Go “old school” and use the Go “old school” and use the Q-tip freeze more oftenQ-tip freeze more often

Q-tip, Cotton Swab, Dipstick

• Hurts less, in my opinion• Great for sensitive areas• Great for “cigarette paper” skin• Takes longer, connect with patient• Not as much damage, can titrate

damage more easily

Scabies

Dermoscopy (Dermlite DL 100 instrument used) helps to locate mite when performing a mineral oil prep for diagnosing scabies

Scabies mite appears as a tiny black dot. Greatly increases yield.

Atopic dermatitis

Dilute bleach baths: ¼ C bleach in ¼-1/2 bathtub of water has been shown to decrease the recurrence rate of staphylococcal skin infections. Problem- not everyone has a bathtub.

Solution

Add 1 teaspoon of bleach to a gallon of water. Fill squirt bottle with solution and thoroughly squirt patient down in shower.

Teach patients to swallow Teach patients to swallow pills using M&Ms or mini-pills using M&Ms or mini-M&MsM&Ms

• Place M&M in mouth but Place M&M in mouth but don’t concentrate on M&Mdon’t concentrate on M&M

• Then drink a glass of water Then drink a glass of water as if you were very thirsty as if you were very thirsty (again, not concentrating on (again, not concentrating on the M&M)the M&M)

• Tilt head forward•M & M will then float back,

making it easier to swallow the “pill”

Give patients a certificate when they complete a difficult course of therapy, etc…

Arkansas Skin Cancer Center

Certificate of Aldara Completion

is hereby granted to

Darrell Rigelto certify that he/she has completed to satisfaction

ASCC Aldara Course Granted: April 18, 2023

Scott Dinehart, MD

Let outside companies get your patients’ wound supplies. Often their insurance company or Medicare will pay for them

Have fun at your practice!

Use a “mystery shopper” in your practice

“Patients remember how you treat them as a person more than how you treat their disease”

Doctor’s office, hold Doctor’s office, hold please.please. vs.vs. “ “Thank you for calling Dr. Thank you for calling Dr. Dinehart’s office. How may Dinehart’s office. How may I help you?I help you?

Make every supervisor or Make every supervisor or manager a “working manager a “working manager” or “player/coach”manager” or “player/coach”

Perform a self-audit of Perform a self-audit of your charts for your charts for accuracy of coding and accuracy of coding and documentation every 3 documentation every 3 monthsmonths

Dinehart’s 3rd Law

• Documentation is like SEX and PIZZA:

• When its good, its VERY good

• When its bad, its still pretty good…

• …and its always better than nothing

Create an “Internet” Create an “Internet” policy for your office policy for your office and discuss it in office and discuss it in office meetingsmeetings

Internet Problems

• Billions lost to recreational workplace surfing

• An average of 30 minutes /day using e-mail for personal non-work related reasons

• 72% of pornographic sites visited during work hours