“Who can blame a discouraged internist who gets a job as a Botox injector?” said Dr. Pak dismissively, of those angling for a piece of the aesthetic-procedure pie. “But it’s sad on many grounds; the way our health-care system is makes it hard for a hardworking doctor to make a living wage.”
Dr. Gerstner disagreed that derms are the envy of other docs; indeed, she feels “a little bit looked down upon, because I think they feel like we’ve sold out to just cosmetics,” she sniffed. “One of my passions is also dysplastic moles and melanoma!”
The other day, Dr. Wechsler was in her offices on Park Avenue—which she is sharing with two gastroenterologists while she renovates new, private digs up the street—wearing a gray dress with a delicate silver necklace and knee-high black boots. Her straight blond hair fell partially in her face, giving her the affect of a shy undergraduate.
An uncannily lovely and youthful-looking 38, Dr. Wechsler is a current darling of the major beauty magazines, who feature her advice and picture regularly in their pages; she has her own column in Marie Claire. She is also the only female doctor in the United States to be board-certified in both psychiatry (her initial choice) and dermatology (for which she completed a second residency after working briefly as a psychiatrist). She has been approached by several skin-care companies offering her a collaborative line, she said, all of which she has turned down because “unless I love something and really believe it works, I’d never put my name on it”; apparently that criterion applies to her yet-untitled book on the mind-body connection, which Simon & Schuster will publish in October.
Dr. Wechsler is interested in the troubled intersection of a woman’s appearance and psyche. “A lot of patients come just for dermatology and we end up talking about stuff,” she said. “For example, someone comes for upper-lip laser hair removal. I like to talk about how it feels as a woman to have all this hair on their upper lip.” Skin care can be so emotional, she said, that “people cry every day here. They don’t leave crying. But I think it’s a positive experience for patients. These days, in most doctor’s offices, it’s just a five-minute appointment. And you don’t really get to know anybody that way.”
The modern New York glamour derm, on the other hand, usually gets to know her patients quite well. This is because she sees many of them “once a month for a peel or microdermabrasion,” Dr. Gerstner said. “And then usually every three to four months for their Botox and filler. My No. 1 procedure right now, that people just are begging for, is the Fraxel laser. I call it Fraxel Friday. It takes 12 to 24 hours to recover, so women love doing it on Friday afternoons so they can recover on the weekends.”
With these kinds of regular dates, perhaps it’s only natural that glamorous derms would begin to inhabit their glamorous patients’ worlds more fully.
“Do I write prescriptions for antibiotics?” said Dr. Wechsler. “Yes. I keep up with a lot of other fields of medicine. I refer to ear, nose and throat all the time, OB/GYN, in vitro, massage therapists, a good place to get a manicure/pedicure, where’d you get those shoes, everything! And kid-related stuff. Camp, school … I have a lot of patients whose kids are applying to nursery school, and I’ve been through that, so I help them. I mean, the skin diseases are interesting and fun and neat to treat. But it’s really the people, people interaction, that’s to me satisfying.”
“I end up giving out all sorts of advice that I probably shouldn’t give,” said Dr. Pak. “Like, you should think about doing your hair this way, or I think that that lip color accentuates the pink undertone in your skin.”
“My patients are my friends. You know?” Dr. Gerstner said. “Half the time when I’m going out to dinner I’m meeting a patient for dinner. Tonight I’m going over to a patient’s house for dinner; she’s having 14 women over. That’s a typical night for me.”