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National standards for ranking physicians may be on the horizon, but many dermatologists doubt that they can be implemented fairly and accurately. Insurance companies have proposed ranking physicians in tiers that could be used to determine levels of reimbursement or the amount of co-pays for patients to see the physician of their choosing.

Economists debate whether the United States has reached a full-fledged recession or is simply teetering on the brink, waiting for some sign it will either topple or be pulled back. Meanwhile, as the debate rages, people are dealing with the effects of soaring energy costs, rising unemployment and inflation.

The subprime mortgage crunch is rippling through our economy in a variety of different ways. Many homeowners are postponing plans to sell until the market stabilizes; others, with hopes for trading up to a bigger home, are opting to stay put, turning instead to remodeling or enlarging.

With constraints on healthcare human resources in some geographic areas in Canada, teledermatology offers advantages, such as increasing access to dermatological expertise. The use of store-and-forward technology avoids the logistical challenges associated with real-time teledermatology.

When I enrolled in medical school - what seems like a lifetime ago - I wanted to be akin to the sage and compassionate Marcus Welby, M.D. I wanted to be a pediatrician who takes care of and cures sick children.

Current Procedural Terminology codes were significantly changed in 2007 to clarify previous confusion, and physicians must understand the changes in order to submit the correct billing and, ultimately, to be reimbursed, one expert says.

Over the past 10 to 15 years, there has been a boom in the phenomenon commonly known as "medspas" - an outgrowth of the purely Aesthetic day spa, combining herbal wraps and massages with medical or near-medical therapies, such as microdermabrasion and chemical peels, and progressing into lasers, fillers and Botox treatments.

As with any legal or insurance planning, the early bird is richly rewarded. Nowhere in practice planning is this truer than in the Buy-Sell agreement. The reason is not so much economic, but political. If this planning is done before any owner is close to a disability, divorce, retirement, or death, all owners are in the same position relative to each other. That makes the negotiation of a standard deal for all owners a much easier and smoother process. Planning early for a Buy-Sell agreement will truly benefit you, your family and your practice.

Starting a successful cosmetic dermatology practice requires a systematic approach to everything from networking and staffing to advertising and office decor.

The physician removed a cyst from the patient's right upper back. The cyst measured 5.0 centimeters in diameter, but it was removed through a 0.9 x 3.1 cm/d opening. I billed the excision based on the 5.0 centimeter size. Is that correct? - Looking for an Opening

To offset the trend of falling reimbursement, you can either see more patients or cut costs. Before you try doubling your patient load or handing out pink slips to your entire staff, consider these ideas to trim expenses in your dermatology practice: