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Total body photography not standard of care


Eckley M. Keach's article in the June 2006 issue of Dermatology Times ("Successful malpractice defense lies in body of evidence") provides tips for dermatologists to reduce the risk of malpractice liability from treating high-risk melanoma patients.

Mr. Keach's contention that "Total body photography is rapidly becoming a standard of care in melanoma care" for treating high-risk melanoma patients is both inaccurate and self-serving.

The current standard of care for high-risk patients includes a full-skin examination on a regular basis (annual in most, but not all, cases) and recording, either by diagram or by photography, the size and locations of lesions that are not clearly typical moles. The use of "mole mapping" photography and software, and of professional photographers for whole body photography, is investigational and at this time is restricted to only a limited number of academic centers and practices.

While Mr. Keach's input is appreciated, as a successful malpractice attorney, his incentive is to set the bar as high as possible, regardless of the actual evidence to the contrary. The standard of care in professional liability cases is determined by prevailing practices of qualified physicians acting reasonably under particular facts and circumstances, not by non-peer-reviewed articles written by plaintiff's attorneys.

- Stephen P. Stone, M.D., F.A.A.D.
American Academy of Dermatology

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