Philippine Dermatological Society

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CUTTING EDGE: Dermatologic Surgery and Legal Issues
Joan Marie L. Zulaybar, M.D.

“Dear God, these fragile hands that cut the flesh steady them as if at rest. Bless this patient yours and mine whose very life is your design. Almighty God, I do pray guide my hand as I work today, Amen.” A surgeon’s prayer

A well-attended forum with Skin and Cancer Foundation, Inc. consultants and residents.

The practice of Dermatology is not only medical but also surgical, and the proper diagnosis and decision-making that comes into managing surgical patients is not only a science but an art. The Skin and Cancer Foundation, Inc. (SCFI), in collaboration with the Dermatologic Surgery Subspecialty Core Group hosted the Continuing Medical Education (CME) conference centered on this theme with “CUTTING EDGE: Dermatologic Surgery and Legal Issues”. The event was held last May 29, 2019 at the St. Luke’s Medical Center – Global city. Accounted for were 152 live attendees and 231 on webinar.

The conference commenced with an industry-sponsored talk by Blossom Tian-Chan, M.D., FPDS, where she reviewed treatment options and psychologic effects of Acne vulgaris in an aptly titled, “AIM for 0scar”. The CME proper then followed, moderated by John Michael Dellariarte, M.D., DPDS, SCFI chairman, Vermèn M. Verallo-Rowell, M.D., FPDS, delivered welcoming remarks. Three compelling cases were presented by second year residents of SCFI. The first case, by Patricia Alessandra Cabral M.D. was on a 37-year-old male with acne scars classified as severe, who underwent subcision and fillers. Jonathan Nevin Yu, M.D., FPDS, gave a discussion on acne scars and new insight on how to treat them with algorithms, methods recommendations and precautions. The second case, presented by Stephanie De Leon M.D. was on a 68-year-old female diagnosed with Trichoepithelioma where excision and grafting was done. Charlene Ang-Tiu, M.D., FPDS, followed with her tips and considerations in closing nasal defects, where she briefly discussed basic anatomy and talked about specific experiences and cases that she treated. The third case, presented by Raphaela Martina Pineda, M.D. was on an 84-year-old male with squamous cell carcinoma in situ where wide excision with purse string closure was done. Eillen Luisa Chen M.D., DPDS then, gave a thorough discussion on Dermatologic surgery pearls for the treatment of nonmelanoma skin cancer where she talked about different surgical, and briefly non-surgical, treatments and their advantages and disadvantages. Thereafter, Atty. Elizabeth Amelia V. Tianco, M.D., FPDS, gave a lecture on Medico-legal issues in Dermatology, where she talked about the proper training of a Dermatologist in the Philippines, standard of care, creation of a patient-physician relationship and grounds for malpractice. The event closed with an open forum and a take home message that as dermatologists, the role of reassuring surgical patients of their conditions, choosing the proper management for that specific patient and managing expectations with proper advice is incumbent. Also, we should continue to cultivate good patient-doctor relationship and trust by respecting our patient’s confidentiality and building good rapport. Then, Purita Paz-Lao M.D., FPDS, the current president of the Philippine Dermatological Society, graciously, gave her closing remarks.

 

Awarding of certificates to the speakers: (from left to right) Atty. Elizabeth Amelia V. Tianco, M.D., Dr. Purita Paz-Lao, Dr. Eillen Luisa Chen, Dr. Charlene Ang-Tiu, Dr. Jonathan Nevin Yu, Dr. Vermèn M. Verallo-Rowell., Dr. Sylvia Jacinto and Dr. Jasmin Jamora.

Learning Pearls:

  1. We must continue to not only see the lesions but always see the patient as a whole, especially as we give management options to the patients and determine what they are and are not willing to undergo. This will help us give tailor fit management, whether it is surgical, or non-surgical, and monotherapy or combination therapy.
  2. Understanding basic anatomy is the key to giving appropriate surgical management to each patients.
  3. As dermatologists, the role of reassuring surgical patients of their conditions, choosing the proper management for that specific patient and managing expectations with proper advice is incumbent

  4. The key points to remember in the practice of Dermatology to avoid litigation is to have proper training and qualifications, act according to the standard of care, nurture strong patient-physician relationships, behave professionally, communicate effectively.

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