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    Predicting the future of dermatology

    Ronald G. Wheeland, M.D.Someone once said that if we don’t know the past we are destined to repeat it.  As I have reached a certain age, I find that I’m more interested in looking at and being aware of the past, so as to better try and accurately predict the future of dermatologic healthcare.  Perhaps by doing so dermatologists can be better prepared for the many unknowns that the future is sure to bring.  I have the luxury of not likely being around in 25 or 30 years to live up to any errors or mistakes I may make in this editorial, giving me the opportunity to make some pretty ridiculous predictions and leave it to the readers to look back from the future to critique these thoughts and determine how smart or wrong I’ve been.  To try and cover this topic methodically, I would like to begin with how I believe dermatology be practiced several decades from now.

    The Practitioner of the Future

    With the multitude of major scientific advances that have already occurred in the diagnostic and therapeutic areas in dermatology, my first (easy) prediction is that an enormous additional number of scientific advances will continue to occur in the future.  The sheer volume of this new knowledge in all areas of dermatology will add to the complexity involved in the management of patients with skin diseases.  While it is not impossible for a solo practitioner to remain optimally well informed as these advances occur and still permit the delivery of the best possible care for all of his or her patients, it will certainly become more difficult in the future. 

    READ: Why you should mentor the next generation of derms

    Because of this, I predict that in the future, solo dermatology practitioners will cease to exist and subspecialty dermatologists will affiliate with one another to practice as a group.   Evidence that this trend has already begun can be found from a recent AAD dermatology practice survey showing a decline over the past ten years in the percentage of solo dermatologists practicing in the United States.  In 2007, 44% of dermatologists were in solo practice, but by 2014 that number had dropped to 35%.  Further, the percentage of dermatologists in dermatology specialty group practices and multispecialty group practices averaged 50-60%.  While there can be many explanations for this dramatic change to have occurred, one reason might be that providing the best possible patient care requires a level of knowledge most easily done by subspecialists affiliating with one another rather than practice alone.  Further subspecialization in dermatology will continue to deal with the scientific advances that emerge in the future.

    NEXT: Research in dermatology

    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 ...


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