Have you noticed all the billboards advertising dermatology services lately? I thought it was only Eastern Idaho, but I was in a small town 50 miles northeast of Las Vegas a month ago (Pahrump, Nevada), and there were 4 billboards in a row advertising dermatology services in Vegas. The answer to this question may be partially answered by article that was recently in the New York Times. Just google ‘New York Times Mohs’. There has been a huge increase in dermatologic surgery in recent years, particularly a procedure called Mohs micrographic surgery. This is when a piece of skin containing skin cancer can be removed and examined in the office of a dermatologist. If the cancer has not been completely removed after the first slice, the provider can go back while the patient is waiting and continue to take additional slices (it is billed by the slice) until the cancer is gone. It is the cutting edge (no pun intended) treatment for skin cancer on parts of the body where there is a limited amount of skin to work with. The problem is, it is very expensive, it can take hours, and it is often done unnecessarily because it is such a revenue generator. Don’t get me wrong, there are times when it is appropriate. I referred two patients last week for the procedure because the cancers were too close to the eye. It will cost those patients around $3000 to have the procedure done. Often when these types of cancers are caught early, they can be removed with a simple excision for around $300-$400. My recommendation is just to try to catch things early enough that the Mohs procedure will not be necessary. When in doubt, check it out!
So, I know you are asking, what was I doing in Puhrump, Nevada? Frontsight! I am not much of a gun guy, but I do own some guns. I bought a XD40 10 years ago and have shot it less than 10 times. I do not know the proper way to hold, clean, load, and shoot it, so I rarely do. Well several of my friends had told me about this intense 4 day handgun training course in Nevada. I did not necessarily want to be around a bunch of gun fanatics, but I did want to learn more how to handle my gun. Long story short, spending 4 days with 500 other people that were ‘packing heat’, after shooting 700 rounds, I feel like I am ready for the bad guys! And last week for my birthday, my wife shocked me by getting me a 9mm Glock 19 Gen 4! Now we can shoot together. I feel so comfortable with my gun now, I actually do what my step dad does and I sleep with the gun under my pillow!