LAS VEGAS The most critical investments one should make in a new surgical practice are a quality surgical table, a top-of-the-line surgical light, and excellent surgical instruments, Dr. James M. Spencer said at the annual meeting of the American Society of Cosmetic Dermatology & Aesthetic Surgery.
"There are a lot of places in life to cut corners. Don't do it here," said Dr. Spencer, a dermatologist in private practice in St. Petersburg, Fla.
A dermatologic surgeon who only intends to do facial work might be well served by a top-flight procedure chair, such as those used by otolaryngologists.
However, Dr. Spencer prefers a high-quality surgical table and an adjustable, ceiling-mounted surgical light.
"Don't be cheap here," he reiterated.
Every surgeon has his or her favorite piece of equipment, and Dr. Spencer is no exception.
"The smartest thing I ever bought in my whole life was an Ellman Surgitron [electrosurgery unit]," he said.
Dr. Spencer noted that he has no financial interest in the Ellman Surgitron company or the recommended product.
Making a foray into surgical practice should be a careful and well-thought-out career move, cautioned Dr. Spencer, who serves on the clinical faculty of the Mount Sinai School of Medicine in New York.
"Why would another doctor refer to you because you took a weekend course?" he asked.
He advises doing a procedural dermatology fellowship, writing papers, doing research, and then, with some expertise to offer, arranging to do a grand rounds lecture at the local community hospital.
Dr. Spencer said young dermatologic surgeons are wise to take Medicare so that they can begin to build a referral practice for patients with skin cancer.
Family physicians often perform skin biopsies, but have a choice about where to send their patients for excisions and repairs.
"Get to know them," he suggested.