In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe — others unsung heroes. All of these colleagues have much to share from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them. Dr. Hruza was born in Prague, but left when his family escaped the Communists and settled in New York City, where he completed his undergraduate degree, medical school and dermatology residency at New York University. He did a laser surgery fellowship at Harvard under Dr. Rox Anderson, followed by one in Mohs surgery at the University of Wisconsin-Madison under the tutelage of Drs. Mohs, Snow and Larson. He spent the next 12 years at Washington University in St. Louis teaching dermatologic surgery. The next phase was a move to private practice in St. Louis and teaching at St. Louis University, where Dr. Hruza is clinical professor of dermatology and otolaryngology. His academic pursuits have included clinical research in laser and dermatologic surgery, resulting in more than 150 scientific publications, including the textbook Principles and Practice of Laser Surgery. Dr. Hruza has been fortunate to be able to present and lecture on four continents about his work. His editorial responsibilities have included editing the Cutting Edge Section of the Archives of Dermatology for a dozen years and being an Assistant Editor for Dermatologic Surgery. Dr. Hruza has been active in organized medicine having served on the Boards of the American College of Mohs Surgery, American Society for Dermatologic Surgery, Association of Academic Dermatologic Surgeons and American Society for Laser Medicine and Surgery (ASLMS). He is Past President of the St. Louis Metropolitan Medical Society, current treasurer of the Missouri State Medical Association and Vice President of ASLMS.
Q. What part of your work gives you the most pleasure?
A. Being able to remove a challenging skin cancer with certainty, to reconstruct the resulting defect with a barely perceptible scar and seeing the relief in the patient’s eyes is very satisfying. It never seems to get old. Each patient is unique with his or her own personality, concerns and anxieties. After 20+ years, I look forward to going to work, as every day brings new challenges, whether it is a patient with a leiomyoscarcoma or one with a large morpheaform basal cell on his nose requiring extensive resection and multi-stage reconstruction.
Q. What is your greatest regret?
A. I have been very fortunate throughout my training and career in that I have few regrets. Wanting to build an ambulatory surgery center (ASC) was on my wish list for at least a dozen years. Finally, this year that dream has become a reality with the opening of Chesterfield ASC. The increase in the quality of patient care has been tremendous. Had I made the effort to get an ASC up and running far earlier in my career, thousands more of my patients would have had the benefit of the ASC. Also, regulations and requirements for ASCs have increased exponentially in the past 10 years, making it far harder to get an ASC certified today. The CMS does not even do initial ASC certifications anymore, relying instead on private organizations such as AAAHC to do it for them with not insignificant additional costs.
Q. Who was your hero and why?
A. Rox Anderson was my laser fellowship director. He can take a complex problem and explain it in simple, easy-to-understand language. His enthusiasm for science is infectious. His theory of selective photothermolysis revolutionized laser therapy with new applications based on it being developed almost three decades later. Rox has an incredible enthusiasm for everything having to do with lasers, light and any other energy source, but he also knows about almost anything in medicine and the sciences. He is a modern renaissance man or a human “Google.” If I could achieve 10% of what Rox has done, I would consider myself successful beyond my wildest dreams. He taught me to believe that no problem is unsolvable; one just needs to think a bit or, in his case, a lot, outside the box to solve difficult problems.
Q. What is the best piece of advice you have received and from whom?
A. My mother survived the Holocaust through a death march, concentration camp and typhus. Both her parents and all four grandparents were killed in concentration camps. At one point in the concentration camp she had forgotten what her mother’s face looked like, and she wished for just 20 more breaths to try to remember her mother’s face. That determination to live allowed her to survive and has always served as inspiration for me to never take life for granted. I try to live every day to its fullest with no regrets.
Online Extra
Q. What is the greatest political danger to the field of dermatology?
A. The health care reform law will have a profound effect on how we practice dermatology. The tens of thousands of pages of future regulations will insert the government ever deeper into the doctor-patient relationship. My fear is regulations and mandates squelching innovation in patient care. Mandated guidelines of care will discourage trying out new and possibly better ways to treat patients. If such an environment existed when Dr. Mohs introduced his technique, Mohs surgery would probably not have become available to our patients, as is the case in most of Europe. As the cost savings in the health care law fall almost exclusively on physicians (hospitals and pharmaceutical companies are exempt), dermatologists are especially vulnerable. Regulators view dermatologic services as not being especially important. This puts us at risk for disproportionate cuts in reimbursement for our services. Dermatologists represent only 2% of physicians, which means that we may be on the losing end of the upcoming battles with other specialties for a rapidly diminishing amount of money available for physician services. This may lead to an accelerated rate of early retirements by the most experienced among us, movement of dermatologists from private practice to becoming employees of large health care organizations and a focus on cosmetic procedures at the expense of medical dermatology. Dr. Barankin is a dermatologist based in Toronto, Canada. He is author-editor of six books in dermatology, and is widely published in the dermatology and humanities literature. He is also co-editor of Dermanities (dermanities.com), an online journal devoted to humanities as they relate to dermatology.
In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe — others unsung heroes. All of these colleagues have much to share from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them. Dr. Hruza was born in Prague, but left when his family escaped the Communists and settled in New York City, where he completed his undergraduate degree, medical school and dermatology residency at New York University. He did a laser surgery fellowship at Harvard under Dr. Rox Anderson, followed by one in Mohs surgery at the University of Wisconsin-Madison under the tutelage of Drs. Mohs, Snow and Larson. He spent the next 12 years at Washington University in St. Louis teaching dermatologic surgery. The next phase was a move to private practice in St. Louis and teaching at St. Louis University, where Dr. Hruza is clinical professor of dermatology and otolaryngology. His academic pursuits have included clinical research in laser and dermatologic surgery, resulting in more than 150 scientific publications, including the textbook Principles and Practice of Laser Surgery. Dr. Hruza has been fortunate to be able to present and lecture on four continents about his work. His editorial responsibilities have included editing the Cutting Edge Section of the Archives of Dermatology for a dozen years and being an Assistant Editor for Dermatologic Surgery. Dr. Hruza has been active in organized medicine having served on the Boards of the American College of Mohs Surgery, American Society for Dermatologic Surgery, Association of Academic Dermatologic Surgeons and American Society for Laser Medicine and Surgery (ASLMS). He is Past President of the St. Louis Metropolitan Medical Society, current treasurer of the Missouri State Medical Association and Vice President of ASLMS.
Q. What part of your work gives you the most pleasure?
A. Being able to remove a challenging skin cancer with certainty, to reconstruct the resulting defect with a barely perceptible scar and seeing the relief in the patient’s eyes is very satisfying. It never seems to get old. Each patient is unique with his or her own personality, concerns and anxieties. After 20+ years, I look forward to going to work, as every day brings new challenges, whether it is a patient with a leiomyoscarcoma or one with a large morpheaform basal cell on his nose requiring extensive resection and multi-stage reconstruction.
Q. What is your greatest regret?
A. I have been very fortunate throughout my training and career in that I have few regrets. Wanting to build an ambulatory surgery center (ASC) was on my wish list for at least a dozen years. Finally, this year that dream has become a reality with the opening of Chesterfield ASC. The increase in the quality of patient care has been tremendous. Had I made the effort to get an ASC up and running far earlier in my career, thousands more of my patients would have had the benefit of the ASC. Also, regulations and requirements for ASCs have increased exponentially in the past 10 years, making it far harder to get an ASC certified today. The CMS does not even do initial ASC certifications anymore, relying instead on private organizations such as AAAHC to do it for them with not insignificant additional costs.
Q. Who was your hero and why?
A. Rox Anderson was my laser fellowship director. He can take a complex problem and explain it in simple, easy-to-understand language. His enthusiasm for science is infectious. His theory of selective photothermolysis revolutionized laser therapy with new applications based on it being developed almost three decades later. Rox has an incredible enthusiasm for everything having to do with lasers, light and any other energy source, but he also knows about almost anything in medicine and the sciences. He is a modern renaissance man or a human “Google.” If I could achieve 10% of what Rox has done, I would consider myself successful beyond my wildest dreams. He taught me to believe that no problem is unsolvable; one just needs to think a bit or, in his case, a lot, outside the box to solve difficult problems.
Q. What is the best piece of advice you have received and from whom?
A. My mother survived the Holocaust through a death march, concentration camp and typhus. Both her parents and all four grandparents were killed in concentration camps. At one point in the concentration camp she had forgotten what her mother’s face looked like, and she wished for just 20 more breaths to try to remember her mother’s face. That determination to live allowed her to survive and has always served as inspiration for me to never take life for granted. I try to live every day to its fullest with no regrets.
Online Extra
Q. What is the greatest political danger to the field of dermatology?
A. The health care reform law will have a profound effect on how we practice dermatology. The tens of thousands of pages of future regulations will insert the government ever deeper into the doctor-patient relationship. My fear is regulations and mandates squelching innovation in patient care. Mandated guidelines of care will discourage trying out new and possibly better ways to treat patients. If such an environment existed when Dr. Mohs introduced his technique, Mohs surgery would probably not have become available to our patients, as is the case in most of Europe. As the cost savings in the health care law fall almost exclusively on physicians (hospitals and pharmaceutical companies are exempt), dermatologists are especially vulnerable. Regulators view dermatologic services as not being especially important. This puts us at risk for disproportionate cuts in reimbursement for our services. Dermatologists represent only 2% of physicians, which means that we may be on the losing end of the upcoming battles with other specialties for a rapidly diminishing amount of money available for physician services. This may lead to an accelerated rate of early retirements by the most experienced among us, movement of dermatologists from private practice to becoming employees of large health care organizations and a focus on cosmetic procedures at the expense of medical dermatology. Dr. Barankin is a dermatologist based in Toronto, Canada. He is author-editor of six books in dermatology, and is widely published in the dermatology and humanities literature. He is also co-editor of Dermanities (dermanities.com), an online journal devoted to humanities as they relate to dermatology.
In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe — others unsung heroes. All of these colleagues have much to share from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them. Dr. Hruza was born in Prague, but left when his family escaped the Communists and settled in New York City, where he completed his undergraduate degree, medical school and dermatology residency at New York University. He did a laser surgery fellowship at Harvard under Dr. Rox Anderson, followed by one in Mohs surgery at the University of Wisconsin-Madison under the tutelage of Drs. Mohs, Snow and Larson. He spent the next 12 years at Washington University in St. Louis teaching dermatologic surgery. The next phase was a move to private practice in St. Louis and teaching at St. Louis University, where Dr. Hruza is clinical professor of dermatology and otolaryngology. His academic pursuits have included clinical research in laser and dermatologic surgery, resulting in more than 150 scientific publications, including the textbook Principles and Practice of Laser Surgery. Dr. Hruza has been fortunate to be able to present and lecture on four continents about his work. His editorial responsibilities have included editing the Cutting Edge Section of the Archives of Dermatology for a dozen years and being an Assistant Editor for Dermatologic Surgery. Dr. Hruza has been active in organized medicine having served on the Boards of the American College of Mohs Surgery, American Society for Dermatologic Surgery, Association of Academic Dermatologic Surgeons and American Society for Laser Medicine and Surgery (ASLMS). He is Past President of the St. Louis Metropolitan Medical Society, current treasurer of the Missouri State Medical Association and Vice President of ASLMS.
Q. What part of your work gives you the most pleasure?
A. Being able to remove a challenging skin cancer with certainty, to reconstruct the resulting defect with a barely perceptible scar and seeing the relief in the patient’s eyes is very satisfying. It never seems to get old. Each patient is unique with his or her own personality, concerns and anxieties. After 20+ years, I look forward to going to work, as every day brings new challenges, whether it is a patient with a leiomyoscarcoma or one with a large morpheaform basal cell on his nose requiring extensive resection and multi-stage reconstruction.
Q. What is your greatest regret?
A. I have been very fortunate throughout my training and career in that I have few regrets. Wanting to build an ambulatory surgery center (ASC) was on my wish list for at least a dozen years. Finally, this year that dream has become a reality with the opening of Chesterfield ASC. The increase in the quality of patient care has been tremendous. Had I made the effort to get an ASC up and running far earlier in my career, thousands more of my patients would have had the benefit of the ASC. Also, regulations and requirements for ASCs have increased exponentially in the past 10 years, making it far harder to get an ASC certified today. The CMS does not even do initial ASC certifications anymore, relying instead on private organizations such as AAAHC to do it for them with not insignificant additional costs.
Q. Who was your hero and why?
A. Rox Anderson was my laser fellowship director. He can take a complex problem and explain it in simple, easy-to-understand language. His enthusiasm for science is infectious. His theory of selective photothermolysis revolutionized laser therapy with new applications based on it being developed almost three decades later. Rox has an incredible enthusiasm for everything having to do with lasers, light and any other energy source, but he also knows about almost anything in medicine and the sciences. He is a modern renaissance man or a human “Google.” If I could achieve 10% of what Rox has done, I would consider myself successful beyond my wildest dreams. He taught me to believe that no problem is unsolvable; one just needs to think a bit or, in his case, a lot, outside the box to solve difficult problems.
Q. What is the best piece of advice you have received and from whom?
A. My mother survived the Holocaust through a death march, concentration camp and typhus. Both her parents and all four grandparents were killed in concentration camps. At one point in the concentration camp she had forgotten what her mother’s face looked like, and she wished for just 20 more breaths to try to remember her mother’s face. That determination to live allowed her to survive and has always served as inspiration for me to never take life for granted. I try to live every day to its fullest with no regrets.
Online Extra
Q. What is the greatest political danger to the field of dermatology?
A. The health care reform law will have a profound effect on how we practice dermatology. The tens of thousands of pages of future regulations will insert the government ever deeper into the doctor-patient relationship. My fear is regulations and mandates squelching innovation in patient care. Mandated guidelines of care will discourage trying out new and possibly better ways to treat patients. If such an environment existed when Dr. Mohs introduced his technique, Mohs surgery would probably not have become available to our patients, as is the case in most of Europe. As the cost savings in the health care law fall almost exclusively on physicians (hospitals and pharmaceutical companies are exempt), dermatologists are especially vulnerable. Regulators view dermatologic services as not being especially important. This puts us at risk for disproportionate cuts in reimbursement for our services. Dermatologists represent only 2% of physicians, which means that we may be on the losing end of the upcoming battles with other specialties for a rapidly diminishing amount of money available for physician services. This may lead to an accelerated rate of early retirements by the most experienced among us, movement of dermatologists from private practice to becoming employees of large health care organizations and a focus on cosmetic procedures at the expense of medical dermatology. Dr. Barankin is a dermatologist based in Toronto, Canada. He is author-editor of six books in dermatology, and is widely published in the dermatology and humanities literature. He is also co-editor of Dermanities (dermanities.com), an online journal devoted to humanities as they relate to dermatology.
