Dermatologists how do you defend your turf?

[LADoc00]

Im not totally convinced dermies have any lock on their market share (say unlike path, rads or other specialist-types). The most profitable dermatology practice in my area is actually run by a DO, and a DO that never did a dermatology residency or any residency for that matter.

Dont you think marketing plays a much greater role than say your hard earned credentials in this arena? Aside from getting more referrals from primary care types (who are doing more of their own derm these days anyway), Im not seeing a huge advantage in even doing the derm residency and fellowship when someone can simply blitz market you under the table, Harvard residency and all.

Aside from educated consumers who *might* recognize board certification and the name of a top residency, I see the average American consumer going more for bling bling.

---

Members don't see this ad.

 

[cdql]

Probably depends on what you're going in for.

If I were going in for simple botox or pimple popping, then yes, the one who advertises the most might get my business.

Conversely, if I'm going in because the disgustingly annoying acne on my face just isn't going away after visiting 5 other dermatologists on my town (true story), then perhaps I'd be interested in who is the best and not who has the most ads.

(The last dermatologist I went to see for my acne, by the way, actually has to start turning away customers because he is getting inundated. He has eliminated all cosmetic procedures from his practice and now charges $500 for an initial consultation!!)

Pretty much, if you're good at your job (and I imagine most dermatologists out there are if they had to scrape, kick, and bite for those highly-coveted residency spots), I'm sure they won't be hurting for business.

 

[xSTALLiONx]

Probably depends on what you're going in for.

If I were going in for simple botox or pimple popping, then yes, the one who advertises the most might get my business.

Conversely, if I'm going in because the disgustingly annoying acne on my face just isn't going away after visiting 5 other dermatologists on my town (true story), then perhaps I'd be interested in who is the best and not who has the most ads.

(The last dermatologist I went to see for my acne, by the way, actually has to start turning away customers because he is getting inundated. He has eliminated all cosmetic procedures from his practice and now charges $500 for an initial consultation!!)

Pretty much, if you're good at your job (and I imagine most dermatologists out there are if they had to scrape, kick, and bite for those highly-coveted residency spots), I'm sure they won't be hurting for business.

Unless.. they create a better race with better skin which is less proned to pathologies and other abnormalities...

 

[ny skindoc]

Im not totally convinced dermies have any lock on their market share (say unlike path, rads or other specialist-types). The most profitable dermatology practice in my area is actually run by a DO, and a DO that never did a dermatology residency or any residency for that matter.

Dont you think marketing plays a much greater role than say your hard earned credentials in this arena? Aside from getting more referrals from primary care types (who are doing more of their own derm these days anyway), Im not seeing a huge advantage in even doing the derm residency and fellowship when someone can simply blitz market you under the table, Harvard residency and all.

Aside from educated consumers who *might* recognize board certification and the name of a top residency, I see the average American consumer going more for bling bling.

There are turf issues in most medical specialties.It is possible for FPs Internists or others to learn some Derm, do Botox etc.. and market themselves but its much more difficult to get a practice going in this way,and there are many issues relating to practicing a field in which you do not have recognized credentials.There is presently an acute shortage of actual residency trained dermatologists so anyone graduating is in high demand and quickly snapped up at very high salaries.Or they can easily set up a busy practice of ther own.
But aggressive entrepeneurs who are physiatrists anesthesiologists etc have set up laser centers and the like so its possible.

 

[dynx]

Probably depends on what you're going in for.

If I were going in for simple botox or pimple popping, then yes, the one who advertises the most might get my business.

Conversely, if I'm going in because the disgustingly annoying acne on my face just isn't going away after visiting 5 other dermatologists on my town (true story), then perhaps I'd be interested in who is the best and not who has the most ads.

(The last dermatologist I went to see for my acne, by the way, actually has to start turning away customers because he is getting inundated. He has eliminated all cosmetic procedures from his practice and now charges $500 for an initial consultation!!)

Pretty much, if you're good at your job (and I imagine most dermatologists out there are if they had to scrape, kick, and bite for those highly-coveted residency spots), I'm sure they won't be hurting for business.

Pretty much anyone can be good at derm. The barriers to the residency are artificial. Now, you should hope to god that people look for board certification to bolster your income but the bottom line is...its not plastic surgery. You're not going to kill anyone by messing up. Board certification means almost nothing and most people can save time and money by going to a FP doc.

 

[cdql]

Pretty much anyone can be good at derm. The barriers to the residency are artificial. Now, you should hope to god that people look for board certification to bolster your income but the bottom line is...its not plastic surgery. You're not going to kill anyone by messing up. Board certification means almost nothing and most people can save time and money by going to a FP doc.

I'm pretty sure incorrectly diagnosing/excising skin cancers or haphazardly firing botox injections into patients is lethal.

 

[dynx]

I'm pretty sure incorrectly diagnosing/excising skin cancers or haphazardly firing botox injections into patients is lethal.

Most those dx go from FP to path...no derm needed. A monkey could inject botox...I think they do now. But if it makes you feel better....YES, THANK GOD FOR DERMS OR NO ONE COULD INJECT BOTOX SAFELY!

 

[cdql]

No no sir, you are correct. And I apologize. Let's get rid of this field. USELESS EXCUSES FOR DOCTORS!

 

[dynx]

No no sir, you are correct. And I apologize. Let's get rid of this field. USELESS EXCUSES FOR DOCTORS!

Whoops! now you're going to far the other way because you're an idiot. See, derm has its place in managing rashes of unknown orgin or helping in the diagnosis of diseases with complex skin manifestations. But when you start talking about "protecting" procedures and managment that can be done by a family doc...and MOST derm can, then you're talking about screwing over the patient just so you can protect your fat paycheck.

 

[ny skindoc]

Pretty much anyone can be good at derm. The barriers to the residency are artificial. Now, you should hope to god that people look for board certification to bolster your income but the bottom line is...its not plastic surgery. You're not going to kill anyone by messing up. Board certification means almost nothing and most people can save time and money by going to a FP doc.

Dermatologists offices are filled with people who would beg to differ.Many of them end up there because other docs had little interest or expertise in handling their skin problems.Not all derm problems are simple to manage. I'm not saying Derm is plastic surgery but a physician who does nothing all day but treat skin problems will come up with a more accurate dx and treatment plans than someone who sees it as a sideline.Thats true about almost anything in medcine.But FPs,Peds can do fine with most common skin problems.

 

[Polska]

I agree that seeing things 100x a day makes you better to diagnosis it. However, it is something of concern if primary care is starting to do Botox and Plastic Surgery wants to take your Derm procedures.. I'm just wondering what the attendings who have experience are thinking. Is this a "they constantly try to encroach on our field" type thing or is this a "we're kinda worried too and trying to get our own lobbying group going"..

I linked to an article in this other post talks about the plastic surgery legislation:
http://forums.studentdoctor.net/showthread.php?t=338305

 

[deleted87716]

it is something of concern if primary care...wants to take your Derm procedures... Is this a "they constantly try to encroach on our field" type thing or is this a "we're kinda worried too and trying to get our own lobbying group going"

Are some dermatologists really worried about primary care docs taking business away from them? In my area, there are relatively few primary care physicians doing any significant cosmetic work...we handle mostly run-of-the-mill acne, rashes, biopsies, moles, superficial neoplasms, etc. Practically every dermatologist around here takes months to see a new patient, unless it's something urgent. I don't hear any of them complaining about not being busy enough.

 

[cdql]

Are some dermatologists really worried about primary care docs taking business away from them? In my area, there are relatively few primary care physicians doing any significant cosmetic work...we handle mostly run-of-the-mill acne, rashes, biopsies, moles, superficial neoplasms, etc. Practically every dermatologist around here takes months to see a new patient, unless it's something urgent. I don't hear any of them complaining about not being busy enough.

I agree. As a patient, it gets irritating waiting a minimum of 3 months to see a dermatologist. I called yesterday and was told that late Feb is when openings would reappear again. FANTASTIC! Perhaps I will just douse my face in lighter fluid and wait until then!

 

[Polska]

So from the responses so far.. This is mostly media hype..

It might also deal with geography.. I can see big urban areas competing.. but if you are the only clinic for a 20 mi radius.. you might have nothing to worry about..?

Right?

 

[Jiminy Cricket]

a good deal of cosmetic procedures are so easy a monkey could do them.....there is no way of safeguarding these procedures, fp will surely grab off a chunk

you guys will have to fight the plastics...maybe get mroe interventional fellowships out there.

it will be like the fight that is sure to begin betw neurology, rads and neurosurg over interventl proc. and neurorads.

 

[dynx]

it will be like the fight that is sure to begin betw neurology, rads and neurosurg over interventl proc. and neurorads.

Sure to begin or sure to continue? I think they are in the 5th round and neurosurg took a beating to begin with but the Rocky theme is starting to play and things look like they may be turning...
I don't think you can beat crazy mother f*ckers that dont sleep.

 

[Taurus]

I posted this article in the allo forum. It seems to me that any physician with an entrepreneurial bent and some business sense could enter the cosmetics field and be successful.

http://www.nytimes.com/2006/11/30/u...820c27b7&ei=5094&partner=homepage&oref=slogin

Five years ago, cosmetic medicine was primarily the domain of plastic surgeons, facial surgeons and dermatologists — medical school graduates who undergo several years of training in facial skin and its underlying anatomy. But now obstetricians, family practitioners and emergency room physicians are gravitating to the beauty business, lured by lucrative cosmetic treatments that require same-day payments because they are not covered by insurance and by a medical practice without bothersome midnight emergency calls.

 

[1bloodyred]

As a couple of the other post have already stated, primary care docs can comfortably examine and treat MOST derm problems.

I know of one FM who advertises the derm portion of his practice. He get most of the common problems including ACNE, general rashes, cancer screenings, biopsies, moles, etc.

He biopsies anything he is not sure about. If it turns out to be something serious or something he does not feel comfortable with, he tells the patient he needs to send them to someone who specializes in more specific cases.

In my area there is a 3 month wait to see a dermatologist. If you have rash, or want a mole checked or biopsied, you don't want to wait 3 months.

Because he advertises he gets lots of derm cases. This means he can charge more due to the complexity or a procedure that he does.

He also does cosmetic things like botox, he has a laser for acne but does not use it as first line treatment. It also does hair removal and other cosmetic procedures.

I'm sure people ask him if he is a dermatologist. He most likely states that he is trained in dermatology. Most FMs are.

Isn't it true that most of the cases that dermatologist see in their office is common thing? Just like most of the cases FMs see in their office are common things for FM.

So, if someone can mamage 70% of all derm cases and has to refer or turn away 30%, thats good numbers.

 

[MDstudent79]

There is presently an acute shortage of actual residency trained dermatologists so anyone graduating is in high demand and quickly snapped up at very high salaries.Or they can easily set up a busy practice of ther own.

Why is there such a shortage given the seemingly high demand for derm residencies among med students?

 

[cdql]

Why is there such a shortage given the seemingly high demand for derm residencies among med students?

...

There is a high demand for these residencies because there is a low supply.

The low # of residency spots for derm would therefore reflect low #'s of dermatologists going out into the marketplace.

In America, we call that a shortage.

 

[YouDontKnowJack]

derms need to stop hogging the ball.

it doesn't do the patient any service to make him wait 3 months for an appt.

if primary care docs weren't getting f*cked left and right, up & down by insurance companies, and being overworked, resulting in effectively lower hourly wages, you wouldn't see an increasing number of nonspecialists entering the cosmetic field.

if there's someone to lynch, it should be the aestheticians who are running health spas. Those chicks have fewer credentials and they're taking home good bacon.

Thank god for lasers and injections and crap that other docs can use.... and get paid for.

 

[OnMyWayThere]

A friend of mine *just* finished his derm residency and signed with a group for $350,000 a year. He is board certified and is doing what the dermatologist is mainly trained to do: diagnose and treat pathology of the skin (and nails?) That turf will always remain the dermatologist's. Now dentists, OB/Gyns and all injecting Botox isn't really competing with a board certified dermatologist persay. That is a whole other business of its own.

 

[sirus_virus]

IMO the artificial demand that derms have created will eventually lead to a large enough constraint on the supply that will force pts to start looking elsewhere for their treatment. In my locale it takes about 2 months to see a derm, and a dcotor just like the one OP is talking about(non-derm) has opened two clinics targeted at 'basic' dermatological consults. My neigbour works at one of these clinics and he says business is good. I am not sure how much of derms business comes form these so called "basic" routines(acne, botox etc) but from the amount of business this guy is doing, my guess is a lot.

Derms protect your turf!!

 

[ny skindoc]

IMO the artificial demand that derms have created will eventually lead to a large enough constraint on the supply that will force pts to start looking elsewhere for their treatment. In my locale it takes about 2 months to see a derm, and a dcotor just like the one OP is talking about(non-derm) has opened two clinics targeted at 'basic' dermatological consults. My neigbour works at one of these clinics and he says business is good. I am not sure how much of derms business comes form these so called "basic" routines(acne, botox etc) but from the amount of business this guy is doing, my guess is a lot.

Derms protect your turf!!

The field of Dermatology has been trying to increase the number of residency spots for several years..its difficult to do as they are funded through hospitals and medicare.You cant just "open them up' there is a strong motivation to do so for the reasons stated. Some effort to have drug companies fund positions has been talked about but that is highly controversial.

 

[Jiminy Cricket]

Im not totally convinced dermies have any lock on their market share (say unlike path, rads or other specialist-types). The most profitable dermatology practice in my area is actually run by a DO, and a DO that never did a dermatology residency or any residency for that matter.

Dont you think marketing plays a much greater role than say your hard earned credentials in this arena? Aside from getting more referrals from primary care types (who are doing more of their own derm these days anyway), Im not seeing a huge advantage in even doing the derm residency and fellowship when someone can simply blitz market you under the table, Harvard residency and all.

Aside from educated consumers who *might* recognize board certification and the name of a top residency, I see the average American consumer going more for bling bling.

dude, wait til im or fp wake up and start derm fellowships.

we'll see derm competetiveness tank overnight.

 

[YouDontKnowJack]

A friend of mine *just* finished his derm residency and signed with a group for $350,000 a year. He is board certified and is doing what the dermatologist is mainly trained to do: diagnose and treat pathology of the skin (and nails?) That turf will always remain the dermatologist's. Now dentists, OB/Gyns and all injecting Botox isn't really competing with a board certified dermatologist persay. That is a whole other business of its own.

good point.

derms will always be good at what they spent years and years on.

and yet, you hear some derms bitching about non-derms doing botox and lasers.

 

[cdql]

good point.

derms will always be good at what they spent years and years on.

and yet, you hear some derms bitching about non-derms doing botox and lasers.

that's probably the case in areas like beverly hills

in an academic setting (like the hospital near me), i usually hear whining in the opposite vein: too many derms are going into cosmetics leaving the remaining dermatologists who do mostly medical work severely overbooked. hence, the outrageous wait times to see a dermatologst.

 

[Donkeyman]

A friend of mine *just* finished his derm residency and signed with a group for $350,000 a year. He is board certified and is doing what the dermatologist is mainly trained to do: diagnose and treat pathology of the skin (and nails?) That turf will always remain the dermatologist's. Now dentists, OB/Gyns and all injecting Botox isn't really competing with a board certified dermatologist persay. That is a whole other business of its own.

It's funny how all dermatologists see Botox as their turf. Dermies somehow think that other specialties are stealing the Botox procedure from them...when in reality, it was not dermatologists who started injecting Botox in the first place...or had it approved by the FDA. Go figure

 

[Taurus]

Creating an artificial shortage of derms may come back to haunt the specialty. If the demand is there and the barrier to entry is low, then other providers will jump on the bandwagon. Family practice for example could take care of many derm problems. The midlevels like NP's could too. Cosmetics is pretty wide open to anyone. People shouldn't be resting on their laurels just because everything is coming up roses today. Change could be much faster than you anticipate and there may not be anything you can do to slow it down.

 

[cdql]

I think there are enough cases out there (e.g. acne, warts, ivy rashes) that the workload can be divvied up.

However, I feel the more challenging cases will always be referred to dermatologists because you really can't beat people who spend their entire lives studying that one area of the body.

I feel FPs, NPs, etc... etc... won't be able to completely replace dermatologists in that regard.

 

[Cholinergic]

I recently went to a medical spa that is run by a physician. I assumed she was a dermatologist but she is a board certified ER doc! How is it possible that she is able to run a skin center and offer botox, restylane, collagen, etc?

 

[cdql]

She's got two things:

1) a medical degree
2) patients willing to see her

As long as you've got those two, you are legal and rolling in the dough.

 

[Taurus]

Medical degree is not required.

PA's and NP's are getting into the game too. It's getting crowded, ain't it?

 

[Cholinergic]

Wow. Surely, there is some kind of licensing board or training exam, right? I mean, she didn't learn about skin care in her ER residency.

 

[Taurus]

Wow. Surely, there is some kind of licensing board or training exam, right? I mean, she didn't learn about skin care in her ER residency.

Um, no. Cosmetics is a business not a specialty.

 

[Cholinergic]

Um, no. Cosmetics is a business not a specialty.

 

[strangeglove]

I'm pretty sure incorrectly diagnosing/excising skin cancers or haphazardly firing botox injections into patients is lethal.

Since when does dermatology own the facial muscles? I always thought dermatology was a skin specialty. It seems that dermatologists have no more claim to botox than anyone else. Actually, the real owners of Botox are the neurologists, who use it to treat dystonia.

 

[PDT4CNV]

Since when does dermatology own the facial muscles? I always thought dermatology was a skin specialty. It seems that dermatologists have no more claim to botox than anyone else. Actually, the real owners of Botox are the neurologists, who use it to treat dystonia.

What was the first FDA approved indication for Botox? (a hint..something to do with the eye). The specialty using botox the longest who actually developed its use in medicine is ophthalmology. We use it to treat strabismus, blepharospasm, hemifacial spasms, excessive lacrimation, etc..

To put things in perspective, ophthalmology has also been at the forefront of the use of light and laser light in medicine. Using the xenon arc photocoagulator in the 1950s before the development of the ruby laser to now where on a daily basis both in the OR and for office procedures we use a variety of lasers such as the ND:YAG, frequency doubled YAG (KTP), Argon green, Infrared Diode, Excimer, CO2, and femptosecond Intralase laser.

A new technology recently developed for use in ophthalmology is a new cutting tool, a plasma knife . The Fugo Blade is a lightweight, handheld, radio-frequency electrosurgical device that generates a cloud of plasma particles around a tiny filament (about as thick as a human hair) at the end of the handpiece. The plasma particles dissolve the molecular bonds of the material they come in contact with, creating an incision 20 to 40 times sharper than an incision made with a diamond blade.

The plasma blade, which was invented by ophthalmologist Richard Fugo, M.D., Ph.D, while initially approved for specific ophthalmic procedures, it is now being used for some non-ophthalmic surgeries. I am sure that dermatologists and plastic surgeons will soon adopt this technology.

http://www.popularmechanics.com/science/extreme_machines/1280776.html?page=2&c=y

Now, in defense of dermatologists, I think that while it may be true that in a days worth of work there can be a lot of acne and bumps and moles, there are a lot of other interesting skin diseases that dermatologists play a key role in their diagnosis and/or mangement. (Mycosis fungoides, Icthyosis, psoriasis, lichen planus, pemphigus and bullous pemphigoid, porphyria, mucocutaneous candidiasis, stevens johnsons, slceroderma, certain skin cancers like basal cell CA of the face requring MOHS...). Many of these diseases have important systemic manifestations which is why dermatologists are still physicians first and foremost.

 

[ajce9]

I recently saw a job post in a Popular medical journal that was hiring for an FP to learn derm and mohs surgery and work along side a dermatologist.

I actually saw two.

Since most of derm can be done by FMs this is a logical pathway.

so, I would also be logical that in a few years FPs will be doing derm fulltime and have derm fellowships that one can choose to do.

I bet if an FP advertised that they did derm in some local paper or radio, they would get a ton of derm patients now.

And, based on national surveys primary care gives the best overall care. Care did not improve with specialty care. This is right out of AAFP website.

 

[ajce9]

By the way, when it comes to cosmetic derm.

Lets say Thermage.

The dermatologist that do this procedure do not do it themselves. They train their Medical assistant to do it.

So if the assistant with one year of education out of high school can do it. So can the FM.

Sometimes they let their PAs do it.

And I can say with great confidence that any FM can deliver better care than a pa or NP.
THIS IS NOT A POST ABOUT PUTTING DOWN PA OR NP. IT IS JUST SIMPLE FACT THAT FMS ARE PHYSICIANS NOT MID-LEVELS.

 

[Fermata]

Explain to me why dermatology shouldn't be a specialty of IM.

 

[ajce9]

Explain to me why dermatology shouldn't be a specialty of IM.

It could be, In fact it could be a fellowship after FP. FPs already see a ton of derm in their office so this would be a natural extension of their practice.


The reason it is not is because of politics. It is the same reason why anesthesialogist don't like PM&R to do pain medicine and GI docs don't like IMs and FPs to do colonoscopies.

Its all a turf battle. It has nothing to do with skill or training.

 

[ajce9]

What was the first FDA approved indication for Botox? (a hint..something to do with the eye). The specialty using botox the longest who actually developed its use in medicine is ophthalmology. We use it to treat strabismus, blepharospasm, hemifacial spasms, excessive lacrimation, etc..

To put things in perspective, ophthalmology has also been at the forefront of the use of light and laser light in medicine. Using the xenon arc photocoagulator in the 1950s before the development of the ruby laser to now where on a daily basis both in the OR and for office procedures we use a variety of lasers such as the ND:YAG, frequency doubled YAG (KTP), Argon green, Infrared Diode, Excimer, CO2, and femptosecond Intralase laser.

A new technology recently developed for use in ophthalmology is a new cutting tool, a plasma knife . The Fugo Blade is a lightweight, handheld, radio-frequency electrosurgical device that generates a cloud of plasma particles around a tiny filament (about as thick as a human hair) at the end of the handpiece. The plasma particles dissolve the molecular bonds of the material they come in contact with, creating an incision 20 to 40 times sharper than an incision made with a diamond blade.

The plasma blade, which was invented by ophthalmologist Richard Fugo, M.D., Ph.D, while initially approved for specific ophthalmic procedures, it is now being used for some non-ophthalmic surgeries. I am sure that dermatologists and plastic surgeons will soon adopt this technology.

http://www.popularmechanics.com/science/extreme_machines/1280776.html?page=2&c=y

Now, in defense of dermatologists, I think that while it may be true that in a days worth of work there can be a lot of acne and bumps and moles, there are a lot of other interesting skin diseases that dermatologists play a key role in their diagnosis and/or mangement. (Mycosis fungoides, Icthyosis, psoriasis, lichen planus, pemphigus and bullous pemphigoid, porphyria, mucocutaneous candidiasis, stevens johnsons, slceroderma, certain skin cancers like basal cell CA of the face requring MOHS...). Many of these diseases have important systemic manifestations which is why dermatologists are still physicians first and foremost.

I respect you opinion. However, all the diseases you mention in the end of your post can be treated and are being treated by many FPs.

Psoriasis, lichen planus, bulous disorders, and MOHS surgery can be taught to anyone who is interested. As far as the systemic manifestations go, who better to treat a patient than an FP or IM when a person has systemic and derm manifestations. FPs and IMs deal with systemic issues all day long.

In fact I think you would agree with me that in many cases if we correct or control the systemic issues the derm issues would resolve.

Here is an example: What does the dermatologist do when he discovers his patient has lupus from the derm presentation?

Answer, He sends her to the IM guys to help control the systemic disease.

As far as the really difficult and rare cases go, there will always be cases like that and even many dermatologist can't dignose them right away. so what do they do, they biopsy it and the pahtologist helps in the diagnosis.

But, here is what I think is the real problem. If many FPs and IMs started doing full scope derm. then they may move away from their general practice. this would create an even bigger primary care problem.

 

[GonnaBeAnMD]

All this talk about general derm, MOHS surgery, etc. being done by non BE or BC dermatologists... do all of these general derm procedures qualify for reimbursement by insurance companies by these practitioners? I highly doubt it.

 

[Joric]

I am from India. Here most of dermatology pracice is done by GPs.

 

[Taurus]

I don't think that derms have to worry about FP's invading their turf. I don't think that many will cross over. It's the NP's and DNP's that the derms have to worry about. They will go after the low hanging fruits in medicine.

 

[a89792123]

Probably depends on what you're going in for.

If I were going in for simple botox or pimple popping, then yes, the one who advertises the most might get my business.

Conversely, if I'm going in because the disgustingly annoying acne on my face just isn't going away after visiting 5 other dermatologists on my town (true story), then perhaps I'd be interested in who is the best and not who has the most ads.

(The last dermatologist I went to see for my acne, by the way, actually has to start turning away customers because he is getting inundated. He has eliminated all cosmetic procedures from his practice and now charges $500 for an initial consultation!!)

Pretty much, if you're good at your job (and I imagine most dermatologists out there are if they had to scrape, kick, and bite for those highly-coveted residency spots), I'm sure they won't be hurting for business.

just out of idle curiosity, for severe nodulocystic acne, what would you do for it after the accutane?

 

[wooo]

there is not a single dermatologist posting in this thread.

I love the way med students and pre-meds assume to know everything about certain spoecialties

 

[Long Dong]

there is not a single dermatologist posting in this thread.

I think NY skindoc is a dermatologist or a derm res.

 

[tum]

there is not a single dermatologist posting in this thread.

there's at least 2