M any dermatologists are under pressure to improve the efficiency and effectiveness of their clinical care in an era of stagnant reimbursement and higher office expenses. In addition, dermatologists in the United States are under increased scrutiny from payers, regulators, and patients who expect uniformly high-quality service from their physicians. The presence of increasing numbers of nondermatologist health care providers marketing themselves as skincare specialists also places increased pressure on dermatologists to demonstrate the value of their services. Patient perceptions of quality health care are important to the physician. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. 1 Highly satisfied patients have improved outcomes in the management of chronic disease vs those less satisfied. 1,2 This reflects increased compliance among satisfied patients. Furthermore, dissatisfied patients are 4 times more likely to seek care elsewhere within 6 months. 1,3 Finally, an inverse correlation has been reported for patient satisfaction rates and medical malpractice claims. 1,4 Quality improvement (QI) systems analyze processes to improve the quality of care, productivity, and efficiency. 5 Hospitals and long-term care centers have had QI committees in place for years as a requirement for accreditation. Despite the advantages of self-assessment, many dermatologists in private practice have not implemented a system to analyze and evaluate quality of care rendered in their practice. Such a system could include quarterly meetings attended by not only the physician but also by representatives from the nursing, technical, and administrative staff. Establishing a small QI committee can also stimulate useful QI initiatives. Implementing QI systems based on information from a sampling of patients has been difficult because of their cost and inconvenience. An Internet-based system offers dermatologists a convenient and inexpensive method to obtain patient satisfaction information. The DrScore Web site (http://www.DrScore.com; Medical Quality Enhancement Corporation, Winton-Salem, North Carolina) provides an online patient satisfaction survey designed to respond to the QI needs of dermatologists by providing data to individual dermatologists to help them improve quality of care and patient perceptions of physician quality. A dermatologist could use these
Androgenetic alopecia (hereditary thinning) is the most common cause of hair loss in both men and women. Chemotherapy-induced alopecia is another distressing cause of hair loss. With a better understanding of follicular biology and the signals responsible for hair growth and regression, targeted therapies for hair loss are being investigated. This review summarises investigational medications for androgenetic and chemotherapy-induced alopecia that are in preclinical stages or later.
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