Viktoryia Kazlouskaya, MD - Dermatologist in New York City

Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person, because you're making a life-changing decision, and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close. I'm your host, Eva Sheie, and you're listening to Meet the Doctor. Today, on Meet the Doctor. My guest is Dr. Viktoryia 

Dr. Kazlouskaya (00:35):
Kazlouskaya. 

Eva Sheie (00:36):
Thank you. She's a dermatologist. And she's here in New York City where we're recording live today. Welcome to the podcast. 

Dr. Kazlouskaya (00:45):
Welcome everybody. 

Eva Sheie (00:46):
So you've had an exciting week. Tell us what you've been up to. 

Dr. Kazlouskaya (00:49):
Yes. So I have recently opened a dermatology practice. It's in the center of Manhattan on Madison Avenue. And I'm really excited about it. It was something I was planning to do for a long time. Originally I was an academic dermatologist. I did a lot of studies. I was doing teaching and I am interested in treating difficult conditions. But eventually I, I see that we need more personalized care. I wanted to spend a little bit more time with my patients because I was forced to see 30, 40 patients a day, sometimes in clinic. And that's something I was thinking that is not a good way to take care of patients. So I wanted to open a small place for me, for my patients to create this kind of like a family environment. My office is called Dermatology Circle, and uh, I didn't like the name institute or clinic or just a center cuz I wanted to be something very kind of like a friend circle, you know, so that people come back and they like what they, as a result, they like the environment. So we can share, we can empower each other, tell the stories. And that was my vision. 

Eva Sheie (02:05):
There's a lot of questions to ask here. Congratulations, first of all. 

Dr. Kazlouskaya (02:09):
Thank you. 

Eva Sheie (02:09):
Welcome. Uh, back to New York. You mentioned studies in difficult conditions. So let's start there. What kinds of things were you studying and, and working on while you were still in academic practice? And what were those difficult conditions? 

Dr. Kazlouskaya (02:23):
So I'm a dermatologist and dermatopathologist. Dermatopathologist, it's a person who examines skin under the microscope. So I like to dive in and understand what exactly is going on. And when I see a patient clinically and then I see what's going on in the microscope, sometimes I have a better idea what's going on. And in my practice, I've seen a lot of patients with autoimmune conditions, with difficult cases of hair loss, uh, inflammatory conditions, uh, difficult psoriasis cases or chronic conditions. So, and I tried to publish, uh, those interesting cases for my colleagues. I have published a couple cases of pretty rare conditions that have maybe 20, 30 cases, uh, in general. So it, it, I think it's exciting, but I think when in this cases, sometimes you need spend time with a patient to find out what's going on and what's what exactly is driving this disease. Sometimes you need two or three, uh, visits to find out exactly what's going on. 

Eva Sheie (03:29):
You sound like a, a detective a little bit.

Dr. Kazlouskaya (03:31):
Yes, exactly. That's, that's how I think, that's how I would describe myself. 

Eva Sheie (03:35):
Can you give us an example of one of those really surprising things that you discovered 

Dr. Kazlouskaya (03:41):
Recently? The last interesting case I've published, it was a rare case of a condition that is caused by sunlight, but it causes inflammation in sebaceous glands, uh, oily glands. And it presents in a very funny way, it can be misdiagnosed as a chronic autoimmune condition, kind of like lupus, but it's very benign and limited. So when we did biopsy, we found out what it was. And basically patient did not need long treatment and he didn't have to have it diagnosis of lupus. So 

Eva Sheie (04:15):
You just need sunscreen, <laugh>. 

Dr. Kazlouskaya (04:17):
Exactly. He just needed sunscreen. And actually he, I treated him, uh, he completely recovered and then he had a wedding where he was outside and, uh, the condition came back just because he didn't use sunscreen. And then of course we just had to repeat it one more time and he was fine. 

Eva Sheie (04:35):
So he learned his lesson? 

Dr. Kazlouskaya (04:36):
Yeah, yeah. 

Eva Sheie (04:37):
Wow. Anyone who's ever tried to make an appointment with their dermatologist using their insurance has certainly experienced. The other side of what you said after that was that you were needing to see 30 or 40 patients a day. Yes. So that's what, 10 minutes a person? 

Dr. Kazlouskaya (04:52):
Yes. It's, it's horrible. And that's why actually I switched my practice as being direct pay or cash pay practice. And I personally believe that that's the model we are probably be moving towards an upcoming years because we as physicians, we also are burnt out because of seeing, uh, that many patients and insurance doesn't pay us for what we do very well. And, uh, I think a lot of patients think about physicians as being rich and very well doing, but honestly, I hardly make my living and I don't even have kids. So I would say that I think it's beneficial for both and it's not, absolutely not driven by money or, um, desire to become rich, but just being able to spend time with my clients, with my patients and communicate with them in a right way. 

Eva Sheie (05:48):
It strikes me that you're probably a bit of a risk taker. So you just said, I don't like the way this is going. I'm gonna go do it a different way. And I think you probably also came to the United States yourself, right? 

Dr. Kazlouskaya (06:02):
Yes. 

Eva Sheie (06:02):
Not your parents? So let's go back in time a little bit. Tell me how that happened. 

Dr. Kazlouskaya (06:08):
Um,  I'm going to cry now.

Eva Sheie (06:17):
It's a lot. You're doing a lot. No, you're the first person that I've ever made cry on the podcast. <laugh> 

Dr. Kazlouskaya (06:29):
<laugh> Okay. So actually I didn't immigrate because of, you know, like, uh, bad life or anything like a lot of people do. Uh, I immigrated in 2011 and uh, I was living in Belarus. I was doing pretty well. I was a chairman of a dermatology department in our second largest medical school in my country. And I was really happy. Uh, but I wanted to learn more about dermatopathology. So I decided to spend two months in in the summer to learn more. And um, so I came to New York for like two months and then I was kind of involved into studies research and I saw so many opportunities here. So I just decided to make my living here. <laugh>, 

Eva Sheie (07:19):
I've said sometimes, you know, moving across the country or moving across the world, it's really not that complicated. You just put your stuff in a suitcase and you just go and if it doesn't work, you just go back. 

Dr. Kazlouskaya (07:32):
Yes. Actually I came with two small suit cases and I wanted to buy new stuff in New York. I took all my old clothing. I was thinking about shopping in New York and throwing out all my old stuff and buy new stuff. And then after those two months when I got involved into so many interesting research, interesting papers, and I was calling my husband and telling, you know what, I really don't want to come back because it's so, it's so cool here. And he was so supportive. He said, you know what? Let me try to get visa. If I get visa, I can work. You can study and we can make it. 

Eva Sheie (08:09):
So he came with you?

Dr. Kazlouskaya (08:11):
He came after. 

Eva Sheie (08:13):
And he's here now too. 

Dr. Kazlouskaya (08:14):
Yeah, yeah, yeah.

Eva Sheie (08:14):
Yeah. So you're, you're lucky to have him too. He was absolutely totally on board. 

Dr. Kazlouskaya (08:21):
Yeah. 

Eva Sheie (08:22):
And now you're in the process of completely changing the way that you practice too. 

Dr. Kazlouskaya (08:27):
Yes. Absolutely. 

Eva Sheie (08:28):
So talk about your vision. 

Dr. Kazlouskaya (08:30):
So I like to incorporate into one place where I can practice medical and cosmetic dermatology. I think it's very important also because sometimes, uh, when those two are divided, a patient doesn't get, uh, an appropriate care because for example, if patient with rosacea comes to a dermatologist using his insurance, it's unlikely he would get, uh, laser treatments which are very necessary in, uh, early stages of rosacea. Or he would have to reschedule and come different day and that will add up to kind of inconvenience I would say. So in my practice I have everything, uh,  together cosmetic medical photography. I have a photography station that allows me to photograph changes before and after so we can make a personalized plan what we need to improve. And I think it's really cool. 

Eva Sheie (09:26):
Dermatology can be really challenging if you're the patient because there's so much you can try to do on your own. And I think a lot of us struggle to solve problems because, you know, you, you can go to the store and just buy stuff, right? Yeah. But everyone reaches a point where it becomes a crisis and they need help. Yes. And then there's the barrier of getting in and how are we gonna pay for it? So have you thought about how you're gonna price your services for your patients so that they can actually come talk to you? 

Dr. Kazlouskaya (10:03):
Yes. I know what insurance pays for those visits and I tried to basically base my pricing based on that and based on time and based on type of service. So for example, if it's just a short visit for couple moles that you want to check and you want to come for 10 minutes just to show them to know if they're okay or not okay. So that would be one price. If there is a chronic condition when, you know, you would spend half an hour with the doctor, it's a different pricing. And if it's maybe a hair loss, when we would want to take tricoscopy pictures and photography and talk about different options, which can be a long conversation, about an hour, that's a different price. And then I also offer more mapping services. That's when we do full body photography of almost it's more appropriate for patients with melanoma, chronic sun damage, that's a different price. And I looked up what the pricing is in similar institutions, what physicians charge in my area. And of course I took everything into consideration. 

Eva Sheie (11:11):
Is it common in New York City for people to just go to the dermatologist without insurance? 

Dr. Kazlouskaya (11:17):
I think it is common and uncommon. It depends on where are you in the city, in Manhattan it probably is a little bit more common, but a lot of my colleagues in Brooklyn also start practicing direct pay. And from my residency program, there are about 10 people who are practicing in this model and nobody comes back. 

Eva Sheie (11:39):
I think you're on the right track. I would much rather just pay and have my problem solved, then take out my insurance card and, 

Dr. Kazlouskaya (11:48):
But there is so much even more to that. I had a patient couple days ago and I still practice couple days in another office where an office takes insurances and the patient had one spot that was suspicious for cancer. It wasn't very, I wasn't very sure. It was a very tiny spot. And I offered biopsy because of course we were worried about basal cell cancer. And um, she has high deductible of about $4,000. And when you do a procedure, a patient doesn't know even what the price would be after this procedure. And I don't even know because, uh, what I do, I just code it according to their, uh, type of procedure. I perform and send it to insurance. And maybe it could be 500, maybe it could be 600, maybe it would be 100. I don't really know. And when I explained it to patient, she denied biopsy and she signed the form that she doesn't want a biopsy. She would want to call insurance first and find out what the price is. And it's a delay of care. 

Eva Sheie (12:50):
Yeah. 

Dr. Kazlouskaya (12:50):
I don't know if the patient will come back, if she will do a biopsy. It was close to her eye and nose. Uh, what if it will grow and damage her eye and nerves. And she's beautiful woman. She was also from Belarus and she had same name as me. She's from the same city. Can you imagine? 

Eva Sheie (13:07):
No. Yes. Well, I hope she comes back. 

Dr. Kazlouskaya (13:10):
I hope so. 

Eva Sheie (13:11):
What if it was something that travels quickly or are you worried about her?

Dr. Kazlouskaya (13:15):
Well, luckily basal cell carcinomas, they don't grow that quickly. So, you know, even if that's what it is, it will take some time to, to increase, but it's still, it's a delay of care, which should, should have happened. That's the same day. 

Eva Sheie (13:32):
Well, I hope that turns out well for her. 

Dr. Kazlouskaya (13:36):
I hope so too. 

Eva Sheie (13:37):
Yes, it's very frustrating. Where would you like to see this new practice of yours be a year from now? 

Dr. Kazlouskaya (13:44):
A year from now, I hope I will have maybe a colleague who can share with me what I'm doing. That's why I didn't even make it under my name. Of course, my last name is hard to pronounce, but I called it circle just because I wanted other people to join it. Maybe we'll have, uh, aesthetician or some other, you know, fun practices that we will offer our people and hopefully will grow. 

Eva Sheie (14:12):
What do you love about New York City? 

Dr. Kazlouskaya (14:13):
Oh, everything <laugh>. Everything. What I don't like about New York City, maybe traffic. 

Eva Sheie (14:18):
Mm-hmm. Sometimes I think it's a little smelly. 

Dr. Kazlouskaya (14:22):
<laugh>. Uh, yes, they, yeah. Yeah. Yesterday, 

Eva Sheie (14:25):
Yeah, yesterday. 

Dr. Kazlouskaya (14:26):
Or the day before. The smoke was horrible. But I enjoy New York City. I, it's very expensive. It's hard to leave. It's the top. Uh, sometimes it's cruel, but I love it. 

Eva Sheie (14:37):
Have you hired anyone to be on your team yet? 

Dr. Kazlouskaya (14:40):
Yes, I hired one person. She's right here. Her name is Eugenia and she actually was a producer in Ukraine. She made a lot of, uh, TV shows and she helps me a lot with media. Uh, she's amazing. 

Eva Sheie (14:53):
That'll be helpful for marketing. So your team is growing. What do you think your patients can expect from you when they come to visit you? 

Dr. Kazlouskaya (15:02):
Well, they definitely should expect an honest, professional opinion. And I am that person that will tell the truth. I don't like to sell services that I think are not working. And I do both medical and cosmetic procedures, but I don't like to push unnecessary procedures. And, uh, although we have a lot of cosmetic services, Botox and fillers and lasers to offer to our patients, I don't think they're always necessary. And so I'm totally comfortable to say, no, you don't need that. And, um, I think that's how it should be. 

Eva Sheie (15:40):
Which lasers do you have? 

Dr. Kazlouskaya (15:42):
I have couple lasers. I have IPL, I have erbium resurfacing laser. I'm getting laser D for hair treatments and superficial resurfacing. Those are my three favorite ones. I have also antioch  and, uh, long pulse antioch for vascular lesions. So we basically have full spectrum of toys, so to say, you know, to cover all main things that our patient, uh, may want. Uh, pigmented spots, red spots, uh, superficial pigmentation, small wrinkles, everything that would usually is needed. 

Eva Sheie (16:20):
I think another thing they could definitely expect from you is to solve whatever problem that they have and not give up. 

Dr. Kazlouskaya (16:27):
Yeah, it's definitely, 

Eva Sheie (16:30):
Do you have any plans to do more research in the future? 

Dr. Kazlouskaya (16:33):
Yes, actually we are making plans with one of the laser companies to study some conditions. And I think it's a great way to, to give more science to cosmetic area because I think it's a wild west happening and it's a wild advertising of sometimes unnecessary procedures. I think patients are very, they don't know what's going on. Uh, they are not educated properly. I don't like the idea when a patient opens an app and buys a treatment without seeing a doctor because the treatment may be unnecessary. Patients are hunting for procedures and for a specific laser instead of seeing a person who would explain them what exactly the condition is and why we need this or that laser and why we need this procedure. So I think it somehow has to be changed, but I, I am scared it won't be changed because a lot of money is involved into, into that. But I mean, I, I can try what I can try, you know, <laugh> 

Eva Sheie (17:37):
Education is, that's why it's so important that people understand and find someone they could trust. So what do you like to do away from work? 

Dr. Kazlouskaya (17:47):
I have two dogs. So we have a lot of fun. I live on City Island and we have beach 10 minutes, uh, from our home and we have huge parks, so we spend a lot of time outdoors walking. 

Eva Sheie (18:02):
What kind of dogs are they? 

Dr. Kazlouskaya (18:03):
They are two little white, uh, Bichon Frise and West Highland Terrier. 

Eva Sheie (18:08):
Foofy dogs.

Dr. Kazlouskaya (18:09):
Yes. Bella and Chika <laugh>. We call them Chika Bella. Like one name for two dogs. <laugh>, 

Eva Sheie (18:17):
This is a really exciting time for you. 

Dr. Kazlouskaya (18:19):
Yes. Very, very stressful, but exciting. 

Eva Sheie (18:22):
You're gonna make it. If someone's listening today and they want to come see you, where should they look for more information about you? 

Dr. Kazlouskaya (18:29):
It's a lot of information. On my Instagram page, we have direct booking service from ZocDoc and we are using a booking system, Jane, where patient can prepay the visit and we don't double book. So, uh, we ask patient to leave a deposit just because that's the way we can allocate a specific time for them and that, that's how it works. 

Eva Sheie (18:53):
That sounds very easy. It is. Most parts of the country you can't do that. So 

Dr. Kazlouskaya (18:59):
I think you can do it everywhere. You just, you just have to want to do this this way. I think it's risky for a physician because of course it's longer time when you would have a full house, uh, with patients. And I think it needs more patients. 

Eva Sheie (19:15):
Anything you can do to make the process easier, which I think is why you're doing this is a good thing. And I think you come out ahead. 

Dr. Kazlouskaya (19:22):
Thank you. 

Eva Sheie (19:24):
Thank you for sharing yourself with us today. 

(19:31)
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