Dr. Kassahun Bilcha: “Never use assumptions for decision making”

Never use assumptions for decision making. When data is lacking, I had assumed and made disastrous decisions. I should have focused on collecting data and delaying my decisions. As a part of this interview series, I had the pleasure of interviewing Dr. Kassahun Bilcha. Dr. Kassahun Bilcha is a distinguished dermatologist currently practicing at U.S. […]

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Never use assumptions for decision making. When data is lacking, I had assumed and made disastrous decisions. I should have focused on collecting data and delaying my decisions.

As a part of this interview series, I had the pleasure of interviewing Dr. Kassahun Bilcha.

Dr. Kassahun Bilcha is a distinguished dermatologist currently practicing at U.S. Dermatology Partners Dulles in Northern Virginia. He completed his second Residency in Dermatology from Emory University in June 2021. He attended medical school in his native country of Ethiopia where he practiced dermatology for six years prior to moving to the United States.

Thank you so much for doing this with us! Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?

I was born in a rural town in northern Ethiopia to a poor, uneducated mother and an former priest father who served the Communist Party. In a community where sending children to school was considered a luxury, my parents insisted I stay educated despite their significant economic hardship. My mother had just turned 14 years old when I was born. Her first child, a daughter, died perinatally one year before. That is why she named me “Kassa” for “compensation” or “replacement.” Like many Africans, I survived through lots of adversaries as a child including war, hunger, serious illnesses, physical injuries, and abuses. Being the first-born child in a family of 10, I learned to sustain myself fast, in addition to consistently attending school. I started working as a tailor at age 14 and supported myself and the family throughout high school. My younger siblings then followed in my footsteps when I left to attended medical school.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Your limit is your mind.” What I have now (and what my children have now) and what I had when I was growing up are as different as chalk and cheese. Convince your mind you will get the cheese, and the rest will be history. Most decisions in my life tended to put me back to the same lifestyle I grew up with. I constantly must teach my mind not to slip back into poverty. I dedicate one hour every day to quiet time to think and pray. This has helped me maximize the set-point limit in my mind. I still have made lots of disastrous decisions, but I have embraced those decisions and moved forward.

You have been blessed with much success. In your opinion, what are the top three qualities that you possess that have helped you accomplish so much? If you can, please share a story or example for each.

Resilience, flexibility, and positivity. Like everybody else, I am happy when I declare success. I am also happy when I declare failure, as I know most failures have upcoming success. It was very difficult to leave my established career and practice. Despite that I was happy to have a residency spot in dermatology in the U.S., and I enjoyed working as an intern and a resident. I think I was a good culture fit for my much-younger co-residents. If I didn’t succeed at going into residency in the U.S., I would have returned to my home country to be just as happy as I am now.

Let’s now shift to the main part of our discussion about ‘Second Chapters’. Can you tell our readers about your career experience before your Second Chapter?

I graduated from medical school in 2004 and randomly became interested in dermatology. My initial interest was public health, but I loved basic science so much that I was looking for a clinical specialty that best links basic science and clinical medicine. I soon realized dermatology can serve as a gateway to lots of fields including basic science, pharmacology, public health, infectious diseases, and other branches of medicine. There was no dermatology residency program in Ethiopia at that time, but with other five colleagues from all over the country, we were able to start a brand-new residency program at Addis Ababa University. I went back after three years and established my own department; at which time I was serving as the only dermatologist to a catchment area of 6 million people.

I soon became chair of the department and clinical director of a 400-bed teaching hospital. My academic profession also grew to associate professor. I practiced for more than six years, during which time I also taught dermatology for medical and paramedical students. My academic focus was on task shifting, in which mid-level medical professionals are trained to take on the role of physicians. I worked as director of a task-shifting training center that trained more than 3,000 healthcare professionals in five years. I also conducted basic science research in collaboration with Karolinska Institute with a focus on atopic dermatitis. As part of the International Society of Dermatology travel award, I spent several months in Iran learning cosmetics and tropical dermatology with Dr. Yahya Dowlati. I have also earned awards from the American Academy of Dermatology and the Society of Pediatric Dermatology. I then worked as a Fulbright Fellow at Georgetown University in 2012, and later served as the Aspen Institute New Voices Fellow in 2014.

And how did you “reinvent yourself” in your Second Chapter?

I didn’t necessarily reinvent myself as I have still maintained my prior dermatology career. However, practicing in a different country that you were trained is very challenging as medical care is strongly tied to sociolinguistic factors. The U.S. has tight regulations and rigorous process of licensing doctors from other countries. Essentially, I had to go back and review medical school textbooks and be able to pass the basic and clinical science exam called USMLE that is also given for U.S. medical students. Panels of expert patients should also assess your practical approach to patients, communication, and language skills. Given dermatology is one of the most competent fields of medicine, not only passing but scoring high is also a requirement. My prior background has boosted my application and I was able to match to dermatology. I then did a one-year internship and three years of dermatology to be able to practice unrestricted.

Can you tell us about the specific trigger that made you decide that you were going to “take the plunge” and make your huge transition?

I had always been against immigration that drains skilled manpower from Sub-Saharan Africa and other developing world. However, I made the difficult decision of moving to the United States at the end of 2015 for family reasons. My wife was living in the U.S. whereas I was living with our two children in Ethiopia. I then learned I must start over and “reinvent” myself for the purpose of maintaining my profession. That involved doing the same thing that any fourth-year medical student would do, from taking the multistep licensure exams, to applying for residency, interviewing at different programs, and then waiting for Match Day. I had to complete a one-year internship in internal medicine and then a three-year dermatology residency to practice independently again in the U.S. I accepted this graciously and was lucky enough to be trained in one of the most prestigious residency programs in the country. Despite being a fully licensed doctor even before I joined residency, learning never ends and I needed to learn every day, not only clinical science, but the culture and communication in the U.S. healthcare system.

What did you do to discover that you had a new skillset inside of you that you haven’t been maximizing? How did you find that and how did you ultimately overcome the barriers to help manifest those powers?

Not every doctor that immigrates to the United States succeeds. There is often a career switch due to the very restrictive licensing process. It is also a long process. It took me more than five years to be able to practice dermatology independently, after years of experience. I thought about this and never tempted to switch career or did other choices. It is also rare for an established doctor to be able to do residency again in the U.S., especially dermatology. I couldn’t find anyone like me who can be of example. Years passed and I made it. Retrospectively, I thought of the following two skillsets that has helped me succeed. I never thought I was equipped with enough perseverance and self-confidence to do this. I also think I have a start-up mindset and I naturally like starting things up. I intentionally avoid complaining on systems and often embrace the process even though it is not ideal.

How are things going with this new initiative? We would love to hear some specific examples or stories.

My start in my new practice has gone very well so far. I am pleased with how I have been received in the community and thrilled with the number of patients I have been able to help so far. At U.S. Dermatology Partners in Dulles, Virginia, we are giving compassionate care based on holistic approach of illnesses. I have a very amazing support team aligned with my interests and expertise. I focus on advanced medical dermatology and skin surgery. I have patients from all over Virginia, D.C., and Maryland specifically referred to see me.

Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

As social beings, we are surrounded by other people and need each other’s support to survive, even more to be successful. Many people have contributed to my success, but three of my dear friends: Sarah Wolfe, Neil Prose, and Scott Norton deserve a special mention. My wife Fetle has also always been part of my success stories.

Can you share the most interesting story that happened to you since you started in this new direction?

I have a few stories, but I don’t feel comfortable sharing, as they involve specific patient scenarios.

Did you ever struggle with believing in yourself? If so, how did you overcome that limiting belief about yourself? Can you share a story or example?

Always. I then say it is time to calm down and pray.

In my own work I usually encourage my clients to ask for support before they embark on something new. How did you create your support system before you moved to your new chapter?

During the process of transitioning, my family, colleagues, faculty members and fellow residents are part of the support system. I have also amazing support team at U.S. Dermatology Partners in Dulles, Virginia. I set my goals at the outset and disclose to the support team. I also openly discuss what I think are my weaknesses and encourage others to provide me feedback without hesitation. My principle is not to take any comment or suggestion personal. I like accommodating and keeping my support teams for life, as long as my goal is not significantly compromised.

Starting a new chapter usually means getting out of your comfort zone, how did you do that? Can you share a story or example of that?

Given my childhood life experience, I was able to accommodate wide range of life adversaries without significant discomfort. Yes, going back to internship and residency from well-established career is a life adversary. I was uncomfortable going through this process and needed to remind myself how it is rather a blessing to have this opportunity. I focused on the light at the end of the tunnel. I calm down and feed my brain every day on my future hope. My comfort level dramatically changed once I started practicing dermatology again. I am extremely happy with my current practice and situation but have also continued to thrive. I did not stop praying and reminding myself how blessed I am.

What are your “5 things I wish someone told me before I started leading my organization” and why? Please share a story or example for each.

I am currently the physician leader of my practice at U.S. Dermatology Partners in Dulles, Virginia. I have cultivated a leadership experience from my previous work in Ethiopia as director and chair. Here are the five things I wished someone told me before I became a leader in a big teaching hospital:

1. Never use assumptions for decision making. When data is lacking, I had assumed and made disastrous decisions. I should have focused on collecting data and delaying my decisions.

2. Time is the best cure. I tried actively managing conflicts in my organization when they are hot to realize lately that some conflicts will heal with time.

3. Rule-of-Law. Regulations and rules are the hallmark of leadership. As leaders we may accommodate certain decisions beyond regulations. I wish I had a reference for some of the decisions I made so I can defend myself and my organization.

4. Consistence. New ideas are often resisted by employers. Many change ideas fail because of lack of consistency. I attempted to implement new charting system for the teaching hospital I was leading. It failed after three months. I wish somebody told me to make this system consistent throughout the hospital and persist for few more months before I declare failure.

5. Resources, resources, resources. As a leader of a teaching hospital in developing country, I used to complain repeatedly how we are poor in resources. This might be partly true, but I now realize I have not used what is available first exhaustively that may include cheap manpower, friendly weather, cohesive society, supportive family members, and patients.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be?

STOP-HUNGER movement. I am convinced our world would have enough resources for everyone if we stop being greedy. Billions of children are still hungry. Millions die of hunger in Sub-Saharan Africa.

We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them. 🙂

Michele Obama; very humble and inspirational. I believe her vibe can re-charge anybody.

How can our readers further follow your work online?

My social media accounts aren’t very active, but readers can connect with me at: Facebook (@Kassahun Bilcha), Instagram (@kasbilcha), and twitter (@kbilcha)

Thank you so much for sharing these important insights. We wish you continued success and good health!

Thank you for giving me this opportunity.

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