RESUMEN
The National Resident Matching Program (NRMP), known as "The Match (TM)," facilitates the placement of medical graduates into residency and fellowship programs in the United States. Programs may opt out of TM for various reasons. The selective and intermittent withdrawal of programs from TM raises ethical concerns surrounding fairness, transparency, beneficence, autonomy, and justice for applicants. We discuss these issues, present the history behind TM, and offer suggestions to promote fairness.
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
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 healthcare 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
This continuing medical education (CME) series reviews updated Delphi consensus surface anatomy terminology through the lens of common medical and procedural dermatology scenarios, helping to underscore high-yield points that can be readily integrated into clinical practice to support patient care. Part I of this series will discuss the current state of surface anatomy terminology in dermatology, outline implications of precise and consistent terminology, provide an illustrative overview of high-yield consensus terminology, highlight prominent landmarks that can aid in critical diagnoses, and relate the importance of precise terminology to medical management. Part II will draw upon consensus terminology to inform management of cutaneous malignancies and support optimal outcomes in dermatologic procedures.
RESUMEN
This continuing medical education (CME) series reviews updated Delphi consensus surface anatomy terminology through the lens of common medical and procedural dermatology scenarios, helping to underscore high-yield points that can be readily integrated into clinical practice to support patient care. Part I of the series reviewed the current state of standardized surface anatomy, provided an illustrative review of consensus terminology, highlighted prominent landmarks that can aid in critical diagnoses, and related the importance of precise terminology to principles of medical management. Part II will utilize consensus terminology to heighten recognition of key landmarks in procedural dermatology to support optimal functional and aesthetic outcomes.