EP208: Dr. Adam Rubin on Medicine, Investing, and Life Lessons

Dr. Adam Rubin on Adapting, Coalition-Building, and Time in a Dermatology Career

Christine hosts Dr. Adam Rubin, Director of Dermatopathology at NYU Langone and Editor-in-Chief of the Journal of Cutaneous Pathology, reviewing his extensive roles in nail disorders, dermatopathology organizations, and major textbooks. Rubin shares an anecdote about taking a medical dermatology fellowship with Dedee Murrell in Sydney after discovering a fellowship listing was a misprint, and describes learning to adapt to different clinical cultures, emphasizing that individuals must adjust to existing systems. He advises building forward momentum in small steps, using coalition-building and organized meeting processes learned at the AMA, and focusing on relationship-centered leadership and big-picture decisions in journal work despite resource limits. Career tips include doing work you love while maintaining non-work interests, learning investing basics early to benefit from compounding, and being selective with time by thoughtfully saying no. 

00:00 Welcome and Guest Intro

01:39 A Fellowship Misprint

03:05 Adapting to New Systems

03:48 Career Progress and Coalitions

05:40 Leading a Journal

06:51 Do Work You Love

07:40 Investing and Compounding

08:31 Protect Your Time

09:10 Host Reflection on Stress

Transcript

Christine Ko: [00:00:00] Welcome back to The Girl Doc Survival Guide. Today I'm very happy to be with Dr. Adam Rubin. Dr. Adam Rubin MD is the Director of the Section of Dermatopathology in the Ronald O Perelman Department of Dermatology at the New York University Grossman School of Medicine and NYU Langone Health in New York City. He also directs the nail clinic and sees patients of all ages at the New York University Grossman School of Medicine. Dr. Rubin specializes in nail disorders, nail surgery, and histopathology of the nail unit. He's currently the Editor-in-chief of the Journal of Cutaneous Pathology. He's also lead editor for the fourth edition of Scher and Daniel's Nails: Diagnosis, Therapy, Surgery. He's an author of the third and fourth editions of the Atlas and Synopsis of Lever's Histopathology of the Skin, and an Associate Editor of the 11th and 12th editions of Lever's Histopathology of the Skin. Dr. Rubin is a current member at large of the Board of Directors of the American Society of Dermatopathology and was [00:01:00] previously a member of the Executive Committee of the International Society for Dermatopathology. He is a board member of the European Nail Society and directs the annual European Nail Society Histopathology Workshop. Dr. Rubin is the president of the Council for Nail Disorders and has served as the Secretary Treasurer and Treasurer of that organization. At the American Medical Association House of Delegates, Dr. Rubin serves as a delegate from the American Academy of Dermatology. Wow, that's a lot. Welcome to Adam. 

Adam Rubin: Thank you so much, Christine. It's really an honor to have this invitation to join you on The Girl Doc Survival Guide. Thank you very much. 

Christine Ko: You have done and you do so much. Can you just start off with a personal anecdote so you seem more human?

Adam Rubin: Absolutely. I did a medical dermatology fellowship with Dedee Murrell in Sydney, Australia. I did this after the end of my residency and before my dermatopathology fellowship. It's this incredible opportunity that I'm very thankful [00:02:00] for. I learned a lot about adapting to a new culture. There's a funny story, which I'm not even sure Dedee knows. At the time, I was on the American Academy of Dermatology Resident and Fellows Committee, and as part of this committee we had a pdf file, a listing of all the different fellowships in the world really. One of them said Dermatopathology with Dedee Murrell in Sydney, Australia. I contacted her, and it turned out that it was a misprint in the book. It was actually dermatopharmacology. But we were on the phone. We were discussing it, and we had a mutual interest. I ended up doing it, and it ended up being one of the most important experiences I've ever had. It was a medical dermatology fellowship where I was rounding on inpatients with residents around the inpatient consult service. I had an HIV dermatology clinic. There was a blistering disease clinic that we went to at the Sydney Children's Hospital. There were of course, a lot of blistering disease patients in Dedee's practice, [00:03:00] so I was really exposed to high level medical dermatology. Dedee is a really inspiring person. I was used to the American style of rounding that you would go and the residents would be ready and the dressings would be open. And they just had a different style, much more relaxed.

I had gotten some feedback where, essentially the message was, You need to adapt to the style here. I learned to adapt. And so I've taken that lesson over time, and it's been very helpful. The lesson being, Other people are not going to adjust to you. You have to adjust to them in systems that already exist. I remember, this is again gonna date me, but we would bring roles of film to be developed into photos. I remember saying to the guy. Please, let me have this back in two days or something. And he looked at me, just shocked. It was never gonna happen on that time schedule.

Christine Ko: Do you have any tips from your career since you have been at two different academic centers, mainly UPenn and then now NYU, but also in Australia; your work with the AMA; and your [00:04:00] role as Editor of the JCP; and your involvement with all these books? What do you think?

Adam Rubin: The first thing I would say is that it's always important to be moving forward, to be making progress. Of course, breaks are needed. But really to keep a long-term outlook and just move forward with what you're doing with intention, even if it's small steps. These go through seasons in life. Sometimes you're busier, sometimes you're less busy.

One thing I felt was very helpful, from the American Medical Association, I learned a lot about the importance of coalition building for support in really any issue. In order to move forward, you really need to work with people who have shared interests to support particular positions. This really applies to, besides organized medicine, really anything in life. If you have a group of like-minded people together with a similar goal, that's how you get things accomplished. The larger amount of people, [00:05:00] usually the greater the strength of the recommendations and the impact, with like consensus statements. The ASDP does that where a group of experts come together, and their opinion then means a lot more than just a single person, even a small group. The other thing I found from the American Medical Association: the importance of an organized process or a parliamentary type process in meetings and decision making. It doesn't have to be super formal, but to allow different people to speak, be able to be heard. It's important that the majority opinion is appreciated, but a minority opinion is also heard and respected. 

I've really learned a lot working at the JCP. I've learned some lessons in terms of navigating systems with limits on resources. I think we are all in situations like that these days. While AI and things like chat GPT can help us, there's still a human element, [00:06:00] and there's still things that you have to navigate.

With the JCP, I've learned to think about the big picture of handling complaints and how to manage decisions. I'm the person that has the overall view about, How does this individual decision affect the society, the people who are contributing, and really what's the best for the society and for the journal and for the people that are contributing? The JCP exists to serve the American Society of Dermatopathology and our members. This guides me in different decisions.

One of the most important things I do in the JCP, as the Editor in Chief, you would think that that the most important decisions are about this manuscript or that word or something like that. The most difficult and important decisions involve relationships with people and trying to help people.

What's your tip for navigating a career?

Christine Ko: The main thing is to do something that you love. That's my main thing. And [00:07:00] then the other thing, though, not so much when I was younger, but increasingly now, I want my life to also have stuff that's not work. I really do still love what I do. I love our jobs, I love our work.

When my kids were younger, it was work, and then my time would be spent with my kids, taking them to birthday parties even, or a soccer game or whatever. I enjoyed that, but now that my kids are older, I think there's a little bit more space, and I realize that I should do something for myself that isn't related to work, even though the work that I do is for myself 'cause I enjoy it.

Adam Rubin: Great. That's great. 

Christine Ko: Thank you, Adam. Is there anything you wish you had known earlier? 

Adam Rubin: This may be silly, but probably the number one thing is actually I wish I had learned the basics of investing earlier. Things like understanding mutual funds and the ETFs. Everything boils down to the power of compounding with time. I remember getting [00:08:00] home from residency, taking a nap, and then getting up later and working. And I would advise younger listeners to look into investing. It's really worth the time because it is really with time that finances can grow. Compounding. And I'll say, starting early. Physicians, we're just so busy, and this is a very important thing. I wish I had looked into it earlier, and that I wasn't so focused on the acute day-to-day things, 'cause it's very important to start early.

The other thing is to examine very carefully what you're doing with your time. You alluded to this about your children, and the time that you have now. Henry David Thoreau, he has this quote, something like, I enjoy a wide margin to my life, which sort of has a pathology, a dermatopathology angle to it also. Time is the one limited resource. So before agreeing to something, really think critically about it and what you will give up [00:09:00] by saying yes. Be comfortable in being selective 'cause it gets easier telling people no over time.

I don't wanna turn it back on you, but I'm interested to learn from you. What's one thing that you wish you had known earlier and would impart to the listeners? 

Christine Ko: It's similar to what you said. The investing thing goes along with what I said a little bit before to spend some time doing something else, and investing is outside of work, but it's definitely something that will benefit us.

For me, I wish I had known to be less stressed. We don't know what our lives are gonna be like. So now I know at this point, my one kid is 18, one kid is 15. Some not so great things have happened. Some really great things have happened, and it's fine. It's been okay. I wish I had just known to go back a little bit and be less stressed and be more accepting of This will all be fine.

 Sadly, the audio recording cut out [00:10:00] here so I don't have the rest of the conversation that I had with Adam. I will ask him again and will release another one with Adam once we record again.

Thank you for listening.