Currents: Practice Success: Keys to Reaching a Higher Level

AMA Hails Passage of Bill Extending Medicare Telehealth Flexibilities

Jack Resneck Jr, MD, President, American Medical Association (AMA) and dermatologist, urges the Senate to pass the bipartisan bill extending telehealth benefits through the end of 2024.

In a statement released by the AMA, he says, “Increased Medicare-covered access to telehealth has been a lifeline to patients and physicians throughout the COVID-19 pandemic, and the American Medical Association (AMA) is pleased by today’s bipartisan vote in the House. The COVID-19 public health emergency made plain that care via telehealth should be available to all Medicare patients, especially with their own physicians, regardless of where they live or how they access these services. From continuity of care, broadened access to care, and removing geographic and originating-site restrictions, our hope is that the flexibilities afforded during the public health emergency will be made permanent. This legislation offers an important step in that direction by extending telehealth benefits to December 31, 2024. We urge the Senate to act on this bipartisan bill, and for the Congress to build on this success.”

New Monkeypox Registry Established

The American Academy of Dermatology (AAD) is encouraging health care professionals to submit data on the skin symptoms of the disease and the vaccine to improve patient care. The World Health Organization and the White House have declared the growing monkeypox outbreak a public health emergency, with the Centers for Disease Control and Prevention recommending that people seek medical care immediately if they develop a new, unexplained skin rash or lesion on any part of their body that they think could be monkeypox. Thanks to a newly launched, comprehensive monkeypox registry, health professionals can share data on the skin symptoms of the disease and the vaccine to improve patient care, the AAD reports in a news release.

“The American Academy of Dermatology and the International League of Dermatologic Societies created a monkeypox registry to help health professionals better understand the skin symptoms of the monkeypox virus and skin reactions to vaccines used to prevent it,” says board-certified dermatologist Esther E. Freeman, MD, PhD, FAAD, a member of the American Academy of Dermatology’s Monkeypox Task Force. “This registry will allow physicians and health care professionals to share valuable information about the cases that they are seeing, which helps us identify dermatologic manifestations of the monkeypox virus.”

Any health care professional taking care of patients with monkeypox or taking care of patients who have received a smallpox/monkeypox vaccine and developed a skin reaction to a vaccine, can contribute to the registry by filling out a brief online form. Patient identifiers such as name or date of birth will not be collected. All de-identified information is kept strictly confidential and will only be shared with researchers compiling information.

Monkeypox is a contagious disease caused by a virus. People who contract monkeypox may have as few as one or two bumps on their skin, and the bumps can look like a blister, pus-filled bump, or open sore. Many may not have a fever or flu-like symptoms. Monkeypox typically lasts two to four weeks.

“During this particular outbreak, we’re seeing that the rash may start in the groin, genital region, around the anus, or around and in the mouth or throat—and sometimes stay in the spot that it started instead of spreading,” says Dr. Freeman. “While the monkeypox rash can be mistaken for chickenpox, shingles, or herpes, there are differences between these rashes. A board-certified dermatologist can narrow down which disease is causing the rash by looking at the pattern of the rash and where the rash appears.”

If the dermatologist suspects monkeypox is the cause, they will swab the skin lesion and send it to a lab, where a polymerase chain reaction (PCR) test will be performed.

People who have been vaccinated against smallpox may be less likely to develop monkeypox. The vaccine is 85% effective in preventing monkeypox, yet many people have not received it because the last routine smallpox vaccines were given in the United States in 1972 due to the elimination of smallpox.

Treatment options for monkeypox are limited. Some antiviral medications are being used to treat people who test positive for monkeypox and are at risk of getting severely ill.

“The monkeypox registry is an important resource to help health professionals improve identification of the disease and help prevent it from spreading further,” says board-certified dermatologist George J. Hruza MD, MBA, FAAD, chair of the American Academy of Dermatology’s Monkeypox Task Force. “The better informed we are, the more equipped we will be to correctly diagnose and treat this infectious disease and identify any potential skin reactions patients experience from the vaccine.”

The American Academy of Dermatology and the International League of Dermatologic Societies created a similar registry on the skin signs of COVID-19, as well as skin reactions to the COVID-19 vaccine, in April 2020.

“The data from the registry has led to the identification of a variety of different skin reactions that are associated with COVID-19,” says Dr. Freeman. “Some reactions are milder, like COVID toes, and others are more severe. People have a large variability in their immune response to the COVID-19 virus and the vaccines, which causes the skin to react differently for each person. We are hoping to gain a similar understanding of monkeypox through this registry.”

Dermatologists are the experts in the diagnosis and treatment of skin rashes. If you have a rash or bump on your skin that you suspect may be monkeypox and you don’t know what caused it, make an appointment to see a board-certified dermatologist.

U.S. Dermatology Partners Launches New Research Institute

With skin diseases affecting Americans at any given time, one of the leading and largest dermatology groups in the country, caring for more than 1.5 million patients each year, is launching a Research Institute. This new program will increase access to otherwise unavailable treatments for various impactful dermatological diseases including, but not limited to psoriasis, atopic dermatitis, prurigo nodularis, hidradenitis suppurativa, bullous pemphigoid, congenital ichthyoses, and non-melanoma skin cancers.

The U.S. Dermatology Partners Research Institute is currently involved in three types of clinical trials: observational studies, interventional, and device trials. The goal of these clinical trials is to assist in the discovery of more safe and accurate diagnostic testing capabilities, prognostic testing capabilities, and patient-centered therapeutic options. This new program will facilitate breakthroughs in the science of prognosis and individualized precision medicine, allowing for a better understanding of disease characteristics, and treatments at the patient-specific level.

“Our goal is to increase the treatments that our clinical team can incorporate into their practices and provide our patients with advanced dermatologic care that can help improve their health and quality of life,” says Chief Executive Officer of U.S. Dermatology Partners, Paul Singh, in a news release. “We’re proud to spearhead this program that’ll help us further our mission while advancing the field of medical dermatology.”

Led by Board-Certified Dermatologist, Dr. Lindsay Ackerman, the Research Institute is centrally supported by an experienced team enabling the healthcare organization to streamline trial startup and conduct multi-site trials. The organization’s clinical trial management capabilities include reporting via a centralized electronic database to allow trial sponsors to access real-time data from the studies.

“Providing access to meaningful interventions that would not otherwise be available for dermatologic diseases of grave consequence continues to be an exciting aspect of our clinical care,” says Dr. Ackerman. “Not only is it incredibly rewarding to facilitate substantial improvement in disease, but in doing so we are also breaking down barriers to care. Being able to deliver these options, while allowing for the development of scientific proof required to ultimately reach millions of others, is both a privilege and responsibility we don’t take lightly.”

The research centers will collaborate with innovative pharmaceutical companies through industry-sponsored clinical studies that involve new treatment agents as well as available medications. Through the Research Institute, U.S. Dermatology Partners will leverage their vast network of patients, clinical team, and board-certified physicians to advance the field of medical dermatology. U.S. Dermatology Partners has participated in 50 trials in 2022, and currently, there are 35 active trials across the organization.

Survey: Many Skip Yearly Derm Visits

A nationwide survey of more than 1,050 people by Myvision.org found many people are avoiding the dermatologist and other specialists. In fact, 48% of survey respondents don’t remember the last time they went to the dermatologist, and only 10% have been to the dermatologist in 2022. The dermatologist ranked as the fourth most difficult doctor to get an appointment with, the survey showed.

The top reason for procrastinating? Money. Just under half (42%) of respondents say they’ve skipped a doctor’s appointment for fear of costs. Others point to scheduling difficulties when avoiding appointments—48% have struggled making appointments due to a busy doctor and two-thirds say they’d go to the doctor more if the doctor had better weekend availability.

Myvision.org surveyed 1,057 Americans about their experiences with doctors that are recommended on an annual or regular basis in June 2022. Respondents ranged in age from 18 to 79 with an average age of 38 years old; 50% were female, 48% male, 1% nonbinary, and 1%transgender.