The physicians are here, too”. A few scattered model-T Fords led him to infer that there were pathologists present. And when he saw a row of overshoes inside, under the hat rack, he is reported to have remarked, “Ah, I see there are laboratory men here”.


# 16 “The World is Coming”

• June 2006 Global Education Conference:• Featured Speaker in China

• Global Communication Instantaneous

• Welcome to our Course Dermatologists/Physicians from all over the Globe


# 17 Medicine is a “Utility”

“Benefit”

Regulated

Who Pays?Example: Electronic Brachytherapy for Skin Cancer: Medicare: year 2011 to 2014:20 fold increase (1214 to 24, 325 teatments)? Economicaly driven; changes made….

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# 18 Leading a Great Course:Love your Faculty; Colleagues; Staff

Success is a team effort

Committed Long-termers

Inter/Intra Specialty Dialogue

Remember those no longer with us:

• Terry Davidson MD; many others, cycle of life

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# 19 Preserve Yourself

Avoid “Pedal to the Medal Lifestyle”

Selectively Disconnect

Say “No”

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# 20 “Procedural Dermatology”now

“Micrographic Surgery &Cutaneous Oncology”

ACGME Fellowship approvalDeal with “Surgery” term20 + years in making…..Ed Krull….Enormous Benefit(s) to specialtyASDS Evolving Cosmetic Fellowships

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#21 Love Yields Success

• Love your patients

• Love your specialty

• Love your staff

• Love yourself


# 22 INVEST IN YOURSELF

• Do the Courses (ie You are here!)• Do the Study• Continually Update• RUN like a Gazelle, or, RUN like a Lion,

But RUN


#23 Fable

• Emperor/Wise Men/Ultimatum:• “You have thirty days to deliver to me a

single concise sentence that I can use to serve as a solution to every problem brought to me. Do it, and you shall be richly rewarded. If you fail, you shall be beheaded.

–Story/Answer: “And this too shall pass”


#24 At The End of The Day

• At the end of the day, hopefully everyone in your office will go home happy.

• However, if someone(s) has to go home unhappy, who should it be??

• My advice, the Physician should always

“Go Home Happy”


#25 Happiness: 3 Amazing Tips from the world’s oldest ongoing

case study:1937 Harvard Sophmores

• 1. Have a Healthy Outlet• 2. Don’t Take Yourself Too Seriously• 3. Happiness Must Be Shared

# 26 Value of Time

• Lesson: Patient Sol Price (lived 93 yrs)• (Price Club/Costco)• “How old are you?”• “I wish I was your age”•


# 27 “People Get ScrewedAll the Time”

• Book by Robert Massi (patient/friend/Fox News TV legal annalyst / “Property Man”)

• You will be wronged by:» The system» People you trusted» People you have no control over

“GET OVER IT” Hubert T. Greenway, M.D.

# 28 Change: Manage it

• Embrace• EMR;Guidelines;Regulations

• Maintain yourself; your are not a ‘provider”

• You are a “Physician”


• Ditch the cell phone at dinner• Disconnect regularly when possible• Concentrate on live converstion with

spouse/partner• Be a solo tasker during this time


#29 Go Offline

# 30 PAC’s

• Political Action Committee• Dermatologists under fire• Formerly success with RUC, etc• Now must have Political support/influence• Business/Practice/Personal Investment ($)• Pyramid: Way the game is played


# 31 PAC’s help Politicians Help Us


People : who give & raise $ People : who give $People : give time & supportPeople : who supportPeople : who votePeople : registered votersPeople : in my district/state

# 32 How Do You Measure Success?

• Different depending on your perspective• Practice/Academics/Research/Financial

• 92 yo mother, Kathryn Greenway, May 2016….”I see you are finally successful”

• “You were in my “Readers Digest”



#33 To Be A Doctor

● People will not remember what exactly “you said”

● People will not remember what exactly “you did”

● People will remember exactly

“How you made them feel”

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Superficial Anatomyand Cutaneous

Surgery

33 Things I have learned in 33 years

From Our Course

Superficial Anatomy and Cutaneous Surgery - Amazon S3 · Concept of “Superficial Anatomy and...

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