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Norman Levine, M.D.
Norman Levine, M.D., is a private practitioner in Tucson, Ariz. He also is a member of the Dermatology Times Editorial Advisory board and a co-medical editor.
Common sense, thick skin are key in age of online physician reviews
Most of us have had experiences of being unjustly accused of poor medical care by a person whose capabilities to make these sorts of judgments are suboptimal at best. What can be done to combat these annoying and sometimes slanderous utterances placed online?
Evidence-based medicine must reign in dermatology
Since we have relatively few drugs in our therapeutic arsenal and care for hundreds of skin diseases, those few drugs tend to get utilized in situations far afield from their original intended use. Anecdotal data is published to validate what is often inappropriate therapy, and once in the literature or in the public domain after a lecture or seminar, it is almost impossible to expunge the spurious information unless there is some horrible side effect.
Moral beliefs guide doctors' decisions during ethical dilemmas
Recently, a 78-year-old woman for whom I had cared in the past returned with a complaint of numerous growths on her neck. I informed the patient that I would be happy to remove her skin tags, but there was no medical indication to do so. The treatment would not be an insurance-covered service. She was not at all happy about this response.
Physician's most important service may be lending patients an eager ear
One of the most difficult lessons that I have had to learn since entering private practice four years ago is that patients want to have their say. In fact, sometimes this is the main reason for the office visit. If we do not understand the full motivation of the person seeking our care, we may fail that patient in a very profound way.
Before implementing EMRs, heed words of warning
Some time ago, I wrote an editorial in this magazine describing my early experience with the use of an electronic medical record. In the article, I indicated that this technology was a valuable addition to the medical office, but there was a fairly steep learning curve and some difficulties in creating a coherent and understandable document. After three years of using an EMR, much of what I said before remains valid.
Editorial: Is defensive medicine a good practice?
Recently, a 27-year-old woman consulted me about hair loss of several years' duration. She was in otherwise good health, and she proved this by showing me an impressive list of perfectly normal laboratory results indicating, among other things, that she did not have anemia or thyroid disease.
Case: Gradually enlarging plaque on hand
Consider porokeratosis if there is an annular plaque with a thin, thready, scaly border.
Case: Persistent facial eruption
Consider factitial dermatitis if lesions are irregularly shaped and there is little or no perilesional inflammation.
Going generic: Formularies limit brand-name choices
A patient with a complicated chronic skin disease consulted me some time ago. He had been under the care of another practitioner and was very satisfied with the quality of the care he had been receiving, but he could no longer afford the treatments being prescribed.
Case: Slightly sore, dark lesion on thigh
Consider angiokeratoma in a solitary, scaly blue-black papule on the extremity.

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