I had the opportunity to work with an amazing dermatologist in his clinic today, and there were several important learning points to take away from the experience.
First, don't make assumptions because you've seen a similar case a hundred times. Just because a patient has what looks like a wart on the bottom of their foot, doesn't mean you can dismiss your other differentials. Make sure to rule out the melanoma or actinic keratosis. Despite having been practicing for so many years and seeing countless numbers of similar cases, the dermatologist still made sure give them conscious thought.
Second, we're here to provide medical advice and treatments to our patients but ultimately, the choice is up to the patient (given capacity is present). Once a patient is sure that they're making an informed decision, they shouldn't feel threatened or so pressured by their physician to start a treatment that they don't feel their concerns are listened to.
Lastly, no matter the resources that are available around us, we should continue to develop our own medical knowledge and skills and provide as much service as we can to our own patients before deferring them to someone else's expertise. We had seen many patients today coming in for simple cases such as acne or warts, where their family physician had not recommended a single treatment to them before referring them to the dermatologist. Even if specialists are much more accessible in more urban cities, generalists should remember that we're also equipped with the knowledge and tools to assist our patients with many of their concerns.
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