The impact of COVID-19 on the practice of dermatology
A recently published study in JAAD highlighted the magnitude of the impact of COVID-19 on dermatology outpatient care in the United States. Data were analyzed from three surveys of nearly 10,000 practicing U.S. dermatologists comparing outpatient volumes and scheduling issues for the week of Feb. 17 to March 16 (survey 1), April 13 (survey 2), and May 18, 2020 (survey 3).
Average weekly patient visits were significantly decreased to 28.2 mid-April from 149.7 mid-February — and rebounding to 96.5 mid-May. At the peak of the pandemic, 95.6% of practices deferred visits and 73.7% of non-emergency visits were postponed for six weeks or more. Pigmented lesion biopsies per week fell from 19.9 to 3.5 during the initial peak of the pandemic, and rebounded to 7.8 mid-May, while postponed biopsies trended from 3.9 to 10.8 to 3.7.
[Access Academy clinical guidance resources to answer common dermatology questions during the COVID-19 pandemic.]
Between February through May, an estimated 10.2 million patient visits below baseline led to practice revenue decreasing by $2.3 billion. Assuming logarithmic recovery, 15.7 million patient visits and $3.5 billion in practice revenue could be lost through 2020. Practices most frequently identified patient social distancing (67%), patient COVID-19 concerns (67%), and office workflow/PPE requirements (56%) as significant challenges to recovery.
The COVID-19 Dermatology Registry has been updated to include questions about side effects of COVID-19 vaccination. The registry also continues to capture information about dermatologic manifestations of COVID-19. Learn more and enter your case today.
The AADA sent an alert to U.S. members about new COVID-19 relief legislation that included a 3.75% increase in Medicare payments for 2021. Get the details.
“I knew I wasn’t going to be able to live with myself if I hadn’t participated in the biggest medical crisis of my lifetime,” said Massachusetts dermatologist Sarita Nori, MD, of her decision to volunteer at a Boston field hospital dedicated entirely to the care of COVID-19 patients. “I didn’t want to get to the end of my career, look back, and think, ‘Oh yeah, that COVID thing happened, and all I did was a couple of punch biopsies.’ I wanted to scientifically see what this disease looked like in a patient, and I felt useless sitting on the sidelines.” Read more about how dermatologists have stood with medical colleagues to help where most needed during the pandemic in DermWorld.
DermWorld Insights and Inquiries: Holiday greeting 2020
For my 65th birthday this year, my wonderful older brother George presented me with a marvelous gift — a leather-bound compilation of the front page of The New York Times including every May 21 from 1955 to 2020. Certain years take special significance in our personal and collective lives. Anyone of my generation can easily relate to 1963 (Kennedy assassination), 1969 (Lunar landing), 1986 (Challenger disaster), and 2001 (9/11). No doubt 2020 is on the list. I will leave it to future historians to comment on the confluence of viral, social, and climactic upheavals in an election year. Keep reading!
HHS announces additional Medicare relief funding
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $20 billion in new funding for physicians and other providers on the frontlines of the COVID-19 pandemic. An additional $4.5 billion was added to the originally planned $20 billion, expecting to meet close to 90% of each applicant’s reported lost revenues and net change in expenses caused by the coronavirus pandemic in the first half of 2020. Read more.
FDA approves topical AK treatment
The U.S Food and Drug Administration (FDA) has approved tirbanibulin (Klisyri®), a novel microtubule inhibitor for the treatment of actinic keratosis (AK) on the face or scalp. Tirbanibulin is a 1% ointment applied once daily for five days.
In Phase III clinical studies, tirbanibulin achieved a significantly higher number of patients with 100% clearance of AK lesions in the treated area compared to the vehicle (44% vs. 5% in study 1 and 54% vs. 13% in study 2), as well as reaching the secondary endpoint of partial (≥75%) clearance of lesions. The new treatment will be launched in the U.S. during the first quarter of 2021.
Dermatologists have good options for treating actinic keratosis, but price fluctuations make picking the highest value option difficult. Read more in DermWorld.
Young Physician Focus: Bidding 2020 farewell (and good riddance!)
This year, working in the medical field has been particularly challenging, but it has also been exciting to witness innovation and adaptation at an astonishingly quick pace. My observation is that most of us have handled the strain of the pandemic at opposite ends of a spectrum: obsessive exercise or stress eating; Kondo-ing closets or binge-watching Netflix; meditating or bottling up emotions into neatly labeled bottles, then swallowing them.Read more from DermWorld Young Physician Advisor Jenna O’Neill, MD.
Three cases of facial swelling reported in Moderna vaccine trial
Two of the participants in clinical trials for Moderna’s COVID-19 vaccine who had received dermal filler injections in the cheeks were reported to have developed facial swelling after receiving the vaccination. One subject had filler injections two weeks prior to the vaccination and the other 6 months prior. A third person, who had had a history of lip injection, reportedly developed lip angioedema two days after receiving the vaccination. Learn more.
AAD members among Medscape’s 25 Rising Stars
As part of Medscape’s 25th anniversary, AAD encouraged members to submit inspiring stories to the publication detailing how they are pushing medicine forward as future leaders in their fields. Medscape received submissions from hundreds of young physicians from across the country who practice in diverse specialties. The finalists treat a myriad of conditions and are united by their commitment and dedication to underserved patient populations. Of Mescape’s 25 Rising Stars, four are AAD members who are using innovation to improve patient care and outcomes.
Adewole “Ade” Adamson, MD, MPP
Dr. Adamson, director of the Pigmented Lesion Clinic at University of Texas at Austin’s Dell Medical School, focuses on evidence-based research to improve skin cancer screening, prevention, and the use of artificial intelligence, particularly for skin of color patients. Read more.
Esther Freeman, MD, PhD
Dr. Freeman is a member of the AAD’s Ad Hoc Task Force on COVID-19. Notably, she is the lead investigator who co-developed the COVID-19 Dermatology Registry alongside her colleagues at Massachusetts General Hospital to help the specialty understand the dermatologic manifestations of the virus. Read more.
Arianne Shadi Kourosh, MD, MPH
Dr. Kourosh is founding director of the Pigmentary Disorder and Multi-Ethnic Skin Clinic at Massachusetts General Hospital. In addition, she founded Project Phoenix, a pro-bono tattoo removal program designed for reformed gang members and human trafficking victims. Read more.
Jenna Lester, MD
Founder and director of the Skin of Color Program in the Department of Dermatology at the University of California, San Francisco, Dr. Lester published a research letter on the dearth of images representing the skin manifestations of COVID-19 on skin of color patients. Read more.
The four AAD members recognized by Medscape as “Medicine’s Rising Stars” are among other pioneering physicians who specialize in different areas, but who have demonstrated leadership in patient care, particularly for marginalized communities. While dermatologists treat serious skin conditions, they are integral partners in health care who collaborate with physicians from all specialties, including those represented on this list.
The AADA has been notified that members are experiencing exceptionally long wait times when calling the iPLEDGE program. The AADA alerted the program sponsors of the problem and they responded that the pandemic has had an impact on the call patterns, which are used to determine staffing and scheduling of call center agents throughout the day. Additionally, the program sponsors assured the Academy that the call center vendor will add a message to the interactive voice response system informing stakeholders that the iPLEDGE program is experiencing a higher-than-normal call volume and to use the iPLEDGE website whenever possible. The AADA continues to work with iPLEDGE to monitor this issue.
Having trouble reaching iPledge? Contact James Scroggs at jscroggs@aad.org to ask the AADA your pressing iPledge questions.
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