Saving Hides

These docs get under your skin

by Heleigh Bostwick

Anita_Licata_Steven_PartilM.D.s Anita Licata and Steven Partilo focus on medical dermatology at their joint practice, Four Seasons Dermatology. The main office is in new quarters on Mountain View Drive in Colchester; satellite offices in Berlin and Middlebury are open a couple of days a week.

Anita Licata grew up in Cincinnati, graduating from Miami University in 1983. She traded her Midwest roots for New England when she was accepted into Yale University School of Medicine. After completing her internship and dermatology residency at Yale New Haven Hospital, she joined the faculty at the University of Vermont in 1993.

Rochester, N.Y., native Steve Partilo was finishing up his undergraduate degree at the University of Colorado at Boulder, which he earned in 1992. He spent the next two years working in the biotech industry before returning to his studies, this time at Columbia University in New York City, where he earned a master of public health in 1995. He headed to Vermont, where he entered the UVM College of Medicine the following year.

Medical degree in hand by 2000, Partilo spent a year interning at Fletcher Allen Health Care and returned to Rochester, where he completed a residency in dermatology. He then returned to Vermont and joined Four Seasons Dermatology, a practice founded by Landon Dennison, M.D.

“Landon retired the next year and I took over the practice,” says Partilo, who ran it alone for the next two years. In 2007, he persuaded Licata to join the practice.

“Dr. Licata was one of my mentors when I was in med school,” says Partilo. “She was on the faculty and we wrote a paper together.”

Their partnership — and Four Seasons Dermatology — has flourished.

“Our focus is on medical dermatology,” says Partilo. “I chose to specialize in dermatology because it’s a nice combination of medicine, surgery, pathology, and infectious disease.” He adds that he enjoys the variety and interacting with patients of all ages, from newborns to centenarians.

Although the practice covers all aspects of medical dermatology from eczema, psoriasis, acne, and rashes to removal of benign lesions and phototherapy, the physicians are especially concerned with detection and treatment of skin cancer. “Dr. Licata ran the melanoma clinic at UVM, so that’s a special area of focus for us,” says Partilo.

Licata’s interest in dermatology began when she took an elective course in medical school. “The visual nature appealed to me,” she says, “and I was fascinated at the way the skin gives clues to systemic diseases.”

They cite a huge rise in the incidence of melanoma, which they also see at the state level. An aging demographic and the shortage of dermatologists in the region, which covers the state of Vermont and Adirondacks, have made Four Seasons the largest private dermatology practice in the state. This includes the main Colchester facility and two satellite offices — one each in Berlin and Middlebury that are open a couple of days a week.

“There’s a big need for skin care,” says Partilo. “We probably have 30,000 visits a year. Some of them are multiple, but many of them are single visits.”

Licata and Partilo see patients from 8 in the morning until 3:30 or 4 in the afternoon. Notes and charting for patients take place after that. “Once a month we do ‘grand rounds’ where we meet with our colleagues at UVM,” says Licata. “We bring interesting or challenging cases with us to get opinions. It’s a great way to share information and pick each other’s brains.”

Running a successful medical practice is a challenge from a business standpoint, says Licata.

“We are working hard to make this a nice place to work and be one of the best small businesses to work for in the area, but we are doctors, not business people.”

For many years the practice was located off San Remo Drive in South Burlington, but Feb. 1, they moved to new and bigger offices on Mountain View Drive in Colchester, just off I-89. “Moving here was part of our goal to deliver excellent medical dermatology, as well as being an outstanding place to work,” says Partilo.

Stephen Yaw, AIA, of Yaw Associates in Burlington designed the new space. He worked with Licata and Partilo on two previous office renovations. “I wanted it to be an aesthetically pleasing space within the confines of an existing building,” says Yaw, adding that he kept the existing sidelights to allow natural light into the interior corridor.

Partilo is especially excited about his “treadmill desk,” which he uses on a regular basis. “It adjusts up and down and I can work and exercise at the same time,” he says with a laugh.

They asked Pam Carter to do the interior design. Carter, who owns the design firm Keeping Good Company in Vergennes, also works for the practice: one day a week in the Middlebury office and one day in Colchester. “Doctors Licata and Partilo wanted to make it a pleasant working environment for the staff and patients with a New England feel,” she says. “I went with a neutral palette and art work that complemented the incredible view here on the third floor.”

“The move went smoothly considering it’s a medical office,” says Karen Spear, operations manager. “We moved on a Thursday evening and were seeing patients on Monday morning.”

There are now 13 examining rooms and three procedure rooms. Each doctor has an office, and other small office spaces allow for more privacy for the medical assistants and physician assistants. There are also two new labs, one of them a “clean” lab, and the phototherapy unit. New amenities for the staff include a break room, storage lockers, and a larger kitchen.

The number of employees has grown from 10, at the beginning, to more than 30. The staff includes two medical doctors, five physician assistants, and one nurse practitioner, Diane Morrissette, who is in charge of the phototherapy unit. There are a number of full- and part-time medical assistants, a clinical manager, financial manager, and Spear, who says, “We get more than 250 calls a day here, so the front office staff rotates daily. Everyone knows all of the positions.”

Licata and Partilo have nothing but praise for their employees. As the practice grows they are looking to increase the number of medical assistants on staff. “We offer on-the-job training,” Licata says. “Some of our medical assistants have even gone on to nursing or medical school.”

Licata and Partilo use technology to meet some of the challenges of running their practice and have converted to electronic medical records. “We started using the medical software last October,” says Licata. “Charts take up a lot of room, and when you’re busy writing, there’s limited eye contact.”

They work around this by having medical assistants enter patient histories on iPads equipped with medical software specific to dermatology. “This leaves us more time to interact with patients and so far we’ve received good feedback, but it’s a learning curve,” Licata says.

Spear adds that, concurrent with the conversion to electronic medical records, the practice has adopted new software for practice management, which includes scheduling and billing. And since the move to the new, much larger office, a Nanny Cam lets the medical staff in back parts of the office know when a patient’s chart folder is available up front.

Increasingly complex government regulations, especially with regard to prescription prices and prior authorizations, are another challenge. “Eight or 10 years ago, most doctors went into private practice; now more than half are employed by hospitals. That has really changed the way doctors work,” says Partilo.

Despite the intense schedule, Licata, who lives in Burlington, finds time to practice yoga. “Bikram yoga is my passion,” she says. She and her husband, Tom, have been married since 1993. The couple met while she was at Yale. He was working for IBM, but now manages the household, which includes their two children, Isabel, 16, and Tom, 18.

Partilo met his future wife, Dunia, while he was traveling in Spain. They live in Shelburne with their two children, Isabella, 8, and Alexander, 5. Dunia works for the HowardCenter as a school therapist at a local elementary school.

The family enjoys skiing in the winter — both kids are on the ski team — and boating on Lake Champlain during the summer months. They travel to Spain every couple of years to visit Dunia’s family.

With healthcare in constant flux, it’s hard to plan ahead, but both partners plan to remain committed to their practice for the next couple of decades.

“We’ve been through a period of substantial and rapid growth — 20 percent annually over the past five years — and now it’s time to consolidate where we are,” says Licata.

“We might consider taking on a younger partner at some point,” says Partilo, adding that medical dermatology is not a frivolous medical elective, it’s a medical need that’s not going to go away.

“The bigger question,” says Licata, “is whether we will be able to navigate the future of healthcare.” •