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Are you a dermatology patient who wants to understand your medication access better? A dermatology provider with questions about how to advocate for patients? You may be a biologic coordinator, practitioner, medical assistant, field access specialist, nurse, pharmaceutical rep, or anyone with skin who wants to hear from leaders in dermatology! That's Derm Good will answer your questions and more!
That's Derm Good is an interview-based podcast with insights and practical tips about dermatology. Host Janelle Ball, a popular speaker and biologic coordinator consultant, is talking to leading experts about current trends in dermatology, access to medication, medication affordability, derm conditions, and advocacy.
Subscribe to That's Derm Good today for fun discussions about treatment, specialty medications, dermatology, careers, and consulting. For questions or to suggest a topic, contact info@thatsdermgood.com. Thanks for listening!
DISCLAIMER: This podcast is for informational purposes only and should not be considered medical or health advice. This podcast does not substitute medical treatment. Always consult a doctor or dermatologist regarding medical advice, diagnoses, or treatment.
Yes, you are submitting prior authorizations for biologics, but it's something more than that. It's caring for the patients. You're advocating for these patients because they can't do it.
Speaker 2:Welcome to That's Derm Good. I'm Janelle Ball, and I'm excited to bring you thought provoking conversations about biologics, specialty medications, treatments, and so much more. I'll be chatting with some amazing guests about access, affordability, and advocacy. You're really going to enjoy this show. Welcome to That's Derm Good.
Speaker 2:Today, my guest is Madison Noel. Madison is a biologic coordinator at Forefront Dermatology. Welcome Madison. Thank you for joining me.
Speaker 1:Thank you so much for having me. I'm so excited.
Speaker 2:Yes. It's always good to talk to other biologic coordinators because it's a unique role.
Speaker 1:Very, very unique. Definitely not for the weak hearted.
Speaker 2:No, not at all. Lots of hard work, but it's definitely a lot of fun. And I think anytime I get to chat with other coordinators, I think it gets exciting. I feel like we're so passionate about what we do when it comes to helping patients and workflow and process and, you know, the struggles that we face when it comes to insurance and the prior authorization process. So it's always a good time.
Speaker 1:Yes, it is. And I love a challenge. I love it when the insurance tells me no because I will make them say yes.
Speaker 2:Right. It's hard to teach somebody that role. Like everybody always says like I fell into this role. Yeah, it's one of those things you kind of have to fall into. You kind of have to enjoy the prior authorization process.
Speaker 2:So falling into it, I feel like it makes it a lot easier because you're willing and open to kind of learn how to actually get access and the tips and tricks and things that we learn along the way to kind of, you know, get around some of the step therapy requirements or, you know, the issues that come up that we always see.
Speaker 1:Absolutely. A 100%.
Speaker 2:So you started out, okay, as medical assistant, where did your journey begin in derm?
Speaker 1:So it started out actually, I was really interested in cosmetology and I was doing side work, like building my portfolio, like doing people's hair and makeup, and I was really into the horror sci fi, you know, FX kind of thing. And I'm a very Halloweeny kind of person. So, but I really enjoyed like making people feel good about themselves. And I'm always that person that will do anything at the end of the day to make sure that you're happy before like anything else I need to do. So, I had learned about the medical assisting, and I didn't know if I was going to like the science aspect of things, because in high school, science used to actually be my weak subject.
Speaker 1:So I was like, if I didn't like the science, then at least I could do the admin portion of it. But then I fell in love so much with assisting and, you know, helping patients in any type of way. And then I found out that there's a thing called dermatology. And I had heard that it was, you know, as anybody else, when you hear it, people are telling you that it's about acne, it's about cosmetic, more of that. So that's what I fell in love with is to know that, you know, oh, it's about for appearance.
Speaker 1:But then when I found out it's way more involved than just acne or cosmetic, it's more about rashes, you know, it's more about immune systems than about, you know, it could be about rosacea, it could be about skin cancers, it could be about acne, it could be about so many multitude of things. And it's a never ending learning journey with dermatology. There's always something to research and learn each and every single day. So when I became a medical assistant and I got into dermatology, I've been doing it since 2018, like you said, fell into the role of becoming a biologic coordinator. And it wasn't called biologic coordinator at the time, it was called admin, there wasn't a thing called BCs at the time.
Speaker 1:So, I fell in love with it because the simple, I mean, when you come from the floor, and you see how those patients are, they're flaring, they're itching, they're, you know, having really bad flare ups, you know, you feel so bad for the patients, and you want them to feel good. You don't want them to live and suffer. And you don't want them to have a moment in their life where they feel like they can't feel confident in their skin or go to work or do whatever they need to for their family. So when I finally became a BC and seeing those patients on the floor that I was helping get an approvals for their biologics, and see the clearance and how they're able to move and feel confident and able to do more than they were before. That is what really drove me.
Speaker 1:It drove me so many miles and those simple thank yous, like you get so much closer to those patients more than being on the floor. It's actually crazy. But it's so exciting and rewarding to know that you're helping them and you're getting them where they need to be, you know, health and confidence. It's amazing. I love it so much.
Speaker 2:Yeah, it's so interesting. Well, I have a cosmetology background actually. I always thought that I wanted to do hair growing up. That's what I did. I did siblings hair and neighbors.
Speaker 2:I had a friend of mine that was like always trying to get me to do these different styles and I loved it. And I went to cosmetology school and a vocational school in high school. And so I was like, this is what I want to do for the rest of my life. And then and then dermatology found me. And so, yeah, very similar to kind of your story, but learning about all the different aspects in dermatology, I think is so so interesting.
Speaker 2:And it really just kind of opens your mind to, you know, that passion of helping patients, helping people. And kind of like you said, I love how you put that as far as like being able to get closer to patients and having these conversations because that's important for us in this role when it comes to getting patients access to medication. When we're having these conversations to see how it affects their day to day. We have a lot of those conversations about their quality of life, what they're doing at school, what they're doing at home, how their chronic condition may be affecting their lifestyle. And we're able to use that information and help them to get the medication.
Speaker 2:Because I guarantee most people don't think like, I've got psoriasis and you know, it's all over my arms and legs and I'm self conscious about going to work or, you know, I've had people say things or, you know, things like that that you see is really happening and don't realize, patients may not realize like, hey, that information can be valuable and we can use that with the insurance company to tell them why you actually need this medication over a topical cream step therapy that's not really going to work.
Speaker 1:Absolutely, a 100%. And you know, I don't see a lot of people do this, but you know, I encourage them as VCs to do this is where, you know, I don't stop when it comes to the insurance telling me no, you know, it's one of those things where some, you know, some patients in some cases, they're going to have to take a little more extra time and a little bit more in-depth than you thought they were going to be. The way that I look at it is if the physician provider wants the patient to be on this type of medicine, I'm going to give everything that I can with the insurance to make sure that that patient is able to get that medicine until I'm not able to do it. There's some things like, you know, with methotrexate, you know, we hear all the time with methotrexate, they got to try and fail the methotrexate for, you know, psoriasis medications, you know, and I go that extra mile to ask patients, you know, is there any, you know, social drinking history or anything like that, you know, to, or extra research that I can to try and add it towards the authorization or the appeal letter, you know, to find any type of contraindication of a reason.
Speaker 1:So there's just sometimes that you have to dig a little bit deeper, because every patient's case is different. Not every patient is the same, not every patient has the same, you know, family history or background history. And that's what's important. And that's what makes them so special, you know, for each patient and to fight for them for each and every one of them.
Speaker 2:Yeah, absolutely. I think there's definitely, we've come a long way where there's so many more, you know, bridge programs and patient assistance programs. But what is really crazy now is that we're seeing a lot of insurance companies thinking that they can take advantage of that and say, oh, well, we're not going to approve it because there's a bridge program that they can get free drug anyway. And that I feel like is becoming a bigger challenge now for so many coordinators. And so trying to help people understand how it actually works and why it's important for them to actually get approved through their insurance company because that's what it's for.
Speaker 2:It's for patient care, you know? So it's frustrating when when you hear these plans, know, that are trying to tell patients no, it's, you know, a plain exclusion or we don't cover. I have one I heard that they excluded psoriasis. Like how do you how do you just exclude one one diagnosis? Like so you so you would approve it if it was like another another condition, but for specifically psoriasis, you don't want to cover it Like that to me, it just does not sound right.
Speaker 1:Yeah. I had another patient just recently. They have a PBM that is like a third party and they make it where it's excluded from them trying to get on patient assistance. Like they're not allowed to get on patient assistance at all. So now this patient can't even get on patient assistance anymore because of his PBM.
Speaker 1:So because of his PBM, no patient assistance, and it doesn't matter which biologic he has to get the drug for free basically, or by sampled. And it's crazy. I mean, I still appealed it, of course, because I don't like the nose. I even called his insurance to see if there was a way that I could approve, you know, the, I guess you could say like a way for him to get approved for the patient assistance. And it's just a turnaround.
Speaker 1:They just like to play these games. I don't want to win.
Speaker 2:I get you completely. You know, it's frustrating because the whole point in going to a doctor to get a diagnosis and get a treatment is so so that you can get a treatment, you know, so that you can feel like, okay, what I'm dealing with is an issue and I'm coming for help. And now the people that I go to for help can't really help me because of the insurance plan that I have, they're restricting. There's got to be a point where there's some kind of insurance reform or something that can change, you know, getting these formularies to change. And now it's commercial plans are more difficult than Medicare and Medicaid.
Speaker 2:Like there's guidelines with Medicare and Medicaid and, you know, patients are able to actually get medications. And, you know, so why is that so difficult with commercial plans? It's been like the most frustrating thing I feel like for this year.
Speaker 1:I completely agree. With the Medicare patients, the new stipulation for 2026 is signing up for that N3P before they can get on patient assistance, you know, so at least that's easier. And then for Medicare patients, if they're denied or Medicaid, you know, once if you submit an appeal, get that determination, they can get drug. But for commercial, it's either, like you said, excluded from the plan and they are no longer able to get any formulary alternative at all, or you have to try six different medicines before you can even get them on the medicine that you're trying to get them on. And a lot of the times I experience, especially with Optima insurance, is that you have to make sure that they pick up a prescription.
Speaker 1:That's their way of, you know, confirming that the patient did try and fail it, even though it's in the note and it's documented, which is crazy. It's so crazy.
Speaker 2:Yeah, it is crazy. I mean, it's just do you ever have patients, like, appeal themselves to the insurance? Or do do they want to?
Speaker 1:I have. There's like maybe like two percent of patients that will, you know, appeal for themselves. And then there's the remainder that I do appeal myself. So, I appeal every Friday for patients. And I also do it in order because I do take care of three offices and eight providers do about 15 in a day at the very most.
Speaker 1:And I free type mine, I don't do any templates or anything like that, because I always said before that every patient's case is different. The biggest thing is that everyone has to read those denials of what their reasoning is. And then that's what you have to answer and you have to provide the answer to them, unfortunately, in a game way and make them convinced that obviously they were wrong. They need to fix this. So I have a couple of patients that will appeal for themselves, but a lot of the times when I appeal, I have to get their signature for consent.
Speaker 1:So in a sense, that's them technically appealing, but I just did all the typing.
Speaker 2:Yeah, it's really interesting. I wonder why not as many patients are willing to appeal for themselves. Like, they just not wanting to be involved?
Speaker 1:I think it's just because they're not educated. I hate to say it, but there's a lot of VCs or, you know, MAs that just don't educate enough to the patients to help them fight for themselves. You know, they can't fight for themselves unless they're told on what to do, you know, so if they're not educated, they can't do anything to do what they need to do to help. Of course, we have those handful amount of patients that, you know, need to be held, you know, hand by hand and guided every two seconds. But the fact is, is that they're trying, they're trying to do what they need to do to make sure our job is easy.
Speaker 1:And, you know, especially like the Medicare patients, you know, they don't know what to do. And their insurance companies are not telling them what to do. They're just like, oh, you got to pay $16,000 for a copay, figure it out. You know, they don't even tell them, hey,
Speaker 2:you gotta sign up for
Speaker 1:the N3P. You could probably afford this. But no, they just say you can't afford this. It's $16,000 for one injection. Figure it out.
Speaker 1:And that's that's not okay. That's not okay. Like, people pay for insurance and they don't get enough education to help them to get where they need to in life.
Speaker 2:Right. How to navigate it. I mean, you know, it's difficult for us even to understand all these different plans and how they work. So I can imagine how much more difficult it is for a patient, you know, especially if it's not a plan that like they've selected, you know, if they were like, hey, I know exactly what I'm getting in this plan. Or it's just an employer that says, Hey, these are the options.
Speaker 2:And you're usually looking at I mean, I remember when I first first job and I had insurance that was offered, they're like, These are the two options. And I'm like, which one's the cheapest? Because I don't want all this money coming out of my my account. And I'm like, I don't know which one to choose, you know? So you don't get a lot of support and education about it.
Speaker 2:And when you do, it's just so much words. It's just, you know, and it's so much confusion that you're just like, where do I even begin?
Speaker 1:I know, I know. And unfortunately, there are some older patients that don't even know about deductibles, you know, and so that makes it even more, you know, difficult to try and navigate them in the right direction because they get confused and then it's too much. If it was me, I would do everything for every patient, if I could. Would do it on my own every single time for them because it's not fair that they don't understand and that they weren't guided to proper information.
Speaker 2:Well, and then all of that on top of having a chronic condition that you actually need biologic for. You know? Now you're you're putting stress on top of that, anxiety, any other, you know, maybe some depression or, you know, just all these other issues that come up that are stemming from this chronic condition. And now you also are like, hey, do you know what your insurance is? Do you know what they have to offer?
Speaker 2:What they cover or what they don't cover? You know, it's it's a crazy thing. You know? It's it's so frustrating. But I think that's where the biologic coordinator role is so so helpful because we are looking at all of that.
Speaker 2:We're we're learning. And I feel like most coordinators that I've met are so open to learning more and to being better at what they do because we're thrown so many different curveballs. You know, there's so many changes that are happening on a regular basis. And, you know, one of the projects that I've been working on right now has been getting almost like a little cheat sheet that can kind of help remember, like, what a TPA is or what a difference between pharmacy benefit manager and like, you know, the different plans that you see that are, what is one, like a Smith Rx or some of these other random ones that made you go through a third party. That's exactly the SmithRx that I was
Speaker 1:talking about with the other patient. Oh my gosh.
Speaker 2:They're terrible. Yeah. They are. And it's it's crazy, but it's like, how do I learn about these ahead of time so I know how to navigate them and what to expect? Because when you go into it knowing exactly how they work, then you it's a little bit easier.
Speaker 2:You may not get very far still because they have so many firewalls up and you can't, you know, you just can't get anywhere, but at the same time, at least you know what you're dealing with.
Speaker 1:Yeah, absolutely. You know, and I tried being proactive to see if there was a way that I was able to see, you know, insurances or things in advance and things like that, that just as you said, but it's so time consuming. And a lot of the times, just as well as you know, with insurance, like, sure, they state this, but it's not going to come or happen until three or four months later. So they may have said that they're going to do this, but it's not going to happen until later. So it's one of those things where be proactive, but don't spend too much time on it because it's not even happening just yet.
Speaker 2:Yeah. So you gotta know where your time is valuable and where you can utilize that time. You know, one of the other things that I was talking about with one of my operations manager, we were just having a conversation about, you know, just almost like just be C smarts, like things that you don't really learn that you just should know, like you pick up on. It's like, okay, how do I pivot from this? Or do I just leave it?
Speaker 2:You know, what do you do in these types of situations when you don't know what the next step should be? You know, and you've got an office that's like, hey, what is the status of this? Or a patient's calling, what's the status of this? Where are we at? You know, why haven't I got my medication And it's been two weeks, you know, or four weeks or even longer sometimes.
Speaker 2:You know, how do you navigate those little things, those little nuances and the things that come up when you're stumped and you're like, I don't know what I'm supposed to do next.
Speaker 1:Well, I will say in the beginning, it was very trying. It was, you know, especially when you're learning new insurances or you're learning about insurance and things like that. I definitely, when I first started as a VC, I definitely used and abused my reps, my FRMs, they, when they offered help, I took it because they could see everything on the inside that I couldn't see. And, you know, we don't have time all the time to call the hub and ask, you know, hey, what's going on with this patient? Use our FRMs, use your reps, like that's, that is something I cannot express enough.
Speaker 1:That's what they're there for. You know, if you don't know anything, or heard something new, or something that you were really confused with, go to them, they might know something because all these other offices or other derm offices have had experience before you even had it. But what I've learned in the process of being a VC is definitely, like I said, not giving up. So when you read those denials, then you kind of question yourself like, oh, like, is denied for DUPIXENT because they haven't tried a TTI, TCS, you know, then what I do is, is I go back, I resend it, and I circle and highlight everything that they said in the denial and resubmit. There's that little trick.
Speaker 1:And then, you know, it's also staying organized, you have to stay organized as a BC, you know, so I have an Excel spreadsheet that I keep every patient on when they're approved, when they're denied, when an appeal needs to be submitted by. And then I also have a binder for each office that I put my new starts in. So I check every two weeks, or every week if I can. And I check to see if we've gotten that authorization determination back in enough times. If I haven't heard in two weeks, and I had to fax the form over, then I'm going to refax it.
Speaker 1:If it's on CoverMyMeds, I should have already had, you know, the determination by then. So, know, it's like trial and error, you know, throughout being a VC, that's how you kind of learn your tips and tricks. Because every VC learns something different, you know, and there's something that you can learn from every VC because they might know tricks that you don't even know. You know, simple things like, you know, when you come up to me and you tell me, you know, what's the status of this and that, you know, that's why you have to go back and you have to have something to document for yourself to keep up with, and look at where, what date you submitted it, when was their visit, you know, you kind of have to investigate your own work, and you've and it should be easy to look at it and know, okay, this was submitted, I haven't heard back, let me call them real quick, or this was submitted, they just didn't answer their phone.
Speaker 2:You know, they got approved, they didn't
Speaker 1:answer their phone. But that's kind of how I've learned from questions, the same questions, and learned to how to navigate and when to, you know, use my resources and my tools in the best way possible.
Speaker 2:Yeah. Absolutely. I think that's the biggest thing is knowing how to navigate and how to use those resources. There's still I feel like there's still a lot of offices that don't even allow, reps to come in or chat with them. And and I I I understand some some of the points.
Speaker 2:You know, you get one rep that comes in and it's overly pushy, and then that just ruins it for everybody. But they could be valuable, you know, when you utilize them the right way and you set those expectations ahead of time, like, hey, we're writing all of these medications and I need some help with this, or I want you to talk to my coordinator, you know, however it works. But I think it's important for us, you know, to be able to have those conversations with both the sales reps and those FRMs because the FRMs are gonna be able to help us navigate, you know, any access issues, but the sales reps are gonna be able to talk about the actual drug itself and tell us how it works. And that is good information for us. I mean, that kind of goes back to your science, you know, but it's funny because I never loved science and I never loved like math.
Speaker 2:Those were my two worst subjects. But now I'm like, oh, you know what? This makes sense. And talk to me about the mechanism of action for this TYK2 inhibitor, you know, whatever it is. I'm like, I want to know because I think it's so interesting, but it also is valuable information that could help me help a patient.
Speaker 1:Absolutely, like it took me forever to understand what a JAK inhibitor was. And I just kept researching and researching and then the ILs and everything. I'm like, I wanna learn more about this. This is really interesting. You know, all of me would be like, confusing, too scary.
Speaker 1:I'm good. But now I'm very intrigued. And I guess you could say like, that's just how I was as an MA. I wanted to be that MA that learned everything and knew everything because I wanted to be that MA where like say if someone, you know, was out of the office or this and that, then I was able to pick up and be able to do where the week had fallen and then be able to, you know, come up strong. You know, I just, I love learning, I love learning new things.
Speaker 1:I love challenges. I love challenges. I really do have fun with doing prior authorizations. I mean, especially talking to insurance companies, because I can be very, very nice, but sometimes they're a little pushy. And, you know, like how we were explaining that with time, you start picking up on things.
Speaker 1:And that's where it becomes easier to have these phone calls with insurers, because then, you know, that person that you're on the phone with, you know, if they know what they're really talking about or not. And you can hear those simple keywords like, no, this can't happen. We don't do this. And you know that they do that. And I'm like, hold on, you do this.
Speaker 1:Let's go back to this conversation. Let's try again. Right.
Speaker 2:Well, you know what? It's everywhere. It's not just in the insurance space. My husband was talking to, I want to say it was like our internet and we had been with him for so long and he was like, you know, like we need to get like some kind of discount. Like your new plans are coming out and they're cheaper than what we're paying.
Speaker 2:Like, why can't we get a discount on this? And the guy was just like adamant about telling us about other things that we should do. Like, oh, you can switch your phone service, your cell phone service to this. And we're like, we don't wanna do all that. Well, he ended up getting off the phone and he called back and talked to somebody different.
Speaker 2:And they and the lady was like super nice. By the way, the ladies name was Janelle Ball, which is the weirdest thing.
Speaker 1:You sure you were on the other side of the phone?
Speaker 2:I know I thought it was the funniest thing ever, but she was able to hook him up. Maybe it's because he was like my wife says Janelle Ball. No, but she completely different answer and completely, you know, like helped him out and fix the the rate that we were at and it was wild. But you see this happening all the time, not just in the dermatology space, not in, you know, with insurance. So tell me a little bit about your plans for becoming a physician assistant.
Speaker 2:Where did that come from? What inspired that? And tell me a little bit about that journey of being in school and
Speaker 1:School is really actually my weakest strength. But again, like I said, I love learning. I love helping people. It really is the highlight of my day And seeing the physicians that I assist by and work under and, you know, see how, how much care that they have for these patients and what they do one on one with these patients, I want that connection. I want that closer connections with the patients.
Speaker 1:I want that closer connection to where I'm actually able to, you know, figure things out for them a little bit more on the deeper level. I'm able to, you know, help them with their quality of life. And it's not just also to help them, but it's also really fun to learn and have a challenge, like I said before, like, because not every patient is the same, you know, they could come in with, know, rheumatoid arthritis, or they could have with the autoimmune disease and end up having to do a biopsy and a diff, you know, and figure out that they need a biologic, you know, just seeing the physicians that I have assist beside, they have been the motivation and derm itself has been the motivation to where I want to assist patients more one on one. I just want to be closer to them and be there for them more than what I can. I just enjoy helping others.
Speaker 1:I've always been that way. I've always helped others before myself. And I just believe that when you come into a clinic, no matter what it is, that you're supposed to treat them like a guest in your home. And unfortunately, there are some clinics out there that do not have that bedside manner, unfortunately. And I feel like the more and more people like you and me, if we were to become physician assistants, or, you know, doctors or nurse practitioners or anything, you know, that's one more stepping stone to add to one of the great providers that are there to help relieve the stress off of patients.
Speaker 1:You know, they come in to be treated like a guest and be taken care of, so that way they can leave all the stress and worries at home, just for that few minutes. And once you feel that confidence that you're there to take care of them, You're there at every step and every moment for them, and you're willing to do whatever it takes. You know, and, and that's what I really want. I want that connection. Absolutely, 100%.
Speaker 1:And I working under Doctor. DeSilva or beside Doctor. DeSilva has been really amazing. And that's one of the pure things that I really love about him is not only his work ethic and him being already crazy intelligent, but the way that he treats patients, he treats them like they're family members. And that is so important.
Speaker 1:And, you know, always goes in with a great attitude, you know, always does whatever he's supposed to, you know, to do to take care of the patient. And it's really inspiring to, you know, see, you know, any physician such as himself, you know, to do that for patients. It's really inspiring. And, you know, that's what makes me want to keep going and keep pursuing my career to hopefully become a physician assistant. So, you know, I could be someone like Doctor.
Speaker 1:D or the other physicians that I've worked beside, you know, and it's just amazing.
Speaker 2:I love that. It just makes it the full circle of care for your patients. You know, you now have the understanding of the bio coordinator role of the access side and then moving into actually the treatment side, I think is really, really cool side of things. And we actually have one of your doctors on not too long ago, but Doctor. DeSilva.
Speaker 2:And it was so cool listening to the way that he treats patients and the way that he supports patients and making sure that they feel, like you said, like they're a guest in their home. And I think there's a lot of that is missing. You you come in, you go into the doctor's appointment and they say, oh, well, this is what you have. Here's a prescription. We'll see you in six weeks, you know?
Speaker 2:And it's frustrating because you feel like you're being dismissed. You know, a lot of times you go in and you get a huge diagnosis like this and you don't even know what questions you were supposed to ask. You know, they go out the window the moment that you stepped in and you heard that you've got a chronic condition. So being able to anticipate some of those questions that patients might have or how to navigate this or what resources could be helpful and, you know, give them understanding. You know, the more empowered the patients feel, the easier it is going to be with that whole treatment plan, that whole process, and when it comes to getting access.
Speaker 1:Absolutely, 100%. And working beside Doctor. DeSilva has been really amazing. And that's one of the pure things that I really love about him is not only his work ethic and him being already crazy intelligent, but the way that he treats patients, he treats them like they're family members. And that is so important.
Speaker 1:And, you know, always goes in with a great attitude, you know, always does whatever he's supposed to do to take care of the patient. And it's really inspiring to, you know, see any physician such as himself, you know, to do that for patients. It's really inspiring. And that's what makes me want to keep going and keep pursuing my career to hopefully become a physician assistant. So, you know, I could be someone like Doctor.
Speaker 1:D or the other physicians that I've worked beside, you know, and it's just amazing.
Speaker 2:Yeah, it's good when you have a role model that's actively, you know, doing that same thing, you know, that's right in front of you that you can see and say, okay, that's how I want to support patients for sure.
Speaker 1:Absolutely. And I even told him one point that I said, is kind of dangerous because if I become a physician assistant, I've already done the MA in the BC world, I'm gonna feel like I'm gonna tell everybody how to do their job. Well, I'm gonna do it myself.
Speaker 2:Oh, know. That's funny.
Speaker 1:And I'm gonna have to learn to cut back.
Speaker 2:That's gonna be a hard thing. That's what I was thinking. You know, like, how would you handle that? Well, you'd be the one that would have to train them because you're you would know exactly how to do it, but then that could be hard.
Speaker 1:It can be very hard, especially.
Speaker 2:Yeah. It'll be really good, though, because, you know, the same work ethic that you have, you can pass that down to somebody else and inspire the next generation of biologic coordinators that are looking to expand or advance their careers. And I think that is something that is really important. We see a lot of coordinators going into maybe the FRM role and that want to be an FRM. That's, you know, there's been a handful of coordinators this past year that I know that have all moved into that role, which is really exciting.
Speaker 2:And I guarantee there's still some that are that are looking to go into more the medical side and the physician assistant role or even going to be a doctor. I think that's really exciting. And this is a great place to kind of start to get that general patient support, patient education, patient access and empathy when they're going into that role. It kind of, I don't know, puts you a little bit ahead of the game.
Speaker 1:Yeah, I think so too. And I think that's what, you know, obviously gave me that perspective and more of a push to want to be one on one with patients, you know, it's because I've been on the floor with them, I've assisted next to physicians beside them. And, you know, and then now I'm in the VC role where I'm learning more and more about patients, you know, when it comes to biologics, but I'm also learning more behind the scenes kind of thing, you know, more about labs, more about conditions, more about what you can and can't do when they're on a biologic and something, you know, medically happens to the patient. Yes, you're assisting with them with biologics, but there's a lot more to it than biologics. And that's one thing that I try to express to people is that yes, you are submitting prior authorizations for biologics, but it's something more than that.
Speaker 1:It's way more than that. It's caring for the patients, you're advocating for these patients, because they can't do it, the insurance won't listen to them, you know, and you're, you're taking on a role where you're supposed to do everything you can for the patient mentally, as in physically, you know, everything, there's so nice where you have to stay until six or 07:00, you know, just so that way you can get that patient approved, and you're waiting on the phone with insurance, you know, if that's what it takes, and that's what you have to do. You know, a lot of people think it's just paperwork, it's you, you and I both know it's way more than just paperwork. It's way more than that. Sure, you got approved.
Speaker 1:Great. That's fantastic. But then for the people that are denied, there's so much work involved in that. It's remembering to do updated prior authorization appeals, calling the insurance, trying to make sure that they get their injection training, you know, there's so much more involved in that. And the amount of heart and mental, you know, capacity that you have to put towards the patient.
Speaker 1:It takes a special person who wants to do everything they can for the patient to succeed in getting their medication and feeling better.
Speaker 2:Yeah, absolutely. I love that. So what advice would you give to someone who's interested in starting in dermatology, but isn't sure which role is right for them?
Speaker 1:Honestly, I am a little biased. I would suggest being a medical assistant, being on the floor, because that's the only way you're going to learn everything. You know, whether it's biologics, whether it's, you know, topicals, or, you know, biopsies, injections, you know, treatments, it's better to know everything, because then when it comes to you becoming a VC, and you have patients that are saying that, oh, I started this new medicine, you know, I don't know if I can take this or this and that, you know, it'll help you succeed for in the future for when you're trying to become a VC, because when you know things on the floor, it makes your job easier, knowing things off the floor and how to assist and guide your patients in the right direction better.
Speaker 2:Yeah, I agree 100%. I also think it's important to learn some of the other roles too, though. When I first started, it was in the front office and I learned so much in the front office. A lot of times people forget about that and they think, you know, oh, you know, you just worked the front desk. It's such a big role.
Speaker 2:It's an important role because you're the face of the company. You're the face of that office And when patients either come in and see you frowning or see you smiling, it's either an invite or an automatic I'm turning around and I'll never come back here again because of your front desk. I don't care how great your doctor is and the rest of your staff is, but if your front desk person is rude or mean or is just off putting, you know, it's gonna make me feel a certain way. And now I feel a certain way about your whole office without even meeting them. And, you know, and I've seen that happen before so many times and it's so difficult to watch.
Speaker 2:It's like, you've got to be smiling all the time. I don't care if you're frustrated or not, but one of the things that I learned, like working with an office and it was remote. And I remember like the phone team, they were like in this group chat and they were like annoyed at how patients were calling and they're like, Oh, patients are so rude today. And, you know, just kind of talking bad about them. I'm just like, hold up, wait a minute.
Speaker 2:You don't know what these patients are going through. Like, it made my blood boil. I was so mad. And I was just like, I had this whole long thing that I sent out to them. I'm like, we need to work on understanding empathy.
Speaker 2:Yes, you might see some patients that are coming in for Botox. They may be a little irritated. You know, maybe they had a bad day. You don't know what's going on in their life, but you also have patients that are coming in with chronic conditions. This is one of my biggest pet peeves, is they're coming in for a follow-up appointment, they don't have their medication, and they go in and the doctor's like, Did you start your medication?
Speaker 2:And the patient's looking at the doctor like, I haven't heard anything. Where's my medication? Like that drives me up the wall. I'm like, no, that should never be happening. You know?
Speaker 2:Like this is the things that patients are dealing with and that, you know, when you come into an office and you're in the front desk, you've got to diffuse that situation. You know, you've got to smile and grit it regardless of what's happening. If they're being rude, obviously, you know, you've got to have some conversations with the office manager to figure out how to diffuse a situation like that. But, you know, it's an important role, I think. How do you handle a patient that's upset about something, you know, not having those answers?
Speaker 2:Okay, it's frustrating, but we've got to be able to navigate that. You know, that's all part of the role as a bio coordinator. You know how to navigate all of that.
Speaker 1:Absolutely. I always say I give my retail voice.
Speaker 2:Yes.
Speaker 1:But I agree. I mean, I think an MA should learn everything because my biggest pet peeve is when an MA says that that's not my job, I don't need to learn this, you know, I don't need to do this and that. Yes, you do. Yes, you do. Because as an MA, if it involves the patient, you need to know this.
Speaker 1:It is your job to know this as well. So, just because you're not the biologic coordinator, that doesn't mean that you should be uneducated on the quantity, the day supply, which injection is for what condition. You still need to learn those things. You know, and I think that was my biggest pet peeve, because I was the type of person where I was thinking like, okay, I'm in the room with the patient with the provider, I'm dictating, I'm getting ready to scribe and this and that. I don't need to take up more time than I'm already doing for the physician treating the patient.
Speaker 1:And it's great to ask questions, it is. And it's very important for you to ask questions to make sure you're clear. But there should be a point in time where you know these things. And you should be able to go ahead and get the patient rocking and rolling, get them in and out. That is the whole point of the goal is to work efficiently, you know, and you're supposed to know these things.
Speaker 1:So that way, you know, if you hear your provider and they're like, Oh, yeah, so we're going go ahead and search from fire, you know, go ahead and get that paperwork ready, rock and roll and go ahead and send the BC, you know, you know, all this other stuff, you know, there's, there's a lot of things that can set you up 100% for success for you and the patient and your provider. And, you know, you just want to do everything you can to not waste time, because then if it's something that you don't know what to do, after several times, then you're sitting there and you're waiting when it could already been done. You know, that's my biggest pet peeve is that I don't, I don't have to do this. Yes, you do. Yes, you do.
Speaker 1:You're part of admin and clinical. You need to do it all.
Speaker 2:Yes. We are all working together. That is the biggest thing. We have to work together to get patients on therapy to support our patients, to make sure that they get the treatment that they deserve.
Speaker 1:Absolutely. And that's my biggest pet peeve is that, you know, there's some people that don't have the motivation to do what they need to for the patient. And that's where I get very upset because your goal and your aspiration should be in this office is to help the patients and get them where they need to be.
Speaker 2:A 100%. Yep. So, You are working so hard outside of work. What do you do and how do you keep your sanity?
Speaker 1:You know, that's that's a good question because there's not really much that I do do. I mean, I'm right now in school to finish up my prereqs. And then I also work a part time job every other weekend. And then me and my husband, we spend as much time as we can together. He works two jobs and we have our two fur babies.
Speaker 1:We have our pugs. We try to go to Puffs and Pints all the time. I am a musical person. Music has always been my first love. So I play drums sometimes in between to kind of help relax a little bit.
Speaker 1:Little little punk rocker here.
Speaker 2:Do you have a whole drum set?
Speaker 1:No, I used to, but I live in an apartment, so I can't have a full drum set. So I got I got my husband for Christmas got me those air band drumsticks, where if you hit them, you know, you can hear the drums and it's, it's really, really good. It's really good. But because since I can't play drums, like I want to in the apartment, I've tried to self teach myself how to play bass guitar in the meantime. So, you know, and I like to do puzzles and kind of like a homebody at the same time.
Speaker 1:I like to go out at the same time. So I do definitely go to the gym a lot. That's another thing. Gotta get that frustration out, girl.
Speaker 2:Yeah, absolutely. I know you have a bad call with an insurance company, go to the gym, run it out.
Speaker 1:Yes, or punch it out. You know, you feel.
Speaker 2:Punch it out. Yeah, whatever, whatever works.
Speaker 1:Just don't hurt nobody. That's fine.
Speaker 2:Exactly. What's one thing about you that might surprise people who only know you in a professional setting?
Speaker 1:Oh, god. Other than my height being four eleven. But I mean, other than the music part, you know, I used to be in the band with my brother. I was in the band when I was 16 with him, and I almost actually didn't get into one of the shows because I was underage. And they ended up letting me in, and
Speaker 2:so many people
Speaker 1:were coming up to me and, like, they're, like, hooraying me and things like that. But I would just I would just say that honestly is just being a little punk rocker alternative girl on the inside.
Speaker 2:You might have to send me some of your music.
Speaker 1:Oh god. God.
Speaker 2:That's awesome.
Speaker 1:It was like from February. Oh my gosh. Our our band name was called Bubbles Dumb Drops. It's crazy. We were trying to create like the band like the Go Go's and then the Beach Boys and then also like, you know, Sex Pistols, like all of them in combined.
Speaker 1:And I mean, I'm not gonna even toot my own horn. We rocked. We killed it. Okay, like, you had a female drummer, 16 years old, killing it. And then we had a bass player that, like, played the long bass, not the kind that you stand up with, not the one that you put over your shoulder.
Speaker 1:And then my brother was the the lead singer. So
Speaker 2:Oh, that's awesome. That's so awesome. Alright. I'll settle for some pictures if I could just see a picture of that. That's awesome.
Speaker 2:I'm so little. You can't even see me behind the set. I love it. That's awesome. So good.
Speaker 2:Well, thank you so much for joining me and this was so much fun. I love, you know, I love this discussion. I love chatting with you since we met, but it was like couple months ago and then I was like, we definitely need to have a conversation on the podcast. That would be so fun. So, yes, not a disappointment at all.
Speaker 1:I was so excited, and I was very honored actually because, you know, I like I said, I followed you on Facebook, and I once I realized who you were, was like, oh my gosh. Like, I'm my tits are sweating right now. And then to know that you had a podcast, and I was like, oh my gosh, I have to listen to this. Like, this is crazy. And then when you asked me to be on here, I'm like, oh my gosh, like, I'm, my heart is beating so fast.
Speaker 1:I'm so nervous, but so excited. And it's been such an amazing opportunity. And I, you know, still to this day, I really hope you know how inspiring it is to see someone who started from front desk, MA, VC, and then started her own, you know, career and started her own business and is now nationwide known is fantastic. And it's very inspirational to know someone such as myself, say, if like BC school never worked out or anything something like this. It's amazing.
Speaker 1:I really am appreciative of this opportunity, and I love speaking with you.
Speaker 2:Yes. Thank you so much, Madison. It's been such a pleasure. Thanks for spending a few minutes with me and listening to That's Derm Good. You can expect new episodes of That's Derm Good every week.
Speaker 2:The podcast is available on your favorite app, where you're listening right now. Subscribe to the podcast so you never miss a new episode. Bye.