something heart-warming

1 Feb

I’ve been hearing this article mentioned in conversations, been seeing it float around my facebook feed for the last couple weeks.  It doesn’t treat the field of dermatology too favorably, though it serves more as an example of a larger problem (as the title implies, increased specialists’ income at cost to the patient) than the problem itself.  So I thought I’d share a recent story of generosity in the field, since it’s been where I’ve spent the last four weeks.  Granted, as John reminded me, I’m learning from pediatric dermatologists predominantly, and one takes a pretty significant pay cut if “pediatric” is in the title, not to mention if one works at an academic institution.  All that aside…

My friend emailed me recently about an area of irritation that she developed on her wrist from wearing a fitbit, asking me whether I thought she should see a specialist and if I had recommendations.  Unfortunately, she’s new to the area and didn’t yet have a primary care doctor set up, so I told her that it would be tricky to see a dermatologist since insurance typically requires a referral, then it would take a while to get an appointment as a new patient.

Literally the next day in clinic, the head of the department was discussing the skin irritation people have been experiencing due to the fitbit.  He met one woman recently, performed some allergy tests and was intrigued.  I told him that, coincidentally, I just heard from a friend experiencing similar symptoms, but that she didn’t have a provider.  Without hesitation he responded, “Oh, I’d be happy to see her.  Does 1:30 this afternoon work for her?”  Keep in mind that this is a pediatric dermatologist, and he was offering to see my 30-year-old friend free of charge on his afternoon reserved for academic responsibilities.  (Also awesome that my friend was willing to drop everything at work to make it in.)

He spent over an hour with us (he and my friend let me sit in), conducting an extensive history and physical exam (especially helpful given her family history of skin cancer), going over her skin findings and putting together a plan, and educating me (he let me conduct the KOH test for fungus).  A nurse and staff member also generously donated their time, helping my friend get registered (an annoyingly lengthy procedure) and patch-testing her for allergies.  He then sent her home with his own personal email address and contact information of adult dermatologists in her area that he recommended.  The whole experience was more than I anticipated, more than I could have hoped.  Kind of renews faith in doctors’ humanity, right?

And, a bit irrelevant, but also pulling at the heart strings, here is Aurelia greeting John when he picked her up from daycare.  She’s been doing something so sweet recently.  For a while now, she’s been crawling into our laps, book in hand, ready to be read to.  Now she’s started actually physically opening one of our hands with her hand and plopping a book directly into the open hand.  There is no confusion about her request.

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3 Responses to “something heart-warming”

  1. Tiffany February 1, 2014 at 7:27 am #

    Such a blessing!! And it was really fun to see you in doctor mode! xo.

  2. rick February 2, 2014 at 4:24 pm #

    sounds about right. we should talk sometime about that article and why the analysis is so wrong (more so than just being wrong, its insinuations are offensive to me and others).

  3. A. February 3, 2014 at 12:55 am #

    Oh man, that article. Dermatology is so funny. I worked for two very different dermatologists before med school (I have no desire to go into derm, but they were paying jobs in medicine so yay). One was amazingly kind, always waived copays and deductibles for police officers, military, friends of staff, and patients he knew we having a hard time financially. He generally only referred patients for MOHS if they had a lesion on their face. Everything else was usually curettage or a simple excision. Apparently he is a huge deal, but I didn’t find out until years later talking to a friend of mine who is a dermatology resident. You would never know from working for him or talking to him. Sweetest man ever. The other dermatologist I worked for was clearly in it for the money: did every cosmetic procedure under the sun, had medical assistants operating a lot of the simpler laser devices (even though he shouldn’t have), and recommended MOHS for all SCCs and BCCs no matter where they were on the body or how big they were. He, conveniently, was a MOHS surgeon and did all the surgeries. To top it off he had a publicist who he used to get him on any tv show or news outlet that would take him. So gross. The only thing that both derms had in common was they were both still making payments on their student loans!! That said, I think the article was perhaps a bit unfair and could have used better examples, but I have definitely seen a very greedy, corrupt, unethical side of dermatology which definitely deserves to be called into question. It seems like presenting all options, risks, benefits, cost to the patient and letting them make an informed decision would be the ethical way to go in this type of situation, but that’s probably just me being a naieve med student. I’m glad you are experiencing the interesting fun side of derm (and hope you are getting to stock up on aquaphor samples… that stuff rocks!)

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