
......Many doctors from many varied specialties are gifted and knowledgeable in treating skin cancers. The key is to find the right one and to avoid the bad ones. The problem in advising the reader how to do this is that we have to generalize. Generalizations may lead to inappropriate labeling of peoples, places and things (just about everything). Unfortunately, to predict or to advise large groups of people, generalizations are the only pragmatic (practical) means.
......For diagnosing a skin cancer, overall dermatologists and Dermatological surgeons have the best training. Do not forget: This is a generalization and there are plenty of other specialists that are better than the worst dermatologists at diagnosing skin cancer.
......Next determine what kind of surgery you think you need by reading this website. If you wish to have removed any basal- or squamous-cell cancer that appears to require Mohs Surgery (as you will see only after you have read the entire website), seek a Mohs surgeon who is a member of the American COLLEGE of Mohs Micrographic Surgery. Be sure to know the training and credentials differences between a COLLEGE trained Mohs surgeon and members of the amazingly closely named American SOCIETY of Mohs Surgery. If the Mohs surgeon is experienced at sewing the holes/defects he/she creates, then you may consider letting the Mohs Surgeon sew the wound. Consider looking at before and after photos and credentials before deciding. If you are not convinced completely, then have the Mohs surgeon remove the tumor with Mohs Surgery to give you the smallest tumor-free defect and refer you to a Board Certified Plastic Surgeon or a Facial Plastic Surgeon for repair of the hole. If the tumor is on the eyelid, it is likely best to see a member of the American Society of Ophthalmic Plastic and Reconstructive Surgeons (Oculoplastic Surgeon, a specialized type of Ophthalmologist or eye doctor) following Mohs Surgery.
......If you have a mole to be removed and you have seen and approve of your dermatologist's work in a similar area on another patient then it may be appropriate to let the dermatologist remove the mole. A good dermatologist, knowing the microscopic behavior of mole cells, will likely not get too close to the edge of the mole. This is because the dermatologist is concerned first with the patient's health and the potential for risk to health by remaining mole cells rather than with the patient's appearance.
......If you decide to have a plastic surgeon remove the mole, it is best to have the mole first biopsied by the dermatologist, who will take a tiny piece. If the mole is read by a Board Certified Dermatopathologist as "bad" or atypical, then have the dermatologist draw the proper margins or circles around the tumor so that the Plastic surgeon won't get too close to the mole. Many Plastic surgeons like to keep their scars small at the expense of leaving invisible or unseen pieces of moles or tumors behind. After all, a bigger scar left by honest Plastic surgeon "A" won't get him/her a better reputation than Plastic surgeon "B" who cuts too close to the edges of moles, resulting in a smaller scar, though it may leave some mole tissue behind in the patient.
......Remember, there are many reasons why doctors do things. Being educated is your best aid. It is often best but not universally good to seek doctors who are fully trained in the USA Doctors who trained at prestigious institutions are often good but do their egos and personalities get in the way of good patient care. Doctors should be in good standing with state and local medical societies. Check the doctor's name with the clerk of the court of the county in which the doctor practices for lawsuits. Doctors who have published or lectured extensively are often "up" on the newest techniques but should know a lot about the older techniques in order to find the best treatment. Visit the doctor before having anything major done. If you don't think the doctor cares, remember this: The smartest doctor in the world won't do you a bit of good if he/she cannot communicate with you or take good care of you. A smart doctor can also be a danger to your health if he or she is supercilious and thinks that error or improvement is never possible. Such a doctor may take risks with your health or fail to appreciate the need for improvement. Medicine is a science always on the advance. A physician's learning and appreciating that medical science (our knowledge) is still in its infancy, is critical to good patient care.
......Always be careful of the way doctors write their credentials. For example, there is a Fort Lauderdale Internist (internal doctor, not a surgeon, not trained a day in surgery) who is Board-Certified in Internal Medicine. She advertises on TV and Radio as a Board Certified Laser Surgeon. This sounds really impressive, but there is no Board Certification for Laser Surgery. She is making a play on the words "board-certified" (in something) and being a laser surgeon, as well. It is deliberately misleading, but it has made her million$.
......Another case is a Fort Lauderdale Board Certified Ophthalmologist who trained in a NON-accredited eye plastic-surgery residency. He actually performs quite a bit of eye plastic surgery, but he is not a member of the respected ASOPRS (previously discussed). He advertises himself extensively as a Board Certified Eye Plastic Surgeon. Nothing could be further from the truth. He is board-certified in Ophthalmology, just as is almost any other eye doctor, but he is not board certified in eye plastic surgery. It is deliberately misleading, but it has made him million$. Caveat Emptor! (Let the buyer beware!)
| Paul
J. Weber, M.D., P.A. 5353 North Federal Highway, Suite 400 Fort Lauderdale, FL 33308 Tel: 954-489-9800 | Fax: 954-489-0401 |
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P.A., All Rights Reserved