Change is inevitable
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, FAAD, August 1, 2023
What drives change is often worth considering, and it’s interesting to see where change takes us. Change can occur simply as a byproduct of growth and innovation but can also be a response to unmet needs. Change is an underlying dynamic in all three of our feature articles this month, with changes impacting the care we give and how it is both sought by our patients and delivered by us. Our cover article on medical tourism addresses the growing consumer participation in “destination medicine.” Millions of Americans, potentially some of your friends and family members, and very likely some of your patients, are seeking medical care outside of the U.S. While much of this care is cosmetic in nature, in other cases patients undertake elective surgical procedures overseas, where the financial savings can easily justify the trip. But at what cost? Our feature article highlights some of the potential problems that can complicate medical tourism. We should all probably keep this possibility in mind and remember to ask about it, particularly when patients present with unusual findings.
As some of our patients change how and where they seek care, so are some of our colleagues changing the ways in which they provide the care they give. While the motivation to switch to a concierge or cash-only practice model may differ among individuals, common themes cited by those who have made the switch include a desire to decrease some of the administrative burden of practicing medicine, as well as regaining more quality time with individual patients. Who among us would not welcome freedom from prior authorizations and any number of the other administrative headaches we face in more traditional practice models? Our award-winning assistant managing editor, Allison Evans interviewed several of our members who have successfully transitioned their practices to concierge or direct pay models and consulted with experts to identify features of a practice that make such a transition likely to succeed. It’s not for everyone, but for some, this might be a very welcome change.
In keeping with our innovation theme of the summer Academy meeting, our final feature this month highlights some of the newest technological advances impacting our specialty. Dermoscopy is mainstream these days but will almost certainly be only the first of the advanced imaging technologies available to us all in the near future. Reflective confocal microscopy and optical coherence tomography are here, and we are fortunate to have colleagues in the field advancing our ability to use these exciting innovative technologies to noninvasively image the skin. It’s exciting to imagine that someday we might be able to fully characterize skin lesions and dermatoses without cutting the skin. And, along with new diagnostic tools, innovations are providing us new ways to treat some of our most complicated disorders, including topical gene therapy for recessive dystrophic epidermolysis bullosa and engineered T cell therapy for mucosal pemphigus vulgaris.
Change may be inevitable, and while it is not always easy, it can lead to growth. It is inspiring to see how innovation is shaping the future of our field. I’m looking forward to seeing what’s next at the Innovation Academy this month. Being able to travel is something I used to take for granted. However, the events of the past few years have renewed my appreciation for being able to get together with my colleagues, even if it does still feel a bit strange to be in crowds without a mask. But assuming the travel gods are willing, I will be there! Hope to see you too!
