Many think of dermatology as superficial: survey

NEW YORK (Reuters Health) –

The public has some misconceptions about what dermatologists actually do, according to a recent U.S. survey.

“Overall, 46 percent of the participants thought that we spend the majority of our time managing skin cancer and 27 percent thought that we spend the majority of our time doing cosmetic procedures,” said Dr. April Armstrong of the University of California-Davis, the study’s senior author.

The results show a lack of understanding of the day-to-day realities of dermatology, the researchers say, and that misperception could affect whether people get needed care for skin diseases or if adequate funding goes to dermatology research.

According to a 2007 workforce survey, only 10 percent of a dermatologist’s work involves cosmetic procedures and the remaining 90 percent is made up of surgery and managing medical conditions, Armstrong and her team point out in the Journal of the American Academy of Dermatology.

For their own study, Armstrong and her colleagues asked a sample of more than 800 people across the United States what they think dermatologists spend most of their time doing.

They also asked participants how important they consider dermatology to be, how much dermatologists earn and how many hours they work, as compared to other types of doctors.

The respondents felt that cardiologists and primary care physicians have “more critical” professions than dermatologists and that plastic surgery is less important. Most people chose the same hierarchy when asked how difficult the job of a dermatologist was, with only plastic surgery rated as easier.

The respondents were correct in certain of their perceptions, including the number of hours worked per week by different types of doctors and the average incomes in the various fields.

Dermatologists tend to work fewer hours than the other specialties, though they report seeing a larger number of patients, according to the study team. Dermatologists also earn less than cardiologists and plastic surgeons but more than primary care physicians, the researchers say.

Dr. Karen Edison, a dermatologist at the University of Missouri Hospital in St. Louis agreed that there are some misconceptions about her field. She told Reuters Health in a phone call that, “While we certainly have expertise and in fact pioneered many of the most popular cosmetic procedures, most of what we do is medical and surgical dermatology.”

According to the American Academy of Dermatology, dermatologists diagnose and treat over 3,000 diseases, ranging from skin cancer to eczema to bacterial infections.

“In addition to the common dermatological conditions which are acne, rosacea, and psoriasis, dermatologists also manage a number of very complex medical dermatological conditions such as blistering diseases, pemphigus or pemphigoids, and a number of cutaneous infections that I think the public is not quite aware of,” Armstrong said.

“Misconceptions about dermatology may discourage patients with severe skin disease who need our expertise to seek care in settings that are not prepared to deliver high quality dermatology care and services,” she added.

“We also do quite a bit of primary care in dermatology,” Edison said. “We talk to patients not only about the need for sun protection, but we talk to them about their smoking, about their diet and exercise, many of us look at a patient as an entire person because the general health of a patient really affects the health of their skin.”

Armstrong and her colleagues write that media emphasis on cosmetic innovations likely contributes to the public’s confusion about what dermatologists really do.

Edison places some of the responsibility with dermatologists as well. “We have also played a part, by in some areas not participating as fully as we perhaps should with the greater house of medicine or the wider medical community,” she said.

Armstrong emphasized that it’s important for dermatologists to find ways to speak to the public about their profession.

“The key message,” Armstrong said, “is that there are gaps in the public understanding of the profession, of dermatologists’ expertise and what we spend the majority of our time doing, and I think there can be educational efforts there to close the gap.”

SOURCE: Journal of the American Academy of Dermatology, online August 28, 2014.