Elyse Rafal, MD - Dermatologist in Stony Brook, New York

Eva Sheie (00:03):
The purpose of this podcast is simple. We want you to get to know your doctor before meeting them in person because you're making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There's no substitute for an in-person appointment, but we hope this comes close.

(00:24):
I'm your host Eva Sheie, and you're listening to Meet the Doctor. Today on meet the doctor. My guest is Dr. Elyse Rafal. She is a board-certified dermatologist, correct?

Dr. Rafal (00:39):
Yes I am.

Eva Sheie (00:40):
And are you in the city or Long Island?

Dr. Rafal (00:43):
I'm in Long Island. Stony Brook, Long Island.

Eva Sheie (00:46):
Welcome to the podcast.

Dr. Rafal (00:48):
Thank you for inviting me.

Eva Sheie (00:50):
I understand this is your first podcast.

Dr. Rafal (00:51):
This is my very first podcast.

Eva Sheie (00:54):
Okay, well you're in the right place and we're here to talk about you. So the best place I can start is to, why don't you tell us about yourself?

Dr. Rafal (01:02):
I am a board certified dermatologist. I'm a private practice in Stony Brook, New York. And I'm a medical and a cosmetic surgical and a research dermatologist. So my practice is a little different because I do medical 50% of the time and together 50% of the time I do cosmetics and I also do a lot of surgery and I also have a research practice. So about 50% of my time is devoted to research. And I do research with pharmaceutical companies, cosmetic companies, and industry developing products that are either not FDA approved at all or are FDA approved for a different indication or post-marketing studies. So it's, it's very interesting. And I run the gamut of doing studies on topical products like creams to systemic products like IV. So I do cosmetic studies and I do also do studies with oral medicines and injectables.

Eva Sheie (02:06):
So how do you find patients to be part of the studies?

Dr. Rafal (02:10):
Well, I've been doing this a long time, <laugh>, so I've been at the facility I'm at for about 23 years. So I have, you know, a lot long term patients. I treat their grandparents, their grandkids and so forth. So we have a big database of patients and I've been working with all the major pharmaceutical and cosmetic companies in the industry for a long time. So they come back from multiple different kinds of studies and it's a lot of fun. It's really a lot of fun. I totally enjoy it.

Eva Sheie (02:43):
It takes a bit of a detective to do studies and keep doing them because they're a lot of work.

Dr. Rafal (02:48):
They are a lot of work. And I tell people because people call me up all the time, I want to do studies so tell me how to do this. And you have to really love patients first of all because you're seeing patients and you also have to love paperwork as much as you can because a lot of paperwork, if you hate paperwork you can't do it because there's so much paperwork. We have consent forms and we have to get IB approval, institutional board approval and you know, we have to write papers at the end and there's a lot of, a lot of work involved that's not patient care and you have to have good research coordinators who are trained and there's a lot of training involved in research and a lot of regulations. So it's a lot of fun.

Eva Sheie (03:36):
Do you enjoy the paper part?

Dr. Rafal (03:38):
I do. I don't mind the paper part. I'm a writer by nature, so in my spare time I like to write poetry and so I'm a writer so I don't really mind the writing and the paperwork. So I'm a visual person so I like to see it in front of me. So whether it's a patient's face, I'm visual or a paper, the written words. So I enjoy that.

Eva Sheie (04:03):
One of the most frustrating things for me is finding a paper that I want to read and then not being able to to get the paper.

Dr. Rafal (04:11):
Yes.

Eva Sheie (04:11):
So I do find myself emailing doctors here and there If I really want to read it, I'll just send an email and say, can I please read this?

Dr. Rafal (04:18):
Exactly. Exactly. It's a way of keeping patients informed also. Mm-hmm <affirmative>, you know, so you can email patients about different studies that you have going on, put it on the website and so forth.

Eva Sheie (04:32):
Is there anything that you're studying right now that you're particularly excited about?

Dr. Rafal (04:36):
Oh, I'm always excited because there's so many interesting studies going on right now. It's, we're doing some really cool studies with cosmetic studies, facial filler studies and new fillers for the face and new medicines for psoriasis, topical and injectables and some pills and new medicines for eczema, atopic dermatitis. We're working on some toenail fungus studies. So some really exciting stuff coming out. Acne studies.

Eva Sheie (05:10):
All things that have a huge impact on people's lives.

Dr. Rafal (05:14):
Exactly. It's a way of getting medicines to patients before they're FDA approved or after they're FDA approved for a new indication. So it is really,

Eva Sheie (05:25):
People find you for specific conditions when they know that you're doing the research. Like do they actually seek you out for help with things that, that they know are coming down the line that aren't approved yet?

Dr. Rafal (05:37):
Absolutely. Absolutely. So yeah. And

Eva Sheie (05:41):
So those are people who are really almost at their wits' end?

Dr. Rafal (05:46):
I would say some of them, yeah. And some of them just like to be on the cutting edge of research and try out new medicines. Some like to further research and some just enjoy the whole research process. There's a lot of education involved so you get to really spend time with the patients and my coordinator spend a lot of time with the patients, educating them on their condition because they may be newly diagnosed with the condition, not know how to treat it or who've given up. So it's a lot of patient education. So it's just like really seeing patients in my clinic where I really like to talk to patients and I love to educate them. I have a lot of handouts in my general practice. I have all kinds of acne handouts and how to use medicines and all kinds of handouts for aging skin, how to apply products because I have my own product line and we have well over 30 products in my product line and we sell also other brands and it's a way of getting patients on the proper treatment and while they're in your office you can give them, you know, medicine.

(06:56):
So it's really good.

Eva Sheie (07:00):
Is there anything that you wish people knew about dermatology that they don't?

Dr. Rafal (07:05):
Yeah, definitely that I really wish people knew that dermatology is not just the skin, it's the skin, hair and nails and you know, dermatologists treat the hair because I have alopecia, I forgot about that, I have an alopecia study, and hair loss is a huge problem for people and hair conditions. So, and I like hair and nails. A lot of skin conditions have nail manifestations and there are a lot of nail diseases and so you have to try to cheat the whole person from head to toe, the hair, the nails and the skin. So I really wish people knew that, that we do it all so they don't have to go to a different type of doctor. Because sometimes they go to a different type of doctor and sometimes it would be more appropriate for them to see a dermatologist for it.

Eva Sheie (07:59):
Are there things you can see about someone's health by looking at their fingernails?

Dr. Rafal (08:03):
Yeah, there's definitely things that come out in the nails that trigger a diagnosis of a condition and absolutely.

Eva Sheie (08:13):
Can you give me some examples maybe?

Dr. Rafal (08:15):
Oh yeah, sure. I see a lot of psoriasis patients and there's something called nail pitting and where the patients get little pits in their nails and that's one of the signs of a patient who has psoriasis. And sometimes and you can look at someone's nails and tell if they have a nail fungus and they get thickening yellow nails and separation of the nail tape on the nail bed and so forth. And there are other things that can cause these things. So you have to be a diagnostician and that's why I love dermatology because you, it's so visual and you really have to put together the patient's and the clinical presentation of the patient.

Eva Sheie (08:59):
You said earlier that you also do surgery. Yes. So what kinds of surgery do you focus on in a dermatology practice?

Dr. Rafal (09:08):
Well, I love surgery. I do a lot of biopsies because we do biopsies to confirm or to make a diagnosis and also to remove lesions. So I do a lot of excisions cut out skin cancers or a mole if someone has a funny looking mole or melanoma. And so I do a lot of ma I do plastic surgery like closures, so that cosmetically their results are very elegant looking. And I do some other surgeries like laser surgery. So we have lasers in our office, all kinds of indications. I do laser hair removal and we do, I have a laser for acne and a laser that does photo damage or aging skin, brown spots, red spots or vascular lesions. And so that's a form of surgery. And we also do chemical peels, acne surgery and so forth.

Eva Sheie (10:14):
I have a very good sense of what your practice looks like today and I want to ask you how you got here and maybe can we go back in time a little bit and tell me about your training?

Dr. Rafal (10:25):
Sure, sure. Well, I graduated from University of Pennsylvania in Philadelphia and I loved college. bring me back there. It's so, so nice. <laugh>.

Eva Sheie (10:36):
I just went to my 25 year reunion. It was perfection.

Dr. Rafal (10:40):
Yes, it was great. And yeah, after college I did an internship and then I did, well first I went to medical school. I was at Harvard and I was also at Downstate and I graduated with honors and distinction and research. I was doing research back then. I knew I wanted to do some research and clinical dermatology. And then I went to University of Michigan for dermatology and it was the best program for clinical research and clinical dermatology. So I, I loved it there and I wanted to kind of get away from New York and have that Midwestern kind of environment. And I loved Ann Arbor. It was a great place to train. I got excellent training and it was really nice. A little cold though. Mm-hmm. <affirmative> a little cold, but it was very nice. And after that I decided I wanted to go back home and I went back to Stony Brook and I was in academics actually at Stony Brook Hospital, Stony Brook University, which is about 1.7 miles from my office now. And I was there for almost seven years. I opened up a dermatopharmacology where I did clinical trials half the time and other half the time I saw patients. And then after seven years I went into private practice around the corner and I really do the same thing in a private practice setting. And it was, it was a lot easier to get to do things in a private practice setting as opposed to a university. So I've been happily there ever since for 23 years.

Eva Sheie (12:19):
And how about your family? Tell me about them.

Dr. Rafal (12:21):
Ah, great. I have two beautiful children. I have a son who's in Austin, Texas, and he's a math and physics major and he is getting his PhD in math and physics and he's in Austin, Texas enjoying himself. And then I have a daughter who goes to Marist College and she's a finance and business major. So we'll see what the future holds for her.

Eva Sheie (12:49):
So she's, is she almost done then? Yes.

Dr. Rafal (12:52):
Yeah. Yes,

Eva Sheie (12:53):
Yes. You've almost launched them both.

Dr. Rafal (12:56):
 <laugh> I know. Yeah. They are fully launched <laugh>.

Eva Sheie (13:01):
That's wonderful. Is there anything you want to tell us about what you like to do outside of work?

Dr. Rafal (13:09):
Well, I love Manhattan. I really do love Manhattan and I love to go to the theater and museums and I love to travel, so I have a passion for traveling. You could almost take me anywhere and I'll go. So I, I love to see different countries and meet different people and learn their culture.

Eva Sheie (13:32):
What is, let's see. Give me a place you never want to go again and the next place that you want to go that you haven't been.

Dr. Rafal (13:41):
Ah, there's so many. You know, I don't know if there's any place that I would say I would definitely not go to, but I was a little turned off by China because there was so much smog when I went there. The pollution was horrible. So it's funny because when we just have this problem, what's going on in New York, I thought about that and it was that kind of situation and I heard they cleaned it up. Otherwise, I like China, it's very interesting, but I didn't like the pollution. Yeah. And there's so many places on my hit list that I haven't been to. It's <laugh>

Eva Sheie (14:17):
Well, what's next on your list? Where are you going?

Dr. Rafal (14:20):
I, you know, I'm thinking about Portugal, I'm thinking about Thailand. There's so many places I'd like to go. Croatia, I haven't been to a lot of places. So I have like a laundry list.

Eva Sheie (14:32):
<laugh>, something to look forward to.

Dr. Rafal (14:34):
Exactly. A lot to look forward to.

Eva Sheie (14:37):
So if you have maybe a perspective patient who's listening today or someone who maybe isn't in New York and is hoping to learn more about your work and maybe your research work, where can they find more about what you're doing?

Dr. Rafal (14:53):
On my website, it's always a good place to start. They can go to my website and learn about me, my practice and what we do. So I think that website is always a good place to, for patients to find out. And they can call up and come in and see me

Eva Sheie (15:11):
In your website. I'll put the link in the show notes, but for, for us, can you tell us what it is?

Dr. Rafal (15:16):
rafaldermatology.com.

Eva Sheie (15:18):
R A F A L. Right. That's great. It's so wonderful learning about your interesting approach today and I really appreciate you taking the, the time to come see us on a Saturday afternoon when it's beautiful outside. You should be at a museum.

Dr. Rafal (15:35):
<laugh>. The pleasure's all mine. Thank you so much.

Eva Sheie (15:38):
Thank you Dr. Rafal.

Dr. Rafal (15:38):
Thank you.

Eva Sheie (15:44):
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