From the editor
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, July 2, 2018
I love a good disaster movie. Epic, poorly overacted tales of impossibly large hurricanes, tsunamis, tornados (even sharknados), and cataclysmic blizzards amuse me like no other movie genre. Like most of us, though, I prefer my disasters on a movie screen, rather than in my own backyard. Lately it seems like we are experiencing more real than fictional natural disasters, many of which have personally affected some of our members. We also see their impact in our practices. Emily Margosian discusses our changing world and explores the role dermatologists may play in responding to public health issues that may arise from climate change and natural disasters, including new and old, but reemerging diseases once thought to be eradicated. Many of these conditions primarily involve the skin, so like it or not, dermatologists are likely to be involved. It is critically important that we recognize and manage diseases with public health implications. Do you know what to do in a public health emergency? Are you reporting infectious diseases correctly? We can help. We even offer a way to help your community in times of crisis: Channel your inner Girl/Boy Scout and consider joining your local Medical Reserve Corps.
Our population is aging as millions of us Baby Boomers enter our “prime time.” Providing dermatologic care for older patients can be complicated, as we must adeptly manage not only their medical conditions, but, also, social and legal issues that impact care. Even with Medicare coverage, financial restrictions may limit the care to which our elderly patients have access. Victoria Houghton offers a thought-provoking look at many facets of caring for elderly patients, including some difficult topics you may prefer never to have to consider, including recognizing signs of elder abuse. However difficult it is to consider, recognition of skin signs that suggest abuse may be life-saving. Other crucial factors that impact medical care in the elderly include treatment adherence and patient comorbidities that impact a given patient’s ability to comply with your treatment regimen. A realistic treatment regimen in a younger patient may be physically impossible in an older one. And make sure that you and your older patient share common goals of care. Our medical training teaches us to cure diseases, a lofty goal we can sometimes accomplish in our younger patients. This is not always possible, or even necessarily desirable, in older patients, for whom the costs of treatment may outweigh the benefits of the “cure.” Without knowing what our patients really want, we risk inadvertently failing to provide them the care that they need and deserve.
To end on a positive note, we thought we’d catch you up on the political happenings of the first six months of 2018. Many of the changes we have been watching for, such as development of alternative payment models, seem to be on hold; however, efforts to dismantle the ACA continue to move forward piece by piece. Our feature article on health policy issues will help bring you up to speed on recent happenings. Regardless of your chosen political party affiliation, it’s been an interesting time to follow politics. The AADA remains our staunch advocate, fighting for the good of our specialty and patients. Many thanks to all the members who volunteer their time, effort and expertise serving on relevant committees on behalf of all of us.
Enjoy a safe and happy Fourth of July!
