Hope Cook, PA-C, is a physician associate, a podcaster for a show called Recharting Your Life with Hope, and an author of a new book titled 'Healing Clinician Burnout: How to Revive Your Life and Career.'

Hope Cook, PA-C

Top Clinical Insights from SDPA 2025: Eczema, Alopecia, Burnout, Vitiligo, JAK Inhibitors

In late June, physician assistants convened at the 

SDPA Annual Summer Dermatology Conference

 in Washington, DC, from June 25 – June 29th, to attend talks from other physician assistants and clinicians.

in people of color. This edition of HCPLive Five spotlights interviews on tips for treating chronic hand eczema, using trichoscopy to differentiate alopecia subtypes, preventing career burnout, breaking down vitiligo misconceptions, and the workup before initiating JAK inhibitors for alopecia.

Tips to Optimize Diagnosis, Management of Chronic Hand Eczema with Adam Friedman, MD

Adam Friedman, MD, professor, chair of dermatology, and director of the Supportive Oncodermatology Program at The George Washington University School of Medicine & Health Sciences, shared clinical insights on diagnosing and managing chronic hand eczema (CHE), emphasizing its diagnostic complexity. CHE has symptoms that overlap with conditions, such as psoriasis, lichen planus, and secondary syphilis. In his interview, Friedman underscored the importance of patient history, especially recurrence, duration, and occupational exposure, and highlighted visual cues to differentiate CHE from other dermatoses.

He also noted that CHE often lacks sharp demarcation, unlike palmoplantar psoriasis, which favors pressure-prone areas. Recognizing patterns like lichenification and confluence helps inform diagnosis.

Trichoscopy Provides Clearer Differentiation of Alopecia Subtypes, With Amy Spizuoco, DO, FAOCD

Amy Spizuoco, DO, FAOCD, a board-certified dermatologist at True Dermatology and a clinical instructor at Mount Sinai, highlighted how trichoscopy enhances diagnostic accuracy in alopecia by revealing key patterns such as black dots, yellow dots, exclamation hairs, and follicular loss. She explained that recognizing these visual cues, like exclamation hairs in alopecia areata or follicular plugging in telogen effluvium, can distinguish scarring from non-scarring forms and guide proper treatment.

Discussing Ways to Help Clinicians Facing Career Burnout, with Hope Cook, PA-C

Hope Cook, PA-C, a physician associate from Georgia Skin Cancer & Aesthetic Dermatology, shared strategies for addressing clinician burnout, emphasizing that burnout is not the end—it can mark a new beginning.

In her session and interview, she introduced her CPR framework: Cocooning (inner reflection and awareness), Planning (evaluating what needs to change), and Revamping or Resigning (deciding whether to reshape or leave one’s role). Using a controlled burn metaphor, Cook illustrated how burnout can clear space for growth and career renewal. Drawing from her book (“Healing Clinician Burnout: How to Revive Your Life and Career”) and podcast, she offered practical, realistic steps clinicians can take to move from feeling stuck to rediscovering purpose in their professional lives.

Breaking Down Vitiligo Misconceptions at SDPA 2025, With Gina Mangin, PA-C

Gina Mangin, MPAS, PA-C, from Sand Lake Dermatology Center, addressed common vitiligo misconceptions, underlining that treatment is possible, even after years of the disease. In an interview, she highlighted the importance of using a Wood’s lamp to confirm diagnosis, especially in patients with skin of color.

Mangin discussed when to escalate to systemic therapy, using markers like rapid progression, confetti depigmentation, and inflammatory borders to assess disease activity. She also said harder-to-treat areas like hands and feet may require both topicals and phototherapy. With new therapies emerging alongside narrowband UVB, Mangin shared her optimism about re-pigmentation and maintaining results through an aggressive, tailored approach.

The Workup Before Initiating a JAK Inhibitor for Alopecia, With David Cotter, MD, PhD

David Cotter, MD, PhD, an assistant clinical professor at the University of Nevada, outlined key steps in evaluating patients with alopecia areata before starting a JAK inhibitor. His recommended workup includes a CMP, fasting lipids, TB and hepatitis B screening, QuantiFERON gold, and often varicella zoster titers—even beyond guideline recommendations—to assess shingles risk. He also considers pregnancy and HIV testing when appropriate.

Cotter stressed that clinicians should feel confident prescribing JAK inhibitors, as long as baseline labs are clear. Follow-up labs are crucial at 12 weeks, with frequency adjusted by patient risk. While many patients see significant regrowth, safety monitoring remains essential throughout treatment.

Videos

Check out insights from SDPA 2025 on eczema, alopecia, vitiligo, burnout, and JAK inhibitor workups—key tips to improve dermatology care.

HCPLive Five at SDPA 2025

Hope Cook, PA-C, life coach, author, and physician associate from Georgia Skin Cancer & Aesthetic Dermatology, spoke at the 

2025 SDPA Annual Summer Dermatology Conference

 in Washington, DC, in a session titled ‘Healing Clinician Burnout: How to Resuscitate Your Life & Career.’

Cook, the author of a recently-released book called ‘Healing Clinician Burnout: How to Revive Your Life and Career,’ spoke in an interview at SDPA with the 

 editorial team about her session and book’s major takeaways. Specifically, Cook spoke about clinicians facing burnout and was asked about the 4 ways she states the sympathetic nervous system reacts to burnout.

How to Begin Thriving After Experiencing Burnout as a Clinician, with Hope Cook, PA-C

“The body doesn't lie,” Cook explained. “I used to teach yoga, and we would say you hold issues in your tissues, so your sympathetic nervous system knows what's going on, even if you don't consciously realize it. I walk people through the 4 types of sympathetic nervous system activation. So one I mentioned was freeze, where you're just frozen. You can't get on Indeed.com, you can't look for a job. You're just stuck. The other one is fight mode. These clinicians are walking around angry, bitter, resentful, they're just mad, and that's how their nervous system responds to that cortisol. And then there's F-A-W-N, so this is where you put your needs on the back burner, and you're sort of in this overdrive people pleasing mode.”

In this mode, Cook noted, clinicians may appear to be thriving from the outside, but she states that when they are burned out, their nervous systems are pushing out cortisol all day. Cook highlights that these types of nervous system activation are not sustainable.

“Then the last one is flight, and this is where you want to run,” Cook said. “...So by recognizing that your nervous system is doing this, it allows you to sort of step back and say, ‘Okay, this is really a fight or flight situation here.’ I need to get myself in a psychologically safe place so that I can think rationally and start making a plan.”

One of Cook’s session’s goals was to help providers identify 3 steps they can take to begin healing their burnout. During her interview, she was asked to share an example of a small but meaningful step that can help a clinician start improving..

“One of the most powerful tools is one of the simplest,” Cook explained. “I call it ‘feel and need.’ So if you can just pause throughout the day and ask yourself, ‘What do I feel?’ You know it takes noticing to notice, and so often we just go through our days on autopilot. We don't notice that we're anxious or disappointed or sad. So you pause, you notice what you feel, and then you ask yourself, ‘What do I need?’ And by doing that, you sort of turn yourself into the observer. So it takes away some of that activation that you've been feeling, and it also puts you in the seat of sort of a compassionate witness.”

For any further information related to the topics highlighted here by Cook, view her full interview segment posted above the summary. To find out more about related topics in dermatology, view our 

The quotes used in this video summary were edited for the purposes of clarity.

Hope Cook, PA-C, speaks in this interview at SDPA about strategies for clinicians seeking to overcome burnout in their careers.

 in Washington, DC, a talk was presented titled ‘Healing Clinician Burnout: How to Resuscitate Your Life & Career,’ and later discussed on-site in an interview with HCPLive.

The presenter was Hope Cook, PA-C, a physician associate from Georgia Skin Cancer & Aesthetic Dermatology. Cook is also a podcaster for a show called Healthcare Clinician Burnout and the author of a newly-released book titled ‘Healing Clinician Burnout: How to Revive Your Life and Career.’

Healing Clinician Burnout: How to Revive Your Life and Career Kindle Edition

“So many clinicians are experiencing burnout, and they don't know what to do,” Cook explained. “They [say to themselves], ‘Maybe I need to slow down, maybe I need to ask for more assistance,’ but they don't really know the framework that will get them from burned out to feeling like this is sustainable. So I created a framework, and I walk people through that during the talk.”

During her talk, Cook had described burnout as not the end of a clinician’s career but, potentially, the beginning of something new. She was asked to walk through what that shift in mindset looks like for a practicing clinician dealing with some form of burnout.

“I use a metaphor of my husband’s, who’s a forester,” Cook said. “When you have a controlled burn, you burn down a forest, and you're getting rid of invasive species, you're getting rid of some of the scraggly trees that may block out the light, and you're making room for new growth. The soil is also going to be richer as a result of this burn. I know it's hard for people to realize this when they're going through burnout, but burnout can be the thing that catapults you to a better place in your career. It gives you the opportunity to look at what's working, what's not working, and what you want to do to move forward.”

Cook’s session at SDPA introduces the notion of the “CPR framework” for healing from burnout. She was asked what these letters stand for and how the framework offers a realistic path forward for busy clinicians who feel stuck or overwhelmed.

“The C stage is 'cocooning,'" Cook said. "So this is a lot of inner work. This is where you get curious about what's really going on. How are you numbing out? How's your nervous system responding? You take a good look at what's working, what's not working, and then you can start planning and preparing. So that's the P stage. That's when you can look at each aspect of your job and sort of craft it to fit your needs, and if your employer can't or won't meet those needs, then that may be a sign that you need to look at other opportunities. The R stage is where you decide, am I going to revamp my job and do everything in my power to make this job sustainable? Or do I need to resign and look somewhere else? Or maybe I want to completely rechart my path and do something outside the clinic.”

Cook’s book ‘Healing Clinician Burnout: How to Revive Your Life and Career’ can be purchased online. For more about her session and its contents, view the full video segment posted above this summary.

To find out more about this topic and related topics highlighted at SDPA 2025, view the 

The quotes contained in this video summary were edited for the purposes of clarity.

In this interview at SDPA 2025, Hope Cook, PA-C, describes the contents of her talk regarding helping clinicians heal from burnout.

Hope Cook, PA-C

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