Certainly it was my father who introduced me to what I do today. But what really drew me to the field is the variety of challenges we face - every patient and every patient situation is distinct, every treatment unique. And every problem requires working through a plan, and presenting options.

Right up front I will say what I can do - and what I can't do. From the first conversation it is about describing and communicating achievable goals. Some will think, for instance, that a laser treatment is a kind of magic wand. It may take a while to understand there is no magic wand - only preparation, understanding and skill.

The patient today is more sophisticated than when I first started, certainly, but the patient is not necessarily better informed. The Internet and "Reality" TV have changed the whole dynamic of information gathering, and to some extent it has changed expectations as well.

And because of all of this, I spend more time with patients educating them about what is correct - and what is not correct. I will give a patient a 25-page booklet that I've prepared - and I'll expect them to read it. And most of my patients do.

I have recently installed Touch MD, A state of the art computer education system for use during our consultations. After meeting with me, patients can watch the information and review the consultation at home, often sharing it with family members. I have also invested in Understand.com and Michaelangelo Network which are web-based patient education tools.

In certain procedures a computer image can aid in describing what is going to happen, but before any procedure is even contemplated there is a substantial communication process. There will likely be at least two visits with me, and one may include a parent or a spouse. It's important to give and receive feedback with a trusted third party.

In the final analysis, my goal is your goal. And we reach that level of understanding together.