4 ways to improve your dermatology care


Got a thin skin about shrinking practice revenue? Offer relief for itchy patients and scratch your own itch to grow the bottom line.

Skin issues, especially those associated with allergies, are some of the most common health problems you see in practice. So they're a great growth opportunity—if your team is ready to learn. More important, they can be the issue that bonds clients to your practice forever.

"Even though many of these cases aren't life-threatening, most clients can't stand hearing their pet scratching all night," says Dr. Mark Grossman of Roanoke Island Animal Clinic in Mantea, N.C. "So if keeping a client is profitable, I'd say a dermatology case is very profitable."


A dermatology program requires your whole team's support to flourish. This starts with the right training, says Dr. Andrew Rosenfeld, DABVP, founder and president of veterinary education company VTEC.

"We can't assume what people know," Dr. Rosenfeld says. "So an effective training program starts with the basics of getting a patient history and builds in complexity."

One good way to get your team on board with training is to invite team members to bring their own pets into the practice for exams. "Nothing hits home more with a technician or a receptionist than when they realize their own pet has issues," Dr. Rosenfeld says.


Once team members are excited and knowledgeable, your next step is to create protocols for common dermatology issues. For example, Dr. Rosenfeld says a protocol for a first-time allergy patient might include a standardized medical history form, an extended examination time, and standard diagnostics (skin scrape, derm culture, and skin cytology). Protocols may also include basic trials, based on the doctor's assessment, and recheck guidelines.

Next, you'll need to teach your team to echo your guidelines when they talk to clients, Dr. Rosenfeld says. For example, when a client calls with a dog that's chronically itching, the receptionist should explain your protocol to prepare the client for the care you'll offer.


Pet owners are more compliant if they know you have a plan. But be realistic and outline a plan B in case the first approach doesn't work.

"Part of the first conversation about a dermatology case is letting the pet owner know that these cases are challenging," Dr. Grossman says. "And the challenge isn't to stop the itch, but to figure out what's causing the itch so we can keep the pet comfortable without frequent visits to the veterinarian. So it might take some patience to resolve the issue. I also let clients know that, as with people, there are some allergy cases where there is no cure, but rather management that controls the condition."


Many dermatology cases can be more profitable for your practice if you focus on client education and patient workups rather than just treat the symptoms.

Dr. Grossman estimates that his practice sees about 90 dermatology cases a week. A workup may include skin scrapes, ear and skin cytology, DTM (dermatophyte test medium) and bacterial cultures, trichograms (hair analysis), and biopsies when needed.

And don't forget that the skin is connected to the rest of the animal. In most pets 4 years or older, Dr. Grossman performs a full CBC and serum chemistry profile, including checking thyroid function. "Hypothyroidism is an immunosuppressive disease, and if it's not diagnosed and managed, it can make solving skin problems really frustrating," he says. "Plus these pets may get some steroids at first, so I want to be sure they're healthy enough for medications."

If clients refuse the diagnostics or treatment you recommend, be prepared with alternatives that will still let you help the pet, Dr. Rosenfeld says.

In some cases, you'll need the help of a specialist to identify the problem and set a course for treatment. Dr. Rosenfeld encourages general practitioners to establish good relationships with referral doctors.

"Dermatology cases can be challenging," Dr. Grossman says. "But they're incredibly rewarding once the problem is solved, the pet is comfortable, and the owner is happy."

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