By Abby S. Van Voorhees, MD, March 01, 2013
I grew up on Dick Tracy. His two-way wrist radio was all-powerful, and seemed cool beyond compare. I can recall many a time when playing with friends that we’d pretend to have these radios, ending our conversations with “over and out.” I must confess though when phones started having cameras I was a naysayer. I was of the camp that thought smaller and lighter were more prized. The lure of getting a tinier phone was what would propel me to trade in the phone I knew for a new one. And yet, I now realize that I missed a cultural shift. I didn’t see the appeal that others did in being able to have a camera always present. Recording life’s events in pictures has become the cultural norm. So much so, that I often wonder whether we’ve become addicted to picture taking. I recently read about restaurants that have started banning cameras to stop people from climbing on chairs to get the most perfect angle of each beautifully presented dish.
Dermatology has been on the edge of this, but I predict that we are about to enter this reality in prime time. I hope that you read this month’s Acta column on using smartphones to aid in skin cancer screenings. In talking with April Armstrong, MD, MPH, we hear the loud rumblings of how we can use these tools to reach those far from dermatologic care. It is clear that the technology is not yet perfect. But it is also clear that it works pretty well. As April explains it, the on-site dermatologist and the teledermatologist agree on the recommendations for care over 80 percent of the time. And already there are technologies that might further enhance our interpretative abilities. Is this sci-fi? I don’t think so. I suspect that all of us have started getting photos from family members asking us what a rash is or whether they need medical care for a new lesion. I know that I have. Patients, too, show up in the office with pictures documenting the history of their rashes hoping to aid in my understanding and assist me in crafting a treatment plan. [pagebreak]
None of what we write about this month is sci-fi-esque. Take our piece on infestations and infections. Not my favorite topic, actually; it gives me a vague crawly feeling when it is discussed. However, more and more we will be seeing skin rashes and lesions of infestations from far and wide. Not that these are necessarily new, they just haven’t been seen too much locally before. This global world thing has us sharing both good and bad! Leishmaniasis clearly falls in the bad category as do all of the other infestations such as bed bugs and chikungunya. Dirk Elston’s admonition to choose your hotel wisely to avoid coming home with bedbugs makes me shudder. So in my opinion there are now two strong reasons to schedule more virtual meetings the annoying airport lines and the possible hitch-hikers that we may pick up from where we might stay.
Another don’t-miss piece this month is our legal column on what holds the interest of the OIG otherwise known as the Office of the Inspector General. The OIG has taken a renewed interest in the workings of our practices, looking for fraudulent billing, incorrect utilization of incident to, and lack of compliance with reassignment rules. So reviewing what our practices are actually doing is imperative. We don’t want to run afoul of these rulings. I think that we might want to add Daniel Shay’s and Alice Gosfield’s admonition “May you never meet the OIG” to our list of well wishes for each other.
Enjoy your reading.