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Physician Q&A With Dr. Lorainne Rosamilia

A dermatologist in State College, Dr. Lorainne Rosamilia was recently honored by Geisinger Health System for ranking in the top 10 percent in patient experience nationally at the health system's annual Top Patient Experience Clinicians Awards Dinner. In 2018, she will serve as president of the Pennsylvania Academy of Dermatology and Dermatologic Surgery.

Dr. Rosamilia was one of PAMED's Top Physicians Under 40 in 2017. PAMED caught up with her for this Q&A:

Q: Why did you become a physician?

A: Well, not to sound irreverent, because one is supposed to say "to help people," which was eventually my sincere motivation, but when I was in junior high and high school, the thing I was very best at was being a student.

I was superb at organizing, studying, and taking tests. And being a "doctor" – or at least what I understood of the process to become one – was to be a student for an extremely long time!

As that educational marathon then proceeded, I was indeed quite skilled at the benchmarks to obtain an MD. But digesting the intangibles of being in public service, assessing the nuances that each human exudes in his or her physical ailments and personalities, is the true draw, and indeed challenge of being a physician who truly "helps people." 

Q: What inspires you in your practice?

A: Being in a specialty like dermatology, the most satisfying moments for me are those when a patient, looks at you and emotes "Sigh … finally … someone knows what I have and what to do about it." Whether it is skin cancer, a worsening case of psoriasis, scarring acne, or a rash that just won't resolve despite many types of treatment, dermatology is all about visual recognition of patterns, almost artistic in a sense. 

Its primarily outpatient and fast-paced nature also provides daily variety; an infant with a birthmark can be in a room adjacent to a 90-year old with melanoma. To be honest, on a daily basis, my nursing staff, support personnel, and physician partners are the true backbone to being motivated to take care of patients at all, simply because a fun work environment, an efficient team, and intelligent and resourceful colleagues mitigate the tangled red tape innate in the modern practice of medicine.

Q: What are the biggest challenges of being a young physician?

A: I surmise that most of the 'under 40' winners will mention similar trends. The number of words typed and mouse clicks required per chart per day keeps increasing while the number of hours in the day does not. In addition, the individuality of the practice of medicine seems to be decreasing, meaning that the decision to prescribe a certain medication or try a course of therapy is often not up to the physician.

Certain standards of care must, of course, be met, given the variety of venues and variably-trained personnel providing medical care in the US; however, the flexibility to be creative and manage each patient as a unique case is, in my opinion, slowly disappearing, likely because of the multiple-pronged tug-of-war between cost-containment, insurance authorizations, lawsuits, and convenience homogenized care versus quality care.

Q: What do you do to achieve work/life balance?

A: For me, fundamentally, I have to prioritize each at the appropriate times. In a world where smartphones and Wifi provide connectivity in even the far reaches of the planet, I try to use this to my advantage instead of something to feel guilty about.

For my family and I, travel, music, hiking/trail running, and general exploration dominate our free time.

When returning from a trip, instead of "checking out" from family life for a day or two catching up on work messages, I do prefer to "check in" on a few small things every day. We try to teach our children that quality face time with loved ones and being active are foremost and that screen time shouldn't be overused or abused, of course, but it's short-sighted, in my opinion, to ignore inevitable work and then pay for it to a higher degree later.

Deciding which work is imperative versus ignorable is the key! [Also during a typical work week, I edit journal articles and talks between patients and after the kids are in bed, which indeed suggests that I don't require much sleep!]

Finally, it would be irreverent to not give supreme credit to my husband, our parents, friends, and childcare support for helping me become a happy professional, family member, and citizen; work would be truly work without the rest.

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