Dr. Schultz, What Keeps You Up at Night

Recently, a patient asked me a really interesting question and she said, “Dr. Schultz, as a dermatologist, what keeps you up at night?” As you might expect, I think about skin cancer a lot. I think about the increasing incidents of skin cancer and all of those sadly unnecessary deaths that occur from skin cancer every year but I really take this question at a more personal level. And what I think about most at night, with respect to dermatology, is anything that prevents my patients from achieving what they’ve entrusted me to do for them. That usually falls into two categories; the first category has to do with what the patient does. Well, I’ve seen a patient and I’ve told them what to do, will the patient follow my instructions? Will they fill the prescription? Believe it or not, half of all prescriptions given to patients by physicians are never filled. If they fill the prescription, will they follow the instructions? Will they use it properly? To help make sure that happens my nurse writes down on a separate piece of paper the specific instructions which does two things, number one it clarifies for the patient what they’re to do but also it’s sort of a reminder, use your medicine. The second category has to do with what I’ve done for the patient. Have I done everything that I can? And that usually involves, number one, have I made the correct diagnosis? Number two; have I given them the best treatment that exists, the best treatment that I know? And I like to believe that generally the answer to both of those questions is yes. Does the patient really like the results of the cosmetic procedure I’ve preformed for them? Or if the patient has a dangerous growth or a skin cancer, was it removed completely by the procedure I did? Did it have any tentacles underneath that prevented me from removing it completely? I think about that until the results of the biopsy come back. At the end of the day, medicine teaches us many things but one of the things that it teaches all of us is humility because you see, doctors are people too just like you and we want to do the best job we can do.