Question: What is the number one reason people see doctors?
- a) because they have a life threatening health problem
- b) because they are obese and want to lose weight
- c) because they don’t get enough exercise and want an exercise program
- d) because they have a skin problem
According to an article in the Mayo Clinic Proceedings this month the answer is “d”. 42.7% of visits are due to skin disorders. You should have known the answer just by looking at the magazines at the grocery checkout counter or watching ads on TV. We worry about skin blemishes but in the past people had to worry about smallpox or TB. It is hard to be serious about health care cost and political change in the face of this statistic. OK, acne scars are bad and skin cancer is real. But, the real danger from skin problems is very low. What can be done to alleviate skin problems without spending half of the U.S. GDP on trivial office visits?
The Mayo Clinic Proceedings article tangentially mentions dermatology telemedicine. Great idea. A picture is indeed worth a thousand words or perhaps a thousand patient visits. What if there was an app for taking a picture of a skin lesion and sending it for a dermatology consult ($10). Think of the cost savings for simple advice for acne or eczema or diaper rash! The improvement in health literacy would be huge and visits to primary care would decline. If a visit to primary care proved to be needed it would be for a substantial skin problem (or something else). Any health system wanting to reduce cost should find this idea fantastic — any health systems out there actually doing this?