Dr. Christopher J. Arpey, American Board of Dermatology
Jul 25, 2014
Dr. Christopher J. Arpey serves as the president of the American Board of Dermatology. His clinical research focuses on skin cancer and reconstruction. He is passionate about his work as a physician, and we had the distinct pleasure to learn more about Dr. Arpey's love of medicine and his advice for future dermatologists.
How did you decide on a career in medicine?
I was raised in a family with a history of no formal education beyond high school, but was fortunate enough to have loving parents who understood the value of education, and encouraged me and my siblings to follow our dreams. There was no one in my family or extended family with any previous experience in health care, though my sister, 9 years older, obtained her nursing degree and had a long career in geriatric nursing.
It is difficult to pinpoint why I chose medicine initially; my family says I first voiced interest in becoming a physician at approximately age 8. From a young age, I had a strong sense of achievement, a broad interest in the lives of others, and a desire to make an impact on others in a significant way. There are many rewarding careers, but I believed all through high school and college that the practice of medicine would allow me to influence the lives of others most tangibly and most significantly.
I have always been a bit of a sentimentalist, and a very spiritual person, and believe there are certain individuals who are intended to serve others. I have spoken with others in service professions, and like many of them, I believe medicine for me was a calling. We can come from all walks of life, and from many cultures, but the pursuit of health and wellness is a universal phenomenon, and illness in many ways is the "great equalizer" among people of all socioeconomic classes and circumstances. To have the opportunity to impact the lives of many people with something more dear to them than nearly anything else--their health--was an opportunity I surely wanted to pursue. After receiving my medical degree 28 years ago, I can tell you that all of my dreams about the rewards of practicing medicine have come true.
What made you pick dermatology as your specialty?
I came to Dermatology indirectly. I began medical school influenced strongly by my hometown pediatrician, Dr. Mintzer. I thought I would return to upstate New York and take care of children. Once I began medical school at the University of Rochester, I was strongly influenced by Dr. Raman Qazi, a wonderful mentor and medical oncologist with whom I spent the summer after my M1 year in a clinical cancer student fellowship. Once again, I completed medical school thinking I would be a medical oncologist following in his footsteps. I imagined exposure to skin diseases would be important to an internist, and tried to obtain a rotation in dermatology as a student, but it was an elective and all of the slots were full.
Therefore, it was as a second-year resident in Internal Medicine at the University of Iowa that I was first exposed to dermatology, where the rotation was an elective. Immediately, I was drawn in by the ability to make a diagnosis by visual recognition, and to have the patient become your ally in health care very quickly. Patients are often highly motivated by what they can see with their own eyes. They can see fairly quickly what their dermatologist can (or cannot!) do to improve their skin conditions. I was also highly impressed with the impact that skin disease makes on the quality of life of patients. Much of patients' psyche becomes involved when their external appearance is affected, not to mention the impact chronic blistering, itching, or ulcerating conditions can have on their lives. In addition, I became interested in how clinicopathologic correlation manifests in the skin--especially being the visual learner I've always been. A dermatologist cares for patients of all ages, both genders, with lots of overlap with a number of other specialties--and skin findings are often germane to systemic diseases as clues or external manifestations of those diseases. After completing my residency in internal medicine, I went on to complete a residency in dermatology, and subsequently a fellowship in dermatologic surgery and oncology. My subspecialty interest is skin cancer and reconstruction, and approximately 80% of my current practice is caring for patients with a variety of skin cancers, and the multidisciplinary care many of them require. I have had the good fortune to care for a number of my patients for over 20 years. To be able to treat and cure the vast majority of patients with skin cancer in a short period of time has been incredibly gratifying. I really love what I do, and look forward to heading in to the clinic every day.
What was/were the most memorable experience(s) during your medical education?
I have a lot of great memories from medical school, and feel very fortunate to have attended the University of Rochester, a very student-oriented school that considers the whole patient, and not merely their illness. There were only 100 of us in a class, and my memories revolve around getting to know those individuals quite well, and learning how to be colleagues to one another, and to support each other. Small group study activities--much more common in all medical schools today--were probably the most formative and memorable for me. Examples include our small group in gross anatomy, groups around microscopes to study, small mentorship activities, and opportunities to volunteer in the community. We had a number of social events, including our yearly class skits, and gatherings at the homes of our peers, that helped me learn about the importance of sharing experiences, stresses, hopes, and aspirations with colleagues that I appreciate years later. The most formative and memorable experience, however, has to be the summer I spent with Dr. Qazi, who had a standard for excellence that still leaves me in awe more than 30 years after I first met him. I believe a person has only a few true mentors in life, and he surely has been one of those few.
As President of the American Board of Dermatology, how do you foresee the field of dermatology changing over the next few years?
Dermatology is a small part of the world of medicine, and has become much more diverse over the past few decades. There has been growth in the basic sciences in dermatology, and its relevance as a model for disease in other organs. The skin is such an accessible organ as a model for disease, and has broad applicability to stem cell research, cancer biology, immunology, infectious disease, and as a route for drug delivery, just to name a few. I believe that as medicine becomes more integrated, we will have the ability to impact discovery in health and human disease more than ever before--and should and will embrace that opportunity.
There has been growth in the surgical and procedural aspects of dermatology, and I believe such growth will continue. There is increasing interest in esthetic dermatology, particularly as our population ages, and our specialty should and will participate in the science of skin rejuvenation as well as maintaining high standards for patients seeking skin rejuvenation. The skin cancer epidemic is also not likely to abate, as ozone depletion continues and outdoor activities expand.
Finally, I think that dermatology will have to be adaptable as will all areas of medicine, to changes in health care and its delivery. I think we will see increasing use and sophistication of teledermatology, especially since the visual nature of our specialty lends itself to that aspect of technology. We will learn to use such resources to provide skin care advice for remote and rural areas, and for underserved populations. As new care models develop, we will have to be nimble partners in delivering integrated care to patients. The future is in teamwork, partnerships, creative use of technology without depersonalizing care, and maintaining high standards no matter the area of medical expertise.
Every few weeks there appears to be a new report discussing burnout rates of physicians and the fact that many would decide not to pursue medicine if given the chance. In this somewhat disheartening environment, what do you believe are the biggest challenges to students entering the medical field? Do you have any advice for these students?
I believe the biggest challenge for students entering the health professions is overcoming the media attention given to health care regulation and finances. We all need to remember that regulations and budgetary restrictions affect all aspects of modern society, regardless of profession, culture, or nationality. At the end of the day, the human condition is such that individuals become ill, and their lives and quality of their lives is important to them. Ultimately, the emotional rewards for assisting one's fellow man or woman with their most prized possession--their health--cannot be surpassed by any other profession or vocation. Each day for me is new day for discovery, and every patient provides a different challenge. To be able to observe the progress in medical discovery over the past 3 decades, and to participate in caring for so many individuals who genuinely appreciate what is done to help them, has been a great joy. I also think avoiding “burnout” is easier when your work is your passion, and for those of us who are clinically active, to be innately curious about one’s fellow person, regardless of background. Such an attitude makes each day interesting and rewarding. I have always worked in academic medical centers, and as a result have always had the pleasure of interacting with students, residents, and fellows on a daily basis. Their curiosity, sense of wonderment, and spirit of altruism and service have played a tremendous role in reminding me daily that being a physician is a gift. The practice of medicine demands the highest of standards, and physicians still command the greatest respect among all professions. Despite all of the external pressures, the unique and highly personal relationship between physician and patient will always exist, and the self-satisfaction from the practice of medicine cannot be equalled. My advice to aspiring students, then, is to follow your passion if medicine is what motivates you; be an active participant in the evolution of the health care system; however, never lose sight of the purpose of your education, which is the first-rate care of the patient. The joys of medicine consistently and easily outweigh any perceived burdens. The decision to pursue a career in medicine is a terrific decision if given the opportunity, and the future has never been brighter.