Resident tips on effective communication with patients, plus ruxolitinib for vitiligo and hydroxychloroquine for oral lichen planus
06/27/19 • 34 min
Three dermatology residents — Dr. Elisabeth Tracey, Dr. Julie Croley, and Dr. Daniel Mazori — discuss tips for clear communication with patients in this special resident takeover of the podcast. Beginning at 6:11, they talk about challenges with topical therapies and setting expectations with patients. “We, as dermatologists, can optimize patient management by being effective communicators,” said Dr. Croley. They provide communication strategies for improving compliance with therapy and ensuring patients have the correct instructions, as well as clarifying patient misconceptions and the importance of maintenance treatment.
We also bring you the latest in dermatology news and research:
1. Topical ruxolitinib looks good for facial vitiligo in phase 2 study.
About half of patients on the two highest doses had a 50% improvement after 6 months of treatment.
2. Patients concerned about clinician burnout.
Almost three-quarters of Americans are concerned about burnout among health care professionals.
3. Antimalarial may be effective, safe for erosive oral lichen planus.
Hydroxychloroquine sulfate may be an effective and relatively safe treatment option for moderate to severe oral lichen planus.
Things you will learn in this episode:
- Review expectations of therapy with patients, such as an intense inflammatory response to topical 5-fluorouracil for actinic keratosis, to ensure that patients remain compliant with the therapy but also feel they can trust you as their physician.
- If patients are hesitant to use topical minoxidil because they are concerned with the length of time they’ll have to use it, use a metaphor for another lifelong commitment such as brushing your teeth. “What I started actually doing is calling topical minoxidil toothpaste for your hair,” said Dr. Mazori.
- Talk to patients about spot-treating with acne or applying topical medication appropriately for psoriasis. “A particular challenge in dermatology with topical medications is not just whether or not they use it or pick up the prescription but how they use it,” said Dr. Tracey.
- Talk to patients about underapplication of sunscreen. Recommend a physical blocker if patients express concerns about systemic absorption.
- Write down instructions to ensure patients have the relevant information. The teach-back method of communicating with patients often is taught in medical school and ensures that the patients have understood what you’ve said, but it doesn’t ensure that they retained it. Strategies such as having medical students write the instructions or copying notes from your electronic medical record to print for patients can help save time.
- Emphasize the importance of maintenance treatment for conditions such as intertrigo, seborrheic dermatitis, or onychomycosis to prevent recurrence.
- Give patients both the trade name and generic name to ensure they use the correct medication.
Hosts: Elizabeth Mechcatie, Terry Rudd
Guests: Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation); Julie Ann Amthor Croley, MD (University of Texas Medical Branch at Galveston); and Daniel R. Mazori, MD (State University of New York, Brooklyn).
Show notes by Melissa Sears, Alicia Sonners, and Elizabeth Mechcatie.
You can find more of our podcasts at http://www.mdedge.com/podcasts.
Email the show: [email protected]
Interact with us on Twitter: @MDedgeDerm
Three dermatology residents — Dr. Elisabeth Tracey, Dr. Julie Croley, and Dr. Daniel Mazori — discuss tips for clear communication with patients in this special resident takeover of the podcast. Beginning at 6:11, they talk about challenges with topical therapies and setting expectations with patients. “We, as dermatologists, can optimize patient management by being effective communicators,” said Dr. Croley. They provide communication strategies for improving compliance with therapy and ensuring patients have the correct instructions, as well as clarifying patient misconceptions and the importance of maintenance treatment.
We also bring you the latest in dermatology news and research:
1. Topical ruxolitinib looks good for facial vitiligo in phase 2 study.
About half of patients on the two highest doses had a 50% improvement after 6 months of treatment.
2. Patients concerned about clinician burnout.
Almost three-quarters of Americans are concerned about burnout among health care professionals.
3. Antimalarial may be effective, safe for erosive oral lichen planus.
Hydroxychloroquine sulfate may be an effective and relatively safe treatment option for moderate to severe oral lichen planus.
Things you will learn in this episode:
- Review expectations of therapy with patients, such as an intense inflammatory response to topical 5-fluorouracil for actinic keratosis, to ensure that patients remain compliant with the therapy but also feel they can trust you as their physician.
- If patients are hesitant to use topical minoxidil because they are concerned with the length of time they’ll have to use it, use a metaphor for another lifelong commitment such as brushing your teeth. “What I started actually doing is calling topical minoxidil toothpaste for your hair,” said Dr. Mazori.
- Talk to patients about spot-treating with acne or applying topical medication appropriately for psoriasis. “A particular challenge in dermatology with topical medications is not just whether or not they use it or pick up the prescription but how they use it,” said Dr. Tracey.
- Talk to patients about underapplication of sunscreen. Recommend a physical blocker if patients express concerns about systemic absorption.
- Write down instructions to ensure patients have the relevant information. The teach-back method of communicating with patients often is taught in medical school and ensures that the patients have understood what you’ve said, but it doesn’t ensure that they retained it. Strategies such as having medical students write the instructions or copying notes from your electronic medical record to print for patients can help save time.
- Emphasize the importance of maintenance treatment for conditions such as intertrigo, seborrheic dermatitis, or onychomycosis to prevent recurrence.
- Give patients both the trade name and generic name to ensure they use the correct medication.
Hosts: Elizabeth Mechcatie, Terry Rudd
Guests: Elisabeth (Libby) Tracey, MD (Cleveland Clinic Foundation); Julie Ann Amthor Croley, MD (University of Texas Medical Branch at Galveston); and Daniel R. Mazori, MD (State University of New York, Brooklyn).
Show notes by Melissa Sears, Alicia Sonners, and Elizabeth Mechcatie.
You can find more of our podcasts at http://www.mdedge.com/podcasts.
Email the show: [email protected]
Interact with us on Twitter: @MDedgeDerm
Previous Episode
Artificial intelligence in dermatology, plus scabies treatment and teledermatology
In this episode, Dr. Vincent DeLeo discusses artificial intelligence (AI) with Dr. Babar Rao, beginning at 10:12. Cognitive computing, which mimics human thought processes to analyze data, can be used along with other advances in AI to support clinical decision-making and physician-patient interactions. Where is dermatology in this world of AI? Dr. Rao discusses clinical scenarios in which AI can be implemented to improve patient outcomes, including hair transplantation and skin cancer evaluation. He also forecasts the future of AI in dermatology.
We also bring you the latest in dermatology news and research:
1. Scabies rates plummeted with community mass drug administration.
2. Teletriage connects uninsured with timely dermatologist care, plus an interview with study investigator Cory Simpson, MD, PhD, a dermatologist at the University of Pennsylvania, Philadelphia. The study was presented at the World Congress of Dermatology.
3. Response endures in cemiplimab-treated patients with cutaneous squamous cell carcinoma.
Things you will learn in this episode:
- Cognitive computing not only processes data but makes sense out of the data from multiple perspectives, including human-computer interactions, vision, and language processing.
- Computer-aided robots can be used to maximize outcomes in hair transplantation.
- Artificial intelligence (AI) software can be used to analyze biopsy slides to help make skin cancer diagnoses.
- Electronic medical records allow physicians to input patient data, which can be helpful from a billing and insurance standpoint, but these systems currently are not able to support physicians in making clinical decisions or in choosing treatment plans based on the available patient data.
- Over the next 10 years, it will become common for clinical decisions to be made based on evidence and data gathered from AI systems and not from research articles or textbooks alone.
Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)
Guest: Babar Rao, MD (Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey)
Show notes by Alicia Sonners, Melissa Sears, and Elizabeth Mechcatie.
You can find more of our podcasts at http://www.mdedge.com/podcasts.
Email the show: [email protected]
Interact with us on Twitter: @MDedgeDerm
Next Episode
Ocular chemical injuries in the dermatology office, plus social media and cosmetic surgery, and moving from psoriasis to psoriatic arthritis
Are you and your staff prepared to handle ocular chemical injuries? Dr. Vincent DeLeo talks with Dr. Shawna K. Langley and Dr. Deborah Moon about common chemical agents used in the dermatology office that can be damaging to the eyes. Dr. Langley shares her experience with a patient who sustained a transient ocular injury following accidental exposure to aluminum chloride during a biopsy of a suspicious lesion on the cheek. Treatment protocols and prevention methods that dermatologists can implement to ensure the best outcome for patients also are discussed.
We also bring you the latest in dermatology news and research:
1: Infections linked with transition to psoriatic arthritis
2: Social media use linked to acceptance of cosmetic surgery
3: Severity, itch improvements remain steady with ruxolitinib for atopic dermatitis
Things you will learn in this episode:
- On average, approximately 7%-10% of all ocular traumas may be attributed to chemical burns.
- The two most important factors to consider when evaluating the extent of an ocular chemical injury include the properties of the chemical and the duration of exposure.
- Damage associated with exposure to acidic chemicals usually is limited to more superficial consequences, while exposure to alkaline chemicals can result in more serious long-term effects such as cataracts or glaucoma caused by deeper penetration of the eye structures.
- The most common immediate side effects of ocular chemical injuries include a sensation of burning (not necessarily immediate) or pain as well as redness or erythema of the eye and eventually vision changes. “One of the learning points to me was that if somebody complains that something has dripped in their eye, even if it doesn’t seem possible and it doesn’t really make sense, and if you had just worked with a caustic substance right before they said that, have them start flushing immediately anyway,” said Dr. Langley.
- The Roper-Hall classification outlines the prognosis based on grade of injury (grades I-IV).
- Immediate irrigation of the eye for 15-30 minutes is the most important variable, which will affect the patient’s long-term prognosis. “This is the one variable that will impact the long-term outcome the most for the patient,” said Dr. Langley.
- Always ask patients if they are wearing contact lenses, as chemicals trapped underneath can cause prolonged burning of the eye. Do not delay irrigation to remove contact lenses. Start irrigation immediately and remove the lenses when possible under irrigation.
- Emphasize urgent follow-up with an ophthalmologist following ocular chemical injuries sustained in the dermatology office. If an ophthalmologist is not immediately available, send the patient to the emergency department.
- Educate support staff about the potential for ocular injuries in the dermatology office and be prepared with the proper equipment to administer immediate treatment.
Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)
Guests: Shawna K. Langley, MD (Loma Linda [Calif.] University Medical Center; Deborah J. Moon, MD (Kaiser Permanente Los Angeles [Calif.] Medical Center and the University of California, Irvine)
Show notes by: Alicia Sonners, Melissa Sears, Elizabeth Mechcatie
You can find more of our podcasts at http://www.mdedge.com/podcasts
Email the show: [email protected]
Interact with us on Twitter: @MDedgeDerm
If you like this episode you’ll love
Episode Comments
Generate a badge
Get a badge for your website that links back to this episode
<a href="https://goodpods.com/podcasts/dermatology-weekly-80310/resident-tips-on-effective-communication-with-patients-plus-ruxolitini-4287989"> <img src="https://storage.googleapis.com/goodpods-images-bucket/badges/generic-badge-1.svg" alt="listen to resident tips on effective communication with patients, plus ruxolitinib for vitiligo and hydroxychloroquine for oral lichen planus on goodpods" style="width: 225px" /> </a>
Copy