1. Dr. Lim, you are a world-renowned
dermatologist and a respected member of the medical community. What was your
reason for attending medical school? Can you please share with us what
motivated you to become a physician?
- When I was growing up, I developed
an avid interest towards science, and found great fulfillment in helping
others. Thus, despite there being no physicians amongst my immediate family
members, a profession in the medical field seemed to be something that I would
truly enjoy and feel gratified in. I grew up in Indonesia, but moved to Canada
for college, and subsequently applied for and attended medical school in the
U.S.; that encapsulates why and exactly how I became involved in the field of
medicine. In terms of specifically dermatology, that was actually by chance.
Throughout my time in medical school, I was initially looking to become a
pediatrician and this thought was largely influenced by the fact that my first-year
clinical mentor was a pediatrician. I truly did enjoy working with children and
adolescents and believed it to be a specialty I would like to pursue myself.
Towards the end of medical school, however, which was my fourth year, I deduced
as a prospective pediatrician, I would need to know more on dermatology as
clearly in kids, you see a lot of rashes.
`At that time, I was in New York and
NYU was reputably known to have a very good dermatology program, which
ultimately led me to complete a clinical elective during my fourth year of
medical school at NYU. From my time there, I was very much impressed with how
dermatology was taught and practiced and made me seriously consider dermatology
as a specialty I would work towards in lieu of pediatrics. The subject matter was
intellectually stimulating, and dermatology, I discovered, was a field I found
immense satisfaction in. So, with that, after applying for a pediatric
internship at various hospitals, I decided to also apply to the dermatology
program at NYU, and only at NYU. I had received an acceptance from pediatric
hospital, but when I was also notified of my acceptance into NYU’s dermatology
program, I became sure that dermatology is what I sought to pursue.
2. As a successful dermatologist
with nearly 40 years of experience, you may have gone through various
obstacles; can you share some of the most difficult moments in your career?
- No doubt, I have truly enjoyed my
career thus far in dermatology. However, likely the most difficult decision I
had to make occurred towards the end of my residency at NYU in dermatology, and
that was whether to go into private practice or to instead further pursue my
academic career. At the time, which was in 1978 or 1979 or so, private practice
was a very popular path to follow for many graduating residents, although it no
longer is today due to administrative burdens. One prevailing reason for this
was the income difference between a profession in private practice and an
academic career in dermatology. Having had a young family with two kids at the
time made this decision all the more arduous, as supporting them was an obvious
consideration I had to make. However, I truly thrived in an academic setting,
as I was constantly intellectually stimulated and challenged. Furthermore, I
was fortunate to have two mentors who helped me in making the decision, which
was to ultimately remain in academic dermatology. This was a very difficult
moment, but in retrospect, I’m confident to say that it was also the most
correct and probably the best decision I have made, as it has led me to a still
ever so stimulating and fulfilling career in dermatology for nearly 40 years
now.
3. Dr. Lim, you have previously been
a professor of Dermatology at NYU school of Medicine and today, you are a professor
at Wayne State University as well as a Senior Vice President for Academic
Affairs at Henry Ford Health System. How do you view yourself as an educator?
What are your principles or philosophies as a teacher?
- This is namely one of the aspects
in which I take tremendous enjoyment and gratification in. Having been an educator
and having mentored and interacted with younger students or faculty members
meant witnessing them grow professionally. In fact, there are a number of
faculty members in our department today whom I first met and knew as medical
students, as well as several others in other respective departments all over
the country whom I’ve also had the great experience of mentoring in the past. I
take a lot of gratification in that – knowing that I have contributed not only
to their growth as a clinician, educator, or researcher, but also that I have
made my contribution in giving back to the specialty. As an educator and as
someone who’s been in this specialty for nearly four decades, the one philosophy
I prescribe to myself and others is to always a find a way to give back to the
field. The younger individuals just entering the field are the very people who
will be contributing and shaping dermatology in pending years. After all, the
young people will become the clinicians and the academics in dermatology who
continue to propel our specialty forward, as well as those who provide the best
care and service to our patients.
4. Do you have any words of advice
for those who are pursuing to be a physician?
- What I wish to impart to all those
seeking to become future physicians is firstly, to know that medicine still is
a very noble profession. Medicine remains one of few, if not the only
profession that endows your various options of continuing to pursue your career,
be it in full-time practice or academic medicine, conducting research, becoming
an educator and mentor for medical students and residents, or if you feel
inclined, managing administrative leadership activity. All in all, it is truly
a wonderful profession, as you simultaneously also develop the core with your
patients by getting to know them as individuals as well as getting to know
their family. This leads me to a second piece of advice: to work hard, but to
also truly appreciate and take satisfaction in interacting with the patients,
and to thereby give back to the profession.
5. You have become the president of
American Academy of Dermatology. What are your key roles, responsibilities, and
principles of leading the world’s largest dermatologic society that represents
more than 18,000 physicians? Can you also share your visions and goals as the
president of this organization?
- It is truly a great honor and
privilege to have been elected as President, especially since this was a
position elected by the entire membership. Now, there are two major
responsibilities we uphold ourselves to at the Academy.
The first is education. As the
American Academy of Dermatology, we pride ourselves as a professional
organization that continues to provide top quality, and what I believe to be
the best medical education for dermatology across the globe. While our members
remain the largest demographic, we are noting that our international audiences
are increasingly attending the summer and annual meetings, which are what I
would describe as the two biggest meetings we host here. In fact, the growth of
our international membership has been exponential as of recent years, and it is
within our objectives that we continue to evaluate, improve, and utilize many
of our resources to better our education system in the AAD.
The second responsibility entails
ensuring health and stability in our members. We are well aware of how
demanding the practice of medicine can be nowadays, namely due to the
administrative burden. As a matter of fact, that is one of the leading causes
of physician burnout. Although dermatology is stated to have a lower rate of
burnout amongst all other specialties, it truly depends on the individual
physician. Therefore, the AAD has made it an ongoing mission to ease such
administrative burdens for our members. Particularly, prior authorization tends
to be the most strenuous for the members, and in order to combat this hitch, we
are currently developing a website to assist our physicians with the especially
laborious process. Moreover, we continue to work with legislators as well as
the payers in making sure that these administrative duties do not render the
actual practice of medicine as onerous for the physicians, including our
members.
As for my vision in regard to the
Academy, there are two goals I hope to accomplish with the members at the AAD.
We stand as a professional
organization for all dermatologists, primarily in the U.S., as it is a great
imperative for the AAD to advocate for this specialty and our members. One
principal goal, I believe, is to encourage our members to be active participants
in the activities of the house of medicine, be it in the American Medical
Association or at the State Medical Societies. This way, our voice in
dermatology continues to be heard and this way, we are able to continuously
make positive contributions on the healthcare discourse, in the local, city,
state, or national level.
Secondly, it is our earnest intent
to provide an apt environment and to generally support the increase in
diversity in dermatology. Specifically, we seek to increase the percentage of what
we call underrepresented minority (URM), which by definition includes groups of
ethnic racial groups where the proportion in medicine is less than the
proportion of the general population, namely African-Americans and Hispanics.
The URM percentage in dermatology, particularly, is quite low, as it is in a
number of other areas and specialties in medicine. Hence, it is within our top
priorities to address this disproportionate representation, and to ultimately
help rectify it. However, I find it critical to mention that this is a
challenge that goes beyond our capabilities at the AAD, as it is indubitably
more of a pipeline issue. We, as a society, first have to increase the
qualified pool of high school and medical school students in order to join
dermatology, or other medical specialties.
6. You have conducted hundreds of
research and served as an editor or co-editor in multiple textbooks. As an
eminent opinion leader in dermatology, what are some major changes or trends
happening in dermatology currently? Also, what do you forecast the major
changes would be in dermatology in the next five years?
- It is truly an exciting era in
dermatology now. As aforementioned, having been in the field for approximately
four decades now, I’ve personally witnessed the science of dermatology mature
and advance over the years. Even so today, our understanding of dermatology
continues to improve and become more sophisticated. Due to this evolution in
the study of dermatology, for example, we are now able to apprehend the mechanism
of the molecular pathway of the development of skin cancer, as well as the
molecular pathway of development of vitiligo, which is a condition where one
loses pigment in the epidermis, resulting in the development of white patches
on the skin. These cases are exemplary of the idea that simply understanding
the pathway itself, as in identifying what is effective and what is abnormal,
can manifest in better treatment.
The most exciting aspect of this is
that all of this is still ongoing, and that current changes are reflective of
changes that I look forward to in coming years. Within the next five years, I
expect further advancements in the findings and drug developments for various
skin disorders, some of which especially include treatments for psoriasis, as
well as dermatitis and eczema.
7. We have learned that you also
specialize in sun damage and photosensitivity. Recently, there have been many
public issues regarding sunscreen ingredients as well as skincare products. Do
you have any concerns regarding this issue or any advice you would like to
share with our readers?
- The issue regarding the
ingredients in sunblock and now skincare products reemerge every spring, from
what I’ve observed. There is no doubt that there are positive effects in being
outdoors, whether that is the benefits in physical activity or receiving a dose
of sun-derived vitamin D. Yet, we’re also very much aware as a society that the
sun’s ray can result in sunburn and the tanning of the skin. It also causes
what we call photo-aging, which is essentially the development of wrinkles and
possibly skin cancer. What we prescribe as the AAD is that maximum protection
should begin with measures that go beyond sunscreen application.
However, this is not to say that
individuals shouldn’t participate in outdoor activities. We simply advocate for
proper protection. Returning to sunscreens, they are no doubt a proven and very
effective means in shielding exposed skin, and while the concern regarding the
various ingredients in sunscreen is valid, the scientific data behind the
substances that receive negative press are, in truth, unsubstantial. So, in
conclusion, my response to concerned patients is that what’s most important is
protection, and that ultimately boils down to applying sunscreen onto exposed
areas.
I’ve also received inquiries and
concerns regarding the “chemical ingredients” in some brands of sunscreen. Such
ingredients are also known as “organic filters” in dermatology, where the
ingredients sink into the skin and function as agents that absorb the harmful
rays. On the other hand, there are inorganic filters, including zinc oxide and
titanium dioxide that simply sit on top of the skin and reflect the rays as
opposed to absorbing them. Sunscreens containing one or both of these latter
ingredients are inert agents that do not lead to any other issues. Therefore, I
often recommend such products to the patients who are tentative of using
organic filters. However, there is a challenge in using those sunscreens, as
they often leave a white sheen. Consequently, some patients dislike such
sunblock products for cosmetic reasons. Nonetheless, the benefits of using
sunscreen as part of protection still significantly outweighs all other
concerns one may have.
8. WKMJ has readers from over 10
countries globally. Please share your final words with our readers?
- What I would like to impart as my
final thoughts include one, as I’ve mentioned earlier, that I view medicine as
a very noble profession, where physicians can not only further the current
understanding of the mechanisms and treatments for various diseases, but also,
and most importantly, help the patients. This is what gives me the greatest satisfaction.
Secondly, I am incredibly grateful to have interacted with and mentored younger
generations within the medical field, as teaching such individuals has been an
enlightening and a truly gratifying experience for myself. I strongly and truly
encourage other experienced physicians to offer their time and knowledge
towards educating the medical students and residents just entering their
specialty, or the overall field. Lastly, I would like to convey to all the WKMJ
readers that today is truly an exciting time in medicine, as there is an
incredible amount of new information acquired from research, and that with such
new knowledge, there is much to be expected in new and improved treatments for
various disorders and conditions, and therefore a greater welfare for our
patients.
Henry
W. Lim, MD, FAAD
President, American Academy of Dermatology
Chair Emeritus, Department of Dermatology,
Henry Ford Hospital
Dr. Henry Lim is the Chair Emeritus of the
Department of Dermatology, Henry Ford Hospital and Senior Vice president of
Academic Affairs, Henry Ford Health System, Detroit, Michigan, USA. As of March
2017, he is the President of the American Academy of Dermatology, the world’s
largest dermatologic society. Prior to coming to Henry Ford Hospital, he was a
Professor of Dermatology at NYU School of Medicine, as well as the Chief of
staff of the New York VA Medical Center. He has published more than 400
articles, and edited 7 textbooks, He is a recognized world authority on
photodermatology. He has also been on Best Doctors list annually since 1994.
Dr. Lim has served as President of Michigan Dermatological Society, Vice
President of the American Academy of Dermatology, President of the American
Board of Dermatology, and the President of the American Dermatological
Association. In 2016, he was selected as the recipient of the Fred W.
Whitehouse, MD Distinguish Career Award of the Henry Ford Medical Group. Dr. Lim
is also an elected member of the dermatology societies in Austria, France,
Spain, the Philippines, China, and the Baltics.