Strategies for Hope Conference

Strategies for Hope: Addressing the opioid crisis in rural communities. May 17, 2019 Berkshire Community College, Pittsfield, Massachusetts Random notes from a compulsive note taker I attended this important conference and am a compulsive note taker. Most people, when the lecturer says, “Good morning,” will mumble back “Good Morning.” But, if one is a pre-med, when the professor says, “Good morning,” you write it down as it may appear as a question on an exam. I never unlearned that habit. These note may be of some value to others.Erik Garcia, M.D.: Homeless Outreach and Advocacy Program, Worc3ester, Massachusetts. Stigma and shame play a big role in epidemics. HIV, opioid. It … Continue reading

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Evolus Launches Jeuveau at Cancun!

NY Times article: Botox Rival Invites Doctors to Party in Cancun, With Fireworks, Confetti and Social Media Posts Link. Top plastic surgeons and cosmetic dermatologists gathered at the Ritz-Carlton in Cancun one weekend this month to learn about a wrinkle-smoothing injection, Jeuveau, that goes on sale this week. It was billed as an “Advisory Board” meeting! All expenses were paid. More than a dozen top doctors gushed about the event on social media — using the company’s preferred hashtag, #newtox — without disclosing that Evolus had paid for their trips. Some of who attended this “working weekend at Cancun” were: Dr. Melanie Petro from Alabama Dr. Lara Devgan, New York … Continue reading

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Dear Skin,

dear skin, you have been the cup of my life embracing the everything mystery called me during those years i never thanked you— employed as you are to bear both the scars and joys of my existence someday you will be dust returning me to the inscrutable All of love, laughter and stars when that day comes you will know a new breath and oh the touch that you have always longed for Sr. Lou Ella Hickman Author Bio: Sister Lou Ella Hickman is a former teacher and librarian. She is a certified spiritual director as well as a poet and writer.  Her poems have appeared in numerous magazines and … Continue reading

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2019 Hot Spots in Dermatology

It is a great pleasure to announce the 32nd Hot Spots in Dermatology Conference held in Hawaii from August 16 – 18, 2019! We have assembled a stimulating agenda, totaling 9 – 12 AMA PRA Category 1 Credit. The program has unique social receptions at which you can mingle with faculty and fellow registrants while watching the sun sink behind the Pacific horizon. Highlights for Hot Spots 2019: Updates on Cutaneous Lymphoma by Madeline Duvic Fine Art and Dermatology by Patrick Kenny Legalized Marijuana Panel Discussion (Pro and Con) Pharmaco-economics and the Biologic Invasion Roy Grekin’s take on his 40 year career as a Mohs Surgeon Conflict of Interest in … Continue reading

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Body Dysmorphic Disorder in Dermatology

        by Elizabeth Cook* Keywords: Body dysmorphic disorder, cosmetic dermatology, cosmetic surgery, screening, surgery We all know someone who sees a different reality in the mirror. We try to convince her that she is beautiful. “No one is staring,” you say. “Your nose looks just fine.” She may point to her cheek and demand confirmation of invisible flaws. I say she because body dysmorphic disorder (BDD) favors women. Like eating disorders, it usually begins in adolescences, but unlike eating disorders the focus is on minimally noticed or imagined defects, not on fat. By the time these women reach adulthood, they end up in the dermatology clinic, seeking … Continue reading

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Why Nothing Works

More humanism and less science, that’s what medicine needs. But humanism is hard work, and so much of science is just Tinkertoy. Robertson Davies Why Nothing Works An Introduction to the Placebo New York Times, November 11, 2018 I have been interested in the placebo response for many years. This recent NY Times article is a good introduction to the topic. Here are some excerpts and random thoughts: The author, Gary Greenberg, attended the Society for Interdisciplinary Placebo Studies in Leiden, Holland (2017). He met some key researchers in placebo there. There is a conviction among many that the placebo is a powerful medical treatment that is ignored by doctors … Continue reading

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Thoughts on Gawande’s “The Upgrade”

In the end, we are dependent upon the creatures we have made. Goethe The Upgrade (Full New Yorker Text) Why Doctor’s Hate Computers by Atul Gawande The New Yorker, November 12, 2018 Gawande’s thesis is that the electronic medical record (EMR) has contributed greatly to the epidemic of physician burnout in the United States. A 2016 study found that physicians spend about two hours doing computer work for every hour spent face to face with a patient. The result has been epidemic levels of burnout among clinicians. Something has gone terribly wrong. The software created for the EMR has spawned this massive monster of incomprehensibility. So much of what physicians … Continue reading

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On Infomercials and Experimercials

Dr. Bernard J. Carroll, an academic psychiatrist, died on September 10, 2018. His work demonstrated that the psychiatric drug literature had become so polluted as to be virtually meaningless, He called most drug trials “infomercials.” See his NY Times Obituary. Over the years, I have observed in my specialty, dermatology, the same is true. The Biologics are being aggressively and venally marketed. The result is that Humira, with sales of $18.5 billion in 2017, is the top selling drug in the world thanks to AbbVie’s multi-pronged marketing strategy. Where are the other Dr. Carrolls in medicine? Does dermatology have one? So many of our academic “stars” have been co-opted and feed … Continue reading

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Medically Unexplained Dermatologic Symptoms (MUDS): Hiding in plain sight?

By David J. Elpern, M.D. J Eur Acad Dermatol Venereol. 2018 Jul;32(7):e265-e266 Keywords: medically unexplained symptoms, somatoform disorders, symptoms, illness, disease Illness is not the same as disease. Illness refers to “the innately human experience of symptoms and suffering.”1 Disease “is what the practitioner creates in recasting illness in terms of theories of disorder.” A person’s subjective experience of how she feels may not assume an underlying pathology. Illness can be organic, psychological or spiritual. A person can feel ill, but not have a disease. Consider Sara (not her real name), a 31-year-old social worker who sought dermatological care for a seven-year history of painful vulvodynia and generalized pruritus. Her … Continue reading

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