J Clin Aesthetic Dermatol 2022;15(6 Suppl 1):S11–S12
Susan Mayne, DNP, FNP-C, DCNP, is a Family Nurse Practitioner who practices dermatology at University Hospitals Cleveland Medical Centers (UHCMC) in Cleveland, Ohio. She received her Master of Science in Nursing with a family focus from Ohio University and her Doctor of Nursing Practice from Kent State University. Dr. Mayne is one of very few in the nation to complete a two-year interdisciplinary post-master’s dermatology NP training program at UHCMC. She is a Clinical Instructor at Case Western School of Medicine and lectures nationally and locally. Her clinical focus is complex skin conditions in pediatric and adult patients.
What inspired you to pursue a career in dermatology?
Susan: I’m professionally fickle— dermatology is my third career. Thankfully, it’s the perfect fit since I don’t have the lifespan for another.
What clinical areas in dermatology interest you the most?
Susan: I find artificial intelligence (AI) and advances in genetic technologies fascinating. On more of the day-to-day stuff, dermoscopy is it. When determining if it is necessary to biopsy a lesion, there are many variables to consider, and it can be tough to make sure lesions are not missed versus leaving the patient with unnecessary scars. I’ve tried all of the most common diagnostic algorithms but have found the “gut” algorithm to be best. That is, with experience you gain a gut instinct for spotting lesions that are better suited for formalin than on the body. The variety of melanoma presentation is stunning. Most of us are familiar with colors and structures common to melanoma, but I’ve biopsied many melanomas that mimic inflamed or benign lesions. Even scarier are featureless melanomas
How do you keep patients engaged in and adherent to their treatment plans?
Susan: With our own deep understanding of dermatologic conditions, it’s easy to mistakenly assume our patients understand the basics of skin function. I take a few extra minutes to educate my patients about their disease, the chronicity of the many conditions we manage, how to control flares, and the medications we use to do so. Many studies show that over half of what we tell our patients does not make it from working memory to long-term memory; for this reason, I keep a binder of printed hand-outs for common conditions in each treatment room.
We are seeing greater use of AI in medical research and practice. What do you see as its benefits and limitations? How does it impact the care you provide your patients? How can we coexist with it in clinical dermatology while still building and maintaining positive clinician-patient relationships?
Susan: I’ve been around long enough to have survived previous technological revolutions that brought as much innovation as they have obsolescence, and I have no doubt the trend will continue as such. I don’t worry about humanity becoming obsolete in the age of AI. As excited as I am about the power of this technology, I try my best to keep an open mind and balance that with a healthy dose of skepticism. The possibilities are endless, from individual- to population-based medicine. We can utilize AI not only to help with risk stratification, but also determine those patients who are likely to respond to outreach programs. AI can drive marketing efforts by predicting which patients will likely need future intervention.
We have also, for obvious reasons, been experiencing a huge surge in the use of telemedicine. Is there an art to teledermatology? How do you incorporate it into your daily practice?
Susan: Telemedicine has been around for quite some time but its use was catapulted into our daily reality at the onset of COVID-19. At the beginning of the pandemic, I would start each day with a double-dose of “Dramamine,” in expectation of the numerous technical glitches I was sure to encounter throughout the day—which at the time seemed on scale with the massive technical disasters only seen in sci-fi movies. But telemedicine technology has come a long way over the past two years and has become an important part of dermatology practice. Telederm provides us with a convenient and efficient way to triage new patients, perform follow-up visits, and touch base with patients who have fallen off the adherence wagon. It also improves access for those who would otherwise be required to wait 6 to 8 months for a specialty visit.
As a provider, what gives you the greatest sense of fulfillment in what you do?
Susan: A patient’s thankful hug and a clinic full of laughter and comradery.
How do you find balance between your personal life and your career? How do you avoid burnout?
Susan: Burnout doesn’t have to be a bad thing—it gives me yet another reason to defer personal responsibility for my irritability, fatigue, and forgetfulness. But seriously, in my humble opinion, burnout is a common side effect of work, and it doesn’t discriminate based on profession. My recipe to combat burnout includes a good sense of humor and supportive colleagues…and the occasional post-clinic “Hungry Man” serving of red, pink, or white wine. This can save your soul from people and situations that raise cortisol levels to brain-pulverizing heights. You’re welcome.
What advice would you give NPs and PAs just beginning their dermatology careers?
Susan: Go ahead and cry! We’ve all been there, and no one will judge. You will also personally understand hyperhidrosis and its quality-of-life impact for your first 2 to 3 years of practice. Whether you’re an NP or a PA, I implore you join associations like the Society of Dermatology Nurse Practitioners (SDNP) or the Society of Dermatology Physician Assistants (SDPA). Outside of collaborating with your physician colleagues, consider using programs such as VisualDX, a succinct diagnostic clinical support program, which I still use daily for its great patient hand-outs. There are also great educational apps like Top Derm and Figure 1 that are engaging and entertaining. Many of these resources also provide free educational webinars given by experts in the field.