Building a Patient-Centered Skincare Practice

Water’s Edge Dermatology
Written by Jessica Ferlaino

At Water’s Edge Dermatology (WEderm), a broad-based general dermatology practice in Florida, highly-trained dermatologists work with a team of health professionals to provide the best quality medical care and patient experience. Service lines include general medical dermatology, cosmetic dermatology, skin cancer prevention, detection and treatment, medical and cosmetic vein care, and plastic surgery. WEderm also has a board-certified radiation oncologist on staff for difficult-to-treat skin cancers, which is not typical for most dermatology practices.
The practice was founded July 1st, 1998 by Dr. Ted Schiff, who is double-board-certified in both dermatology and dermatopathology. Dr. Schiff started with only one other employee, a nurse (still with the practice, now a Nurse Practitioner) named Sharon Barrineau. That first WEderm office was located in Okeechobee, Florida, a small rural town in the center of the state.

A number of Dr. Schiff’s original Okeechobee patients still see him at that office, twenty years later, including now-94-year-old Carl Eaton. Carl is a decorated WW II combat veteran who first started visiting Water’s Edge when it opened, with his late wife. With a number of successful skin cancer removals and recoveries under his belt by now, Carl is so fond of Dr. Schiff and the staff that even when not in treatment, he still stops by for coffee, donuts and conversation almost every week. Dr. Schiff puts it this way:

“It’s our pleasure and privilege to have been of service to Carl all these years, and our honor to call him both patient and friend. He’s a genuine American war hero who reminds us not only of our nation’s history, but also of our own history of service to the wonderful residents of Okeechobee during the past two decades.” Less than a year after opening that first office, Dr. Schiff opened a second part-time office at a cardiologist’s office in Palm Beach Gardens that was only open one morning a week. That practice was soon open a full day, and after a short while, it was so busy that it outgrew its welcome in the shared space.

By 2000, a full-time office was opened in Palm Beach Gardens, and the practice has continued with this pattern to create the rest of its thirty-four facilities in Florida. As each office became successful and busy, another office was opened to meet growing demand across more communities, usually further north or west from the original offices.

Since its inception twenty years ago, WEderm has grown slowly but steadily – never simply for the sake of increasing its size, but rather, to bring its special brand and quality of skincare services to more Floridians in need of and clamoring for it. Such is the case with the recent opening of its thirty-fourth and newest location, in Venice, on Florida’s southwest Gulf Coast. While the practice usually designs and opens its own offices, it has become increasingly open to acquisition of other dermatology practices that have historically functioned under similar parameters and upheld the same high quality of medical care and customer service.

“We have plans for growth of the practice, both by opening up further new offices, and also by looking to acquire quality practices that fit within our geographic span,” says Dr. Schiff.

The reason for the success of the practice boils down to its ability to provide high-quality care to its patients. Patient care is the priority, and treating the staff well is a close second. “I’m a firm believer that, if you take the best care of the patient that you can, and you take good care of your staff by compensating them well and treating them well, the medical practice will flourish, and that’s been our philosophy going forward,” says Dr. Schiff.

Employees are treated respectfully and equally including the physicians, nurse practitioners, physician assistants, and the administrative staff. The approximately 450 to 500 employees work toward the mission of providing superior patient care, and when the employees are treated well, they tend to want to work harder for the company’s ultimate goal. Diversity in the workforce is encouraged, and all differences are accepted as long as they do not interfere with the work being done.

The quality of care provided is not the only trait that sets it apart from the competition; the quality of its facilities is also exceptional. “We have the nicest facilities with the best equipment, the best technology available, and the best staff to support the doctors,” says Dr. Schiff.

Most of its thirty-four medical offices are in freestanding buildings as opposed to large buildings or strip malls like many other dermatology practices. “It is most important to provide the proper medical care, but we also have to provide the most efficient and best environment to provide that care. The quality of our medical spaces that we practice from is always far above what would be considered the average.”

Dealing with different insurance companies can be a challenge for WEderm. Patients often have a difficult time understanding what insurance covers, and as deductibles get higher, patients are responsible for more of their healthcare costs. “Almost all of our patients see us via their insurance, and most don’t have a good understanding of their deductibles and copays. Those sort of financial issues, not directly medical issues, pose a significant challenge, which grows more complicated all the time,” says Dr. Schiff.

The primary way that WEderm invests in its communities in Florida is by being a great employer. It practices in many small, rural towns where it provides valuable employment while being a vital part of the community. The dermatology practice also regularly supports organizations within its communities such as local charity work and little league teams. Another great investment is that all of its offices offer periodic skin cancer screening services that are free of charge.

WEderm strives to raise awareness about skin cancer through its website and educates each patient during the complimentary skin cancer screenings. Patients are taught about the importance of doing a monthly self-exam and are shown how to do it. “We educate our patients one by one as they see us. We provide literature and pamphlets with instructions and photographs of how to do a skin exam,” says Dr. Schiff.

The practice partners with the RDK Melanoma Foundation to raise awareness. The non-profit organization is looking to save lives through education about prevention and early detection of skin cancer. It operates in the school districts of Florida to ensure that sun safety education is a part of the curriculum.

WEderm further separates itself from competitors by providing quarterly grand rounds for the most complex and challenging dermatology cases from across the practice. These are clinical examination, consultation and learning sessions, where a group of experienced practitioners (and often medical students) examine patients with the most difficult cases, discussing treatment options, and devising a plan of future care. While Grand Rounds are common in university teaching hospitals, they are quite rare for a private dermatology practice such as WEderm.

Water’s Edge Dermatology’s grand rounds are conducted by Dr. Joseph Jorizzo, a nationally-recognized dermatology practitioner and professor who is also coauthor of the standard textbook of dermatology used by all students, residents, and physicians. The practice gathers patients with the most complicated, still unresolved (or unknown) skin conditions at its clinical office in Palm Beach Gardens, which is also the practice’s administrative headquarters.

Practitioners present patients to Dr. Jorizzo for him to examine and he discusses his assessment with the group. There are usually ten to fifteen patients being presented and approximately fifteen to twenty people in attendance. The group collaborates to find better therapies and help the patient find solutions. The patient receives the best advice and excellent care, and the WEderm clinical team is provided with regular, substantial educational opportunities.

It’s a great advantage for patients of WEderm that the practice offers medical and cosmetic dermatology, radiation oncology, vein care, and plastic surgery, all in one practice. Most dermatology practices don’t offer radiation oncology for difficult-to-treat skin cancers.

“We are the only dermatology practice that employs a full-time radiation oncologist and we also use a linear accelerator, which is the same machine a hospital would use to treat other sorts of cancers with electron beam therapy,” says Dr. Schiff.

WEderm is also one of the few dermatology practices to offer vein care at such a high level, with both an experienced, board-certified vascular surgeon and an interventional radiologist on the team. The Vein Center at Water’s Edge Dermatology currently has 15 locations, treating everything from varicose and spider veins to the most serious venous diseases.

In response to growing demand, the practice added plastic surgery to its service offerings in 2017. Board-certified plastic surgeon Dr. Juan Giachino Jr. now provides a full complement of popular cosmetic procedures, while consulting with dermatology and radiation oncology to provide skin cancer patients with the best possible range of treatment and recovery options.

The ability to be evaluated and treated by a team of top skincare specialists, working on your case together in interdisciplinary fashion, is unique. From the comprehensive care, to the convenience, to the advantages of collegial collaboration, WEderm puts great effort into identifying delivering the best possible solutions for its patients with skin problems.

In the future, Water’s Edge Dermatology plans to expand the services that are available. The practice has grown nicely through its reputation; physicians are always looking to join due to word of mouth among doctors.

The great success of the practice all comes back to proper education and training, hard work, treating patients with the highest quality of care, and treating the staff well. “Our practice basically grows and thrives based on the quality of the care we provide and the way we treat all of our staff. As that reputation grows, the practice grows along with it,” says Dr. Schiff.



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