By Abby S. Van Voorhees, MD, February 03, 2014
I like what Albert Einstein had to say about flexibility: The measure of intelligence is the ability to change.” It’s not that I find change always easy; it challenges me as it does the rest of us. But somehow I inherently like it. Like when I move the furnishings around my house. All of a sudden I can’t help but think that the couches will look better if simply turned 90 degrees, or it might spice things up to have my bed in a different place in my room. My kids groan and my husband gives me that patient look that says, “I am only doing this since I know it will make you happy.” While sometimes these efforts are a complete bust with the pieces of the room returning once again to their baseline positions, often there is something refreshing and newly engaging about having my very same stuff hanging out in a different way.
So while others resist change, I sort of welcome it. Therefore you can guess my reaction when you notice this month that we only have two feature articles. We made this change since these two pieces were so comprehensive that we needed the extra space. This isn’t a permanent change, but we felt that depth was more important than number of features, and we trust that you agree.
I hope that each of you reads our piece on dermatologic care teams this month. I doubt that this will be a passing phase. For the skeptics amongst you, the Institute of Medicine has proclaimed that “the clinician operating in isolation is now seen as undesirable in health care.” As we’ve seen so many times before, what Washington wants in health care it gets in health care. Many of these strategies are not new; we all work with our staffs to try to take care of patients as efficiently and sensitively as possible. However, the degree to which we need to embrace this new paradigm is what makes this article so important. By the way, I loved hearing from Randall Roenigk, MD, about the identification of the Sister Mary Joseph nodule by one of the Mayo Clinic nurses.
This type of thinking is also apparent in cosmetic dermatology, where leaders understand that a little flexibility can maximize the good results, while minimizing the less appealing ones. More injections with less volume in each one sounds simple but it requires being open to handling patients differently, and it is giving patients better results. Be sure to read our piece on neurotoxins and fillers to get news about the latest developments. It seems that our patients’ faces will look better as a consequence of these changes too.
Not everything can be flexible though, and knowing what can from what cannot is critical. Be sure to read our legal column on HIPAA privacy violations and how to handle them, our coding piece on the exact coding definitions for biopsies and excisions of lips and eyelids, as well as our story on cloud storage for EHR. It’s best, in these situations, to be a bit of a bore, and just handle these things exactly as outlined each and every time.
I wanted also this month to say a word about my column from last December. One of you wrote that I seemed to suggest that residents in Botswana were not adequately supervised. I certainly intended no such implication. I very much appreciate it when you either write or tell me your thoughts about anything we do in DW. We take your comments quite seriously as we keep striving to make this publication better and better. And by the way, my living room truly does look better with the couches shifted!
Enjoy your reading.