Dermatologists give insights, advice to improve quality of patient care

Physicians have had to make changes in the way they run their offices, while keeping abreast of quickly changing and developing medicine. They've adjusted their priorities to keep up with the times.

On Call talks to dermatologists every month about the medical, business and legislative issues that affect their specialty. This month we asked dermatologists what do they do, either in patient care, in practice management or any activity, that they feel helps improve their practice and their ability to care for patients?

For example, Bryan O. Barnett, M.D., in Tracy, Calif., says he's found a new trick for treating difficult warts - and it's really a gem.

"One thing that works for me for nasty single lesion warts around fingernails - I inject them with yeast antigen".

"I read about doing that, and then I had to figure out how to get ahold of the antigen, but I've been doing it for about a year now and, boy, does it works like a charm"!

"The yeast antigen shots work because they get the immune system involved. The immune system goes after the yeast antigen and figures out that you actually have a wart virus infection and it goes after the virus to destroy it," he explains.

Dr. Barnett, who had been a pediatrician for 10 years before going back and doing a dermatology residency in the early 90s, says he read about the yeast antigen, then had to locate a supplier because usually it goes to allergists for use in skin testing.

"The biggest problem is the patient has to sit still for a shot which, believe it or not, I thought most people would not be able to chance. In reality, they handle it just fine, even the male patients, and that's really saying something."

Dr. Barnett says patients really appreciate finding a solution to a problem many had given up on.

"Once they understand that you're not giving them a yeast infection and that you're trying to get their immune system to do the job, they are all pretty excited about it.

"And it doesn't take long - about two to three weeks and they're gone. You know the best thing is that when you freeze warts, you get a horrible painful ugly blister that's in the way every time you try to do something. With this, that doesn't happen. It gets a little puffy and it just starts going away.

"I've had more fun getting rid of things that I couldn't get rid of before; I tell you, it's been a blast!"

Political involvement In Tamarac, Fla., Glenn L. Zellman, M.D., says the best thing he's done is get out of his office.

"There are a lot of things that affect physicians and, unfortunately, legislators really control our futures. They control the laws regarding malpractice reform and, unfortunately, lawyers make up most of the legislators - so what I did is that I got involved politically and was the campaign manager for a buddy of mine who ran for the state legislature.

"I ran the campaign and he won and now we have a friend in the legislature. Another legislator is also married to a dermatologist, so now we really have a voice. My friend got a score of 100 from the Florida Medical Association, and he's definitely on the side of doctors when it comes to malpractice reform and issues like non-physicians performing medical procedures such as lasers."