Modern Aesthetics | Baby Steps
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Baby Steps

By: Richard G. Fried, MD, PhD

Whether it is the embryonic culmination and birth of a practice, the inception of a new idea for your existing practice, or a transition career move, the birth process of these important moves inevitably and thankfully begins with “baby steps”. Running like a thoroughbred horse out the proverbial gate, untrained and unprepared, can result in crippling or fatal initial steps. Injury by misdirection, misstep, fall, exhaustion, or even slaughter can lead to dissolution or demise of an otherwise promising and profitable idea or endeavor. While a “baby steps” conceptualization seems at first blush to be insulting or infantilizing, it is the manner by which most great ideas and practices mature and flourish.

Aesthetic practice is a fertile medium for the inception and cultivation of a wide array of intellectual, technical, and procedural skills. To name but a few, consider the following professional and personal endeavors: The opening of a new medical/surgical/cosmetic practice, starting a new job, accepting an academic appointment, learning new medical or surgical skills, acquiring and learning new laser skills, learning and mastering skin fillers, injecting botulinum toxin, becoming or hiring a Mohs surgeon, performing clinical trials, becoming a consultant and/or speaker, or providing services as an expert witness. This plethora of possibilities is an incomplete list of the opportunities that can be explored and embraced by new and practicing physicians.

For some physicians, these professional fantasies and potential opportunities feel inevitable and simple. For others, they feel impossible and unthinkable! We must realize and respect that the initial origin of these ideas and professional fantasies vary tremendously. They may emerge early in a career and thus be prominent and begging for fruition at the completion of residency training. In contrast, they may emerge with fervor after 30 years of clinical practice. Whether initially spawned by the simple miracle of impregnation, later infused by the passion of a life-long dream, continually buoyed by an uplifting impulse, or gleaned from a heartfelt and introspective “bucket list,” an idea is born. This idea must be protected and nurtured until it has sufficient legs to carry and support it.

The evolutionary process of bringing this idea to reality inevitably ebbs and flows. Adjectives describing the intrapsychic experience include but are not limited to futile, comical, overzealous, grandiose, and inebriated.

Akin to baby steps, the steps along the way are sometimes random, sometimes purposeful, often tentative, and frequently result in stumbles and falls. Supporting and lifting this “brainchild” can allow for the survival and enthusiastic success of this “offspring.” Although “baby steps” can be initially frustrating, reaching full stride too soon often leads to suboptimal outcomes. The delay of gratification that accompanies an organized game plan and systematic implementation does have its own rewards. The exuberant joy and relief that frequently are part and parcel of early steps and triumphs would be sorely missed. Gradual implementation allows for a better refined direction and perspective that can often avert “running” into dangerous pitfalls. Baby steps, by definition, require that one put more “skin in the game,” which emotionally makes us feel more deserving of our successes.

Just like any caring parent, developing and continually redefining a “master parenting plan” can allow for the evolution of a child with a refined and strong gait capable of balance and endurance. Allowing baby steps to mature into a refined stride is the key to a child and clinician who can be “master of their professional marathon.”

Wherein Board-Certified Dermatologist and Licensed Psychologist Richard G. Fried, MD, PhD considers the intersections of psychology and aesthetics.