Mar. 11—New Hampshire's rates of skin cancer are well above the national average, and the co-founder of ConvenientMD urgent care hopes to increase access to the care needed to help prevent it.

Max Puyanic partnered with Ben Collins, who served as chief growth officer at ConvenientMD, to open Optima Dermatology & Medical Aesthetics, which has been in the works since both left the company in 2020 to find solutions for shortages in dermatologists. More providers are retiring than graduating from residency programs.

"You have to wait longer to see a dermatologist than any other type of specialist," Puyanic said. And the wait times continue to worsen.

The first location opened in Exeter last year. Others have since opened in Bedford, Portsmouth and Salem. The network also includes locations in Maine, Ohio and Indiana.

Eventually, the Exeter location will move into a new 10,000-square-foot facility in Stratham. The facility is set to open mid-May.

Melanoma is best treated if caught early as the chance of survival drops from 99% to 65% within as little as two months, Puyanic said. New Hampshire has the fourth highest rate of melanoma in the country.

"Melanomas have more than doubled in the last 20 years," he said. "That's because the ozone is getting thinner and people are spending more time outside. We are getting older as a society."

The goal of Optima is to see patients within two weeks.

Last week, Collins and Puyanic showed off the Bedford location at 176 S. River Road, which features "Revolutionizing Skin Care" signs throughout the building.

The mission includes increasing access "to expert dermatology care and delivering an unparalleled patient experience."

The space has 12 exam rooms, which includes specialized equipment for both medical and aesthetic care, including the highly specialized Mohs surgery. The company works close with primary care providers.

"We'll expand into new territories and continue to grow our existing practices," Collings said.

Recruitment efforts

Because of the demand, dermatologists can choose to live almost anywhere and may choose places like New York City, Miami or San Francisco. Collins said there are a limited number of dermatology residency programs available.

"We are out there saying, 'Hey guys, what about Bedford, New Hampshire? What about Concord, New Hampshire?'" Puyanic said. "We are trying to really create a lot of interest for dermatologists to come to New Hampshire."

In Bedford alone, the company hopes to eventually have up to four providers and a total of more than 20 workers, including nurses and medical assistants.

One recruit was Dr. Molly Cowdrey, a board-certified dermatologist who came from New York City. She completed her medicine internship and dermatology residency at Dartmouth-Hitchcock Medical Center in Lebanon and previously worked in Burlington, Mass.

When it comes to skin cancer, cure rates are super high if discovered early, she said.

"But if you have to wait for a really long time, things can go south pretty fast, especially with a melanoma diagnosis," Cowdrey said. "Also there is the mental reassurance. If you have a spot that you are worrying about for months on end it can be really taxing on the patient."

If the number of dermatologists were to do one skin exam across the entire population it would take five years, she said.

Dr. Ryan Karmouta, a board-certified dermatologist, came from Laguna Beach, California. The Harvard Medical School graduate completed a transitional year at Harvard-affiliated Cambridge Health Alliance in Boston and his residency at UCLA Health in Los Angeles.

"We convinced him to come to New Hampshire," Collins said.

The practice will include specialists in all areas of dermatology.

"That's not normal in dermatology," Puyanic said. "Often in most practices you have one dermatologist who does all these things."

Besides recruitment, Optima is also developing a training program for support staff, nurses and medical assistants.

A new venture

Collins and Puyanic started the new venture after leaving ConvenientMD in March 2020. Optima started with making an investment in a group of practices in Ohio and Indiana, both underserved by dermatologists.

"We decided to use that as a base," Puyanic said. "Initially, we started growing in Ohio."

The headquarters in Portsmouth has a patient service team that handles most appointments, and soon a pathology lab will be located.

A patient will have the option to travel to different locations if appointments open up. The company also works to reduce the cost of visits that come out of pocket for patients.

"This will become easier for us as we build up more offices and bring on more physicians," Collins said. The company wants to be in every major region in the state.

Optima — a name which has nothing to do with dermatology — became a brand after acquiring the practices, Collins said.

"We wanted something that spoke to our mission," Puyanic said. "So revolutionizing skin care, creating access, providing the highest level of care and treating every patient the way we want our friends and family treated."

Melanoma can become life-threatening in as little as six weeks if untreated, but is highly preventable with annual skin checks.