I like to say that medical care is more than just making the right diagnosis and prescribing the right treatment. To get patients well, you also have to get patients to take the medication. Yet those three pillars of medicine—the right diagnosis, the right treatment, and good adherence—are only half the story. The other half is delivering that care to patients.
This month, we cover several related issues, including how dermatologists can help pediatric patients and caregivers deal with bullying (page 33), a commentary on value-based care vs fee-for-service models (page 12), and an analysis of more than 200,000 online patient reviews of their dermatologist (spoiler: patients love their dermatologists; page 39).
I’m looking forward to another commentary, one on how telemedicine just does not replace in-person visits (page 38). For the last few months, I’ve been doing telemedicine visits one half day per week, and I have enjoyed the change of pace. It may not be the most cost-effective use of my time, but, hey, I’m a crazy academic, so that does not matter so much to me. Many of the patients I see in telemedicine visits are happy—veritably ecstatic in the current environment—not to have to come to the office.
To the extent that we have data—and there is high-quality evidence available based on an exceptional randomized, controlled clinical trial—online dermatologic care delivery does not just improve access, treatment outcomes can be just as good with online care as they are with in person care.1-4
Change can be invigorating, so we ought to be feeling young and vigorous these days!
References
1. Young PM, Chen AY, Ford AR, Cheng MY, Lane CJ, Armstrong AW. Effects of online care on functional and
psychological outcomes in patients with psoriasis: a randomized controlled trial. J Am Acad Dermatol. Published online June 5, 2019. doi:10.1016/j.jaad.2019.05.089
2. Armstrong AW, Chambers CJ, Maverakis E, et al. Effectiveness of online vs in-person care for adults with psoriasis: a randomized clinical trial. JAMA Netw Open. 2018;1(6):e183062. doi:10.1001/jamanetworkopen.2018.3062
3. Armstrong AW, Ford AR, Chambers CJ, et al. online care versus in-person care for improving quality of life in psoriasis: a randomized controlled equivalency trial. J Invest Dermatol. 2019;139(5):1037-1044. doi:10.1016/
j.jid.2018.09.039
4. Ford AR, Gibbons CM, Torres J, et al. Access to dermatological care with an innovative online model for psoriasis management: results from a randomized controlled trial. Telemed J E Health. 2019;25(7):619-627. doi:10.1089/tmj.2018.0160
