People hate Dermatologists

[MarlyMarl]

What do you say to those people who seem to have an aversion to Dermatologists? That say "you're in it for the money and the lifestyle?"

The people who demean and try to belittle the importance of skin care and act as if Dermatology is 98% jock itch and acne? Wouldn't dermatology be less compensated if it was such a cushy and irrelevant occupation? Enlighten me please.

Why do you enjoy Dermatology?

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[sore eye asses]

Q: What do you say to those people who seem to have an aversion to Dermatologists?

A: "Don't be scared, lil fella. Dermatologists are cuddly and sweet."

Q: That say "you're in it for the money and the lifestyle?"

A: I've never had someone accuse me of this, and I've never formulated an answer for this question because it never seemed necessary.

Q: The people who demean and try to belittle the importance of skin care and act as if Dermatology is 98% jock itch and acne?

A: I'd say it's closer to 99% jock itch and acne. But then what would all those people do who have jock itch and acne if they couldn't go to their dermatologist to get rid of it? There'd be an unchecked jock itch epidemic without us derms.

Q: Wouldn't dermatology be less compensated if it was such a cushy and irrelevant occupation?

A: I like tacos.

Your request: Enlighten me please.

My reply: You done been enlightened, son!

Q: Why do you enjoy Dermatology?

A: Because it's pretty and sweet and never bites too hard.

 

[sensitive skin]

Q: Why do you enjoy Dermatology?

A: It's all about the little things. For example, Friday I "delivered" an intact 4cm epidermoid cyst. Needless to say, it was a cathartic experience.

And the other little things like, comedone extractions. Completes my life on a level that my friends and family cannot understand.

 

[N-Surge]

A: I like tacos.

QFT! And it doesn't have to be the "fourth meal", unlike when on IM.

 

[dantt]

Wouldn't dermatology be less compensated if it was such a cushy and irrelevant occupation?

Tight cap on number of dermatologists trained.

 

[CandidateofDerm]

Tight cap on number of dermatologists trained.

Not that tight. Spots have only increased by something like 25 percent since late 90s. Derms are paid well bc there are chances for small procedures and cash pay. Cms payments never have and never will have anything to do with supply and demand bc the central planners can't keep up. Truthfully though you won't make the most money in derm. There are lots of fields in medicine from ortho to rads to that make more money. It's the lifestyle that can't be beat for a reasonable return. If u want to make the big money in derma like tHey do in some of those other specialties u better be heavily cosmetic or ready to work ur butt off in clinic hour time (which IMHO is much more physically demanding than just about any area of medicine).

 

[abcabc1]

What do you say to those people who seem to have an aversion to Dermatologists? That say "you're in it for the money and the lifestyle?"

The people who demean and try to belittle the importance of skin care and act as if Dermatology is 98% jock itch and acne? Wouldn't dermatology be less compensated if it was such a cushy and irrelevant occupation? Enlighten me please.

Why do you enjoy Dermatology?

I don't think it's an aversion, so much as envy from other Physicians and other people who work harder and don't earn as much.

IMHO, most people who enter Dermatology DO choose that field b/c it offers the combination of high pay, nice lifestyle and almost 100% outpatient work. That said, I don't think there's anything wrong with that although it is taboo to go around admitting to it.

If you really think about it, what aspects of the Science and Medicine of Dermatology would make it the most competitive field? IMO, nothing. It is the pay/lifestyle combination that makes Derm what it is.

 

[napster289]

I always have passion on skin caring. I'd love seeing everyone with a clear skin although some do not have those they spend money and time for it. As long as you're happy and knows the limit of what you're doing then keep on doing it because there's nothing wrong with it.

 

[Long Dong]

When i was 10 and found my dad's stash of porn, i knew then i loved looking at skin.

 

[sore eye asses]

When i was 10 and found my dad's stash of porn, i knew then i loved looking at skin.

I had a similar experience, but for some reason my dad had a stash of soft core porn. So, naturally, I grew to love impossible sequences of events that ended with me staring at a man's cleanly shaven ass whilst it gyrated over what I can only assume was a woman underneath. And for the climax, they panned to...you guessed it, the guy's grimacing face.

Like in shawshank redemption, where Red can't squeeeze a drop without say so, my weiner is conditioned to respond only to 45-minute sex sequences set at poolside that end with a guy's twisted up face resembling something between constipation, suprise, and having been tased in the taint.

 

[Otis601]

You can't just go around tasing people

 

[kleindike]

Well, not for me because it's part of my monthly routine, and I'm loving it everytime I see my dermatologist 'coz she takes care of my face.

 

[sore eye asses]

You can't just go around tasing people

ok, cute little baby edward furlong. you get your way. this time!

 

[Zoom-Zoom]

Oh come on. Derm is cool, the work and the pathology is really neat. But I don't know a single student pursuing derm who isn't in some way motivated by the lifestyle and compensation. This is totally reasonable and understandable, but to say it's not a big "pro" on the derm list is kind of laughable. And the compensation is directly proportionate to the % of elective procedures, which you might argue makes it of less actual medical "relevance." I wouldn't make that argument per se, but to say the compensation beats that of neurologists or internists or the majority of specialties because of some inherent medical necessity just doesn't add up. You've been enlightened.

 

[doctalaughs]

Oh come on. Derm is cool, the work and the pathology is really neat. But I don't know a single student pursuing derm who isn't in some way motivated by the lifestyle and compensation. This is totally reasonable and understandable, but to say it's not a big "pro" on the derm list is kind of laughable. And the compensation is directly proportionate to the % of elective procedures, which you might argue makes it of less actual medical "relevance." I wouldn't make that argument per se, but to say the compensation beats that of neurologists or internists or the majority of specialties because of some inherent medical necessity just doesn't add up. You've been enlightened.

No one is saying that lifestlye isn't a pro in derm, just as no one denies it in radonc, psychiatry, ophthalmology and many other specialties that are light on emergencies.

However, perhaps you should "enlighten" someone when you have a just a bit of actual knowledge about a specialty rather than repeating trite stereotypes that you heard around the hospital and in class. Compensation in derm (and every specialty) is not based on medical necessity - it's based on a rather arbitrary fee schedule. For the majority of dermatologists it is also not primarily based on % of elective procedures (<10% of most derm practices) - you can be compensated in dermatology very well by finding and cutting out skin cancers, following melanoma patients with thorough skin checks, treating psoriasis and other autoimmune disorders. Add in mohs surgery and reading your own path slides (if you want). You certainly won't need to touch cosmetics if you aren't inclined.

 

[Cirrus83]

What do you say to those people who seem to have an aversion to Dermatologists? That say "you're in it for the money and the lifestyle?"

The people who demean and try to belittle the importance of skin care and act as if Dermatology is 98% jock itch and acne? Wouldn't dermatology be less compensated if it was such a cushy and irrelevant occupation? Enlighten me please.

Why do you enjoy Dermatology?

Ignore them. I mean, you've seen all the patients who really needed a dermatologists' help and how much you help people with seriously debilitating diseases. And honestly until very recently I never even met a derm patient who wasn't super grateful-and that patient had a serious documented behavioral problems.

I don't think the specialty sniping is limited to dermatology anyway, almost all the fields have some insult or another for other fields. I think I've heard pretty much every field trash every other field by now, lol.

 

[droliver]

What do you say to those people who seem to have an aversion to Dermatologists?

Well many derm practices are set up as patient mills to maximize revenue and turnover and patients pick up on this. When the doctor breezes in and out under 1 minute or sic their nurse/PA/NP on them patients resent it.

 

[MOHS_01]

Well many derm practices are set up as patient mills to maximize revenue and turnover and patients pick up on this. When the doctor breezes in and out under 1 minute or sic their nurse/PA/NP on them patients resent it.

There would be plenty of time for hand holding if they were performing $3.5k and up lipo/augs/face lifts/etc. When you're knocking it out $38-100 at a time you have to move a little faster. Sometimes they do have to stop and take a little longer, though... such as the not too uncommon scenario of having to undo some damage... for example, re-education efforts to remove the poor information provided by the "skin specialist" who works in some office pushing products and procedures while their employer is in the OR somewhere.

 

[doctalaughs]

There would be plenty of time for hand holding if they were performing $3.5k and up lipo/augs/face lifts/etc. When you're knocking it out $38-100 at a time you have to move a little faster. Sometimes they do have to stop and take a little longer, though... such as the not too uncommon scenario of having to undo some damage... for example, re-education efforts to remove the poor information provided by the "skin specialist" who works in some office pushing products and procedures while their employer is in the OR somewhere.

There are bad docs in every specialty but since Dr. Oliver comes over to this forum to remarking on unethical derm practices I'll ask him to go sit with a dermatopathologist for a few months and watch the slides that come across from some plastic surgeons. Talk about money mills- biopsying A-Z specimens that are benign, huge excisons of benign things, tiny shave biopsies for inflammatory conditions- of course they always come in as "lesion" and no ddx because we all know dermpath is an exact science

 

[droliver]

There are bad docs in every specialty but since Dr. Oliver comes over to this forum to remarking on unethical derm practices

Nobody implied anything about "unethical", my observation is on why people frequently comment to me on why do not enjoy going to see the Dermatologist. You hear the same complaint about ophthalmology and really busy ortho practices as well. The business model of many such places is to herd 50-75+ patients thru per day such that they feel like a herd of cattle..

 

[MOHS_01]

It's the business model because it's the one that works best; it is the predictable and inevitable result of the reimbursement system placed before us. If one provides covered services -- particularly low reimbursement per episode of care services -- throughput becomes make or break. When I was doing a fair amount of general derm having 50 patients on the schedule would have been a fairly light day.

@doctalaughs -- the experience you describe is well known and rather common. So is the 50-75+ derm visits/day practice droliver describes. At our training institution everyone knew by name the community offenders.... not only those you describe (and there were some awful ones) but also folks who would submit an excision that was 1cm wide and 5cm long, 5+ punch biopsies out of a single inflammatory process, etc.

People may "hate" their dermatologist much in the same way many of our colleagues belittle and demean the field. It is almost comical how quickly the tone changes when they have something they need one for... or have tried something on a patient that made it worse.

 

[IzzyMD09]

Who hates dermatologists?

Pts....probably because they have to wait, 5-7 months to see one, unless they are uninsured and then they just go to the ER

Other Doctors.....jealousy, not the cushy lifestyle because any field could provide a cushy lifestyle, esp in OP clinics, the money, medical dermatologists dont get paid that much, medical dermatologists doing surgical procedures get paid but get paid more because of the procedures/malpractice insurance, cosmetic crap can be/is done by any physician, np pa whatever, so it cant be the money thing either.... it really boils down to jealously, lets face it, Derm is like Top Gun Its the best of the best, and even some of those best dont get in.....

 

[NAGNAM]

Who hates dermatologists?

Pts....probably because they have to wait, 5-7 months to see one, unless they are uninsured and then they just go to the ER

Other Doctors.....jealousy, not the cushy lifestyle because any field could provide a cushy lifestyle, esp in OP clinics, the money, medical dermatologists dont get paid that much, medical dermatologists doing surgical procedures get paid but get paid more because of the procedures/malpractice insurance, cosmetic crap can be/is done by any physician, np pa whatever, so it cant be the money thing either.... it really boils down to jealously, lets face it, Derm is like Top Gun Its the best of the best, and even some of those best dont get in.....

not just that, but you can totally forego the ability to properly form a coherent paragraph

 

[N-Surge]

Izzy is thinking out loud, which is like totally allowed here.

it's also perfectly ok to forgo punctuation, spelling, and things like "." ' s

We are a rough crowd!

 

[dermathalon]

Right on N-Surge, on board with you here.

What's with the people getting so focused on punctuation...we all surely have better things to do than check, re-check, and triple check a post for punctuation......especially on a forum like this one