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A Conversation With Sailesh Konda, MD

A Conversation With Sailesh Konda, MD

Sailesh Konda, MDDr Konda is an assistant clinical professor of dermatology at the University of Florida Health System where he serves as medical director and director of Mohs surgery and surgical dermatology. He completed his undergraduate and medical education at George Washington University in Washington, DC, as part of a 7-year BS/MD program. He went on to complete an internship in internal medicine at Boston University/Boston Medical Center in MA and worked as a research associate at the University of California, San Francisco. After completing his dermatology residency at Howard University Hospital in Washington, DC, he received additional fellowship training in Mohs surgery/procedural dermatology at Loma Linda University Medical Center in Loma Linda, CA. 

He has a special interest in the evolving role of private equity (PE) within dermatology. Dr Konda has lectured extensively on PE pearls and pitfalls in more than 30 local, regional, and national settings to dermatology residents and dermatologists in all stages of their careers.


Q. What part of your work gives you the most pleasure?
A.
A majority of my practice revolves around Mohs micrographic surgery. I derive great satisfaction from seamlessly intertwining surgical skill with pathological diagnosis to treat skin cancer and restore function and cosmesis in the outpatient setting. Every day is exciting and unpredictable as tumors can lead to challenging surgical defects and creative reconstructions. Additionally, I enjoy teaching dermatologic surgery to residents and fellows. 

Q. Who was your hero/mentor and why?  
A.
There have been many mentors along the way who have shaped my career in dermatology. Dr Brian Berman was my first and foremost mentor. During medical school, I worked with him as a research fellow, and he helped nurture my passion for dermatology. Prior to dermatology residency, I also worked with Dr Howard Maibach, who instilled an inquisitiveness for basic science research in me. As a dermatology resident, Drs Rebat Halder and Harold Minus pushed me to become the best possible dermatologist and Drs Pavan Nootheti and Rueben Bueno helped expand my surgical skillset. I went on to complete my Mohs surgery fellowship with Dr Abel Torres, who taught me the finesse of tumor extirpation and reconstruction. We shared many a good laugh and several years later, Dr Torres followed me to the University of Florida! Early in my career, I crossed paths with Dr Jane Grant-Kels. She taught me the importance of dermatoethics and gave me the courage to tackle controversial issues facing the field of dermatology. 

Q. What is the greatest political danger in the field of dermatology?
A.
The greatest political danger in the field of dermatology is the infiltration of our leadership with dermatologists who have sold their practices to and partnered with PE firms. These leaders have used their positions of influence as a platform to convince other dermatologists to join the current wave of PE-backed consolidation. They have given lectures, organized one-sided panels, and manipulated our professional societies to support PE-backed dermatology groups. The danger herein lies if the dermatology community is not aware of the financially driven agendas of these leaders and their undisclosed conflicts of interest. Ultimately, these leaders aim to enrich themselves by selling the field of dermatology to private corporations.

Q. Which medical figure in history would you want to have a drink with and why? 
A.
Dr Arnold S. Relman: an American renowned clinician and professor of medicine. He passed away in 2014 from complications of advanced malignant melanoma. He served as a longtime editor of The New England Journal of Medicine and wrote extensively on the medical-industrial complex. In a lecture at the University of North Carolina, he asked, “The key question is: Will medicine now become essentially a business or will it remain a profession? Will we act as businessmen in a system that is becoming increasingly entrepreneurial or will we choose to remain a profession, with all the obligations for self-regulation and protection of the public interest that this commitment implies?” As we enter the next decade, these are important questions to consider for the field of dermatology.  

Q. What is the best piece of advice you have received and from whom? 
A.
The best piece of advice I received was from Dr Grant-Kels. We published an article about the status of PE involvement in dermatology in the Journal of the American Academy of Dermatology, which was published online in October 2018.1 The article was removed a week later without any prior notice. After spending an entire month responding to concerns from PE-involved dermatologists and general counsels representing PE groups, the article was reposted online in November 2018. Dr Grant-Kels summarized our defining experience with a variation of a well-known phrase: “If you’re taking flak, you must be over the target.”


Reference
1. Konda S, Francis J, Motaparthi K, Grant-Kels JM. Future considerations for clinical dermatology in the setting of 21st century American policy reform: Corporatization and the rise of private equity in dermatology. J Am Acad Dermatol. 2019;81(1):287-296.e8. doi:10.1016/j.jaad.2018.09.052

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