Dermatologist

Finding the Perfect Dermatologist

When it comes to the health of your skin, working with a dermatologist is one of the most important relationships that you will have in your life. This skin care specialist will be one of the main players in ensuring your physical and emotional well-being during the process, and will help you not just find solutions to your problems, but will guide you toward making healthier decisions about your skin. That’s why, when looking for a dermatologist, you don’t want to take the selection of your doctor lightly. Although the search process may feel frustrating at times, if you put in the effort and the energy into finding the right dermatologist for your needs, you are likely to achieve significantly better results.

What Is a Dermatologist?

A dermatologist is a doctor specializing in the treatment of nails, skin, hair, and mucous membranes (inside the mouth, inside the nose, and the eyelids). It is a specialty that requires significant expertise and knowledge because any mistakes won’t just negatively impact the patient’s health, but could impact their self esteem as well. This is why, when looking for a dermatologist, you want to ensure that you’ve found someone who is experienced and also truly cares about the well being and self esteem of their patients.

Overall, a dermatologist can treat over 3,000 different skin conditions, including rosacea, psoriasis, skin cancer, eczema, nail infections, hair loss, and acne. They can also help patients reduce the signs of wrinkles, age spots, or other problems that show up with aging skin. A dermatologist can help you get rid of acne and acne scars, as well as help you find ways to deal with psoriasis.

Dermatologists are trained to go beyond diagnosis of problems and writing of prescriptions, but can also offer professional skin care treatments. They may inject wrinkle fillers, dermal fillers or botulinum toxin into the skin to reduce wrinkles. Dermatologists also regularly provide cryotherapy, which is a procedure to remove warts or age spots. A dermatologist can go beyond improving the appearance of skin, and will surgically remove or provide treatment for skin cancers that can be life threatening.

  • Moh’s surgery: This dermatological specialty involves completing a fellowship to learn about providing a microscopically controlled surgery for the treatment of some forms of cancer.
  • Dermatopathologist: After residency, this type of dermatologist completes a fellowship after which she or he can specialize in diagnosing specific diseases by looking at them under a microscope.
  • Procedural dermatology: Here, the dermatologist receives advanced training as a surgeon.
  • Cosmetic dermatology: This specialty provides advanced training on treatments that improve patient’s aesthetic appearance.
  • Research: A dermatologist may elect to become a researcher of skin, hair, and nails and will work within the confines of a laboratory, rather than working directly with patients.

How to Find a Dermatologist

There are a lot of different ways to find a dermatologist, but you want to find a doctor that specializes with your specific issue. A good first step to try is to get a referral from your physician. If you already like your primary care physician and the attention and care you receive, then they’ll likely refer you to a dermatologist who has a similar approach to patients. Also, talking to your primary doctor first can help you find a dermatologist who specializes in your specific skin problems, thereby increasing chances of a successful outcome.

If you don’t have a primary doctor, or simply don’t like the options she or he gave you, you can also look into the American Academy of Dermatology. This organization maintains a list of doctors in your area and can help you find one that will match your needs more closely. You can search through the list to find a dermatologist that will be conveniently close to where you live and work, but remember that when going simply based on a list, the first specialist you meet may not be the right one for you. After all, it’s not just about finding someone who is good, but someone who can also build rapport with their patients.

Another option would be to talk to your friends and ask if they’ve gone to a dermatologist they could recommend. When talking to your friends, it’s a good idea to ask the following questions:

  • How long have they seen the dermatologist?
  • Did your friend like the staff?
  • Was it easy to get information about procedures or treatments?
  • Was there a long wait time at the office?
  • Did your friend feel rushed during appointments?
  • Did the dermatologist listen carefully to your friend’s concerns without excessive interruptions?

However, one of the best ways to judge a friend’s referral is not to just ask questions, but quite simply, to look at their skin. Does their skin look healthier? It is improving over time? Were they able to get rid of acne problems or scars? Looking at your friend’s skin may be the best way to judge the quality of a dermatologist.

Finally, if you live near a university, or if the hospital near your home or work has a residency program for doctors, you may be able to find a dermatologist by contacting the hospital or the university directly. Many faculty members at universities also maintain their own private practices and take on a limited number of patients. However, keep in mind that if you have health insurance that is very limiting in nature, you may not be able to opt for your first choice.

How to Make Sure Your Dermatologist is the Right Fit

When choosing a dermatologist, there are many things to consider. A lot of this information can be gleaned during your consultation, before scheduling any treatment. Consultations are usually free or inexpensive and give patients an opportunity to get to know the doctor better. You are not obligated to accept treatment from a doctor on your first consultation, and if you feel that the dermatologist is either not taking you seriously or isn’t clearly answering questions, then you should feel no obligation working with them. In fact, if you are pressured to undergo treatment without being given time to research other options or the treatment itself, consider it a major red flag.

Some dermatologist offices may even run a type of “patient mill” where their staff will capitalize on patient’s feelings of insecurity, and will pressure them to make an appointment for treatment right away. The catch? If you change your mind after making the appointment, you won’t be able to cancel unless you pay a hefty fee. Keep this in mind, especially if you are seeking treatment for a strictly aesthetic issue, where your frustration and feelings of self consciousness may cause you to make a hasty decision and work with a dermatologist who doesn’t have your best interests in mind.

The Consultation Process

During the consultation, you will usually meet with the dermatologist in her or his office, and this is a visit mainly to make sure that you will be a good fit with the specialist. Note that this isn’t like a first appointment with a general physician where you get a full physical, and you normally will not be carefully examined during this visit. Instead, use this visit as an opportunity to ask questions about your specific problems and pay close attention to how the dermatologist answers them. Usually, you will get general answers as the doctor had not completed a careful examination, but her or his attitude toward you should give you quite a bit of information about their approach to patients. To get the most out of the visit, ask the following questions:

  • Do you accept my type of insurance?
  • How long will it take me to get an appointment if I notice a problem?
  • Does the dermatologist have patient references available?
  • How will I get emergency care on weekends and holidays?
  • Does the dermatologist specialize in a particular field of dermatology?
  • Has the doctor commonly treated your specific issue?
  • How many years has the doctor been practicing in this field? (They should have at least five years of experience to ensure that they’ve treated enough cases and made enough mistakes on other patients to know better at this point. You don’t want them to practice on you.)

All of these questions are going to cover the dermatologist’s expertise and the inner workings of the office, but there is one thing that you can’t necessarily ask in an interview and that is how you get along with the doctor. Some of those observations include:

  • How does their bedside manner fit in with your personality? Going to the doctor can be stressful and sometimes even painful. Having someone that you don’t trust or don’t like in the office with you will only make the treatment less bearable.
  • Do you feel comfortable talking about specific healthcare issues with the doctor? If you can’t openly talk about your healthcare issues with the dermatologist you are interviewing, then you should move on. You should always be able to tell your doctor about any healthcare issue that may arise or it could risk your health, whether it’s your primary health physician, dermatologist, or any other specialist – they need complete information.
  • Is the office clean and orderly? Look around the office. Are the employees playing around with each other and making jokes? If yes, then that attitude can translate into poor health care for you, with lost files and incorrect scheduling or billing. Also, visit the bathroom. If there is easily visible filth in your potential dermatologist’s office, you can only imagine what microscopic filth must exist in the office and may end up on surgical tools that are used for in-office outpatient procedures.

Before the First Assessment Visit

Now that you’ve had your first consultation and decided on a dermatologist who is a good fit for you, here is what you can expect from your first visit as an actual patient:

Beforehand, do a full-body check on your own. Use mirrors for hard to see areas and pay close attention to any skin discolorations or other visible problems. Make note of any spots on your body that are new or changing. Even if you’re not sure that a spot is growing or changing, but think that it is, make sure to tell your dermatologist so that she or he can make their own assessment. In addition, make note of moles that are bleeding or itching, growths on your skin, or any lesions, especially those that are hesitant to heal. Your dermatologist won’t be able to note changing moles or spots unless you mention them. Lastly, write down any additional questions that you have for your dermatologist. It is easy to forget those questions you promised yourself you would never forget unless you write them down.

During the Exam

When you come in for your full exam, you dermatologist is likely to ask you many questions. It is highly important that you answer them truthfully and in-depth, even if you may feel embarrassed at times. Having complete information will allow your dermatologist to make a better assessment, which should lead to a more effective treatment. Some questions may include:

  • How long have you been dealing with this specific issue?
  • How does it affect your daily life?
  • For girls and women: Do you use oral contraceptives? Do you have regular menstrual periods? Are you pregnant or do you plan on becoming pregnant?
  • What types of soaps, creams, or beauty products to you use?
  • What medications do you take?
  • What family history of any illness do you have, especially skin cancer?
  • Have you had treatments for this issue before? Were they effective?

In your initial exam, you will dress down so that your dermatologist can examine the entire surface of your skin and make notes of any issues. The initial visit will not normally take a long time to complete, but it is important for proper treatment. Before you go in for the visit, don’t forget to remove all the nail polish from your fingernails and toenails, as this can help the dermatologist assess if there are any underlying health issues based on the health of your nails. You should remove all of your makeup as well, so that your doctor can accurately examine the skin on your face.

At the end of your visit, your dermatologist will discuss the various treatment options available to you, from surgery to simple skin care creams. If medication is necessary, you will probably be given medication that will require follow-up visits to make sure the medication is working. The dermatologist may be able to begin a treatment as well, depending on the seriousness of your problem.

It’s All about You

Remember, finding the right dermatologist may not always be easy, but anything worthwhile rarely is. Your skin is the first thing that people see, and you want to ensure that you’re working with the best professional, who won’t make your problem worse. Even more importantly, your dermatologist can be a life saver if she or he identifies early skin cancer that your regular physician did not. Therefore, your life may potentially depend on whether you’ve chosen the right skin care specialist. Whatever you do, don’t get discouraged if you can’t find a good fit right away, and under no circumstances allow your dermatologist’s office to pressure you into making an immediate appointment for treatment if you don’t feel comfortable.

References
Third party resources are provided for educational reference purposes only and have no association to The Derm Review. Always consult your medical advisor before making decisions.
Advanced Dermatology

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