Advice to improve patient care

Pearls from members

“Dermatologic Surgery Pearls: Optimizing Safety, Satisfaction, Efficiency” (S008)
Friday, 9 a.m.–12 p.m.
Room 2

Diana Bolotin, MD, PhD
Assistant professor, section of dermatology, University of Chicago

“Patient satisfaction with dermatologic procedures hinges on many factors. Pain during procedures is a significant variable affecting patients’ perception of their experience. Techniques to reduce pain associated with local anesthesia injections and patient-directed adjuncts, such as utilizing music and anxiolytic medication, are important components of an intraoperative pain management plan. Management and reduction of pain during both surgical and cosmetic dermatologic procedures in adults and children is the key to an improved patient experience.”

Daniel Brian Eisen, MD
Professor of clinical dermatology, University of California, Davis

“Wound edge approximation is a basic tenet of dermatologic surgery. Following subcuticular suture placement, the skin edges should be apposed, and ideally pressing against each other. However, many neophyte and even experienced surgeons find their sutured wound edges are often several millimeters apart, a situation that requires the edges to be pulled together with an additional cuticular layer of sutures. This may result in more tension at the wound edges and a higher incidence of track marks. One cause of poor wound edge approximation is the presence of skin bevels. Excisions performed with the scalpel pointed toward the outside of the ellipse (reverse bevel) can reduce the presence of bevels and result in a wound where the edges are approximated without the need for excessive tensioned cuticular sutures or the need to remove the bevels prior to suturing.”

Nicholas J. Golda, MD
Associate professor of dermatology, University of Missouri

“Ensuring that our patients are having the best possible experience with their care should be something we are all, as dermatologists, engaged with — not because we are being forced to do it by external forces — but because it is an essential part of taking excellent care of our patients. Communication issues underlie most problems that patients experience with health care. When a patient, staff member, or referring provider present you with a concern, think first about how better communication may have improved things or averted the issue.”

Emily Clara Newsom, MD
UCLA division of dermatology, Los Angeles

“Studies show that patients recall less than half the information given by their physicians. Use of video in medicine increases patient comprehension and satisfaction and decreases anxiety. We developed two informational videos on Mohs surgery: traditional and narrative. The focus of the traditional video is purely didactic. The narrative video includes patient testimonials, patient-physician interaction, and animations. Our Mohs surgery patients all reported that the videos were helpful for understanding Mohs surgery, with the majority (73%) recommending the narrative over the traditional format (27%). Our study shows that technology is useful for patient satisfaction, and ultimately a balance is needed between offering a comforting narrative while setting realistic expectations about the Mohs procedure and associated risks in a succinct manner.”

 

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