Reply to Letter: Effectiveness of Mohs and Close

March 2018 | Volume 17 | Issue 3 | Editorials | 368 | Copyright © March 2018

Hugh M. Gloster Jr. MD

University of Cincinnati, Cincinnati, OH

In conclusion, medicine is constantly adapting, and physicians make changes to their practice that they believe will increase efficiency without compromising patient care. The MMS practice at our institution is high volume (14-17 MMS cases per day) and the vast majority of patients come from referrals outside of the practice. The MCT technique saves over 13 minutes for cases that clear in one stage, which is a significant amount of time over the course of a day if this technique is utilized for several patients. This extra time allows for the more efficient completion of medical records and teaching of residents and fellows. These tasks are never left over at the end of the day as Konda and colleagues imply. Ultimately, the quality of our practices as Mohs surgeons can be evaluated on the effectiveness of surgery (acceptable recurrence rates), cost effectiveness (non-outlier status), and patient satisfaction (excellent evaluations, reviews, and confidence of referring physicians that their patients are being well-treated). The MMS practice at our institution consistently satisfies all three categories.References
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  6. Ad Hoc Task Force, Connolly SM, Baker DR, et al. AAD/ACMS/ASDS/ASMS 2012 appropriate use criteria for Mohs micrographic surgey: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol. 2012; 67:531-550.
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