By Abby S. Van Voorhees, MD, December 02, 2013
This month I am happy to report that my son has returned from Delhi, India. When planning for his semester abroad he was anticipating excitement and adventure, seeing a country both foreign, and yet so engaging. Well he (and therefore me too) got more than we bargained for…a bout of Dengue fever, so I’m sure that you all can understand my happiness with getting him back home to the U.S. Despite the sleepless nights his illness caused, when people would ask if I was sorry that he had traveled so far, the answer had to be no. The world truly has become much smaller and the young understand that boundaries that would have held me back and kept me closer to the familiar no longer apply. I also see it in my residents. When government rulings limit what unsupervised residents can do in the U.S., they realize that experiences await them if they are willing to travel to Botswana…and travel they do. Don’t think that would have occurred to me when I was in training…heading up to the New England Derm meetings in Boston seemed like an adventure back then. The magnitude of the culture change is striking; the very definition of the dermatologic community at large has shifted.
Our column this month on international dermatology describes another country as exotic to many of us as India: China. For so long much of what has been happening in Chinese medicine has been out of sight and unknown. However, just as China has opened its economy to the world, its medical community is also embracing the west. In just a few short years the Chinese have “leap-frogged” to having papers submitted to Western journals — talk about a transformation! I thought it was interesting to understand the role of the SARS epidemic in motivating some of these changes. It seems to me that there have been bumps in the road in their steps to modernize, but it is heartening to see the efforts at providing care for the billions that call China home. Imagine, though, the idea of paying the equivalent of eight dollars annually to cover your health insurance!
Improving the care of patients is not unique to the Chinese. The time has come for us all to benchmark our practices to achieve higher quality of care, yet remain in business. Sound overwhelming? There is no denying it; if you don’t know your own practice’s stats you will be at a grave disadvantage in negotiating with insurers since they have been keeping track of each of our practice patterns for years. EHRs certainly help since they can help us investigate our own coding profiles, insurance denial rates, etc. With ACOs up and running in parts of this country, knowing the true cost of doing business is critical to being able to not sell your practice down the river. I think this is a definite must-read this month.
Another feature this month that you’ll want to be sure to read is the one on the Choosing Wisely campaign, a brainchild of the American Board of Internal Medicine Foundation. They teamed up with Consumer Reports to educate the public about wasteful medical tests and practices. Almost all of the medical specialty societies have now joined the effort, including our Academy. Who would have thought that the magazine that guided my purchase of a new wall oven now is going to publicize “outlying” dermatologic decision-making? We truly are entering a new phase in the dermatologic community. So read up about the ways to save health care dollars in the derm arena to make sure that you are not caught in the public’s crosshairs needlessly.
Hopefully each of you will enjoy this month’s issue of DW despite the pressing and competing demands of the holidays. Much cooking and buying of gifts awaits me, too. Our gift to each of you is the feature on the greats in dermatology. We all should be thankful that we can stand on their shoulders to practice dermatology as we know it, care of their insights. Hope that you enjoy learning more about them. Wishing each of you a happy and healthy holiday!
Enjoy your reading.