A Conversation With Erin Barrett, MD

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Dr Erin Barrett (Wei) is an academic dermatologist and researcher with a distinguished academic and clinical career. She earned her MD with honors from Harvard Medical School after completing her undergraduate studies at MIT in chemistry and biology. Dr Barrett completed her dermatology residency at the University of Miami, where she was chief resident and received the Celia and Samuel Resnik Research Award for her work on nodular melanoma.

From 2016 to 2022, she was faculty at Brigham and Women’s Hospital-Harvard Medical School, where she was medical director for Brigham and Women’s-Westwood, directed the Bullous Disease Clinic, and received multiple recognitions, including a research grant from the International Pemphigus and Pemphigoid Foundation and Brigham Way recognition from then President Dr Betsy Nabel in recognition for excellence in patient care. Dr Barrett is a National Institutes of Health-funded (R01) researcher with active involvement in several major research grants.

In 2022, she joined the University of Nebraska Medical Center, where she holds leadership roles, including director of clinical trials, co-director of the Bullous Disease Clinic, director of inpatient dermatology, and director of the Skin of Color Clinic. Additionally, she serves as the medical director of specialty clinics and teledermatology. Dr Barrett is also an associate editor for VisualDx and a reviewer for top dermatology journals.

Q. What part of your work gives you the most pleasure?

A. The part of my work that gives me the most pleasure is building long-term relationships with my patients and helping my patients with bullous disease get better. It is incredibly rewarding to watch them improve over time, and to know I have made a meaningful impact in their lives, especially for those dealing with chronic, complex conditions.

Q. Are an understanding and appreciation of the humanities important in dermatology and why?

A. As a woman, mother, wife, daughter, friend, woman of color, and immigrant, I have a profound empathy for those around me. I have had times in my life when we had food insecurities, many times in my life when I was different than everyone else, more times in my life than not when I was the underdog, and it is these times that have taught me the most. Having a broader understanding of the human experience allows me to offer more empathetic and comprehensive care. Dermatology is about more than just treating skin conditions—it is about treating the whole person. I relate to my patients, coworkers, and staff on a deeper, human level through our shared struggles as humans, which may be the reason why my patients feel comfortable sharing things with me and often refer their friends and families to me. An understanding and appreciation of the humanities are crucial in medicine.

Q. What is your greatest regret?

A. My biggest regret is wasting my time in regret. I have a lot of regrets, but I have learned from each one, and I consider them important lessons. Every regret has helped me grow as both a person and a physician. We have such a limited time on Earth (4000 weeks if lucky), so I try not to dwell on regrets but instead use them to make better decisions moving forward.

Q. Who was your hero/mentor and why?

A. I have been fortunate to have had many mentors throughout my career, each of whom has shaped my professional journey in meaningful ways. Dr Ruth Ann Vleugels stands out for her remarkable ability to balance her roles as both a clinician and a mother. I will never forget how she helped me prepare for my first regional talk late at night after putting her children to bed—an act that truly went above and beyond. I admire her capacity to recognize the potential in everyone, and it was because of her encouragement that I began interviewing for chair and equivalent positions a few years ago. I aspire to embody the same mentorship qualities she does, valuing and nurturing the strengths in others. Dr Joe Merola sparked my interest in clinical trials and showed me the importance of believing in the people around you. Drs Thomas Kupper and Mitch Rubenstein taught me invaluable leadership skills and how to manage large departments effectively. Dr Ashley Wysong reminded me that life is about more than just medicine, while Dr Jane Grant-Kels has been an important mentor in helping me see the depth and richness of life in dermatology—and beyond it. Her perspective has been instrumental in guiding me toward maintaining a healthy balance between my career and personal life.

Q. Which patient had the most effect on your work and why?

A. There is not just one patient, but many, who have profoundly influenced my work. However, I would say my patients with bullous diseases have had the most significant effect on me. These patients face challenging, often painful, and chronic conditions, and working with them has deepened my commitment to improving care and outcomes for those with complex dermatologic diseases. This resulted in my R01 project on studying several potential cures for this population; the technology has the potential to treat all autoimmune disease.

Q. What is the best piece of advice you have received and from whom?

A. The best piece of advice I have received was from a mentor who taught me to always keep learning and growing in medicine. This advice has been a guiding principle throughout my career. It reminds me to stay open to new ideas and approaches, whether in clinical practice or research, and to constantly strive for improvement.

Q. Which medical figure in history would you want to have a drink with and why?

A. I would love to have drinks with the first Asian female physician in America, Dr Margaret Chung. Born in the tail end of the 1800s, she was the first Chinese American physician in the United States at a time when opportunities were limited for both Asian Americans and women. She became a leading surgeon during World War II for the US Navy and was called the “Mother of Marines.” Her story resonates with me because she did not just fight for her place in the medical field—she actively worked to support and uplift others.

Q. What is the greatest political danger in the field of dermatology?

A. The greatest political danger in dermatology right now is the potential impact of Medicare cuts and the growing cost of health care, which has been an ongoing challenge. The article “An Open Letter to Congress on Nonprofit Hospital Finances” by Andrew Donahue, FHFMA, CPA, which was sent to me by a friend and chief medical officer of a local health care system, was impactful. In it, Donahue discusses that on average, nonprofit hospitals have an “operating margin of just 1.2%” and the “75/75 conundrum,” which means that about 75% of revenue for nonprofit hospitals comes from government programs like Medicare and Medicaid with either fixed or declining payments; on the other hand, 75% of hospital expenses (salaries, benefits, and supplies) are rising due to inflation and staffing shortages. These changes could significantly limit access to dermatologic care for many patients, particularly older patients or those with chronic conditions or in underserved populations. These changes also create an environment that favors large private practice groups run by private equity or even large hospital mergers, creating medical giants; this trend is due in part to decreased overhead in some instances and by in large due to greater negotiating power with private insurers. This is a real concern, as it could impact both patient outcomes and the ability of dermatologists to provide high-quality care. Another article, “The Gilded Age of Medicine is Here” by Dhruv Khullar, published in The New Yorker, describes the growing dominance of private equity and corporate interest in health care, which often prioritizes profit over patient care, leading to worse outcomes and financial strain on hospitals. All these drivers are pushing corporatization of care, which is not a direction that is beneficial to patients, doctors, or health care systems.