Leading when you’re not the practice owner
Answers in Practice
By Megan Bennett, Staff Writer, November 1, 2025
DermWorld talks to Sama Carley, MD, FAAD, chief of dermatologic surgery at Sharp Rees-Stealy in San Diego, about exhibiting leadership qualities even when you don’t lead the practice.
DermWorld: Tell us about your practice.
DermWorld: As part of a multispecialty group, how do you exhibit leadership qualities in the workplace?
Dr. Carley: I’ve found it to be, so far, easier in these types of groups. For people who are taking jobs in either corporate medicine or big multispecialty groups, many want to just go in, take care of their patients, and go home. There’s a much smaller subset of people who want to take on leadership roles or engage with the group. I’ve found it a bit easier than in academics, where everybody is trying to climb a ladder. It comes down to speaking up and taking initiative. If you find something missing in that group and you want to start a program, initiate something, start a new committee, etc., the structure is there and, in most cases, supportive.
So many of us have imposter syndrome, especially early-career dermatologists. We’re joining this large group where we don’t fully understand the nuances of the office politics. A lot of us tend to stay quiet and say, “Well, I don’t know as much. I’ll let somebody else speak up.” But one of my mentors gave me incredibly useful advice that if you’re in a meeting, and you have a thought, speak up. It’s very likely that you know just as much or you’re just as engaged as everybody else in that meeting. That’s helped me a lot, for example, when leading our [Multidisciplinary Cutaneous Oncology] Tumor Board. In my group when I joined, there were many issues affecting patient care due to a lack of multidisciplinary coordination. The dermatologists felt unseen within the house of medicine and the structure of the group. That’s where I came in. We decided to establish the tumor board program, and we had many different specialties come together on a regular basis and led by a dermatologist. I do strongly believe that in cutaneous oncology, the dermatologist is the conductor of the symphony of treatment. We increased the lines of communication between specialties and increased multidisciplinary coordination. It truly comes down to just speaking up with confidence, even when you don’t think that you know enough or you’re having those mild bouts of imposter syndrome.
DermWorld: How do you balance this while still fitting into your workplace dynamics and not overstepping with colleagues?
Dr. Carley: When I first joined the group, because I didn’t have as good an understanding of the nuances of the political structure, I found a few people who I could trust who shared the goal of building out the Mohs program. I trusted them to help me navigate those political nuances. Now that it’s been a few years, and I understand the layout better on my own, it comes down to creating a good stakeholder analysis — sitting down and thinking about all the different players, what are all of their goals and motivations, and how can I get them to align with mine? That’s imperative when you have many minds and opinions together.
“A good leader is not cold and unflinching. A good leader treats other people like human beings and understands the people who they’re leading and working with.”
DermWorld: When you joined your current practice, how did you navigate managing staff who had been working for the group for many years?
Dr. Carley: When I joined, the Mohs program did not exist yet, so I joined as a general dermatologist. One of the dermatologists had just moved out of state, so I took over his office space, his patient roster, his medical assistant, everything. I got to know the staff, their kids, their goals and motivators, what was stressing them out in their personal lives, etc. We work together all day, every day. I see them as much as I see my family. If you go in and treat them like the human beings they are and get to know them, things just naturally fall into place. It all comes down to the fact that our staff are not roles. They’re not robots. They’re people. I’m still with my medical assistant that I had from day one.
DermWorld: What kind of resources and opportunities have you leveraged to grow your leadership skills in the specialty?
Dr. Carley: I was straight out of fellowship when I built out a Mohs program from scratch without any guidance within the group, so I used many of the resources from the AAD and American College of Mohs Surgeons, such as the AAD’s CLIA handbook and ACMS’s leadership program. In that program, I was paired with a mentor and had regular meetings. It was imperative when I was in the thick of it politically to have somebody who could be a confidential and objective sounding board.
DermWorld: What advice do you have for other dermatologists looking to lead from wherever they are?
Dr. Carley: I’m going to steal some words from Dr. Marta Van Beek. She talks about the importance of vulnerability as a leader. You have to show vulnerability. A good leader is not cold and unflinching. A good leader treats other people like human beings and understands the people who they’re leading and working with.
Lastly, there are many different leadership styles. Everyone’s personality is different. Everyone’s group dynamics are different. I don’t think it’s a one-size-fits-all. I’ve been given leadership advice in the past as a woman to be very stern because women don’t get taken seriously as much or our boundaries get pushed more. But while that advice works for some people, it doesn’t work for my personality style. I have to mesh work and personal to create a work culture I’m comfortable with. I want to get to know everybody that I’m working with, so I understand their good days and their bad days.
Sama Carley, MD, FAAD, FACMS, is chief of dermatologic surgery at Sharp Rees-Stealy in San Diego.
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This content was created with the particular needs of early-career dermatologists in mind. See the rest of our Career Launch resources for young physicians.
