April 9, 2020

An update from our Chief Medical Officer:

One of the most important traits for a company, particularly during a crisis, is to instill an environment and culture of open dialogue and communication. As Bill noted in his last CEO message, we won’t always get everything right at first, especially when there may not be easy solutions and ideal answers during a constantly evolving situation. But we are open to questions and feedback and strongly committed to continuous improvement. Along these lines, I was glad to field a question this week from one our Mohs histotechnicians, who expressed concern about potentially increased risk of coronavirus transmission during Mohs laboratory work. The Mohs committee of the Quality Council investigated and researched the topic and has disseminated a Question & Answer response to all our Mohs surgeons and lab personnel. We will continue to monitor for new information. Fortunately, there is no scientific evidence to date of increased risk, but I am gratified that an inquiry was made and that we were able to alleviate the fears.

I also want to continue to encourage all QDP employees, whether working or furloughed to maintain social isolation measures. I know everyone has likely been encouraged by the recent news that the ‘stay at home’ orders and distancing measures across the US appear to be having a positive impact. Evidence suggests that states like Washington and California enacting aggressive measures early are now flattening their curves. It remains paramount for all of us not to become complacent. It will take great fortitude to maintain our efforts for another 6 weeks, as most models show a need to continue distancing measures through May. But, at that point we may have saved thousands of lives by not overwhelming our health care resources. This graphic from North Carolina this week is convincing.

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An article published Tuesday in the CDC journal Emerging Infectious Diseases from Los Alamos National Laboratory entitled ‘High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus’ notes that Covid-19 has a much higher affinity for cell receptors in the oropharynx, accounting for its very high transmissibility in populations.* The authors conclude,

“Our results suggest that a combination of control measures, including early and active surveillance, quarantine, and especially strong social distancing efforts, are needed to slow down or stop the spread of the virus. If these measures are not implemented early and strongly, the virus has the potential to spread rapidly and infect a large fraction of the population, overwhelming healthcare systems. Fortunately, the decline in newly confirmed cases in China and South Korea in March 2020 and the stably low incidences in Taiwan, Hong Kong, and Singapore strongly suggest that the spread of the virus can be contained with early and appropriate measures.”

We all can, and must, continue making this our reality.

I also want to continue emphasizing the importance of maintaining a favorable perception within our communities and our specialty. This includes how we manage our practices and the patients we care for in-person and using TeleDerm.  You have heard me mention in the past how companies like QualDerm with financial backing from private investors have been scrutinized and criticized. Another article in the New York Times yesterday identified some private-equity backed dermatology practices that, according to the Times reporter, appear to be placing profits over safety by continuing to treat patients in a ‘business as usual’ manner.** Despite a response from in-house counsel on suspension of cosmetic services and pairing down to essential services, it was clear the article was meant to be unfavorable. QualDerm providers are using their best clinical judgment to determine what care is urgent and necessary, what can be managed with e-visits, and what can be postponed. These are difficult decisions and often specific to the particular patient and local factors. But, I remain very confident that  our providers are carefully considering the quality and safety of their care and following the Quality Council recommendations and those of our specialty societies, CMS and CDC. In doing so, QualDerm will continue to maintain a stellar reputation for quality and safety. I thank all of you for contributing to this effort and to our image as practices of choice for patients and providers.


Finally, I would like to congratulate Dr. David Brodland from our PA platform practice Zitelli & Brodland. Dave is the 2020 recipient of the Fred Mohs Award, the highest honor for lifetime achievement in the American College of Mohs Surgery. I also congratulate Dr. Barry Leshin from our NC platform practice The Skin Surgery Center. Barry received the ACMS Distinguished Service Award for leading the development of the ACMS Foundation, the charitable giving arm of the Mohs College. We are very proud to have them as leaders within QualDerm Partners!

Stay safe and best wishes,

John Albertini, MD

* CDC article can be read here.

** New York Time article can be read here.


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