What's in a name?

September 1, 2004

Dermatologists -whether or not they perform complex surgical procedures - have mixed feelings about the term, although most think it will only confuse the issue.

Dermatology has long been trying to achieve recognition as a surgical specialty, and it recently succeeded.

What's in a name?

"On Call" wondered what dermatologists think of the new designation and whether they think it will be clear to their patients. We also asked whether dermatologists who include surgical procedures in their practice, but who haven't had the specific surgical residency training programs, will try to grandfather in to the board cert-ification by exam. Do they think the certification is important enough to go through the testing?

Dermatologists - whether or not they perform complex surgical procedures - have mixed feelings about the term, although most think it will only confuse the issue. Even dermatologists who don't consider themselves surgeons think the term will not be clear for patients.

Jay A. Levin, M.D., of Atlanta, says, "It sounds confusing to me. I don't think the public will pick up on that as a distinct or recognized entity as compared with the title dermatologic surgery. It's vague and less descriptive than dermatology and dermatologic surgery."

He describes himself to patients as a dermatologic surgeon and plans to continue to do so.

"If I had to use the designation, I would probably use a sign that said both procedural dermatology and surgery. I'd be afraid that people would think that all I did was procedures like skin patch testing or phototherapy."

Objections The objection to the term dermatologic surgeons comes primarily from other surgical subspecialties such as plastic and reconstructive surgeons who contend that all official surgical subspecialties include general surgery training - something that dermatologists don't have, even if they do surgery.

Dr. Levin started out in a surgical residency, but he doesn't buy the argument.

"I actually did part of a surgical internship but decided I didn't want to be a plastic surgeon," he tells Dermatology Times. "Most of us had some training in surgery. Even without that, I consider myself a dermatologic surgeon based on the training I got in my dermatology residency. To me, dermatologic surgery means you're doing surgery on the skin. Going to a dermatologic surgeon, patients know they're not seeing a plastic surgeon and they're not getting an appendix or a gall bladder removed."

Likes idea, not designation Kelly Jerstad, M.D., is a fellowship-trained Mohs surgeon in Sioux Falls, S.D. She likes the fact that the subspecialty will officially exist, but isn't pleased with the designation.