The Associates in Dermatology of Traverse City recently expanded from 10 exam rooms to 21—and now uses scribes, a sort of “two heads are better than one” at every appointment. The two major changes have transformed how quickly and personally patients can be seen, according to founder and dermatologist Joan Griner, MD, and the scenario is a win-win for both patients and docs.
“By increasing our available exam space, we have improved the patient flow for each provider,” Griner says. Instead of the typical industry six-month wait to get in to see a dermatologist, AID can see patients within days instead.
In addition, there is now a scribe in the exam room with each patient, tapping away on an iPad, recording everything for the doctor.
“Our Medical Assistants (MAs) are fantastic,” Griner says. “They are in the rooms with us, noting what we see on the patient’s skin and recording our recommendations. For example, they might begin setting up a procedure while I’m discussing it with the patient. Or they might step out and retrieve samples of a product I’m recommending. They remain a silent partner, quietly performing their job in the background.”
An additional benefit of the scribe system, Griner adds, is that the MAs get to connect with the patients personally.
“They now have a stronger sense of purpose and interest in the care of the individual patient, which reflects in the subsequent interactions with that patient, such as for phone calls or scheduling,” she says. “They have a greater ownership of patient care and a desire to be a part of the success of our practice.”
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Griner sees a multitude of skin care issues, but because of the prevalent population of retirees in Northern Michigan, she most often treats skin cancer and UV damage.
“At least one third of my patients travel to warm, sunny climes in the winter, essentially exposing their skin to intense UV light 12 months of the year,” she says. “Most people choose to live here to enjoy the outdoors! And while the most effective way to protect your skin is to avoid sun exposure, I recognize my patients need more realistic options.”
Griner encourages her patients to limit their direct sun exposure time, particularly aiming to avoid midday sun from 10 a.m. to 4 p.m. in the summer, to always look for shade (umbrellas, trees, cabanas), to choose hats with a wide brim to cover ears and neck, and wear long-sleeve “sun shirts” and pants.
“I recommend sunscreen with SPF 30, containing titanium dioxide or zinc oxide. These have always been my favorites because they are a more effective ‘physical’ block. They screen all waves of UV light and typically don’t cause as much irritation. Several really good products are on the market, and they will not make you look like Casper the friendly ghost.”
Griner recommends patients who have had skin cancer or a family history of skin cancer, see their dermatologist every year. She recommends every six months if they have had a melanoma within the last five years. Also, patients who have had “atypical” or “dysplastic” moles should be seen yearly, as these are thought to be a marker for higher risk of developing melanoma.
“Anyone who notices a spot that captures their attention, whether it be because it is new, itching, bleeding or darker, or the ‘ugly duckling’ that doesn’t look like the rest, should be seen by a dermatologist,” Griner says.
Griner recommends setting aside 15 minutes once a month for monitoring moles and using UMSkinCheck, a free app developed by The University of Michigan to guide users through a skin check.
“Just like every other cancer, early detection is the key in skin cancer,” Griner says. “The difference is that skin is so readily accessible that you CAN exam it at home!”