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Texas Dermatology is a multi-location dermatology practice delivering comprehensive skin care across Texas. With a team of 50+ staff members supporting patient access and operations, the practice has built its reputation on clinical excellence and accessibility.
Tim Waters, Business Office Director, oversees all nonclinical operations—from scheduling and patient intake to staffing coordination and workflow optimization. As patient demand grew, Waters faced a fundamental challenge: how to scale access without tethering his entire team to phones or endlessly adding headcount.
Texas Dermatology was caught in an operational bind. Patient demand was growing, but the practice had no scalable way to handle the volume. The team of 50+ staff members found themselves constantly semi-attached to phones, handling routine intake work instead of solving the complex problems they were actually hired for.
"With us, it's really kind of a crapshoot as to what was coming in," Waters explains. "Having to keep forty to fifty people semi-attached to a telephone is never ideal for us, especially when you want to remain dynamic and be able to sort of serve patient needs."
Mondays were particularly brutal. Like most medical practices, Texas Dermatology faced a weekly surge of patient calls—appointment requests, rescheduling needs, questions about procedures. The practice had no reliable way to track how many calls they were missing, but Waters knew the number was significant.
"Before Elise AI, it's hard to really even know how many calls we were missing," Waters says. "I can tell you that we were missing calls."
The operational problems ran deeper than missed connections. Staff members spent their time on routine tasks—intake, scheduling, answering basic questions—work that consumed hours without leveraging their clinical expertise. Waters knew his team was capable of sophisticated problem-solving, but the phone volume kept them stuck in a cycle of data collection rather than solution delivery.
The traditional fix—adding more staff—wasn't solving the problem. More headcount meant more training, more turnover, and more coordination challenges. Texas Dermatology needed a fundamentally different approach.
When Texas Dermatology began evaluating AI vendors, Waters prioritized two things: technical capability and partnership quality. The dermatology specialty comes with complexities that generic call centers can't handle. Patients often use colloquial terms for medical procedures—saying "mole surgery" when they mean Mohs micrographic surgery—requiring an AI system with genuine healthcare fluency.
But technical capability alone wasn't enough. Waters wanted a partner, not just a vendor. He needed a team that understood healthcare workflows and could adapt quickly as the practice's needs evolved.
"Going with Elise AI made sense for us because we love smaller dynamic teams that allow us to be flexible and essentially form strong relationships," Waters explains. "We love that we can pick up the phone, that they're an email away, that they're a chat away. They are also very friendly and personable people, so just also fun to solve problems with."
EliseAI's healthcare expertise gave Texas Dermatology a crucial advantage. The American healthcare system's complexities—authorizations, referral processes, insurance verification—can't be explained in a quick email. Working with a team that already understood these workflows meant the practice didn't have to start from zero.
"Being able to start at square one or square two was an easier jump-off point for us," Waters notes. "Speaking to someone who speaks the language is always easier when you're talking about something as complex as the American healthcare system."
Implementation moved quickly. Within weeks, Waters could see the vision taking shape. The practice began projecting what three months and six months would look like, and started planning staffing adjustments based on efficiency gains they were already experiencing.
The impact was immediate and measurable. Each month, Elise now handles 2,000 calls, schedules 600+ appointments, and books 250+ new patients—taking over 130 hours of routine work off the staff's plates.
But the real transformation runs deeper than the numbers. Waters describes his team's role shifting from intake-then-solutions to solutions-based work. Staff members now focus on the expertise that justified their hiring in the first place, rather than spending hours collecting variables before they can solve problems.
"My team is focusing now using Elise on the jobs that are more directly associated with the solution," Waters explains. "It's great to basically be presented with strategic data that you need in order to then make your decision based on the expertise of why we hired that individual."
The staff response has been enthusiastically positive. Any tool that makes their jobs easier gets immediate embrace, and Elise has made their day-to-day work noticeably smoother. Instead of being on the front lines of data intake, team members spend their time solving complex problems that actually require human judgment and clinical knowledge.
Patient interactions have also been surprisingly positive. Many patients appreciate the efficiency—they want to book an appointment and move on with their day, not engage in extended phone conversations. In reviewing call transcripts, Waters has found that patients often don't realize they're speaking with AI rather than a human receptionist.
"What has surprised me the most is that half the time, based on the transcripts that we've reviewed, it's not even very clear that the patient knows they're talking to Elise," Waters says. "I think being able to put that human touch on AI-based solutions has really helped us."
For Waters personally, Elise's efficiency aligns with his problem-solving approach. He appreciates getting straight to the point without the extraneous elements that typically accompany human-to-human phone calls. The platform delivers what he needs: accurate data, completed tasks, and strategic insights that help him make better operational decisions.
Texas Dermatology isn't finished building. The practice is excited about tools in EliseAI's product pipeline that will enable new strategic initiatives. Waters sees the partnership as an ongoing conversation about what helps dermatology practices operate more effectively.
His advice to practices considering AI comes down to metrics and honesty. Look at your data and ask whether the historical approach of adding more staff can actually solve your problem. For Texas Dermatology, the answer was clear: they needed to change the fundamental model.
"For any organization that's on the fence as to whether this is the right move, I would ask yourself to just look at your metrics and see is there the ability to solve the problem that historically has plagued you by adding more people," Waters says.
The results speak for themselves. Texas Dermatology has become more available to intake more patients, freed up staff for higher-value work, and built a system that scales with growth rather than constraining it. The practice is no longer trying to stay balanced on a mechanical bull of volume—they've built a foundation that handles whatever comes through the door.
Tim Water is the Business Office Director at Texas Dermatology, where he oversees business operations and administrative strategy across the organization. With extensive experience in dermatology practice management, he brings a knowledgeable, operations-focused perspective to the work he leads.
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