Back, again. Different cancer. Update#2 - heading to surgery 12/15 AM

[Ms. Toad]

4. I've never met such an arrogant jerk as the first one.

(Aside from residents who aren't confident enough in their abilities to work well with patients who are experts in their own conditions.)

I've fired doctors before for incompetence, or refusal to work with insurance - but this was a whole new level.

This time around I had to take pot luck for the initial visit (3 weeks ago), since dermatologists are always backlogged. I was assigned to the "clinic." So I called ahead to make sure clown#1 was not assigned clinic duty. I named him, and informed the staff that I would see anyone but him - and explained why. Fortunately, one of the residents who did surgery #3 (under the care of my favorite dermatologist) was on clinic duty - and made sure I was scheduled with my favorite dermatologist for this surgery.

Aside from trusting her implicitly, I love how she works with her residents and coaches them to learn new skills. I knew this thing wasn't a lipoma (I know the texture of a lipoma, and this wasn't it). But she let the resident dictate r/o lipoma. A bit later, as she was showing the resident how to find all the tendrils of it since it was dug in pretty deep - she commented, "that's pretty firm." The resident thought for a minute and said, maybe we should rule out a dermatofobroma. Bingo. No embarassing her in front of the patient. No jumping in to correct her. Just a well-placed comment to lead her to the right conclusion. Had I not had the medical understanding I have as to this thing, I wouldn't even have noticed the subtle teaching.