RESUMEN
Patient demand for procedures has increased in the evolving landscape of cosmetic dermatology. This has been fueled, in part, by social media and the growing normalization of cosmetic enhancements; however, this has led some patients to have potentially unrealistic expectations, placing undue pressure on dermatologists to meet these often unrealizable demands. This pressure is further exacerbated by patients who are seen as difficult, demanding, and time-consuming and who may require extensive counseling. Physicians may adopt dynamic or differential pricing strategies to offset the additional time and effort these patients require. We discuss the ethical concerns surrounding these pricing strategies in the cosmetic sphere, highlight the importance of transparency in pricing, and offer suggestions to promote clarity and fairness in cosmetic dermatology practices.
RESUMEN
While the prevalence is still being determined, more medical students are utilizing application consulting companies when applying to competitive residencies such as dermatology. We outline the structure of these companies, the scope of services provided, and the costs associated. We also discuss the ethical implications for the use in the residency application process of such firms and the impact of these practices on the candidate selection process. Finally, we offer possible solutions and measures that mitigate the impact of the use of consulting firms in residency applications. Application consulting services are meant to assist clients in maximizing their chances for a successful application cycle. Many companies cater to both prospective residency and pre-medical candidates, including "Med School Insiders," "BeMo Academic Consulting," and "Elite Medical Prep." The scope of application consulting services is vast. Clients can request services such as personalized school selection, application advising, document preparation review [e.g., curriculum vitae (CV), personal statements, and essays), electronic residency application service (ERAS)], and interview coaching. Another service offered is residency match advising, which details specific requirements programs desire. Prospective clients would gain a significant advantage, mainly when used at the outset of medical school training when planning a trajectory for competitive specialties. We review the ethical issues associated with using these consulting services.
RESUMEN
Doxxing, a type of cyberbullying, occurs when an individual's personal information is shared without consent and with malintent. Doxxing can be seen as a form of vigilantism, a way to hold others accountable for their actions or opinions; however, this form of justice can have catastrophic impacts on the victim, especially physicians. Since the COVID-19 pandemic, where physicians and health care providers strongly led public health advocacy efforts on social media, the frequency of doxxing and cyberbullying has increased. Diversity, equity, and inclusion (DEI) initiatives have also recently sparked controversy in dermatology and medicine, where advocates for DEI and those opposed to DEI initiatives have also been doxxed. This behavior is incredibly taxing on an individual's mental health, with substantial negative implications on a person's social, personal, and professional life. We discuss the ethical considerations of doxxing and avenues for better protecting physicians.
RESUMEN
A recent resolution with approximately 100 signatories entitled "Sunsetting All Diversity, Equity, and Inclusion (DEI) Programs" administered by the American Academy of Dermatology (AAD) sparked controversial debate within the field. Despite the AAD voting against the proposal to eliminate DEI initiatives, many underrepresented medical groups wondered how to move forward and create safe spaces for everyone. We discuss the relevance of DEI programs in today's society and the ethical challenges that may arise. We conclude with actionable recommendations on how organizations can improve their current DEI strategies to ensure they are more inclusive and not perceived as discriminatory.
RESUMEN
BACKGROUND: Dermatologists are trained in diagnostic and therapeutic procedures for cutaneous lesions, yet comparative trends for basic dermatologic procedures across dermatology providers are lacking at the national level. OBJECTIVE: To trend common dermatologic procedures among general dermatologists, Mohs surgeons, primary care providers or primary care physicians (PCPs), and nonphysician clinicians (NPCs). METHODS: Longitudinal analysis of 2016 to 2021 Medicare Public Use Files. RESULTS: Aggregate dermatologic procedural volume decreased 3.0%. Procedural volume declined among general dermatologists (-11.7%), Mohs surgeons (-16.7%), and PCPs (-41.7%) but increased among NPCs (+57.5%). The proportion of procedures by general dermatologists decreased substantially for premalignant destructions (-6.2%), skin biopsies and shave removals (-4.7%), and malignant excisions (-4.1%) and more notably in counties that were nonmetro (-7.1%), low in income (-6.1%), and with <4.0 dermatologists per 100,000 population (-7.0%). CONCLUSION: Aggregate procedural volume decreased across the study period with general dermatologists, Mohs surgeons, and PCPs performing a progressively smaller proportion. The increase in procedures by NPCs may help to address demand but underscores the value of formalized procedural training. The procedural decline by general dermatologists in rural and low-income counties and those with baseline dermatologist shortages may exacerbate existing unmet need. Primary limitation included lack of commercial data.
RESUMEN
Despite most Americans having healthcare coverage, coverage does not equate to access. For many, healthcare coverage is being threatened by contractual disagreements between major health insurers and hospitals. In New York, in efforts to control costs, Aetna and United Healthcare have recently engaged in contentious contract negotiations with NewYork-Presbyterian and Mount Sinai medical centers, resulting in unprecedented ripples in patients' health plans and access. These disruptions have been shown to negatively impact patient health and result in patients managing their treatment at steep out-of-pocket rates or scrambling to find new providers in-network. We discuss the ethical implications of fallouts between insurance companies and hospitals and their impacts on patients.
RESUMEN
Race, ethnicity, language, sex, age, income, insurance status, location, and other socioeconomic and demographic factors influence access to and quality of care for patients with psoriasis, which can potentially lead to inequitable outcomes.
