Physician Heal Thyself

doctor_diagnosisSunscreen is one of my most frequent recommendations.  Anyone who has even the slightest familiarity with Maine Laser Skin Care, including those who have not yet been to our Augusta offices, can attest to this fact.

Many studies, especially from Australia where the sun is most especially strong, have demonstrated that sunscreen is a very important part of sun protection.  Sunscreen is also vital to preventing skin cancer and photoaging.

However, despite these conclusive studies, a recent study shows that U.S. physicians on the whole are not recommending sunscreen on a regular basis.  This result is quite shocking.

checkupA study, published in the January 2014 issue of “Journal of the American Medical Association Dermatology”, analyzed the National Ambulatory Medical Care Survey from 1989-2010.  This survey identified patient visits to outpatient doctor’s office throughout the U.S., which included 18.3 billion (yes, billion) visits nationwide during this period of time.

According to this analysis, doctors documented recommending sunscreen in 12.83 million visits, which represents only 0.07% of visits!  When the patient had a diagnosis of any skin disease, the percentage did increase, but sunscreen was only mentioned at a 0.9% rate.  To the credit of dermatologists, they did the best of all the physicians, mentioning sunscreen 86.4% of all visits to their offices.

This study also looked at which patients received the most recommendations for sunscreen.  Sunscreen was mentioned most frequently to white people and patients over 70 years old.

Sunscreen was recommended least commonly to children.  The most common diagnosis associated with a sunscreen mention was actinic keratosis, which is a pre-cancerous condition caused by UV light exposure.

My reaction to this study was to ask, “Why?”.  The authors did sympathize that primary care doctors, including pediatricians, are under immense pressure to treat acute problems as well as manage chronic diseases, while also counseling patients on a multiplicity of issues.

spf_30Having been there myself as a primary care doc for 32 years, I certainly sympathize.  However, the only way to change behavior is to identify the problem, educate doctors and patients about the problem, and continue to measure to document improvement.

The increasing incidence of skin cancer should give all of us impetus, both healthcare professionals and citizens alike, to encourage daily use of sunscreen and other sun-protective behaviors.  The old adage of an ounce of prevention being better than a pound of cure certainly is appropriate here.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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