There are so many changes that affect coding and reimbursement, it's not difficult to understand that some of the changes are not well-received by dermatologists. This is especially true with many new services that include costly drugs and equipment and that require a significant amount of physician time to perform.In this issue, I'll share some questions sent in by frustrated readers, their solutions to the reimbursement dilemmas, and my "You can't do that" advice.
The hairline and eyebrow must be considered when dealing with the temporal region.
Cleveland ? "What if there were no topical corticosteroids? Or if a patient were unable to use them?"
National report ? Modern goals for wart therapy are based on both lesion clearance and recurrence prevention, and achieving those objectives, especially in tough cases, usually requires a combination approach incorporating an agent that will provide antiviral and immunomodulatory activity, says Stephen K. Tyring, M.D., Ph.D.
Atlanta -- "Community-acquired MRSA is just exploding among the urban patient population we serve," says Henry Michael Blumberg, M.D., an epidemiologist and director of the division of infectious disease at Emory University School of Medicine.
With increasing reports of dermatology patients waiting for three months or longer, some dermatologists feel that industry funding could at least make a dent in the shortage of skin specialists.
It is an easy procedure, is reassuring to the patient, and usually only a single treatment is required. However, if necessary, the procedure can be repeated after three to six weeks.
After more than a year of almost nonstop claptrap about there being "too many" new drugs comes a sobering fact ? even as pharmaceutical companies poured a record amount of money into drug development in 2005, statistics from the Food and Drug Administration (FDA) show that the agency approved only 20 new drugs, down from 36 in 2004. Only once in the last 10 years has the number of newly approved drugs been lower than last year's figure.
Mississauga, Ontario -- Covalon Technologies has received approval from the Food and Drug Administration for CovaClear Ag, a hydrated collagen dressing that contains antimicrobial silver.
Palm Beach, Fla. ? There has been a significant growth in the dispensing of cosmeceutical products, driven by consumer demand, which has taken the place of dispensing of prescription products as the mainstay of the dermatologist's dispensing practice, says a Florida dermatologist.
VOIP has improved and become more user-friendly, to the point where "ordinary" computer users rather than just the early adopters are installing and using VOIP software.
The new guidelines that regulate physicians who prescribe isotretinoin for their patients are demanding and time-consuming.
Pigmented lesions such as caf? au lait spots are also difficult to remove permanently. In fact, a significant percentage of children who are treated with lasers, whether it's YAG or 532 pulsed dye laser, actually get worse.
Although cutaneous melanoma is rare in children, congenital nevi are one of several known risk factors for melanoma.
Dr. Zachary tells Dermatology Times that dermatologists should ask questions of presenters when they hear data presented at medical meetings to determine the clinical benefit of therapeutic interventions.
To begin, ask the patient what they expect. How much downtime do they want: one day, two days, three days or none? Next, select the superficial peeling agent based on what the doctor and the patient are comfortable with.
Las Vegas ? A versatile pulsed light device provides effective skin tightening for today's discriminating patients, according to Stephen Bosniak, M.D.
Dr. Smith points out that collagen products are white and opaque so they can be injected close to the surface without worrying about any visual color abnormality.
Las Vegas ? Sculptra (Dermik) can offer a highly effective restoration of volume, but age plays an important role in how dermatologists should approach their technique of sculpting with the filler, Danny Vleggaar, M.D., says.
New products in the pipeline will add more versatility to fillers, but until they arrive, Dr. Cohen suggests alternatives such as using a 32-gauge needle to fill in etched-in lines in the nasolabial folds and vertical lip lines.
The unit measurement is made by finding out how much of the toxin is lethal to 50 percent of mice in a study. But that amount may vary when new production processes are introduced.
Orlando ? The Baumann Skin Typing System is a multi-dimensional representation of skin types. Using it will save dermatologists time and lead to more effective skin care, Leslie Baumann, M.D., says.
The emphasis on blood vessel quantity over quality might explain why efforts to grow new vessels in patients with ischemic complications by simply supplying cells with VEGF have fared poorly.
Harrison Hot Springs, British Columbia ? There have been many advances in laser technology for medical applications, but for the treatment of pediatric skin diseases, dermatologists are still turning to the "tried-and-true" pulsed dye, Q-switched pigment and CO2 lasers.
The dermatology field's increasing shift toward cosmetic services requires practitioners to examine the relationship among patients, their dermatologists and other participants in the cosmeceutical market, say William P. Coleman III, M.D., and Zoe D. Draelos, M.D., a Dermatology Times editorial adviser, who answered a series of questions on the topic for staff correspondent John Jesitus.
