I’m a big fan of imperfection. Believe it or not, I view imperfection as the ultimate goal of a professional skin care practice. This may come as a jolly surprise to my employees, who know that my management style is hardly laissez-faire. I have a fixation for hospital-cleanliness, for instance. To paraphrase the great Robert Duvall character in Apocalypse Now, I love the smell of Windex in the morning. Clutter bugs me, and I don’t know how otherwise reasonable people can work in it. Until quite recently, I could not tolerate denim worn in the office (I’ve never been a fan of “Casual Fridays”), because I thought it brought out the most slovenly tendencies in people.

Some patient diseases – such as skin cancer or acne – are especially well-suited to co-management between a dermatologist and an aesthetician. The physician may see the patient, but typically it is for a shorter amount of time and the patient is usually referred to the aesthetician, who can educate the patient on medication use, make sure follow-up appointments are kept, and help the patient with the psychological aspect of the disease. Because aestheticians scrutinize the patient’s skin, they are also more likely than the nurse – or even the dermatologist – to notice and question potentially cancerous lesions.