BONUS Episode: All Things Melanin, Skin Cancer and Why Representation in Dermatology Matters: Part II with Dr. Jeffrey Scales

This week on the B-MED podcast our esteemed guest, Dr. Jeffrey Scales, dermatologist, entreprenuer and founder of the North Carolina Center for Dermatology, unpacks all things melanin, skin cancer and the importance of diversity in the field of dermatology.  Dr. Scales shares the crucial role of protecting our skin from sun exposure, regardless of your skin tone and also enlightens us about the exciting journey of entrepreneurship in medical practice.

When it comes to the world of medicine, representation and access to healthcare are more important than ever. Through Dr. Scales' lens, we explore these critical issues.  Our conversation also navigates the complex landscape of payment models in the medical sphere, underscoring how doctors balance their innate desire to help with the financial necessities of running a practice.

As we wrap up our engaging conversation, he shares his personal interests and hobbies during the bolus round, adding a personal touch to our enlightening chat. Don't miss this captivating conversation where we learn, grow, and understand the nuances of melanin, dermatology, entrepreneurship, and much more!

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Transcript

Speaker 1: 0:00

So what is melanin? That word, we hear it all the time. I'm melanated the melanin in my skin. We're going to talk all about what melanin is today and much, much more on this episode of the BlackMed Connect podcast with our phenomenal guest, dr Jeffrey Scales. He's a dermatologist and he's the founder of the North Carolina Center for Dermatology. On this episode we talk a little bit about what melanin is, skin cancer, about the practice of dermatology and the amazing things you can do as a dermatologist to care for your patients. We also can't forget our bolus round where we asked Dr Scales some rapid fire questions, but you got to stick around to the end to hear what his answers are to those amazing questions.

Speaker 1: 0:43

Let's jump right into the episode. Roll the music. You mentioned a little bit about the work-life balance that you've been able to create with dermatology. Can you share a little bit about what were the circumstances or what made you found your own practice and how did you go about doing that? Because here on the BMIC podcast we're also really excited about innovation and ownership and entrepreneurship and everything in between. Can you share a little bit about what it was like to start your practice?

Speaker 2: 1:20

Sure, at the time I started my practice it was a lot more common than it is now. Medicine has become increasingly corporating. Increasingly, you find that hospitals and hospital systems monopolize a lot of the area around where they are. It is much more challenging for people to consider something like that now. Dermatology still is one of those specialties that avails itself of the opportunity to do that, although diminishingly so. It's nice to own my own practice. There are some great responsibilities that come with it, as well as some headaches that come with it, but that's going to be in any setting that you work. My wife works at the hospital and she is a division chief and she's responsible for 12, 14 doctors and she has certain kinds of problems that she experiences. I have different problems that I experience things like making payroll, checking what sort of benefits we offer, things like that that really respond more to being a business owner. There's working in a particular job and there's working on a particular job, so I'm often balancing both those things. Today I'm rushing around seeing patients and then someone will stop me and ask do we need to do this transfer? Is it time let's check on medical benefit? These things I get pulled in another direction have to be a different person, have to be a business person, and so I've done so long now I've gotten used to it In many regards. If you ask most doctors, all they want is to practice medicine. That's what they're trained to do. They want to take care of patients and make people better, and that's very much my desire as well. But I also have to balance that other part. Now you could work for a large hospital system much as you do and my wife does. But you also realize it's not just invasions. There's all sorts of responsibilities for your division. You have committees, you need to be on leadership roles that you will play, particularly as you're there longer, and so that takes on a different type of demand. So I think it's just deciding which you want. But with that in mind, I'm fortunate I have my own small private practice medicine. Now I'm expanding into opening a small aesthetic center right next door in some space on that island, and the open house will be in early December I think December the 3rd be agreed upon and that's fun and exciting. That's choosing to do something. That's very different. It's very different type of medicine. Well, consumer medicine is medicine where people hey, can't I just to have some services that are not covered by insurance, so the entire insurance issue is different. So it has given me the opportunity to develop some new skills. It's given me the opportunity to acquire certain assets and things. I give a perfect example of my condo space, where I have my practice and also where I have my aesthetics, and it's appreciated significantly since I've owned it. So it's something that's really up game well with and learn to be a landlord, as well as other skills that come with that learning how to get contractors and get things repaired. That's again another set of skills that you don't necessarily have to have if you work in a big hospital system or a big practice. So, yes, it's had great benefits.

Speaker 2: 4:26

I really like the idea of ownership. I've taught my children all three of them that it's important to own something. It's not just to own a car or to own consumer items. Those are things that we're really good at as a people. We are great consumers. We're some of the best consumers in the world. We spend a disproportionate amount of money on certain fields, certain types of businesses that really depend on us, but I think the ownership of business, the benefits that come with that including the tax benefits that come with that are important to consider.

Speaker 2: 4:59

Being an employee is good. You can make a money as an employee, but always you need to have something on the side. So my daughter is going to Madison and I've talked to her about that. I said, yeah, honey, and I've told all three of them but this was one of the only ones that listens I told all three of them you need to have some kind of business on the side. You need to have something that is working for you, that other people are working for to help benefit you. So a perfect example is this my wife and I purchased a small condominium from her mother in Miami and we got it for a reasonable price and we rented out and it provides a certain amount of money per month and, as I told my daughter, you have people who go to work every day, who pay the rent, who put money towards your education, towards your long-term benefit. It will always be something that you want. It will appreciate. That's the type of business that you need to have indefinitely. So there are tax benefits and things, and you don't have to be planned to be a big landlord forever, but you certainly can do things like that that help you from a tax standpoint and long-term asset benefit, and I think we all need to think about that. If it's not that business, it can be something else. I started a little line of products here which called Dr Clear Skin, and I like it very much and it's slowly growing. It's never going to be L'Oreal or Revlon or something like that, but it's something I do and it's something that, again, I get some benefit from in terms of learning to be an owner, and so I am trying to teach all of my children and everyone I can talk to about the importance of owning assets, things that appreciate.

Speaker 2: 6:32

We spend a lot of money on things that depreciate cars, vacations, food, all these experiences. There's nothing wrong with any of those things, but those have to be things that you do along with the other things. You should always be looking for something to be involved with, be it some kind of small business it could be a lawn mowing business or something or something Just something that you can have, that you can start on your own and you can build into. It doesn't have to be something you start off really big, as I tell them, you have to be something big. But it has to be something big, because the ownership classes in this country, as we've seen, are the ones that reap the spoils of the economy that we have, and be it Jeff Bezos or Berkshire Hathaway or any of those things, those are ownership issues and I know I'll never be any of those people when I'm seeing that aint. But there's a reason that people own things. There's a reason that they own companies, swords, teams and things like that. We need to own those things as well, because that's how you develop economic clout in the society.

Speaker 2: 7:31

Now, how much you spend, but what assets you have. What can you control? What benefits your brain? In that regard, for instance, I hire. I have a very diverse staff. I have a number of people who are Hispanic, a number of people who are African American, someone from India, people, a lady from Cuba. These are people who, in many regards, may not have had some of the same opportunities to be in some of the positions that they are, because sometimes they don't necessarily get the benefit of being hired in the same way that other people are. So I feel very good about that, about the opportunity to put people in positions to do things that perhaps they would not get the same opportunity in other places.

Speaker 1: 8:08

I love that. I love that. I think to your point of ownership. It's critical.

Speaker 1: 8:14

We are such a large consumer group, we are constantly consuming from others, so any opportunities to talk about the importance of ownership and even you know for I know a lot of people in training now who even have small side hustles as they're coming through training, and I think that's something that's unique and interesting. Or even for me, I wrote my children's book as a trainee. So it doesn't have to, you don't have to wait to start. You may not be able to finish everything at the same time, you may have to kind of obviously put your emphasis on getting through training or getting through med school, but you can start small, like you said, and it can hopefully grow. So you know, thank you for that advice.

Speaker 1: 8:57

I'm listening, just as much as I hope my audience is, to the wisdom you're sharing, because ownership is so critical, especially in a time where corporate, like you're saying, corporate medicine is taking over and changing the landscape of medicine, and so I've always admired individuals who have their own practices and people who are starting maybe their own direct primary care or direct practices as well. So thank you for sharing that importance and value of ownership, and you know that's what we're all about here thinking about innovative and creative ways to have our careers, because it doesn't have to look one particular way. And so you mentioned your aesthetic clinic. You mentioned your product line. Can you share more about what is your product line all about and what will you be doing in your new clinic when you want to be separate?

Speaker 2: 9:45

Sure. So I started a little really curate a little product line that I put together that focuses on assisting with shaving difficulties. So I have a number of steps in a little package that I put together that should help enhance people having successful shaving. There are quite a number of people who have difficulty shaving and I think that it's often overlooked, particularly among us, and I think there are some things that we need to consider, and so I have put together a few little products which I think will make shaving a bit easier for both men and women in the areas where they shave. So it's called Dr Clear Skin. You mentioned the aesthetic center, and the aesthetic center is a place where some of that same interest will apply. I have a particular laser that's good for people of all skin types to help with decreasing the amount of hair people grow in some areas. There's a number of men and women that can benefit from decreasing how much hair grows and complexity of some of the shaving issues that come with it, and so that will take place there, as well as a few other cosmetic items that we are going to be offering chemical peels, microdermabrasion, laser treatment, morpheus 8 treatments things that have benefit for many people and it's a very new avenue for us. We've been doing some of it slowly, but it's something. Now that we're taking a more aggressive approach and a lot of regards is funny.

Speaker 2: 11:11

I'm 62 years old and what a lot of people talk to me about is when am I going to retire? And frankly, I have no interest in retirement right now. I read two good books that talked about retirement and in it they say never retire. You don't have to continue to work as you are. But if you're able to do something and you're capable still, which I feel like I'm still able to do both of what I do then why stop?

Speaker 2: 11:34

For many people, what is retirement? Retirement is sitting at home, watching TV, playing golf four times a week, pinching your pennies and hoping that your Medicare is going to last. Those are things that perhaps I'll get to at some point, but at the moment I'm starting this new endeavor and I'm looking forward to it. I'm looking for the challenge. My children are all grown. I think my risk is less Some risk, but it's less risk because my wife and I are only two we really have to take care of right now. So if it goes great which I'm confident it will then I'm going to be excited and there will be a new phase in my life when I learn something. If it is slow to start or perhaps doesn't go as I would like it to, I can take some time to redouble my efforts, learn from it and keep moving. So it's very interesting to have a life. I wouldn't have said that when my children were 17 and 18. But now that they're well into their adult lives, I have a bit more freedom to try something.

Speaker 1: 12:26

Yeah, that's exciting. I love that. I love how you're taking us on this journey of your career and it ultimately doesn't stop right. What you make it is how you make it intriguing and interesting, and what terms and twists you're going to have to not only keep it exciting for you, but really benefit and impact a lot of people as well. You've spoken about the impact on patients. You've spoken about how you've been able to hire a diverse staff, and now you're talking about ways in which you'll help a different population of patients.

Speaker 1: 12:54

So I'm really appreciative and I'm learning a lot on this podcast episode, as I hope my audience is as well. And you mentioned before or we may not have talked about it just yet, but you have your practice and we know that only about 3% of all dermatologists are black or African-American. So what has it been like being in this space as a person of color, as a black individual, and what advice would you have for someone who's trying to potentially go into a field where diversity really isn't what we would like it to be? What would be your thoughts on that?

Speaker 2: 13:32

So that's a good question. Dermatologists are a wonderful field of medicine. It's probably one of the most challenging to get into at this particular point. It wasn't always that way, but it is now, partly because it can be quite easily practiced without worrying about a family. You certainly can have a family, you can have it, you can work part-time, you can work full-time. So in a lot of ways it's an ideal bit of medicine, or a field of medicine where you can achieve a lot of things.

Speaker 2: 14:00

It's very challenging to get into, made very good efforts to try to diversify, but it's one of the least diverse fields of medicine. I think if you were to look at income based upon the types of specialties and you would correlate a line, a bunch of graphs looking at the percentage of diversity both by sex and by ethnicity, I think you would find that the more expensive or the greater the income is, especially the fewer people of color, the fewer women that they have, be it neurosurgery, orthopedics, dermatology, dermatology is making strides to diversify itself, which is good. One of the reasons is necessary because people of color need to have people in various specialties that are prepared to welcome them into their practices. There are some practices that probably are not as inviting for people of need with a color. A perfect example is Medicaid use. So in our state a disproportionate number of people on Medicaid are both black and white, but it's very hard to find dermatologists willing to even accept that. So it affects people of color, it affects children and we're one of the few private practices willing to accept that in our area. Certainly you have the universities like Duke and UNC which do a great job of helping.

Speaker 2: 15:22

But I never wanted to limit access to what can be important care to people on the basis of whether they are Medicaid or Medicare. Those people are people very much like my family. Those are people, those are my relatives, those are best. From where I come. I'm two generations from sharecropping, literally two generations from sharecropping. So when I see these patients I see my people, I see my family, I see my cousins and my grandmother. So the idea of providing something for them that might be necessary.

Speaker 2: 15:59

I don't in any way want to overestimate my value as a physician or the need that people might have for me, but I will say that there are a number of us who just have great needs and cannot access things because of limitations, be it economic limitations and sometimes societal and social limitations. To watch what's happened in this country after President Obama became president and his leaving and watching the pendulum swing back in a lot of ways that I just thought were inconceivable at this particular time in American history has really been eye-opening. So, as I told my daughter who is going to spend it, says, a part of what happens with people that are doctors of color is that you are the great equalizer. You're the one that makes sure that when a person steps into a room, regardless of their economics or regardless of their ethnicity be they white, black or otherwise that those things aren't taken into consideration when medical decisions are made. It will provide for them the care that you would provide the same for your family and your friends, regardless of their backgrounds, and I consider that part of my role.

Speaker 2: 17:03

My role is to make sure that people who sometimes don't get a voice, don't get access to things that are important to them, have an opportunity to have that in our setting. And so you ask about diversity and dermatology. What do you want to do to get dermatology? So I did go off on a tangent there a bit.

Speaker 1: 17:17

No, that's a great tangent. Before you go on, I want to say something to the audience about what you mentioned. You mentioned that Medicaid patients are oftentimes not accepted by certain practices in the area and I think for our audience, who may or may not understand that Medicaid doesn't always pay the same amount for the same procedures or the same amount for the same things you're doing in the clinic, as a private insurance provider may provide or may pay. So when a practice owner is making a decision or the clinic is making a decision about how many of a certain group of patients they can take, a lot of times they're thinking about the money aspect of it and not taking into consideration that black and brown individuals and those of lower socioeconomic status may be lumped in just because of that type of insurance that they have or the Medicaid that they have. You've mentioned it a few times, one with the practice example, and even previously when you mentioned you're going to be in a setting where you train with a lot of Medicaid patients or Medicare patients. That's important to take into consideration too Because, again, like you mentioned, dr Scales, if your individuals who are doing the training aren't really considerate of the patients they're taking care of? What example are they going to set? What type of culture will it be at the institution that you train? So it's all integrated.

Speaker 1: 18:41

And I don't think we talk about enough in our training and even in our early careers about how the payment models we are kind of dealing with, whether these are not by choice. Right, we come into medicine to help people. We don't think about what it costs and, as you said, I think about my grandmother or my mother or my auntie when I'm just having a conversation with a patient. But a lot of the decisions that are made involve the money side and the money exchange to keep the lights on for some practices and to make revenue as well. So I just wanted to bring that part back into the conversation because it intertwines a lot with the patient care we provide and the types of challenges that we have as health care professionals trying to give the best care to our patients. So I'll let you proceed, but I wanted to reiterate that point too.

Speaker 2: 19:31

Yeah, I think it's all appropriate to think about this. I think in many regards, like I was telling my daughter again when she's going to the clinic, I said you're there training to be a doctor, but you, being a doctor represents in your community something different than many other communities, one so a perfect example. She did really well at Spelman College. She was extremely good student and she's very smart and she's very motivated. There were other college students that would come to her because she got admitted to the University of Pennsylvania through a particular program called the PATH program, where they will identify you early as a person that's qualified to go to their institution and they will offer you early admission. And she got that. She didn't have to take DMCAD or interviews or anything. She had an interview for the program but anyway she got admitted. Very smart young lady. But there were young other students who were trying to do the same thing. They would come up to her and ask her questions. They would see her and hold her in a certain esteem and she said to me you know, dad, get tired of people asking me about these things. I get tired of people saying, oh, you're that smart when they did that and I say I understand your point, honey, I understand what you're trying to say, that you want to be seen like everyone else. You are like it. But she was just because you got this program, because you're smart. I mean, yeah, you're smart, that's fine. You're very social, you get out and do things.

Speaker 2: 20:45

But realize that sometimes what do you represent? You represent an opportunity in ways that other people have not seen before. I've had patients come to my office and come great distances and they'll bring their children and they'll say I want you to see what a black doctor looks like. And it seems like a very small issue. It is a very small issue from my point of view. But what does that represent? It represents seeing opportunity in a place where they may never have seen opportunity before. Hey, I had someone said hey, you look like my cousin. So when they see me and I look like their cousin, they realize so my cousin could be a doctor, my family members can be a doctor. And you know I'm not going to say that being a doctor is the greatest thing. It's not. It's a nice profession, it's wonderful, I enjoy it.

Speaker 2: 21:34

But what you represent is someone who's able to go out into the greater society and to achieve things that are challenging and to be like the rest of us. Opportunity, seeing yourself in positions that you can't get. Other people don't see you. So a reminder, her, that speak to these people, talk to these other kids because they see you as something that they would aspire to be like. So that's where those sorts of things come up. So, yes, it is different. My daughter's been with me when we're here in Durham and she's seen people stop me and thank me and talk to me and it just really made a really big impact on her and ever think of it. It's like, hey, you're a great doctor, a doctor's skill is kind of thing, because that's definitely isn't the case in that regard. But what it then represents again is communities that are striving to do better things. So it's much more than just the practice of medicine in the role that you play.

Speaker 1: 22:34

Absolutely, absolutely. I love that. I love that the community really does admire. And it starts early. It starts when you're in med school, starts even when you're in college and individuals are trying to get to that stage. So you kind of carry this badge of honor almost for your community, and even when we're not thinking about it because I know I oftentimes I'm not thinking about the fact that I'm carrying this but other people are watching and looking up to you and it's something that they admire. So you bring up a great point there.

Speaker 1: 23:06

Hello everyone, are you enjoying the episode so far this week? Well, I'm excited to announce that this week's episode is sponsored by the BMed app. That's right, you heard it the BlackMed Connect app. This app will be for any black or brown, pre medical students, medical students, residents, fellows and attendings, even for institutions. We're in the process of developing our app and we wanted to share it with you now. So if you're interested in receiving updates on when the BMed app will be available to the world, then head on over to bmedconnectcom slash app app and join the wait list. Let's jump right back into the episode. I want to switch gears a little bit, because I would like to ask you for a little bit of your dermatologic expertise here. I'm going to actually start with a very basic question, because in the common vernacular right now we use the term melanin a lot Melanin, melanated skin. Loving our skin, which we do Can you share with the audience what is melanin and why do different individuals or different ethnicities have different types or different amounts of melanin?

Speaker 2: 24:16

Sure. So melanin is the color aspect of your skin. With rare exception, everyone has melanin in their skin. Exceptions are people who are a bit of LIGO, like Michael Jackson and many others. But it is a particular compound that's made in the skin to protect the skin and some of the things below the skin from getting damaged as a result of the sun. So the sun is wonderful, we need it for vitamin D, we need it for all sorts of things, but as it enters the skin it damages the skin and the skin has to repair itself. There's all these little chemicals that are in the body that are there that correct the damage that takes place when you're out in the sun. So this happens every time you're out. But your body corrects. It also shields some other things below the skin by putting up. I like to think of it like an umbrella. Melanin is like an umbrella in the skin. It keeps things from going deeper than it needs to. Now, the more melanin you have, the less penetration of the sun rays deeper into your skin, the less you have, the greater chance you have of penetrating and leading to types of skin cancer.

Speaker 2: 25:24

People of color and that's a broad word that I've been using, a broad term I've been using. But people of color generally have a baseline SPF of about three. Spf represents sun protection factor. So if I put my skin out in the sun, how long does it take it to turn red? Then I apply the SPF and then I measure how long that same skin takes to turn red again. When you say three, that means that it took three times the length of time to turn red than it did before. And that's true up to about SPF, about 15. And then there are some other factors that come into play, but anyway.

Speaker 2: 26:00

So melanin is there to protect the inner parts of the body. People ask well, if I get some sun, I get more melanin, don't I? I mean we all get a bright, brown or winter in the sun. That's a great thing. That's one of the adaptive responses that the body has developed. But along the way some damage is taking place that is generally reversible but can be cumulative, meaning at the more sun I get over my lifetime, the better chance I have of skin cancer, premature wrinkling from sun. So melanin is a great important thing. It is not the same thing as shade. So I mean melanin doesn't mean you won't get burned or that you won't get skin cancer or that you can't have some of the changes that come. It just gives you a better chance of avoiding those things longer.

Speaker 1: 26:45

Awesome, excellent, excellent. And so if you could share a little bit about skin cancer, because you've mentioned it a few times here in this portion, why is it that, as black individuals and black and brown individuals, are they more or less likely to get skin cancer? You mentioned the melanin protection that we get. Is the severity any different? Can you speak a little bit about the differences in skin cancer by race and ethnicity?

Speaker 2: 27:10

Sure. So ethnicity, yes, every person is capable of having skin cancer. Having darker skin decreases your risk. The last study I looked at, which is really quite old, says that we have about one-tenth the risk of skin cancer that the average person has. The location person has. Now that's very broad numbers that you can't hold it to. But basically what it says is that our risk is lower if you have brown skin.

Speaker 2: 27:36

Skin cancer is the most common cancer in the United States. What it means is the sun goes through the skin and it damages particular cells in the skin. So we talked about melanin before. Melanin is created by these particular cells called melanocytes. Melanocytes job is to produce these little color packets and to distribute them to the skin around them. But when damaged melanocytes become melanoma, melanoma is a highly deadly type of cancer that can affect all people. Melanoma generally happens in some distributed areas, but you can get melanoma in places like the lining of the brain, the back of the eye, all sorts of things. So partly sun related, but not completely sun related. So that's one type of skin cancer that's probably the most deadly one that we talk about commonly.

Speaker 2: 28:27

Secondly, there is basal cell carcinoma. There are these cells called basal cells which help divide and create new skin. And then there's swamous cells. Those are the cells in between the basal cells in the top layers of skin, and those two can become skin cancer. So those are the three most common types that we talk about and, as I said there, it is the most common type of cancer. In the United States it's probably at least in excess of a million cases a year. The majority of them are treated easily and repaired and you go by your business. But some of them can be challenging. Melanoma is very serious. Squamous cell carcinoma can be very serious. Basal cell to a lesser degree, but still possible to be deadly.

Speaker 1: 29:06

So what can people do? What should our listeners and those who may be watching? What should they look out for? What should they tell their family members to look out for when they think about the potential for skin cancer?

Speaker 2: 29:18

Sure. So it's hard to have easy, simple statements that make it possible to determine all kinds of cancer in the skin, but there are the five ABCDE criteria. So A represents asymmetry, something that used to be round but now it's not round anymore. B border irregularity it is jacket around the edge. C color variability Two colors, three colors in a particular mole instead of just one. D is diameter six millimeters or greater are the higher risk lesions. And E is evolution rate of change Is it changing slowly or is it changing fast? Those are common recommendations for people to look at, and if they see anything that looks remotely suspicious, you should follow up with a dermatologist Preferably a dermatologist, someone who can help interpret what they see, and to get the specimen in the hands of a dermatopathologist, a person that does nothing but study skin under the microscope.

Speaker 1: 30:15

Absolutely so. When people go to get their physicals, should they ask for their doctors to kind of take a look at their moles, or what do you think about that?

Speaker 2: 30:23

I think ideally, that would take place. No, I've had physicals in the last few years. People don't even take your clothes off anymore. It used to be you took your clothes off. Obviously we went for physicals. That's changed quite a bit, so I think it's hard to get it without specifically asking for it and with that in mind, particularly if you are in a higher risk category, meaning you have fairer skin, it's worthwhile then following up with a dermatologist who can check your moles.

Speaker 1: 30:48

Excellent, and so any parting words from a perspective of this aspect, the dermatology aspect, before we move to our bolus round, do you have any parting words that you wanna share with the listeners or those who are maybe watching?

Speaker 2: 31:02

Sure. So not only recommendations I'd say is that pay attention to your skin. You can have your partner look at the back and the areas that you can't see. If there's anything that looks unusual, maybe concerning maybe something changing quickly, it's worthwhile going to a doctor, be it your primary care doctor or a dermatologist, and letting someone look at it and let them check it. I mentioned that earlier that browner skin people have less skin cancer, but one of the statistics that comes up, or one of the things that comes up, is that when found, it tends to be more advanced. So part of it is that perhaps there's some biology about that, where browner skin people tend to have more aggressive skin hazards. Perhaps there's some socioeconomics about that, that people have less access to doctors who can catch these cancers earlier. And third, sometimes people are not as comfortable looking at certain skin diseases in browner skin people. So I think it's important that If you have anything that remotely looks suspicious, let someone check it. I've found all types of skin cancers and all sorts of people over in my life.

Speaker 1: 32:02

Great advice and great wisdom there and even mentioning we don't always even learn about different skin conditions on different shades of skin or different complexions. So I think there's a big push now, even in medical education and even in books and in textbooks, to include individuals of all different skin tones. So even bringing that up is really important. So I do want to thank you for sharing with us, but we definitely have to still do our bolus round here. So the bolus round for those who may not have heard of this before is our fun rapid fire round that we do with our guests, similar to when we give a bolus in medicine, which is when we give a large amount of fluids rather quickly. If a patient may be in a traumatic situation or maybe has an infection or dehydrated, we give that bag of fluid and we call that a bolus. So if you don't mind, dr Scales, we're going to jump into our bolus round. Are you ready?

Speaker 2: 32:58

Let's do it.

Speaker 1: 33:04

All right. So my first question for you is are you a Duke fan or a Tarhill fan? Or I'll even give you the opportunity to say if you're an other fan.

Speaker 2: 33:14

Sure. So when I first moved here, people asked me which did I like best, duke or UNC? Now I had come from Maryland, suburban Washington, so we had the University of Maryland and all of them were in the ACC at that time. So I would say Maryland. People like no seriously which was Duke or UNC. So I appreciate good sports, I like Duke and UNC. My wife happens to work at UNC so right now I cheer as a Tarhill but I'm always happy to see teams in the area do well. I've lived places where college sports were not very big, like in Cincinnati, and even in the Washington DC area was to a lesser degree. I was there when Georgetown was really big in college basketball but college football was not quite as big a sport there as pro football.

Speaker 1: 33:54

Awesome, awesome. I often run into the problem of not knowing who I want to root for either. So, being a Duke med grad and a UNC Chapel Hill pediatrician, it's a hard choice of what color blue I'm going to go for on a given day.

Speaker 2: 34:09

Yes, I can understand that.

Speaker 1: 34:12

All right. So if you had to choose one vacation, would you choose a warm weather destination or a cold weather destination, and where would you go?

Speaker 2: 34:19

Warm- weather, without a doubt. The bulk of my vacations are warm weather. I do like to ski in cold temperatures. I don't get to do it very often. I probably ski once every couple years, and that might be five to seven days. But I'll go through the a couple warm weather vacations two, three, four times a year. Yes, I love warm weather.

Speaker 1: 34:38

Fantastic, fantastic. Well, if you had to choose one sport to watch, which sport would you watch for the rest of your life?

Speaker 2: 34:46

That's a great question. I'd probably watch basketball. I like pro basketball and college basketball. I like pro football and college football as well, so I couldn't go wrong with any of those things. So if I had to just choose one pro and college I'd probably watch the NBA.

Speaker 1: 35:00

Fantastic. What's your favorite team?

Speaker 2: 35:02

So in the NBA, I am from the Washington DC area, and so we have the Washington Wizards, which used to be the Washington Bullets. Most of you are too young to ever have known that, but it is. I'd probably say it's my favorite team. They're not competitive. They haven't been competitive in a long time. So I enjoy good basketball, no matter who plays it. I'd love to see Washington do well, but that's going to be some time. I think, yeah, that's going to be some time.

Speaker 1: 35:28

Absolutely Well. Okay, a few more questions here. If you had to choose what type of music you want to listen to whether that be gospel or R&B or rap or hip hop or reggae or jazz what genre would you pick in? Who's your favorite artist?

Speaker 2: 35:42

Wow, I like many different types of. I had to just choose one. So I like reggae, I like classic jazz, I like smooth jazz, I like. I do like some classical. I've been listening to Afro beats lately. I really have enjoyed that and so it's hard to narrow it down. I'd like hip hop. I'd listen to old school. I really would rap just first game out. So I've been listening to that since the beginning, back to the Sugar Hill game. So I like everything I did. Some of it now has gotten a bit out of hand. It's a bit too violent, big two corporate. So I've had to choose one. It really depends on the day. Some days I'm feeling a little bit down. I put on some really hardcore rap and I like. And there's some days I just feel like listening to jazz. I listen to a fair amount of jazz, so probably tend to go to concerts. Someone says, choose a concert to go to. I would go to a jazz concert.

Speaker 1: 36:27

Fantastic, fantastic, and I love that Jazz Afro beats all of the above. You need all of them. I feel like for them, whatever mood you're in.

Speaker 2: 36:35

Yes, and reggae I like a lot too. I really like reggae.

Speaker 1: 36:38

Wonderful and okay. Last question would you share a little bit more, just one more time, for our listeners about your organization and how they can find you and if they would like to come and see what you're doing, even as a patient, come to see you. If you could share some information there.

Speaker 2: 36:54

Sure, I'm at the North Carolina Center for Dermatology in Durham, north Carolina. Our number here is 919-484-9551. You can find us on the web, nccdermatologycom. We have a Facebook page, instagram as well, so you can find us there. You can find me also under Dr Clear Skin, dr Jeffree Scales. I am available to be reached here. We have a website as well, where we take new patients, of course, and that website also includes a place for you to send email if you're interested, so I can be found many different places.

Speaker 1: 37:31

Excellent. Well, thank you for sharing that, and if you're in this area, I can't leave without asking you your favorite restaurant in this area. So if someone's coming to see you and also wants to get something to eat, where would you send them?

Speaker 2: 37:42

Yeah, I'm a real foodie. I love eating in restaurants around here, be it Raleigh, durham, chapel Hill. I'm biased towards the Durham restaurants. I think they happen to be the best. If I had to choose a restaurant, and with that in said, I'll choose probably my favorite restaurant in the areas of restaurant, called Lanterry, which is in Chapel Hill. Believe it or not, it's a mix of southern and Asian food. I also like a restaurant in Raleigh which I was eating it last weekend called Brewery Brevana. It's both a brewery and the Asian restaurant and a bookstore, all wrapped up in one Really elegant looking place. I like that place, and then there's a long list of others that I like. So in an effort not to bore anyone, but yes, I definitely like there's one in Raleigh too, called Death in Taxes, which I really like.

Speaker 1: 38:26

What a name.

Speaker 2: 38:28

I go to everything around here barbecue restaurants, asian restaurants and I like good Mexican food too.

Speaker 1: 38:35

Fantastic. Well, I just want to say thank you so much for your time. I know I've gained a lot of wisdom from this episode. I hope the listeners have as well in those who are watching. And so, if you don't mind liking this episode, if you're on YouTube and subscribing to the channel and if you are listening, be sure to follow the Black Med Connect podcast for more fantastic episodes. And I just want to say again thank you, dr Skills, and until next time, always remember for my audience to dream without limits. All right, bye bye, bye everyone.

Speaker 1: 39:08

We hope you enjoyed this episode with Dr Jeffrey's skills. We had an amazing conversation where we talked about certain skin conditions and skin cancers, as well as the importance of diversity within the field of dermatology, and so much more. We appreciate our guests for taking time out to have this amazing conversation. We also had a lot of fun during our bowlers round learning more about Dr Skills and his interests. If you're interested in learning more about how to connect with Dr Skills, visit nccdermatologycom to learn more and be sure to check out the Dr Clear Skin product line as well. If you enjoyed this conversation, comment below and tell us what you learned or what you took away from the episode.

Speaker 1: 39:55

Don't forget to smash that like button. Go ahead, do it right now. Go ahead, smash that like button. If you're on YouTube and if you haven't subscribed to the channel yet, what are you doing? Go ahead and hit that subscribe button as well. If you're listening on all podcast platforms, go ahead and hit that follow button. Thank you again, dr Skills, and to all our listeners out there or those who are watching. Always remember to dream without limits. Bye.