Which would you prefer: to be incorrectly diagnosed with a serious illness and to undergo painful and unnecessary treatment, or not to be diagnosed with the serious illness you actually have, only to find out the truth too late? Neither outcome, of course, is desirable. But both have happened to patients who have been treated for dermatological concerns by a person who was not a board-certified dermatologist. It's important to understand why it matters whether a doctor performs your skin biopsy.
The medical community has done an excellent job in recent years of making the public aware of skin cancer, especially melanoma. Campaigns have sprung up around recognizing and getting prompt treatments for suspicious skin lesions. For baby boomers, who spent thousands of youthful hours in the sun without sunscreen, and a younger generation who flocked to tanning booths, the warnings are apt. Skin cancer is on the rise in the United States, and patients must be their own first line of defense, watching for skin changes that could indicate cancer.
But just getting a suspicious mole or spot checked out isn't a magic bullet that will save you from melanoma or other skin cancers. It matters very much who is examining you and deciding on your course of treatment.
You may assume that the efficient person in a white coat who comes into the exam room to peer at your skin is a doctor. Often, that person may have only a bachelor's degree. But you likely won't be told that unless you ask.
Chances are, if you end up on the examining table of a dermatology office, draped in a sheet, you're already feeling vulnerable and concerned about the health of your skin. You may not feel comfortable asking the person poised over you, peering at every mole and freckle, if they are qualified. But you absolutely should.
A recent New York Times article reported that many dermatology clinics, for which skin checks are described as their "bread and butter," are misdiagnosing patients' benign lesions as cancer, or recommending aggressive treatment for slow-growing cancers that could be treated much less invasively (and expensively). What's worse, some of the patients observed for the article actually did have serious melanomas that their care providers missed. How is this happening?
If you are asking yourself how so many doctors can be missing the signs of skin cancer, while also diagnosing minor lesions as serious, the answer is twofold. First, many of the health care professionals patients see, and assume are doctors, are in fact physician assistants. They may have some training and experience, but not to the extent that a board-certified dermatologist does. When not only your appearance, but your health and life are on the line, the difference is a crucial one. You need a medical doctor with the extensive training required to distinguish between a benign lesion and an aggressive melanoma.
The second part of the equation is, unfortunately, profit. Particularly with the aging population of baby boomers, dermatology is big business. The market for dermatology services in the United States, not including cosmetic procedures, is in the neighborhood of $11 billion annually. The market continues to grow, according to market research firm IBISWorld.
This area of medicine's profit potential has drawn the notice of private equity firms, which purchase dermatology practices around the U.S. and staff them primarily with less-trained medical professionals such as physician assistants. While these professionals may not introduce themselves as doctors, their demeanor and dress lead many patients to assume that they are. That's why it is important to ask your provider's credentials before you submit to an examination. They may have the best intentions, but they are there to help the company that owns the practice turn a profit, and that means they may be encouraged to over-treat some skin lesions, and rush through exams in a way that causes them to miss others.
The standard of care in dermatology, or any field of medicine, is what a reasonable doctor in the same situation would do to treat a patient. Aggressive treatment for slow-growing cancers or non-cancerous lesions, or overlooking a potentially life-threatening melanoma, are often a violation of this standard. If the patient suffers damages, such as disfigurement, pain, financial loss, or death, as a result of a provider's failure to uphold their duty of care, medical malpractice has occurred.
If you suspect that your dermatology practice treated you unnecessarily, too aggressively, or failed to identify a cancerous skin lesion during an exam, you may be entitled to compensation for any damages you suffered as a result. You may wish to consider consulting with an experienced Oregon medical malpractice attorney to discuss whether you have a claim worth pursuing. Feel free to contact our law office with any questions.
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