Dermatology is an Auditory Specialty
One of the appeals of dermatology for the medical student is that it is such a visual specialty. So many so called ‘spot diagnoses’ can be made simply by looking at the rash. Medical students around the world applying to dermatology programs can be heard saying “I like that it’s such a visual specialty.” The dermatologist comes to the rescue in so many unusual and bizarre rashes because of their ability to immediately recognize certain patterns.
Medicine & Dermatology are auditory specialties too
We rarely hear it said - but dermatology is an auditory specialty too. We can make diagnoses by listening to what our patients actually say. We can sort out many challenging diagnoses by sorting out the actually story of the patient’s medical issues.
How can I differentiate between a challenging case in which the biopsy suggests lichen planopilaris but yet the clinical examination suggests it is not? By carefully listening to the patient’s story!
How can I differentiate between a challenging case of a 34 year old female in which one clinician feels the diagnosis is chronic telogen effluvium and another clinician feels it’s diffuse alopecia areata? Certainly the scalp examination will be important but so will the patient’s story!
How can I differentiate between a challenging case in a 4 year old boy in which one clinician feels the diagnosis is alopecia areata and another clinician feels it’s trichotillomania? Certainly the scalp examination will be important but so will the patient’s story!
Sir William Osler (1849-1919)
William Osler was a Canadian physician and one of the 4 founding professors of John Hopkins Hospital . He was not only a physician but an educator, philosopher (and apparently a wonderful practical joker too). He is often honoured with the title as the “Father of Modern Medicine.” Hs teachings and words have influenced the practice and careers of countless physicians around the world.
Sir Osler once provided advice about listening to patients:
Sir Osler’s advice is too often forgotten in era of fancy diagnostic tests. The patient’s story still remains a powerful tool when tough diagnoses need to be made. If I practiced hair loss medicine without the chance to speak to the patient, I’d certainly make a great number of errors in diagnosis. That’s even with all the dermatoscopes I own, the array of tests I have at my disposal, and even with the wonderful dermatoapthologists that I’m so lucky to work with.
The patient’s story is important!
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887