DermHelpCentral

Shared Decision Making

Recently, there was an excellent introduction to Shared Decision Making (SDM) in the Medical Journal of Australia.  SDM is a very important concept, and sadly, it is rarely encountered in medical practice at this time.

A useful precis appears in the MJA article:
"Shared decision making enables a clinician and patient to participate jointly in making a health decision, having discussed the options and their benefits and harms, and having considered the patient's values, preferences and circumstances. It is not a single step to be added into a consultation, but a process that can be used to guide decisions about screening, investigations and treatments."

Shared Decision Making:  What clinicians need to know and why should they bother.

Anchor Taping - Ingrown Nail

Ingrown nail (Onychocrptosis, from Greek onyx nail and kryptos hidden) is a common and painful form of nail disease. It is mostly commonly seen in teenagers and young adults, however, it can occur at virtually any ages. The common symptoms are discomfort and pain in the affected nail. The great toe is the most commonly involved digit. If this condition is not treated properly, it can develop an infection, cause difficulty in walking and potentially compromise the quality of life of the affected individual.

Proper nail cutting can be helpful to prevent ingrown nails.

Here we would like to introduce an anchor taping method that was devised by Dr. Hiroko Arai in Japan. Dr. Arai is one of the world-renowned nail specialists who has been advocating this simple, conservative but effective nail taping method. It is our hope that this simple but powerful technique can help our patients with this debilitating condition,. 

You can easily purchase taping materials at the local drug store or online shop. The following is what you will need for taping.
1. Elastic gauze tape (Elastikon)
2. Paper surgical tape for fixation
3. Scissors

Anchor Taping:
Taping is an easy and effective treatment method that will alleviate pain and relieve inflammation and granulation tissue, and the method is to be taught to patients.
Full Version: Download Nail Taping

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A Rational Approach to Isotretinoin

I started prescribing isotretinoin (then called Accutane) when it was first approved for use in 1982. Since then, there has been no time during my career when I have not had patients taking the drug. Isotretinoin has revolutionized the treatment of acne and is responsible for the fact that we see far fewer cases of severe disfiguring cystic acne today than we did prior to its approval.

I would like to share some of my observations over the past 32 years of prescribing this drug.

Read full article:   Download Isotretinoin_ Elpern -- edit

iPledge Program

Who's My Doctor?

Osler wrote: “The practice of medicine is an art not a trade, a calling not a business.”  However, many physicians (and other providers) have figured out how to game the system for financial gain.  Insights into this can be found at two databases.  One lists payments to over 800,000 U.S. providers by Medicare and the other documents payments from 17 drug companies to physicians.  In many cases, you can find your physician in these databases.

How Much Medicare Pays for Your Doctor’s Care
Use this form to find a doctor or other medical professional among the more than 800,000 health care providers that received payments in 2012 from Medicare Part B, which covers doctor visits, tests and other treatments. Payments may also cover overhead, such as staff salaries and drug costs. In some cases, when doctors work as salaried employees of group practices, the payments that show up under their names go to their institutions. Related Articles: Sliver of Medicare Doctors Get Big Share of Payouts.

 

Dollars for Docs:  How Drug Companies Money Reaches Physicians
In recent years, drug companies have started releasing details of the payments they make to doctors and other health professionals for promotional talks, research and consulting. As of 2013, 17 companies published the information, most because of legal settlements. Use this tool to search for payments. Read more about the data.