Being homeless
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, July 1, 2021
It is truly hard for me to imagine, and yet every day I drive by a growing number of thrown-together blue tarps and tents that pass for homes. The comfort that my privilege affords me allows me to be irritated by the piles of trash accumulating around the scattered hovels and somehow ignore the fact that there are people living inside. Maybe, just maybe, it is easier to be angry, rather than horrified.
I don’t know how to fix the homeless problem, but I have had the privilege of caring for people experiencing homelessness. As I tried to match treatments for their skin with realistic options, I realized how much we rely on simple assumptions in our daily care. We assume our patients can arrive on time for their appointments and that they can get to the pharmacy to fill their prescriptions. We assume that they will use the medications we prescribe, and we never question whether they have a safe place to keep their meds. We assume that their medications will be there from one day to the next. We presume our patients have running water to take their pills and wash their wounds. And we expect our patients to get better. Unfortunately, homelessness makes all these simple expectations very challenging and, in some case, impossible. Our feature about providing dermatologic care to homeless patients highlights some of the difficulties that may be experienced by those with unstable housing as they access our health care system — if they access it at all. This excellent article by Assistant Editor Emily Margosian highlights the work some of our fellow AAD members have done in their own communities caring for homeless patients. I think their stories will both inspire you and help you better care for your own patients who may be in the same situation, either now or in the future.
One of the silver linings of the COVID pandemic has to be the rapid adoption of telehealth. I recall being hesitant to embrace virtual visits a few years ago, and now I cannot imagine not having them as part of my patient care armamentarium. It has been an interesting learning experience finding out what we can and cannot do well through a video camera. The need for immediate widespread adoption of telehealth broke down many of the barriers that may have discouraged many of us from trying telemedicine, not the least of which is lower compensation than in-person visits. Without legislative intervention, once the public health emergency is declared over, these benefits will end. Read about the Academy’s efforts to ensure that telemedicine remains a viable — and available — option for providing health care as we go forward.
At DermWorld, we love to look forward to the future, and in this edition, we look at changes in the world of clinical trials. Newer technologic advances offer novel opportunities and new ways to reach out and potentially increase participation in clinical trials. If done well, this may expand our research opportunities to persons and communities we might not otherwise reach, and hopefully enhance our knowledge base quicker and easier.
In addition to these outstanding feature articles, our staff writers and, of course, our Editorial Advisory Workgroup members have done a great job pulling together a variety of topics of interest in their columns this month. While I am sure many of you are spending time outdoors, celebrating life again sans mask, I encourage you to enjoy a little downtime! And, of course, read this month’s DermWorld!
