Recent Wall Street Journal Article “Belittles” Efforts of Dermatologists, Dr. Doris Day

Modern Aesthetics Editorial Board member Doris Day, MD, FAAD, didn’t hold back when speaking out against a recent Wall Street Journal article portraying dermatology as a cushiony specialty and citing that as a reason it is gaining increasing traction from medical students. 

“The Wall Street Journal article unfortunately belittled what it takes to become a dermatologist and to actually practice dermatology,” Dr. Day said. 

The article, titled, “$500,000 Pay, Predictable Hours: How Dermatology Became the ‘It’ Job in Medicine,”refers to dermatologists as having “some of medicine’s most enviable work lives.” 

Work-life balance and a median salary of about $541,000 a year do not adequately represent the reasoning for an increase in medical residency applications for dermatology, Dr. Day said. 

“Dermatology, I think, is one of the most intricate, complicated, most comprehensive specialties in medicine,” Dr. Day said.

Dr. Day explained that throughout residency and continuing into practicing dermatology, doctors in this specialty must be knowledgeable on a wide scope of areas including travel medicine, infectious disease, cancer, and rheumatology. Every organ gives signs via the skin, our strength is that we are trained to study those signs, without complex technology; instead, we rely on experience and decades of ongoing study.

“I had a patient who came in for neuromodulator treatment," Dr. Day said. "A few weeks later we saw changes in one eyelid that were not consistent with the expected treatment results. Upon further investigation and an MRI, she was diagnosed with cancer of the lacrimal gland. She was completely asymptomatic, but the treatment helped unmask the tumor, and instead of thinking she simply had a lid droop, we referred her to an ophthalmologist and worked together to uncover the underlying issue and help her get treatment early. She is now cancer free and doing well."

Being a dermatologist practicing aesthetic medicine isn’t always glitz and glam, she added; having a strong background and education in the field is crucial. 

“We can often diagnose diseases via the skin even before they’re diagnosed internally because we are medical sleuths and we study signs of internal disease that are visible in the skin," Dr. Day said. "It takes constant study of all levels of medicine, throughout our careers, to take the best care of our patients." 

A focus on skin care has become increasingly popular among Americans and social media marketing has created another avenue of revenue for dermatologists, adding to the lure for entering the industry. But Dr. Day explains the popularity for healthy skin and added revenue streams should not take away from the fact that dermatology training is “intense, it’s long.” 

“To make it seem like it’s easy hours, not a lot of work to get it, or it’s a cop-out specialty is really to misunderstand the value of what we do as dermatologists,” Dr. Day said. “This skin is our organ of choice and what we look at, but we’re really seeing whole people that have complex medical issues, and we address all of them on a regular basis.”  

The American Academy of Dermatology Association posted on its website a letter to the editor written by president Seemal R. Desai, MD, FAAD reading in part: 

"It is extremely concerning that this article may leave readers with the impression that aspiring dermatologists are primarily driven by flexible schedules and financial gain. This diminishes the profound impact dermatologists have on patients’ health and well-being. While cosmetic procedures are indeed valuable services provided by many dermatologists, they represent only one aspect of the comprehensive medical care we offer.  

As highly trained physicians, dermatologists form lasting partnerships with our patients, diagnosing conditions that can be debilitating, stigmatizing, and even life threatening. With their highly specialized knowledge, dermatologists are integral to improving the quality of life for patients of all ages and are essential parts of every aspect of the healthcare ecosystem. It is imperative that the breadth of life-changing services provided by dermatologists be conveyed to the public, offering a more complete picture of the field and the physicians who dedicate their lives to the health and well-being of the public."

Despite the increasing popularity of aesthetic medicine, that segment accounts for only a fraction of the patients many dermatologists see daily. Many Americans suffer daily from skin diseases such as atopic dermatitis, psoriasis, and rosacea—none of which was mentioned in the article—as well as skin cancer.