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Dermatologists more elusive than ever…

Thanks to med blogger Kevin MD for highlighting an interesting, though cynical, comment about the extended wait times that many people have in getting an appointment to see a dermatologist.

“It’s just as well that there’s a long wait. Someone who comes in with a rash is likely to be biopsied and end up with a scar. If they wait until an appointment is available the rash will probably have cleared up.”

The Boston Globe explains why consumers are having a hard time getting dermatologist appointments:

“In dermatology, the waits are created both by patient demand and, some believe, by dermatologists’ shifting their time to new, more lucrative or complex procedures. Public service campaigns have heightened fear of skin cancer, and melanoma cases are rising, meaning more people are seeking appointments.

At the same time, some dermatologists are devoting time to cosmetic procedures, or to skin cancer surgery that used to be done by general surgeons. Meanwhile, the federal government limits the number of residents hospitals can train, and hospitals would have to create more dermatology slots at the expense of other specialties. This means the number of dermatologists entering practice each year has remained flat, at about 300 nationally, making it difficult for practices to hire new doctors. Just as many have been retiring in the past five years.”

Have you had a hard time finding a dermatologist?

This post originally appeared on Dr. Val’s blog at

Back Pain 911 – a doctor finds out what real pain is like

Speaking from experience, back pain can be totally incapacitating.  Several years ago I traveled to Colorado for my first ski trip in that beautiful state.  As I was bending over to hoist my unimaginably heavy ski boot duffle bag over my shoulder, I suddenly felt a knife-like pain in my lower back.  It took my breath away and I couldn’t stand up straight.  My friends looked at me quizzically.  I crawled into the ski lodge and lay on the floor, trying to understand what was going on.  I assumed that the pain would pass in an hour or so… but three days later I still couldn’t really move.  After some discussion with colleagues over the phone, I decided to call 911.  My friend’s young kids were filled with glee as a firetruck pulled up to the lodge, and they brought in a stretcher to take me out.  I felt like a total idiot – I hadn’t even hurt myself on the slopes.  As a doctor I could imagine how eyes would roll in the ER when they heard: “32 year old female complaining of back pain after lifting her suitcase.”  That doesn’t merit an ER visit, complete with firemen and ambulances, does it?

On my way to the hospital, tears filled my eyes with each jolt of the ambulance.   I couldn’t control it, and I wondered if the ambulance team thought I was being a baby.  I was stuffed inside an MRI machine soon after arriving in the ER, and the doctor who ordered it soon gave me the unexpected news: “everything looks just fine.  Your MRI is normal.”

I couldn’t believe it.  I was sure I had herniated a disk or ripped some muscles off my spine, or maybe I had  burst a blood vessel in my spinal cord – or maybe I had cancer?  Nope.  Everything was normal.

I stayed overnight in the hospital – at one point I met the orthopedic surgeon on call.  I could tell immediately that I was supremely uninteresting to him – nothing to operate on, give her some pain medicine and get her out of here!  I just wanted someone to explain to me why everything was “normal” and yet each tiny movement made me whimper in pain.

Well, I wish I could tell you that I figured out the source of my pain, or that I found a miracle cure for it.  As it turns out, it took about a month for me to move around comfortably again, nothing really helped the pain (vicodin made me sleepy and nauseated), and even now, from time to time I get a twinge of that old pain if I bend a certain way.

I guess what I learned is that pain is real – even if all the tests argue otherwise.  And one thing’s for sure, I take all my patients’ pain complaints very seriously.  “Throwing my back out” was the best education I could have had for my career in pain management.

Val Jones is a licensed practitioner of Rehabilitation Medicine and Senior Medical Director of Revolution Health’s portal. No information in this blog is intended to diagnose or treat any condition. The opinions expressed here are Val’s and do not necessarily reflect those of Revolution Health.This post originally appeared on Dr. Val’s blog at

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