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Collaborating to stop an infectious disease

A dermatologist collaborates with an infectious disease specialist to treat a tricky case of leprosy.

Dr. Hamilton's story

Keith Hamilton
Keith Hamilton, MD, Perelman School of Medicine, University of Pennsylvania
At the infectious disease clinic at the Hospital of the University of Pennsylvania, we often need to collaborate with other specialists to treat our patients. Infectious diseases can affect all parts of the body, so it’s vital that we have strong bonds with and easy access to colleagues in other specialties who can help us.

Recently, we received a referral for a patient who had returned to the US with leprosy. Although this disease is well-known, it is quite rare in the US, so we knew we needed help diagnosing and treating him. Fortunately, I had previously worked with dermatologist Dr. Carrie Kovarik and knew she had significant international experience, as well as extensive experience with leprosy cases through her global teledermatology system.

After we confirmed the diagnosis, Dr. Kovarik and I scheduled a joint session with the patient, which saved him significant time and let us work together to come up with the most effective treatment plan. Treating leprosy requires the use of several antibiotics but also often involves suppressing the immune system, which dermatologists often do for treating psoriasis and other autoimmune conditions, so Dr. Kovarik’s input was incredibly helpful. Having a joint session ensured that all of us, the patient included, were on the same page about the treatment plan.

Over the next few weeks, Dr. Kovarik and I were able to continue our collaboration as the patient healed, refining and adjusting the treatment plan as needed to ensure a quick recovery.

Every time I collaborate with another specialist, I learn something new; it really helps me become a better physician. The closer we can work together, the more opportunities we all have to improve the care we provide and give patients a better experience.  While breaking out of our daily silos and workflows can be challenging, making it a habit to collaborate with one another is rewarding for us and improves our patient care.

The dermatologist's perspective

Carrie Kovarik

“I worked with Dr. Hamilton both as an infectious disease fellow and faculty member, so when he contacted me for help with a lepromatous leprosy patient, I jumped at the opportunity. We were able to see the patient together, confirm the diagnosis, and come up with a treatment plan. The patient is now much improved, thanks to the coordinated team care we provided and mutual respect we share. Building relationships and establishing trust between specialties takes time, but it’s the best thing for all of us.”

─ Carrie Kovarik, MD, Perelman School of Medicine, University of Pennsylvania

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