By Lisa Garner, MD
Perceptions are important — regardless of whether they are accurate. I recently served on the AAD’s Ad Hoc Task Force on Perceptions of Dermatology, which deals with the perception of our specialty. The group convened in response to a 2011 study that queried senior staff and physician leaders at 13 medical associations to get a sense of their view of dermatology and dermatologists. The results were largely good, with respondents giving dermatologists high marks for raising awareness of and effectively treating serious diseases like skin cancer.
But not all the news was good. The survey also turned up a number of areas in which the perception of dermatologists is less than stellar. Whether these perceptions are ultimately correct or incorrect, all of them have some root cause in the real world, and we must do what we can to counter them.
I try to reach out to primary care physicians in my area to let them know I am available for urgent referrals.
One of the primary negative impressions that came out of the survey is that dermatologists are difficult to access. It’s true that the availability of dermatological care varies widely from region to region. Care is plentiful in some locations, but there are long wait times in many areas. Other areas are critically underserved. One way to combat this impression is for dermatologists to be more aware of access issues. Dermatologists in underserved areas may need to make special efforts to see referrals in a timely manner, particularly in urgent cases.
One way dermatologists can provide care to underserved areas is through the Academy’s AccessDerm program. Participating AAD members and residents can volunteer to consult remotely on dermatology cases using mobile devices and the Internet. Primary care providers who work in participating clinics submit consultations that dermatologists then receive on their personal mobile devices or the Internet via HIPAA-compliant means. Not only is this a good way to reach underserved populations, but it also helps to bolster relationships between participating dermatologists and primary care physicians.
Dermatologists are also seen as hesitant to conduct hospital consultations. Our practice offices tend to be physically separated from hospitals, and many dermatologists do not conduct regular hospital visits. Some of the many obstacles include problems with reimbursement and the need to learn the various specialized record-keeping systems hospitals use.
Although these factors can be burdensome, we must work harder to accommodate hospital consultations. The hospital is in many ways perceived as the primary edifice of health care. If we wish to be seen as full and vital members of the health care system, we need to have a visible presence in hospitals.
Continuing with the theme of visibility, dermatologists are seen as underrepresented on medical boards and other leadership bodies within the house of medicine, and may be perceived as isolated from their peers in other specialties. One way the Ad Hoc Task Force on Perceptions of Dermatology identified to counter this perception is through increased development of leadership skills. Programs such as those offered by the AAD’s Leadership Institute may help dermatologists develop the skills they need to enhance their participation in county and state medical societies, and other leadership organizations.
The Leadership Institute includes a variety of stand-alone programs as well as sessions at the Annual and Summer Academy meetings for those who are interested in enhancing their leadership skills.
In my practice, I have worked to combat these impressions in a number of ways. I make hospital visits a regular part of my routine, and I try to reach out to primary care physicians in my area to let them know I am available for urgent referrals. One way I have worked to make myself a more visible participant in the medical process is through increased use of follow-up letters to update physicians who have refered patients to my practice.
None of the negative perceptions we encounter are entirely fair. Yet it is important that we do what we can to reverse them. As health care continues to evolve, we will continue to see a growing emphasis on team care approaches. If dermatologists allow these negative impressions to persist among colleagues, we risk losing our credibility and, as a result, our rightful place as full participants in the process.
Dr. Garner is a board-certified dermatologist in private practice in Garland, Texas. She serves as vice president of the AAD and is chair of the Ad Hoc Task Force on Perceptions of Dermatology. She is also a member of the Ad Hoc Task Force on Office-Based Surgery and Ad Hoc Task Force on Teledermatology.
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