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As attorneys and consultants to thousands of physicians across the country, we are constantly astounded by the attitudes of physicians regarding the sale of their medical practices. Most often, today, we hear the complaint that doctors do not feel they can sell a practice for any significant value. They generally do not feel the practice is "worth anything," especially if they do not have younger partners to buy them out.

A few months ago, I wrote an editorial for Dermatology Times on the subject of Mohs micrographic surgery and its potential abuses. I noted that while the procedure is very beneficial, it is sometimes overused for questionable indications.

Even Mohs surgeons with ample experience in detecting basal cell and squamous cell carcinomas can have difficulty detecting malignant melanocytes in frozen sections, making many apprehensive about using Mohs surgery for lentigo maligna. But proponents of the technique say the fast results and reduced rate of recurrence make Mohs well worth the effort.

As the Food and Drug Administration (FDA) reviews the safety of therapeutic and cosmetic botulinum toxin injections, dermatologists say adding warnings to Botox Cosmetic (botulinum toxin A, Allergan) would be unwarranted.

Nearly two decades after the introduction of botulinum toxin A for therapeutic indications, Botox Cosmetic (botulinum toxin A, Allergan) ranks among the safest and most successful æsthetic treatments available, dermatologists say. But, because of its relatively high cost, doctors say they would welcome competitive botulinum toxin options.

IPL," "photo-facial," light treatment, laser treatment - whichever name you use, intense pulsed light systems have become the single most popular light devices in use today. Their sales are largely unregulated, with most of the devices being used in spas, "medi-spas" and "rejuvenation facilities." Though universally offered, can IPL treatments differ at these "nonphysician facilities" and physicians' offices?

Occupational dermatitis is common, but often overlooked by primary care physicians. Therefore, dermatologists' skills are needed to not only diagnose work-related dermatitis, but also to identify the offending agents and manage the condition.

If it weren't for off-label drug use, dermatologists might have no medications at all. That may be a facetious statement, but it is one commonly repeated by dermatologists. A study from Stanford University a few years ago indicated that 20 percent of all drugs were prescribed off-label, and with biologics, fillers, immunomodulators and other drugs, dermatology's percentage may be even higher.