Learning Laser Tattoo Removal By Volunteering For A Community Clinic
I applied to become a volunteer at a community clinic here in Portland a few months ago and the only position they had available was for a tattoo removal doctor. The clinic is called Project Erase, a nonprofit tattoo removal clinic that charges anywhere from $25-55 per treatment, based on a sliding scale of the client’s income.
I would have loved to see patients in clinic instead but I jumped at the opportunity to learn something new and still be able to give back.
The Application Process
The application process was quite a bit more involved than I expected. It took 6 months from the time I applied to the point of getting my first shadow shift scheduled.
The nice thing is that I am now in their system and with a clear background check I can easily transition from tattoo removal to working in their community clinics.
The Training Process
I did my first shadow session last night, working under a doctor who does this work about once per month. There was a medical scribe and a front office person who all helped me with the orientation process.
My critique is that I didn’t find the clinician very knowledgeable when it came to the working with different colors, dealing with complications and managing patients who react strongly to the laser therapy. In his defense, he was quite honest about his experience level and also mentioned that I should shadow the more experienced docs as well.
He was absolutely delightful to work with. He had the perfect personality to work there, lighthearted, funny and friendly. I really enjoyed my time there, we all laughed a lot, a big plus when working a night-shift.
The CLIENTELE
Project Erase is run by Outside In, a community clinic focusing on homeless youth and the impoverished population of Portland.
Those with gang and prison tattoos are the main focus of this program. These are individuals who are trying to transition back into society but encounter major obstacles due to their visible ink.
There are quite a few mentally ill individuals in this unique patient population, requiring a little more work upfront to gain the trust of such client.
The Equipment
A tattoo removal clinic can be quite small apparently. There is one exam room with a laser, adjustable exam chair, goggles and a skin cooling device. There is a computer for documentation and an A/C since the machine can heat up the room quite a bit.
The waiting room is simple with multiple chairs and one front desk person who does all the scheduling. They actually have a really nice electronic scheduling system but not all the clients have online access or digital devices allowing them to access the scheduling software.
The laser we use is a Quanta Q-Plus C device which has a few different heads for different size spot treatments as well as a wide enough wavelength broadband which allows treatment of the dark colors (blacks/blues), yellow/orange/reds, and blue/greens.
The Procedure
It’s quite simple, easier done with 2 people, an assistant who holds the chiller device (The Syneron Synercool) close to the skin and the clinician who runs the laser head over the inked areas.
It’s best to run the laser beam only over the areas with ink, applying the beam on normal skin just increases pain and creates more inflammatory tissue which has to heal.
As the tattoo removal process advances for a patient who is on their final treatments, we generally turn up the joules to the highest setting, which means the laser beam is strongest, offering the highest penetration. This is when patients describe the most amount of pain, get the most amount of redness and ‘burns’ after the procedure.
Increasing the duration between treatments, using more cooling measures of the skin and focusing the beam only on the inked skin can all help diminish side effects.
The frequency setting is wonderful because it can allow a skilled clinician to go over the inked area much quicker which is really helpful for patients who experience a lot of discomfort.
When set at a frequency of 1 Hz we apply 1 zap every 1 second… that’s tedious and painful. However, in tight corners and on sensitive areas including eyelids etc we have no choice but to turn down the frequency. On our device we can turn the frequency up to 10 Hz, delivering 10 zaps per second. If I don’t move the laser head fast enough I would apply 10 zaps to the same area, terrible for healing and I can potentially create excess scar tissue.
A Potential Business Model
The nonprofit model is actually quite intelligent though it can step on the toes of those who are trying to make money by removing ink the traditional way.
I didn’t decide to volunteer in order to start my own tattoo removal business, it’s not the kind of financial endeavor that excites me. However, I always like to learn new skills which could be potentially income-generating in the future.
In a nonprofit model one starts a business in order to provide a service possibly to those who cannot afford it otherwise. By creating a sliding scale price model, a person in a lower socioeconomic status can still take advantage of the services.
Naturally, there wouldn’t be as much money to be made. This is where my whole financial independence philosophy comes into play for a doctor. It’s far easier to be a clinician in this country if money is not a driving factor.
I can open a non-profit, be essentially tax-exempt, have the majority of my office equipment donated to me, hire volunteers for office-staffing for free and still pay myself a reasonable though discounted salary in order to keep the business running.
How to Form a Nonprofit Corporation (National Edition): A Step-by-Step Guide to Forming a 501(c)(3) Nonprofit in Any State (How to Form Your Own Nonprofit Corporation)
Furthermore, I can apply for grants or hire grant writers who can help me funnel private and public funds to my business.
It’s very easy to cross that fine line and take advantage of the system. As a matter of fact many of the larger medical groups take advantage of the nonprofit status by operating under a for-profit and not-for-profit model simultaneously.
The Reason I Volunteer
I am drawn to volunteering because it allows me to give back to my local community while I get to do the things I enjoy doing. Whenever money is taken out of the equation I feel that I have an easier time convincing myself as to the exact reason why I am doing something.
By volunteering I also learn new skills, meeting new people, broaden my network, create a good name for myself and maintain my clinical skills.
I couldn’t imagine doing this if I already worked full-time at my job. Even less likely if I had a family with kids and pets and a fleet of cars to maintain. As I’ve simplified my life it has become easier to fill my time voids with meaningful projects.