By Abby Van Voorhees, MD, October 01, 2015
The age of genetic promise is here. If the 1800s were the time of understanding antisepsis, and the 1900s the era of antibiotic and vaccination breakthroughs, then our time will be known as the time of genetic understandings. Fueled by the human genome project there has slowly been a quiet revolution. Diseases that heretofore were simply dreadful are being deciphered. I can remember the first dystrophic EB patient that I took care of as a resident. We tried to no avail to arrest her endless blistering with etretinate, the precursor of acitretin. Her parents were willing to do almost anything to try to lessen the impact of this disease. Despite the known risks of using a teratogenic medication in a young girl, there were no alternatives. And the prevailing wisdom was that her childbearing concerns were the least of her worries. I don’t know what ever happened with this patient, but I bet her family would be astounded. As our understanding of these diseases is elucidated, therapies can be more specifically targeted and therefore are more effective. Read our feature this month as we update you on the progress in our understanding of these syndromes...it is pretty remarkable! While not seen every day, I’m sure that we each can remember someone who suffered like my patient, and that you’ll all share my excitement for the astonishing progress that has been made.
We also started a new column this month called “Outside Perspectives.” It will look at developments in other branches in medicine. Our inaugural column looks at global payment models that are being pilot tested in oncology. I am glad that oncologists are leading the fray. Their medications are pricey, and developing systems that protect the practitioners from “holding the bag” is going to be key to this program’s success. Those who participate in this pilot program will be protected financially for three years. After that those not controlling costs will be cut from the program. We will definitely want to keep our eyes on their experiences. Expensive procedures like Mohs or medications like the biologics will need to be incorporated carefully into any dermatology global payment model that the future may hold. Hopefully we’ll be able to apply learned lessons to ourselves.
We also reached out to our plastic surgery colleagues for our Acta column. The investigators update us on the burgeoning use of cosmetic procedures in the elderly and their relative safety. While the focus of the article is oriented toward complications that cause hospitalization, the study is also important in its implication for the many cosmetic procedures that we do. If you’ve not already read this paper, I encourage you to take a look.
What else is new a couple of very practical things. If you allow patients to pay their bills with credit cards, then you must read our piece on the chips now present in newly issued cards. Up until now, fraudulent charges were the issuing institution’s worry, but not after Oct. 1. Be forewarned if your office lacks the chip technology; you may find yourself on the hook. We also include a primer on a practice’s key financial performance indicators. These are both definitely must read pieces.
Much new impacting us this month. We highlight it all from soup to nuts — we’ve come a long way from the 1840s, baby.
Enjoy your reading.