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Invited Commentary | Practice Gaps

Timely Surgical Follow-up for Melanoma Among Medicare Beneficiaries

Elaine Lin, BS1; Jerry D. Brewer, MD2
[+] Author Affiliations
1Currently a medical student at School of Medicine, Loma Linda University, Loma Linda, California
2Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
JAMA Dermatol. 2015;151(7):741. doi:10.1001/jamadermatol.2015.0559.
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The incidence of melanoma is increasing worldwide and is rising faster than that of any other cancer in white individuals. Early detection of and treatment aids in identifying less advanced tumors plus prompt surgical treatment could alleviate stress and anxiety. The study by Lott et al1 in this issue of JAMA Dermatology provides the first population-based look at delay of surgery for melanoma among Medicare beneficiaries. The authors demonstrate that 1 in 5 patients with a new diagnosis of melanoma experience delays in reexcision/definitive excision of longer than 1.5 months, and 8.1% experience delays of longer than 3 months. This delay is minimized when dermatologists perform the biopsy and surgical procedure, suggesting increased efficiency when coordinating care within the same specialty. Thus, a potential practice gap of effective coordination of care with other medical specialties, including plastic surgery and primary care medicine, exists.

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