When the private equity firms move into skin cancer treatment, you know the story is not going to end well for patients. Think lots of treatments, but hit or miss on protecting you from serious cancers.
There’s a simple self-protection solution for the many boomers – like me – who need to get skin lesions regularly looked at by the skin doctor.
Just ask this question whenever you meet a new practitioner who proposes to examine your skin and cut or freeze off the growths there: What is the degree behind your name?
Surprisingly often – at least to me as a fairly sophisticated but usually trusting medical consumer – the answer is: Maybe a bachelor’s degree at most. When what you really want and need is an MD who is board-certified in dermatology.
Welcome to the new world of buckraking dermatology practices, where old-fashioned MD dermatologists are getting bought out by investment firms who install phone banks for instant scheduling and hire physician’s assistants and nurse practitioners to do the front-line treatment.
Somewhere in the back, or maybe in another city, is the actual board-certified dermatologist who is supervising the work of these semi-trained non-MDs.
A harrowing piece in today’s New York Times details the consequences observed first-hand by a reporter at some of these dermatology clinics:
- Overly aggressive treatment recommendations — deep biopsies and even radiation treatment – for what would turn out to be benign lesions;
- Missed cancers;
- and for the federal Medicare program, which pays for most of these treatments which happen in outpatient clinics, a deep hole of claims paid on wasteful and incompetent care.
Plenty of skin lesions turn out to be benign when examined under the microscope, But you can greatly increase your odds of getting correct care – not too much, not too little – by insisting on treatment with an actual board-certified dermatologist.
That ought to be an obvious point, but in today’s world of the corporatization of medical care, it pays to ask questions and not assume that every person who approaches you wearing a white coat and wielding a knife is an actual doctor.