Opportunity Cost

One of the basic principles covered in my college economics class that often seems relevant is the concept of opportunity cost. When making decisions, the cost of something includes what we give up by not choosing an alternative. The cost of 10 years of training to become a dermatologist is not just tuition; it also includes whatever else could have been done with those 10 years. Internalizing the opportunity cost concept may be helpful for how we think about many decisions, including medical ones.

Abortion is a timely issue. Let’s be frank. Some people think it is only a question of a woman’s liberty to control her body; those folks seem, at least at times, to ignore the opportunity cost of what is, to some other people, the value of the baby (a baby, to their thinking, who is being murdered). This glass is half full and half empty. There are people who think abortion rights are about killing babies; those folks seem, at least at times, to ignore the opportunity cost of what is, to some other people, preventing a heinous government intrusion on a woman’s right to control her own body. I am pompous enough to think I have an answer to almost everything, and even I do not see a resolution to the abortion rights conundrum.

Anchored on that, questioning skin cancer prevention strategies may not seem quite so controversial. Advising patients to protect themselves from the sun seems like an entirely reasonable precaution. I would certainly recommend using sunscreen to prevent sunburn and wearing a hat and/or sunscreen to keep the sun off the face. On the other hand, have we considered the relaxation benefits of sun exposure? Might safe sun exposure reduce blood pressure in the general population? If there were even a small effect on reducing blood pressure in the general population, it may be that universal counseling for complete sun avoidance might marginally increase cardiovascular events, which could cause more morbidity and mortality. Just food for thought.

In addition to skin cancer awareness, in this issue, we cover:

• Food allergies (Is there an opportunity cost to giving up peanut products in schools?)

• Ocular rosacea (We can treat with oral antibiotics, but are we causing antibiotic resistance?)

• Comorbidities in atopic dermatitis such as mental health issues (Should we consider how medical resources may otherwise be used before we recommend blanket mental health screening for our patients with AD?)

I would not be too disappointed if some people read this article, internalize the opportunity cost concept, and immediately wonder: “How could the time I spent reading this article have been better used? How might this page of the magazine have been better used?”