Health Anxiety: Tables and Appendix

Table 1. Demographic Data Age 0 – 9            5 10 – 14        8 15 — 19      20 20 – 29       41 30 – 39       10 40 – 49       23 50 – 59       28 60 – 69       39 70 – 79       39 80 – 84       12 85 – 89       14 > 90            2 Male =            97 Female =     115 Trans =            1 (87 yo woman with confusion) New Patient                      34 Returning Patient            188 Table 2. HA Questions Are you worried a lot about a particular health problem? Y N Do you tend to worry about your health in general? Y N Have you ever … Continue reading

Health Anxiety in a Dermatology Practice

Abstract: Health Anxiety is a common affliction of patients seeking medical attention, yet many physicians are unaware of it.  We surveyed 222 consecutive patients in a dermatology practice in Massachusetts and found that upwards of 40% were aware of some level of health anxiety. Keywords: health anxiety, dermatology, Massachusetts, actinic keratoses, cryotherapy, survey,, Tyrer Introduction Patients see doctors with varying degrees of concern regarding their health. Some, require tests or treatments. A subset of patients have severe health anxiety (HA) and cannot be reassured by tests, procedures or pharmaceuticals but may be helped (at least temporarily) by a sympathetic listening face and reassurance. Tyrer et al succinctly and lucidly introduced … Continue reading

It’s Freezing in our County: Medicare Reimbursement in 2012

by David J. Elpern and Mariah L. Ferrara Abstract: We have documented the access to dermatology care in the Berkshire County, Massachusetts. Of the six dermatologists practicing in the area only two accept Medicaid patients and for one of these, the wait for an appointment was over six months. Our data show unequal access to dermatologic care in Western Massachusetts Keywords:  dermatology, access to care, Medicaid, dermatologist, medical insurance. Berkshires, Massachusetts, cryotherapy, liquid nitrogen Introduction: It is clear to Medicaid recipients nationwide that they have difficulty in obtaining health care from large numbers of private practitioners There are many reasons for this, but chief among them is that physicians are … Continue reading


The Business of Medicine: Old paradigm and new  I wish I was a young buck looking for my first job. Recently, I received an email promoting a new position: Hi Dr. …, Hope this email finds you well! I’m contacting you regarding a Dermatology Opening in [a scenic rural area]  Please see below for details and send CV if interested. Seeking a BE/BC Dermatologist to join its medical staff.  Join the most trusted hospital in the area due to its highly trained physician staff and its arms-length affiliation with the University of [X] Hospital in {Y]. The community itself is an attractive university town located in the Foothills of the redacted … Continue reading

Health Anxiety

seen every day in medical offices Health Anxiety: lurking in plain sight All practitioners will learn useful information from this article. Excerpts “Many patients, despite how much they would like to, cannot do what we would like them to do: ‘stop worrying.’” As physicians, we see a few such people every day. Health Anxiety seems to be epidemic (perhaps, endemic) in our communities, yet it is poorly recognized. “People with health anxiety do not ask relief from somatic symptom, but rather only desire freedom from worry about disease. A key component of health anxiety is rumination, so that patients cannot stop thinking about a disease once the thought has come … Continue reading

Person-to-Person Exchanges in El Salvador

by Cailtin Stiglmeier, M.D. encuentros breves crean amistades duranderas  Cuban proverb Abstract: Every year, seventy-five high school students from Central New York State alight in rural el Salvador for a week-long adventure involving international aid, manual labor, no plumbing, and no Facebook.  As a pediatrician, I’ve had the privilege of joining this group three years in a row. What ensues during this week is nothing short of chaotic and miraculous. Keywords: global health, travel, el salvador, young life. The third year for myself. The first time for many. The tenth year of partnership with this rural community in Rancho Grande, El Salvador. Every year another adventure, a week of … Continue reading

What’s in a name? That which we call a rose.

rose-moles all in stipple on trout that swim… G.M. Hopkins, Pied Beauty By Jorge Roman B.S. The vast array of plant life that inhabit this earth has proven to be a great muse for humanity. People have used the ample pool of imagery provided by plants to create gorgeous works of art and what is dermatology if not a visual art? The countless colors, textures, shapes, and sizes displayed by plants have been used by dermatologists as a source of inspiration for describing the skin and its pathology. Arborization is a ubiquitous term used to describe everything from the vessels of a basal cell carcinoma to the dendrites of melanocytes. … Continue reading

Medical Mergers, Hospital Takeovers and the Changing Face of Medicine: Does Solo and Small Dermatology Practice Have a Future?

by Noah Scheinfeld, M.D., J.D. Full Article: Medical Mergers, Hospital Takeovers and the Changing Face of Medicine Abstract and Introduction: The trend toward business consolidation, which has affected industries as diverse as car manufacture, advertising, and banks, has been accelerating among entities that provide medical care.  That is, there are fewer and fewer entities that provide medical care, although the ranks of these larger medical entities have swollen.   The Great Recession of 2008, and the “The Patient Protection and Affordable Care Act” (PPACA of 2010 (commonly called the “Affordable Care Act” (ACA) or, colloquially, “ObamaCare”) have hastened this consolidation.  More and more residents (including dermatology residents) completing their training after … Continue reading

Code Black at the Brigham

by Gerrick Gu, Williams College ‘17 As an undergraduate intern, I spent the month of January, 2015, in Boston, shadowing cardiac surgeons at the Brigham and Women’s Hospital. Through long days I had the opportunity to observe complicated procedures performed by some of the most famous heart surgeons in the world. One of them was Dr. Michael Davidson,, a titan in the field of aortic aneurysm surgery. Although repairing large blood vessels involves a team approach, only one fearless cardiac specialist does the actual fixing. On a good day with no complications this surgical process can take up to 14 or 15 hours. Dr. Davidson was the acknowledged expert, shouldering … Continue reading

Can Doctors and Patients be Partners in Healthcare?

By James Channing Shaw, M.D. Trust in doctors. It used to be absolute. If our sick patients improved, we were celebrated. When we failed, families praised us for trying. This arrangement was not right, but no doctor went to any great lengths to change the perception. About three decades ago, the pendulum swung. Now doctoring is frequently viewed as market share, self-promotion, unnecessary procedures and testing. It would seem that professionalism has become obsolete. Patients, too, have changed with the times. Many patients would like to have every test, expect their health problems to be cured, fixed painlessly, no disruption to social calendars, easy parking, and why can’t this cancer be … Continue reading

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