By Abby S. Van Voorhees, MD, November 01, 2012
Did you know that November used to be the ninth month of the year? Yet when Julius Caesar made January the first month of the year there was no talk of renaming November. Even today November sits in position 11 with a name that means number 9. Don’t know if the ancient Romans were a flexible lot or whether when Caesar spoke one just bit one’s tongue.
Flexibility, and the need to play well with others, has once again become the mantra as we move more fully into the 21st century. It is the code for success. We see it everywhere as we look around; workers of all stripes are re-inventing themselves in new occupations and positions. Getting fired has become the “opportunity” to reconsider and pursue another direction. In derm, losing our jobs has not been a worry for most of us. Yet being flexible and engaging others in the surrounding universes has become just as necessary for our survival. It strikes me that most of this month’s Dermatology World in one way or another concerns the need to be flexible as health care takes its turns.
Take for example, virtual microscopy. Though it seems sort of amazing, in Acta this month you will read about how microscopes are on their way out — replaced by computer images that are as accurate, facilitate storage, are cheaper to purchase, and more successfully preserve unique views of pathology. And most of all, these images are easily shared with those down the hall, across town, and on the other side of the globe. It’s not much of a leap to understand the benefits possible to clinical practice and medical education. Hard to imagine that the multi-headed scope that sits in the dermpath lab across the hall from my office is breathing its last gasps. Flexibility. [pagebreak]
Another example — working with non-derms in the care of patients with skin disease. Always was a good idea to have a presence in the hospital. Now, however, the urgency for interfacing with the local physician community has become acute. Rob Sidbury, MD, points out the many benefits of hosting focused continuing medical education lectures for primary care physicians “It’s a short-term outlay in terms of time, but it will have a long-term benefit because you will become the go-to person in the group.” That is just the first step, though. As ACOs develop, we see flexibility in novel ways. In this piece both Alexa Kimball, MD, and Randy Roenigk, MD, allude to the need for collaboration with their primaries. “The advantage of being in an ACO is that resources can be freed up when payment is not purely fee-for-service to allow for increased consultation in a way that still compensates dermatologists,” Dr. Kimball says. Dr. Roenigk speaks to us about trying out novel strategies such as virtual consults to help the primaries serve patients well. Flexibility.
It is everywhere in this issue; just check out our Legally Speaking column this month. The topic: who controls your patients’ health data, the EHR company or you? This is one I think that you will find extremely timely. Clearly learning to negotiate with the EHR company is key. Flexibility.
The days of being the sole captain of the ship are heaving their last sighs. However, if you were hoping to retire to get away from all this, be sure to read our piece on ending your practice. No such luck! Seems that retirement also requires lots of flexibility to pursue current passions and invent some others. I suppose there is always John Stanley’s solution of just getting lost in a book or two or more. It saved me from many nights of helping my sister with the dishes when I was young, so it might just be the winning formula once again.
Enjoy your reading!