It occurred to me this morning in the shower, that dermatology is doomed. First, let me explain something about dermatology. It is one of the most competitive medical specialties (if not the most competitive) to get a residency in. Every year for the last couple of years, there have been about 200 senior medical students applying for only 30 positions nationwide. It is a highly sought-after specialty because dermatologists are not on call, have a scheduled 9-to-5 workweek (or whatever other schedule they prefer), and to put the cherry on top of their cake: they are well compensated.
This has not always been the case, however. Only in the last decade or so has dermatology become popular. Before, it was the specialty of choice for those barely passing medical school. The simple answer to this turn around for dermatology was the introduction of Botox to treat wrinkles, which was officially approved by the FDA in 2002 for such purposes. Botox has been around for a long time but in the last thirty years it has been researched to treat various muscular disorders because Botulinum toxin (all that Botox is) effectively inhibits the neuron from stimulating the muscle to contract.
Now, we all know that we all don't want to grow old ... or at least not look any older than we actually are. Thank you Hollywood! Botox was a terrific antidote to looking old and wrinkly and people paid big bucks for the treatment.
But with the recent economic trends, this Botox fueled rush into dermatology will soon be over. With the price of oil and the value of the dollar continuously repelling each other like magnets of the same polarity, it will become too expensive to (a) manufacture Botox and (b) to get to the dermatologist for the injection. 95% of people will prefer putting food on their family's table over looking young again. The other 5%? There will always be people suffering from body dysmorphic disorders or being plain selfish who will continue to want the Botox injections despite the cost but their contributions to the portfolios of dermatologists will be negligible.
Will dermatologists still be necessary after Botox? I dare say no. A well-trained family physician should be able to care for most skin problems without the need for a specialist. And for everything else, a good research hospital will be the answer. Good bye dermatology, it was a pleasure to have known you!
