Director of Clinical Dermatology Therapeutics Clinical Research San Diego, CA
| Published January 18, 2023
My name is Dr. Nick Brownstone, and I'm here with Dr. Neil Batia, board certified dermatologist. Neil, always nice to catch up with you. Pleasure. Whether it's about dermatology or current events, first thing I want to ask is if you can go back in time. What advice would you give yourself as a first year dermatology resident? Yeah, is back in time. Needless to say, that was back in 95, but I'd probably talk about expectations. Think about your first job may not be your last job. Think about creating a niche for yourself. If you want to get involved with research or in industry or anything else, just create your specialty, stay in your focus, learn a little bit about everything, but try to stay in a niche that you can be proud of and dive deep into. I think the other thing, too, in residency now, the demands are still very high academic, very high achieving, and I would just try to find some balance, but I think if I could go back again and find that balance, I would say, all right, well, just keep your foot on the gas and not so much on the brake. Great advice. I'm a big fan of the back to the future movies. I'm thinking back to the future Ford. Neil Bocce goes back in time and gives himself advice to be the best resident he could be. God. Well, I would start a better diet. I would exercise more and color my hair more often. So we talked about the past. Now thinking in the future, what innovation in dermatology are you most excited about? Yeah, it's been fun. I mean, my career now is mainly in clinical research, and we've been watching just the innovations of the Januskinase inhibitors, the biologics, all the strategies to manage itch, which we really didn't have options for. I mean, we were all groomed on topical steroids and all the other innovations that were so focused on active ingredients. But now the vehicles of topicals are really exciting. And I think, too, just the approach to thinking about the process of disease, not just the bandage in front of us. I think there's some really good things that are coming in the pipeline that we also just really have to strategize with. I think dermatologists just need to not be afraid of their own shadow. We got to, again, put our patients interest forward because they're going to come somewhere else if we're not so called comfortable or whatever we want to call it. So I think dermatologists just need to get out of our own shadow and start being aggressive again. Let's switch gears here for the last question. This is something that I always have trouble with. How do you communicate a serious disease, serious diagnosis to your patients? Can you give me some tips? Sure. Actually just happened a couple of weeks ago. First of all, you have to really do these things in person. I mean, you have to put your hands on people. You have to look them in the eye, talk to them, them about the severity of what's happening, whether it be melanoma, whether it be other kind of cancer, whether it be something bolus or inflammatory that they may not understand. Because the problem is if you do it over the phone, they may not hear anything past the bad news, even more so they'll start doing research on their own. And you want to be prepared on how you're going to talk to them about what's in front of them, what the management plan is. But part of medicine is, again, putting your hands on people. Dermatology is 3d. You got to be with people. And when I was teaching, I used to tell the residents, you cannot leave the room without putting your hands on them, whether you shake their hands or anything else. And delivering bad news is part of that. You have to be able to feel the compassion and know that you're with them and not just giving the bad news. You're part of the bad news and part of the solution. Also, always great catching up with you. Appreciate your answer. Oh, thank you. Thanks for having me. Bye.
In this episode of Under Your Skin, Dr Nick Brownstone chats with Dr Neal Bhatia about giving advice to a first-year dermatology resident, innovations in dermatology, and advice on communicating a serious diagnosis to a patient.
If you could go back in time, what advice would you give yourself as a first-year dermatology resident?
Dr Bhatia explains that he would discuss expectations and emphasize that a first job may not be a last job.
He would also advise a first-year dermatology resident to create a niche for themselves. They should aim to learn about everything but also create a specialty and stay in a niche that they can be proud of and dig into deeply.
Dr Bhatia also acknowledges that academic demands are high in residency; he would advise a first-year resident to try to find a balance while keeping their foot on the gas and off the brake.
What innovations in dermatology are you most excited about?
Over the course of his career, Dr Bhatia has enjoyed watching innovations develop around Janus kinase inhibitors, biologics, and strategies and options to manage itch.
He recalls being groomed on topical steroids and innovations focused on active ingredients, but comments that now, the vehicles of the topicals are getting attention. He also praises the approach of thinking about the process of disease.
Dr Bhatia also encourages dermatologists to put patients’ interests forward, get out from their own shadow, and learn to be aggressive again.
How do you communicate a serious diagnosis to your patients?
Dr Bhatia emphasizes the importance of communicating serious diagnoses in person. He encourages physical touch and eye contact when discussing the severity of a diagnosis. He advises against relaying a serious diagnosis over the phone, since patients in that scenario may not absorb any information besides the negative news and may begin doing research on their own; he encourages dermatologists to be prepared on how to talk to patients about what’s ahead and the management plan for their diagnosis.
He reiterates that putting your hands on patients is vital; he refers to dermatology as 3D and emphasizes the importance of being present with your patients. He has advised residents that they shouldn’t leave the exam room without some physical touch with their patients, even if that means just shaking hands.
Dr Bhatia comments that delivering bad news is part of being present with patients and that it’s important to relate that you’re not just delivering the bad news, you are part of the solution as well.