What They Don’t Teach You in Medical School

Julie Fridlington, MD; Dermatologist, Westlake Dermatology and Cosmetic Surgery, Westlake, TX

“Diseases don’t read the textbooks.” I’ve referenced this phrase repeatedly during my years of dermatological practice. Nothing ever looks like it does in school or on paper—and despite our comprehensive medical training, today’s dermatologists must keep pace with evolving technology and understand the need for a broad-spectrum view of skin care.

Patient Care
One of the things I love most about my specialty is the ability to help my patients look and feel better about themselves. Today’s skin care treatments are increasingly effective, and minimally invasive procedures meet the demand for noticeable results with little downtime.
 
Patients can be overwhelmed by what they see on television or read about in the magazines. My job is to treat both a patient’s medical and cosmetic needs while helping them navigate the vast array of skin care products on the market. I also want to arm my patients with knowledge so that they understand why many procedures (Botox, lasers) are a waste of money without the regular use of sunscreen.
 
Patients in the Know
During my introduction to private practice, I found my rhythm to interacting with patients. Patient care is a learned skill and one I’ve developed through trial and error. Each patient is unique—they may have previously established prejudices or had prior negative experiences with doctors. It’s important to remain empathetic, even on an “off” day.
 
Treating an increasingly informed patient base has encouraged my own growth; in fact, I love when a patient does research on their condition before coming to the office. Lack of information can lead to lack of compliance. Knowledge truly does empower the patient and allows them to take responsibility for their own health and become a partner in their treatment.
 
Importance of Touch
Unfortunately, unlike many medical conditions, skin diseases are evident to the outside world. Some skin conditions like acne, psoriasis and eczema can be emotionally debilitating, lower a patient’s self-esteem and make them fearful of physical touch.
 
Patients with these disorders tend to get touched less and they are more hesitant to touch their friends and family members. I once trained with a dermatologist who emphasized the importance of touch, and I didn’t realize until I had progressed in my own practice just how much psychology and emotion is connected to the skin. Now, I make a point to touch my patients—especially in front of their loved ones—so that they know it is okay.
 
Healthy Skin
The healthy, active environment in the Austin area has inspired me to better understand the correlation between diet, lifestyle and the skin. Certain lifestyle choices—such as subpar nutrition, smoking, unmanaged stress and alcohol consumption—contribute to chronic disease and overall poor health, including conditions of the skin.
 
It is my firm belief that dietary choices affect the skin, and I am happy to talk to my patients about their diet. It’s important that I am able to care for the totality of my patients’ health, as what happens in our skin is a direct reflection of what’s going on in the rest of the body.
 
Medicine will continue to evolve throughout the span of my career. As both a doctor and a lifetime student immersed in the science of dermatology, I am a work in progress—if I wasn’t always learning, I would be in the wrong field!