A few years ago I had a small basal cell carcinoma scraped off my lower leg, band-aid applied and that was that. This year I had a different dermatologist and a similar lesion. This time it was scraped off and I was sent to a Moh’s surgeon (basically a Dermatologist with special Moh’s training. It began as a technique called chemosurgery, developed by Frederic E. Mohs, MD, in the late 1930s, but was not widely known. In the mid 1960s, Perry Robins, MD, became the first dermatologist to study the technique with Dr. Mohs, and he helped advance the procedure into what is now called Mohs micrographic surgery).
I was one of multiple patients that day – it felt a bit like an assembly line in my little surgery booth. A wide excisional biopsy was done, a prescription for opiods written (not filled), and a follow up scheduled. It took about 3 hours to complete this visit – 6 weeks to heal.
Later I talked to a general surgeon asking, “Is all this Moh’s surgery really needed. I’m not concerned about a cosmetic result.” He felt that either nothing needed to be done or a simple excision by a general surgeon would be his choices. Basal cell carcinomas have a very low potential for becoming a problem.
The lucrative side of Dermatology is now enticing venture capitalists to set up stand alone dermatology clinics staffed by physician assistants. The potential abuses and over-treatments are well documented in this article in the New York Times. Moral of the story: seek a second opinion is the treatment appears too aggressive and/or if you are not seen by a board certified Dermatologist. Thanks to Joan Horner for recommending this article.
Thanks, Jim…..I just went through Mohs surgery in two areas and the healing process is SLOW. I had to be convinced it was better to have this done (in my case by a doctor) as felt the risk of it spreading was pretty low. Your comments plus the New York Times article will make me more circumspect in the future.
Diane