Troubled economy: Are derms seeing an impact on their practices?

September 1, 2008

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.

Key Points

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.

On Call wondered if dermatologists are seeing any effect on their practices. Are patients taking a second look at medical care when determining where to spend their money? We asked dermatologists around the country if they are seeing an impact, and - so far - most say any decreases they see are being offset by other factors.

Some dermatologists are actually wondering about reports on the troubled economy.

"None at all. Dermatology is very high volume. We're so busy, we just hired another physician. We are in an area where there's a lot of skin cancer, and we have an elderly population who still need medical treatments for things like eczema, psoriasis, warts and pre-cancers."

Practicing in a primarily medical/surgical dermatology group with five dermatologists, Dr. Jean-Baptiste says the busy office made her consider all the news reports.

"Sometimes, when you don't see these things in your own world, you wonder how much of it is a media phenomenon," she says.

Although other doctors think they see some effect of an economic slowdown in their practices, they say it's primarily limited to cosmetic procedures, and even then, other procedures may help balance that decrease.

In San Antonio, Van E. Perry, M.D., F.A.A.D., a general and pediatric dermatologist, says his patient load has been pretty steady, because he, too, deals with a lot of skin cancers and other medical conditions.

"Patients all have a pretty standard co-pay, because these aren't elective procedures, so they are coming in as usual.

"San Antonio seems pretty insulated from a lot of the economic pressures; the housing market is strong, and we haven't had a lot of layoffs yet. AT&T executives are moving to Dallas, so that could create some issues. "

Easing challenges

Dr. Perry says his office does recognize some of the challenges patients are already facing, and are trying to help where they can.

"If there's any problem, it's generally in their transportation and paying for gas. So, we try to make appointments as convenient as possible.

"If we can do two procedures in one visit, we will - that's something we've always done.

"I also try to go to the location nearest the patient. We're probably trying to be even more aware of that when we schedule appointments."

Stephen A. Vannucci, M.D., F.A.A.D., who practices in Chico, in north central California, is seeing a little less cosmetic spending, but with insurance companies still paying, he says the impact hasn't been major yet.

"One thing I have noticed is that payments are coming in a little more slowly. Patient deductibles keep getting higher and higher, and with more and more responsibility for paying falling to the patient, I've noticed that it is taking a little longer to get paid."

In Manhattan, Sumayah Jamal, M.D., Ph.D., F.A.A.D., thinks it's a bit early to assess the impact of a possible recession, although she says patients appear to be getting a bit more conservative in their medical choices.

"I'm doing a bit less in laser procedures than before, and people don't seem to be doing as many of the trivial procedures - things that aren't covered by insurance, like skin tags and hemangiomas. That does seem to be slowing down," Dr. Jamal says.