Quality, Safety, and Service

The role of specialists in medicine.

If you needed heart surgery to lengthen the quality of your life, you would not go to a general practitioner or family medicine doctor. It is doubtful that you would even consider consulting a specialist outside the cardiology field. For instance, if you needed a stent put into your heart, you would seek a surgeon that specializes in interventional cardiology. To ensure the highest level of care you would want someone that has the proper credentials and specializes in this service.

The point is that many forms of medical practice are highly specialized. Many believe that finding a specialist to help with your dermatological or "skin" needs may be a simple task. However, an esthetician, general practice doctor or internist do not necessarily have the expertise and additional years of training for taking care of the biggest organ of the body — the skin. It is these qualifications that make the specialty of dermatology even more unique.

The skin is a manifestation of what is on the inside. Oftentimes dermatologists are thoroughly trained in internal medicine or family practice prior to being allowed to undergo the necessary years of advanced training in dermatology. The practice of cosmetic dermatology is even more specialized than general dermatology. It requires that the specialist be an artist, has the client’s best interest in mind, and is able to integrate art and medicine to optimize the most aesthetic yet natural looking results for their clients. Too often clients ignore this important factor in choosing a doctor to provide medical services on their skin. Often they do not stop to ask whether their physician is a licensed and board-certified dermatologist. Some practitioners claim to be board-certified. "Board-certified" is similar to saying, "I passed my test", but it is important to ask what specialty they are board-certified in. Clients should make sure that their skin doctor is Board Certified in Dermatology. Unfortunately, clients often entrust those who advertise dermatology services even though these practitioners do not hold a specialized advanced training certification.

Worse yet, clients choose non-physicians (e.g. nurses, physician’s assistants) to provide services when these individuals may, in actuality, have very little experience in treating skin and can possibly cause unnecessary harm, all the while charging fees similar to that of a dermatologist. .

In 2005 "a physician board certified in family medicine" had her North Carolina Medical License suspended for, among other reasons, creating "a false impression with the public" that she was "board certified " in dermatology".
OCTOBER 2006 PG 40

Ask to see dermatologist's professional certification and license. Most physicians are proud of their accomplishments and would present it to their clients if they have nothing to hide.

Many clients unknowingly choose non-board certified physicians. These physicians will provide services within the spectrum of dermatology without informing the client that they are not specifically trained in the field. They may also neglect to give the client an option for referral to a board-certified dermatologist.

Some examples of procedures that should be performed by a board-certified specialist are: skin screening, skin biopsies, mole removals and cosmetic dermatology services. "In a study of 7 institutions representative of the U.S. medical schools in general, nearly 25% of all medical students surveyed had never even observed a skin cancer examination, and 43% had never examined a patient for skin cancer"

"In a study of 7 institutions representative of the U.S. medical schools in general, nearly 25% of all medical students surveyed had never even observed a skin cancer examination, and 43% had never examined a patient for skin cancer"

Overall, dermatologist diagnosed almost twice as many lesions correctly when compared to non-dermatologist (75% Vs 40%, respectively")
OCTOBER 2006 PG 40

Dr Micki Ly is a board certified dermatologist. She provides general adult, pediatric, and cosmetic dermatology services with her specialty being in Cosmetic Dermatology and is recognized as the Hawaii Aesthetic Enhancement Consultant for other doctors. She does not practice general or family medicine or other fields beyond her scope of training.

Don’t get caught on flawed advice. You want to get the quality of service you expect and deserve from your selected physician. Just sometimes this requires you to do a little homework.