Alright – so today we’ve got the honor of introducing you to Tina Moussally. We think you’ll enjoy our conversation, we’ve shared it below.

Alright, Tina thanks for taking the time to share your stories and insights with us today. Setting up an independent practice is a daunting endeavor. Can you talk to us about what it was like for you – what were some of the main steps, challenges, etc.

Utah passed the most progressive legislation allowing PA’s independent full practice authority for providers with more than 10,000 hours in their fields in 2021, and was finalized in 12/21. I chose to move here from Hawaii hoping to find an established practice to join but quickly realized that I was considered an outsider and despite over 16years of experience in dermatology and substantial need in the community, I did not receive and offer. I was forced to open my practice with very little experience in practice management or what that entailed. Because of my inexperience I chose to start very slowly, learning all positions, writing all my own protocols and SOP’s prior to hiring any assistance. I did no advertising and worked to carefully curate the practice slowly so as to not let it over run me. I did so in one leased room by myself for 8months before bringing on an assistant in month 9, an EMR system in month 10 and a biller in month 11. The first year was wrought with long nights of paperwork and processes but I was learning valuable insights in business and able to open with no loans by keeping overhead low and doing it myself. Year two was time to build up and that was harder than I had hoped. I took a loan out for a device and finally spent money on marketing. I was staying afloat and out of the red. In 2024 I purchased a commercial building for my practice, hired another staff member who is an esthetician which expanded the practice offerings and am turning a modest profit. I still do many things myself and will hire again as the practice grows. In retrospect while the slow curation of the practice was beneficial for my growth as an owner, it is better from a marketing perspective to come out large and impressive from the start so the growth curve and profits don’t struggle, however that also has significant business struggles, weaken patient care and can overwhelm providers. As a practice owner I would say you have to weigh out the benefits of taking out loans, hiring experts to manage things for you and going big from the beginning versus growing slowly, building through word of mouth and learning all aspects without loans but with less revenue coming in. I like to think of it as a slow burn build up versus the explosive and reactive growth.

Tina, love having you share your insights with us. Before we ask you more questions, maybe you can take a moment to introduce yourself to our readers who might have missed our earlier conversations?

As a PA my internship was in Oncology where I worked for a year and a half before I realized I was internalizing too much of the stress of critical and dying patients. I had done more surgical rotations in school and decided that path was more inline with who I am. I began working with a practice that had both a Plastic surgeon and a Dermatology provider where I split time in both fields. I learned a great deal in that position and felt drawn to Medical and aesthetic Dermatology which was in the early era of injectable aesthetics. I have been injecting now almost two decades and I would say that is my specialty. However, I know that I also feel most fulfilled when I am saving lives and using my medical left brain. I particularly feel gifted at skin cancer screenings and mole checks, having been dubbed a melanoma whisperer at my practice in Hawaii from a very high rate of cancer detection. Because of my plastics days I am highly skilled in surgical techniques and beautiful closures which I now perform on all of my skin cancer patients.
My practice is now integrated and comprehensive to care for the skin of every patient from the most serious of skin cancers to anti-aging injectables. The combination of care actually benefits all patients and delivers higher level results by enhancing the effectiveness of those treatments. By addressing underlying skin conditions alongside aesthetic improvements we see synergistic effects and patients achieve healthy and beautiful skin. We have a luxury boutique medical practice that has the feel of a medspa but focuses on prevention of skin disease and aging using evidence based medicine, natural looking aesthetic injectables and lasers.

Have you ever had to pivot?

I personally initiated and grew a practice in California in 2007 with two MD’s who subsequently cut me out of contracts. I gave them 12years of dedication while trying to politely fight for what was mine before deciding to walk away from a multi-million dollar practice that is still very successful today with only verbal recognition. I could have chose to pursue legal action but instead I walked away with the self restraint and self respect of knowing if I had built it before, I could build it again. While in hindsight I may have stayed too long, I did finally make the decision to choose my future rather than continuing to build something for someone else. I chose to pivot with the knowledge I could bet on me. The experience and lesson I gained there would be enough to carry with me into my future practice. Bottom line, get it in writing before you give your business acumen out for free, learn from mistakes as well as successes and believe in yourself so wildly you can walk away from anything, knowing what’s waiting for you will be even better.

Training and knowledge matter of course, but beyond that what do you think matters most in terms of succeeding in your field?

Success is really determined by doing what you love with passion. Training and knowledge mean nothing if you don’t love what you do. People can feel passion and while you might be able to fake it till you make it with training and knowledge, after all everyone has to start at ground zero, you cannot fake passion. You know you have passion for your field if you would do it for free; if you want to eat, sleep and live it not just work it. That doesn’t mean you can do it for free as any serious business must sustain itself to continue to exist. It means that if you weren’t succeeding in your field, your passion won’t allow you to stop trying to obtain success.

Contact Info:

• Website: https://dermhaven.com
• Instagram: https://instagram.com/ms.dermhaven
• Facebook: https://Facebook.com/luminouscomplexion
• Youtube: https://YouTube.com/@Dermhaven

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