Categories

Tag: Dermatology

The P.A. Problem: Who You See and What You Get

Recently, the New York Times published an article on excessive costs incurred by mid-level providers over-treating benign skin lesions. According to the piece, more than 15% of biopsies billed to Medicare in 2015 were done by unsupervised PA’s or Nurse Practitioners. Physicians across the country are becoming concerned mid-levels working independently without proper specialty training. Dr. Coldiron, a dermatologist, was interviewed by the Times and said, “What’s really going on is these practices…hire a bunch of P.A.’s and nurses and stick them out in clinics on their own. And they’re acting like doctors.”

They are working “like” doctors, yet do not have training equivalent to physicians. As a pediatrician, I have written about a missed diagnosis of an infant by an unscrupulous midlevel provider who embellished his pediatric expertise. This past summer, astute physician colleagues came across an independent physician assistant, Christie Kidd, PA-C, boldly referring to herself as a “dermatologist.” Her receptionist answers the phone by saying “Kidd Dermatology.”

The Doctors, a daytime talk show, accurately referred to Ms. Kidd on a May 7, 2015 segment as a “skin care specialist.” However, beauty magazines are not held to the same high standard; the dailymail.com, a publication in the UK, captioned a picture of “Dr. Christie Kidd”, as the “go-to MD practicing in Beverly Hills.”

The article shared how Ms. Kidd treats the Kardashian-Jenner family, “helping them to look luminous in their no-make-up selfies.”

Continue reading…

Acne Cured by Self-Experimentation

In November, at Quantified Self Europe, Martha Rotter, who lives in Ireland, gave a talk about how she cured her acne by self-experimentation. She summarizes her talk like this (slides here):

When I moved to Ire­land in 2007, I began to have skin prob­lems. It began gradu­ally and I attrib­uted it to the move, to stress, to late nights drink­ing with developers and cli­ents, to travel, to whatever excuses I could think of. The stress was mul­ti­plied by the anxi­ety of being embar­rassed about how my face looked, but also because my new job in Ire­land involved me being on stage in front of large audi­ences con­stantly, often sev­eral times a week. A year later my skin was per­petu­ally inflamed, red, full of sores and very pain­ful. When one spot would go away, two more would spring up in its place. It was a tough time. I cried a lot.

Frus­trated, I went to see my homet­own der­ma­to­lo­gist while I was home for hol­i­days. He told me that a) this was com­pletely nor­mal and b) there was noth­ing I could do but go on anti­bi­ot­ics for a year (in addi­tion to spend­ing a for­tune on creams and pills). I didn’t believe either of those things.

I was not inter­ested in being on an anti­bi­otic for a year, nor was I inter­ested in Accu­tane (my best friend has had it mul­tiple times and it hasn’t had long term res­ults, plus it can be risky). What I was inter­ested in was fig­ur­ing out why this was hap­pen­ing and chan­ging my life to make it stop. I refused to accept my dermatologist’s insist­ence that what you put in your body has no effect on how you look and feel.

Continue reading…

Registration

Forgotten Password?