Why have dermatologists for common skin issues?

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Discussion Overview

The discussion revolves around the role and necessity of dermatologists in treating common skin issues, including chronic conditions like psoriasis, and the perceived overlap with primary care physicians. Participants explore the scope of dermatology, the expertise required, and the challenges faced in accessing dermatological care.

Discussion Character

  • Debate/contested
  • Conceptual clarification
  • Exploratory

Main Points Raised

  • One participant questions the necessity of dermatologists, suggesting that primary care doctors could handle common skin issues like acne and rashes, and that dermatologists may focus on high-volume procedures.
  • Another participant argues that dermatology encompasses more than just basic treatments, highlighting the specialty's ability to diagnose atypical rashes and perform surgical procedures that general practitioners may not manage.
  • Some participants emphasize the importance of dermatologists in staying updated on current treatments for complex skin conditions, which may not be feasible for general practitioners due to their broader focus.
  • A participant mentions the significant role dermatologists play in treating patients with severe skin damage from burns, noting the pain associated with recovery.
  • One participant expresses frustration with the long wait times for dermatology appointments, suggesting that this could lead to missed opportunities for timely treatment.
  • Another shares a personal experience of inadequate treatment from a family doctor, leading to a worsening condition before seeing a dermatologist.
  • A humorous comment references the historical significance of dermatologists in relation to famous figures, though it does not directly address the medical aspects of dermatology.

Areas of Agreement / Disagreement

Participants express a range of views, with some supporting the necessity of dermatologists while others question their role compared to primary care physicians. The discussion remains unresolved regarding the overall value and efficiency of dermatological care.

Contextual Notes

Participants highlight issues such as long wait times for appointments and the varying levels of care provided by different types of physicians, which may affect patient outcomes. There is also a recognition of the complexity of skin conditions that may require specialized knowledge.

sean1234
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After visiting my derm, which I probably will for the rest of my life due to the chronic condition of psoriasis, I ask what is the point of this specialty? Consider the issues derms address: pathologies are basically acne, rashes, cancer or whatever, all of which need either some sort of ointment or systemic antibiotic treatment, or simple excision. (Cosmetic stuff like botax, skin resurfacing, etc can be done by a plastic surgeon.) It leaves me to wonder why a primary care doc couldn't address these pathological matters. Granted primary care docs are busy enough as it is, is the derm's purpose to treat the high volume of simple procedures? The typical derm residency program is preceded by one year in internal medicine. It seems these simple skin matters could be included in the internists' training. Simply having more internists could fill the void caused by eliminating derm.

But don't expect the derms to let this happen, especially when they work 9-5 with no on call. Charging $140 for about ten minutes of their time is great too.

Look at these salary figures:
Allied Physicians, Nurses and Pharmacists June 2006
Years 1-2 *** >3 *** Max
Internal Medicine $154,000 *** $176,000 *** $238,000
Dermatology $ 195,000 *** $308,000 *** $452,000
 
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Skin'em all, the leeches.
 
Dermatology includes a lot more than prescribing ointments for acne. Sure, they may get a lot of those cases coming in, but that's not why the specialty is a specialty. They have the expertise to diagnose the more atypical "rashes" and those that affect much more of the body, as well as those misdiagnosed by the general practitioners and that then don't respond to creams and ointments for "eczema". They are trained in a number of surgical procedures along with other treatments that your general practitioner would not be able to handle.

Yes, there is overlap with cosmetic/plastic surgery. Dermatologists specialize in the skin, while other plastic surgeons specialize in repair of other defects, like in bone.

Ask yourself this...why are you visiting a dermatologist for your psoriasis rather than your GP? It's very likely because you expect the dermatologist to be more up-to-date on current treatments available that your GP wouldn't have time to keep up with. The GP's job is to identify common, simple-to-treat medical problems, and to recognize when a problem is outside their training and refer their patients to the specialists to handle the more difficult problems. Ideally, each of your physicians communicates with all the others so that you get the best care possible.
 
I would assume that dermatologists play a significant role in helping patients who have had a lot of their skin damaged from burns/fires. I have heard that recovering from severe burns is one of the most painful experience known.
 
The simple answer is that a dermatologist is a specialist, and you can't expect a GP to have such in-depth knowledge and experience in every area of medicine. That's the whole point of a specialist, in any profession.
 
I don't visit one ANYMORE ...you have to book a month or even 3 months in advance and by then the infection (which I had from a cut) would have been gone or you would have been gone in my opinion (mine was minor but it could be serious for someone else). By the time I saw the dermatologist it was 2 MONTHS later! And yes the infection was gone and I still went because I had to make the appointment so I might as well go..but of course there wasn't much to look at. =/

does this happen with all dermatologists or just the ones where I am
 
I went to a family doc for a rash on my face. All she could say was, stop itching it. I ended up like this.


http://img169.imageshack.us/img169/7171/meinanecollarfg8.jpg
 
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Ah, the infamous head cone!
 
Dermatologists are extremely important, especially if you plan on being famous.

Just take poor William Herschel, for example. He discovered a planet and had it named after him. Alas, astronomers banded together and decided all planets should be named after Roman gods except for Herschel's planet, which would be named after the Greek god, Uranus.

Now, the only objects named after poor Herschel are a small crater on the Moon, a large crater on Mars, and a humungous crater on Saturn's moon, Mimas; plus he has a small asteroid named after him. Considering most asteroids, including Herschel 2000, are too small to attain a spherical shape, his asteroid is probably not particularly appealing.

So far, nothing on Jupiter's moon, Io, has been named after Herschel, but I'm sure it's just a matter of time. I think the overall goal is to name a crater on every cratered object in the solar system after Herschel.

Had good dermatologists existed back in his day, he'd probably still have a planet named after him.

Edit: Yes, I know his painting doesn't show any abnormal skin conditions, but the only ugly paintings that survive are of people that pissed off Isacc Newton.
 
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