Operational Flexibility and Layered Care Strategies Drive Practice Resilience in Dermatology
Scalable systems, proactive patient engagement, and integrated treatment strategies may strengthen both clinical outcomes and operational resilience in dermatology practices, according to Ava Shamban, MD, during her session, “Layered Value: Optimizing Patient Outcomes and Practice Performance,” presented at Music City SCALE 2026.
The session examined how layered operational models can support growth, continuity of care, and adaptability during periods of disruption. Dr Shamban outlined the infrastructure behind AVA MD’s multi-location practice model, emphasizing integration between medical dermatology, aesthetics, clinical research, and operational management.
The Santa Monica location was described as the “operational core of the practice,” with integrated front- and back-office workflows supporting both high-volume clinical care and aesthetic services. The practice also maintains an internal research division with dedicated coordinators and medical assistants, allowing “real-time integration of clinical innovations” and early adoption of emerging therapies.
A multidisciplinary staffing structure, including physicians, nurse practitioners, physician assistants, nurses, and research personnel, supports a protocol-driven care model intended to improve efficiency and consistency while maintaining clinical quality.
The presentation focused heavily on resilience planning following disruption from the January 2025 Palisades Fire, which significantly reduced patient access and contributed to approximately 3000 fewer patient visits over the year. Dr Shamban emphasized that “resilience requires intentional system design, not reactive responses.”
In response, the practice implemented operational changes aimed at preserving continuity of care and stabilizing growth. Twice-weekly cross-office Zoom meetings and a WhatsApp-based communication channel facilitated rapid information sharing and collaborative problem-solving across locations.
Telehealth became a key operational pivot. Prescription refill calls were converted into billable virtual visits, maintaining patient access while generating approximately $35,000 over 6 weeks. The strategy demonstrated the value of “reframing existing workflows” during periods of limited in-person access.
Proactive patient engagement also emerged as a major focus. Weekly review of patient lists allowed teams to identify opportunities for additional services and improve retention. This shift from reactive scheduling to proactive care coordination aimed to strengthen adherence and maximize visit value.
The session also highlighted “stackables,” or layered procedural combinations designed to enhance treatment outcomes and patient satisfaction while improving practice efficiency. Combining complementary procedures within a single visit created what Dr Shamban described as “layered value,” linking patient outcomes with operational performance.
Dr Shamban concluded that “growth is not linear and requires ongoing adaptation,” emphasizing that successful practices integrate both strategy and execution.
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Reference
Shamban A. Layered value: optimizing patient outcomes and practice performance. Presented at: Music City SCALE Symposium; May 13–17, 2026; Nashville, TN.
