Dermatology RANT
May 2008

A few weeks ago I started to develop some sort of seemingly minor skin infection in a couple of places.  So after decades of being able to get along in life perfectly well without going to a Dermatologist, my wife felt it was finally time for me to venture into what I always felt was merely the land of the vain.

A quick glance at the insurance provider's directory found Dr. Tamara Moss nearby.  Luckily the receptionist taking my call asked if I knew where to go, because the provider directory and Dr. Moss' own web site both displayed an outdated address a half mile away from the current location, in Forest Hills rather than Rego Park.  They were thrilled that a weekday mid-day appointment would be OK, and gave me a slot for that afternoon.

The waiting room time wasn't unusually long (for a typically busy NYC medical practice) and the visit went smoothly, with the doctor performing a head to toe exam at my request.  The doctor quickly and confidently gave the symptoms a name and didn't feel that a scraping or biopsy was immediately necessary.  She prescribed two topical creams - a steroid and an antifungal - to be applied in no particular order.

The first application of the creams was uneventful but the subsequent night-time application was quite a bit more exciting.  I applied to the infected spots the antifungal (Econazole Nitrate, a.k.a. Spectazole) first, then the steroid cream (Fluocinonide, a.k.a. Fluonex or Lidex) on top of it, and went to sleep shortly afterward.

I woke up about an hour later feeling like ALL my flesh was on fire.  I was red from head to toe and my skin felt like it was sunburned.  Thankfully my breathing and heartbeat was OK so instead of calling 911 and unlocking the front door just in case, I rushed to the 24 hour CVS pharmacy a few blocks away and at the recommendation of the pharmacist immediately took Benadryl and aspirin.  Symptoms began subsiding within an hour but didn't go away completely for nearly a full day.

Disaster averted, I waited until first thing in the morning to call the doctor.  I gave the receptionist my name and identified myself as a patient from the day before, and told her I had an allergic reaction to medications prescribed by the doctor.  After putting me on hold for a moment she said the doctor "will try to call you back today".

Their records have my home, work and cell numbers so there shouldn't be any difficulty reaching me, right?

That day came and went without a phone call.

The next day I did receive a call - from "the doctor's office".  But only the PA was in.

How nice of the doctor to try so hard.  I hope I wasn't interrupting somebody's Botox injections, or a life-and-death laser hair removal procedure.

With the help of the pharmacist and another MD I avoided further difficulties and we eventually determined the problem was an interaction with a time-release Niacin supplement I took that evening shortly before applying the creams.

Now this is just my opinion - mind you a relatively well informed opinion of someone whose spouse has nursing background and whose in-law is an experienced and successful medical malpractice attorney - that a doctor shouldn't be quite so casual with a patient who is complaining of an allergic response.  Allergic reactions can kill.  They should be taken seriously.

Draw your own conclusions but from now on I'll be seeing a real doctor.


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