by guest blogger Sancy Leachman, M.D., Ph.D., Oregon Health & Science University
This year’s Storrs Lectureship is undoubtedly one of the most unusual meetings I have ever attended. I don’t want you to interpret “unusual” as a code word for “bad,” but you can interpret it as “unconventional.” The typical didactic format was abandoned in favor of short, TED-type presentations followed by abundant discussion. The lectureship is designed to reflect “Fran Storrs’ mission” in a “Fran Storrs’ way.” For those of you that know Fran, you’ll know what I mean by that. For those that don’t, suffice it to say that Fran doesn’t back away from controversy and doesn’t hesitate to tackle difficult problems, but she approaches them with humor (and a lot of laughter!). The conference was a spectacular embodiment of all those things – more than anything, we addressed the problem of deep thinking. As practitioners of medicine, we are confronted daily with complex problems that require action on our part, but we don’t have time to contemplate these complexities and consider options as thoroughly as possible, especially with the counsel of experts. At this year’s Storrs Lectureship, we all took the time to think deeply, to question thoroughly, to disagree with experts, and most of all, to seek the best answers for our patients, community, and society.
This year’s topic was “Melanoma Screening & Diagnostics: Do They Make a Difference?” This topic was precipitated by the fact that skin cancer screening is not recommended by the U.S. Preventive Services Task Force, which limits coverage by the Affordable Care Act. Before we demand or mandate new screening and diagnostics technologies, it is CRITICAL that we know: Are they making a difference? But the data and answers are complex and incomplete. Experts were assembled to help tease out the key elements in real time and we were able to ask meaningful questions like: “Should skin cancer screening be recommended by the USPSTF?”; “What evidence do we need to assure it is beneficial for patients and society?” “What are the legal implications of making this recommendation?” For example, if the USPSTF recommends screening and we fail to screen all patients, are we more vulnerable from a legal perspective?
Obviously, I can’t capture the conference in a blog (view it online), but I do have a few thoughts: Dermatologists need to participate as actively as possible in this controversy, because our specialty is going to be driven by it for years to come. We need to be careful what we ask for, because we just might get it. And we should never be distracted from the patients’ best interest by our own fear of litigation (though I will continue to manage my highest risk melanoma patients in collaboration with other providers!). So, signing off on this topic until next year – new topics for next year’s committee are welcome now!