Ronald G. Wheeland, M.D.
Ronald G. Wheeland, M.D., is a private practitioner in Tucson, Ariz. He is former president of the American Academy of Dermatology, the American Society for Dermatologic Surgery and the American Society for Laser Medicine and Surgery, and a long-standing member of the Dermatology Times editorial Advisory board and a co-medical editor.
Should indigents be denied self-paid cosmetic surgery?
In a previous editorial I wrote of what I called the "unfairness" of the cosmetic surgery taxes that a number of states were either considering implementing or had already implemented as a way to balance their budgets or provide funding for indigent patient care services or support of medical research.
Is dermatology abdicating to other specialties?
If we don't learn about these new forms of treatment, we lose.
Cosmetic surgery patients: Unfair tax targets?
The incredible rate at which outpatient surgery has been growing over the past decade is partly a function of increased patient demand for a variety of cosmetic surgical procedures. However, this growth has triggered a response in several state legislatures that may be detrimental to many potential patients who are interested in having cosmetic surgery performed. That legislative response has been to attempt to tax cosmetic surgery procedures.
DERMATOLOGY CASE CHALLENGE: Generalized hyperkeratosis in a very sick man
An 84-year-old man presents with pruritic, generalized, erythematous and crusted hyperkeratotic dermatitis. The patient's history is remarkable for laryngeal cancer, chronic obstructive lung disease, chronic renal insufficiency, and long-term prednisone therapy for possible bullous pemphigoid. The photograph demonstrates an erythematous, tense skin surface with severe crusted hyperkeratosis on the patient's hand.
Office-based cosmetic surgery: How can it be proven safe?
By 2005, it is estimated that most surgical procedures will be performed in the outpatient setting. How safe is office-based cosmetic surgery? All of us who perform such surgery believe it is incredibly safe ? or we wouldn't provide those services in an office setting. But, what proof backs up that statement? That data is very difficult to obtain since there are no federal requirements for reporting adverse events during office-based surgeries, and only a handful of states mandate reporting in such cases. Plus, those states have extremely variable reporting requirements, making data analysis extremely difficult.
State legislation and the cosmetic surgeon
As the old adage goes: "All politics is local." Never has this been truer than now, especially with regard to ambulatory cosmetic surgery. Many state legislatures have recently taken up the topic of office-based surgery, primarily cosmetic surgery, as a "white hat" issue driven under the guise of public safety, even though there has been no substantiated proof that a problem exists. Unfortunately, with only a few exceptions, cosmetic surgeons and the organizations that represent them have been late in coming to the realization that some well-intentioned, but misguided, legislation and rules have been passed into law in several state legislatures, and those laws are beginning to have an adverse effect on the practices of many office-based cosmetic surgeons. As a result, cosmetic surgeons and their patients are beginning to suffer the consequences of ignoring the activities of some state legislatures.
The next generation of dermatologists
Being a member of the baby boom generation, I have read a lot about what has been written about my generation and the generations that will follow. I've read articles and heard a multitude of news stories describing the next generation as being lazy, having a "me-first attitude," being poorly motivated and having an overall hedonistic attitude about life. In fact, if you were to believe some of the information, you might conclude that our country is doomed to failure if left in the hands of this next generation.
DERMATOLOGY CASE CHALLENGE Two long-standing lesions: Which is worrisome?
This 1.5-cm oval pigmented plaque demonstrates many of the features of malignant melanoma described by the mnemonic ABCD.
How not to miss commonly overlooked diagnoses
Melanoma, aortic stenosis, appendicitis, meningitis, depression, and thyroid disease are among the disorders that can confound the best diagnostician. What clues can point you in the right direction?


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