Take Responsibility for Your Own Care or Pay the Consequences
Posted Thu, Jun 23, 2011

The 19 year old sophomore sat on the exam table looking at the floor. A college student with obvious charm and kindness, she appeared withdrawn and shy. Covering her face were pustules , redness, and several cysts. Her mother was in tears fearing her child could not continue college because of depression concerning her appearance. They had been to a “doctor”, at a dermatologist’s office for the past 6 weeks and after taking several ineffective oral antibiotics and 6 different topical medications; having spent hundreds of dollars this family could ill afford to lose; after having hopes for a resolution dashed by failure to respond; her “doctor” recommended Acutane – a drug known to cause depression in students. This is to ignore also the potential for injury to eyes, liver, and cholesterol. A drug that causes depression is being recommended for a depressed college student. I looked at the different medicines and out of curiosity, if nothing else, gazed at the prescribing doctor’s name on the bottle. The doctor was a name unfamiliar to me with the suffix “PA” after her name. “PA: Physician Assistant”. The child was not being treated by a doctor but by a “doctor” i.e. “PA”. The doctor was a dermatologist who saw the patient once and referred her to his employee “doctor” with a diploma as a “PA” and this “doctor” with 2 years of education diagnosing everything from brain tumors to acne was going to give a depressed student a drug that might induce depression!
A 65 year old female patient had progressive shortness of breath and acute anxiety. She and her husband went to a University affiliated hospital emergency room where the doctor noted no evidence of heart disease and omitted a chest Xray or scan. He sent her home for a cardiac stress test. Her primary care physician, noting the absence of cardiac symptoms ordered a chest scan and found a pulmonary embolism. The patient survived and will never trust an emergency room doctor again.
A patient saw an advertisement for a new form of ultrasound to reduce fat in her abdomen. She called our office and told the receptionist, “Don’t give me smartlipo or slim lipo, or cool lipo. I don’t want Velashape or Zeltique or Zerona. I just want the new ultrasound so if you don’t have it I will go somewhere else.” The patient never considered the value of examination or diagnosis.
Noted physician experts in plastic surgery and dermatology have published their opinion that the often promoted “stem cell face lift” is at this time hyperbole and does not exist as a separate procedure. Nevertheless, judging from its popularity in the lay and medical press, many patients seek this “new break-through”.
From seeking help for disease to addressing cosmetic concerns, many patients fail to follow minimal procedures for assuring responsible care for themselves and their loved ones. As examples:
• Interview physicians when there is time.
• Look at before and after results
• Check physician credentials at least using Google and hospital references
• Seek second opinions when care does not appear effective or when an elective medical/surgical path is recommended
• Use resources like Mayo Clinic and John’s Hopkins websites
• Maintain objectivity
It is nice to remember 50 years ago when a physician sat at your side and held your hand. Today we have much better diagnostic and therapeutic aides with which to intervene; but… they will only be available for those who take responsibility for their own care.


Edward Lack
Edward Lack MD is a board certified dermatologist and a board certified dermatologic cosmetic surgeon. He is President and Medical Director of MetropolitanMD, a multispecialty cosmetic surgery center in Chicago,which is unique in having a double board certified cosmetic dermatologic surgeon, a double board certified facial plastic surgeon, and a double board certified cosmetic plastic surgeon. Dr. Lack is also the Past President of The American Academy of Cosmetic Surgery.

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