LEXINGTON Doctors tell some very novel stories about how they chose their particular specialty, but never before or since has someone roller skated their way into a residency and their life’s work. Joseph P. Bark, MD, dermatologist and founder of Dermatology Consultants, tells the abbreviated story this way: “As a teenager I took up roller skating and became very good at it, so good that I started winning competitions. I won two national championships in a row and was embarking on defending my title when a problem developed on the skin of one foot. A dermatologist solved the problem, and I did indeed win an unprecedented third national title. I thought about that dermatologist’s treatment, and I began to think that dermatology might be something I would enjoy as a career.”
Bark pursued medical school at the University of Kentucky, and it was there he attended a series of lectures on dermatologic conditions with Dr. Glenn Marsh. “At that point, I was hooked. I did a mentorship with Dr. Marsh during medical school, and I was sure dermatology was for me,” says Bark. After an internship in internal medicine, Bark completed a residency in dermatology at the Medical College of Georgia in Augusta, Ga.
Since Bark and his wife had common roots in Lexington, they returned to the Bluegrass in 1976 where he began what has become a remarkable 40-year career as one of the most prominent dermatologists in the country and one of the most recognized doctors in Kentucky.
Educational Broadcasting
Bark’s passion for his specialty and his drive to take medical education directly to the public soon led to his reputation and recognition transcending the area of dermatology. This aspect of his career began simply, “I was invited to be a guest on Dr. Talk, a local television show that featured physicians from various fields coming on air to discuss the current status of their specialty. I ended up doing 48 episodes on dermatology.” Soon he was asked to host his own show called Ask the Doctor.
At this time, Bark also did a guest spot on a regionally syndicated TV show in Cincinnati, which unexpectedly led to another outgrowth of his career. During a commercial break, Bark and the host, Bob Braun, discussed doing a Q&A show where doctors answered questions sent in by listeners. “When we came back on the air, Bob really surprised me when he said I was going to write a book based on questions from the listeners. Well, I did write that book and ultimately, two more books. It was all great fun,” says Bark. Partly through the promotion of these books, Bark became a national crusader for protection from the sun’s ultraviolet radiation. He encouraged other physicians to embrace mass media by teaching radio and television technique at the AMA annual meeting as a member of the National Association of Physician Broadcasters.
Building a Practice Legacy
After a few years in solo practice and with a group practice, Bark established Dermatology Consultants. The group has grown to the point of needing more space and is now located at 2424 Harrodsburg Rd. One half of the space is dedicated to medical and surgical dermatology and the other half is cosmetic dermatology. The practice now has four dermatologists – Bark, Erika N. Music, MD, Kelli G. Webb, MD, and W Patrick Davey, MD, MBA, FACP – as well as three physician assistants – Ryan Filiatreau, PA-C, Samantha Stratton, PA-C, and Lauren Curry, PA-C. Davey, a Mohs surgeon, is the newest physician in the practice, having joined last fall, and James LaGrew, MD, will be joining in the summer 2017, bringing their total to five physicians. The cosmetic dermatology division, Skin Secrets, is also adding a third esthetician.
Dr. Erika Music joined Dermatology Consultants six years ago and is now the managing partner. She grew up in Ashland and Lexington and graduated from the UK College of Medicine in 2006. She completed an internship in general surgery at UK and did her dermatology residency at Cook County Hospital in Chicago.
“We are growing and were simply out of space,” says Music of the practice’s new location. “Dr. Bark started our practice 40 years ago and has established a very successful, well-respected business. We are fortunate enough to have the problem of needing a larger space as we add new providers and services.”
Davey was born in Sioux City, Iowa. He attended medical school at Washington University in St. Louis, went on to a full residency in internal medicine at the University of Indiana and is board certified in internal medicine. This was followed by a residency in dermatology at University of Iowa School of Medicine and a dermatologic surgery fellowship at the same institution. He is board certified in dermatology and is a fellow of the American Academy of Mohs Surgery. Davey spent 20 years in Lexington with Dermatology Associates of Kentucky before moving to Arizona for four years of solo practice. When the opportunity arose to join Dermatology Consultants, he happily returned to Lexington.
Don’t Underestimate the Skin
According to Bark, the importance of the skin cannot be underestimated. “Skin is the first defense against everything harmful that may contact the body – bacteria, viruses, parasites, all kinds of infectious agents and also toxins man-made and natural, and of course radiation from the sun,” he says. The skin also participates in eliminating toxins from the body, is “the body’s air conditioning unit” via perspirational cooling, and is an indicator of the dysfunction and disease of other organs.
What Bark considers the biggest advancement during his 40-year career may surprise you. “The most significant technological discovery in dermatology in my career is better sunscreen,” he says. “I have been a very strong advocate of sun protection my whole career, and I remain so. There are some misconceptions about sun exposure, such as that you get all the damage you are going to get by the time you are 18. Where did that come from? It’s totally wrong. Another is that dark skinned people from equatorial areas don’t get sun-induced skin tumors. Again, not true. Bob Marley died of metastatic malignant melanoma. Many people have been taught that African Americans just don’t get malignant melanoma. Cancer really does not discriminate, and it becomes much more dangerous when healthcare workers think it does.”
An area of special concern to Davey, and one where he believes we can strongly impact the incidence of skin cancer, is tanning beds. Davey posits, “The purchase of one series of tanning bed visits increases the risk of developing malignant melanoma by 65 percent. I was among a group advocating legislation that mandated parental consent for tanning bed use by anyone under 18 years of age. Last session the legislation passed both the State House of Representatives and the State Senate but was lost in the negotiations for a state budget. We will be looking to find a sponsor for the next session.”
When it comes to skin cancer, many people, including physicians, do not realize that the majority are removed by dermatologists. “Mohs surgery was designed as a way to minimize the risk of recurrence and leave as much tissue for reconstruction and as little scarring as possible,” says Davey. “Dr. Frederic Mohs developed the technique named after him in the 1930’s, but it wasn’t until 1971 when frozen section margins were added that Mohs surgery became the benchmark method for removing skin cancers. By taking small specimens from marked sites of the edges of removed tissue and examining them under the microscope we’re able to make a map of the tumor. If cancer cells are seen in an area, additional tissue is removed only in that area. This saves as much normal skin for reconstruction as possible.”
As the practice’s Mohs expert, Davey’s schedule is almost entirely surgical, usually consisting of eight to 10 skin cancer procedures a day. And while Davey handles some reconstruction himself, he says, “I do not hesitate to call on my colleagues in oculo-plastic, facial plastic, and plastic surgery to handle defects that are outside my scope.”
As is the national trend, cosmetic dermatology is a burgeoning business that dovetails nicely with the tenets of protection and preservation of healthy skin. Bark spends two days a week on the cosmetic side of the practice because he is passionate about physician administration of these treatments. “I like the effects of Botox, fillers, and topical antioxidants, but I want to stress that all of these procedures must be performed by a well-trained and experienced doctor. There is no place for these procedures being handed off to a technician,” says Bark. “The face has 43 muscles, and only with a detailed knowledge of the dynamic interactions of these muscles can an intelligent plan be made for using Botox to stop dynamic wrinkling.”
Up Next for Skin Disease
Beyond improved surgical techniques, one of the most promising advancements in all of medicine, including dermatology, is the advent of immunobiological agents. “In this category, we naturally think of cancer, but psoriasis, a life-altering disease, has been found to result from one small side chain anomaly in an enzymatic cascade that regulates the proliferation of scaly tissue on the skin. Correction of this side chain defect will eliminate the disease,” says Bark.
In the future Davey predicts, “The creation of biologic and immune therapies will be custom constructed to each patient’s genome for the eradication of each specific tumor type.”
For now, Music says, “It is my hope to continue to build on the legacy Dr. Bark began in 1976. I am humbled he chose me as his partner and will continue providing excellent patient care for our general, surgical, and cosmetic dermatology patients in our Lexington and Richmond offices. We have just started a clinic in Georgetown, and I would like to see that become a permanent location in the next few years.”
As for Bark, “I have no plans to retire, ever. The truth is I enjoy what I do so much that I feel I have really never worked a day in my life. So I want to keep doing what I’m doing. I love it.”
Cancer really does not discriminate, and it becomes much more dangerous when healthcare workers think it does.– Dr. Joseph Bark