Family Med with a emphasis on dermatology

[Parmer]

I was at a family medicine interest group meeting and someone said they are a first year family medicine resident and they were planning on emphasizing derm in their practice. Are there derm fellowships available for family medicine residents?

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[ajce9]

None at this time. But most FPs get a good amount of derm in their training and most FPs can manage about 70% of all derm problems. This is because the majority of derm problems seem to be bread and butter cases.

You can do a bioplsy of a mole with proper training. You will get that in you residency.

Anything you don't know, you refer out.

If you don't know it just be honest with the patient. come up with a differential go from there. If you feel it is an emergency, refere out.

NOW I WANT YOU TO THINK REAL HARD AND TELL ME HOW MANY OUTPATIENT DERM CONDITIONS ARE AN EMERGENCY?

 

[McDoctor]

This came up on here a little while ago. You might find some more info by doing a search.

The key question here, if such fellowships exist, is whether or not insurance companies recognize you as a dermatologist and reimburse you as such. You perhaps can call yourself a fellowship trained dermatologist, but if major insurance providers don't recognize you as such (and pay you as such) then what's the point? And do you really think other primary care doctors, who also possess a modicum of dermatologic skills, are going to refer their patients to another FP with extra derm training or a board certified dermatologist? Most will probably recommend the classic residency trained dermatologist for their patients with complex dermatologic problems.

Just my $0.02 on the issue: If you want to be a dermatologist, and have the lifestyle perks that come with it, you pretty much have to work your a$$ off to get into the competitive residencies. There are no good shortcuts to this cushy lifestyle through FP.

 

[ajce9]

I don't think an FP should be treating complex derm problems to begin with. If you are thinking of doing mohs surgery, forget it.
But most derm issues can be seen by FPs.

As far as insurance companies go. They will pay you fairly well for a biopsy or treatment of common derm conditions. They may not pay as well as a derm but they still pay well. This is due to the nature of derm itself. A derm office visit will pay better than a general office visit sometimes. Its not always based on what you see. It is also based on the coding.

As far as getting a referals, you should not rely on them. Go out and get the business yourself.