The doctor-patient relationship
Psoriasis is a specialty
As medical specialists, dermatologists are trained in the science and the art of caring for the skin. These doctors emerge from their medical training with a broad understanding of many different aspects of skin care. Dermatologists may then choose to specialize even further, focusing their practice on specific skin diseases, skin cancer or cosmetic procedures, for example.
The level of expertise and interest in treating psoriasis varies greatly among dermatologists. Certain doctors place a greater emphasis than others on treating psoriasis patients and keeping up with the wide variety of medications.
Psoriasis is a challenging disease to treat. People with psoriasis should be diligent about educating themselves about their treatment options. They should then use this knowledge to select a doctor who is able to respond to their needs, including providing an extensive choice of psoriasis treatments.
The doctor-patient relationship
The role of a patient has evolved into that of a meticulous consumer in today's health-care environment, especially with the increase in managed-care models of health insurance. Increasingly, it is the patient's responsibility to ensure his or her care is the best and most appropriate for his or her condition. Finding the right doctor and developing a good relationship is critical to positive treatment results. A growing body of evidence suggests that patients who actively participate in their care have better treatment outcomes.
Generally, it is reasonable to look for a doctor who takes into consideration the patient's quality of life and preferences, as well as the facts of the medical condition. This type of doctor shares information with the patient about his or her diagnosis, explains the range of treatments available and discusses what to expect from treatment. Plus, the doctor provides clear explanations, takes the time to listen to patient concerns and is honest but encouraging.
Communication between you and your doctor is a two-way street. Feeling confident with your provider's ability and bedside manner is important. You should be able to talk to your doctor without feeling frustrated or embarrassed. It is also important to find a doctor who encourages you to be an active partner in choosing treatment options.
If you do not have a doctor or you would like a second opinion, the Psoriasis Foundation may be able to direct you to a dermatologist in your area. You can access the Psoriasis Foundation Physician Directory by visiting www.psoriasis.org/treatment/directory or by calling a patient education support specialist at 800.723.9166.
Knowledge and realistic expectations
To become a true partner in your care, learn as much as possible about psoriasis and have realistic expectations. Education is the first step. The Psoriasis Foundation provides free educational booklets and this Web site, www.psoriasis.org, that contain the latest information about many different aspects of psoriasis, as well as information about the various treatments.
"It is definitely to the patient's advantage to know what kinds of treatments are out there, so that you don't end up being told that 'there is nothing more to do for your psoriasis–you just have to live with it,' when, of course, that is not the case at all," says John Y. M. Koo, M.D., of the University of California at San Francisco.
While education goes a long way in fighting the disease, it does not offer a cure. "This is a disease that is with the affected person for life," says Robert Stern, M.D., of Boston's Beth Israel Deaconess Medical Center. "There will be flares of the disease and treatments will fail, even when they worked before. Sometimes failures occur with good explanation. The long- and short-term toxicities of treatments have to be considered, as does the risk of a flare following treatment."
Updated October 2005
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