If you were served legal papers at work tomorrow, would you know who to call and what your rights are?

Dr. Anna Chacon welcomes Dr. Gita Pensa, an emergency physician who survived a devastating 12-year malpractice case that fundamentally changed how she practices and teaches medicine. What began as a seemingly routine patient encounter in 2006 evolved into two jury trials, an appellate reversal, and an exhausting journey through a system few physicians truly understand. How do you maintain clinical excellence when every decision feels like it might define your career? Dr. Pensa's transformation from isolated defendant to informed advocate offers critical lessons for physicians navigating today's complex medico-legal landscape.

The conversation explores essential realities physicians face: understanding liability in follow-up care, recognizing the difference between adverse outcomes and malpractice, navigating insurance company decisions, and managing the emotional toll of litigation. Dr. Pensa shares hard-won insights about state-specific legal climates, medical board investigations, the true timeline of legal proceedings, and why understanding the system you're operating in matters more than expecting fairness. This episode provides practical guidance on protecting your practice, your mental health, and your ability to provide excellent patient care when the stakes are highest.

Dr. Gita Pensa is an emergency physician and Adjunct Associate Professor in the Department of Emergency Medicine at Brown University's Warren Alpert School of Medicine, where she has practiced since 2001. A graduate of the University of Pennsylvania School of Medicine (1997), Dr. Pensa survived a 12-year malpractice case that transformed her into a physician defendant well-being coach and consultant. She formerly hosted AEM Early Access podcast and regularly contributes to Emergency Medicine Reviews and Perspectives (EM:RAP), co-hosting its UC Max program. Dr. Pensa's honors include the 2018 National Faculty Mentor of the Year award and RI ACEP's Special Service Recognition Award for courageous advocacy.

In This Episode:

• (0:22) The patient encounter that sparked a 12-year legal battle
• (5:07) Liability concerns around patient follow-up and system limitations
• (10:46) Understanding your malpractice insurance and coverage gaps
• (14:46) Why settlements don't mean what you think they mean
• (17:01) Surviving two trials and learning to navigate the legal system
• (20:19) Medical board investigations and credential disclosure requirements
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients in remote and rural communities. As the first dermatologist serving Alaska's Bush region, she travels by bush plane to reach isolated communities. Dr. Chacon holds medical licenses in all 50 states, DC, Guam, and the U.S. Virgin Islands, providing both in-person and teledermatology services.

Resources:

Website:

• (00:00:00) - Ana Chacon on Medical malpractice litigation
• (00:03:53) - The doctor in the ER case
• (00:07:17) - Dr. Got ghosted by his patient
• (00:09:55) - Malpractice Insurance: What Does It Cover?
• (00:12:43) - The Importance of Going to Trial
• (00:17:04) - How to Win a Medical malpractice Case
• (00:22:13) - Insurance company sues for fraud

How does a physician turn personal struggle into professional purpose?

Dr. Anna Chacon welcomes Dr. Brittany Busse, a physician and healthcare disruptor who has transformed systemic challenges into powerful solutions for independent practitioners. Specializing in addiction, trauma, and mental health, Dr. Busse left surgical residency at UC Davis after experiencing discrimination and sexual harassment. Rather than let adversity define her, she founded the ViTel Health Physician Services Cooperative and now champions alternative revenue streams through remote patient monitoring and chronic care management. Dr. Busse shares her path from burnout to building a movement that empowers doctors to reclaim autonomy.

This conversation explores the hidden discrimination in medical training, the courage required to walk away from traditional pathways, and the victim-to-visionary mindset shift that changes everything. Can physicians truly thrive outside insurance-based models? Dr. Busse discusses overcoming fear and shame when starting private practices, finding your first 100 patients through authentic passion, and why the overachiever's trap keeps doctors from taking risks. The episode reveals how precision medicine, concierge care, and physician cooperatives are reshaping healthcare delivery while addressing the systemic abuse that drives physician burnout and threatens the future of independent practice.

In This Episode:

• (00:00) Dr. Brittany Busse - from telehealth startup pioneer to founding a physician cooperative that helps doctors find alternative revenue streams
• (05:35) Surviving systemic abuse in medical training and why most residents stay silent about discrimination and harassment they experience
• (14:21) The real cost of healthcare consolidation and why employed physicians are losing autonomy while corporate systems prioritize profit over care
• (31:47) Why the victim mindset keeps physicians trapped and how reclaiming your narrative changes everything about your practice
• (37:09) Conquering the overachiever's trap and marketing fears that prevent physicians from launching successful independent practices
• (40:59) Finding your first 100 patients through authentic passion and why you don't need a million followers to thrive
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients in remote and rural communities. As the first dermatologist serving Alaska's Bush region, she travels by bush plane to reach isolated communities. Dr. Chacon holds medical licenses in all 50 states, DC, Guam, and the U.S. Virgin Islands, providing both in-person and teledermatology services.

Resources:

Website: https://www.physician-cooperative.com

Main Platform: https://www.vitelhealth.com

LinkedIn: https://www.linkedin.com/in/brittanybussemd/

Podcast: Your First 100 for Medical Practices &am...

• (00:00:00) - How to Get Out of the Trap
• (00:00:31) - How to Change Healthcare Through Remote Medical Care
• (00:08:32) - One Residency Doctor's Fight for Personal Rights
• (00:12:07) - Patients speak out about their residency experiences
• (00:20:41) - Bradley on the Retinal Injury
• (00:28:10) - On the culture of surgical residency
• (00:31:43) - How to survive a Medical Services Organization relationship
• (00:37:12) - How do you get paired with telehealth companies?
• (00:39:45) - Start your own practice with White Glove

What are adaptogens, and why did one dermatologist believe they were the answer to COVID-era skin pathology?

Dr. Anna Chacon welcomes board-certified dermatologist Dr. Marianna Blyumin-Karasik, MD FAAD, co-founder of Precision Skin and Body Institute and creator of Stamina Cosmetics. Dr. Blyumin-Karasik shares her remarkable journey from childhood in the Soviet Union—where summers by the lake and forest therapy shaped her worldview—to establishing a thriving holistic dermatology practice in South Florida. Her approach centers on patient education, comprehensive algorithmic care, and the belief that true skin health requires addressing internal wellness, immune balance, and lifestyle factors alongside clinical treatment. What inspired her unique philosophy? How does connecting with nature inform modern dermatological practice?

The conversation explores the intersection of traditional dermatology and integrative wellness, examining how stress manifests in skin conditions and why adaptogenic ingredients matter for skin resilience. Dr. Blyumin-Karasik discusses building Precision Skin and Body Institute with her co-founder Dr. Leslie Clark—including opening the practice just weeks after giving birth to twins. She reveals the inspiration behind Stamina Cosmetics, developed during the COVID-19 pandemic when patients' stress-induced skin pathology reached crisis levels. The episode concludes with essential advice for emerging dermatologists: stay true to scientific integrity, resist trendy procedures lacking evidence, and build patient trust through education and credibility rather than chasing social media trends.

In This Episode:

• (00:00) From Soviet Estonia to becoming a dermatologist: How nature, immigration, and family values shaped a holistic practice philosophy
• (06:30) The serendipitous discovery: When one mysterious hospital rash revealed dermatology as a window to internal medicine
• (13:00) Building Precision Skin Institute: Opening a comprehensive practice weeks after giving birth to twins
• (19:00) Creating Stamina Cosmetics: Responding to COVID-era stress with adaptogenic ingredients and wellness rituals
• (24:00) The entrepreneurship journey: Self-funding skincare, banking support, and the power of knowing your "why"
• (28:09) Advice for emerging dermatologists: Stay true to scientific integrity over social media trends
• Share with a dermatology pro you know, like and subscribe to hear all of our future episodes!

About the show: Welcome to Skin Deep, a podcast designed for dermatology professionals. Host Dr. Anna Chacon, a distinguished dermatologist and author, shares her unique experiences and offers valuable insights on the future of dermatology, including telemedicine and teledermatology in reaching underserved communities. Dr. Chacon provides actionable recommendations for dermatology practices, emphasizing compassion, patient education, and staying current with advancements in the field.

About the host: Dr. Anna Chacon, board-certified dermatologist and founder of Indigenous Dermatology, specializes in treating patients in remote and rural communities. As the first dermatologist serving Alaska's Bush region, she travels by bush plane to reach isolated communities. Dr. Chacon holds medical licenses in all 50 states, DC, Guam, and the U.S. Virgin Islands, providing both in-person and teledermatology services.

Resources:

Precision Skin and Body Institute: https://www.precisionskininstitute.com/

Dr. Blyumin-Karasik's LinkedIn: https://www.l...

• (00:00:00) - How COVID is affecting skin?
• (00:00:35) - Meet Anna Chacon
• (00:13:54) - Dermatology Specialist opens her practice in Davie
• (00:19:51) - Stamina Cosmetics
• (00:24:14) - Start-up and Business Development
• (00:28:15) - Dr. Mariana's message for new dermatologists in their first