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This article is the authors' final version prior to publication in SKINmed, Volume 17, Issue 3, May-June 2019, Pages 152-153.

The published version is available at here. Copyright © Pulse Marketing & Communications


Many of us remember when a dermatology practice was cash only, and $5 cash was considered appropriate for a specialist. The general practitioner received $2 for an office visit and $4 for a home call. If you recall those days, “dearie you are much older than I.” 1

Not so long ago, the practitioner was confronted with obtaining a referral from the Health Maintenance Organization (HMO) in order to see the patient. Some plans permitted only four such referrals for specialists, annually, so the patient, who might have had a visit or two for gastritis and a similar number of visits for an eye infection, was just out of luck if poison ivy appeared on the scene. 2

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Dermatology Commons