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The Coronavirus Economy: How my job as a cosmetic dermatologist has changed

April 4, 2020, 5:00 PM UTC

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As one of the most in-demand cosmetic dermatologists in New York City, Dr. Doris Day has patients from all over the country vying for a spot in her appointment book to get a touch of Botox or filler or to try out one of her 30 in-office devices. She’s a regular on the aesthetics conference circuit, serving as keynote speaker at dermatology summits all over the world and a veteran presenter at the annual meetings of the American Academy of Dermatology and the American Society for Dermatologic Surgery (ASDS).

But as the coronavirus pandemic continued its vicious spread across the globe, Day made the difficult decision to close her practice, putting a pause on the routine she’d long mastered and the success that came with it, unsure of when normalcy might return.

As of 2019, there were an estimated 20,000 or so dermatologists practicing in the United States, accounting for a market size of more than $7 billion, and the demand for cosmetic treatments and procedures, like injectables and lasers, is growing exponentially every year. Despite the industry’s growth, though, visits to the dermatologist aren’t exactly necessary during a global health crisis, and many providers have followed Day’s lead in closing their practices to avoid a further spread of the virus. With large overheads, expenses, and staff members who depend on them, it’s unclear how badly this will affect these docs and the dermatology sector at large.

Fortune spoke with Day for a new series, The Coronavirus Economy, to ask about how the outbreak of COVID-19 has affected her employment status and her plans for the future, and to get a sense of how she has been handling this news, both as a business owner and personally.

Dr. Doris Day made the difficult decision to close her practice, putting a pause on the routine she’d long mastered and the success that came with it.
Courtesy of Doris Day

Fortune: How did you decide to close your practice, and what was the immediate impact?

Day: I went from 100 to zero. We were full speed ahead, fully booked with patients traveling from around the city and around the country to come in and have procedures done. I made the decision based on CDC recommendations but also based on my understanding of pandemics, knowing that you’re never really where you think you are.

Even though for a while, it seemed like nothing was going to happen, I knew that we were in that lag period. I’ve been in practice for 20 years, I’ve been on the boards of the ASDS, and I’ve mentored many people behind me, so I thought it was important that I set the tone and set an example by shutting down relatively early, in order to encourage others to feel good about doing something similar. Some people did, and some people didn’t, but a lot of people reached out to me asking what I was doing, why I was doing it, and how I was going to manage my staffing.

It’s surprising to hear that before closing, your schedule was still at full capacity, even as many people started to steer clear of travel and any unnecessary appointments.

I have a really large force of patients, so even as some, who were traveling from other parts, were canceling their appointments, the ones who are local were happy to take their places and get in. The other thing was that some patients had a sense that this was all looming and wanted to come in right away before they couldn’t come in again for an indefinite period of time. They wanted to come in and have their treatment because they knew it would probably be a month or so before they could get back in.

It’s almost like it got busier right before because people had a sense that this was coming and wanted to go out knowing that they could hang on for as long as possible until this ends. Unless someone couldn’t get here from traveling, most wanted to get in. People, even now, are asking if it’s too late and if they can still get in, but I’ve had to tell them that it’s unfortunately too late.

How have you handled having employees who depend on you?

I made the decision to compensate my staff for 30 days with full pay and full benefits because I felt that I could field this better than they could. This sort of thing blindsides everyone at once, so I knew we would need to figure it out together. I have a great team of six people who work for me. It’s not a big team, but I’ve always learned to not be in debt and to keep your overhead low, so I have a relatively tight office that has controlled overhead. I felt that I was well-positioned, just from my daily practices of living well within my means in office and in life, to absorb this better than my staff could.

Dr. Doris Day is a regular on the aesthetics conference circuit, serving as keynote speaker at dermatology summits all over the world.
Courtesy of Doris Day

Obviously, your work can’t really be done from home, so what will you and your staff be doing while your practice is closed?

We had a big conversation and all decided how we were going to proceed and how we would use this time. I didn’t really have to set it as an expectation; everyone was eager to come up with projects to do from home—all those things that we want to do that we don’t usually have time for. My office operates on checklists, and we make protocol for everything we’re speaking about and working on. We have piles and piles of projects that we’ve wanted to work on—things we’ve wanted to write, redoing our website—so everybody has tasks assigned, and everybody has projects that they’re working on.

When we decided to close, we worked together to cancel all upcoming appointments and sent emails out and called patients to make sure no one was left wondering what their lab results were or anything like that. I’m really proud of my team and the work they’re doing, and they’re really just showing such ingenuity in making the most of this time. I’ve also had so many projects that I personally wanted to work on. I wanted to go through all my files, do a lot of writing, make some videos, just all these things I’ve wanted to get done. And since we’re completely redoing our website, we’re all working on the content and looking for pictures to include, so we’re all still busy with things that we’re grateful to now have the time to do.

You’ve also been quite active on Instagram, sharing useful information about COVID-19 with your following. How do you plan to continue with that sort of content in the coming weeks?

I’m sort of figuring out what I’m going to do. I’m going to make another video on what a virus is and then some on the rashes you can get from wearing a mask or the rashes you can get from over-washing, things that I haven’t really heard in the news. My strategy for content has been to post things that I would want to see and things that I need. I figure if it’s true for me, it’s probably true for others. I’ve seen the level of anxiety among my patients and friends, and I realized it was time to put something calming on my Instagram, so I posted a guy playing the cello in the mountains, and I wrote about just taking a moment to breathe and be calm. People were responding saying, “I really needed that,” and the truth is, we all do. We all need that.

I have this great position of authority. Wearing a lab coat and being called a doctor is powerful. It’s an awesome job if you are willing to accept it as that. My dad always taught me that doctors are healers and that it’s a calling more than a job. So, my calling and my privilege is to be able to help people not feel helpless or hopeless but to understand the facts in a way that will help them navigate these difficult times. The reality is this is a very, very difficult time, and it’s very scary, but most of us will come through this just fine. It’s how we look at those numbers. We don’t have control over anything except our behavior and our attitude.

Hopefully, your behavior will be listening and implementing social distancing as much as possible, and your attitude will be doing your best and spending this time doing something you’ve always wanted to do, whether that’s taking care of your skin differently or going through all the products you have and learning about their ingredients. I’m going to try to help with that and teach people something they didn’t know—like that when you over-wash, you’re actually washing away layers of your skin and layers of protection, and you’ll be more prone to infection and rashes as a result.

How are you personally dealing with the stresses of this pandemic and having to close your business?

I knew very early on that I was going to go from a full, busy day to basically no income and really into the negative since my overhead and expenses are still there. That’s one thing that’s surreal. It’s actually gut-wrenching because in 20 years, our practice has never once closed for more than a week. Now, not only am I going to be closed, but it’s already a week, and I have no idea when this will end. I don’t know if I’ll be back in two weeks or three weeks or four weeks or even six. What am I going to do? How am I going to support this? How far into my own reserve will I need to go to help my staff through this? To me, they’re family, and I want to keep my family intact, and I don’t want them to be in trouble either.

The pressure is there to make sure that I do the right thing but that I’m also able to come out okay on the other side. I hope that when I come back, things will eventually rebound to where they were, but it’s a very scary, very complicated situation. There’s really no great way to prepare for this. I think, as much as there was, I naturally prepared for this, by having a low overhead and whatnot, but it’s bad. It’s really, really bad.

More coronavirus coverage from Fortune:

—This famed economist doesn’t think we’re headed for another Great Recession
—South Korea has the most comprehensive coronavirus data. What it’s taught us so far
—10 questions about the 2020 election during the coronavirus pandemic, answered
6 steps to sustainably flatten the coronavirus curve
—How hackers are exploiting the coronavirus—and how to protect yourself
—Hong Kong launches a surveillance operation to track suspected coronavirus patients
—Listen to Leadership Next, a Fortune podcast examining the evolving role of CEOs
—WATCH: The race is on to create a coronavirus antiviral drug and vaccine

Subscribe to Fortune’s Outbreak newsletter for a daily roundup of stories on the coronavirus and its impact on global business.