By Abby S. Van Voorhees, MD, October 01, 2014
All of America has become increasingly diverse. Growing up near New York City, I never knew anything else. As the entry port for many, people often settled down no further than a few minutes from Ellis Island. No one, however, understood the changes that the last few decades would bring. Immigrant communities have migrated to every corner of the U.S. Rural towns not only have all of the same strip mall shops, but also have ethnic restaurants and markets. We truly are no longer a country of the descendants of the Mayflower.
The impact on dermatology of this diversity is the subject of our feature on cultural sensitivity. We not only look different, but also have different beliefs and skin practices. We need to be sensitive to these cultural differences. I especially liked Dr. Pandya’s comment that “cultural competence is central to professionalism, and it should include humility, empathy, curiosity, respect, sensitivity, and awareness.” And what about the impact of diseases on people of different backgrounds? It is misguided to assume that the response will be universally the same. We are reminded that it can be influenced by a community. John Harris, MD, PhD, talks about the impact of vitiligo on peoples of Indian descent in comparison to those of other cultures. Other times, as we all well know, the response to disease is highly individual. Temitayo Ogunleye, MD, reminds us that it is best to try to treat people “by using the hair care practices that they’re used to.” We as a country have always been strengthened by willingness to welcome others to our midst; we now just have to be sure that our dermatology practices reflect this.
Teledermatology has the potential to be a big part of dermatology, but how will it be organized? The upcoming election may determine the answer. Sabra Sullivan, MD, PhD, tells us that “before teledermatology can go live, state licensure issues, liability concerns, reimbursement mechanisms, and appropriate coding all must be addressed.” We learn in this month’s feature story that the Interstate Medical Licensure Compact proposed by the Federation of State Medical Boards (FSMB) could lift the current licensure restrictions so that qualified physicians would be eligible for expedited licensure in all participating states. This sharing of information and processes across state borders is essential to allow this technology to really take a leap forward. Options under consideration range from the FSMB compact to a national license solution. Perhaps neither of these may prevail. One thing is clear though; there are important issues at stake for dermatology in this midterm election.
Hope that you are enjoying the fall. Here in Philly we are enjoying apples galore. I’ve been munching while working on this issue. Hope you are too.
Enjoy your reading.