Skin cancer care has undoubtedly changed since the start of the COVID-19 pandemic. Orit Markowtiz, MD, highlights how she continues to provide high-quality care to her patients with suspected and confirmed skin cancer in her practice in New York City, NY.
Dr Markowitz is associate professor of dermatology at the Icahn School of Medicine at Mount Sinai and director of pigmented lesions and skin cancer in the department of dermatology faculty practice Mount Sinai Doctors; chief of dermatology at Queens Hospital Center-Icahn School of Medicine, and director of the Pigmented Lesions Clinic at the Brooklyn Veterans Hospital of Downstate University Medical Center, all in New York City, NY.
Transcript
Dr Markowitz: Guidelines are fluid. In various parts of the country, though, it's still the same core guidelines, which is you want to see patients in the office at a more limited basis. You don't want to have crowded waiting rooms, which many dermatologist offices, especially ones that are specializing in skin-cancer screenings and so forth, they tend to be in demand.
Aside from avoiding crowded waiting rooms, the virtual visit is essentially part of the tools for us to evaluate and take care of our patients safely at home. The National Cancer Comprehensive Network guidelines basically limited visits to real, dire urgencies. Melanoma, of course, is considered an urgency, as are some of the more deadly, rare skin-cancer tumors, like Merkel cell and very-advanced cases of squamous cell. That being said, as I mentioned, the rules are changing daily, what we can do in the office and outside the office.
However, I do believe that until we have a solution for keeping everyone safe in indoor spaces, we are going to have our virtual appointments as part of regular care even as offices are open. In my practice, I'm having all of my patients set up a virtual visit prior to any in-office visit for two reasons. One, to set and manage the expectations in terms of some of them don't realize that it's not exactly the same as it was before. It gives me an opportunity to answer their questions, remind them to wear a mask when they're coming to the office, remind them that I don't want them idling or waiting in waiting areas and so forth. The other reason is that most things I can manage from home, and they don't realize that. At least, if I can manage some of the easier or more straightforward issues, like we start talking about their dry skin and moisturizers and sunscreen, then their in-office visit is really to deal with the things that we absolutely have to deal with in person.
I have a lot of thoughts about dermatology in general, having been an educator now for 15 years, specializing in skin cancer and dermoscopy. My thought is that many of us educators are still providing our lecture platforms through webinars. I'm co-chairing various meetings, and now we're converting to virtual. Now's a great opportunity for people at home if they've wanted to brush up on diagnostic skills or to learn more about various things that they can do from home.
Imaging is something that is really helpful in understanding lighting and various technologies in order to evaluate their patients, and then to take the time to look at videos such as these, so they can also get some tips and tricks on how to manage their patients safely from home.
This year, the estimate for skin cancer is that two people will die every hour of every day from skin cancer. We all know that this is impacting our younger generation, not just older patients. Therefore, we need to let our patients know that it's safe to have a telederm visit. This way, it also opens the communication lines so that they're aware that this is something urgent and important, and that they get the care that they need, whether it's virtually or even in person.
