Josephine Nguyen, M.D.
Dermatologist
- Service Branch: Navy
- Location: Navy Hospital Bremerton
- Specialty: Dermatology
Navy Lieutenant Commander Josephine Cam-Van Nguyen, M.D., is the sole Navy dermatologist for the entire Pacific Northwest region. She provides daily patient care to active-duty service members, dependents and retirees. After a busy day, Josephine loves to spend time outdoors with her friends.
”Because of the Military, I had the best dermatology education in the country, so I want to ensure that I take great care of my patients.“
Navy Lieutenant Commander Josephine Cam-Van Nguyen, M.D., is the sole Navy dermatologist for the entire Pacific Northwest region. She provides daily patient care to active-duty service members, dependents and retirees. After a busy day, Josephine loves to spend time outdoors with her friends.
”Because of the Military, I had the best dermatology education in the country, so I want to ensure that I take great care of my patients.“
"Here's a photo of my sister and me at the baptism of our niece, Isabella. My sister encouraged me to join the Military and go to the Naval Academy."
"Here's a photo of my sister and me at the baptism of our niece, Isabella. My sister encouraged me to join the Military and go to the Naval Academy."
"A typical day for me involves getting up around 5 a.m. I workout for about an hour, then I make my dogs breakfast and get ready for work. For me, the mornings are my personal time of self-reflection and meditation."
"A typical day for me involves getting up around 5 a.m. I workout for about an hour, then I make my dogs breakfast and get ready for work. For me, the mornings are my personal time of self-reflection and meditation."
"So I'm a big proponent of natural foods for my dogs. I feed them a mixture of raw beef, oatmeal, carrots, apples, spinach, kale and a concoction of other supplements including B vitamins and fish oil."
"So I'm a big proponent of natural foods for my dogs. I feed them a mixture of raw beef, oatmeal, carrots, apples, spinach, kale and a concoction of other supplements including B vitamins and fish oil."
"I serve as chairman of the Women Physicians Section of the American Medical Association, and today I'm expecting a call from Harley Grant, who's the civilian director and my staff liaison. We're discussing the impact of working together to increase membership within the section."
"I serve as chairman of the Women Physicians Section of the American Medical Association, and today I'm expecting a call from Harley Grant, who's the civilian director and my staff liaison. We're discussing the impact of working together to increase membership within the section."
"I arrive to work around 7:30 a.m. I've been at Naval Hospital Bremerton for about a year now and it's a great experience to work at a smaller hospital."
"I arrive to work around 7:30 a.m. I've been at Naval Hospital Bremerton for about a year now and it's a great experience to work at a smaller hospital."
Benefits Of Medicine In The Military
Josephine explains to residents attending the morning report the benefits of practicing medicine in the Military versus the civilian sector.
Josephine explains to residents attending the morning report the benefits of practicing medicine in the Military versus the civilian sector.
NGUYEN: I know you guys are still in the learning phases, but even, like, you would think, like, even beyond — after residency and taking your patients, like, you all — there’s always a transition phase of your career, where you’re like, “OK, I’m good seeing patients now, I want to do something else like run hospitals, or do international aid.” And that’s what’s awesome about medicine, is that the civilian side, people pretty much have to stay in that pathway, or, I mean, or then they can transition, but then to transition to the executive level, it takes a big — a big transition, while for the Military, like, you can just jump from one to another, and then just still go back and take care of patients. So it’s been — I mean, it’s just — just to encourage you that your choice to go Military was great.
Dermatology Residency
As head of the dermatology department, Josephine is responsible for mentoring residents who are training in the specialty. She works closely with Dr. Matt Parrott and teaches him how to provide exceptional patient care and treatments. Today they see a young child with a sebaceous cyst.
As head of the dermatology department, Josephine is responsible for mentoring residents who are training in the specialty. She works closely with Dr. Matt Parrott and teaches him how to provide exceptional patient care and treatments. Today they see a young child with a sebaceous cyst.
NGUYEN: Lieutenant Matt Parrot is an awesome intern that’s been rotating with me for the past two weeks in dermatology. So we’re heading down right now to morning report for all of family medicine, and Matt and I will be giving a morning report. And that includes case reports as well as a talk about the importance of sunscreen use. PARROT: I’m Lieutenant Parrot. I’m on derm right now with Dr. Nguyen. So we’re going to start off with some cases that I’m going to present and then Dr. Nguyen’s going to talk about some of the specific details of that, and then if we have time we’ll go on to just a brief sunscreen talk. NGUYEN: I get the privilege of working with residents, including medical students and interns. I see their strengths, I work with their weaknesses and help them round that out, and I teach them how to not only be a better physician, but be a physician leader. PARROT: Yeah, so I know on the scalp you can get these pilar cysts, which are sort of like an epidermal inclusion cyst, kind of a cousin to that — NGUYEN: Yeah. PARROT: — which are a little more firm. That’s typically what I see on the scalp that’s like that. I don't know if that happens in infants though. NGUYEN: It’s un — you don’t commonly see it in infants, you’re right. It feels like some — like what we call a sebaceous cyst. However, in a young child, you always want to make sure it’s not something like a tumor, something of — or something that is vascular, of blood origin. So I thought — so before we refer him to a surgery, I think we should order — what? What do you think we should order? PARROT: Do an ultrasound. NGUYEN: Yeah. Thank you. You were a good patient today. Alright, thank you. It was nice to meet you.
"Matt and I got to see a wide variety of patients with skin conditions, including psoriasis, dermatomyositis and rosacea. What I teach Matt is to take a step back, look at the patient overall and teach them how to take care of themselves."
"Matt and I got to see a wide variety of patients with skin conditions, including psoriasis, dermatomyositis and rosacea. What I teach Matt is to take a step back, look at the patient overall and teach them how to take care of themselves."
"This is the excision kit that the corpsman set up for me to use for today's surgery. It includes all the typical tools that you use during an excision including a scalpel, dissecting scissors, forceps, blunt scissors to cut sutures and skin hooks."
"This is the excision kit that the corpsman set up for me to use for today's surgery. It includes all the typical tools that you use during an excision including a scalpel, dissecting scissors, forceps, blunt scissors to cut sutures and skin hooks."
"We use local anesthetic to numb the area around the patient's shoulder before we start the procedure."
"We use local anesthetic to numb the area around the patient's shoulder before we start the procedure."
Melanoma Excision
Josephine performs a skin cancer excision on a patient's shoulder.
Josephine performs a skin cancer excision on a patient's shoulder.
NGUYEN: Hi, sir. How are you? PATIENT: Fine. NGUYEN: It’s good to see you again. PATIENT: Yeah, same here. NGUYEN: So this is my corpsman who’s going to be working with us today. PATIENT: Hello. CORPSMAN: Hello. NGUYEN: And I’d like to go over with you what the diagnosis was and what we will be doing. PATIENT: OK. NGUYEN: Is that OK? PATIENT: Yes. NGUYEN: So when we biopsied this lesion, it was a melanoma. So melanoma is from long-term sun damage, and it’s cancer of the pigment cells. The good news is that it was a very early melanoma, so we look at a certain depth — it was less than .75 millimeters. We’re going to take a one-centimeter margin around the whole thing, so when we take it out, you’ll end up with a scar probably about four to five centimeters long. Alright, sir, you ready to rock and roll? PATIENT: Yes, ma’am. NGUYEN: I actually just want to cut down to the subcutaneous fat, so I know that that’s exactly where I want to hit, and that’s as far as I need to go — go to cut this melanoma out. Mr. Gordon, you’re doing great. So we have the skin cancer out, so now we’re going to run all the edges with my corpsman and just make sure all the pinpoint bleeding is done, so this is where we have the teamwork. That’s what’s great about the Military, is you use their leadership to train the people to help you. It makes my day overall a lot less hectic and more efficient. Perfect. At this point I’m very happy, I’m not concerned that this is going to rip at all. Today I was able to cut out a melanoma, which, luckily it was a very early, thin melanoma, but if left for another year, it could have quickly gotten a lot thicker and metastasized and the patient could have died within a couple of months.
Career In Dermatology
Josephine explains what she likes most about being a Navy dermatologist.
Josephine explains what she likes most about being a Navy dermatologist.
NGUYEN: So the neat thing about dermatology is it allows you to not only do patient care but do a lot of procedures, the surgeries, lasers, biopsies, excisions, and your patient pool is both kids, young adults and the elderly. So it allows you to see — do a wide variety of things and see a lot of different patients.
Melanoma Pathology
After she performs the melanoma excision, Josephine prepares the specimen for pathology.
After she performs the melanoma excision, Josephine prepares the specimen for pathology.
NGUYEN: So it’s important for every specimen that we — we take out, we submit for pathology. And the pathologist will then take slices through this whole thing to evaluate if any of the edges have any residual cancer in them. So it’s important for me to hear from them, to make sure that this whole thing is clear of cancer. So then I put this specimen into formaldehyde, and that prevents bacteria or fungus from growing into it. So — and that’s our specimen cup, and we label it with the patient information.
Trail Run With Dogs
Military physicians have an hour blocked off each day free of patient care. Josephine takes advantage of this time by going for a run on base with her two dogs.
Military physicians have an hour blocked off each day free of patient care. Josephine takes advantage of this time by going for a run on base with her two dogs.
NGUYEN: We’re often so busy running around either taking care of patients, doing administrative work, counseling people, that we have an hour blocked out in which you do not have patient care. And that allows you to just take a step away and get a mental break.
"This is the nature trail we have on base. Many of the trees have been here for hundreds of years and they're marked so that they're not cut down. It's almost like a historical landmark in a way. I love that I can take my dogs here to let them run off leash."
"This is the nature trail we have on base. Many of the trees have been here for hundreds of years and they're marked so that they're not cut down. It's almost like a historical landmark in a way. I love that I can take my dogs here to let them run off leash."
"I adopted Peter and Kippy from my brother about three years ago. Kippy is a Maltese poodle and Peter is a Maltese poodle Shih Tzu, and Peter is Kippy's son."
"I adopted Peter and Kippy from my brother about three years ago. Kippy is a Maltese poodle and Peter is a Maltese poodle Shih Tzu, and Peter is Kippy's son."
"We have social events, like today's chili cook-off, at least once a month, and I try to attend whenever I can because I enjoy the camaraderie. I'm vice president of the wardroom, and here I am with the social chair who helped organize the event. I'm holding a bowl of my favorite chili, which is made with venison."
"We have social events, like today's chili cook-off, at least once a month, and I try to attend whenever I can because I enjoy the camaraderie. I'm vice president of the wardroom, and here I am with the social chair who helped organize the event. I'm holding a bowl of my favorite chili, which is made with venison."
Light Therapy Treatment For Skin
Josephine uses light therapy to treat a young patient with vitiligo, a disease that causes a loss of skin color.
Josephine uses light therapy to treat a young patient with vitiligo, a disease that causes a loss of skin color.
NGUYEN: The use of ultraviolet light to treat inflammatory skin conditions like vitiligo or chronic itch — it’s a very powerful tool because there’s no ingestion of medication, and you’re using a natural form of therapy to suppress the immune system. Obviously this is something that you use for a very limited time. You don’t want to use it for a long period of time because of the risk with skin cancer and photo-aging. I’m excited because I believe that this patient will respond well to the light therapy.
"I use this camera for my telehealth appointments. Our setup is fairly portable. I can do real-time, synchronous visits using the camera, speakers and a microphone."
"I use this camera for my telehealth appointments. Our setup is fairly portable. I can do real-time, synchronous visits using the camera, speakers and a microphone."
"Since I have two rooms, these indicators let me know the status of each patient. If the first patient is there, it's marked yellow and green, if the second patient is there, it's green only, and then if I'm done, I flip it to red."
"Since I have two rooms, these indicators let me know the status of each patient. If the first patient is there, it's marked yellow and green, if the second patient is there, it's green only, and then if I'm done, I flip it to red."
Telemedicine Demo
Josephine leads the hospital's telemedicine initiative, and has one scheduled appointment every day that occurs via videoconference.
Josephine leads the hospital's telemedicine initiative, and has one scheduled appointment every day that occurs via videoconference.
NGUYEN: One of the leadership projects that I oversee and I’m actually in charge of for the whole hospital is the telehealth initiative. My job specifically is to see what needs there are for military patients that are spread out in smaller locations that don’t have access to specialists, and I help ensure that they get the care that they need quickly and expediently. So today I have an active-duty male that was not able to see a dermatologist in his local area, because there is no military dermatologists available nearby him. Clinically, looking at it, it doesn’t look concerning for melanoma. PATIENT: OK, that’s really good news. I appreciate it. That makes me feel a lot better about it. I was concerned, you know, because of the changes that I’ve noticed over time. So I really appreciate that advice. NGUYEN: Wonderful. Thank you so much, and please make an appointment again if you have any other questions. PATIENT: Yes, ma’am. Thank you. NGUYEN: Thank you.
"The laser on the right is for hair removal, and the one next to it is the pulsed dye laser used for vessels. The hair removal laser I used on my patient today has a pedal that I pump with my foot to activate."
"The laser on the right is for hair removal, and the one next to it is the pulsed dye laser used for vessels. The hair removal laser I used on my patient today has a pedal that I pump with my foot to activate."
"The whites are our formal uniforms that you would wear for special functions like promotion ceremonies or official duties. The reason I have these out today is because we just had a uniform inspection to make sure all the insignia are on correctly. If I wasn't wearing my scrubs at work, I'd be wearing my working uniform, which is either my blue cammies or my khakis."
"The whites are our formal uniforms that you would wear for special functions like promotion ceremonies or official duties. The reason I have these out today is because we just had a uniform inspection to make sure all the insignia are on correctly. If I wasn't wearing my scrubs at work, I'd be wearing my working uniform, which is either my blue cammies or my khakis."
Dermatology Skin Exam
Josephine is the Navy's only dermatologist serving the entire Pacific Northwest. Her patients are active-duty service members, dependents and retirees of all ages with a variety of skin conditions. Today, she uses a laser hair removal treatment on a petty officer suffering from pseudofolliculitis barbae.
Josephine is the Navy's only dermatologist serving the entire Pacific Northwest. Her patients are active-duty service members, dependents and retirees of all ages with a variety of skin conditions. Today, she uses a laser hair removal treatment on a petty officer suffering from pseudofolliculitis barbae.
NGUYEN: The best of my job is, people come in with a wide range of knowledge about their skin. Some people know all about gentle skin care; other people are like, “I don't even know what moisturizer to use.” So it’s exciting for me to be able to see where patients are at, and then imparting them a certain amount of knowledge and then having them come back and continue to layer knowledge. Hi, good morning, how are you? PATIENT: Good morning, how are you? NGUYEN: Good to see you again. PATIENT: Good to see you as well. NGUYEN: Petty officer is here to treat PFB, or pseudofolliculitis. Because of the thickness and curliness of the hair, when the hair gets cut, it curls back into the skin and causes a keloidal papule, or a scar. So this is extremely tender, painful and itchy and cosmetically disfiguring. So we’ve found that use of the laser hair removal to target the hair follicles to actually decrease the thickness in the caliber of the hair. How did you feel the last treatment went? No side effects? PATIENT: No, ma’am. NGUYEN: OK, so maybe we can be more aggressive then. So the hair bulb, which is below the skin surface, is the target, and that’s where the origin of the hair is from. And — so you’re not destroying the hair itself — you’re trying to target the origin of the hair, which is the bulb or the bulge. I currently serve as the sole Navy dermatologist for the Pacific Northwest. Because of the Military, I had the best dermatology education in the country, and I want to ensure that I take great care of my patients. So I teach them how to take care of themselves, and then they come back to me to fine-tune their regimen.
"Each month, we invite a speaker to our leadership development initiative lecture series. This afternoon, I'm meeting with HM1 Aragon, who spent time overseas as the sole corpsman to a Marine Corps battalion. I want him to talk about the reality of his experience in the battlefield and how it shaped his own views on life."
"Each month, we invite a speaker to our leadership development initiative lecture series. This afternoon, I'm meeting with HM1 Aragon, who spent time overseas as the sole corpsman to a Marine Corps battalion. I want him to talk about the reality of his experience in the battlefield and how it shaped his own views on life."
"I live in Gig Harbor, Washington and the bay is literally two-and-a-half miles away from where I live, and so any day of the week I can drive or run down to the water."
"I live in Gig Harbor, Washington and the bay is literally two-and-a-half miles away from where I live, and so any day of the week I can drive or run down to the water."
Kayaking On Puget Sound
Josephine enjoys living in the Pacific Northwest and takes advantage of her beautiful surroundings. She especially loves kayaking in Gig Harbor, a picturesque bay in Puget Sound.
Josephine enjoys living in the Pacific Northwest and takes advantage of her beautiful surroundings. She especially loves kayaking in Gig Harbor, a picturesque bay in Puget Sound.
NGUYEN: In the Military, hospitals open at sometimes six or seven o’clock, but by the time the hospital hits 1600, or 4 p.m., it’s 95 percent empty. They encourage you to have strict hours and they encourage you to leave and go home and take care of your family, because they know that if you’re not having that relaxing time and having family life, you won’t be able to contribute at work fully. One of my favorite activities is kayaking. It combines some of the best natural elements that are available to you — one, being outside in nature, and two, being surrounded by one of the most peaceful things in the world, which is water. Water is known to be therapeutic, and to be surrounded by it and watching and hearing the waves, is very — it’s so soothing for anybody. I think the best part was actually just hanging out with your friends on the water, where you’re just away from everybody, everything and the noise. And the awesome part is that it’s my job that took me out here. I never would have thought to even come out to the Pacific Northwest, because I grew up in DC. And that’s what’s the great part about the Military — it takes you out of your comfort zone and puts you — transplants you somewhere that you’d never even think about, and my gosh, that’s been the whole story of my career in the Military, is this continual growth, expansion and meeting new people from all walks of life.
"I have friends I've made from meet-ups in Tacoma, at work, school and church, and the best part of the day is getting to relax with them after work. Tonight, we're all having dinner together at a local restaurant."
"I have friends I've made from meet-ups in Tacoma, at work, school and church, and the best part of the day is getting to relax with them after work. Tonight, we're all having dinner together at a local restaurant."
