Seek and Find
Now that it is summertime and people are "out and about" in sandals, flip-flops, and barefoot, here is an opportunity to help your patients, your doctor, and your practice. Sun means exposure and that can lead to skin cancer and other skin related problems. Too often the doctor is in too much of a hurry to get "in and out" and take care of whatever the initial problem is that the patient has presented with that day. But here is a great opportunity for the Medical Assistant to shine.
Take a minute and do a quick skin exam. Check between the toes, top and bottom. Take the time to check both the bottom and the back of the heels. That area is often ignored because it is too hard to reach. Note calluses, cracks, moist areas between toes, etc. If you find anything, ASK the patient about it. More often than not, they are just as concerned as you are. If your office keeps product on hand, take a moment to get out the product the doctor might want to prescribe or dispense. Then, in your presentation of the patient to your doctor, let him or her know that the patient has "cracked heels and is concerned. I got out the Urea cream just in case."
More importantly, though, when doing your exam of the patient’s feet, look for any growths, lesions, moles, warts, abnormal areas, and note them, ask the patient about the area in question. "How long has this been here?" Has it changed? Has it got bigger? Color change? Has it ever been biopsied?
Skin cancer is becoming more and more common, and even more so in the feet. Often the first signs of Melanoma are small lesions in the feet. It is vital to get an early diagnosis. When should an abnormal lesion be biopsied? Excellent question! All you need to remember is your ABC's, or in this case, your ABCDEs.
A is for Asymmetry-----Does one half of the growth look the same as the other?
B is for Borders---------Are the edges smooth and defined, or irregular and uneven
C is for color-------------Is it one solid color, or multiple shades?
D is for diameter--------Is it bigger than a pencil eraser?
E is for elevation--------Is it raised up over the rest of the skin?
ANYONE of these should trigger a discussion, and if more than one of these are present, that should trigger a biopsy. Biopsies are fast, safe, reliable, covered by most insurance plans, and can be done the same day in office. More importantly, you might save someone's life. Our office finds 3-5 malignant melanomas per year and many more squamous cell carcinomas. If caught and treated early and aggressively, the survival rate is high.
Another reason is "peace of mind" for your patient, and for you. Patients may have "wondered about something" or been worried about it for years but not sure what to do. The doctor gets to be the "voice of reason" and maybe even the hero in the eyes of the patient. But YOU, the medical assistant, are the REAL hero because you took the time to “seek and find.”
April Foutz, RMA, PMAC
Back Office Manager
Indiana Podiatry Group