What doctor should you see for eczema?

Hand EczemaThe world of health care can be a complex and confusing world to navigate.  Add in the mix of different insurance plans which can regulate your path to your doctor, and that makes it all the more confusing.  For instance, your insurance plan may make you see your primary care physician or pediatrician before you can see a specialist such as a dermatologist or allergist.

So for eczema, what type of doctor should you see?

The answer to who you should see for eczema may depend on whether you are asking for yourself (if you are an adult) or for your child.

For children, common physicians who treat eczema include dermatologists, allergists/immunologists, and pediatricians.

Dermatologists are doctors that specialize in the skin, hair and nails.  Eczema is one type of skin condition that treat these disorders.  Dermatologists complete extra training in their specialty.  Pediatric dermatologists further specialize in skin, hair and nail diseases of kids.  You may see some physicians advertise themselves as being board-certified.  This means that they passed certain training requirements and passed the board exam for that specific area.  Thus, you may see someone advertised as a board-certified dermatologist or a board-certified pediatric dermatologist.

Allergists/immunologists first train in internal medicine or family medicine or pediatrics and then further specialize in allergy/immunology.  Because eczema does have an immunologic basis, this is a condition that allergists and immunologists also treat.  Additionally, if food allergy or other environmental allergy is suspected, this may be further reason to refer to an allergist.

Pediatricians focus on the health and diseases involving kids.  Since eczema is a common condition affecting kids, many pediatricians are well versed in this condition. However, some pediatricians may have limited training in the skin. In this case, you may want to seek further care from either a dermatologist or allergist.

Primary care physicians (PCPs) are for adults what pediatricians for kids.  If PCPs are not able to manage the eczema, you will most likely be referred to a dermatologist.  Referral to an allergist is less common for the adult population with eczema. That may be because environmental triggers play a smaller role in adult eczema as compared to childhood eczema.

Regardless of who you see, the important thing is that your physician is well-versed in treating eczema.

Just as important is the relationship that you have with your physician.  Eczema can be a very frustrating condition so it’s important that you have a good teammate to face eczema head on!

For an interesting paper on physician referral patterns and treatment patterns for eczema, see this paper.

Highlights from the AAD 2013 in Miami

Alas, the 2013 annual meeting of the American Academy of Dermatology is nearing its close.  It’s been a great 4 days in Miami — albeit a little colder and cloudier than expected, but hey, we’re all indoors enjoying the sessions anyways right?

courtesy of Flickr user ceiling
courtesy of Flickr user ceiling

After a jam-packed schedule, I now have a little bit of time to give you an update on the meeting.

This has been an exciting year in dermatology and yesterday’s Plenary Session attested to that.  Dr. Daniel Siegel gave remarks as his term draws to a close and as Dr. Dirk Elston  looks towards his incoming presidency of the AAD. Dr. Siegel remarked on some of the challenges that we have as dermatologists as the government continues to look at the proper way of reimbursements for all of medicine including dermatology.  Dr. Siegel was optimistic about his forecast for the  coming years of dermatology, predicting advances in science and technology which would allow for personalized treatment for the deadly cancer melanoma and “biopsies” without having to cut the skin.  He also called for us to continue to work together as a group as dermatologists continue to be the expert group that provides skin care.

It’s been an exciting year under Dr. Siegel’s direction, and of course, we will always remember his getting his head shaved at the Summer AAD in Boston afterSkinPAC raised more than 1 million dollars!

‘Tis the Dermatology Interview Season, cont.

The Dermatology Interview Season is firmly underway! 

This can be a very exciting but also stressful time.

Here are some of my personal quicktips for the interview season based on past experience (disclaimer, my past experience was years ago…):

Pre-interview dinners. Helpful to go.  You’ll learn a lot about the program and the personality of residents.  Some programs may ask for feedback from residents or faculty who are present.  Be yourself.  Be nice.  Try to be on time (although winter travel can always be tough to predict!) Look up the restaurant and dress appropriately.

Tips for the interview. It may be helpful to take a look at the frequently asked questions list.  Get a curveball?  Don’t worry — probably meant to see how you think through things or respond.  You’re not expected to know everything or be perfect.  And it’s okay to say, “I don’t know” — that’s true for any situation.

Thank you letters. Rank list is probably already made by the time your letter arrives, but send emails or letters as you see fit; try to put something somewhat personal in there.

‘Tis the Dermatology Residency Interview Season

Sure, it’s the Holiday Season, but it’s also residency interview season! Some of you may be in the midst of interviews (granted, you’re probably catching a well needed break this week and neck).

Here’s a list of some FAQs that would be handy to be prepared for at your dermatology residency interview!

Why derm?
Why this program?
Why this city?
What are you looking for in a program?
What other programs are you considering?
If not derm, what would you do?
Tell me about yourself.
Tell me about a difficult situation you have been in.
Tell me about a medical case where an ethical problem came up.
Tell me about an interesting derm case.
What is the most interesting thing you have done?
Tell me about your research/project/case report.
Who are your role models?
Tell me about the last book you read.
Specific interests in derm?
Where do you see yourself in 5 years? 10 years?
When have you been a leader?
How are you a team player?
What achievement are you most proud of?
Any questions?

For research applicants:
Be prepared to give a 5 min synopsis of your research.
Be prepared to answer ?’s regarding literature surrounding your area of research.
Who are potential research mentors at this program?
If you don’t have a PhD, do you think you can be a successful physician-scientist?
What challenges do you envision as a physician-scientist?
Why do so few dermatologists do research or stay in academics and what makes you different?