Should Non-Dermatologists Practice “Dermatology”?

Via Skin & Aging: Dermatology vs. Dermatologist

The Importance of Specialists

However, there cannot be any misrepresentation on the part of the physician. Every patient should be given an option of seeing a specialist who really is a specialty-trained, board-certified physician. It is not okay, in my opinion, for any physician to call him/herself a “dermatologist” simply because he or she has an interest in the field, especially when this claim has purely financial motivation.

Dr. Goldenberg, Section Editor of Issues in Dermatology, is a Dermatopathology Fellow at the University of Colorado Health Sciences Center, Department of Pathology, in Denver, CO.

Vs: Seeing the Good Side of our Colleagues

I have tremendous confidence in the skills of my dermatologist colleagues. I regularly see their commitment to their patients and our specialty. Like Dr. Goldenberg, I think it means something to be a “dermatologist” and believe it is wrong for a doctor to try to mislead patients.

I wonder, though, if Dr. Goldenberg goes too far in impugning the motivation of medical colleagues in other disciplines. Is there evidence that “many physicians, foreign and U.S. medical graduates alike, claim to be ‘dermatologists’ even though they have no training in the field whatsoever”? Unless there’s good evidence to the contrary, I think it is wrong to suggest that other physicians’ acts are based on “purely financial motivation”; we all have financial motivations, but it seems to me that physicians are largely driven by a desire to improve the lives of their patients.

There is a strong tendency to see our colleagues’ mistakes and never see their successes. Such experiences seem to bolster the all-too-human tendency to think the worst of others. We’ll all agree it is wrong to mislead patients about one’s training and experience. It may also be wrong to believe the worst of colleagues and to assume a priori that they are acting outside of their capabilities and training.

Dr. Feldman, Chief Medical Editor, is in the Department of Dermatology at Wake Forest University Baptist Medical Center in Winston-Salem, NC.

Dermatology Staff Salaries:

Staffing is the highest expense item for most dermatology practices, often comprising more than 50% of total practice overhead.

Via Skin & Aging Journal. The staff salary national averages in this issue of Skin & Aging were drawn from The Health Care Group�s 2006 Staff Salary Survey. In the fourth quarter of 2005, questionnaires were mailed to more than 9,000 medical practices nationwide and 739 practices responded, including 49 dermatology practices. Those dermatology practices supplied 565 different staff salaries. The complete 2006 Staff Salary Survey, with more staff categories and additional results, is organized by staff position, geographic region and metropolitan statistical area.

Catalog of clinical dermatology images

Catalog of clinical dermatology images

Via University of California, San Diego:

American Academy of Dermatology: Skin cancer & tanning beds.

From the AAD: Skin Cancer Public Service Advertisements

The ADD has a campaign targeting teens to try to prevent them from using tanning beds. A Swedish study presents strong evidence that indoor tanning increases the risk of melanoma, especially when indoor tanning begins at an early age.

From the American Academy of Dermatology:
On an average day, more than one million Americans tan in tanning salons. Of the customers, 70 percent are Caucasian girls and women, aged 16 to 49 years. These numbers continue to rise each year, despite research which demonstrates the risks of indoor tanning, including premature aging such as age spots and wrinkles, and even worse, the danger of skin cancer. To help educate the public, particularly teenagers, the Academy’s 2006 – 2007 skin cancer public service advertisement (PSA) campaign speaks to teens in a language they can understand, instant messaging (IM).  Approximately 53 million American computer users – most of them teens – use IMs. Many exchange IMs more frequently than e-mail. It has a language all its own, and the Academy has developed this campaign specifically for teens who use it.

Fact Sheets

Indoor Tanning Fact Sheet 
Skin Cancer Fact Sheet (2006)
Melanoma Fact Sheet (2006)

Articles from The Journal of the American Academy of Dermatology

The indoor UV tanning industry: A review of skin cancer risk, claims, and regulation 
Do adolescent tanners exhibit dependency?
Sunlight, tanning booths and vitamin D

Articles from other scientific, peer-reviewed journals

Pediatrics

Use of sunscreen, sunburning rates, and tanning bed use among more than 10,000 US children and adolescents

Pamphlets

The Darker Side of Tanning
Ultraviolet Index 
Skin Cancer
Basal Cell Carcinoma
Squamous Cell Carcinoma
Melanoma

More information on skin cancer

SkinCancerNet

New PDT skin cancer light treatment for home use?

Via Medgaget

Professor Ifor Samuel, a physicist from St Andrews University, along with Dr. James Ferguson, head of photobiology at Ninewells Hospital, have teamed up to develop a new way to treat skin cancer.

From the press release.

A new light-emitting 'sticking plaster', which will revolutionise the treatment of skin cancer, has been developed by researchers at the University of St Andrews and Ninewells Hospital, Dundee. 

The new device, which builds on established photodynamic therapy treatment (PDT) methods, not only reduces pain but has the potential to be used by patients in their own home.

The breakthrough, a portable lightweight light source powered by a pocket-sized battery, is the brainchild of St Andrews' physicist Professor Ifor Samuel, and dermatology consultant Professor James Ferguson, head of the photobiology unit at Ninewells Hospital Dundee.

The pair teamed up four years ago to combine their expertise in photo-physics and photodynamic therapy to create a new way of treating skin cancer. The result is a 'light bandage' which contains its own light source and is so portable that patients can go about their daily business while under treatment.

Professor Samuel said: "By adapting the latest technology to an existing treatment method, we have developed a compact light source for treating common skin cancers. It can be worn by the patient in a similar way to a sticking plaster, while the battery is carried like an iPod."

The light is generated by an organic light-emitting diode, (OLED) and is a spin-off of Professor Samuel's work on advanced displays. "It's very exciting to be have developed a new technology that helps treat skin cancer patients," he said.

Professor Ferguson said: "This new device will have a major impact on the treatment of skin cancers. The light-emitting patch is a low-cost, portable and convenient method of treatment. Our initial pilot trials have already shown its effectiveness and we find patients requesting this treatment over conventional methods."

The new approach is much more convenient and comfortable than conventional methods as lower light levels are used (reducing pain), and the patient can move around during treatment.

Gruntdoc visits the Dermatologist.

 GruntDoc on bedside manner.

However, Derm's lack of any appreciable bedside manner has me reevaluating one of my longest-held beliefs, that people don't really care if their doctor has a great bedside manner, but only really want a doctor who is very competent and does the job right.

And, painfully, I have to look hard at myself. I am, occasionally, a touch cranky. I try very very hard to not be cranky toward my patients, but I'm not in such denial to say I never act cranky with a patient.

Physician, heal thine own bedside manner. Me first.