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October 2010

Practice Gaps—Performing Inadequate BiopsyComment on “Inadequate Biopsy Technique and Specimen Size”

Author Affiliations

Author Affiliation: Department of Dermatology, Marshfield Clinic, Marshfield, Wisconsin.

Arch Dermatol. 2010;146(10):1181-1182. doi:10.1001/archdermatol.2010.292

As a resident, I asked one of my dermatology mentors, a procedural minimalist, about his philosophy for obtaining pathology specimens for the dermatopathologist. He stated that he always tried to give the dermatopathologist not 1 cell more than was necessary to make the correct diagnosis. Sellheyer and colleagues point out trends from their dermatopathology practice and suggest that the minimalist philosophy can create difficulties in practice, and it is more common to see inadequate specimens from dermatologists and the physician extenders they supervise. As a growing and substantial percentage of the dermatology workforce employ or supervise a growing number of physician extenders,1 and as access issues lead more dermatology care to be performed by nondermatologists, the practice gap of selecting adequate biopsy technique and specimen size may grow.

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