Best Practices: Tribeca Skin Center
Founder Sherwin Parikh on choosing dermatology and changing the practice model
Sherwin Parikh, principal and founder of Tribeca Skin Center, has maintained a thriving practice in downtown Manhattan for over 15 years and is regularly quoted by beauty denizens at media outlets like New York Magazine and Refinery29.
Dr. Parikh began his business shortly after finishing medical school, seeking to emulate what was at the time a new type of startup culture: a non-hierarchical and truly collaborative office structure. He was kind enough to speak with us about his preference for a medium-sized practice, how phones have changed how we see dermatology, and the importance of hydration.
The start of your practice paralleled the use of patient tech in the early 2000s. Can you talk a little bit about that?
I was young. I started in 2001. Tribeca Skin Center was born out of the idea that we were entering a proper tech era. That period was the heyday of Startups with a capital “S,” and it felt like medical practices should follow along by providing an electronic platform for physicians and patients to engage in, one that offered services as simple and intuitive as getting your intake form finished before you show up at the office. That wasn’t the case back in the day, and it’s why, in 2004, The Wall Street Journal highlighted us as the first paperless private practice in the country.
Again, it was an easy transition for me because I was just in my late 20s, and my peers in other industries had these open loft-like places in which they communally worked. I was like, “That’s what our office should look like for everyone who’s in the office, whether it’s patients, physicians, or staff because it does create a sense of community. Everyone works together.” It disassembled some of the sense of hierarchy.
Your practice is about the same age as selfies. What change in treatments have you seen in that time?
People see themselves a certain way and at certain angle on their phone, so they come in knowing they want this shadow or that line erased. It’s fascinating. I don’t find it an obsessive or particularly dangerous behavior. I find it just reflective of the time. That also could be because my office is downtown and closer to Brooklyn, so my patient base tends to be part of a population that has always been interested in taking very good care of itself.
Now how has this affected procedures? Interestingly, Botox requests don’t really fluctuate. People just know about it, and they’re into it or they’re not, so it’s a fixed number. Filler, on the other hand, has an occasional big uptick, but that’s because a celebrity like Kylie Jenner will do her lips and make 2 million people think, “I want my lips done.”
The other procedure that’s come to the fore is PRP, which stands for platelet-rich plasma: your own blood is drawn and spun down, the plasma is taken off the top, and then re-infused into the skin with a small pen through tiny incisions that allow the liquid to soak in. It’s like putting on heavy moisturizer that goes a little bit deeper — except the moisturizer is your own plasma!
I always wonder how people choose their specialty. How did you decide on dermatology?
It’s a combination of having talent in your specialty, enjoying certain aspects of that field, and process of elimination. I was a groomsman at the wedding of my Columbia Medical School classmate, who went into neurosurgery. I realized while giving the toast that he had solidified what he wanted to be very early on. I experienced the choice a bit differently.
My mother is a retired OBGYN, and I started out like, “Oh my God, delivering babies! This is in my blood. So amazing.” But then, wake me up at 4:00 AM to deliver a high-risk pregnancy? Less amazing. Dermatology was also very competitive, and I wanted the challenge. I think most saliently for me, derm presents terrific opportunities to take small problems and fix them quickly. Like, “You have acne? I can treat that.”
The fact that you can see your results in front of your face is truly gratifying. That’s very different from giving, say, a cholesterol medicine and using numbers to imagine what’s going on inside of a patient’s arteries. In that regard I think the choice came down to something very visual for me. Also, I had a knack for it. In the end, the choice fit really well.
How would you say the average patient’s expectations have changed in the time you’ve been in business?
Great question. This relates to our philosophy, which is that people increasingly want their health and their treatment explained to them.
Patients have always wanted a treatment that work, but more and more they want to know why things are happening.
Medicine is responding by investigating the interplay of lifestyle factors. We look at a patient’s history, what their job is like, how they sleep. I think if those things are examined on a patient-to-patient basis consistently, then the patient has a better outcome, and the physician has a more gratifying clinical life.
What choices went into having a medium-sized practice?
When I started my practice, I wanted to change the model, and there weren’t tons of people I could convince to do that with me. I knew that I liked the collegiality of having a few physicians to bounce things off of on a day-to-day basis, to interact with and not be completely solo. The idea was to have a multi-member single specialty practice with a few positions and medical assistants, and then support staff. I also wanted to keep to a single office.
We finesse our umbrella philosophy on a week-to-week basis by discussing things amongst ourselves, and I find that’s just easier to do when we’re all in the same place. We talk about the nature of a disease process, the nature of the psychology of our patients, and the nature of the healthcare economy and how it’s changing our prescribing habits and our practices. I like to be able to personally have discussions around topics like, “This is the way you converse with a patient to allay their fear” or “This is the way you respond to this request from a patient to create a good report.”
Vital Signs
New toy you’re excited about: SkinPen microneedling with PRP.
Trick that gets you through the day: Two liters of water. Also sitting down for lunch — never standing!
Best-selling product: Mad Hippie Vitamin C serum.
Most satisfying procedure to perform: This is going to sound so basic, but I have to say filler, because both patient and physician can see it together and enjoy it at the very moment of impact. It only looks better as the next couple days go by.
Parting piece of advice to give NYC dwellers on their skin: Humidify your bedroom in the winter — dry heat wreaks havoc!
Learn more about Tribeca Skin Center here!
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